THOSE; of us who have devoted a certain amount of our time and energy to the
study of dreams have early come to realize the value of a dream as a
starting-point in the analysis of certain mental states, particularly those
of an abnormal character.
Frequently, in the hopeless tangle of symptoms, complaints and disconnected
facts in the history as originally obtained, especially in old-standing
cases, one does not really know just where to begin, what to start with in
the first efforts to struggle with the problem of the ultimate genesis and
evolution of the condition which is presented to him at the particular
moment. Of course, by a careful review of the patient's past life history,
gone over by persistent questioning and cross-examination, one can begin
with the family history and step by step trace the history of the patient
from earliest childhood or infancy through the various stages and phases of
activity and development up to the very moment of examination. This may at
times appear quite dull, quite uninteresting and entirely unnecessary to
certain patients. For this reason and also for many other reasons, which I
shall not enumerate at this point it is at times well to resort to dream
analysis. And in analyzing dreams it is well to remember a fact, with which
I believe all psychoanalysts will agree, namely, that by a most thorough and
far-reaching analysis of a SINGLE DREAM, we can, by following out to the
ultimate ends the various clues which are given us and the various by-paths
which offer themselves to us in the course of the analysis--we can, I
repeat, should we be so inclined, root up the entire life history of the
dreamer. This may not be necessary in all cases. But, at any rate, if we
desired so to do for scientific purposes, we could arrive at such results.
In such an analysis we would, of course, first take up, individually, every
portion and every element of every portion of the dream, and by means of
each such lesser or greater element of the dream, we could arrive at a mass
of material, a wealth of information concerning the past experiential,
emotional, mental and moral life of the individual whose dream we were at
the moment analyzing. In fact, one could ferret out the full life history in
great detail, thus obtaining a complete autobiography leading far down into
the depths of the dreamer's mental life and into the inner world of his own.
With the material so obtained one could truly reconstruct the complete life
history, piecemeal, until the wonderful and inspiring structure of the
mental world of the dreamer would be reared, reaching far back to early
childhood and perhaps even to infancy, extending so far forward as to give
us a prophecy, based on the dreamer's dynamic trends and emotional trends
and leanings, of the probable future, stretching forth its tentacles in all
directions, and, uncovering the psychic underworld in its every part,
holding up before our eyes the naked mind, in its length, its breadth and
its thickness.
I am not referring here particularly to the employment of the method of
hypnosis, especially as practiced by Prince, or to Freud's so-called free
association (which is frequently really forced association) or Jung's word
association methods. I am speaking only of analysis of the dream by ordinary
conversation and introspection, in the normal waking state. Of course, were
the latter method supplemented by these other methods, the results would be
so much the more complete and far-reaching. I may mention, specifically,
that the employment of Freud's free association method would be helpful here
in gathering information because, when employing this method, one
practically forces the one being analyzed to think by analogy and by
comparison, insisting that he tell you what a certain word or name or scene
or experience or what not reminds him of, what it resembles, what he can
compare it to, no matter how remote its connection, no matter how unrelated,
how far-fetched or how silly the association may appear in his own eyes--in
other words, we demand that he co-operate by suspending critical selection
and judgment. Although, as I say, Freud's, Jung's, Prince's and other
methods may be advantageously employed, still, it seems to me, although I
cannot yet state this in final or positive terms, that, at least in most
cases, such an unravelment and resurrection of the past life history can be
obtained by an analysis of the dream conducted in the ordinary, waking
state, and the usual conversational mode of history-taking and daily oral
intercourse.
It needs no repetition or elaboration to convince psychoanalysts (I use the
term "psychoanalyst" in the broad, unrestricted sense of the word, including
the supporters of all possible schools or standpoints or methods in
psychoanalysis or mental analysis, and not limiting it to Freud's
psychoanalysis) of the essential and fundamental truth of this statement. I
shall, therefore, not unnecessarily lengthen this paper by endeavoring to
bring forth complete evidence of the truth of this assertion.
