One of the sharpest criticisms psychoanalysis comes from Karl Popper Assumptions and disclaimers(1963). When he reviewed the work of psychoanalysts, he found that he was looking at something that was “more like astrology than astronomy” (Popper, 1963). Studying these theories, he writes, had the effect of “an intellectual conversion or revelation”: once your eyes were opened, you saw corroborating examples everywhere, and the world seemed full of verifications. Anyone who fails to see what you see is either blinded by class interest or suffering from as yet unanalyzed repression (Popper, 1963).
Its main point is Freud had constructed a theory that could not be tested in reality. Popper argued that a theory is only meaningful if it proves you wrong. According to Popper, Freud’s theory cannot be falsified and excludes nothing. An interpretation is already expected for any behavior the patient may exhibit and its opposite, so the patient can never challenge the theory. A theory that aims to explain everything, according to Popper, explains nothing.
Let’s say you walk in and tell your friend that you’re upset that he’s drifting away. The therapist wonders aloud whether she is covering up her grief angerit’s a perfectly reasonable thing to wonder about. You think about it and say no, you’re really sad, you know the difference. A good therapist sees anger reading as one opportunity among others. The challenge comes when it becomes the only thing that can be read. Then your word “no” can be heard as an affirmation: of course you still cannot feel anger, anger is something that is pushed away! Again, you’re saying that you’re not really pushing anything, and that can also be taken as evidence of resistance.
Popper’s critique is not perfect, but it points to the possible shortcomings of traditionalism therapyand it may be of particular importance to the neurodivergent population. Many neurodivergent clients describe going to therapy as some kind of defense or resistance, only to be read by therapists who are trained, have good hearts, and work faithfully within a respected tradition.
Most psychological theories are based on data from people who are generally neurotypical, but in practice they are applied as if they are guaranteed to be true for everyone. Freud’s resistance theory, Adler’s compensation framework for inferiority, Klein’s account of splitting, and projection developed in clinical settings that do not include autistic or ADHD adults are recognized as a recognized population, and the field has not returned to reconsidering them in terms of what is now known about neurodevelopmental differences. A small body of research on therapeutic work with neurodivergent adults is beginning to emerge, but it has not yet reached many academic programs.
The danger is most acute when the client’s neurodivergence has not yet been identified, because no one in the room has the framework to properly understand what is being said. An autistic client who says that he takes his partner’s words literally and is genuinely confused about what he means is not being defensive, naïve, or submissive. An ADHD client who says he forgot an appointment because he forgot it has nothing underneath it suggests a similarly accurate account, but a therapist trained to listen for hidden content can reread it to avoid it.
Many neurodivergent adults have spent their lives being doubted by people who thought they must be something else because what they said didn’t match what was expected of them. If this suspicion is encountered again, this time with the authority of an expert who may or may not be excused, it may come down harder than simple mistrust, even if no one intends harm.
It is not a difficult fact that a person can study himself. Research on the limits of self-knowledge shows that people routinely confuse explanations for their behavior, constructing plausible accounts after the fact that have little to do with the actual reasons for what they do (Cassam, 2014). So the lesson is that the client is always right and the therapist always overreaches, but neither side has an established truth.
A good therapist must be able to hear what the client has to say, because people do not always know themselves and understanding often comes to them. But this must be balanced with epistemic humility, a willingness to conduct one’s studies as assumptions that may be wrong. Exactly where that line is drawn, between pressing a useful issue and dismissing a self-aware person, no theory can decide in advance, because it depends on the particular person, the particular moment, and the particular thing being said.
Popper himself did not reject psychoanalysis; he thought that it could contain important assumptions of the science being tested (Popper, 1963). But the basis of his caution is worth keeping close. An unfalsifiable interpretation should be treated as what it is: a theory, an unproven idea, a possibility.
In practice, the therapist may suggest an interpretation and interpret it as a suggestion. A client can take a challenge seriously and still hold onto the reality of their feelings, while leaving the challenge open to the possibility of holding onto something they missed. Perhaps the most beneficial thing any kind of supportive relationship can give to a person trust weighing the interpretation, keeping what fits and marking what doesn’t.
