Freud - Complete Works (672 page)

The Dissolution Of The Oedipus Complex

4091

   I have no doubt that the
chronological and causal relations described here between the
Oedipus complex, sexual intimidation (the threat of castration),
the formation of the super-ego and the beginning of the latency
period are of a typical kind; but I do not wish to assert that this
type is the only possible one. Variations in the chronological
order and in the linking-up of these events are bound to have a
very important bearing on the development of the individual.

   Since the publication of Otto
Rank’s interesting study,
The Trauma of Birth
, even
the conclusion arrived at by this modest investigation, to the
effect that the boy’s Oedipus complex is destroyed by the
fear of castration, cannot be accepted without further discussion.
Nevertheless, it seems to me premature to enter into such a
discussion at the present time, and perhaps inadvisable to begin a
criticism or an appreciation of Rank’s view at this
juncture.

4092

THE LOSS OF REALITY IN NEUROSIS AND PSYCHOSIS

(1924)

4093

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4094

THE LOSS OF REALITY IN NEUROSIS AND PSYCHOSIS

I have recently¹ indicated as one of the
features which differentiate a neurosis from a psychosis the fact
that in a neurosis the ego, in its dependence on reality,
suppresses a piece of the id (of instinctual life), whereas in a
psychosis, this same ego, in the service of the id, withdraws from
a piece of reality. Thus for a neurosis the decisive factor would
be the predominance of the influence of reality, whereas for a
psychosis it would be the predominance of the id. In a psychosis, a
loss of reality would necessarily be present, whereas in a
neurosis, it would seem, this loss would be avoided.

   But this does not at all agree
with the observation which all of us can make that every neurosis
disturbs the patient’s relation to reality in some way, that
it serves him as a means of withdrawing from reality, and that, in
its severe forms, it actually signifies a flight from real life.
This contradiction seems a serious one; but it is easily resolved,
and the explanation of it will in fact help us to understand
neuroses.

   For the contradiction exists only
as long as we keep our eyes fixed on the situation at the
beginning
of the neurosis, in which the ego, in the service
of reality, sets about the repression of an instinctual impulse.
This, however, is not yet the neurosis itself. The neurosis
consists rather in the processes which provide a compensation for
the portion of the id that has been damaged - that is to say, in
the reaction against the repression and in the failure of the
repression. The loosening of the relation to reality is a
consequence of this second step in the formation of a neurosis, and
it ought not to surprise us if a detailed examination shows that
the loss of reality affects precisely that piece of reality as a
result of whose demands the instinctual repression ensued.

   There is nothing new in our
characterization of neurosis as the result of a repression that has
failed. We have said this all along, and it is only because of the
new context in which we are viewing the subject that it has been
necessary to repeat it.

  
¹
‘Neurosis and Psychosis’
(1924
b
)

The Loss Of Reality In Neurosis And Psychosis

4095

   Incidentally, the same objection
arises in a specially marked manner when we are dealing with a
neurosis in which the exciting cause (the ‘traumatic
scene’) is known, and in which one can see how the person
concerned turns away from the experience and consigns it to
amnesia. Let me go back by way of example to a case analysed a
great many years ago,¹ in which the patient, a young woman,
was in love with her brother-in-law. Standing beside her
sister’s death-bed, she was horrified at having the thought:
‘Now he is free and can marry me.’ This scene was
instantly forgotten, and thus the process of regression, which led
to her hysterical pains, was set in motion. It is instructive
precisely in this case, moreover, to learn along what path the
neurosis attempted to solve the conflict. It took away from the
value of the change that had occurred in reality, by repressing the
instinctual demand which had emerged - that is, her love for her
brother-in-law. The
psychotic
reaction would have been a
disavowal of the fact of her sister’s death.

