Freud - Complete Works (553 page)

Introductory Lectures On Psycho-Analysis

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   So we are now faced by the
depressing discovery that, though we can give a satisfactory
explanation of the individual neurotic symptoms by their connection
with experiences, our skill leaves us in the lurch when we come to
the far more frequent typical symptoms. Furthermore, I am far from
having made you acquainted with all the difficulties that arise
when consistently pursuing the historical interpretation of
symptoms. Nor do I intend to do so; for, though it is my intention
not to gloss things over to you or conceal them, I cannot throw you
into perplexity and confusion at the very beginning of our common
studies. It is true that we have only made a beginning with our
efforts at understanding the significance of symptoms; but we will
hold fast to what we have achieved and pursue our way step by step
to a mastery of what we have not yet understood. I will try to
console you, therefore, with the reflection that any fundamental
distinction between one kind of symptom and the other is scarcely
to be assumed. If the individual symptoms are so unmistakably
dependent on the patient’s experience, it re mains possible
that the typical symptoms may go back to an experience which is in
itself typical - common to all human beings. Other features which
recur regularly in neuroses may be general reactions which are
imposed on the patients by the nature of their pathological change,
like the repetitions or doubts in obsessional neurosis. In short,
we have no grounds for premature despair; we shall see what remains
to be seen.

   A quite similar difficulty faces
us in the theory of dreams. I could not deal with it in our earlier
discussions on dreams. The manifest content of dreams is of the
greatest diversity and individual variety, and we have shown in
detail what one derives from this content by means of analysis. But
alongside of these there are dreams which equally deserve to be
called ‘typical’, which happen in everyone in the same
way, dreams with a uniform content, which offer the same
difficulties to interpretation. They are dreams of falling, flying,
floating, swimming, of being inhibited, of being naked and certain
other anxiety dreams - which lead, in different people, now to this
and now to that interpretation, without any light being thrown on
their monotony and typical occurrence. But in these dreams too we
observe that this common background is enlivened by additions that
vary individually; and it is probable that, with a widening of our
knowledge, it will be possible, without constraint, to include
these dreams too in the understanding of dream-life which we have
acquired from other dreams.

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LECTURE XVIII

FIXATION TO TRAUMAS - THE UNCONSCIOUS

LADIES AND
GENTLEMEN
, - In my last lecture I expressed a desire that
our work should go forward on the basis not of our doubts but of
our discoveries. We have not yet had any discussion of two of the
most interesting implications that follow from our two sample
analyses.

   To take the first of these. Both
patients give us an impression of having been ‘fixated’
to a particular portion of their past, as though they could not
manage to free themselves from it and were for that reason
alienated from the present and the future. They then remained
lodged in their illness in the sort of way in which in earlier days
people retreated into a monastery in order to bear the burden there
of their ill-fated lives. What had brought this fate upon our first
patient was the marriage which she had in real life abandoned. By
means of her symptoms she continued to carry on her dealings with
her husband. We learnt to understand the voices that pleaded for
him, that excused him, that put him on a pedestal and that lamented
his loss. Although she was young and desirable to other men, she
had taken every precaution, real and imaginary (magical), to remain
faithful to him. She did not show herself to strangers and she
neglected her personal appearance; furthermore, once she had sat
down in a chair she was unable to get out of it quickly, she
refused to sign her name, and she could not make any presents, on
the ground that no one ought to receive anything from her.

   The same effect was produced on
the life of our second patient, the young girl, by an erotic
attachment to her father which had started during the years before
her puberty. The conclusion she herself drew was that she could not
marry as long as she was so ill. We, however, may suspect that she
had become so ill in order not to have to marry and in order to
remain with her father.

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   We cannot dismiss the question of
why, in what way and for what motive a person can arrive at such a
remarkable attitude to life and one that is so inexpedient -
assuming that this attitude is a general characteristic of neuroses
and not a special peculiarity of these two patients. And in fact it
is a general feature, of great practical importance, in every
neurosis. Breuer’s first hysterical patient was similarly
fixated to the period when she was nursing her father in a serious
illness. In spite of her recovery, in a certain respect she
remained cut off from life; she remained healthy and efficient but
avoided the normal course of a woman’s life. In every one of
our patients, analysis shows us that they have been carried back to
some particular period of their past by the symptoms of their
illness or their consequences. In the majority of cases, indeed, a
very early phase of life is chosen for the purpose - a period of
their childhood or even, laughable as this may sound, of their
existence as an infant at the breast.

