Is Psychoanalysis Pseudo-Science?

Is Psychoanalysis a Pseudo-Science?
Karl Popper versus Sigmund Freud

Author(s): Adolf Grnbaum
Source: Zeitschrift fr philosophische Forschung, Bd. 31, H. 3 (Jul. - Sep., 1977), pp. 333-353
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ABHANDLUNGEN
IS PSYCHOANALYSIS A PSEUDO-SCIENCE?
Karl Popper versus Sigmund Freud*
byAdolf Griinbaum, Pittsburgh
S 1. Introduction
Those who have seen the exploits of the former nightclub magician
Uri Geller on television may have asked themselves: Are the pheno
mena produced by Geller genuine evidence for the actual occurrence
of extrasensory perception? A well-known article in the prestigious
journal Nature (Targ and Puthoff [1974]) argues that the answer is
"yes". But a contrary conclusion is advocated in a paper entitled
"ESP: Teaching 'Scientific Method' by Counterexample" (Blatt
[1975]; see also the more detailed critiques by Hanlon [1974],
Christopher [1975], Randi [1975] and Gardner [1976]). Blatt pro
poses to analyze purported cases of clairvoyance, precognition, tele
pathy and psychokinesis in order to show students of physics how "to
sort out what is science and what is not science in themodern twen
tieth century world" (p. 1079).
Recently a group of eminent scientists in theUnited States issued a
formal denunciation of astrology as a pseudo-science whose horo
scopes defraud the public. Shortly afterward, David Susskind con
vened a television panel to discuss the scientific merits of astrology.
One of the panel members expressed sympathy with intelligent
scep tics who reject astrology, because he believes that only weak
defenses of it had been offered by its advocates. But he hastened to
* This
paper is a preliminary version of the author's much larger and revised essay of the
same title that is to appear in R. Stern, L. Horowitz & J. Lynes (eds.), Science and Psycho
therapy, New York, Haven Press, 1978. In that larger version, considerable attention is
devoted as well to Freud's psychogenetics, etiological theory and metapsychology, which
had to be neglected in the present, shorter paper for lack of space. Furthermore, the
account given there of the inductivist conception of supportive instances is considerably
more rigorous than the formulation which was possible in the lesser space here.
The author is indebted to Stanley Rachman and Edward J. Shoben, Jr. for very helpful
advice on both substance and bibliography relevant to this paper. He has also benefited
from the scholarship of George Alexander, Cynthia Freeland, Stanley Imber, Ian Mitroff,
Irwin Savodnik, Alvin Shapiro, Karl Popper and Gerhard Werner. And he thanks the
National Science Foundation as well as the Fritz Thyssen Stiftung for support of research.
Additional are found within the text.
specific acknowledgements
334 ADOLF GRUNBAUM
state that in his view, sound evidential support can be cited in favor of
astrology.
Turning to psychoanalysis, let us focus initially on only that part of
psychoanalysis which is a congeries of purported methods of therapy.
Here we find a rather acrimonious situation of claims and counter
claims. Thus, Erich Fromm wrote:
"Indeed, the facile denial of the therapeutic success of psychoanalysis says
more about the difficulty of some fashionable authors to grasp the complex data
with which psychoanalysis deals than about psychoanalysis itself. Criticism by
people with little or no experience in this field cannot stand up against the
testimony of analysts who have observed a considerable number of people relieved
of troubles they complained about. Many patients have experienced a new sense
of vitality and capacity for joy, and no other method than psychoanalysis could
have produced these changes" ([1970], pp. 3-4).
In short, outside psychoanalysis, there is no salvation for troubled
souls. Statements of this sort have provided ammunition for the
following harsh indictment of psychoanalytic treatment by the British
Nobel laureate cancer researcher P. B. Medawar who wrote:
"The opinion is gaining ground that doctrinaire psychoanalytic theory is the
most stupendous intellectual confidence trick of the twentieth century; and a
terminal product as well - something akin to a dinosaur or a zeppelin in the
history of ideas, a vast structure of radically unsound design and with no
posterity" ([1975], p. 17).
Why are there such diametrically opposed appraisals of the scien
tific status of psychoanalysis? Before trying to deal with this
question, some words of caution about the meaning of the omnibus
term "psychoanalysis" are in order. In the first place, it is necessary to
distinguish psychoanalysis as a developmental theory of the psycho
dynamics of human behavior from the various modes of treatment or
psychiatric intervention which have been labeled "psychoanalytic" by
their practitioners. This distinction is important, if only because the
answer to the following key question is still a matter of debate:
Exactly what is the logical connection, if any, between the etiological
hypothesis that a specified kind of infantile experience is causally
relevant to a stated sort of adult disorder, on the one hand, and the
kind of treatment which Freud or his followers have administered to
patients afflicted by that disorder, on the other? In the second place,
when someone like Erich Fromm speaks of administering psycho
analytic treatment, he may well be referring to a type of presumed
therapy which differs from Freud's in its avowed ol]ectives no less
than in its procedures. Thus, whereas Fromm talks about positive joy
as an outcome of treatment, Freud [1962] much less ambitiously
aimed at the exchange of outright hysterical misery for just the
common garden variety of unhappiness. Freud would consider it a
satisfactory outcome of treatment, if he could restore a patient's
ability to have affectionate interpersonal relations and to work
IS PSYCHOANALYSIS A PSEUDO-SCIENCE? 335
("lieben und arbeiten"). Other psychoanalysts, notably Thomas Szasz,