   We might expect that when a
psychosis comes into being, something analogous to the process in a
neurosis occurs, though, of course, between different agencies of
the mind; thus we might expect that in a psychosis, too, two steps
could be discerned, of which the first would drag the ego away,
this time from reality, while the second would try to make good the
damage done and re-establish the subject’s relations to
reality at the expense of the id. And, in fact, some analogy of the
sort can be observed in a psychosis. Here, too, there are two
steps, the second of which has the character of a reparation. But
beyond that the analogy gives way to a far more extensive
similarity between the two processes. The second step of the
psychosis is indeed intended to make good the loss of reality, not,
however, at the expense of a restriction of the id - as happens in
neurosis at the expense of the relation to reality - but in
another, more autocratic manner, by the creation of a new reality
which no longer raises the same objections as the old one that has
been given up. The second step, therefore, both in neurosis and
psychosis, is supported by the same trends. In both cases it serves
the desire for power of the id, which will not allow itself to be
dictated to by reality. Both neurosis and psychosis are thus the
expression of a rebellion on the part of the id against the
external world, of its unwillingness - or, if one prefers, its
incapacity - to adapt itself to the exigencies of reality, to
Αυάγχη
[Necessity]. Neurosis and psychosis differ from each other far more
in their first, introductory, reaction than in the attempt at
reparation which follows it.

  
¹
In
Studies on Hysteria
(1895
d
).

The Loss Of Reality In Neurosis And Psychosis

4096

   Accordingly, the initial
difference is expressed thus in the final outcome: in neurosis a
piece of reality is avoided by a sort of flight, whereas in
psychosis it is remodelled. Or we might say: in psychosis, the
initial flight is succeeded by an active phase of remodelling; in
neurosis, the initial obedience is succeeded by a deferred attempt
at flight. Or again, expressed in yet another way: neurosis does
not disavow the reality, it only ignores it; psychosis disavows it
and tries to replace it. We call behaviour ‘normal’ or
‘healthy’, if it combines certain features of both
reactions - if it disavows the reality as little as does a
neurosis, but if it then exerts itself, as does a psychosis, to
effect an alteration of that reality. Of course, this expedient,
normal, behaviour leads to work being carried out on the external
world; it does not stop, as in psychosis, at effecting internal
changes. It is no longer
autoplastic
but
alloplastic
.

   In a psychosis, the transforming
of reality is carried out upon the psychical precipitates of former
relations to it - that is, upon the memory-traces, ideas and
judgements which have been previously derived from reality and by
which reality was represented in the mind. But this relation was
never a closed one; it was continually being enriched and altered
by fresh perceptions. Thus the psychosis is also faced with the
task of procuring for itself perceptions of a kind which shall
correspond to the new reality; and this is most radically effected
by means of hallucination. The fact that, in so many forms and
cases of psychosis, the paramnesias, the delusions and the
hallucinations that occur are of a most distressing character and
are bound up with a generation of anxiety - this fact is without
doubt a sign that the whole process of remodelling is carried
through against forces which oppose it violently. We may construct
the process on the model of a neurosis, with which we are more
familiar. There we see that a reaction of anxiety sets in whenever
the repressed instinct makes a thrust forward, and that the outcome
of the conflict is only a compromise and does not provide complete
satisfaction. Probably in a psychosis the rejected piece of reality
constantly forces itself upon the mind, just as the repressed
instinct does in a neurosis, and that is why in both cases the
consequences too are the same. The elucidation of the various
mechanisms which are designed, in the psychoses, to turn the
subject away from reality and to reconstruct reality - this is a
task for specialized psychiatric study which has not yet been taken
in hand.

The Loss Of Reality In Neurosis And Psychosis

4097

   There is, therefore, a further
analogy between a neurosis and a psychosis, in that in both of them
the task which is undertaken in the second step is partly
unsuccessful. For the repressed instinct is unable to procure a
full substitute (in neurosis); and the representation of reality
cannot be remoulded into satisfying forms (not, at least, in every
species of mental illness). But the emphasis is different in the
two cases. In a psychosis it falls entirely on the first step,
which is pathological in itself and cannot but lead to illness. In
a neurosis, on the other hand, it falls on the second step, on the
failure of the repression, whereas the first step may succeed, and
does succeed in innumerable instances without overstepping the
bounds of health - even though it does so at a certain price and
not without leaving behind traces of the psychical expenditure it
has called for. These distinctions, and perhaps many others as
well, are a result of the topographical difference in the initial
situation of the pathogenic conflict - namely whether in it the ego
yielded to its allegiance to the real world or to its dependence on
the id.

