Freud - Complete Works (554 page)

   But that is not all. Thanks to a
second discovery of Breuer’s, which seems to me even more
significant than the other and which he shared with no one, we
learn still more of the connection between neurotic symptoms and
the unconscious. Not only is the sense of the symptoms regularly
unconscious, but there is an inseparable relation between this fact
of the symptoms being unconscious and the possibility of their
existing. You will understand me in a moment. I follow Breuer in
asserting that every time we come upon a symptom we can infer that
there are certain definite unconscious processes in the patient
which contain the sense of the symptom. But it is also necessary
for that sense to be unconscious in order that the symptom can come
about. Symptoms are never constructed from conscious processes; as
soon as the unconscious processes concerned have become conscious,
the symptom must disappear. Here you will at once perceive a means
of approach to therapy, a way of making symptoms disappear. And in
this way Breuer did in fact restore his hysterical patient - that
is, freed her from her symptoms; he found a technique for bringing
to her consciousness the unconscious processes which contained the
sense of the symptoms, and the symptoms disappeared.

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   This discovery of Breuer’s
was not the result of speculation but of a fortunate observation
made possible by the patient’s co-operation. Nor should you
torment yourselves with attempts at understanding it by tracing it
back to something already known; you should recognize in it a new
fundamental fact, by whose help much else will become explicable.
Allow me, therefore, to repeat the same thing to you in another
way.

   The construction of a symptom is
a substitute for something else that did not happen. Some
particular mental processes should normally have developed to a
point at which consciousness received information of them. This,
however, did not take place, and instead - out of the interrupted
processes, which had been somehow disturbed and were obliged to
remain unconscious - the symptom emerged. Thus something in the
nature of an exchange has taken place; if this can be reversed the
therapy of the neurotic symptoms will have achieved its task.

   This discovery of Breuer’s
is still the foundation of psycho-analytic therapy. The thesis that
symptoms disappear when we have made their unconscious
predeterminants conscious has been confirmed by all subsequent
research, although we meet with the strangest and most unexpected
complications when we attempt to carry it through in practice. Our
therapy works by transforming what is unconscious into what is
conscious, and it works only in so far as it is in a position to
effect that transformation.

   And now I must quickly make a
short digression, to avoid the risk of your imagining that this
therapeutic work is accomplished too easily. From what I have so
far said a neurosis would seem to be the result of a kind of
ignorance - a not knowing about mental events that one ought to
know of. This would be a close approximation to some well-known
Socratic doctrines, according to which even vices are based on
ignorance. Now it would as a rule be very easy for a doctor
experienced in analysis to guess what mental impulses had remained
unconscious in a particular patient. So it ought not to be very
difficult, either, for him to restore the patient by communicating
his knowledge to him and so remedying his ignorance. One part at
least of the symptom’s unconscious sense could be easily
dealt with in this way, though it is true that the doctor cannot
guess much about the other part - the connection between the
symptoms and the patient’s experiences -, since he himself
does not know those experiences but must wait till the patient
remembers them and tells them to him. But even for this a
substitute can in some instances be found. One can make enquiries
about these experiences from the patient’s relatives and they
will often be able to recognize which of them had a traumatic
effect, and they can even sometimes report experiences of which the
patient himself knows nothing because they occurred at a very early
period of his life. Thus, by combining these two methods, we should
have a prospect of relieving the patient of his pathogenic
ignorance with little expense of time or trouble.

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   If only that was how things
happened! We came upon discoveries in this connection for which we
were at first unprepared. Knowledge is not always the same as
knowledge: there are different sorts of knowledge, which are far
from equivalent psychologically. ‘Il y a fagots et
fagots’, as Molière has said. The doctor’s
knowledge is not the same as the patient’s and cannot produce
the same effects. If the doctor transfers his knowledge to the
patient as a piece of information, it has no result. No, it would
be wrong to say that. It does not have the result of removing the
symptoms, but it has another one - of setting the analysis in
motion, of which the first signs are often expressions of denial.
The patient knows after this what he did not know before - the
sense of his symptom; yet he knows it just as little as he did.
Thus we learn that there is more than one kind of ignorance. We
shall need to have a somewhat deeper understanding of psychology to
show us in what these differences consist. But our thesis that the
symptoms vanish when their sense is known remains true in spite of
this. All we have to add is that the knowledge must rest on an
internal change in the patient such as can only be brought about by
a piece of psychical work with a particular aim. We are faced here
by problems which will presently be brought together into the
dynamics
of the construction of symptoms.

   I must ask now, Gentlemen,
whether what I am saying to you is not too obscure and complicated.
Am I not confusing you by so often taking back what I have said or
qualifying it by starting up trains of thought and then dropping
them? I should be sorry if that were so. But I have a strong
dislike of simplifying things at the expense of truthfulness. I
have no objection to your receiving the full impact of the
many-sidedness and complexity of our subject; and I think, too,
that it does no harm if I tell you more on every point than you can
at the moment make use of. I am aware, after all, that every
listener or reader puts what is presented to him into shape in his
mind, shortens it and simplifies it, and selects from it what he
would like to retain. Up to a certain point it is no doubt true
that the more there is at one’s disposal the more one is left
with. Permit me to hope that, in spite of all the trimmings, you
have clearly grasped the essential part of what I have told you -
about the sense of symptoms, about the unconscious and about the
relation between them. No doubt you have also understood that our
further efforts will lead in two directions: first towards
discovering how people fall ill and how they can come to adopt the
neurotic attitude to life - which is a clinical problem; and
secondly towards learning how the pathological symptoms develop
from the determinants of the neurosis which remains a problem of
mental dynamics. There must moreover be a point somewhere at which
the two problems converge.

