Freud - Complete Works (715 page)

The Question Of Lay Analysis

4397

   Some remarks that have been made
in the course of this discussion have led me to suspect that, in
spite of everything, my book on lay analysis has been misunderstood
in one respect. The doctors have been defended against me, as
though I had declared that they were in general incompetent to
practise analysis and as though I had given it out as a password
that medical reinforcements were to be rejected. That was not my
intention. The idea probably arose from my having been led to
declare in the course of my observations (which had a controversial
end in view) that untrained medical analysts were even more
dangerous than laymen. I might make my true opinion on this
question clear by echoing a cynical remark about women that once
appeared in
Simplicissimus
. One man was complaining to
another about the weaknesses and troublesome nature of the fair
sex. ‘All the same,’ replied his companion,
‘women are the best thing we have of the kind.’ I am
bound to admit that, so long as schools such as we desire for the
training of analysts are not yet in existence, people who have had
a preliminary education in medicine are the best material for
future analysts. We have a right to demand, however, that they
should not mistake their preliminary education for a complete
training, that they should overcome the one-sidedness that is
fostered by instruction in medical schools and that they should
resist the temptation to flirt with endocrinology and the autonomic
nervous system, when what is needed is an apprehension of
psychological facts with the help of a framework of psychological
concepts. I also share the view that all those problems which
relate to the connection between psychical phenomena and their
organic, anatomical and chemical foundations can be approached only
by those who have studied both, that is, by medical analysts. It
should not be forgotten, however, that this is not the whole of
psycho-analysis, and that for its other aspect we can never do
without the co-operation of people who have had a preliminary
education in the
mental
sciences. For practical reasons we
have been in the habit - and this is true, incidentally, of our
publications as well - of distinguishing between medical and
applied analysis. But that is not a logical distinction. The true
line of division is between
scientific
analysis and its
applications
alike in medical and in non-medical fields.

The Question Of Lay Analysis

4398

   In these discussions the bluntest
rejection of lay analysis has been expressed by our American
colleagues. A few words to them in reply will, I think, not be out
of place. I can scarcely be accused of making a misuse of analysis
for controversial purposes if I express an opinion that their
resistance is derived wholly from practical factors. They see how
in their own country lay analysts put analysis to all kinds of
mischievous and illegitimate purposes and in consequence cause
injury both to their patients and to the good name of analysis. It
is therefore not to be wondered at if in their indignation they
give the widest possible berth to such unscrupulous mischief-makers
and try to prevent any laymen from having a share in analysis. But
these facts are already enough to diminish the significance of the
American position; for the question of lay analysis must not be
decided on practical considerations alone, and local conditions in
America cannot be the sole determining influence on our views.

   The resolution passed by our
American colleagues against lay analysts, based as it essentially
is upon practical reasons, appears to me nevertheless to be
unpractical; for it cannot affect any of the factors which govern
the situation. It is more or less equivalent to an attempt at
repression. If it is impossible to prevent the lay analysts from
pursuing their activities and if the public does not support the
campaign against them, would it not be more expedient to recognize
the fact of their existence by offering them opportunities for
training? Might it not be possible in this way to gain some
influence over them? And, if they were offered as an inducement the
possibility of receiving the approval of the medical profession and
of being invited to co-operate, might they not have some interest
in raising their own ethical and intellectual level?

VIENNA
,
June
1927

4399

PSYCHO-ANALYSIS

(1926)

4400

Intentionally left blank

4401

PSYCHO-ANALYSIS

Since psycho-analysis was not mentioned in the
eleventh edition of the
Encyclopaedia Britannica
, it is
impossible to restrict this account to its advances since 1910. The
more important and the more interesting portion of its history lies
in the period before that date.

PREHISTORY

   In the years 1880-2 a Viennese
physician, Dr. Josef Breuer (1842-1925), discovered a new procedure
by means of which he relieved a girl, who was suffering from severe
hysteria, of her many and various symptoms. The idea occurred to
him that the symptoms were connected with impressions which she had
received during a period of agitation while she was nursing her
sick father. He therefore induced her, while she was in a state of
hypnotic somnambulism, to search for these connections in her
memory and to live through the ‘pathogenic’ scenes once
again without inhibiting the affects that arose in the process. He
found that when she had done this the symptom in question
disappeared for good.

