plain; it appears as a representation, a repetition of the original
significant scene. However, we are not forced to stop at this semblance
of a solution; when we examine more closely the relation between these
two people, we shall probably be enlightened concerning something of
wider importance, namely, the purpose of the compulsive act. The nucleus
of this purpose is evidently the summoning of the maid; to her she
wishes to show the stain and refute her husband's remark: "It is enough
to shame one before the maid." He--whose part she is playing--therefore
feels no shame before the maid, hence the stain must be in the right
place. So we see that she has not merely repeated the scene, rather she
has amplified it, corrected it and "turned it to the good." Thereby,
however, she also corrects something else,--the thing which was so
embarrassing that night and necessitated the use of the red
ink--impotence. The compulsive act then says: "No, it is not true, he
did not have to be ashamed before the maid, he was not impotent." After
the manner of a dream she represents the fulfillment of this wish in an
overt action, she is ruled by the desire to help her husband over that
unfortunate incident.
Everything else that I could tell you about this case supports this clue
more specifically; all that we otherwise know about her tends to
strengthen this interpretation of a compulsive act incomprehensible in
itself. For years the woman has lived separated from her husband and is
struggling with the intention to obtain a legal divorce. But she is by
no means free from him; she forces herself to remain faithful to him,
she retires from the world to avoid temptation; in her imagination she
excuses and idealizes him. The deepest secret of her malady is that by
means of it she shields her husband from malicious gossip, justifies her
separation from him, and renders possible for him a comfortable separate
life. Thus the analysis of a harmless compulsive act leads to the very
heart of this case and at the same time reveals no inconsiderable
portion of the secret of the compulsion neurosis in general. I shall be
glad to have you dwell upon this instance, as it combines conditions
that one can scarcely demand in other cases. The interpretation of the
symptoms was discovered by the patient herself in one flash, without the
suggestion or interference of the analyst. It came about by the
reference to an experience, which did not, as is usually the case,
belong to the half-forgotten period of childhood, but to the mature life
of the patient, in whose memory it had remained unobliterated. All the
objections which critics ordinarily offer to our interpretation of
symptoms fail in this case. Of course, we are not always so fortunate.
And one thing more! Have you not observed how this insignificant
compulsive act initiated us into the intimate life of the invalid? A
woman can scarcely relate anything more intimate than the story of her
bridal night, and is it without further significance that we just
happened to come on the intimacies of her sexual life? It might of
course be the result of the selection I have made in this instance. Let
us not judge too quickly and turn our attention to the second instance,
one of an entirely different kind, a sample of a frequently occurring
variety, namely, the sleep ritual.
A nineteen-year old, well-developed, gifted girl, an only child, who was
superior to her parents in education and intellectual activity, had been
wild and mischievous in her childhood, but has become very nervous
during the last years without any apparent outward cause. She is
especially irritable with her mother, always discontented, depressed,
has a tendency toward indecision and doubt, and is finally forced to
confess that she can no longer walk alone on public squares or wide
thoroughfares. We shall not consider at length her complicated
condition, which requires at least two diagnoses--agoraphobia and
compulsion neurosis. We will dwell only upon the fact that this girl has
also developed a sleep ritual, under which she allows her parents to
suffer much discomfort. In a certain sense, we may say that every
normal person has a sleep ritual, in other words that he insists on
certain conditions, the absence of which hinders him from falling
asleep; he has created certain observances by which he bridges the
transition from waking to sleeping and these he repeats every evening in
the same manner. But everything that the healthy person demands in order
to obtain sleep is easily understandable and, above all, when external
conditions necessitate a change, he adapts himself easily and without
loss of time. But the pathological ritual is rigid, it persists by
virtue of the greatest sacrifices, it also masks itself with a
reasonable justification and seems, in the light of superficial
observation, to differ from the normal only by exaggerated pedantry. But
under closer observation we notice that the mask is transparent, for the
ritual covers intentions that go far beyond this reasonable
justification, and other intentions as well that are in direct
contradiction to this reasonable justification. Our patient cites as the
motive of her nightly precautions that she must have quiet in order to
sleep; therefore she excludes all sources of noise. To accomplish this,
she does two things: the large clock in her room is stopped, all other
clocks are removed; not even the wrist watch on her night-table is
suffered to remain. Flowerpots and vases are placed on her desk so that
they cannot fall down during the night, and in breaking disturb her
sleep. She knows that these precautions are scarcely justifiable for the
sake of quiet; the ticking of the small watch could not be heard even if
it should remain on the night-table, and moreover we all know that the
regular ticking of a clock is conducive to sleep rather than disturbing.