avowedly do not -aimat the relief of the symptoms of distress. Instead,
they emphasize a patient's need for becoming more free to make his
own decisions, more honest with himself or herself andmore vaguely,
becoming a better, more mature person as a cardinal aim of analytic
treatment.
It is to be understood in the sequel that I do, of course, allow for
these distinctions between different components of Freud's theory
and between diverse construals of the aims of psychoanalytic treat
ment even when I use the omnibus term "psychoanalysis" . Indeed,
much further on, I shall devote separate attention to Szasz's
non-medical conception of the aims of Freudian treatment, a concep
tion which he attributes to Freud himself. These distinctions having
been noted, I now return to the following question: Why are there
such diametrically opposed appraisals of the scientific merits of
Freudian psychoanalysis? Do these clashing verdicts arise simply from
disagreements as to what has actually been observed, or just from
conflicting reports about the conditions under which the purported
data were obtained? Itwill emerge that, in the case of psychoanalysis,
contrary evaluations are often rooted in divergences concerning the
logical requirements which must be met by observed findings, if these
are to qualify as genuinely supportive evidence for a given theory.
Thus, Medawar surely does not deny Fromm's contention that at least
some psychoanalyzed patients do feel better after such treatment, any
more than he denies that when people have a cold, almost all of them
get better after drinking coffee for a sufficient number of days. We
can all seewith our own eyes that people who have colds do get better
after drinking coffee long enough. But one hopes or even assumes that
Fromm would not consider these recoveries to be sufficient evidence
for regarding coffee drinking as therapeutic against colds. And hence
one must ask just why Fromm feels entitled tomaintain that psycho
analysis is therapeutic, merely because after sufficiently long treat
ment, analysts have observed improvement in their patients. No
wonder that even the practicing psychoanalyst Peterfreund complains
([1971], p. 9) about the absence of a "generally agreed-upon criterion
of psychoanalytic evidence".
Does current philosophy of science furnish us with a general logical
recipe for distinguishing pseudo-science from genuine science such
that we can assess the scientific status of Freudian psychoanalysis and
of its neo-Freudian variants.One such logical recipe has been proposed
by Karl Popper, who speaks of it as a "criterion of demarcation"
1 For an illuminating discussion of some of the most recent alternative construals of psycho
analytic treatment, see Morris N. Eagle [1978], forthcoming.
336 ADOLF GRUNBAUM
between science and non-science. Popper tells us that his 20th

century criterion is not only new but constitutes a successful advance
over itsmajor traditional predecessor, which he disapprovingly labels
"inductivism". Popper is referring disparagingly to the time-honored
idea that theories about natural or cultural phenomena are scientific
to the extent that they are justified by so-called "induction" from
observation or experiment. And one of Popper's major avowed reasons
for his rejection of any inductivist criterion of demarcation is the
following ([1962], ch. I): The code of scientific integrity employed by
all forms of inductivism allegedly authenticates psychoanalysis as
well-supported by a mass of evidence alongwith KarlMarx's theory of
history and perhaps even astrology. Claiming that psychoanalysis has
much more in common with astrology thanwith the genuine sciences,
Popper considers his own criterion of demarcation to be far superior to
that of inductivism. For he believes that his own recipe does indict
psychoanalysis as pseudo-scientific along with astrology, whereas the
canons of inductivism willy-nilly authenticate Freud's theory as bona
fide science.
Popper's challenging contentions raise two questions. The first
question is: Does traditional inductivism as typified by Francis Bacon
and J. S.Mill authenticate the therapeutic and developmental claims
of psychoanalysis to be scientific, while Pop per's demarcation
criterion indicts these claims as pseudo-scientific, on' with astrology
and with certain versions of Marxism? I shall try to argue that the
answer to this question about psychoanalysis is "no" and that psycho
analysis is at best only marginally scientific as judged by the inducti
vism of Bacon andMill, whereas much of it does pass scientific muster
by Popper's criterion of demarcation. The second, much broader
question raised by Popper's claims is: Has present-day philosophy of
science furnished accepted and quite generally applicable criteria
which must be met by any observed finding, if that finding is to
qualify as genuinely supporting evidence for a given theory? As far as
I can see, regrettably the answer is that, to a significant extent, this
general problem of scientific validation remains unsolved in important
respects.
? 2. Popper's Proposed Demarcation Between Science and

Pseudo-Science as a Purported Alternative to Inductivism
Popper asks "When should a theory be ranked as scientific"? And

he claims that the so-called inductive method pioneered by Francis
Bacon gives the following answer: If a theory T can explain or predict
a sufficiently large number of observational results, then T auto
matically qualifies as well-supported by the evidence. In that case, T

becomes credible or probable in the Iight of the evidence. And T
qualifies as scientific in so far as it is rendered credible or probable by
the evidence.
Thus Popper depicts post-Baconian inductivism as automatically
according scientific status to a theory under the following conditions:
The theory explains enough observed facts and no facts are known
which contradict the theory. On the basis of this historiography,
Popper concludes that inductivism is helpless to deny scientific status
to either astrology or psychoanalysis. For the astrologers can point to
a stupendous mass of favorable observational evidence based on
horoscopes and biographies. And the psychoanalysts can drown you in
a mass of favorable clinical observations. indeed, according to Popper
([1962], pp. 32-37), Freud's formulation of his theory was so
fiendishly clever that whatever happened, the theorywas bound to be
confirmed by it. It was immune even to the avowedly fallible kind of
disproof furnished by accepted though theory-laden and hence
dubitable observation statements. Popper claimed that precisely the
immunity of psychoanalysis to this kind of refutation indicts it as
pseudo-scientific. And Popper had concluded that all versions of
time-honored inductivism do indeed accord scientific credentials to
Freud's theory. Hence Popper believed himself to be offering a new,
anti-inductivist criterion of demarcation when he issued the following
ringingmanifesto:
"(1) It is easy to obtain confirmations, or verifications, for nearly every theory -
if we look for confirmations.
(2) Confirmations should count only if they are the result of risky predictions;
that is to say, if, unenlightened by the theory in question, we should have
expected an event which was incompatible with the theory - an event which
would have refuted the theory2.
(3) Every 'good' scientific theory is a prohibition; it forbids certain things to
happen. The more a theory forbids, the better it is.
(4) A theory which is not refutable by any conceivable event is non-scientific.
Irrefutability is not a virtue of a theory (as people often think) but a vice.
(5) Every genuine test of a theory is an attempt to falsify it, or to refute it.
Testability is falsifiability" ([1962], p. 36).
" . . One can sum up all this by saying that the criterion of the scientific
status of a theory is its falsifiability, or refutability, or testability" ([1962],
p. 37).
Long before Pop per's aforecited injunction that "Confirmations
should count only if they are the result of risky predictions", Bacon
(NovumOrganum III, Section 21 ff.) made a vital contribution toward
distinguishing merely positive from supportive instances of a theory
by emphasizing that some kinds of positive instances can differ
2 For a detailed critique of Popper's defense of this requirement, see (Gr?nbaum [1976al,
pp. 107-110).
338 ADOLF GRtNBAUM
radically from others in evidential value. Thus Bacon stress-es that

