Freud - Complete Works (21 page)

Studies On Hysteria

98

   But in doing without somnambulism I
might be depriving myself of a precondition without which the
cathartic method seemed unusable. For that method clearly rested on
the patients in their changed state of consciousness having access
to memories and being able to recognize connections which appeared
not to be present in their normal state of consciousness. If the
somnambulistic extension of memory were absent there could also be
no possibility of establishing any determining causes which the
patient could present to the physician as something unknown to him
(the patient); and, of course, it is precisely the pathogenic
memories which, as we have already said in our ‘Preliminary
Communication’ are ‘absent from the patients’
memory, when they are in a normal psychical state, or are only
present in a highly summary form’.

   I was saved from this new
embarrassment by remembering that I had myself seen Bernheim
producing evidence that the memories of events during somnambulism
are only
apparently
forgotten in the waking state and can be
revived by a mild word of command and a pressure with the hand
intended to indicate a different state of consciousness. He had,
for instance, given a woman in a state of somnambulism a negative
hallucination to the effect that he was no longer present, and had
then endeavoured to draw her attention to himself in a great
variety of ways, including some of a decidedly aggressive kind. He
did not succeed. After she had been woken up he asked her to tell
him what he had done to her while she thought he was not there. She
replied in surprise that she knew nothing of it. But he did not
accept this. He insisted that she could remember everything and
laid his hand on her forehead to help her to recall it. And lo and
behold! she ended by describing everything that she had ostensibly
not perceived during her somnambulism and ostensibly not remembered
in her waking state.

Studies On Hysteria

99

   This astonishing and instructive
experiment served as my model. I decided to start from the
assumption that my patients knew everything that was of any
pathogenic significance and that it was only a question of obliging
them to communicate it. Thus when I reached a point at which, after
asking a patient some question such as: ‘How long have you
had this symptom?’ or: ‘What was its origin?’, I
was met with the answer: ‘I really don’t know, I
proceeded as follows. I placed my hand on the patient’s
forehead or took her head between my hands and said: ‘You
will think of it under the pressure of my hand. At the moment at
which I relax my pressure you will see something in front of you or
something will come into your head. Catch hold of it. It will be
what we are looking for. - Well what have you seen or what has
occurred to you?’

   On the first occasions on which I
made use of this procedure (it was not with Miss Lucy R.) I myself
was surprised to find that it yielded me the precise results that I
needed. And I can safely say that it has scarcely ever left me in
the lurch since then. It has always pointed the way which the
analysis should take and has enabled me to carry through every such
analysis to an end without the use of somnambulism. Eventually I
grew so confident that, if patients answered, ’I see
nothing’ or ‘nothing has occurred to me’, I could
dismiss this as an impossibility and could assure them that they
had certainly become aware of what was wanted but had refused to
believe that that was so and had rejected it. I told them I was
ready to repeat the procedure as often as they liked and they would
see the same thing every time. I turned out to be invariably right.
The patients had not yet learned to relax their critical faculty.
They had rejected the memory that had come up or the idea that had
occurred to them, on the ground that it was unserviceable and an
irrelevant interruption; and after they had told it to me it always
proved to be what was wanted. Occasionally, when, after three or
four pressures, I had at last extracted the information, the
patient would reply: ‘As a matter of fact I knew that the
first time, but it was just what I didn’t want to say’,
or: ‘I hoped that would not be it.’

Studies On Hysteria

100

   This business of enlarging what
was supposed to be a restricted consciousness was laborious - far
more so, at least, than an investigation during somnambulism. But
it nevertheless made me independent of somnambulism, and gave me
insight into the motives which often determine the
‘forgetting’ of memories. I can affirm that this
forgetting is often intentional and desired; and its success is
never more than
apparent
.

   I found it even more surprising
perhaps that it was possible by the same procedure to bring back
numbers and dates which, on the face of it, had long since been
forgotten, and so to reveal how unexpectedly accurate memory can
be.

   The fact that in looking for
numbers and dates our choice is so limited enables us to call to
our help a proposition familiar to us from the theory of aphasia,
namely that recognizing something is a lighter task for memory than
thinking of it spontaneously. Thus, if a patient is unable to
remember the year or month or day when a particular event occurred,
we can repeat to him the dates of the possibly relevant years, the
names of the twelve months and the thirty-one numbers of the days
of the month, assuring him that when we come to the right number or
the right name his eyes will open of their own accord or that he
will feel which is the right one. In the great majority of cases
the patient will in fact decide on a particular date. Quite often
(as in the case of Frau Cäcilie M.) it is possible to prove
from documents belonging to the period in question that the date
has been recognized correctly; while in other cases and on other
occasions the indisputable accuracy of the date thus chosen can be
inferred from the context of the facts remembered. For instance,
after a patient had had her attention drawn to the date which had
been arrived at by this ‘counting over’ method, she
said: ‘Why, that’s my father’s birthday!’
and added: ‘Of course! It was because it was his birthday
that I was expecting the event we were talking about.’