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   I will not go into this any
further to-day. But since we still have some time to spare, I
should like to direct your attention to another characteristic of
our two analyses, which, once again, it will only be possible to
appreciate fully later on - to the gaps in the patients’
memories, their amnesias. As you have heard, the task of a
psycho-analytic treatment can be expressed in this formula: its
task is to make conscious everything that is pathogenically
unconscious. You will perhaps be surprised to learn, then, that
this formula can be replaced by another one: its task is to fill up
all the gaps in the patient’s memory, to remove his amnesias.
This would amount to the same thing. We are thus implying that the
amnesias of neurotic patients have an important connection with the
origin of their symptoms. If, however, you consider the case of our
first analysis you will not find this view of amnesia justified.
The patient had
not
forgotten the scene from which her
obsessive action was derived; on the contrary, she had a vivid
recollection of it; nor did anything else forgotten play a part in
the origin of the symptom. The position with our second patient
(the girl with the obsessional ceremonial), though less clear, was
on the whole analogous. She had not really forgotten her behaviour
in earlier years - the fact that she had insisted on the door
between her parents’ bedroom and her own being left open and
that she had driven her mother out of her place in her
parents’ bed; she remembered this very plainly, even though
with hesitation and unwillingly. The only thing we can consider
striking is that the first patient, in carrying out her obsessional
action on countless occasions, had never
once
noticed its
resemblance to her experience on her wedding-night, and that the
memory of it did not occur to her when she was directly asked to
look for the motives of her obsessional action. And the same thing
applies to the girl, whose ceremonial and its causes were moreover
connected with a situation which was identically repeated every
evening. In both these cases there was no true amnesia, no missing
memory; but a connection had been broken which ought to have led to
the reproduction or re-emergence of the memory.

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   A disturbance of memory of this
kind is enough for obsessional neurosis; but the case is different
with hysteria. As a rule the latter neurosis is marked by amnesias
on a really large scale. In analysing each separate hysterical
symptom one is usually led to a whole chain of impressions of
events, which, when they recur, are expressly described by the
patient as having been till then forgotten. On the one hand, this
chain reaches back to the earliest years of life, so that the
hysterical amnesia can be recognized as an immediate continuation
of the infantile amnesia which, for us normal people, conceals the
beginnings of our mental life. On the other hand, we learn with
astonishment that even the patient’s most recent experiences
can be subject to forgetting, and that the occasions which
precipitated the outbreak of the illness or led to its
intensification are in particular encroached upon, if not
completely swallowed up, by amnesia. It regularly happens that
important details have disappeared from the total picture of a
recent recollection of this sort or that they have been replaced by
falsifications of memory. Indeed it happens with almost equal
regularity that certain memories of recent experiences only emerge
shortly before the end of an analysis memories which had been held
back till that late moment and had left perceptible gaps in the
continuity of the case.

   Such restrictions upon the
faculty of memory are, as I have said, characteristic of hysteria,
in which, indeed, states also arise as symptoms - hysterical
attacks - which need leave no trace behind them in the memory. If
things are different in obsessional neurosis, you may conclude that
what we are dealing with in these amnesias is a psychological
characteristic of the change that occurs in hysteria and is not a
universal feature of neuroses in general. The importance of this
distinction is reduced by the following consideration. We have
comprised two things as the ‘sense’ of a symptom: its
‘whence’ and its ‘whither’ or ‘what
for’ - that is, the impressions and experiences from which it
arose and the intentions which it serves. Thus the
‘whence’ of a symptom resolves itself into impressions
which came from outside, which were necessarily once conscious and
may have since become unconscious through forgetting. The
‘whither’ of a symptom, its purpose, is invariably,
however, an endopsychic process, which may possibly have been
conscious at first but may equally well never have been conscious
and may have remained in the unconscious from the very start. Thus
it is not of great importance whether the amnesia has laid hold on
the ‘whence’ as well - the experiences on which the
symptom is supported - as happens in hysteria; it is on the
‘whither’, the purpose of the symptom, which may have
been unconscious from the beginning, that its dependence on the
unconscious is founded - and no less firmly in obsessional neurosis
than in hysteria.

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   But in thus emphasizing the
unconscious in mental life we have conjured up the most evil
spirits of criticism against psycho-analysis. Do not be surprised
at this, and do not suppose that the resistance to us rests only on
the understandable difficulty of the unconscious or the- relative
inaccessibility of the experiences which provide evidence of it.
Its source, I think, lies deeper. In the course of centuries the
naïve
self-love of men has had to submit to two major
blows at the hands of science. The first was when they learnt that
our earth was not the centre of the universe but only a tiny
fragment of a cosmic system 0; scarcely imaginable vastness. This
is associated in our mind: with the name of Copernicus, though
something similar had already been asserted by Alexandrian science.
The second blow fell when biological research destroyed man’s
supposedly privileged place in creation and proved his descent from
the animal kingdom and his ineradicable animal nature. This
revaluation has been accomplished in our own days by Darwin,
Wallace and their predecessors, though not without the most violent
contemporary opposition. But human megalomania will have suffered
its third and most wounding blow from the psychological research of
the present time which seeks to prove to the ego that it is not
even master in its own house, but must content itself with scanty
information of what is going on unconsciously in its mind. We
psycho-analysts were not the first and not the only ones to utter
this call to introspection; but it seems to be our fate to give it
its most forcible expression and to support it with empirical
material which affects every individual. Hence arises the general
revolt against our science, the disregard of all considerations of
academic civility and the releasing of the opposition from every
restraint of impartial logic. And beyond all this we have yet to
disturb the peace of this world in still another way, as you will
shortly hear.