some kinds of positive instances of the theory carry much more
weight than others in providing support for it. For example, cases of
people recovering from colds after drinking coffee do constitute
positive instances of the far-fetched therapeutic hypothesis H that,
ceteris paribus, coffee drinking always cures colds and is necessary to
effect such a cure. But, by themselves, these positive instances p are
hardly supportive of H. For there is no evidence that, ceteris paribus,
people who avoid coffee fail to recover from colds. If there were
instances q of such people, they would serve to disconfirm the rival
hypothesis that coffee-drinking is causally irrelevant to recovering
from a cold. And the co-availability of the two sets of positive
instancesp and q would render the union of these sets supportive of H,
although - taken by themselves! - the instances in either set are
separately only positive. Hence positive instances of a hypothesis may
fail to have inductiveprobative significance by failing to contribute to
thewarranted credibility of the hypothesis.
Let me be more precise about the distinction between merely
positive and supportive instances by saying the following: An instance
is a "positive" one with respect to a non-statistical theory T, if its
occurence or being the case can be explained by T in conjunction with
suitable initial conditions, as inmy coffee-drinking example; but a set
of instances is supportive of T, if it is positive and has the probative
significance of conferring a stronger truth presumption on T than T
has without that instance. As we shall see in fn. 4, this Baconian
distinction between merely positive and supportive instanceswas also
emphasized by J. S.Mill ([1887], e. g. p. 313). And it is vital for the
proper inductive appraisalof at least those strong causal hypotheses of
Freudian theory which are of the form "X is universally (ceteris
paribus) a cause of Y, and X is the only cause of Y'. Thus, just as in
the putative coffee-drinking example, the specified Baconian distinc
tion is pertinent to the inductive appraisal of any idealized psycho
therapeutic hypothesis which would attribute the same strong kind of
causal relevance to specified Freudian treatment when suitably
administered to analysands in a given diagnostic category. Mutatis
mutandis, the same remark applies to the inductive appraisal of a
universal causal assertion of the stated strong kind, if made by an
etiological hypothesis or by a conjecture of pathogenicity. The latter
types of theoretical claim are sometimes supposed to undergird
psychoanalytic treatment.
Hence at least in the case of such - perhaps idealized - Freudian
causal hypotheses as are of the stated strong kind, we can say the
following: Contrary to Popper, the mere existence of a largemass of
known positive instances in (n = 1, 2, ... .m) each one of which
instantiates both the presumed type of cause and the predicted kind
of effect does not at all require the neo-Baconian inductivist to grant
that the given Freudian causal hypothesis has good scientific
credentials. The reason is that the neo-Baconian inductivist predicates
the supportiveness of the specified positive instances in - which will
hereafter be said to be of sort "A" - on the logically contingent
availability of a further sort B of known positive instances as follows:
In each of the latter positive instances of the given strong causal
hypothesis, the presumed cause and its purported effect are both
absent. But if it is logically contingent whether instances inwhich the
presumed cause is absent are also devoid of the corresponding effect
(and conversely), then the given causal hypothesis T must be falsi
fiable in Popper's (fallible) sense as follows: It must be logically
possible that there be instances in which the presumed cause C is
absent while the alleged effect E is present, a state of affairs which
would falsify T's assertion that C is causally necessary for the
occurrence of E. It is clear, therefore, that Baconian inductivism
predicated the scientific credibilification of the stated sort of strong
causal hypothesis on its falsifiability several centuries before Popper
deemed the latter to be the touchstone of scientific status in his
criterion of demarcation. Thus, at least for the case of such causal
hypotheses, Popper no more origiated the falsifiability requirement
for potential scientific acceptability than he inventedmodus tollens!
But in fairness to Popper, it should be noted that there has been
one important school of inductivists among both philosophers and
eminent scientists who championed the following doctrine, though
without particular regard to the case of causal hypotheses: Any
positive instance of a hypothesis also necessarily qualifies as a
supportive instance of the hypothesis such that the evidential support
for the hypothesis is increased by the sheer repetition of further posi
tive instances3. This doctrine that any positive case of a hypothesis is
thus automatically also supportive to some degree is usually called
"enumerative inductivism".
But, Bacon rejected enumerative inductivism as "puerile" (cf.
Griunbaum [1976 b], Section 2, pp. 215-222). And so did J. S. Mill
([1887], Book III, ch. III, ?? 2 and 3; ch. XXI, ? 3), who was mindful
of law-like hypotheses asserting specific causal connections when he
characterized induction by simple enumeration pejoratively as
follows: "This is the kind of induction which is natura to the mind
when unaccustomed to scientific methods" (ibid., p. 226)4. Little
3 Cf. E. Nagel ([1963], Section VI, pp. 805-808), who argues (p. 807) that nearly all of
Carnap's inductive methods adopt this doctrine and that it leads to results which "are
incongruous.. .with any plausible rationale of controlled experimentation".
4 In amplification of his Baconian condemnation of inductio per enumerationem simplicem,
340 ADOLF GRONBAUM
wonder that in a very recent treatise on epidemiology (Susser [1973],