   The closest analogy to this
behaviour of our neurotics is afforded by illnesses which are being
produced with special frequency precisely at the present time by
the war - what are described as traumatic neuroses. Similar cases,
of course, appeared before the war as well, after railway
collisions and other alarming accidents involving fatal risks.
Traumatic neuroses are not in their essence the same thing as the
spontaneous neuroses which we are in the habit of investigating and
treating by analysis; nor have we yet succeeded in bringing them
into harmony with our views, and I hope I shall be able at some
time to explain to you the reason for this limitation. But in one
respect we may insist that there is a complete agreement between
them. The traumatic neuroses give a clear indication that a
fixation to the moment of the traumatic accident lies at their
root. These patients regularly repeat the traumatic situation in
their dreams; where hysteriform attacks occur that admit of an
analysis, we find that the attack corresponds to a complete
transplanting of the patient into the traumatic situation. It is as
though these patients had not finished with the traumatic
situation, as though they were still faced by it as al immediate
task which has not been dealt with; and we take this view quite
seriously. It shows us the way to what we may call an
economic
view of mental processes. Indeed, the term
‘traumatic’ has no other sense than an economic one. We
apply it to an experience which within a short period of time
presents the mind with an increase of stimulus too powerful to be
dealt with or worked off in the normal way, and this must result in
permanent disturbances of the manner in which the energy
operates.

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   This analogy is bound to tempt us
to describe as traumatic those experiences too to which our
neurotic patients seem to be fixated. This would promise to offer
us a simple determinant for the onset of neurosis. Neurosis could
then be equated with a traumatic illness and would come about owing
to inability to deal with an experience whose affective colouring
was excessively powerful. And this indeed was actually the first
formula in which (in 1893 and 1895) Breuer and I accounted
theoretically for our new observations. A case like that of the
first of the two patients in my last lecture - the young married
woman separated from her husband - fits in very well with this
view. She had not got over the failure of her marriage and remained
attached to that trauma. But our second case - that of the girl
with a fixation upon her father - shows us already that the formula
is not sufficiently comprehensive. On the one hand, a little
girl’s being in love like this with her father is something
so common and so frequently surmounted that the term
‘traumatic’ applied to it would lose all its meaning;
and, on the other hand, the patient’s history showed us that
in the first instance her erotic fixation appeared to have passed
off without doing any damage, and it was only several years later
that it reappeared in the symptoms of the obsessional neurosis.
Here, then, we foresee complications, a greater wealth of
determinants for the onset of illness; but we may also suspect that
there is no need to abandon the traumatic line of approach as being
erroneous: it must be possible to fit it in and subsume it
somewhere else.

   Here once more, then, we must
break off the course we have started on. For the moment it leads no
further and we shall have to learn all kinds of other things before
we can find its proper continuation. But on the subject of fixation
to a particular phase in the past we may add that such behaviour is
far more widespread than neurosis. Every neurosis includes a
fixation of that kind, but not every fixation leads to a neurosis,
coincides with a neurosis or arises owing to a neurosis. A perfect
model of an affective fixation to something that is past is
provided by mourning, which actually involves the most complete
alienation from the present and the future. But even the judgement
of a layman will distinguish sharply between mourning and neurosis.
There are, on the other hand, neuroses which may be described as a
pathological form of mourning.

   It may happen, too, that a person
is brought so completely to a stop by a traumatic event which
shatters the foundations of his life that he abandons all interest
in the present and future and remains permanently absorbed in
mental concentration upon the past. But an unfortunate such as this
need not on that account become a neurotic. We will not attach too
much value to this one feature, therefore, in characterizing
neurosis, however regularly present and however important it may
usually be.