As a matter of fact, this conclusion or generalization applies not alone to
dreams but to any single element in the objective or subjective world which
may be seized upon as the initial stimulus and from which, as a
starting-point, association of ideas, in ordinary conversation or aided by
any of the more or less experimental or artificial but valuable methods
heretofore mentioned, may be begun and continued ad libitum or even ad
infinitum, under the tactful guidance and judgment of the investigator. For
example, if I may be permitted to tread upon the dangerous path of
near-sensationalism or extremism, I may mention that were I to take even so
common, so widely used, and so relatively insignificant a word as the
definite article "the" as the initial stimulus, and have one of my fellowmen
or fellow-women (whose full co-operation, it is assumed, I have previously
obtained) give me one or more free or random word associations, and
thereafter, with these newly acquired elements, continued to forge my way
into the thickly wooded and unexplored recesses of the unknown and
mysterious forest of the mind, I doubt not but that I should achieve the
same results as if I had started upon my journey with a dream. If this be
true, and I firmly believe that it is, in the case of that universally used
and apparently inconsequential word "the," to which the normal person can be
expected to have such a large number of associations, of varying degrees of
intimacy or remoteness, how much truer is it when we have such a definite
mental fact or mental state as a dream as the starting-point of our hunting
expedition?
The dream gives us something tangible to start with, something near at home
to the dreamer or patient, something interesting and amusing to him,
something baffling and so frequently unintelligible to him, and, as a
consequence, a more conscientious, earnest and wholehearted co-operation can
be obtained from the person whose mental life is being investigated. Here is
something vivid to him, something of personal interest to him. And so we can
look to him to lend us his aid in better spirit and in fuller measure than
might otherwise be obtainable.
I have been referring in my previous remarks, for the most part, to
unravelment of the normal individual's life history. But my remarks are
equally applicable to a mentally disturbed individual's life history and to
the genesis of abnormal psychic states, particularly those to be met with in
the neuroses and psychoneuroses.
So true is the generalization, indeed the truism or dictum here laid down,
that, in only the psychoanalyst knows how many instances, by the analysis of
a single, even the very first dream, one can arrive at the rock-bottom depth
of the trouble at hand--yes, at the very genesis of the condition. It is not
my intention in this paper to report such cases in full detail, since the
presentation of even a single such case would be too lengthy for publication
in an ordinary medical or other journal, and in many instances might well go
to make a good-sized book, a real autobiography of more or less interest, if
not to the average reader, at least to the psychoanalyst and to the person
who has undergone the psychoanalysis. Without attempting to present an
elaborate history or complete analysis, but rather merely to call attention
to the truth of the general problem which is being discussed in this paper,
I shall, however, mention a few definite illustrations of this sort.
A man of sixty was brought to my dispensary clinic by his wife (I say
"brought" and not "accompanied" by his wife, advisedly). She accompanied him
into my examining room. He had an almost complete aphonia, spoke hoarsely
and in a whisper and presented all the signs of abductor laryngeal
paralysis; added to which there was a partial hemiplegia of the right side
involving the upper and lower extremities, but not the face or any of the
cranial nerves other than that supplying the right laryngeal abductor. I
shall not give any other points in the history except that this paralysis
was of four months' duration, there was some resistance to movements at the
elbow and knee, but Babinski and other indications of a central organic
lesion were absent. The results of the rest of the physical examination need
not be mentioned except that the patient presented evidences of
arteriosclerosis. The patient was of dull mentality, meek humble and
subservient; he was much below par mentally (I did not put him through any
special intelligence tests), had little information to offer, constantly
resorted to "I don't know" as a reply, and could co-operate but little. I
did, however, obtain the important bit of information that seventeen years
ago he had had an almost complete aphonia of several weeks' duration and
that one day, while on board ship, he became seasick, vomited, became
frightened, went to his room, and suddenly his voice returned to him. So
sudden was the transformation that many of his fellow-passengers insisted
that he had been deceiving them and had purposely simulated the condition he
had previously presented. The case was one of hysteria, the patient
presenting at the time of my examination signs of abductor laryngeal
paralysis (laryngological examination disclosed a right-sided abductor
palsy) and right-sided partial hemiplegia.
For the next two visits the wife accompanied, or rather, brought the patient
to the clinic and I could get but little information and consequently
progressed but little. I asked him, in her presence, to come alone the next
time--which he did. The description of the onset of the attack, which was
furnished me on his previous visits, proved the hysterical nature of the
condition: he had suddenly been attacked by nausea and vomiting, fell to the
floor, lay there, more or less unconscious (as he described it) for five or
ten or more minutes, was assisted to his feet, went to his bed with
practically no assistance, a few hours later found that he could speak
little more than above a whisper, and in another few hours or more his right
side became weak and failed him. He had insisted that the onset came on
suddenly. He had denied any quarrels or trouble at home. Nothing could be
obtained from him as to his thoughts just prior to the attack or as to any
special emotional shocks.