ch. 6, p. 71), it is claimed that, in amended form, Mill's inductivist
canons for supporting causal hypotheses "provide a foundation for
epidemiological hypotheses". Indeed, in the case of causal hypotheses
of the previously stated strong kind, Bacon's and Mill's "inductive
methods" had long ago prompted inductivists to demand controlled
experiments - or at least the aforementioned two sorts of positive
instancesA and B which such experiments can yield - as a check on
whether a given set of positive instances indeed does have the proba
tive significance of being supportive as well. Generally, controlled
experiments furnish a collation of the results obtained from the
so-called "experimental group" with those yielded by the so-called
"control group". In the case of causal hypotheses which are stochastic
rather than universal, our earlier definition of "positive instance" needs
to be consistently generalized in some way.
But Isaac Levi has maintained (private communication) that in the
case of a non-universal but causal (Freudian) therapeutic hypothesis
H, we confront the following situation: Being positive but not
necessarily supportive can no onger be distinguished in controlled
inquiry from being positive-and-supportive as a property of a set of
instances since no data from the experimental group can any longer
Mill writes: "When a fact has been observed a certain number of times to be true, and is not
in any instance known to be false, if we at once affirm that fact as a universal truth or law
of nature, without either testing it by any of the four methods of induction, or
deducing it from other known laws, we shall in general err grossly" (ibid., p. 402). "Popular
notions are usually founded on induction by simple enumeration; in science it carries us
but a little way. We are forced to begin with it; we must often rely on it provisionally, in
the absence of means of more searching investigation. But, for the accurate study of nature,
we require a surer and a more potent instrument. It was, above all, by pointing
out the insufficiency of this rude and loose conception of Induction, that Bacon
merited the title so generally awarded to him, of Founder of the Inductive Philosophy"
?
(ibid., p. 227). "Why is a single instance, in some cases, sufficient for a complete induc
tion, while in others, myriads of concurring instances, without a single exception known or
presumed, go such a very little way toward establishing a universal proposition? Whoever
can answer this question knows more of the philosophy of logic than the wisest of the
? It is with
ancients, and has solved the problem of induction" (ibid., p. 228). regard to
furnishing inductive support for "particular laws of causation" (ibid., pp. 402?403) that
Mill denies the value of enumerative inductions, which had been countenanced probatively
ever since antiquity. But he contrasts specific causal laws with what he takes to be a true
"law of cause and effect" . .we are
generalized (ibid., p. 403). And he contends (id.) that ".
justified in the seeming inconsistency, of holding induction by simple enumeration to be
good for proving this general truth, the foundation of scientific induction and yet refusing
to rely on it for any of the narrower inductions." His argument for this conclusion is as
follows: "Now the precariousness of the method of simple enumeration is in an inverse
ratio to the largeness of the generalization. The process is delusive and insufficient, exactly
in proportion as the subject-matter of the observation is special and limited in extent. As
the sphere widens, this unscientific method becomes less and less liable to mislead; and the
most universal class of truths, the law of causation, for instance, and the principles of
number and of geometry, are duly and satisfactorily proved by that method alone, nor are
they susceptible of any other proof (ibid., p. 402).
separately qualify as positive instances of the given H, and neither can

any data from the control group so qualify any longer. Levi's point
seems to be well taken at least for those non-universal causal assertions
of therapeutic efficacy which make no specific statistical claim of the
percentage incidence of improvement. For such a qualitative causal
claim H of therapeutic efficacy is elliptical for themerely comparative
rank-order assertion that a given type of treatmentX causally effects a
higher rate of specified improvement than either no (formal) treat
ment or treatment-other-than-X.And hence Levi points out that, thus
construed, H is not even positively instantiated by any sample of
patients in a given diagnostic category who received treatment X and
some of whom exhibit improvement. Instead, both an experimental
group of X-treated patients and a control group of matched patients
who were not so treated is required to furnish even a bare positive
instance of the qualitative causal proposition H. Thus, in this situa
tion, controlled tests are needed to obtain any positive instances at all
rather than just to confer supportiveness on already positive instances
yielded by the experimental group.
For these reasons, let it be granted that Levi's point is both sound
and significant for the case of the purely qualitative kind of
non-universal causal proposition. Yet I believe that it is still an open
question whether being positive-but-not-necessarily-supportive cannot
still be usefully distinguished from being positive-and-supportive as a
possible property of the following set I of instances: Each member of
I is a sample of suitable patients separately yielded by either an
experimental group or a control group in tests of a statistico-causal H
which numerically specifies some percentage or other of resulting
cures towithin a comparatively small interval.
In any case, it is clear that we must guard against trivializing
psychoanalytic claims of therapeutic efficacy when appraising them
inductivistically. Being causal, the issue of validation posed by these
claims for the neo-Baconian inductivist is certainly not justwhether at
least some analytically treated patients get better in specified respects,
any more than the therapeuticity of coffee-drinking for colds turns
solely on whether at least some cold-sufferers get better after con
suming coffee for some minimum period of time. Thus, Erich
Fromm's aforecited regrettably naive defense of analytic treatment
implicitly trivialized the proposition that Freudian intervention is
therapeutic. It is easy to find at least some cold-suffererswho undergo
the coffee-drinking "treatment" for, say, a month and who then get
rid of their symptoms. Also, as amatter of empirical fact, it is easy to
find some patients who complained of certain symptoms andwho got
rid of their symptoms after, say, several years of analytic treatment.
But case vignettes are not enough! And we shall see in the next section
342 ADOLF GRONBAUM
that in point of empirical fact, it is far from easy - even 80 years after
the birth of psychoanalysis - to find data which pass muster as even
moderately strong inductive support for the folowing therapeutic
thesis of many analysts: In some stated diagnostic categories,
(neo-)Freudian treatment is more efficacious - in specified ways -
not only than no treatment but also than non-analytic treatment
modes, both of which can issue in nothing better than symptom-sub
stitution, at least in the long run. Thus, it will turn out that
neo-Baconian inductivists are far from helpless to discount instances
of improvement in psychoanalytically treated patients as non-suppor
tive of the claim that their (neo-)Freudian treatment as such was
causally relevant to their improvement, and indeed necessary for it.
We are now ready to deal more specifically with both the falsi
ficationist (Popperian) and the inductivist (neo-Baconian) assessment
of the scientific status of psychoanalysis.
? 3. The Scientific Status of Psychoanalysis vis-a-vis

