BY A. W. VAN RENTERGHEM M.D., AMSTERDAM

(Concluded)

WE are frequently confronted with the question: "Just why does an erotic

conflict cause the neurosis? Why not just as well another conflict?" To

this the only answer is, "No one asserts that this must be so, but evidently

it always is so, in spite of anything that can be said against it. It is,

notwithstanding all assurances to the contrary, still true that love (taken

in its large sense of nature's course, which does not mean sexuality alone),

with its problems and its conflicts of the most inclusive significance, has

in human life and in the regulation of the human lot a much greater

importance than the individual can image.

The trauma-theory (meaning what was in the beginning conceived by Breuer and

Freud) is therefore out of date. When Freud came to the opinion that a

hidden erotic conflict forms the real root of the neurosis, the trauma lost

its pathogenic significance.

An entirely different light was now thrown upon the theory. The trauma

question was solved, and thrown aside. Next in order came the study of the

question of the erotic conflict. If we consider this in the light of the

chosen example, we see that this conflict contains plenty of abnormal

moments, and at first sight does not suffer comparison with an ordinary

erotic conflict. What is especially striking, seemingly almost unbelievable,

is the fact that it is only the exterior action, the pose, of which the

patient is conscious, while she remains unconscious of the passion which

governs her. In the case in question the actual sexual factor

unquestionably remains hidden, while the field of consciousness is entirely

governed by the patient's pose. A proposition formulating this state of

affairs would read as follows.

In the neurosis there are two erotic inclinations which stand in a fixed

antithesis to each other, and one of these at least is unconscious.

It might be said of this formula, that although perhaps it is adapted to

this case, possibly it is not adapted to all cases. Most people, however,

are inclined to believe that the erotic is not so widespread. It is granted

that it is so in a romance, but it is not believed that the most affecting

dramas are more often enacted in the heart of the citizen who daily passes

us by unnoticed, than upon the stage.

The neurosis is an unsuccessful attempt of the individual to solve in his

own bosom the sexual question which perplexes the whole of human society.

The neurosis is a disunity in one's inmost self. The cause of this inward

strife is because in most men the consciousness would gladly hold to its

moral ideal, but the subconsciousness strives toward its (in the present-day

meaning) immoral ideal. This the consciousness always wants to deny. These

are the sort of people who would like to be more respectable than they are

at bottom. But the conflict may be reversed; there are people who

apparently are very disreputable, and who do not take the slightest pains to

limit their sexual pleasures. But looked at from all sides this is only a

sinful attitude, adopted, God knows for what grounds, because in them, back

of this, there is a soul, which is kept just as much in the subconsciousness

as the immoral nature is kept in the subconscious of moral men. (It is best

for men to avoid extremes as far as possible, because extremes make us

suspect the contrary.)

This general explanation was necessary in order to explain to some extent

the conception of the erotic conflict in analytical psychology. It is the

turning-point of the entire conception of the neurosis.

After Breuer's discovery, putting into practice the "chimney sweeping" so

justly christened by his patient this method of treatment has evolved into

shorter psychoanalytical methods, which we will now discuss in succession in

their main points.

In his use of the primitive method, Freud depended upon the time saving of

hypnotism and upon the circumstance that many could not be brought into the

desired deep degree of provoked sleep. The aim of this operation was to call

up in the patient another state of consciousness, in which it would be

possible for him to remember facts which had given cause for the origin of

the phenomena, facts which thus far had remained hidden from the ordinary

daily consciousness. By questioning the patient when in this state, or by

spontaneous production of phantasies communicated by the patient while in

hypnosis, memories come to light and affects connected with them are relaxed

(these are abreagirt [rearranged], as the expression is) and the desired

cure is attained. This just-mentioned method (cathartic, cleansing) and

more especially the modified one, which aims especially at the promotion of

a spontaneous production of phantasies communicated by the patient while

under hypnotism, is still used in practice by some investigators. In what

follows we go still further back--Freud next sought for a method to render

hypnotism unnecessary. He discovered it by applying an artifice which he

had seen Bernheim use during a visit (1887) to the latter's clinic at Nancy.

Bernheim demonstrated upon a hypnotized patient how the amnesia of the

somnambulist is only an appearance.

With this aim in view, Freud from then on ceased to hypnotize his patients

and substituted for that method, "spontaneous ideas." This means that when

the analysis of a patient who is awake is obstructed, and has come to a dead

stop, he is told to communicate anything which comes into his mind, no

matter what idea, what thought, even if the thing were very queer to him or

seemed meaningless. In the material thus obtained the thread should be found

leading to the semi-forgotten, the thing hidden in the consciousness. In

single cases--where the resistance toward bringing into consciousness the

forgotten or repressed thing, the complex, was slight--this method of

treatment very quickly attains its end, but in others where the resistance

was greater, the spontaneous ideas merely brought about indirect

representations, mere allusions as it were to the forgotten element. Here

favorable results either were not so readily obtained, or else were entirely

lacking. In conjunction with this, Freud planned a simple method of

interpretation by means of which, from the material thus obtained, the

repressed complexes could be brought to consciousness.