   This was at a date before the
investigations of Charcot and Pierre Janet into the origin of
hysterical symptoms, and Breuer’s discovery was thus entirely
uninfluenced by them. But he did not pursue the matter any further
at the time, and it was not until some ten years later that he took
it up again in collaboration with Sigmund Freud. In 1895 they
published a book,
Studies on Hysteria
, in which
Breuer’s discoveries were described and an attempt was made
to explain them by the theory of ‘
catharsis
’.
According to that hypothesis, hysterical symptoms originate through
the energy of a mental process being withheld from conscious
influence and being diverted into bodily innervation
(‘
conversion
’). A hysterical symptom would thus
be a substitute for an omitted mental act and a reminiscence of the
occasion which should have given rise to that act. And, on this
view, recovery would be a result of the liberation of the affect
that had gone astray and of its discharge along a normal path
(‘
abreaction
’). Cathartic treatment gave
excellent therapeutic results, but it was found that they were not
permanent and that they were not independent of the personal
relation between the patient and the physician. Freud, who later
proceeded with these investigations by himself, made an alteration
in their technique, by replacing hypnosis by the method of free
association. He invented the term ‘psycho-analysis’,
which in the course of time came to have two meanings: (1) a
particular method of treating nervous disorders and (2) the science
of unconscious mental processes, which has also been appropriately
described as ‘depth-psychology’.

Psycho-Analysis

4402

SUBJECT-MATTER OF
PSYCHO-ANALYSIS

   Psycho-analysis finds a
constantly increasing amount of support as a therapeutic procedure,
owing to the fact that it can do more for its patients than any
other method of treatment. The principle field of its application
is in the milder neuroses - hysteria, phobias and obsessional
states; and in malformations of character and sexual inhibitions or
abnormalities it can also bring about marked improvements or even
recoveries. Its influence upon dementia praecox and paranoia is
doubtful; on the other hand, in favourable circumstances it can
cope with depressive states, even if they are of a severe type.

   In every instance the treatment
makes heavy claims upon both the physician and the patient: the
former requires a special training and must devote a long period of
time to exploring the mind of each patient, while the latter must
make considerable sacrifices, both material and mental.
Nevertheless, all the trouble involved is as a rule rewarded by the
results. Psycho-analysis does not act as a convenient panacea
(‘
cito, tute, jucunde
’) for psychological
disorders. On the contrary, its application has been instrumental
in making clear for the first time the difficulties and limitations
in the treatment of such affections. For the moment it is only in
Berlin and Vienna that there are voluntary institutions which make
psycho-analytic treatment accessible to the wage-earning
classes.

Psycho-Analysis

4403

   The therapeutic influence of
psycho-analysis depends on the replacement of unconscious mental
acts by conscious ones and is effective within the limits of that
factor. The replacement is effected by overcoming internal
resistances in the patient’s mind. The future will probably
attribute far greater importance to psycho-analysis as the science
of the unconscious than as a therapeutic procedure.

   Psycho-analysis, in its character
of depth-psychology, considers mental life from three points of
view: the dynamic, the economic and the topographical.

   From the first of these
standpoints, the
dynamic
one, psycho-analysis derives all
mental processes (apart from the reception of external stimuli)
from the interplay of forces, which assist or inhibit one another,
combine with one another, enter into compromises with one another,
etc. All of these forces are originally in the nature of
instincts
; thus they have an organic origin. They are
characterized by possessing an immense (somatic) store of power
(‘
the compulsion to repeat
’); and they are
represented mentally as images or ideas with an affective charge.
In psycho-analysis, no less than in other sciences, the theory of
the instincts is an obscure subject. An empirical analysis leads to
the formulation of two groups of instincts: the so-called
‘ego-instincts’, which are directed towards
self-preservation, and the ‘object-instincts’, which
are concerned with relations to an external object. The social
instincts are not regarded as elementary or irreducible.
Theoretical speculation leads to the suspicion that there are two
fundamental instincts which lie concealed behind the manifest
ego-instincts and object-instincts: namely (
a
) Eros, the
instinct which strives for ever closer union, and (
b
) the
instinct of destruction, which leads towards the dissolution of
what is living. In psycho-analysis the manifestation of the force
of Eros is given the name ‘
libido
’.

Psycho-Analysis

4404

   From the
economic
standpoint psycho-analysis supposes that the mental representatives
of the instincts have a charge (
cathexis
) of definite
quantities of energy, and that it is the purpose of the mental
apparatus to hinder any damming-up of these energies and to keep as
low as possible the total amount of the excitations with which it
is loaded. The course of mental processes is automatically
regulated by the ‘
pleasure-unpleasure
principle
’; and unpleasure is thus in some way related to
an increase of excitation and pleasure to a decrease. In the course
of development the original pleasure principle undergoes a
modification with reference to the external world, giving place to
the ‘
reality principle
’, in accordance with
which the mental apparatus learns to postpone the pleasure of
satisfaction and to tolerate temporarily feelings of
unpleasure.

  
Topographically
,
psycho-analysis regards the mental apparatus as a compound
instrument, and endeavours to determine at what points in it the
various mental processes take place. According to the most recent
psycho-analytic views, the mental apparatus is composed of an
‘
id
’, which is the repository of the instinctual
impulses, of an ‘
ego
’, which is the most
superficial portion of the id and one which has been modified by
the influence of the external world, and of a
‘
super-ego
’, which develops out of the id,
dominates the ego and represents the inhibitions of instinct that
are characteristic of man. The quality of consciousness, too, has a
topographical reference; for processes in the id are entirely
unconscious, while consciousness is the function of the ego’s
outermost layer, which is concerned with the perception of the
external world.