the Falsificationist and Inductivist Criteria of Demarcation
Psychoanalysis offers not only a psychodynamic theory to explain

behavior but also a type of treatment - optimistically dubbed
"therapy" - to be practiced for the alleviation of psychological
disturbances. But such influential writers as Thomas Szasz have
disavowed the curative or medical construal of the psychoanalytic
encounter between the analyst and the analysand. Hence after
considering Hans Eysenck's curative challenge to analytic treatment,
I shall deal in due course with Szasz's reply to Eysenck. But for the
time being, expository clarity will be served by employing the idiom
of themedical model in discussing analytic therapeutics.
The respective falsificationist and inductivist criteria which I shall
employ for assessing the scientific status of psychoanalysis will apply
to claims of therapeutic efficacy no less than to assertions of
pathogenicity or etiology. And hence it will emerge via parity of
reasoning that I am not incurring any loss of generality when I
proceed as follows: I shall focus for the most part on the therapeutic
theses of psychoanalysis as a test case for Popper's allegation that for
any observed behavior whatever all forms of inductivism are incompe
tent to derogate psychoanalysis as pseudo-scientific. When thus con
centrating on Freudian therapeutics, I do not need to take a stand on
whether its theory is deducible from Freudian (ontogenetic) psycho
dynamics5.Hence I can allow that Freud's theory may conceivably have
5 For a discussion of this issue of deducibility, see Eysenck and Wilson ([1973],
pp. 375-376).
a correct account of the etiology and pathogenesis of certain disorders

while failing to provide successful therapeutic prescriptions for them.
Generally speaking, it is not incumbent upon a psychodynamic theory
to produce effective recommendations for psychotherapy in order to
qualify as etiologically explanatory, any more than a theory which
explains carcinogenesis can be expected to guarantee that cancer is
curable. Indeed, it is entirely conceivable that some psychological
disorders are fully as irreversibleas death seems to be. And in that case
it would be utopian to try to cure them. By the same token,when a
given type of disorder is treatable, the treatment for itmay have little
direct relation to its etiology or pathogenesis: As an illustration of this
point, the psychologist M. N. Eagle cites the facetious claim that
ordinary headaches are generally caused by an under-concentration of
aspirin in the blood!
Popper felt entitled to indict psychoanalysis as unscientific after
having addressed the following challenge to Freudians:
"But what kind of clinical responses would refute to the satisfaction of the
analyst not merely a particular analytic diagnosis but psychoanalysis itself? And
have such criteria ever been discussed or agreed upon by analysts?" ([1962],
p. 38)
Whereas in regard to the demarcation problem Popper is primarily
concerned with the scientific entertainability of a hypothesis, the
inductivist is more concerned with its scientific credibility amid
allowing - no less than Popper does - that any one kind of observed
finding is fallible and, to this extent, of limited probative significance
even if it is a negative instance. Hence let us now see quite specifically
how the Bacon-Mill inductivist can use his requirements for supporting
evidence to impugn the scientific credentials of the proposition that
psychoanalytic treatment is causally efficacious therapeutically. Itwill
then be c ear how inductivist demands for control groups in the
testing of causal hypotheses can prevent the developmental part of
Freudian psychodynamics from adducing clinical instances uncritically
with impunity in favor of its etiological or pathogenic claims con
cerning, say, hysteria, depression, or fetishistic sexual behavior6. Thus,
it will emerge, for example, how the inductivist can, in principle,
challenge Freudian causal claims about the etiological role of repressed
(not conscious) homosexuality in paranoia7, and of the causal origi
nation of male homosexuality in conflictual incestuous wishes,
coupled with castration anxiety and wish-denial.
Just how do inductivist canons enjoin us to employ experimental
6 On fetishes, see Freud ([1971], Essay I, pp. 42?44). On aetiology, see esp. p. 44 and
footnotes by Freud on pp. 44?45 of the 1910, 1915, and 1920 editions. An example of a
foot fetish and its aetiology is discussed in the 22nd Lecture of Freud ([1966], p. 357).
7 On paranoia and homosexuality, see Freud ([1955], Vol. 2, p. 151).
344 ADOLF GRUNBAUM
controls as a curb on giving undeserved causal credit to psychiatric

treatment of a specified kind for such improvement as is shown by
patients during or after treatment? As is well known, though
apparently overlooked by Popper, neo-Baconian inductivist canons
discount instances of subsequently improved patients as non-suppor
tive, unless the incidence of improvement among treated patients
exceeds the so-called spontaneous remission rate!Depending upon the
construal of the causal therapeutic hypothesis at issue, the "spon
taneous" remission rate is understood as either (i) the rate of a stated
sort of improvement among those who do not receive the specified
kind X of psychiatric treatment, regardless of whether or not they
receive some formal professional treatment other thanX, or (ii) the
improvement rate among those who receive no formal, professional
treatment of any type and no "attention placebo" treatment from a
professional therapist. But when one speaks of "spontaneous remis
sion" tout court, it is the latter construal which is intended. Hence
when I intend the phrase "spontaneous remission rate" to be
understood in the former sense (i), which is relativized to a given
formal treatment mode X, I shall speak of the "relativized spon
taneous remission rate". In either case, it is clear, of course, that to
classify certain remissions as "spontaneous" is not to categorize them
as uncaused, but only as not caused by a stated kind of formal pro
fessional treatment.
Note that in the definition of the non-relativized sense of "spon
taneous", even the kind of treatment which the administering
therapist avowedly conceptualizes as mere attention-placebo treat
ment has been advisedly included under the rubric of formal pro
fessional intervention. The motivation for this inclusion was to
categorize remissions among recipients of such mere placebo treat
ment as "non-spontaneous" no less than those remissions that are
exhibited by recipients of treatment which is conceptualized as
authentic rather mere placebo. And the rationale for thus lumping
together the former remissions with the latter can be understood in
the light of the conjecture of leading students of treatment-outcome
that insofar as formal psychotherapy is at all causally efficacious, it is
the one common factor of attention placebo which deserves causal
credit for being the therapeutic agent. This conjecture is at least
suggested by the application of Mill's method of agreement to the
following finding of"tie score effect" to be reported later on below:
There seems to be parity in regard to outcome success as between a
whole gamut of different types of psychotherapy.
Consider any given population P of patients in a certain (Freudian)
diagnostic category who underwent psychoanalytic treatment. It
might well be that even more than 50 per cent of P are known to have
exhibited improvement (in a stated respect) for (at least) a period T

