PSYCHOANALYSIS
The foundations of this method and theory were laid by Sigmund
Freud of Vienna, and set forth by him in his epoch-making book,
the _Interpretation of Dreams_, published in 1900. Two schools of
psychoanalysis exist at the present time: the Vienna school, which
adheres strictly to the doctrines of Freud; and the Zurich school,
which subscribes to a modification of these doctrines as taught by Dr.
Jung.
While both schools agree upon general principles as to the anatomy of
the mind, they differ in their teaching as to the _modus operandi_ of
mental disease. Freud holds that functional nervous disorders are due
to the retention by the subconscious mind of an infantile attitude
towards life, and especially towards sex, and that this attitude,
which should have been outgrown and left behind, sets up stresses and
strains in the mind which lead to the manifestations of mental disease.
He gives us the concept of the accumulation of emotion in this wound
in the mind, just as pus accumulates in an abscess, giving rise to
tenderness and pain. He conceives the function of the psychoanalyst
to be to lance this abscess by bringing the subject of distress into
consciousness, whereby the repressed emotion is realised and fully
experienced, and thereby got rid of. This process is technically known
as ABREACTION.
The psychologist who conducts the analysis is very likely to be the
recipient of this repressed emotion because, at the moment of its
arrival in consciousness, he is apt to be standing in the line of
fire. This acceptance of the repressed emotion by the operator is
conceived to be a most important phase of the cure, and is known as the
TRANSFERENCE.
That this factor of the transference opens a door to most serious
difficulties and dangers cannot be denied. The via media between undue
influence and callous indifference is hard to find. It is maintained
that more analysis will work off the emotion which much analysis has
succeeded in lying bare, but in actual practice the process is not so
simple and often leads to complications.
This transference of emotion to the analyst, together with the
deleterious effects of continual and prolonged dwelling upon the
unsavoury aspects of life which takes place in a psychoanalysis,
constitute serious objections to this method of therapy.
Jung holds that mental disease is due to a failure of adaptation in
the present, leading to regression to an infantile mode of thinking.
It will thus be seen that the two theories, while based upon the same
data, are fundamentally different, and must lead to differences in
practical application.
Both schools explore the subconscious mind by means of dream analysis,
and to this method the Zurich school also adds the method known as
word reaction. The process of dream analysis is extremely complicated.
Briefly, the patient is instructed to recount a dream, and this dream
is then taken point by point, and the “free associations” traced out
in the following manner. He is instructed to take an image in his
dream as a starting-point, turn his mind loose, and watch where it
goes, the theory being that it will retrace the association train of
ideas by which the dream image was derived from the underlying wish.
An elaborate technique exists for interpreting these dream images; so
elaborate as to be beyond the scope of the present volume. How much of
this technique is sound and how much is arbitrary is still a matter of
opinion among psychologists; we have little data as yet as to the part
played by unintentional suggestion on the part of the psychoanalyst,
no doubt a considerable factor in some cases, and an exceedingly
falsifying and misleading one.
The word association method of Jung is less open to objection on the
ground of arbitrariness, and its operation is simpler. A list of
anything from a dozen to a hundred or more words is made out. The
first half-dozen words have usually no particular significance, but
then follow a series of words believed to be specially associated
with the different types of complex which may become split off from
consciousness; lists of these have been worked out by different
students of this school, but although one of these lists is usually
used as a basis, the analyst generally inserts words which he
believes will especially bear upon the patient’s particular problems.
These words are called out to the patient, one at a time, and he
is instructed to utter the first word that comes into his head in
connection with each. The time he takes to do this is taken by a
stop-watch usually working to one-fifth of a second. The first
half-dozen of unimportant words will show the patient’s average
reaction time, but if any words among the subsequent ones have special
significance for him, there will be a perceptible lengthening of the
time he takes to reply; moreover the replies may be curious, and either
show special bearing upon his problems, or, by their irrelevancy, show
that the original idea was discarded as unspeakable and a substitute
hastily extemporised. If the list be read over again it will be found
that, whereas those words which have no special significance are
usually responded to by the same reaction word, those which bear upon
the patient’s emotions produce a change in the reaction word. Free
association is then resorted to, as in the case of dream symbols,
to discover the underlying train of ideas and the factors in the
subconscious from which they derive their emotion.
Many Freudians make use of this method also, and indeed the two methods
of dream analysis and word association are generally regarded as
supplementary. The chief value of the latter lies in the fact that it
can be used in cases where the patient is either unable or reluctant to
co-operate.
The difference in the view-point of the two schools of psychoanalysis
leads to a difference in the method of handling the patient; the
Freudian who believes that all nerve trouble is due to the retention
of infantile habits of thinking, confines himself to analysis and
nothing but analysis, offering the patient little or nothing in the way
of explanation or instruction, but simply aiding him to lay bare the
depths of his subconscious mind, believing that by so doing pent-up
emotions will be worked off and split-off complexes reassociated to
the personality. The disciple of Jung, on the other hand, believing
that the trouble is due to a present failure of adaptation, though
using the psychoanalytic method to reveal and bring into consciousness
the dissociated complexes, uses a considerable amount of teaching and
explanation in an endeavour to enable the patient to assimilate the
fruits of experience and adapt himself to his environment. The Freudian
complains that the follower of Jung beclouds the issue by unintentional
suggestion, and the latter accuses the former of unnecessarily
prolonging the process by leaving the patient to find his own way
unaided by a wider experience.
The teaching and explanatory method, generally known as re-education,
is chiefly associated with the name of du Bois, who was its
original exponent, but as, in his day, the psychoanalytic method of
investigating the causes of mental disease was unknown, he was often
groping in the dark, and dealing with secondary symptoms and effects,
so that his method fell into disrepute in the eyes of the new school;
but that this method, wisely handled, can be of great benefit in
expediting a cure and lessening the painfulness of the process is
beyond gainsay.