Independently of Freud, the Zurich school (Bleuler, Jung) had planned the

association method in order to penetrate into the patient's

subconsciousness. The value of this method is chiefly a theoretical

experimental one; it leads to an orientation of large circumference, but

necessarily superficial in regard to the subconscious conflict (complex).

Freud compares its importance for the psychoanalyticus; with the importance

of the qualitative analysis for the chemist.

Not being completely satisfied with his method of spontaneous ideas Freud

sought shorter paths to the subconscious, and therefore undertook the study

of the dream-life (dealing with forgetfulness, speaking to one's self,

making mistakes, giving offense to one's self, and with superstition and

absent-mindedness, and the study of word quibbles taken in their widest

sense), to all of which we are indebted for the possession of his three

important books: "Die Traumdeutung?" (First edition 1900, third edition

1912); "Zur Psychopathologie des Alltagslebens" (1901-1907); "Der Witz und

seine Bedeutung zum Unbewussten" (1905).

Because of the discovery of the repressed and the forbidden in the soul

life, the instructions contained in the three last-named works are of great

importance and of help to us in the study of the spontaneous ideas of the

patient brought to light by free association. But what is of more importance

for analysis is the study of what may well be termed Freud's masterpiece,

"Die Traumdeutung."

Jung expresses himself as follows in regard to Freud's ingenious discovery.

"It can be said of the dream that the stone which was despised by the

architect has become the corner-stone. The acorn of the dream, of the

ephemeral and inconsiderable product of our soul, dates from the earliest

times. Before that, men saw in the dream a prophecy for the future, a

warning spirit, a comforter, a messenger of the gods. Now we join forces

with it in order to explore the subconscious, to unravel the mysteries which

it jealously guards and conceals. The dream does this with a completeness

which amazes us. Freud's exact analysis has taught that the dream as it

presents itself to us, exhibits merely a facade, which betrays nothing of

the inmost part of the house. But where, by attention to certain rules we

are able to bring the dreamer to express the sudden ideas awakened in him in

talking over the sub-division of his dream, then it very quickly appears

that the sudden ideas follow a determined direction, and are centralized

about certain subjects, possessing a personal significance and betraying a

meaning, which in the beginning would not have been suspected back of the

dream, but which stand in a very close symbolical relation, even to details,

to the dream facade. This peculiar thought-complex, in which all the threads

of the dream are united, is the looked-for conflict in a certain variation

which is determined by the circumstances. What is painful and contradictory

in the conflict is so confused here that one can speak of a

wish-fulfillment; let us, however, immediately add that the fulfilled wishes

apparently are not wishes, but are such as frequently are contradictory to

them. As an example let us use the case of a daughter who inwardly loves her

mother and dreams that the latter is dead, much to her sorrow. Dreams like

this are frequent. The contents make us think as little as possible of a

wish-fulfillment, and so one might perhaps get the idea that Freud's

assertion--that the dream presents in dramatic form a subconscious wish of

the dreamer--is unjust.

That happens because the non-initiated does not know how to differentiate

between manifest and latent (evident and hidden) dream contents. Where the

conflict worked over in the dream is unconscious, the solution, the wish

arising from it, is also unconscious. In the chosen example, the dreamer

wished to have the mother out of the way; in the language of the

subconscious it says: I wish that mother would die. We are aware that a

certain part of the subconscious possesses everything which we can no longer

remember consciously, and especially an entirely thoughtless, childish wish.

One can confidently say that most of what arises from the subconscious has

an infantile character, as does this so simple sounding wish: "Tell me,

father, if mother died would you marry me?" The infantile expression of a

wish is the predecessor of a recent wish for marriage, which in this case we

discover is painful to the dreamer. This thought, the seriousness of the

included meaning is, as we say, "repressed into the subconscious" and can

there necessarily express itself only awkwardly and childishly, because the

subconscious limits the material at its disposal, preferably, to memories of

childhood and, as recent researches of the Zurich school have shown, to

"Memories of the race," stretching far beyond the limits of the individual.

It is not the place here to explain by examples the territory of

dream-analysis so extraordinary composed; we must be satisfied with the

results of the study; dreams are a symbolical compensation for a personally

important wish of the daytime, one which had had too little attention (or

which had been repressed).

As a result of the dominant morals, wishes which are not sufficiently

noticed by our waking consciousness and which attempt to realize themselves

symbolically in the dream are as a rule of an erotic nature. Therefore it is

advisable not to tell individual dreams in the presence of the initiated,

because dream symbolism is transparent to one acquainted with its

fundamental rules. Therefore we have always to conquer in ourselves a

certain resistance before we seriously can be fitted for the task of

unraveling the symbolical composition by patient work. When we finally

comprehend the true meaning of a dream then we at once find ourselves

transposed into the very midst of the secrets of the dreamer and to our

amazement we see that even an apparently meaningless dream is full of sense

and really bears witness of extremely important and serious things

concerning the soul-life. This knowledge obliges us to have more respect for

the old superstition concerning the meaning of dreams, a respect which is

far to seek in our present-day rationalistic era.

