that objections to our conception of the dream have been raised also by
persons who, as psychoanalysts, have themselves been interested in the
interpretation of dreams. It would have been too extraordinary if so
pregnant an opportunity for new errors had remained unutilized, and
thus, owing to comprehensible confusions and unjustified
generalizations, there have been assertions made which, in point of
incorrectness are not far behind the medical conception of dreams. One
of these you already know. It is the declaration that the dream is
occupied with the dreamer's attempts at adaptation to his present
environment, and attempts to solve future problems, in other words, that
the dream follows a "prospective tendency" (A. Maeder). We have already
shown that this assertion is based upon a confusion of the dream with
the latent thoughts of the dream, that as a premise it overlooks the
existence of the dream-work. In characterizing that psychic activity
which is unconscious and to which the latent thoughts of the dream
belong, the above assertion is no novelty, nor is it exhaustive, for
this unconscious psychic activity occupies itself with many other things
besides preparation for the future. A much worse confusion seems to
underlie the assurance that back of every dream one finds the
"death-clause," or death-wish. I am not quite certain what this formula
is meant to indicate, but I suppose that back of it is a confusion of
the dream with the whole personality of the dreamer.
An unjustified generalization, based on few good examples, is the
pronouncement that every dream permits of two interpretations, one such
as we have explained, the so-called psychoanalytic, and another, the
so-called anagogical or mystical, which ignores the instinctive impulses
and aims at a representation of the higher psychic functions (V.
Silberer). There are such dreams, but you will try in vain to extend
this conception to even a majority of the dreams. But after everything
you have heard, the statement will seem very incomprehensible that all
dreams can be interpreted bisexually, that is, as the concurrence of two
tendencies which may be designated as male and female (A. Adler). To be
sure, there are a few such dreams, and you may learn later that these
are built up in the manner of certain hysterical symptoms. I mention all
these newly discovered general characteristics of the dream in order to
warn you against them or at least in order not to leave you in doubt as
to how I judge them.
4. At one time the objective value of dream research was called into
question by the observation that patients undergoing analysis
accommodate the content of their dreams to the favorite theories of
their physicians, so that some dream predominantly of sexual impulses,
others of the desire for power and still others even of rebirth (W.
Stekel). The weight of this observation is diminished by the
consideration that people dreamed before there was such a thing as a
psychoanalytic treatment to influence their dreams, and that those who
are now undergoing treatment were also in the habit of dreaming before
the treatment was commenced. The meaning of this novel discovery can
soon be recognized as a matter of course and as of no consequence for
the theory of the dream. Those day-remnants which give rise to the dream
are the overflow from the strong interest of the waking life. If the
remarks of the physician and the stimuli which he gives have become
significant to the patient under analysis, then they become a part of
the day's remnants, can serve as psychic stimuli for the formation of a
dream along with other, emotionally-charged, unsolved interests of the
day, and operate much as do the somatic stimuli which act upon the
sleeper during his sleep. Just like these other incitors of the dream,
the sequence of ideas which the physician sets in motion may appear in
the manifest content, or may be traced in the latent content of the
dream. Indeed, we know that one can produce dreams experimentally, or to
speak more accurately, one can insert into the dream a part of the
dream material. Thus the analyst in influencing his patients, merely
plays the role of an experimenter in the manner of Mourly Vold, who
places the limbs of his subjects in certain positions.
One can often influence the dreamer as to the _subject-matter_ of his
dream, but one can never influence _what he will dream_ about it. The
mechanism of the dream-work and the unconscious wish that is hidden in
the dream are beyond the reach of all foreign influences. We already
realized, when we evaluated the dreams caused by bodily stimuli, that
the peculiarity and self-sufficiency of the dream life shows itself in
the reaction with which the dream retorts to the bodily or physical
stimuli which are presented. The statement here discussed, which aims to
throw doubt upon the objectivity of dream research, is again based on a
confusion--this time of the whole dream with the dream material.
This much, ladies and gentlemen, I wanted to tell you concerning the
problems of the dream. You will suspect that I have omitted a great
deal, and have yourselves discovered that I had to be inconclusive on
almost all points. But that is due to the relation which the phenomena
of the dream have to those of the neuroses. We studied the dream by way
of introduction to the study of the neuroses, and that was surely more
correct than the reverse would have been. But just as the dream prepares
us for the understanding of the neuroses, so in turn the correct
evaluation of the dream can only be gained after a knowledge of neurotic
phenomena has been won.