On his fourth visit I asked him to tell me any dream he had had recently and
which had made an impression upon him. He could give me no aid. Nothing
came to mind. I asked him if he had dreamed the night before, and he told
me he had had a dream the afternoon of the preceding day, during an
afternoon nap. Here is the dream: He found himself struggling with a
tremendous snake, the upper part of which was in human form, the features
being very hazy and not at all recalled. The snake was vigorously
endeavoring to enwrap itself about him and to strangle him, and he was
desperately and fiercely struggling to defend himself against it and to free
himself from it--and yet he could not fight it off. In desperation and in
fear he cried aloud for help. This was the end of the dream, for, at this
point, members of his family came rushing toward him to inquire what was
wrong with him, and due partly to shock and his own activity in the dream,
and partly perhaps to the noise of the footsteps and of the conversation of
those who came running toward him to inquire into the cause of his
distressful cries, he awoke.
The thoughts and reveries just preceding the dream and the thoughts and
experiences during the morning preceding the dream, although the true
inciters of the dream, and although concerned with the central figure (his
wife) in this little drama, need not be detailed since the dream has a wider
and more deeply arising significance.
I could not learn definitely from him whether the series of associated
thoughts turned first from his wife to his troubles with her, to her
attitude toward him, and then to her resemblance in this respect (her
nagging, pestering persistence and actual persecution of him) to a snake
which is endeavoring to enwrap itself about him, to strangle him, to
withdraw from him his very life's blood, etc. This may or may not have been
the line of associations just preceding the dream.
He had no idea as to what the dream meant. Using free association, in
ordinary face-to-face conversation, I asked him what "snake" reminded him
of. The association came in a moment. He smiled, became embarrassed, said
it was foolish of him to tell me this, but it reminded him of his wife. He
had always looked upon his wife as a snake in human form. He had frequently
called her "snake" because of her conduct toward him. She had wound herself
about his life in snake-like fashion.
And then came the story of their troubles. This was his second wife. She
was fifteen years his junior. He was meek, feeble, of weak will-power,
without initiative. She was domineering. Although his wife never told him
so openly and in so many words, he felt convinced that the trouble had begun
more or less because his wife's sexual libido was not satisfied in her
sexual relations with him. He admits that she is a passionate woman, her
sexual libido was of such strength that he, much older than she, and not too
strong physically, could but little gratify her. The first complaints and
the sole trouble which appeared on the surface were financial--he barely
made a living and she complained thereat continually, bitterly and
tyrannically. It seems that her complaint in this direction was justified.
It is difficult to determine just what role her lack of sexual gratification
played-- whether it only acted as stirring up the embers of dissatisfaction
(with his weekly earnings) which already existed, or whether it was the
basic factor, led to her dissatisfaction with her matrimonial choice, and
caused her to seek some more or less valid cause for complaint, in that way
permitting her, more or less consciously, to transfer her dissatisfaction
and discontent from the lack of sexual gratification to the hard pressed
financial condition (which perhaps she might, for that matter, have been
willing to endure, did she but obtain the full gratification of her sexual
craving). At any rate, both of these factors played their role in causing
domestic disagreement, one factor being openly acknowledged as the cause by
his wife, the other factor never mentioned by her, but believed by him to be
an important accessory, if not the main, fundamental and primary source of
the trouble. His wife, using his poor earning capacity as a weapon, and with
the demand for "more money" as her battle-cry, carried on a campaign of
complaint, grumbling, nagging, fault-finding, insult and abuse, but little
short of persecution, making conditions wretched and miserable at home.
