Freud - Complete Works (555 page)

Introductory Lectures On Psycho-Analysis

3362

LECTURE XIX

RESISTANCE AND REPRESSION

LADIES AND
GENTLEMEN
, - Before we can make any further progress in our
understanding of the neuroses, we stand in need of some fresh
observations. Here we have two such, both of which are very
remarkable and at the time when they were made were very
surprising. Our discussions of last year will, it is true, have
prepared you for both of them.

   In the first place, then, when we
undertake to restore a patient to health, to relieve him of the
symptoms of his illness, he meets us with a violent and tenacious
resistance, which persists throughout the whole length of the
treatment. This is such a strange fact that we cannot expect it to
find much credence. It is best to say nothing about it to the
patient’s relatives, for they invariably regard it as an
excuse on our part for the length or failure of our treatment. The
patient, too, produces all the phenomena of this resistance without
recognizing it as such, and if we can induce him to take our view
of it and to reckon with its existence, that already counts as a
great success. Only think of it! The patient, who is suffering so
much from his symptoms and is causing those about him to share his
sufferings, who is ready to undertake so many sacrifices in time,
money, effort and self-discipline in order to be freed from those
symptoms we are to believe that this same patient puts up a
struggle in the interest of his illness against the person who is
helping him. How improbable such an assertion must sound! Yet it is
true; and when its improbability is pointed out to us, we need only
reply that it is not without analogies. A man who has gone to the
dentist because of an unbearable toothache will nevertheless try to
hold the dentist back when he approaches the sick tooth with a pair
of forceps.

   The patient’s resistance is
of very many sorts, extremely subtle and often hard to detect; and
it exhibits protean changes in the forms in which it manifests
itself. The doctor must be distrustful and remain on his guard
against it.

   In psycho-analytic therapy we
make use of the same technique that is familiar to you from
dream-interpretation. We instruct the patient to put himself into a
state of quiet, unreflecting self-observation, and to report to us
whatever internal perceptions he is able to make - feelings,
thoughts, memories in the order in which they occur to him. At the
same time we warn him expressly against giving way to any motive
which would lead him to make a selection among these associations
or to exclude any of them, whether on the ground that it is too
disagreeable
or too
indiscreet
to say, or that it is
too
unimportant
or
irrelevant
, or that it is
nonsensical
and need not be said. We urge him always to
follow only the surface of his consciousness and to leave aside any
criticism of what he finds, whatever shape that criticism may take;
and we assure him that the success of the treatment, and above all
its duration, depends on the conscientiousness with which he obeys
this fundamental technical rule of analysis. We already know from
the technique of dream-interpretation that the associations giving
rise to the doubts and objections I have just enumerated are
precisely the ones that invariably contain the material which leads
to the uncovering of the unconscious.

Introductory Lectures On Psycho-Analysis

3363

   The first thing we achieve by
setting up this fundamental technical rule is that it becomes the
target for the attacks of the resistance. The patient endeavours in
every sort of way to extricate himself from its provisions. At one
moment he declares that nothing occurs to him, at the next that so
many things are crowding in on him that he cannot get hold of
anything. Presently we observe with pained astonishment that he has
given way first to one and then to another critical objection: he
betrays this to us by the long pauses that he introduces into his
remarks. He then admits that there is something he really cannot
say - he would be ashamed to; and he allows this reason to prevail
against his promise. Or he says that something has occurred to him,
but it concerns another person and not himself and is therefore
exempt from being reported. Or, what has now occurred to him is
really too unimportant, too silly and senseless: I cannot possibly
have meant him to enter into thoughts like that. So it goes on in
innumerable variations, and one can only reply that ‘to say
everything’ really does mean ‘to say
everything’.

   One hardly comes across a single
patient who does not make an attempt at reserving some region or
other for himself so as to prevent the treatment from having access
to it. A man, whom I can only describe as of the highest
intelligence, kept silence in this way for weeks on end about an
intimate love-affair, and, when he was called to account for having
broken the sacred rule, defended himself with the argument that he
thought this particular story was his private business. Analytic
treatment does not, of course, recognize any such right of asylum.
Suppose that in a town like Vienna the experiment was made of
treating a square such as the Hohe Markt, or a church like St.
Stephen’s, as places where no arrests might be made, and
suppose we then wanted to catch a particular criminal. We could be
quite sure of finding him in the sanctuary. I once decided to allow
a man, on whose efficiency much depended in the external world, the
right to make an exception of this kind because he was bound under
his oath of office not to make communications about certain things
to another person. He, it is true, was satisfied with the outcome;
but I was not. I determined not to repeat an attempt under such
conditions.

Introductory Lectures On Psycho-Analysis

3364

   Obsessional neurotics understand
perfectly how to make the technical rule almost useless by applying
their over-conscientiousness and doubts to it. Patients suffering
from anxiety hysteria occasionally succeed in carrying the rule
ad absurdum
by producing only associations which are so
remote from what we are in search of that they contribute nothing
to the analysis. But it is not my intention to induct you into the
handling of these technical difficulties. It is enough to say that
in the end, through resolution and perseverance, we succeed in
extorting a certain amount of obedience to the fundamental
technical rule from the resistance - which thereupon jumps over to
another sphere.

