Freud - Complete Works (550 page)

Introductory Lectures On Psycho-Analysis

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   But can psycho-analysis do more
here? Yes, it actually can. I hope to be able to show you that,
even in a case so hard of access as this, it can discover something
which makes a first understanding possible. And to begin with I
would draw your attention to the inconspicuous detail that the
patient herself positively provoked the anonymous letter, which now
gave support to her delusion, by informing the scheming housemaid
on the previous day that it would cause her the greatest
unhappiness if her husband had a love affair with a young girl. In
this way she first put the notion of sending the anonymous Letter
into the housemaid’s head. Thus the delusion acquires a
certain independence of the letter; it had been present already in
the patient as a fear - or was it as a wish? Let us now add to this
the small further indications yielded by only two analytic
sessions. The patient, indeed, behaved in a very unco-operative way
when, after telling me her story, she was asked for her further
thoughts, ideas and memories. She said that nothing occurred to
her, that she had told me everything already, and after two
sessions the experiment with me had in fact to be broken off
because she announced that she already felt well and that she was
sure the pathological idea would not come back. She only said this,
of course, from resistance and from dread of the continuation of
the analysis. Nevertheless, during these two sessions she let fall
a few remarks which allowed of, and indeed necessitated, a
particular interpretation; and this interpretation threw a clear
light on the genesis of her delusion of jealousy. She herself was
intensely in love with a young man, with the same son-in-law who
had persuaded her to come to me as a patient. She herself knew
nothing, or perhaps only a very little, of this love; in the family
relationship that existed between them it was easy for this
passionate liking to disguise itself as innocent affection. After
all our experiences elsewhere, it is not hard for us to feel our
way into the mental life of this upright wife and worthy mother, of
the age of fifty-three. Being in love like this, a monstrous and
impossible thing, could not become conscious; but it remained in
existence and, even though it was unconscious, it exercised a
severe pressure. Something had to become of it, some relief had to
be looked for; and the easiest mitigation was offered, no doubt, by
the mechanism of displacement which plays a part so regularly in
the generating of delusional jealousy. If not only were she, the
old woman, in love with a young man, but if also her old husband
were having a love affair with a young girl, then her conscience
would be relieved of the weight of her unfaithfulness. The phantasy
of her husband’s unfaithfulness thus acted as a cooling
compress on her burning wound. Her own love had not become
conscious to her, but its mirror-reflection, which brought her such
an advantage, now became conscious as an obsession and delusion. No
arguments against it could, of course, have any effect, for they
were only directed against the mirror-image and not against the
original which gave the other its strength and which lay hidden,
inviolable, in the unconscious.

Introductory Lectures On Psycho-Analysis

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   Let us now bring together what
this effort at a psycho-analysis, short and impeded as it was, has
brought to light for an understanding of this case - assuming, of
course, that our enquiries were correctly carried out, which I
cannot here submit to your judgement. Firstly, the delusion has
ceased to be absurd or unintelligible; it had a sense, it had good
motives and it fitted into the context of an emotional experience
of the patient’s. Secondly, the delusion was necessary, as a
reaction to an unconscious mental process which we have inferred
from other indications, and it was precisely to this connection
that it owed its delusional character and its resistance to every
logical and realistic attack. It itself was something desired, a
kind of consolation. Thirdly, the fact that the delusion turned out
to be precisely a jealous one and not one of another kind was
unambiguously determined by the experience that lay behind the
illness. You recall of course that, the day before, she had told
the scheming maid that the most dreadful thing that could happen to
her would be her husband’s unfaithfulness. Nor will you have
overlooked the two important analogies between this case and the
symptomatic action which we analysed - the explanation of its sense
or intention and its relation to something unconscious that was
involved in the situation.

   Naturally this does not answer
all the questions that we might ask in connection with this case.
On the contrary, the case bristles with further problems-some that
have in general not yet become soluble and others which could not
be solved owing to the particular circumstances being unfavourable.
For instance, why did this lady who was happily married fall in
love with her son-in-law? and why did the relief, which might have
been possible in other ways, take the form of this mirror-image
this projection of her state on to her husband? You must no: think
it is otiose or frivolous to raise such questions. We already have
some material at our disposal which might possibly serve to answer
them. The lady was at a critical age, at which sexual needs in
women suffer a sudden and undesired increase; that alone might
account for the event. Or it may further have been that her
excellent and faithful husband had for some years no longer enjoyed
the sexual capacity which the well-preserved woman required for her
satisfaction. Experience has shown us that it is precisely men in
this position, whose faithfulness can consequently be taken for
granted, who are distinguished by treating their wives with unusual
tenderness, and by showing particular forbearance for their nervous
troubles. Or, again, it may not be without significance that the
object of this pathogenic love was precisely the young husband of
one of her daughters. A powerful erotic tie with a daughter, which
goes back in the last resort to the mother’s sexual
constitution, often finds a way of persisting in a transformation
of this sort. In this connection I may perhaps remind you that the
relation between mother-in-law and son-in-law has been regarded
from the earliest times of the human race as a particularly awkward
one and that among primitive people it has given rise to very
powerful taboo regulations and ‘avoidances’. The
relation is frequently excessive by civilized standards both in a
positive and negative direction. Which of these three factors
became operative in our case, or whether two of them or perhaps all
three came together, I cannot, it is true, tell you; but that is
only because I was not permitted to continue the analysis of the
case for more than two sessions.