Freud correctly terms dream-analysis the royal road which leads to the

subconscious; it leads us into the most deeply hidden personal mysteries

and, therefore, in the hand of the physician and the educator is an

instrument not to be too highly valued.

The opposition to this method makes use of arguments which chiefly (as we

will observe, from personal motives) originate in the still strongly

scholastic bent, which the learned thought of the present-day exhibits. And

dream-analysis is precisely what inexorably lays bare the lying morals and

the hypocritical pose of men, and now for once makes them see the reverse

side of their character. Is it to be wondered at that many therefore feel

as if some one were stepping on their toes?

Dream-analysis always makes me think of the striking statue of worldly

pleasure which stands before the cathedral at Basel. The front presents an

archaic sweet smile, but the back is covered with toads and snakes.

Dream-analysis reverses things and allows the back side to be seen. That

this correct picture of reality possesses an ethical value is what no one

can contradict. It is a painful but very useful operation, which demands a

great deal from the physician as well as from the patient. Psychoanalysis

seen from the standpoint of therapeutic technic consists chiefly of numerous

analyses of dreams; these in the course of treatment, little by little,

bring what is evil out of the subconsciousness to the light and submit it to

the disinfecting light of day, and thereby find again many valuable and

pretendedly lost portions of the past. It represents a cathartic of especial

worth, which has a similarity to the Socratic "maieutike," the "obstetric."

From this state of affairs one can only expect that psychoanalysis for many

people who have taken a certain pose, in which they firmly believe, is a

real torture, because according to the ancient mystic saying: "Give what you

have, then shall you receive!" They must of their own free will offer as a

price their beloved illusions if they wish to allow something deeper, more

beautiful and more vast to enrich them. Only through the mystery of

self-sacrifice does the self succeed in finding itself again renewed.

There are proverbs of very old origin which through the psychoanalytical

treatment again come to light. It is surely very remarkable that at the

height to which our present-day culture has attained this particular kind of

psychic education seems necessary, an education which may be compared in

more than one respect with the technic of Socrates, although psychoanalysis

goes much deeper.

We always discover in the patient a conflict which at a certain point is

connected with the great social problems, and when the analysis has

penetrated to that point, the seemingly individual conflict of the patient

is disclosed as the conflict, common to his environment and his time.

Thus the neurosis is really nothing but an individual (unsuccessful to be

sure) attempt to solve a common problem It must be so, because a common

problem, a "Question" which plunges the sick man into misery is--I can't

help it--"the sexual question," more properly termed the question of the

present-day sexual moral.

His increased claim upon life and the joy of life, upon colored, brilliant

reality, must endure the inevitable limitations, placed by reality, but not

the arbitrary, wrong, indefensable limitations which put too many chains

upon the creative spirit mounting from out the depths of animal darkness.

The nervous sufferer possesses the soul of a child, that arbitrary

limitation which represses and the reason for which is not understood. To be

sure it attempts to identify itself with the morals, but by this it is

brought into great conflict and disharmony with itself. On one side it

wishes to submit, on the other to free itself--and this conflict we speak of

as the neurosis.

If this conflict in all its parts were clearly a conscious one, then

naturally no nervous phenomena would arise from it. These phenomena arise

only when man cannot see the reverse side of his being and the urgency of

his problem. Only under these circumstances does the phenomena occur which

allows expression to the non-conscious side of the soul.

The symptom is thus an indirect expression of the nonconscious wishes,

which, were they conscious to us, would come into a violent conflict with

our conceptions of morals. This shadowy side of the soul withdraws itself,

as has once been said, from the control of the consciousness; by so doing

the patient can exert no influence upon it, cannot correct it and can

neither come to an understanding with it nor get rid of it, because in

reality the patient absolutely does not possess the subconscious passions.

Rather they are repressed from out the hierarchy of the conscious soul, they

have become autonomous complexes, which can be brought again into

consciousness only with great resistance through analysis. Many patients

think that the erotic conflict does not exist for them; in their opinion the

sexual question is nonsense; they have no sexual feeling. These people

forget that in place of that they are crippled by other things of unknown

origin. They are subject to hysterical moods, bad temper, crossness, from

which they, no less than their associates, suffer. They are tortured by

indigestion, by pains of every sort, and are visited by the whole category

of other nervous phenomena. They have this in place of what they lack in the

sexual territory, because only a few are privileged to escape the great

conflict of civilized man of the present day. The great majority inevitably

takes part in this common discord.

As specimens of dream-analysis I will give resumes of two histories of

illness told me by Dr. Jung.

The Journal of Abnormal Psychology, Volume 10 · 第 20 / 162 题