She does admit that there is not the least probability that flowerpots
and vases left in place might of their own accord fall and break during
the night. She drops the pretense of quiet for the other practice of
this sleep ritual. She seems on the contrary to release a source of
disturbing noises by the demand that the door between her own room and
that of her parents remain half open, and she insures this condition by
placing various objects in front of the open door. The most important
observances concern the bed itself. The large pillow at the head of the
bed may not touch the wooden back of the bed. The small pillow for her
head must lie on the large pillow to form a rhomb; she then places her
head exactly upon the diagonal of the rhomb. Before covering herself,
the featherbed must be shaken so that its foot end becomes quite flat,
but she never omits to press this down and redistribute the thickness.
Allow me to pass over the other trivial incidents of this ritual; they
would teach us nothing new and cause too great digression from our
purpose. Do not overlook, however, the fact that all this does not run
its course quite smoothly. Everything is pervaded by the anxiety that
things have not been done properly; they must be examined, repeated. Her
doubts seize first on one, then on another precaution, and the result is
that one or two hours elapse during which the girl cannot and the
intimidated parents dare not sleep.
These torments were not so easily analyzed as the compulsive act of our
former patient. In the working out of the interpretations I had to hint
and suggest to the girl, and was met on her part either by positive
denial or mocking doubt. This first reaction of denial, however, was
followed by a time when she occupied herself of her own accord with the
possibilities that had been suggested, noted the associations they
called out, produced reminiscences, and established connections, until
through her own efforts she had reached and accepted all
interpretations. In so far as she did this, she desisted as well from
the performance of her compulsive rules, and even before the treatment
had ended she had given up the entire ritual. You must also know that
the nature of present-day analysis by no means enables us to follow out
each individual symptom until its meaning becomes clear. Rather it is
necessary to abandon a given theme again and again, yet with the
certainty that we will be led back to it in some other connection. The
interpretation of the symptoms in this case, which I am about to give
you, is a synthesis of results, which, with the interruptions of other
work, needed weeks and months for their compilation.
Our patient gradually learns to understand that she has banished clocks
and watches from her room during the night because the clock is the
symbol of the female genital. The clock, which we have learned to
interpret as a symbol for other things also, receives this role of the
genital organ through its relation to periodic occurrences at equal
intervals. A woman may for instance be found to boast that her
menstruation is as regular as clockwork. The special fear of our
patient, however, was that the ticking of the clock would disturb her
in her sleep. The ticking of the clock may be compared to the throbbing
of the clitoris during sexual excitement. Frequently she had actually
been awakened by this painful sensation and now this fear of an erection
of the clitoris caused her to remove all ticking clocks during the
night. Flowerpots and vases are, as are all vessels, also female
symbols. The precaution, therefore, that they should not fall and break
at night, was not without meaning. We know the widespread custom of
breaking a plate or dish when an engagement is celebrated. The fragment
of which each guest possesses himself symbolizes his renunciation of his
claim to the bride, a renunciation which we may assume as based on the
monogamous marriage law. Furthermore, to this part of her ceremonial our
patient adds a reminiscence and several associations. As a child she had
slipped once and fallen with a bowl of glass or clay, had cut her
finger, and bled violently. As she grew up and learned the facts of
sexual intercourse, she developed the fear that she might not bleed
during her bridal night and so not prove to be a virgin. Her precaution
against the breaking of vases was a rejection of the entire virginity
complex, including the bleeding connected with the first cohabitation.
She rejected both the fear to bleed and the contradictory fear not to
bleed. Indeed her precautions had very little to do with a prevention of
noise.
One day she guessed the central idea of her ceremonial, when she
suddenly understood her rule not to let the pillow come in contact with
the bed. The pillows always had seemed a woman to her, the erect back of
the bed a man. By means of magic, we may say, she wished to keep apart
man and wife; it was her parents she wished to separate, so to prevent
their marital intercourse. She had sought to attain the same end by more
direct methods in earlier years, before the institution of her
ceremonial. She had simulated fear or exploited a genuine timidity in
order to keep open the door between the parents' bedroom and the
nursery. This demand had been retained in her present ceremonial. Thus
she had gained the opportunity of overhearing her parents, a proceeding
which at one time subjected her to months of sleeplessness. Not content
with this disturbance to her parents, she was at that time occasionally
able to gain her point and sleep between father and mother in their
very bed. Then "pillow" and "wooden wall" could really not come in
contact. Finally when she became so big that her presence between the
parents could not longer be borne comfortably, she consciously simulated
fear and actually succeeded in changing places with her mother and
taking her place at her father's side. This situation was undoubtedly
the starting point for the phantasies, whose after-effects made
themselves felt in her ritual.
