Freud - Complete Works (706 page)

   ‘All this is very far away
from what you promised to tell me.’

The Question Of Lay Analysis

4346

   You have no notion how close I am
to fulfilling my promise. Even in organisms which later develop an
efficient ego-organization, their ego is feeble and little
differentiated from their id to begin with, during their first
years of childhood. Imagine now what will happen if this powerless
ego experiences an instinctual demand from the id which it would
already like to resist (because it senses that to satisfy it is
dangerous and would conjure up a traumatic situation, a collision
with the external world) but which it cannot control, because it
does not yet possess enough strength to do so. In such a case the
ego treats the instinctual danger as if it was an external one; it
makes an attempt at flight, draws back from this portion of the id
and leaves it to its fate, after withholding from it all the
contributions which it usually makes to instinctual impulses. The
ego, as we put it, institutes a
repression
of these
instinctual impulses. For the moment this has the effect of fending
off the danger; but one cannot confuse the inside and the outside
with impunity. One cannot run away from oneself. In repression the
ego is following the pleasure principle, which it is usually in the
habit of correcting; and it is bound to suffer damage in revenge.
This lies in the ego’s having permanently narrowed its sphere
of influence. The repressed instinctual impulse is now isolated,
left to itself, inaccessible, but also uninfluenceable. It goes its
own way. Even later, as a rule, when the ego has grown stronger, it
still cannot lift the repression; its synthesis is impaired, a part
of the id remains forbidden ground to the ego. Nor does the
isolated instinctual impulse remain idle; it understands how to
make up for being denied normal satisfaction; it produces psychical
derivatives which take its place; it links itself to other
processes which by its influence it likewise tears away from the
ego; and finally it breaks through into the ego and into
consciousness in the form of an unrecognizably distorted
substitute, and creates what we call a symptom. All at once the
nature of a neurotic disorder becomes clear to us: on the one hand
an ego which is inhibited in its synthesis, which has no influence
on parts of the id, which must renounce some of its activities in
order to avoid a fresh collision with what has been repressed, and
which exhausts itself in what are for the most part vain acts of
defence against the symptoms, the derivatives of the repressed
impulses; and on the other hand an id in which individual instincts
have made themselves independent, pursue their aims regardless of
the interests of the person as a whole and henceforth obey the laws
only of the primitive psychology that rules in the depths of the
id. If we survey the whole situation we arrive at a simple formula
for the origin of a neurosis: the ego has made an attempt to
suppress certain portions of the id
in an inappropriate
manner
, this attempt has failed and the id has taken its
revenge. A neurosis is thus the result of a conflict between the
ego and the id, upon which the ego has embarked because, as careful
investigation shows, it wishes at all costs to retain its
adaptability in relation to the real external world. The
disagreement is between the external world and the id; and it is
because the ego, loyal to its inmost nature, takes sides with the
external world that it becomes involved in a conflict with its id.
But please observe that what creates the determinant for the
illness is not the fact of this conflict - for disagreements of
this kind between reality and the id are unavoidable and it is one
of the ego’s standing tasks to mediate in them - but the
circumstance that the ego has made use of the inefficient
instrument of repression for dealing with the conflict. But this in
turn is due to the fact that the ego, at the time at which it was
set the task, was undeveloped and powerless. The decisive
repressions all take place in early childhood.

The Question Of Lay Analysis

4347

   ‘What a remarkable
business! I shall follow your advice and not make criticisms, since
you only want to show me what psycho-analysis believes about the
origin of neurosis so that you can go on to say how it sets about
combating it. I should have various questions to ask and later on I
shall raise some of them. But at the moment I myself feel tempted
for once to carry your train of thought further and to venture upon
a theory of my own. You have expounded the relation between
external world, ego and id, and you have laid it down as the
determinant of a neurosis that the ego in its dependence on the
external world struggles against the id. Is not the opposite case
conceivable of the ego in a conflict of this kind allowing itself
to be dragged away by the id and disavowing its regard for the
external world? What happens in a case like that? From my lay
notions of the nature of insanity I should say that such a decision
on the part of the ego might be the determinant of insanity. After
all, a turning-away of that kind from reality seems to be the
essence of insanity.’

   Yes. I myself have thought of
that possibility, and indeed I believe it meets the facts - though
to prove the suspicion true would call for a discussion of some
highly complicated considerations. Neuroses and psychoses are
evidently intimately related, but they must nevertheless differ in
some decisive respect. That might well be the side taken by the ego
in a conflict of this kind. In both cases the id would retain its
characteristic of blind inflexibility.

The Question Of Lay Analysis

4348

   ‘Well, go on! What hints on
the treatment of neurotic illnesses does your theory
give?’

   It is easy now to describe our
therapeutic aim. We try to restore the ego, to free it from its
restrictions, and to give it back the command over the id which it
has lost owing to its early repressions. It is for this one purpose
that we carry out analysis, our whole technique is directed to this
aim. We have to seek out the repressions which have been set up and
to urge the ego to correct them with our help and to deal with
conflicts better than by an attempt at flight. Since these
repressions belong to the very early years of childhood, the work
of analysis leads us, too, back to that period. Our path to these
situations of conflict, which have for the most part been forgotten
and which we try to revive in the patient’s memory, is
pointed out to us by his symptoms, dreams and free associations.
These must, however, first be interpreted - translated - for, under
the influence of the psychology of the id, they have assumed forms
of expression that are strange to our comprehension. We may assume
that whatever associations, thoughts and memories the patient is
unable to communicate to us without internal struggles are in some
way connected with the repressed material or are its derivatives.
By encouraging the patient to disregard his resistances to telling
us these things, we are educating his ego to overcome its
inclination towards attempts at flight and to tolerate an approach
to what is repressed. In the end, if the situation of the
repression can be successfully reproduced in his memory, his
compliance will be brilliantly rewarded. The whole difference
between his age then and now works in his favour; and the thing
from which his childish ego fled in terror will often seem to his
adult and strengthened ego no more than child’s play.