   A neurosis usually contents
itself with avoiding the piece of reality in question and
protecting itself against coming into contact with it. The sharp
distinction between neurosis and psychosis, however, is weakened by
the circumstance that in neurosis, too, there is no lack of
attempts to replace a disagreeable reality by one which is more in
keeping with the subject’s wishes. This is made possible by
the existence of a
world of phantasy
, of a domain which
became separated from the real external world at the time of the
introduction of the reality principle. This domain has since been
kept free from the demands of the exigencies of life, like a kind
of ‘reservation’; it is not inaccessible to the ego,
but is only loosely attached to it. It is from this world of
phantasy that the neurosis draws the material for its new wishful
constructions, and it usually finds that material along the path of
regression to a more satisfying real past.

The Loss Of Reality In Neurosis And Psychosis

4098

   It can hardly be doubted that the
world of phantasy plays the same part in psychosis and that there,
too, it is the storehouse from which the materials or the pattern
for building the new reality are derived. But whereas the new,
imaginary external world of a psychosis attempts to put itself in
the place of external reality, that of a neurosis, on the contrary,
is apt, like the play of children, to attach itself to a piece of
reality - a different piece from the one against which it has to
defend itself - and to lend that piece a special importance and a
secret meaning which we (not always quite appropriately) call a
symbolic
one. Thus we see that both in neurosis and
psychosis there comes into consideration the question not only of a
loss of reality
but also of a
substitute for
reality
.

4099

A SHORT ACCOUNT OF PSYCHO-ANALYSIS

(1924)

4100

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4101

A SHORT ACCOUNT OF PSYCHO-ANALYSIS

I

Psycho-analysis may be said to have been born
with the twentieth century; for the publication in which it emerged
before the world as something new - my
Interpretation of
Dreams
- bears the date ‘1900’. But, as may well be
supposed, it did not drop from the skies ready-made. It had its
starting-point in older ideas, which it developed further; it
sprang from earlier suggestions, which it elaborated. Any history
of it must therefore begin with an account of the influences which
determined its origin and should not overlook the times and
circumstances that preceded its creation.

   Psycho-analysis grew up in a
narrowly-restricted field. At the outset, it had only a single aim
- that of understanding something of the nature of what were known
as the ‘functional’ nervous diseases, with a view to
overcoming the impotence which had so far characterized their
medical treatment. The neurologists of that period had been brought
up to have a high respect for chemico-physical and
pathologico-anatomical facts; and they were latterly under the
influence of the findings of Hitzig and Fritsch, of Ferrier, Goltz
and others, who seemed to have established an intimate and possibly
exclusive connection between certain functions and particular parts
of the brain. They did not know what to make of the psychical
factor and could not understand it. They left it to the
philosophers, the mystics and - the quacks; and they considered it
unscientific to have anything to do with it. Accordingly they could
find no approach to the secrets of the neuroses, and in particular
of the enigmatic ‘hysteria’, which was, indeed, the
prototype of the whole species. As late as in 1885, when I was
studying at the Salpêtrière, I found that people were
content to account for hysterical paralyses by a formula which
asserted that they were founded on slight functional disturbances
of the same parts of the brain which, when they were severely
damaged, led to the corresponding organic paralyses.

A Short Account Of Psycho-Analysis

4102

   Of course this lack of
understanding affected the
treatment
of these pathological
conditions badly as well. In general this consisted in measures
designed to ‘harden’ the patient - in the prescription
of medicines and in attempts, mostly very ill-contrived and
executed in an unfriendly manner, at bringing mental influences to
bear on him by threats, jeers and warnings and by exhorting him to
make up his mind to ‘pull himself together’. Electrical
treatment was given out as being a specific cure for nervous
conditions; but anyone who has endeavoured to carry out Erb’s
detailed instructions must marvel at the space that phantasy can
occupy even in what professes to be an exact science. The decisive
turn was taken in the eighties, when the phenomena of hypnotism
made one more attempt to find admission to medical science - this
time with more success than so often before, thanks to the work of
Liébeault, Bernheim, Heidenhain and Forel. The essential
thing was that the genuineness of these phenomena was recognized.
Once this had been admitted, two fundamental and unforgettable
lessons could not fail to be drawn from hypnotism. First, one was
given convincing proof that striking somatic changes could after
all be brought about solely by mental influences, which in this
case one had oneself set in motion. Secondly, one received the
clearest impression - especially from the behaviour of subjects
after
hypnosis - of the existence of mental processes that
one could only describe as ‘unconscious’. The
‘unconscious’ had, it is true, long been under
discussion among philosophers as a theoretical concept; but now for
the first time, in the phenomena of hypnotism, it became something
actual, tangible and subject to experiment. Apart from all this,
hypnotic phenomena showed an unmistakable similarity to the
manifestations of some neuroses.

