One confounding factor has been that the SSRIs challenge traditional diagnostic schemes. The successes of medications across diagnostic categories suggest unrecognized commonalities among them. Taken together with certain readily observed clinical phenomena, these facts suggest that the essential benefits of (SSRI) medications derive from their capacity to modify aggression, writes psychoanalyst Richard Gottlieb MD in the 50/3 issue of the Journal of the American Psychoanalytic Association (JAPA) to be published October 29, 2002.
The hypothesis posed in the article "A Psychoanalytic Hypothesis Concerning the Therapeutic Action of SSRI Medications" readily generates strategies for future neuroscientific investigations of mind/brain. For example, diverse symptoms might first be categorized according to the importance of unconscious aggressive conflict, rather than according to the more usual conscious superficial descriptors. This hypothesis also suggests that electrochemical and neuroanatomical correlates of such diverse symptoms might have more in common than previously suspected.