   Here I can only touch upon the
theme in passing. The conclusion I drew from all these observations
was that experiences which have played an important pathogenic
part, and all their subsidiary concomitants, are accurately
retained in the patient’s memory even when they seem to be
forgotten - when he is unable to call them to mind.¹

  
¹
As an example of the technique which I have
described above of carrying out investigations in
non-somnambulistic states - that is, where there is no extension of
consciousness - I will describe an instance which I happen to have
analysed in the course of the last few days. I was treating a woman
of thirty-eight, suffering from anxiety neurosis (agoraphobia,
attacks of fear of death, etc.). Like so many such patients, she
had a disinclination to admitting that she had acquired these
troubles in her married life and would have liked to push them back
into her early youth. Thus she told me that she was seventeen when
she had had a first attack of dizziness, with anxiety and feelings
of faintness, in the street in her small native town, and that
these attacks had recurred from time to time, till a few years ago
they had given place to her present disorder. I suspected that
these first attacks of dizziness, in which the anxiety faded more
and more into the background, were hysterical and I made up my mind
to embark on an analysis of them. To begin with she only knew that
this first attack came over her while the was out shopping in the
principal street. ’What were you going to buy?’ -
‘Different things, I believe; they were for a ball I had been
invited to.’ - ‘When was this ball to take
place?’ - ‘Two days later, I think.’ -
‘Something must have happened to agitate you a few days
before, something that made an impression on you.’ - ‘I
can’t think of anything. After all, it was twenty-one years
ago.’ - ‘That makes no difference; you will remember
all the same. I shall press on your head, and when I relax the
pressure, you will think of something or see something, and you
must tell me what that is.’ I went through this procedure;
but she remained silent. ’Well, has nothing occurred to
you?’ - ‘I have thought of something, but it
can’t have any connection with this.’ - ‘Tell it
to me anyway.’ - ‘I thought of a friend of mine, a
girl, who is dead. But she died when I was eighteen - a year later,
that is.’ - ‘We shall see. Let’s stick to this
point. What about this friend of yours?’ - ‘Her death
was a great shock to me, as I used to see a lot of her. A few weeks
earlier another girl had died, and that had made a great stir in
the town. So after all, I must have been seventeen at the
time.’ - ‘There, you see, I told you we could rely on
the things that come into your head under the pressure of my hand.
Now, can you remember what you were thinking about when you felt
dizzy in the street?’ -(‘I wasn’t thinking of
anything; I only felt dizzy.’ - ‘That’s not
possible. States like that never happen without being accompanied
by some idea. I shall press once more and the thought you had will
come back to you.... Well, what has occurred to you?’ -
‘The idea that I am the third.’ - ‘What does that
mean?’ - ‘When I got the attack of dizziness I must
have thought: "Now I am dying, like the other two girls."
' - ‘That was the idea, then. As you were having the
attack you thought of your friend. So her death must have made a
great impression on you.’ - ‘Yes, it did. I can
remember now that when I heard of her death I felt it was dreadful
to be going to a ball, while she was dead. But I was looking
forward so much to the ball and was so busy with preparations for
it; I didn’t want to think of what had happened at
all.’ (We may observe here a deliberate repression from
consciousness, which rendered the patient’s memory of her
friend pathogenic.)

   The
attack was now to some extent explained. But I still required to
know of some precipitating factor which had provoked the memory at
that particular time. I formed what happened to be a lucky
conjecture. ’Do you remember the exact street you were
walking along just then?’ - ‘Certainly. It was the
principal street, with its old houses. I can see them now.’ -
‘And where was it that your friend lived?’ - ‘In
a house in the same street. I had just passed it, and I had the
attack a couple of houses further on.’ - ‘So when you
went by the house it reminded you of your dead friend, and you were
once more overcome by the contrast which you did not want to think
of.’

   I
was still not satisfied. There might, I thought, be something else
at work as well that had aroused or reinforced the hysterical
disposition of a girl who had till then been normal. My suspicions
turned to her monthly periods as an appropriate factor, and I
asked: ‘Do you know at what time in the month your period
came on?’ The question was not a welcome one. ‘Do you
expect me to know that, too? I can only tell you that I had them
very seldom then and very irregularly. When I was seventeen I only
had one once.’ - ‘Very well, then, we will find out
when this once was by counting over.’ I did the counting
over, and she decided definitely on one particular month and
hesitated between two days immediately preceding the date of a
fixed holiday. ‘Does that fit in somehow with the date of the
ball?’ She answered sheepishly: ‘The ball was on the
holiday. And now I remember, too, what an impression it made on me
that my only period that year should have had to come on just
before the ball. It was my first ball.’

  
There is no difficulty now in reconstructing the interconnection
between the events, and we can now see into the mechanism of this
hysterical attack. It is true that the achievement of this result
had been a laborious business. It required complete confidence in
my technique on my side, and the occurrence to the patient of a few
key ideas, before it was possible to re-awaken, after an interval
of twenty-one years, these details of a forgotten experience in a
sceptical person who was, in fact, in a waking state. But once all
this had been gone through, the whole thing fitted
together.

Studies On Hysteria

101

   After this long but unavoidable
digression I will return to the case of Miss Lucy R. As I have
said, then, my attempts at hypnosis with her did not produce
somnambulism. She simply lay quietly in a state open to some mild
degree of influence, with her eyes closed all the time, her
features somewhat rigid, and without moving hand or foot. I asked
her if she could remember the occasion on which she first had the
smell of burnt pudding. ‘Oh yes, I know exactly. It was about
two months ago, two days before my birthday. I was with the
children in the schoolroom and was playing at cooking with
them’ (they were two little girls). ‘A letter was
brought in that had just been left by the postman. I saw from the
postmark and the handwriting that it was from my mother in Glasgow
and wanted to open it and read it; but the children rushed at me,
tore the letter out of my hands and cried: "No, you
shan’t read it now! It must be for your birthday; we’ll
keep it for you!" While the children were having this game
with me there was suddenly a strong smell. They had forgotten the
pudding they were cooking and it was getting burnt. Ever since this
I have been pursued by the smell. It is there all the time and
becomes stronger when I am agitated.’