Things at length became quite unbearable to him--so much so that, feeble in
willpower and lacking in initiative as he was and is, he was compelled to
leave home and live with his aunt, since his wife had practically deserted
him. Although she had sold out the furniture and the rest of the
furnishings of the home, and had pocketed the money thus received, she
repeatedly called at his aunt's home for no other purpose than to force him
to pay her sums of money for her weekly maintenance. On each such visit she
would act the tyrant, would storm and rage furiously, would subject him to
stinging rebukes and deliver biting tongue-lashings, causing him in
consequence to be much upset and nervous the rest of the day. The very
morning on which he had had the attack, which was followed by his present
trouble (partial aphonia and partial hemiplegia) his wife had paid him one
of these unusually stormy and noisy, and, to say the least, unwelcome
visits. She had carried the attack to such a point that our patient became
so emotionally upset (he is a harmless, emotional, kindly, unassuming and
indifferent sort of old fellow) that he suddenly was attacked with nausea
and vomiting, and, frightened, fell to the floor, with the consequences
above detailed. I need not go further into the history and analysis of this
case, but the story thus far elicited is more than sufficient to show that
here we have a specific instance in which, by the analysis of a single
dream, we have arrived at the genesis of an hysterical paralytic syndrome of
four months' duration. The analysis took but a few minutes. It may be
mentioned, in parentheses, that a full knowledge of the cause of the
condition did not lead to a disappearance of the palsy. In other words, as
we all know, knowledge per se does not lead to action or to the assertion or
development of the will-power. I may say, also, that the events here related
were not suppressed or repressed, for, as soon as the question of his wife
was taken up, the patient admitted that it was she who was the real cause of
his present conditions, and he thereupon detailed the story above related.
He assured me that he had always been fully aware that it was she who had
brought about his present condition, although, of course, he did not know
whether he had had an hysterical, apoplectic or other sort of attack. In
fact he believed his condition was permanent and incurable-- especially
since he had been treated at various neurological clinics for many weeks
past without the slightest improvement or progress.
Were we to follow up this history we could unearth the full life history of
this patient, including the genesis of his early attack of aphonia. But I
deem this unnecessary and inadvisable in this paper, as mentioned
previously.
Here, then, we have a definite case in which by the analysis of a single and
incidentally the first dream we have arrived at the genesis of the
psychoneurotic disorder.
From this same standpoint I have studied another case, a married woman of
twenty-nine, with marked neurasthenic and hysterical symptoms (including
astasia-abasia, anesthesias, palpitation of the heart, throbbing sensations
in the stomach and a great many other symptoms). This case I studied for
upwards of four months, with almost daily visits to the hospital where she
was being cared for. I made quite an intensive study of her dream life and
of her past life history, and I find that had I taken the very first dream
which I obtained from her and conducted a thorough analysis with this dream
as my first mile-post, I would have arrived at a full genesis of the
condition, which was of ten years' duration. In this case, also, I must
repeat, there was no indication of repression, the patient having always
understood very well the origin and cause of her condition. Here, too, we
find that the knowledge alone did not lead to her recovery. This case I
shall report in detail at a later date.
In this connection, I cannot keep from reciting the dream of a young girl of
twelve which I had the good fortune to study. She came to me complaining
about her throat. There was something dry, "a sticking" in her throat. She
did not know what it was. Would I look at her throat? I found nothing
abnormal, and was about to dismiss her when I observed that her hands were
bluish. I felt them. They were cold. I thought at once of probable heart
disease. I was soon informed that she had heart disease. She had been told
so by other doctors. This proved to be the case, as I learned on examining
her.
Being keenly interested in this subject of dreams, I wondered whether, if
she were subject to periods of cardiac decompensation of varying degree, she
did not have dreams of a terrifying nature (about burglars, robbery and the
like), because of embarrassment of breathing during sleep, resulting from
her cardiac insufficiency and consequent circulatory and respiratory
disturbance. I asked her whether she had been dreaming much of late. She
told me she had had a dream the preceding night. What was it? I inquired.
She had dreamed that she had died. Her mother had put her in a coffin,
carried her to the cemetery and then proceeded to bury her. Her mother had
first forced something into her mouth (it seemed to be a whitish powder),
and then lowered her into the grave and filled the grave with dirt. That is
all that she could remember.
I shall not enter into a complete analysis or interpretation of this dream.
There is no doubt, however, to every psychoanalyst who has devoted his
attention to dreams, that the analysis of such a dream should prove most
interesting. It is also apparent that by taking up the various elements of
the dream and following them untiringly along the various trails and
ramifications which lead on in various directions, one could unmask the
entire life history of this twelve-year-old girl.