   It now appears as an
intellectual
resistance, it fights by means of arguments and
exploits all the difficulties and improbabilities which normal but
uninstructed thinking finds in the theories of analysis. It is now
our fate to hear from this single voice all the criticisms and
objections which assail our ears in a chorus in the scientific
literature of the subject. And for this reason none of the shouts
that reach us from outside sound unfamiliar. It is a regular storm
in a tea-cup. But the patient is willing to be argued with; he is
anxious to get us to instruct him, teach him, contradict him,
introduce him to the literature, so that he can find further
instruction. He is quite ready to become an adherent of
psycho-analysis - on condition that analysis spares him personally.
But we recognize this curiosity as a resistance, as a diversion
from our particular tasks, and we repel it. In the case of an
obsessional neurotic we have to expect special tactics of
resistance. He will often allow the analysis to proceed on its way
uninhibited, so that it is able to shed an ever-increasing light
upon the riddle of his illness. We begin to wonder in the end,
however, why this enlightenment is accompanied by no practical
advance, no diminution of the symptoms. We are then able to realize
that resistance has withdrawn on to the doubt belonging to the
obsessional neurosis and from that position is successfully defying
us. It is as though the patient were saying: ‘Yes,
that’s all very nice and interesting, and I’II be very
glad to go on with it further. It would change my illness a not if
it were true. But I don’t in the least believe that it
is
true; and, so long as I don’t believe it, it makes
no difference to my illness.’ Things can proceed like this
for a long time, till finally one comes up against this uncommitted
attitude itself, and the decisive struggle then breaks out.

Introductory Lectures On Psycho-Analysis

3365

   Intellectual resistances are not
the worst; one always remains superior to them. But the patient
also knows how to put up resistances, without going outside the
framework of the analysis, the overcoming of which is among the
most difficult of technical problems. Instead of remembering, he
repeats
attitudes and emotional impulses from his early life
which can be used as a resistance against the doctor and the
treatment by means of what is known as ‘transference’.
If the patient is a man, he usually extracts this material from his
relation to his father, into whose place he fits the doctor, and in
that way he makes resistances out of his efforts to become
independent in himself and in his judgements, out of his ambition,
the first aim of which was to do things as well as his father or to
get the better of him, or out of his unwillingness to burden
himself for the second time in his life with a load of gratitude.
Thus at times one has an impression that the patient has entirely
replaced his better intention of making an end to his illness by
the alternative one of putting the doctor in the wrong, of making
him realize his impotence and of triumphing over him. Women have a
masterly gift for exploiting an affectionate, erotically tinged
transference to the doctor for the purposes of resistance. If this
attachment reaches a certain height, all their interest in the
immediate situation in the treatment and all the obligations they
undertook at its commencement vanish; their jealousy, which is
never absent, and their exasperation at their inevitable rejection,
however considerately expressed, are bound to have a damaging
effect on their personal understanding with the doctor and so to
put out of operation one of the most powerful motive forces of the
analysis.

Introductory Lectures On Psycho-Analysis

3366

   Resistances of this kind should
not be one-sidedly condemned. They include so much of the most
important material from the patient’s past and bring it back
in so convincing a fashion that they become some of the best
supports of the analysis if a skilful technique knows how to give
them the right turn. Nevertheless, it remains a remarkable fact
that this material is always in the service of the resistance to
begin with and brings to the fore a
façade
that is
hostile to the treatment. It may also be said that what is being
mobilized for fighting against the alterations we are striving for
are character-traits, attitudes of the ego. In this connection we
discover that these character-traits were formed in relation to the
determinants of the neurosis and in reaction against its demands,
and we come upon traits which cannot normally emerge, or not to the
same extent, and which may be described as latent. Nor must you get
an impression that we regard the appearance of these resistances as
an unforeseen risk to analytic influence. No, we are aware that
these resistances are bound to come to light; in fact we are
dissatisfied if we cannot provoke them clearly enough and are
unable to demonstrate them to the patient. Indeed we come finally
to understand that the overcoming of these resistances is the
essential function of analysis and is the only part of our work
which gives us an assurance that we have achieved something with
the patient.

   If you further consider that the
patient makes all the chance events that occur during his analysis
into interferences with it, that he uses as reasons for slackening
his efforts every diversion outside the analysis, every comment by
a person of authority in his environment who is hostile to
analysis, any chance organic illness or any that complicates his
neurosis and, even, indeed, every improvement in his condition - if
you consider all this, you will have obtained an approximate,
though still in complete, picture of the forms and methods of the
resistance, the struggle against which accompanies every
analysis.

Introductory Lectures On Psycho-Analysis

3367

   I have treated this point in such
great detail because I must now inform you that this experience of
ours with the resistance of neurotics to the removal of their
symptoms became the basis of our dynamic view of the neuroses.
Originally Breuer and I myself carried out psychotherapy by means
of hypnosis; Breuer’s first patient was treated throughout
under hypnotic influence, and to begin with I followed him in this.
I admit that at that period the work proceeded more easily and
pleasantly, and also in a much shorter time. But results were
capricious and not lasting; and for that reason I finally dropped
hypnosis. And I then understood that an insight into the dynamics
of these illnesses had not been possible so long as hypnosis was
employed. That state was precisely able to withhold the existence
of the resistance from the doctor’s perception. It pushed the
resistance back, making a certain area free for analytic work, and
dammed it up at the frontiers of that area in such a way as to be
impenetrable, just as doubt does in obsessional neurosis. For that
reason I have been able to say that psycho-analysis proper began
when I dispensed with the help of hypnosis.