I do not know what you will think about this, but I must assure you that
I do not regret having taken so much of your interest and of your
available time for the problems of the dream. There is no other field in
which one can so quickly become convinced of the correctness of the
assertions by which psychoanalysis stands or falls. It will take the
strenuous labor of many months, even years, to show that the symptoms in
a case of neurotic break-down have their meaning, serve a purpose, and
result from the fortunes of the patient. On the other hand, the efforts
of a few hours suffice in proving the same content in a dream product
which at first seems incomprehensibly confused, and thereby to confirm
all the hypotheses of psychoanalysis, the unconsciousness of psychic
processes, the special mechanism which they follow, and the motive
forces which manifest themselves in them. And if we associate the
thorough analogy in the construction of the dream and the neurotic
symptom with the rapidity of transformation which makes of the dreamer
an alert and reasonable individual, we gain the certainty that the
neurosis also is based only on a change in the balance of the forces of
psychic life.
III
GENERAL THEORY OF THE NEUROSES
SIXTEENTH LECTURE
GENERAL THEORY OF THE NEUROSES
_Psychoanalysis and Psychiatry_
I am very glad to welcome you back to continue our discussions. I last
lectured to you on the psychoanalytic treatment of errors and of the
dream. To-day I should like to introduce you to an understanding of
neurotic phenomena, which, as you soon will discover, have much in
common with both of those topics. But I shall tell you in advance that I
cannot leave you to take the same attitude toward me that you had
before. At that time I was anxious to take no step without complete
reference to your judgment. I discussed much with you, I listened to
your objections, in short, I deferred to you and to your "normal common
sense." That is no longer possible, and for a very simple reason. As
phenomena, the dream and errors were not strange to you. One might say
that you had as much experience as I, or that you could easily acquire
as much. But neuroses are foreign to you; since you are not doctors
yourselves you have had access to them only through what I have told
you. Of what use is the best judgment if it is not supported by
familiarity with the material in question?
Do not, however, understand this as an announcement of dogmatic lectures
which demand your unconditional belief. That would be a gross
misunderstanding. I do not wish to convince you. I am out to stimulate
your interest and shake your prejudices. If, in consequence of not
knowing the facts, you are not in a position to judge, neither should
you believe nor condemn. Listen and allow yourselves to be influenced by
what I tell you. One cannot be so easily convinced; at least if he comes
by convictions without effort, they soon prove to be valueless and
unable to hold their own. He only has a right to conviction who has
handled the same material for many years and who in so doing has gone
through the same new and surprising experiences again and again. Why, in
matters of intellect these lightning conversions, these momentary
repulsions? Do you not feel that a _coup de foudre_, that love at first
sight, originates in quite a different field, namely, in that of the
emotions? We do not even demand that our patients should become
convinced of and predisposed to psychoanalysis. When they do, they seem
suspicious to us. The attitude we prefer in them is one of benevolent
scepticism. Will you not also try to let the psychoanalytic conception
develop in your mind beside the popular or "psychiatric"? They will
influence each other, mutually measure their strength, and some day work
themselves into a decision on your part.
On the other hand, you must not think for a moment that what I present
to you as the psychoanalytic conception is a purely speculative system.
Indeed, it is a sum total of experiences and observations, either their
direct expression or their elaboration. Whether this elaboration is done
adequately and whether the method is justifiable will be tested in the
further progress of the science. After two and a half decades, now that
I am fairly advanced in years, I may say that it was particularly
difficult, intensive and all-absorbing work which yielded these
observations. I have often had the impression that our opponents were
unwilling to take into consideration this objective origin of our
statements, as if they thought it were only a question of subjective
ideas arising haphazard, ideas to which another may oppose his every
passing whim. This antagonistic behavior is not entirely comprehensible
to me. Perhaps the physician's habit of steering clear of his neurotic
patients and listening so very casually to what they have to say allows
him to lose sight of the possibility of deriving anything valuable from
his patients' communications, and therefore, of making penetrating
observations on them. I take this opportunity of promising you that I
shall carry on little controversy in the course of my lectures, least of
all with individual controversialists. I have never been able to
convince myself of the truth of the saying that controversy is the
father of all things. I believe that it comes down to us from the Greek
sophist philosophy and errs as does the latter through the overvaluation
of dialectics. To me, on the contrary, it seems as if the so-called
scientific criticism were on the whole unfruitful, quite apart from the
fact that it is almost always carried on in a most personal spirit. For
my part, up to a few years ago, I could even boast that I had entered
into a regular scientific dispute with only one scholar (Lowenfeld, of
Munich). The end of this was that we became friends and have remained
friends to this day. But I did not repeat this attempt for a long time,
because I was not certain that the outcome would be the same.