   It is not easy to over-estimate
the importance of the part played by hypnotism in the history of
the origin of psycho-analysis. From a theoretical as well as from a
therapeutic point of view, psycho-analysis has at its command a
legacy which it has inherited from hypnotism.

   Hypnosis also proved a valuable
aid in the study of the neuroses - once again, first and foremost,
of hysteria. Charcot’s experiments created a great
impression. He suspected that certain paralyses which appeared
after a trauma (an accident) were of a hysterical nature, and he
showed that, by suggesting a trauma under hypnosis, he was able to
provoke paralyses of the same sort artificially. The expectation
was thus raised that traumatic influences might in all cases play a
part in the production of hysterical symptoms. Charcot himself made
no further efforts towards a psychological understanding of
hysteria; but his pupil, Pierre Janet, took up the question and was
able to show, with the help of hypnosis, that the symptoms of
hysteria were firmly dependent on certain unconscious thoughts
(
idées fixes
). Janet attributed to hysteria a
supposed constitutional incapacity for holding mental processes
together - an incapacity which led to a disintegration
(dissociation) of mental life.

A Short Account Of Psycho-Analysis

4103

   Psycho-analysis, however, was not
in any way based on these researches of Janet’s. The decisive
factor in its case was the experience of a Viennese physician, Dr.
Josef Breuer. In 1881, independently of any outside influence, he
was able with the help of hypnosis to study and restore to health a
highly-gifted girl who suffered from hysteria. Breuer’s
findings were not given to the public until fifteen years later,
after he had taken the present writer (Freud) into collaboration.
This case of Breuer’s retains its unique significance for our
understanding of the neuroses to this day; so that we cannot avoid
dwelling on it a little longer. It is essential to realize clearly
in what its peculiarity consisted. The girl had fallen ill while
she was nursing her father, to whom she was tenderly attached.
Breuer was able to establish that all her symptoms were related to
this period of nursing and could be explained by it. Thus it had
for the first time become possible to obtain a complete view of a
case of this puzzling neurosis, and all its symptoms had turned out
to have a meaning. Further, it was a universal feature of the
symptoms that they had arisen in situations involving an impulse to
an action which, however, had not been carried out but had for
other reasons been suppressed. The symptoms had, in fact, appeared
in place of
the actions that were not performed. Thus, to
explain the aetiology of hysterical symptoms, we were led to the
subject’s emotional life (to affectivity) and to the
interplay of mental forces (to dynamics); and since then these two
lines of approach have never been dropped.

A Short Account Of Psycho-Analysis

4104

   The precipitating causes of the
symptoms were compared by Breuer to Charcot’s traumas. Now it
was a remarkable fact that all these traumatic precipitating
causes, and all the mental impulses starting from them, were lost
to the patient’s memory, as though they had never happened;
while their products - the symptoms - persisted unaltered, as
though, so far as they were concerned, there was no such thing as
the effacing effect of time. Here, therefore, we had a fresh proof
of the existence of mental processes which were unconscious but for
that very reason especially powerful - processes which we had first
come to know in post-hypnotic suggestion. The therapeutic procedure
adopted by Breuer was to induce the patient, under hypnosis, to
remember the forgotten traumas and to react to them with powerful
expressions of affect. When this had been done, the symptom, which
had till then taken the place of these expressions of emotion,
disappeared. Thus one and the same procedure served simultaneously
the purposes of investigating and of getting rid of the ailment;
and this unusual conjunction was later retained in
psycho-analysis.

   After the present writer had,
during the early nineties, confirmed Breuer’s results in a
considerable number of patients, the two, Breuer and Freud,
together decided on a publication,
Studies on Hysteria
(1895
d
), which contained their findings and an attempt at a
theory based on them. This asserted that hysterical symptoms arose
when the affect of a mental process cathected with a strong affect
was forcibly prevented from being worked over consciously in the
normal way and was thus diverted into a wrong path. In cases of
hysteria, according to this theory, the affect passed over into an
unusual somatic innervation (‘conversion’), but could
be given another direction and got rid of
(‘abreacted’), if the experience were revived under
hypnosis. The authors gave this procedure the name of
‘catharsis’ (purging, setting free of a strangulated
affect).