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   Let us turn now to the second of
the discoveries which follow from our analyses; in its case we need
not fear having to make a subsequent qualification of our views. I
have described to you how our first patient carried out a senseless
obsessional action and how she reported an intimate memory from her
past life as having some connection with it: and how afterwards I
examined the connection between the two and discovered the
intention of the obsessional action from its relation to the
memory. But there is one factor which I have entirely neglected,
though it deserves our fullest attention. However often the patient
repeated her obsessional action, she knew nothing of its being
derived from the experience she had had. The connection between the
two was hidden from her; she could only quite truthfully reply that
she did not know what it was that was making her carry out her
action. Then suddenly one day, under the influence of the
treatment, she succeeded in discovering the connection and reported
it to me. But she still knew nothing of the intention with which
she was performing the obsessional action - the intention of
correcting a distressing portion of the past and of putting her
beloved husband in a better light. It took a fairly long time and
called for much labour before she understood and admitted to me
that such a motive alone could have been the driving force of her
obsessional action.

   The link with the scene after her
unhappy wedding-night and the patient’s affectionate motive
constituted, taken together, what we have called the
‘sense’ of the obsessional action. But while she was
carrying out the obsessional action this sense had been unknown to
her in both directions - both its ‘whence’ and its
‘whither’. Mental processes had therefore been at work
in her and the obsessional action was the effect of them; she had
been aware of this effect in a normal mental fashion, but none of
the mental predeterminants of this effect came to the knowledge of
her consciousness. She behaved in precisely the same way as a
hypnotized subject whom Bernheim had ordered to open an umbrella in
the hospital ward five minutes after he woke up. The man carried
out this instruction when he was awake, but he could produce no
motive for his action. It is a state of affairs of this sort that
we have before our eyes when we speak of the existence of
unconscious mental processes
. We can challenge anyone in the
world to give a more correct scientific account of this state of
affairs, and if he does we will gladly renounce our hypothesis of
unconscious mental processes. Till that happens, however, we will
hold fast to the hypothesis; and if someone objects that here the
unconscious is nothing real in a scientific sense, is a makeshift,
une façon de parler
, we can only shrug our shoulders
resignedly and dismiss what he says as unintelligible. Something
not real, which produces effects of such tangible reality as an
obsessional action!

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   And we meet with what is in
essence the same thing in our second patient. She had made a rule
that the pillow must not touch the back of the bedstead, and she
had to obey this rule though she did not know where it came from,
what it meant or to what motives it owed its power. Whether she
herself regarded the rule as a matter of indifference, or whether
she struggled against it or raged against it or decided to
transgress it - none of this made any difference to her carrying it
out. It had to be obeyed, and she asked herself vainly why. We must
recognize, however, that these symptoms of obsessional neurosis,
these ideas and impulses which emerge one knows not whence, which
prove so resistant to every influence from an otherwise normal
mind, which give the patient himself the impression of being
all-powerful guests from an alien world, immortal beings intruding
into the turmoil of mortal life - these symptoms offer the plainest
indication of there being a special region of the mind, shut off
from the rest. They lead, by a path that cannot be missed, to a
conviction of the existence of the unconscious in the mind; and
that is precisely why clinical psychiatry, which is acquainted only
with a psychology of consciousness, can deal with these symptoms in
no other way than by declaring them to be signs of a special sort
of degeneracy. Obsessional ideas and obsessional impulses are not,
of course, themselves unconscious, any more than the performance of
obsessional actions escapes conscious perception. They would not
have become symptoms if they had not forced their way into
consciousness. But their psychical predeterminants which we infer
by means of analysis, the connections into which we insert them by
interpretation, are unconscious, at least until we have made them
conscious to the patient by the work of analysis.

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   If, now, you consider further
that the state of affairs which we have established in our two
cases is confirmed for every symptom of every neurotic illness -
that always and everywhere the sense of the symptoms is unknown to
the patient and that analysis regularly shows that these symptoms
are derivatives of unconscious processes but can, subject to a
variety of favourable circumstances, be made conscious - if you
consider this, you will understand that in psycho-analysis we
cannot do without what is at the same time unconscious and mental,
and are accustomed to operate with it as though it were something
palpable to the senses. But you will understand as well, perhaps,
how incapable of forming a judgement on this question are all those
other people, who are only acquainted with the unconscious as a
concept, who have never carried out an analysis and have never
interpreted dreams or found a sense and intention in neurotic
symptoms. To say it for our ends once again: the possibility of
giving a sense to neurotic symptoms by analytic interpretation is
an unshakeable proof of the existence - or, if you prefer it, of
the necessity for the hypothesis - of unconscious mental
processes.