   At this point two observations
may be in place. It must not be supposed that these very general
ideas are presuppositions upon which the work of psycho-analysis
depends. On the contrary, they are its latest conclusions and are
‘open to revision’. Psycho-analysis is founded securely
upon the observation of the facts of mental life; and for that very
reason its theoretical superstructure is still incomplete and
subject to constant alteration. Secondly, there is no reason for
surprise that psycho-analysis, which was originally no more than an
attempt at explaining pathological mental phenomena, should have
developed into a psychology of normal mental life. The
justification for this arose with the discovery that the dreams and
mistakes of normal men have the same mechanism as neurotic
symptoms.

Psycho-Analysis

4405

   The first task of psycho-analysis
was the elucidation of nervous disorders. The analytic theory of
the neuroses is based on three corner-stones: the recognition of
(1) ‘
repression
’, of (2) the importance of the
sexual instinct and of (3) ‘
transference
’.

   (1) There is a force in the mind
which exercises the functions of a censorship, and which excludes
from consciousness and from any influence upon action all
tendencies which displease it. Such tendencies are described as
‘repressed’. They remain unconscious; and if one
attempts to bring them into the patient’s consciousness one
provokes a ‘
resistance
’. These repressed
instinctual impulses, however, have not always become powerless. In
many cases they succeed in making their influence felt in the mind
by circuitous paths, and the indirect or substitutive satisfactions
of repressed impulses thus achieved are what constitute neurotic
symptoms.

   (2) For cultural reasons the most
intense repression falls upon the sexual instincts; but it is
precisely in connection with them that repression most easily
miscarries, so that neurotic symptoms are found to be substitutive
satisfactions of repressed sexuality. The belief that in man sexual
life begins only at puberty is incorrect. On the contrary, signs of
it can be detected from the beginning of extra-uterine existence;
it reaches a first culminating point at or before the fifth year
(‘early period’), after which it is inhibited or
interrupted (‘latency period’) until the age of
puberty, which is the second climax of its development. This
diphasic onset of sexual development seems to be distinctive of the
genus Homo. All experiences during the first period of childhood
are of the greatest importance to the individual, and in
combination with his inherited sexual constitution form the
dispositions for the subsequent development of character and
disease. It is wrong to make sexuality coincide with
‘genitality’. The sexual instincts pass through a
complicated course of development, and it is only at the end of it
that the ‘primacy of the genital zones’ is attained.
Before this there are a number of ‘pregenital’
organizations of the libido - points at which it may become
‘fixated’ and to which, in the event of subsequent
repression, it will return (‘
regression
’). The
infantile fixations of the libido are what determine the form of
any later neurosis. Thus the neuroses are to be regarded as
inhibitions in the development of the libido. There are no specific
causes of nervous disorders; the question whether a conflict finds
a healthy solution or leads to a neurotic inhibition of function
depends upon quantitative considerations.

Psycho-Analysis

4406

   The most important conflict with
which a small child is faced is his relation to his parents, the
‘
Oedipus complex
’; it is in attempting to
grapple with this problem that those destined to suffer from a
neurosis habitually come to grief. The reactions against the
instinctual demands of the Oedipus complex are the source of the
most precious and socially important achievements of the human
mind; and this holds true not only in the life of individuals but
probably also in the history of the human species as a whole. The
super-ego, too, the moral agency which dominates the ego, has its
origin in the process of overcoming the Oedipus complex.

   (3) By
‘
transference
’ is meant a striking peculiarity
of neurotics. They develop towards their physician emotional
relations, both of an affectionate and hostile character, which are
not based upon the actual situation but are derived from their
relations to their parents (the Oedipus complex). Transference is a
proof of the fact that adults have not overcome their former
childish dependence; it coincides with the force which has been
named ‘suggestion’; and it is only by learning to make
use of it that the physician is enabled to induce the patient to
overcome his internal resistances and do away with his repressions.
Thus psycho-analytic treatment acts as a second education of the
adult, as a corrective to his education as a child.

   Within this narrow compass it has
been impossible to mention many matters of the greatest interest,
such as the ‘
sublimation
’ of instincts, the part
played by
symbolism
, the problem of
‘
ambivalence
’, etc. Nor has there been space to
allude to the applications of psycho-analysis, which originated, as
we have seen, in the sphere of medicine, to other departments of
knowledge (such as Social Anthropology, the Study of Religion,
Literary History and Education) where its influence is constantly
increasing. It is enough to say that psycho-analysis, in its
character of the psychology of the deepest, unconscious mental
acts, promises to become the link between psychiatry and all of
these other branches of mental science.