virtually without symptom-substitution. Let us speak of improvement
which is virtually unaccompanied by symptom-substitution as
"unalloyed" improvement. Then we must emphasize that the specified
incidence of unalloyed improvement I in the class P for the time T
does not have the probative import of redounding to the credit of
Freudian treatment as such, unless the following condition'is met: The
percentage of I in P for the duration T- which is putatively over
50 per cent - surpasses the percentage rate of relativized spontancous
and unalloyed remission-for-the-time-T. Subject to impending qualifi
cations, it is an empirical question whether the rate of spontaneous
remission - either spontaneous simpliciter or relativized to some parti
cular formal treatment-mode - is non-zero in any given diagnostic
category D or not. One qualification is thatmembership inD needs to
be (fallibly) ascertainable without the kind of intervention by the
therapistwhich would nullify the relevant type of spontancity of any
ensuing remissions. This qualification will turn out to play a role in an
argument by Freudian apologists thatwe shall consider later on.
In 1973, Eysenck discussed some of the empirical findings
regarding spontaneous remission which are pertinent to the inductive
credentials of the efficacy of Freudian treatment as such. At that
time, he wrote:
"Spontaneous remission is just about the best-documented, most clear-cut, and
most reliable fact in the whole history of neurotic illness; Freud's failure to
predict its existence, and in fact his theory's insistence on the impossibility of
spontaneous remission, are very strong arguments against the adequacy or truth of
that theory. The failure of relapse and of symptom substitution to occur after
spontaneous remission is another crucial feature of this argument [reference
omitted]; these were confidently predicted by psychoanalysts on the basis of
Freud's theory to occur after any type of symptomatic treatment, or no treat
ment, yet the evidence is quite conclusive that in fact they do not occur with any
frequency at all (Eysenck & Wilson" [1973], pp. 378-379).
At least some of the empirical contentions offered here by
Eysenck have been supported by still more recent findings presented
by R. Bruce Sloane and his co-workers [1975]. These investigators
report a very largewait list improvement rate after giving a careful
account (ibid., pp. 4-7) of the criteria for assessing improvement.
Moreover, Sloane et al. found that there is virtually no symptom
substitution in improved adult neurotics who had received behavior
therapy.
In any case, it is clear that even numerous instances of psycho
analytically-treated patients in a given D who subsequently exhibit
unalloyed long-term improvement I of a specific sort can fail to
support the following therapeutic thesis: The outcome I is to be
credited causally to the efficacy of Freudian treatment. Indeed, the
346 ADOLF GRONBAUM
outcome I in the treated group may well furnish a remission rate lower
than the spontaneous one, thereby giving rise to the possibility that
the treatment made at least some of the patients in D worse! In
psychiatry no less than in somatic medicine, there can be iatrogenic or
doctor-induced disease.
Hence it would clearly be a commission of the fallacy of post hoc
ergo propter hoc to ascribe causal efficacy to Freudian treatment
merely on the strength of improvement exhibited by analytically
treated patients. By the same token, it would fallaciously trivialize a
Freudian claim of therapeutic efficacy, as we saw, to construe it as
asserting merely that some psychoanalytically-treated patients
improve in specified ways. For to credit analytic treatment as such
causally with therapeutic efficacy is to assert at least that its results
significantly exceed the relativized spontaneous remission rateg.
Therefore, contrary lesser results would have the form of statistical
information about pertinent samples. But nonetheless Popper would
presumably not wish to deny qua deductivist that constant failure to
surpass the spontaneous remission rate would serve to refute the
hypothesis of therapeutic effectiveness under the avowedly fallible
assumption of suitable initial or auxiliary conditions! Such assump
tions are explicitly countenanced by Popper as part of his schema for
falsifications. Therefore, by Popper's standards- though not by Pierre
Duhem's! (cf. Gruinbaum [1976 b], Section V) - the claim that
Freudian treatment is effective is falsifiable, albeit only fallibly and
hence revocably. To say that this falsifiability is revocable is to say
that any given presumed falsification is corrigible but not that the very
logical possibility of some falsification or other of the thesis of thera
peutic efficacy is itself revocable.
But according to Popper's demarcation criterion, such falsifiability
of a hypothesis is sufficient for its scientific status though not, of
course, for its being a corroborated scientific hypothesis. Therefore,
by Popper's standards, which are those of a fallibilist rather than
dogmatic falsificationist, the thesis that psychoanalytic treatment is
therapeutic does qualify for scientific status without prejudice to
whether this therapeutic claim will turn out to be actually
8 Psychoanalytic claims of therapeutic efficacy have traditionally been construed as asserting at

least that Freudian treatment is a causally necessary condition for the extent and quality of
improvement attained by psychoanalytically-treated patients. On that construal. Freudian
treatment is claimed to exceed the relativized spontaneous remission rate. But in contexts in
?
which it is allowed that there is a "plurality of causes" ? in the sense of J. S. Mill [1887]
for a given degree of patient-improvement, the following weaker claim might be made
concerning a given type T of treatment: The administration of T is not itself causally
necessary for the stated degree of improvement but is only one of a number of conditions
whose disjunction is thus causally necessary.
corroborated by the results. In ? 4, we shall soon reach a similar