Now you will surely judge that so to reject the discussion of literature
must evidence stubborness, a very special obtuseness against objections,
or, as the kindly colloquialisms of science have it, "a complete
personal bias." In answer, I would say that should you attain to a
conviction by such hard labor, you would thereby derive a certain right
to sustain it with some tenacity. Furthermore, I should like to
emphasize the fact that I have modified my views on certain important
points in the course of my researches, changed them and replaced them by
new ones, and that I naturally made a public statement of that fact each
time. What has been the result of this frankness? Some paid no attention
at all to my self-corrections and even to-day criticize me for
assertions which have long since ceased to have the same meaning for me.
Others reproach me for just this deviation, and on account of it declare
me unreliable. For is anyone who has changed his opinions several times
still trustworthy; is not his latest assertion, as well, open to error?
At the same time he who holds unswervingly to what he has once said, or
cannot be made to give it up quickly enough, is called stubborn and
biased. In the face of these contradictory criticisms, what else can one
do but be himself and act according to his own dictates? That is what I
have decided to do, and I will not allow myself to be restrained from
modifying and adapting my theories as the progress of my experience
demands. In the basic ideas I have hitherto found nothing to change, and
I hope that such will continue to be the case.
Now I shall present to you the psychoanalytic conception of neurotic
manifestations. The natural thing for me to do is to connect them to the
phenomena we have previously treated, for the sake of their analogy as
well as their contrast. I will select as symptomatic an act of frequent
occurrence in my office hour. Of course, the analyst cannot do much for
those who seek him in his medical capacity, and lay the woes of a
lifetime before him in fifteen minutes. His deeper knowledge makes it
difficult for him to deliver a snap decision as do other
physicians--"There is nothing wrong with you"--and to give the advice,
"Go to a watering-place for a while." One of our colleagues, in answer
to the question as to what he did with his office patients, said,
shrugging his shoulders, that he simply "fines them so many kronen for
their mischief-making." So it will not surprise you to hear that even in
the case of very busy analysts, the hours for consultation are not very
crowded. I have had the ordinary door between my waiting room and my
office doubled and strengthened by a covering of felt. The purpose of
this little arrangement cannot be doubted. Now it happens over and over
again that people who are admitted from my waiting room omit to close
the door behind them; in fact, they almost always leave both doors open.
As soon as I have noticed this I insist rather gruffly that he or she go
back in order to rectify the omission, even though it be an elegant
gentleman or a lady in all her finery. This gives an impression of
misapplied pedantry. I have, in fact, occasionally discredited myself by
such a demand, since the individual concerned was one of those who
cannot touch even a door knob, and prefer as well to have their
attendants spared this contact. But most frequently I was right, for he
who conducts himself in this way, and leaves the door from the waiting
room into the physician's consultation room open, belongs to the rabble
and deserves to be received inhospitably. Do not, I beg you, defend him
until you have heard what follows. For the fact is that this negligence
of the patient's only occurs when he has been alone in the waiting room
and so leaves an empty room behind him, never when others, strangers,
have been waiting with him. If that latter is the case, he knows very
well that it is in his interest not to be listened to while he is
talking to the physician, and never omits to close both the doors with
care.
This omission of the patient's is so predetermined that it becomes
neither accidental nor meaningless, indeed, not even unimportant, for,
as we shall see, it throws light upon the relation of this patient to
the physician. He is one of the great number of those who seek
authority, who want to be dazzled, intimidated. Perhaps he had inquired
by telephone as to what time he had best call, he had prepared himself
to come on a crowd of suppliants somewhat like those in front of a
branch milk station. He now enters an empty waiting room which is,
moreover, most modestly furnished, and he is disappointed. He must
demand reparation from the physician for the wasted respect that he had
tendered him, and so he omits to close the door between the reception
room and the office. By this, he means to say to the physician: "Oh,
well, there is no one here anyway, and probably no one will come as long
as I am here." He would also be quite unmannerly and supercilious during
the consultation if his presumption were not at once restrained by a
sharp reminder.
You will find nothing in the analysis of this little symptomatic act
which was not previously known to you. That is to say, it asserts that
this act is not accidental, but has a motive, a meaning, a purpose, that
it has its assignable connections psychologically, and that it serves as
a small indication of a more important psychological process. But above
all it implies that the process thus intimated is not known to the
consciousness of the individual in whom it takes place, for none of the
patients who left the two doors open would have admitted that they meant
by this omission to show me their contempt. Some could probably recall a
slight sense of disappointment at entering an empty waiting room, but
the connection between this impression and the symptomatic act which
followed--of these, his consciousness was surely not aware.