The Question Of Lay Analysis

4349

IV

   ‘Everything you have told
me so far has been psychology. It has often sounded strange,
difficult, or obscure; but it has always been - if I may put it so
- "pure". I have known very little hitherto, no doubt,
about your psycho-analysis; but the rumour has nevertheless reached
my ears that you are principally occupied with things that have no
claim to that predicate. The fact that you have not yet touched on
anything of the kind makes me feel that you are deliberately
keeping something back. And there is another doubt that I cannot
suppress. After all, as you yourself say, neuroses are disturbances
of mental life. Is it possible, then, that such important things as
our ethics, our conscience, our ideals, play no part at all in
these profound disturbances?’

   So you feel that a consideration
both of what is lowest and of what is highest has been missing from
our discussions up till now? The reason for that is that we have
not yet considered the
contents
of mental life at all. But
allow me now for once myself to play the part of an interrupter who
holds up the progress of the conversation. I have talked so much
psychology to you because I wanted you to get the impression that
the work of analysis is a part of applied psychology - and,
moreover, of a psychology that is unknown outside analysis. An
analyst must therefore first and foremost have learnt this
psychology, this depth-psychology or psychology of the unconscious,
or as much of it at least as is known to-day. We shall need this as
a basis for our later conclusions. But now, what was it you meant
by your allusion to ‘purity’?

   ‘Well, it is generally
reported that in analyses the most intimate - and the nastiest -
events in sexual life come up for discussion in every detail. If
that is so - I have not been able to gather from your psychological
discussions that it is necessarily so - it would be a strong
argument in favour of restricting these treatments to doctors. How
could one dream of allowing such dangerous liberties to people of
whose discretion one was not sure and of whose character one had no
guarantee?’

   It is true that doctors enjoy
certain privileges in the sphere of sex: they are even allowed to
inspect people’s genitals - though they were not allowed to
in the East and though some idealistic reformers (you know whom I
have in mind) have disputed this privilege. But you want to know in
the first place whether it is so in analysis and why it must be so.
- Yes, it is so.

The Question Of Lay Analysis

4350

   And it must be so, firstly,
because analysis is entirely founded on complete candour. Financial
circumstances, for instance, are discussed with equal detail and
openness: things are said that are kept back from every
fellow-citizen, even if he is not a competitor or a tax-collector.
I will not dispute - indeed, I will myself insist with energy -
that this obligation to candour puts a grave moral responsibility
on the analyst as well. And it must be so, secondly, because
factors from sexual life play an extremely important, a dominating,
perhaps even a
specific
part among the causes and
precipitating factors of neurotic illnesses. What else can analysis
do but keep close to its subject-matter, to the material brought up
by the patient? The analyst never entices his patient on to the
ground of sex. He does not say to him in advance: ‘We shall
be dealing with the intimacies of your sexual life!’ He
allows him to begin what he has to say whenever he pleases, and
quietly waits until the patient himself touches on sexual things. I
used always to warn my pupils: ‘Our opponents have told us
that we shall come upon cases in which the factor of sex plays no
part. Let us be careful not to introduce it into our analyses and
so spoil our chance of finding such a case.’ But so far none
of us has had that good fortune.

   I am aware, of course, that our
recognition of sexuality has become - whether admittedly or not -
the strongest motive for other people’s hostility to
analysis. Can that shake our confidence? It merely shows us how
neurotic our whole civilized life is, since ostensibly normal
people do not behave very differently from neurotics. At a time
when psycho-analysis was solemnly put on its trial before the
learned societies of Germany - to-day things have grown altogether
quieter - one of the speakers claimed to possess peculiar authority
because, so he said, he even allowed his patients to talk: for
diagnostic purposes, clearly, and to test the assertions of
analysts. ‘But’, he added, ‘if they begin to talk
about sexual matters I shut their mouths.’ What do you think
of that as a method of demonstration? The learned society applauded
the speaker to the echo instead of feeling suitably ashamed on his
account. Only the triumphant certainty afforded by the
consciousness of prejudices held in common can explain this
speaker’s want of logical thought. Years later a few of those
who had at that time been my followers gave in to the need to free
human society from the yoke of sexuality which psycho-analysis was
seeking to impose on it. One of them explained that what is sexual
does not mean sexuality at all, but something else, something
abstract and mystical. And another actually declared that sexual
life is merely one of the spheres in which human beings seek to put
in action their driving need for power and domination. They have
met with much applause, for the moment at least.

The Question Of Lay Analysis

4351

   ‘I shall venture, for once
in a way, to take sides on that point. It strikes me as extremely
bold to assert that sexuality is not a natural, primitive need of
living organisms, but an expression of something else. One need
only take the example of animals.’

   That makes no difference. There
is no mixture, however absurd, that society will not willingly
swallow down if it is advertised as an antidote to the dreaded
predominance of sexuality.

   I confess, moreover, that the
dislike that you yourself have betrayed of assigning to the factor
of sexuality so great a part in the causation of neurosis - I
confess that this scarcely seems to me consistent with your task as
an Impartial Person. Are you not afraid that this antipathy may
interfere with your passing a just judgement?