If a pillow represented a woman, then the shaking of the featherbed till
all the feathers were lumped at one end, rounding it into a prominence,
must have its meaning also. It meant the impregnation of the wife; the
ceremonial, however, never failed to provide for the annulment, of this
pregnancy by the flattening down of the feathers. Indeed, for years our
patient had feared that the intercourse between her parents might result
in another child which would be her rival. Now, where the large pillow
represents a woman, the mother, then the small pillow could be nothing
but the daughter. Why did this pillow have to be placed so as to form a
rhomb; and why did the girl's head have to rest exactly upon the
diagonal? It was easy to remind the patient that the rhomb on all walls
is the rune used to represent the open female genital. She herself then
played the part of the man, the father, and her head took the place of
the male organ. (Cf. the symbol of beheading to represent castration.)
Wild ideas, you will say, to run riot in the head of a virgin girl. I
admit it, but do not forget that I have not created these ideas but
merely interpreted them. A sleep ritual of this kind is itself very
strange, and you cannot deny the correspondence between the ritual and
the phantasies that yielded us the interpretation. For my part I am most
anxious that you observe in this connection that no single phantasy was
projected in the ceremonial, but a number of them had to be
integrated,--they must have their nodal points somewhere in space.
Observe also that the observance of the ritual reproduce the sexual
desire now positively, now negatively, and serve in part as their
rejection, again as their representation.
It would be possible to make a better analysis of this ritual by
relating it to other symptoms of the patient. But we cannot digress in
that direction. Let the suggestion suffice that the girl is subject to
an erotic attachment to her father, the beginning of which goes back to
her earliest childhood. That perhaps is the reason for her unfriendly
attitude toward her mother. Also we cannot escape the fact that the
analysis of this symptom again points to the sexual life of the patient.
The more we penetrate to the meaning and purpose of neurotic symptoms,
the less surprising will this seem to us.
By means of two selected illustrations I have demonstrated to you that
neurotic symptoms carry just as much meaning as do errors and the dream,
and that they are intimately connected with the experience of the
patient. Can I expect you to believe this vitally significant statement
on the strength of two examples? No. But can you expect me to cite
further illustrations until you declare yourself convinced? That too is
impossible, since considering the explicitness with which I treat each
individual case, I would require a five-hour full semester course for
the explanation of this one point in the theory of the neuroses. I must
content myself then with having given you one proof for my assertion and
refer you for the rest to the literature of the subject, above all to
the classical interpretation of symptoms in Breuer's first case
(hysteria) as well as to the striking clarification of obscure symptoms
in the so-called dementia praecox by C. G. Jung, dating from the time
when this scholar was still content to be a mere psychoanalyst--and did
not yet want to be a prophet; and to all the articles that have
subsequently appeared in our periodicals. It is precisely investigations
of this sort which are plentiful. Psychoanalysts have felt themselves so
much attracted by the analysis, interpretation and translation of
neurotic symptoms, that by contrast they seem temporarily to have
neglected other problems of neurosis.
Whoever among you takes the trouble to look into the matter will
undoubtedly be deeply impressed by the wealth of evidential material.
But he will also encounter difficulties. We have learned that the
meaning of a symptom is found in its relation to the experience of the
patient. The more highly individualized the symptom is, the sooner we
may hope to establish these relations. Therefore the task resolves
itself specifically into the discovery for every nonsensical idea and
useless action of a past situation wherein the idea had been justified
and the action purposeful. A perfect example for this kind of symptom is
the compulsive act of our patient who ran to the table and rang for the
maid. But there are symptoms of a very different nature which are by no
means rare. They must be called typical symptoms of the disease, for
they are approximately alike in all cases, in which the individual
differences disappear or shrivel to such an extent that it is difficult
to connect them with the specific experiences of the patient and to
relate them to the particular situations of his past. Let us again
direct our attention to the compulsion neurosis. The sleep ritual of our
second patient is already quite typical, but bears enough individual
features to render possible what may be called an _historic_
interpretation. But all compulsive patients tend to repeat, to isolate
their actions from others and to subject them to a rhythmic sequence.
