Meet Richard Lane
Since 1999, the Sigmund Freud Foundation and the Austrian Fulbright Commission invite American scientists for a study visit which is combined with a visiting professorship on a university in Vienna. We introduce you to 2023's grantee Richard D. Lane, who arrived in March and took office in Berggasse 19.
What does it mean to you, working at Berggasse 19?
It is a dream come true. Psychoanalysis has been part of my life from an early age, as my father trained to become an analyst at the Chicago Institute for Psychoanalysis when I was a youngster. I grew up exposed to terms like “psychoanalysis” and “psychosomatic medicine” in an environment in which these disciplines were thought to represent the highest levels of intellectual attainment and clinical importance. As I developed my own career as a psychiatrist, psychodynamic psychotherapist and neuroscientist, I have remained fascinated with Freud’s writings and the entire field that he pioneered. For someone with my interests and background, it is hard to imagine working at a place more meaningful than Berggasse 19.
We know it is not your first stay in Vienna – what makes this city special to you?
Vienna has been special to me through the years precisely because it is the birthplace of psychoanalysis. Having spent some time here now, I can say that Vienna is brimming with riches of all kinds – art, history, music, architecture, and intellectual pursuits of all kinds. The city has a wonderful transportation system, is teeming with great restaurants and is surprisingly affordable. I have found that in general people here are quite friendly and helpful. It is a joy to live here for a sustained period of time.
Why did you apply for the Fulbright-Freud Scholarship?
I was very honored to be invited to apply for this fellowship by the Fulbright program. Although I can’t be sure, I imagine I received this invitation because the intersection of neuroscience and psychoanalysis is one of the areas of special interest for this fellowship and I had a record of contributions in that area. The invitation arrived in 2020 just when our book Neuroscience of Enduring Change: Implications for Psychotherapy was published by Oxford University Press. The opportunity to teach a course based on the book, at the birthplace of psychoanalysis, seemed like such a great opportunity. Moreover, I had begun collaborating with psychoanalytic researchers on the topic of memory reconsolidation, a phenomenon that was first described by Sigmund Freud. The opportunity to develop this line of research further in honor of Sigmund Freud held special appeal.
Can you tell us more about the research project you are pursuing during your stay?
The fundamental concept of our model of enduring change is that problematic emotional memories can be updated or reconsolidated by virtue of having new, corrective emotional experiences. We have therefore created a paradigm in which the functional neuroanatomy of this phenomenon can be studied with functional magnetic resonance imaging. A pilot neuroimaging study will be conducted this spring with collaborators at the University of Lausanne in Switzerland. We are excited to see whether specific brain areas interact as we predict to implement corrective emotional learning. Freud always dreamed that the mind could be explained by neuroscience. A century after he did his work the tools are now available to help make that dream a reality.
A second set of projects will be executed here at the Medical University of Vienna. A core idea in psychoanalysis and psychodynamic psychotherapy is that expanding the ability to consciously experience emotions is a key mediator of change. This is related to memory reconsolidation in that the new emotional experiences can themselves update the memories if these experiences occur when the memories have been reactivated in psychotherapy. We have at our disposal several completed data sets in which patients have been treated in psychotherapy. With the help of talented colleagues I have developed a coding system for emotional awareness in German that we will apply to inventories obtained before, during and after the psychotherapy treatment to determine the degree to which promoting emotional awareness helps to explain how much people benefit from the psychotherapy.
Can you define “enduring change” for us? What does this mean in your work?
In psychotherapy research we evaluate whether people improve as a result of a course of treatment relative to where they were before treatment started. A key question is whether improvement, if it occurs, is lasting or enduring, say for two years or more after treatment has ended. Research shows that many types of psychotherapy treatments bring about improvement by the time treatment ends but relapse occurs at disappointingly high rates. Psychoanalysis is a more intensive treatment that aspires to achieve enduring outcomes, i.e. improvement without relapse. The phenomenon of memory reconsolidation is relevant here as reconsolidation involves changing the problematic memories themselves, as opposed to suppressing them or creating new learning that outcompetes the old learning. The latter two mechanisms leave the old problematic memories intact and thus the vulnerability to relapse remains. Memory reconsolidation, which changes the memories themselves, may be necessary for enduring change. As such, it may be the neural mechanism underlying the enduring change that psychoanalysis has traditionally sought to achieve. The fact that Sigmund Freud was the first person to describe what we now call memory reconsolidation makes this all the more relevant and fascinating.
What are the key challenges for mental health, being confronted with economic changes, the ever-faster digitization in all parts of everyday life and the division of the world into political blocks?
These are very stressful times and the interpersonal connections that facilitate relationships and coping capacity are compromised by our increasing reliance on technology. The Covid-19 pandemic also lead to a significant increase in mental health problems, substance use and other maladaptive behaviors. A key organizing concept is that these changes either cause or are caused by significant emotional distress. Finding ways to help people process their distress, avoid becoming bitter and hopeless and helping them to still get the most out of life is probably the key mental health challenge that we face today.
What can the current clinical approach on mental health learn from psychoanalysis and vice-versa?
Third party payers are especially interested in brief treatments that are effective in reducing symptoms and bringing people relief. These brief treatments focus on what is maintaining the current problem. They help many people and the treatments can be repeated if symptoms recur. Thus, they have an important place in our armamentarium. Psychoanalysis attempts to get at the cause of the mental distress, as opposed to what maintains it, and thus aspires to more lasting or enduring treatment outcomes. It is therefore important to recognize that briefer treatments can be effective and are often the right choice for many people. By contrast, when symptom-focused treatments don’t work or aren’t a good fit for a given person, treatments that aim for a more definitive result may be preferable.
Please let us know more about your general fields of interest as a scholar.
The focus of my career has been emotion. It is a fascinating topic that I have been able to pursue in different ways from both clinical and basic science perspectives. I’ve been fortunate to be trained as a clinician and appreciate how important it is to be aware of one’s emotions for the purposes of regulating one’s own emotions and facilitating interpersonal relationships. I’ve also been trained as a neuroscientist and researcher and been fortunate to be able to study emotions and the mechanisms by which they influence mental and physical health in healthy volunteers and clinical groups. This includes studying brain mechanisms and physiological changes in the body. What I’ve particularly enjoyed is the ability to make clinical observations, study the mechanisms involved and bring back what I’ve learned to improve clinical care. This in turn inevitably leads to new observations, raises new and interesting basic science questions and thus the cycle repeats. This dialogue between clinical observations and basic science research is in many ways exemplified by the work I am doing during this fellowship and it is a pleasure to be able to share the knowledge generated with trainees and more senior colleagues alike.