Freud - Complete Works (651 page)

Two Encyclopaedia Articles

3923

  
The Diphasic Onset of Sexual
Development
. - Towards the end of the fifth year this early
period of sexual life normally comes to an end. It is succeeded by
a period of more or less complete
latency
, during which
ethical restraints are built up, to act as defences against the
desires of the Oedipus complex. In the subsequent period of
puberty
, the Oedipus complex is revivified in the
unconscious and embarks upon further modifications. It is only at
puberty that the sexual instincts develop to their full intensity;
but the direction of that development, as well as all the
predispositions for it, have already been determined by the early
efflorescence of sexuality during childhood which preceded it. This
diphasic development of the sexual function - in two stages,
interrupted by the latency period - appears to be a biological
peculiarity of the human species and to contain the determining
factor for the origin of neuroses.

  
The Theory of Repression
.
- These theoretical considerations, taken together with the
immediate impressions derived from analytic work, lead to a view of
the neuroses which may be described in the roughest outline as
follows. The neuroses are the expression of conflicts between the
ego and such of the sexual impulses as seem to the ego incompatible
with its integrity or with its ethical standards. Since these
impulses are not
ego-syntonic
, the ego has
repressed
them: that is to say, it has withdrawn its interest from them and
has shut them off from becoming conscious as well as from obtaining
satisfaction by motor discharge. If in the course of analytic work
one attempts to make these repressed impulses conscious, one
becomes aware of the repressive forces in the form of
resistance
. But the achievement of repression fails
particularly readily in the case of the sexual instincts. Their
dammed-up libido finds other ways out from the unconscious: for it
regresses
to earlier phases of development and earlier
attitudes towards objects, and, at weak points in the libidinal
development where there are infantile fixations, it breaks through
into consciousness and obtains discharge. What results is a
symptom
and consequently in its essence a substitutive
sexual satisfaction. Nevertheless the symptom cannot entirely
escape from the repressive forces of the ego and must therefore
submit to modifications and displacements exactly as happens with
dreams - by means of which its characteristic of being a sexual
satisfaction becomes unrecognizable. Consequently symptoms are in
the nature of compromises between the repressed sexual instincts
and the repressing ego-instincts; they represent a wish-fulfilment
for both partners to the conflict simultaneously, but one which is
incomplete for each of them. This is quite strictly true of the
symptoms of hysteria, while in the symptoms of obsessional neurosis
there is often a stronger emphasis upon the side of the repressing
function owing to the erection of reaction-formations, which are
assurances against sexual satisfaction.

Two Encyclopaedia Articles

3924

  
Transference
. - If further
proof were needed of the truth that the motive forces behind the
formation of neurotic symptoms are of a sexual nature, it would be
found in the fact that in the course of analytic treatment a
special emotional relation is regularly formed between the patient
and the physician. This goes far beyond rational limits. It varies
between the most affectionate devotion and the most obstinate
enmity and derives all of its characteristics from earlier erotic
attitudes of the patient’s which have become unconscious.
This
transference
alike in its positive and in its negative
form is used as a weapon by the resistance; but in the hands of the
physician it becomes the most powerful therapeutic instrument and
it plays a part scarcely to be over-estimated in the dynamics of
the process of cure.

  
The Corner-Stones of
Psycho-Analytic Theory
. - The assumption that there are
unconscious mental processes, the recognition of the theory of
resistance and repression, the appreciation of the importance of
sexuality and of the Oedipus complex - these constitute the
principal subject-matter of psycho-analysis and the foundations of
its theory. No one who cannot accept them all should count himself
a psycho-analyst.

  
Later History of
Psycho-Analysis
. - Psycho-analysis was carried approximately
thus far by the work of the writer of this article, who for more
than ten years was its sole representative. In 1906 the Swiss
psychiatrists Bleuler and C. G. Jung began to play a lively part in
analysis; in 1907 a first conference of its supporters took place
at Salzburg; and the young science soon found itself the centre of
interest both among psychiatrists and laymen. Its reception in
Germany, with her morbid craving for authority, was not precisely
to the credit of German science and moved even so cool a partisan
as Bleuler to an energetic protest. Yet no condemnation or
dismissal at official congresses served to hold up the internal
growth or external expansion of psycho-analysis. In the course of
the next ten years it extended far beyond the frontiers of Europe
and became especially popular in the United States of America, and
this was due in no small degree to the advocacy and collaboration
of Putnam (Boston), Ernest Jones (Toronto; later London), Flournoy
(Geneva), Ferenczi (Budapest), Abraham (Berlin), and many others
besides. The anathema which was imposed upon psycho-analysis led
its supporters to combine in an international organization which in
the present year (1922) is holding its eighth private Congress in
Berlin and now includes local groups in Vienna, Budapest, Berlin,
Holland, Zurich, London, New York, Calcutta and Moscow. This
development was not interrupted even by the World War. In 1918-19
Dr. Anton von Freund of Budapest founded the Internationaler
Psychoanalytischer Verlag, which publishes journals and books
concerned with psycho analysis, and in 1920 Dr. M. Eitingon opened
in Berlin the first psycho-analytic clinic for the treatment of
neurotics without private means. Translations of the writer’s
principal works, which are now in preparation, into French, Italian
and Spanish, testify to a growing interest in psycho-analysis in
the Latin world as well.

