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An Outline Of Psycho-Analysis

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   We shall not be disappointed,
but, on the contrary, we shall find it entirely intelligible, if we
reach the conclusion that the final outcome of the struggle we have
engaged in depends on
quantitative
relations - on the quota
of energy we are able to mobilize in the patient to our advantage
as compared with the sum of energy of the powers working against
us. Here once again God is on the side of the big battalions. It is
true that we do not always succeed in winning, but at least we can
usually recognize why we have not won. Those who have been
following our discussion only out of therapeutic interest will
perhaps turn away in contempt after this admission. But here we are
concerned with therapy only in so far as it works by psychological
means; and for the time being we have no other. The future may
teach us to exercise a direct influence, by means of particular
chemical substances, on the amounts of energy and their
distribution in the mental apparatus. It may be that there are
other still undreamt-of possibilities of therapy. But for the
moment we have nothing better at our disposal than the technique of
psycho-analysis, and for that reason, in spite of its limitations,
it should not be despised.

An Outline Of Psycho-Analysis

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CHAPTER VII

AN
EXAMPLE OF PSYCHO-ANALYTIC WORK

We have arrived at a general acquaintance with
the psychical apparatus, with the parts, organs and agencies of
which it is composed, with the forces which operate in it and with
the functions allotted to its parts. The neuroses and psychoses are
the states in which disturbances in the functioning of the
apparatus come to expression. We have chosen the neuroses as the
subjects of our study because they alone seem accessible to the
psychological methods of our intervention. While we are trying to
influence them, we collect observations which give us a picture of
their origin and of the manner in which they arise.

   I will state in advance one of
our chief findings before proceeding with my description. The
neuroses (unlike infectious diseases, for instance) have no
specific determinants. It would be idle to seek in them for
pathogenic excitants. They shade off by easy transitions into what
is described as the normal; and, on the other hand, there is
scarcely any state recognized as normal in which indications of
neurotic traits could not be pointed out. Neurotics have
approximately the same innate dispositions as other people, they
have the same experiences and they have the same tasks to perform.
Why is it, then, that they live so much worse and with so much
greater difficulty and, in the process, suffer more feelings of
unpleasure, anxiety and pain?

   We need not be at a loss to find
an answer to this question. Quantitative
disharmonies
are
what must be held responsible for the inadequacy and sufferings of
neurotics. The determining cause of all the forms taken by human
mental life, is, indeed, to be sought in the reciprocal action
between innate dispositions and accidental experiences. Now a
particular instinct may be too strong or too weak innately, or a
particular capacity may be stunted or insufficiently developed in
life. On the other hand, external impressions and experiences may
make demands of differing strength on different people; and what
one person’s constitution can deal with may prove an
unmanageable task for another’s. These quantitative
differences will determine the variety of the results.

   We shall very soon feel, however,
that this explanation is unsatisfactory: it is too general, it
explains too much. The aetiology put forward applies to every case
of mental suffering, misery and disablement, but not every such
state can be termed neurotic. The neuroses have specific
characteristics, they are miseries of a particular kind. So we must
after all expect to find particular causes for them. Or we may
adopt the supposition that, among the tasks with which mental life
has to deal, there are a few on which it can especially easily come
to grief; so that the peculiarity of the phenomena of neurosis,
which are often so very remarkable, would follow from this without
our needing to withdraw our earlier assertions. If it remains true
that the neuroses do not differ in any essential respect from the
normal, their study promises to yield us valuable contributions to
our knowledge of the normal. It may be that we shall thus discover
the ‘weak points’ in a normal organization.

   The supposition we have just made
finds confirmation. Analytic experiences teach us that there is in
fact one instinctual demand attempts to deal with which most easily
fail or succeed imperfectly and that there is one period of life
which comes in question exclusively or predominantly in connection
with the generation of a neurosis. These two factors - the nature
of the instinct and the period of life concerned - call for
separate consideration, although they are closely enough
connected.

An Outline Of Psycho-Analysis

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   We can speak with a fair degree
of certainty about the part played by the period of life. It seems
that neuroses are acquired only in early childhood (up to the age
of six), even though their symptoms may not make their appearance
till much later. The childhood neurosis may become manifest for a
short time or may even be overlooked. In every case the later
neurotic illness links up with the prelude in childhood. It is
possible that what are known as traumatic neuroses (due to
excessive fright or severe somatic shocks, such as railway
collisions, burial under falls of earth, and so on) are an
exception to this: their relations to determinants in childhood
have hitherto eluded investigation. There is no difficulty in
accounting for this aetiological preference for the first period of
childhood. The neuroses are, as we know, disorders of the ego; and
it is not to be wondered at if the ego, so long as it is feeble,
immature and incapable of resistance, fails to deal with tasks
which it could cope with later on with the utmost ease. In these
circumstances instinctual demands from within, no less than
excitations from the external world, operate as
‘traumas’, particularly if they are met half way by
certain innate dispositions. The helpless ego fends them off by
means of attempts at flight (
repression
), which later turn
out to be inefficient and which involve permanent restrictions on
further development. The damage inflicted on the ego by its first
experiences gives us the appearance of being disproportionately
great; but we have only to take as an analogy the differences in
the results produced by the prick of a needle into a mass of cells
in the act of cell-division (as in Roux’s experiments) and
into the fully grown animal which eventually develops out of them.
No human individual is spared such traumatic experiences; none
escapes the repressions to which they give rise. These questionable
reactions on the part of the ego may perhaps be indispensable for
the attainment of another aim which is set for the same period of
life: in the space of a few years the little primitive creature
must turn into a civilized human being; he must pass through an
immensely long stretch of human cultural development in an almost
uncannily abbreviated form. This is made possible by hereditary
disposition; but it can almost never be achieved without the
additional help of upbringing, of parental influence, which, as a
precursor of the super-ego, restricts the ego’s activity by
prohibitions and punishments, and encourages or compels the
setting-up of repressions. We must therefore not forget to include
the influence of civilization among the determinants of neurosis.
It is easy, as we can see, for a barbarian to be healthy; for a
civilized man the task is hard. The desire for a powerful,
uninhibited ego may seem to us intelligible; but, as we are taught
by the times we live in, it is in the profoundest sense hostile to
civilization. And since the demands of civilization are represented
by family upbringing, we must bear in mind the part played by this
biological characteristic of the human species - the prolonged
period of its childhood dependence - in the aetiology of the
neuroses.