conclusion concerning at least some of Freud's etiological hypothe
ses9.
In connection with Popper's indictment of psychoanalysis, it seems
to me essential to distinguish the (revocable) falsifiability of the
theory as such from the readiness of its defenders to accept adverse
evidence as refuting. Lack of scientific honesty on the part of the
defenders of a theory and even of its originator does not render the
theory itself unfalsifiable.
What of Freud's own hospitality to adverse evidence and his
concern, if any, for adequately supporting evidence? He himself was
not only pessimistic regarding the feasibility of actually demonstrating
the efficacy of psychoanalytic treatment but gave a strange twist to
the cognitively unsolved question of efficacy by transmuting it into a
sociological problem of resistance to new treatmentmodes, which will
solve itselfwith the passage of time ([1949], pp. 386-387).
Nonetheless, Freud issued an important disclaimer, which will be
seen to be very noteworthy insofar as the aim of psychoanalytic
treatment is supposed to be the resolution of the complexes which are
hypothesized to underlie pathological symptoms. Such resolution
needs to be distinguished from the mere symptom-substitution which
Freudians have alleged to be the best that non-analytic treatment
modes or spontaneous remission can be hoped to achieve. Freud's
disclaimer - which he labeled "Strictly secret"! in a 1910 letter to
Ferenczi - reads as follows:
"It seems to me that in our influencing of the sexual impulses we cannot
achieve anything other than exchanges and displacements, never renunciation,
relinquishment or the resolution of a complex (Strictly secret!). ... Our thera
peutic gain is a barter.... The last piece falls into the well only with death itself"
(Jones [1955], p. 447).
At this point, I should explain my reasons for not being persuaded
by JohnWatkins's objection that my concern with the efficacy of
psychoanalysis as a therapy is wasted labor in regard to Popper's
assessment of psychoanalysis as constituting a pseudo-scientific
theory.
Firstly, the non-therapeutic part of Freud's theory contains causal
hypotheses of a developmental and etiological sort, and - under an
impending proviso - at least some of these causal hypotheses are, in
principle, falsifiable by controlled inquiry according to Popper's
fallibilistic standards, no less than those particular other causal
hypotheses which claim that Freudian treatment is therapeutically
effective. There is such falsifiability of causal hypotheses provided
9 Hence I must diverge from Ackermann's unqualified conclusion ([1976]), p. 160) that
currently psychoanalysis is not a Popperian scientific discipline.
348 ADOLF GRONBAUM
that their theoretical antecedent causal conditions and their conse

quents can be observationally certified to have occurred, a kind of
certification which Popper takes to be in principle feasible, even if
only fallibly, when a theory specifies the observational manifestations
of its theoretical states. But an inductivist will wish to point out here
that this epistemic feasibility is predicated on some kind of inductive
link between the observational indicators and the presence of
theoretical antecedent causal conditions or consequents. And, as
Kyburg has justly emphasized, the ways in which the theoretical
antecedent causal conditions would manifest themselves empirically in
specified kinds of circumstances are themselves specified by the
theory under test. Yet despite such falsifiability in principle, some of
Freud's etiological claims may be quite hard to test (falsify). For
example, his assertion of a homosexual etiology for paranoia in adult
males might well be a case in point, since the repressed homosexual
childhood experiences which he envisaged as the cause of male
paranoia presumably comprised both fancied and actual experiences
of this kind. For pertinent documentation of testability, I refer the
reader to Kline andto Eysenck &Wilson ([1973]).
Secondly, it is perhaps arguable that the Freudian theory of human
psychodynamics permits the deduction of Freud's therapeutics. And if
so, then the refutability of the latterwould, of course, also assure the
refutability of the former.
Third, regardlessof the deducibility of the therapeuticity of Freud's
treatment modes from the rest of his theory, this therapeutics ispart
of overall Freudian psychoanalytic theory. And if Popper was aware
of the falsifiability of Freudian therapeutics, it was at best one-sided
on his part not to have acknowledged that. I find no hint of awareness
in Popper's ([1962], ch. I) that Freudian therapeutics does indeed
qualify as a scientific theory by his falsificationist standards.
So much then forWatkins's objection.
In regard to the inductivist, we already saw that the question as
to the scientific credentials of psychoanalytic therapeutics is
tantamount to the following question: What are the actual empirical
findings concerning the extent, if any, to which psychoanalytic
treatment succeeds in surpassing the (relativized) spontaneous
remission rate in any given diagnostic category? But I must now
emphasize that there is a host of difficult subsidiary questions here
which must be answered before this question becomes susceptible of a
meaningful and empirically-supported reply. For example, there is
much imprecision in the diagnostic categories of neuroses and in
certifying membership of patients in one of these. Also, it is unclear
what criteria are to be employed in assessing improvement in a given
diagnostic category such as depressives. Is there improvement in a
previously depressed man who is full of joy after treatment, if he also

now beats his wife and children when they cannot keep up with his
energetic demands? As R. B. Sloane et al. put it, ". . .a patient is not
an island unto himself. A treatment which makes him feel marvelous
may seem disastrous and cause catastrophe to those he lives andworks
with" ([1975], p. 7).
Whatever the various subsidiary questions, which arewell-known to
those who are familiar with treatment-outcome research, the in
ductivist places the logical burden of formulating a meaningful and
warranted claim of therapeutic success for Freudian treatment on the
advocates and dispensers of psychoanalytic treatment. I would add
that the moral burden of doing so likewise belongs squarely on the
shoulders of these advocates and dispensers. Yet Iwas told recently by
one psychoanalyst that the diagnostic category to which a patient
belongs is not behavioristic and cannot be known until after at least
two years of analysis, while another told me that the diagnostic
category cannot be known until the analysis is entirely over. On their
view, the spontaneous remission rate for any diagnostic category
countenanced by psychoanalysis can therefore not be ascertained.
And, furthermore, in their view it therefore cannot be discovered
whether psychoanalytic treatment improves on the (relativized)
spontaneous remission rate in its diagnostic categories. It cannot be
emphasized enough that if this state of affairswere indeed an integral
part of analytic therapeutics, it would pose a grave difficulty of
epistemic validation and moral justification for the advocates of
Freudian treatment. Oddly enough, the two psychoanalysts who
posed the epistemic obstacle viewed it asmeeting my ethical challenge
to their advocacy of psychoanalytic treatment. For my part, I can be
only distressed by themoral evasiveness of this gambit.
Lest my epistemic and moral objection here be misunderstood, let
me emphasize the following: I am not making the demand that
Freudian diagnostic categories be applicable to some individuals
independently of any and all psychoanalytic theory. Henry Kyburg
has rightly deemed such a demand to be epistemically exorbitant, if
only because no corresponding requirement ismet in particle physics.
There the theory under test itself can be used in an inductive argu
ment to interpret certain white streaks on a photographic print as
betokening the presence of some kind of particle to which the theory
predictively ascribes specified properties, an ascription whose ex
perimental scrutiny will serve to test the theory. To contrast the
exorbitant demand with the lesser demand which I am actually
addressing to psychoanalysts in the spirit of Eysenck, letme first give
an analogy. Neurosurgeons clearly employ some theoretical principles
in the (fallible) diagnostic identification of a meningioma. But they
350 ADOLF GRCJNBAUM
would and certainly should shrink from advocating surgical extirpa