   The cathartic method was the
immediate precursor of psycho-analysis; and, in spite of every
extension of experience and of every modification of theory, is
still contained within it as its nucleus. But it was no more than a
new medical procedure for influencing certain nervous diseases, and
nothing suggested that it might become a subject for the most
general interest and for the most violent contradiction.

A Short Account Of Psycho-Analysis

4105

II

   Soon after the publication of
Studies on Hysteria
the partnership between Breuer and Freud
came to an end. Breuer, who was in reality a consultant in internal
medicine, gave up treating nervous patients, and Freud devoted
himself to the further perfection of the instrument left over to
him by his elder collaborator. The technical novelties which he
introduced and the discoveries which he made changed the cathartic
method into psycho-analysis. The most momentous step, no doubt, was
his determination to do without the assistance of hypnosis in his
technical procedure. He did so for two reasons: first, because, in
spite of a course of instruction with Bernheim at Nancy, he did not
succeed in inducing hypnosis in a sufficient number of cases, and
secondly, because he was dissatisfied with the therapeutic results
of catharsis based on hypnosis. It is true that these results were
striking and appeared after a treatment of short duration, but they
turned out not to be permanent and to depend too much on the
patient’s personal relations with the physician. The
abandonment of hypnosis made a breach in the course of development
of the procedure up to then, and it meant a fresh start.

   Hypnosis had, however, performed
the service of restoring to the patient’s memory what he had
forgotten. It was necessary to find some other technique to replace
it; and the idea occurred to Freud of substituting for it the
method of ‘free association’. That is to say, he
pledged his patients to refrain from any conscious reflection and
to abandon themselves, in a state of quiet concentration, to
following the ideas which occurred to them spontaneously
(involuntarily) - ‘to skim off the surface of their
consciousness’. They were to communicate these ideas to the
physician even if they felt objections to doing so, if, for
instance, the thoughts seemed too disagreeable, too senseless, too
unimportant or irrelevant. The choice of free association as a
means of investigating the forgotten unconscious material seems so
strange that a word in justification of it will not be out of
place. Freud was led to it by an expectation that the so-called
‘free’ association would prove in fact to be unfree,
since, when all conscious intellectual purposes had been
suppressed, the ideas that emerged would be seen to be determined
by the unconscious material. This expectation was justified by
experience. When the ‘fundamental rule of
psycho-analysis’ which has just been stated was obeyed, the
course of free association produced a plentiful store of ideas
which could put one on the track of what the patient had forgotten.
To be sure, this material did not bring up what had actually been
forgotten, but it brought up such plain and numerous hints at it
that, with the help of a certain amount of supplementing and
interpreting, the doctor was able to guess (to reconstruct) the
forgotten material from it. Thus free association together with the
art of interpretation performed the same function as had previously
been performed by hypnotism.

A Short Account Of Psycho-Analysis

4106

   It looked as though our work had
been made much more difficult and complicated; but the inestimable
gain was that an insight was now obtained into an interplay of
forces which had been concealed from the observer by the hypnotic
state. It became evident that the work of uncovering what had been
pathogenically forgotten had to struggle against a constant and
very intense resistance. The critical objections which the patient
raised in order to avoid communicating the ideas which occurred to
him, and against which the fundamental rule of psycho-analysis was
directed, had themselves already been manifestations of this
resistance. A consideration of the phenomena of resistance led to
one of the corner-stones of the psycho-analytic theory of the
neuroses - the theory of repression. It was plausible to suppose
that the same forces which were now struggling against the
pathogenic material being made conscious had at an earlier time
made the same efforts with success. A gap in the aetiology of
neurotic symptoms was thus filled. The impressions and mental
impulses, for which the symptoms were now serving as substitutes,
had not been forgotten without reason or on account of a
constitutional in capacity for synthesis (as Janet supposed); they
had, though the influence of other mental forces, met with a
repression the success and evidence of which was precisely their
being debarred from consciousness and excluded from memory. It was
only in consequence of this repression that they had become
pathogenic - that is, had succeeded in manifesting themselves along
unusual paths as symptoms.