Now let us place, side by side with this small analysis of a symptomatic
act, an observation on a pathological case. I choose one which is fresh
in my mind and which can also be described with relative brevity. A
certain measure of minuteness of detail is unavoidable in any such
account.
A young officer, home on a short leave of absence, asked me to see his
mother-in-law who, in spite of the happiest circumstances, was
embittering her own and her people's existence by a senseless idea. I am
introduced to a well preserved lady of fifty-three with pleasant, simple
manners, who gives the following account without any hesitation: She is
most happily married and lives in the country with her husband, who
operates a large factory. She cannot say enough for the kind
thoughtfulness of her husband. They had married for love thirty years
ago, and since then there had never been a shadow, a quarrel or cause
for jealousy. Now, even though her two children are well married, the
husband and father does not yet want to retire, from a feeling of duty.
A year ago there happened the incredible thing, incomprehensible to
herself as well. She gave complete credence to an anonymous letter which
accused her excellent husband of having an affair with a young girl--and
since then her happiness is destroyed. The more detailed circumstances
were somewhat as follows: She had a chambermaid with whom she had
perhaps too often discussed intimate matters. This girl pursued another
young woman with positively malicious enmity because the latter had
progressed so much further in life, despite the fact that she was of no
better origin. Instead of going into domestic service, the girl had
obtained a business training, had entered the factory and in consequence
of the short-handedness due to the drafting of the clerks into the army
had advanced to a good position. She now lives in the factory itself,
meets all the gentlemen socially, and is even addressed as "Miss." The
girl who had remained behind in life was of course ready to speak all
possible evil of her one-time schoolmate. One day our patient and her
chambermaid were talking of an old gentleman who had been visiting at
the house, and of whom it was known that he did not live with his wife,
but kept another woman as his mistress. She does not know how it
happened that she suddenly remarked, "That would be the most awful thing
that could happen to me, if I should ever hear that my good husband also
had a mistress." The next day she received an anonymous letter through
the mail which, in a disguised handwriting, carried this very
communication which she had conjured up. She concluded--it seems
justifiably--that the letter was the handiwork of her malignant
chambermaid, for the letter named as the husband's mistress the
self-same woman whom the maid persecuted with her hatred. Our patient,
in spite of the fact that she immediately saw through the intrigue and
had seen enough in her town to know how little credence such cowardly
denunciations deserve, was nevertheless at once prostrated by the
letter. She became dreadfully excited and promptly sent for her husband
in order to heap the bitterest reproaches upon him. Her husband
laughingly denied the accusation and did the best that could be done. He
called in the family physician, who was as well the doctor in attendance
at the factory, and the latter added his efforts to quiet the unhappy
woman. Their further procedure was also entirely reasonable. The
chambermaid was dismissed, but the pretended rival was not. Since then,
the patient claims she has repeatedly so far calmed herself as no longer
to believe the contents of the anonymous letter, but this relief was
neither thoroughgoing nor lasting. It was enough to hear the name of the
young lady spoken or to meet her on the street in order to precipitate a
new attack of suspicion, pain and reproach.
This, now, is the case history of this good woman. It does not need much
psychiatric experience to understand that her portrayal of her own case
was, if anything, rather too mild in contrast to other nervous patients.
The picture, we say, was dissimulated; in reality she had never overcome
her belief in the accusation of the anonymous letter.
Now what position does a psychiatrist take toward such a case? We
already know what he would do in the case of the symptomatic act of the
patient who does not close the doors to the waiting room. He declares it
an accident without psychological interest, with which he need not
concern himself. But this attitude cannot be maintained toward the
pathological case of the jealous woman. The symptomatic act seems no
great matter, but the symptom itself claims attention by reason of its
gravity. It is bound up with intense subjective suffering while
objectively it threatens to break up a home; therefore its claim to
psychiatric interest cannot be put aside. The first endeavor of the
psychiatrist is to characterize the symptom by some distinctive feature.
The idea with which this woman torments herself cannot in itself be
called nonsensical, for it does happen that elderly married men have
affairs with young girls. But there is something else about it that is
nonsensical and incredible. The patient has no reason beyond the
declaration in the anonymous letter to believe that her tender and
faithful husband belongs to this sort of married men, otherwise not
uncommon. She knows that this letter in itself carries no proof; she can
satisfactorily explain its origin; therefore she ought to be able to
persuade herself that she has no reason to be jealous. Indeed she does
this, but in spite of it she suffers every bit as much as she would if
she acknowledged this jealousy as fully justified. We are agreed to call
ideas of this sort, which are inaccessible to arguments based on logic
or on facts, "_obsessions_." Thus the good lady suffers from an
"_obsession of jealousy_" that is surely a distinctive characterization
for this pathological case.