I wish, however, to direct the reader's attention to only one aspect of this
dream--the death of the dreamer. She denied that she feared death or that
she thought of death because of her heart disease or from any other cause. I
next inquired: "Do you wish or have you ever wished you were dead?" The
reaction of the girl was immediate and intense. She stood frightened,
embarrassed; her eyelids twitched convulsively in rapid succession, her face
gradually assumed a suppressed crying expression, tears came to her eyes,
they soon flowed freely and rolled down her cheeks; she sobbed, and, through
her tears, she uttered, almost inarticulately, the one word, "Yes." A
convulsive, inspiratory grunt, a bashful, receding, turning away of the head
and body, a raising of the hands to cover her face and hide her tears, and
hasty, running steps to get away, while murmuring audibly "Let me go away,"
followed rapidly one upon the other. I gently seized her hand, calmed and
reassured her. And, through sobs and tears, in almost inaudible tones, in
starts and spurts, and reluctantly replying to questions which were forced
upon her, producing replies which were literally drawn from her against her
will, she told me this little story: A little boy cousin of hers, three
years her junior, had begun school two years or so later than she, and yet,
in spite of this handicap, this little relative had outstripped her in
school, he being now in a higher grade than she herself was. She would not
be so much concerned or worried about this not-to-be-proud-of performance,
had not the boy's mother that week visited her home and there, in the
presence of other people, talked considerably about her boy's progress in
school, his rapid advance as compared with that of our little dreamer, her
relative stupidity and backwardness. And so this boy's mother had continued
for some time in the same strain. This caused our little girl to feel much
embarrassed--in fact, ashamed and mortified. She had felt that way for
several days past, it had made her cry, had made her feel miserable and
unhappy; so much so that she had wished she were dead. I shall not continue
this analysis further. But it is plainly seen that here too, by a single
dream, we have come upon life-experiences, viewpoints and mental material
which affords us efficient and sufficient weapons to boldly attack the
fortress of her full life history, her mental qualities, her trends, her
psychic depth, her mental makeup in its entirety, in its every dimension.
It is interesting to note that on the morning following the experience which
I had with this child, she came to see me a second time, and, on my
examining her throat, it presented the typical picture of bilateral
tonsillitis, the final result of the initial sticking sensation in her
throat, which she had experienced the day before. After taking a culture
from her throat as a matter of routine to exclude a possible diphtheria, the
patient, greatly disturbed because of her newly-discovered trouble, burst
forth into bitter tears, and, still sobbing, rushed abruptly from the room.
A week later, when I saw her again, she had regained her emotional
equilibrium and we reviewed her dream and its analysis without any special
signs of emotional disturbance.
Very interesting, also, was my experience about a week following this when,
casually reciting this little girl's dream, its significance and her
conduct, to an old lady whom I know very well, I found that she too was
presenting all the signs of emotional upset, for, as I proceeded with my
recital, tears gradually came to her eyes, her face assumed a suppressed
crying expression, she tried to smile through her tears, and finally, unable
to control her emotions, she broke out into a free and unrestrained weeping
spell, following which I learned from her that the recital of this girl's
condition, her dream and its meaning, recalled to her mind her darling
daughter, a noble girl of sixteen years of age, who had died some fifteen
years ago, after a long period of incapacitation and a miserable existence
brought on by tonsillitis, chorea, rheumatism and, finally, heart disease,
with all the extreme signs and symptoms of broken cardiac and renal
compensation. Here, then, I had touched another complex, which, if followed
up, would lead me into the innermost depths and recesses of this old lady's
soul-life, into the holiest of holies of her mental life.
The writer will be pardoned for not here giving fuller histories, or for not
carrying out the analyses to their ultimate goals, or for not giving the
interpretations of the two dreams presented. That was not the primary object
of this communication.
I wish, in conclusion, to repeat that through the conscientious and most
far-reaching analysis of a single dream, or, in fact, of a single element of
a dream or a single element or stimulus in the objective or subjective
world, one may, at least not infrequently, unearth the full life history of
normal or abnormal individuals, and the genesis and evolution of
psychopathic affections.
The reader may justly inquire why the analyst should resort to dream
analysis instead of taking the history of the case in the usual way. In all
cases the patient should be permitted to tell her story in her own way.
This method of procedure, with cross questioning, may and should indeed be
sufficient to unravel the case for us in most cases. But if we find that we
have not gained the confidence of the patient and have not that condition of
being en rapport with the patient which is essential for progress and
success in the analysis, one may resort to dream analysis, not so much for
the purpose of following the royal road to what the Freudian school calls
"the unconscious," but rather with the object of obtaining the confidence of
the patient and of having something definite to start with.
AN ACT OF EVERYDAY LIFE TREATED AS A PRETENDED DREAM AND INTERPRETED BY
PSYCHOANALYSIS