   Between 1911 and 1913 two
movements of divergence from psycho-analysis took place, evidently
with the object of mitigating its repellent features. One of these
(sponsored by C. G. Jung), in an endeavour to conform to ethical
standards, divested the Oedipus complex of its real significance by
giving it only a
symbolic
value, and in practice neglected
the uncovering of the forgotten and, as we may call it,
‘prehistoric’ period of childhood. The other
(originated by Alfred Adler in Vienna) reproduced many factors from
psycho-analysis under other names - repression, for instance,
appeared in a sexualized version as the ‘masculine
protest’. But in other respects it turned away from the
unconscious and the sexual instincts, and endeavoured to trace back
the development of character and of the neuroses to the ‘will
to power’, which by means of overcompensation strives to
check the dangers arising from ‘organ inferiority’.
Neither of these movements, with their systematic structures, had
any permanent influence on psycho-analysis. In the case of
Adler’s theories it soon became clear that they had very
little in common with psycho-analysis, which they were designed to
replace.

Two Encyclopaedia Articles

3925

  
More Recent Advances in
Psycho-Analysis
. - Since psycho-analysis has become the field
of work for such a large number of observers it has made advances,
both in extent and depth; but unfortunately these can receive only
the briefest mention in the present article.

  
Narcissism
. - The most
important theoretical advance has certainly been the application of
the libido theory to the repressing ego. The ego itself came to be
regarded as a reservoir of what was described as narcissistic
libido, from which the libidinal cathexes of objects flowed out and
into which they could be once more withdrawn. By the help of this
conception it became possible to embark upon the analysis of the
ego and to make a clinical distinction of the psychoneuroses into
transference neuroses
and
narcissistic
disorders. In
the former (hysteria and obsessional neurosis) the subject has at
his disposal a quantity of libido striving to be transferred on to
extraneous objects, and use is made of this in carrying out
analytic treatment; on the other hand, the narcissistic disorders
(dementia praecox, paranoia, melancholia) are characterized by a
withdrawal of the libido from objects and they are therefore
scarcely accessible to analytic therapy. But their therapeutic
inaccessibility has not prevented analysis from making the most
fruitful beginnings in the deeper study of these illnesses, which
are counted among the psychoses.

  
Development of Technique.
- After the analyst’s curiosity had, as it were, been
gratified by the elaboration of the technique of interpretation, it
was inevitable that interest should turn to the problem of
discovering the most effective way of influencing the patient. It
soon became evident that the physician’s immediate task was
to assist the patient in getting to know, and afterwards in
overcoming, the resistances which emerged in him during treatment
and of which, to begin with, he himself was unaware. And it was
found at the same time that the essential part of the process of
cure lay in the overcoming of these resistances and that unless
this was achieved no permanent mental change could be brought about
in the patient. Since the analyst’s efforts have in this way
been directed upon the patient’s resistance, analytic
technique has attained a certainty and delicacy rivalling that of
surgery. Consequently, everyone is strongly advised against
undertaking psycho-analytic treatments without a strict training,
and a physician who ventures upon them on the strength of his
medical qualification is in no respect better than a layman.

Two Encyclopaedia Articles

3926

  
Psycho-Analysis as a
Therapeutic Procedure
. - Psycho-analysis has never set itself
up as a panacea and has never claimed to perform miracles. In one
of the most difficult spheres of medical activity it is the only
possible method of treatment for certain illnesses and for others
it is the method which yields the best or the most permanent
results - though never without a corresponding expenditure of time
and trouble. A physician who is not wholly absorbed in the work of
giving help will find his labours amply repaid by obtaining an
unhoped-for insight into the complications of mental life and the
interrelations between the mental and the physical. Where at
present it cannot offer help but only theoretical understanding, it
may perhaps be preparing the way for some later, more direct means
of influencing neurotic disorders. Its province is above all the
two transference neuroses, hysteria and obsessional neurosis, in
which it has contributed to the discovery of their internal
structure and operative mechanisms; and, beyond them, all kinds of
phobias, inhibitions, deformities of character, sexual perversions
and difficulties in erotic life. Some analysts (Jelliffe, Groddeck,
Felix Deutsch) have reported too that the analytic treatment of
gross organic diseases is not unpromising, since a mental factor
not infrequently contributes to the origin and continuance of such
illnesses. Since psycho-analysis demands a certain amount of
psychical plasticity from its patients, some kind of age-limit must
be laid down in their selection; and since it necessitates the
devotion of long and intense attention to the individual patient,
it would be uneconomical to squander such expenditure upon
completely worthless persons who happen to be neurotic. Experience
upon material in clinics can alone show what modifications may be
necessary in order to make psycho-analytic treatment accessible to
wider strata of the population or to adapt it to weaker
intelligences.

Two Encyclopaedia Articles

3927

  
Comparison between
Psycho-Analysis and Hypnotic and Suggestive Methods
. -
Psycho-analytic procedure differs from all methods making use of
suggestion, persuasion, etc., in that it does not seek to suppress
by means of authority any mental phenomenon that may occur in the
patient. It endeavours to trace the causation of the phenomenon and
to remove it by bringing about a permanent modification in the
conditions that led to it. In psycho-analysis the suggestive
influence which is inevitably exercised by the physician is
diverted on to the task assigned to the patient of overcoming his
resistances, that is, of carrying forward the curative process. Any
danger of falsifying the products of a patient’s memory by
suggestion can be avoided by prudent handling of the technique; but
in general the arousing of resistances is a guarantee against the
misleading effects of suggestive influence. It may be laid down
that the aim of the treatment is to remove the patient’s
resistances and to pass his repressions in review and thus to bring
about the most far-reaching unification and strengthening of his
ego, to enable him to save the mental energy which he is expending
upon internal conflicts, to make the best of him that his inherited
capacities will allow and so to make him as efficient and as
capable of enjoyment as is possible. The removal of the symptoms of
the illness is not specifically aimed at, but is achieved, as it
were, as a by-product if the analysis is properly carried through.
The analyst respects the patient’s individuality and does not
seek to remould him in accordance with his own - that is, according
to the physician’s - personal ideals; he is glad to avoid
giving advice and instead to arouse the patient’s power of
initiative.