Introductory Lectures On Psycho-Analysis

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   I notice now, Gentlemen, that I
have been talking to you about a number of things which you are not
yet prepared to understand. I did so in order to carry out the
comparison between psychiatry and psycho-analysis. But there is one
thing that I can ask you now. Have you observed any sign of a
contradiction between them? Psychiatry does not employ the
technical methods of psycho-analysis; it omits to make any
inferences from the
content
of the delusion, and, in
pointing to heredity, it gives us a very general and remote
aetiology instead of indicating first the more special and
proximate causes. But is there a contradiction, an opposition in
this? Is it not rather a case of one supplementing the other? Does
the hereditary factor contradict the importance of experience? Do
not the two things rather combine in the most effective manner? You
will grant that there is nothing in the nature of psychiatric work
which could be opposed to psycho-analytic research. What is opposed
to psycho-analysis is not psychiatry but psychiatrists.
Psycho-analysis is related to psychiatry approximately as histology
is to anatomy: the one studies the external forms of the organs,
the other studies their construction out of tissues and cells. It
is not easy to imagine a contradiction between these two species of
study, of which one is a continuation of the other. To-day, as you
know, anatomy is regarded by us as the foundation of scientific
medicine. But there was a time when it was as much forbidden to
dissect the human cadaver in order to discover the internal
structure of the body as it now seems to be to practise
psycho-analysis in order to learn about the internal mechanism of
the mind. It is to be expected that in the not too distant future
it will be realized that a scientifically based psychiatry is not
possible without a sound knowledge of the deeper-lying unconscious
processes in mental life.

Introductory Lectures On Psycho-Analysis

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   Perhaps, however, the much-abused
psycho-analysis has friends among you who will be pleased if it can
be justified from another direction - from the therapeutic side. As
you know, our psychiatric therapy is not hitherto able to influence
delusions. Is it possible, perhaps, that psycho-analysis can do so,
thanks to its insight into the mechanism of these symptoms? No,
Gentlemen, it cannot. It is as powerless (for the time being at
least) against these ailments as any other form of therapy.
We
can understand, indeed, what has happened in the patient,
but we have no means of making the patient himself understand it.
You have heard how I was unable to pursue the analysis of this
delusion beyond a first beginning. Will you be inclined to maintain
on that account that an analysis of such cases is to be rejected
because it is fruitless? I think not. We have a right, or rather a
duty, to carry on our research without consideration of any
immediate beneficial effect. In the end - we cannot tell where or
when - every little fragment of knowledge will be transformed into
power, and into therapeutic power as well. Even if psycho-analysis
showed itself as unsuccessful in every other form of nervous and
psychical disease as it does in delusions, it would still remain
completely justified as an irreplaceable instrument of scientific
research. It is true that in that case we should not be in a
position to practise it. The human material on which we seek to
learn, which lives, has its own will and needs its motives for
co-operating in our work, would hold back from us. Let me therefore
end my remarks to-day by informing you that there are extensive
groups of nervous disorders in which the transformation of our
better understanding into therapeutic power has actually taken
place, and that in these illnesses, which are difficult of access
by other means, we achieve, under favourable conditions, successes
which are second to no others in the field of internal
medicine.

Introductory Lectures On Psycho-Analysis

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LECTURE XVII

THE
SENSE OF SYMPTOMS

LADIES AND
GENTLEMEN
, - In the last lecture I explained to you that
clinical psychiatry takes little notice of the outward form or
content of individual symptoms, but that psycho-analysis takes
matters up at precisely that point and has established in the first
place the fact that symptoms have a sense and are related to the
patient’s experiences. The sense of neurotic symptoms was
first discovered by Josef Breuer from his study and successful cure
(between 1880 and 1882) of a case of hysteria which has since
become famous. It is true that Pierre Janet brought forward the
same evidence independently; indeed, the French worker can claim
priority of publication, for it was only a decade later (in 1893
and 1895), while he was collaborating with me, that Breuer
published his observation. In any case it may seem a matter of some
indifference who made the discovery, for, as you know, every
discovery is made more than once and none is made all at once. And,
apart from this, success does not always go along with merit:
America is not named after Columbus. The great psychiatrist Leuret
gave it as his opinion, before Breuer and Janet, that even the
delusional ideas of the insane would certainly be found to have a
sense if only we understood how to translate them. I must admit
that for a long time I was prepared to give Janet very great credit
for throwing light on neurotic symptoms, because he regarded them
as expressions of
idées inconscientes
which dominated
the patients. But since then he has expressed himself with
exaggerated reserve, as if he wanted to admit that the unconscious
had been nothing more to him than a form of words, a make shift,
une façon de parler
- that he had meant nothing real
by it. Since then I have ceased to understand Janet’s
writings; but I think he has unnecessarily forfeited much
credit.

   Thus neurotic symptoms have a
sense, like parapraxes and dreams, and, like them, have a
connection with the life of those who produce them. I should now
like to make this important discovery plainer to you by a few
examples. I can indeed only assert, I cannot prove, that it is
always and in every instance so. Anyone who looks for experiences
himself, will find convincing evidence. But for certain reasons I
shall choose these examples from cases not of hysteria but of
another, highly remarkable neurosis which is fundamentally very
much akin to it and about which I have a few introductory remarks
to make.

Introductory Lectures On Psycho-Analysis

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   This neurosis, known as
‘obsessional neurosis’, is not so popular as the
universally familiar hysteria. It is not, if I may express myself
thus, so obtrusively noisy, it behaves more like a private affair
of the patient’s, it dispenses almost entirely with somatic
phenomena, and creates all its symptoms in the mental sphere.
Obsessional neurosis and hysteria are the forms of neurotic illness
upon the study of which psycho-analysis was first built, and in the
treatment of which, too, our therapy celebrates its triumphs. But
obsessional neurosis, in which the puzzling leap from the mental to
the physical plays no part, has actually, through the efforts of
psycho-analysis, become more perspicuous and familiar to us than
hysteria, and we have learnt that it displays certain extreme
characteristics of the nature of neurosis far more glaringly.