An Outline Of Psycho-Analysis

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   As regards the other point - the
specific instinctual factor - we come upon an interesting
discrepancy between theory and experience. Theoretically there is
no objection to supposing that any sort of instinctual demand might
occasion the same repressions and their consequences; but our
observation shows us invariably, so far as we can judge, that the
excitations that play this pathogenic part arise from the component
instincts of sexual life. The symptoms of neuroses are, it might be
said, without exception either a substitutive satisfaction of some
sexual urge or measures to prevent such a satisfaction; and as a
rule they are compromises between the two, of the kind that come
about in accordance with the laws operating between contraries in
the unconscious. The gap in our theory cannot at present be filled;
our decision is made more difficult by the fact that most of the
urges of sexual life are not of a purely erotic nature but have
arisen from alloys of the erotic instinct with portions of the
destructive instinct. But it cannot be doubted that the instincts
which manifest themselves physiologically as sexuality play a
prominent, unexpectedly large part in the causation of the neuroses
- whether it is an exclusive one remains to be decided. It must
also be borne in mind that in the course of cultural development no
other function has been so energetically and extensively repudiated
as precisely the sexual one. Theory must rest satisfied with a few
hints that betray a deeper connection: the fact that the first
period of childhood, during which the ego begins to be
differentiated from the id, is also the period of the early sexual
efflorescence which is brought to an end by the period of latency;
that it can hardly be a matter of chance that this momentous early
period subsequently falls a victim to infantile amnesia; and
lastly, that biological changes in sexual life (such as the
function’s diphasic onset which we have already mentioned,
the disappearance of the periodic character of sexual excitation
and the transformation in the relation between female menstruation
and male excitation) - that these innovations in sexuality must
have been of high importance in the evolution of animals into man.
It is left for the science of the future to bring these still
isolated data together into a new understanding. It is not in
psychology but in biology that there is a gap here. We shall not be
wrong, perhaps, in saying that the weak point in the ego’s
organization seems to lie in its attitude to the sexual function,
as though the biological antithesis between self-preservation and
the preservation of the species had found a psychological
expression at that point.

An Outline Of Psycho-Analysis

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   Analytic experience has convinced
us of the complete truth of the assertion so often to be heard that
the child is psychologically father to the adult and that the
events of his first years are of paramount importance for his whole
later life. It will thus be of special interest to us if there is
something that may be described as the central experience of this
period of childhood. Our attention is first attracted by the
effects of certain influences which do not apply to all children,
though they are common enough - such as the sexual abuse of
children by adults, their seduction by other children (brothers or
sisters) slightly their seniors, and, what we should not expect,
their being deeply stirred by seeing or hearing at first hand
sexual behaviour between adults (their parents) mostly at a time at
which one would not have thought they could either be interested in
or understand any such impressions, or be capable of remembering
them later. It is easy to confirm the extent to which such
experiences arouse a child’s susceptibility and force his own
sexual urges into certain channels from which they cannot
afterwards depart. Since these impressions are subjected to
repression either at once or as soon as they seek to return as
memories, they constitute the determinant for the neurotic
compulsion which will subsequently make it impossible for the ego
to control the sexual function and will probably cause it to turn
away from that function permanently. If this latter reaction
occurs, the result will be a neurosis; if it is absent, a variety
of perversions will develop, or the function, which is of immense
importance not only for reproduction but also for the entire
shaping of life, will become totally unmanageable.

   However instructive cases of this
kind may be, a still higher degree of interest must attach to the
influence of a situation which every child is destined to pass
through and which follows inevitably from the factor of the
prolonged period during which a child is cared for by other people
and lives with his parents. I am thinking of the
Oedipus
complex
, so named because its essential substance is to be
found in the Greek legend of King Oedipus, which has fortunately
been preserved for us in a version by a great dramatist. The Greek
hero killed his father and took his mother to wife. That he did so
unwittingly, since he did not know them as his parents, is a
deviation from the analytic facts which we can easily understand
and which, indeed, we shall recognize as inevitable.

An Outline Of Psycho-Analysis

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