tion of an operable brain tumor of this type as therapeutic treatment
for it if the very extirpation were their sole epistemic avenue for
diagnosing ameningioma as such. For in that hypothetical eventuality,
the advocacy of surgery as the treatment of choice would be ill
founded. By the same token, Imaintain that if Freudian treatment for
the symptoms of which patients complain in pre-Freudian terms is to
be advocated on the grounds of being more therapeutic than either no
treatment or than non-analytic (shorter, less expensive) intervention,
then theremust be a test of its purported causal efficacy. I do grant
that as part of such a test, Freudian theory must itself be used to
make fallible determinations of the diagnostic categories to which
patients in the experimental and control groups belong. But such use
of the theory must exclude the (complete) administration of the very
treatment whose therapeutic efficacy is still at issue. Hence Kyburg's
comparison with the epistemic practices of particle physics cannot
legitimate - and presumably is not intended to legitimate - the
epistemically and ethically evasive response given by the two psycho
analysts to my challenge to their advocacy of Freudian treatment.
Some analysts have likened their conduct toward their patients to
that of surgeons who operate only on those who are either good bets
as genuine beneficiaries of surgical treatment or who have nothing at
all to lose. But this procedure can be followed by psychoanalysts even
in principle, let alone in practice, only if comparisons with (rela
tivized) spontaneous remission rates for appropriate diagnostic
categories do make it possible to conjecture which patients are indeed
good bets and which ones have nothing to lose besides the substantial
cost of an analysis. And an analysismay exact a price that is not only
financial. Thus, it is fairly unclear on what grounds a recent defender
of analytic treatment made the following claim: "Certainly the
experienced analyst knows full well that analysis is not helpful in
certain clinical categories and is even contraindicated for others"
(Engel [1975], p. 581). Might the patients in question not have gotten
stillworse without analytic?
To make quite explicit where I take the burden of proof to belong,
let me point out that, as an inductivist sceptic, it is emphatically not
incumbent upon me to show that psychoanalytic treatment is
ineffective! In this vein, critics of such treatment as, for example,
Hans Eysenck (Eysenck & Wilson [1973], p. 374), Stanley Rachman
[19711 and others have argued that there is no satisfactory evidence
showing that psychoanalytic treatment succeeds in surpassing the
spontaneous remission rate, although others have sharply challenged
their analysis and consider the question moot. One reason given for
such objection is that the studies cited by Eysenck defy interpreta
tion, because they involve heterogeneous populations evaluated by

non-comparable criteria.
So far as I can see, despite the strongly revisionist stancewhich the
psychoanalyst Peterfreund takes toward current psychoanalysis in his
purported information-processing approach (Peterfreund & Schwartz
[1971], ch. 22, Section H, pp. 351-358), he is no more mindful of
Eysenck's challenge than Erich Fromm was. Indeed, there is no
mention at all of Eysenck's challenge in Peterfreund's book.
(To be Continued in no. 32/1)
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Is Psychoanalysis Pseudo-Science?

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Is Psychoanalysis a Pseudo-Science?

Karl Popper versus Sigmund Freud

byAdolf Griinbaum, Pittsburgh

("lieben und arbeiten"). Other psychoanalysts, notably Thomas Szasz,

between science and non-science. Popper tells us that his 20th

? 2. Popper's Proposed Demarcation Between Science and

Popper asks "When should a theory be ranked as scientific"? And

matically qualifies as well-supported by the evidence. In that case, T

radically from others in evidential value. Thus Bacon stress-es that

wonder that in a very recent treatise on epidemiology (Susser [1973],

separately qualify as positive instances of the given H, and neither can

? 3. The Scientific Status of Psychoanalysis vis-a-vis

Psychoanalysis offers not only a psychodynamic theory to explain

a correct account of the etiology and pathogenesis of certain disorders

controls as a curb on giving undeserved causal credit to psychiatric

exhibited improvement (in a stated respect) for (at least) a period T

8 Psychoanalytic claims of therapeutic efficacy have traditionally been construed as asserting at

corroborated by the results. In ? 4, we shall soon reach a similar

that their theoretical antecedent causal conditions and their conse

previously depressed man who is full of joy after treatment, if he also

would and certainly should shrink from advocating surgical extirpa

tion, because they involve heterogeneous populations evaluated by

(To be Continued in no. 32/1)

Ackermann, R. J. [1976]. The Philosophy of Karl Popper. Amherst: University of

Bergin, A. E. [1970]. The evaluation of outcomes. In Handbook of

Eysenck, H. J. and Wilson, G. D. [1973] The Experimental Study of Freudian

Freud, S. [1924]. Collected Papers, vol. 1, transi. John Rickman. London:

Kernberg, O. F. [1973]. Summary and conclusions of and

May, P. R. [1973]. Research in and International

Rachman, S. [1971]. The Effects of New York: Press.

greatly exaggerated." American Psychologist 31 : 621:37.

Szasz, T. S. [1968] Law, Liberty and New York: Collier Books.

Targ, R. and Puthoff, H. [1974]. Information transmission under conditions of

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