Most of them wash too much. Agoraphobia (topophobia, fear of spaces), a
malady which is no longer grouped with the compulsion neurosis, but is
now called anxiety hysteria, invariably shows the same pathological
picture; it repeats with exhausting monotony the same feature, the
patient's fear of closed spaces, of large open squares, of long
stretched streets and parkways, and their feeling of safety when
acquaintances accompany them, when a carriage drives after them, etc. On
this identical groundwork, however, the individual differences between
the patients are superimposed--moods one might almost call them, which
are sharply contrasted in the various cases. The one fears only narrow
streets, the other only wide ones, the one can go out walking only when
there are few people abroad, the other when there are many. Hysteria
also, aside from its wealth of individual features, has a superfluity of
common typical symptoms that appear to resist any facile historical
methods of tracing them. But do not let us forget that it is by these
typical symptoms that we get our bearings in reaching a diagnosis. When,
in one case of hysteria we have finally traced back a typical symptom to
an experience or a series of similar experiences, for instance followed
back an hysterical vomiting to its origin in a succession of disgust
impressions, another case of vomiting will confuse us by revealing an
entirely different chain of experiences, seemingly just as effective. It
seems almost as though hysterical patients must vomit for some reason as
yet unknown, and that the historic factors, revealed by analysis, are
chance pretexts, seized on as opportunity best offered to serve the
purposes of a deeper need.
Thus we soon reach the discouraging conclusion that although we can
satisfactorily explain the individual neurotic symptom by relating it to
an experience, our science fails us when it comes to the typical
symptoms that occur far more frequently. In addition, remember that I am
not going into all the detailed difficulties which come up in the course
of resolutely hunting down an historic interpretation of the symptom. I
have no intention of doing this, for though I want to keep nothing from
you, and so paint everything in its true colors, I still do not wish to
confuse and discourage you at the very outset of our studies. It is true
that we have only begun to understand the interpretation of symptoms,
but we wish to hold fast to the results we have achieved, and struggle
forward step by step toward the mastery of the still unintelligible
data. I therefore try to cheer you with the thought that a fundamental
between the two kinds of symptoms can scarcely be assumed. Since the
individual symptoms are so obviously dependent upon the experience of
the patient, there is a possibility that the typical symptoms revert to
an experience that is in itself typical and common to all humanity.
Other regularly recurring features of neurosis, such as the repetition
and doubt of the compulsion neurosis, may be universal reactions which
are forced upon the patient by the very nature of the abnormal change.
In short, we have no reason to be prematurely discouraged; we shall see
what our further results will yield.
We meet a very similar difficulty in the theory of dreams, which in our
previous discussion of the dream I could not go into. The manifest
content of dreams is most profuse and individually varied, and I have
shown very explicitly what analysis may glean from this content. But
side by side with these dreams there are others which may also be termed
"typical" and which occur similarly in all people. These are dreams of
identical content which offer the same difficulties for their
interpretation as the typical symptom. They are the dreams of falling,
flying, floating, swimming, of being hemmed in, of nakedness, and
various other anxiety dreams that yield first one and then another
interpretation for the different patients, without resulting in an
explanation of their monotonous and typical recurrence. In the matter
of these dreams also, we see a fundamental groundwork enriched by
individual additions. Probably they as well can be fitted into the
theory of dream life, built up on the basis of other dreams,--not
however by straining the point, but by the gradual broadening of our
views.
EIGHTEENTH LECTURE
GENERAL THEORY OF THE NEUROSES
_Traumatic Fixation--The Unconscious_
I said last time that we would not continue our work from the standpoint
of our doubts, but on the basis of our results. We have not even touched
upon two of the most interesting conclusions, derived equally from the
same two sample analyses.
In the first place, both patients give us the impression of being
_fixated_ upon some very definite part of their past; they are unable to
free themselves therefrom, and have therefore come to be completely
estranged both from the present and the future. They are now isolated in
their ailment, just as in earlier days people withdrew into monasteries
there to carry along the burden of their unhappy fates. In the case of
the first patient, it is her marriage with her husband, really
abandoned, that has determined her lot. By means of her symptoms she
continues to deal with her husband; we have learned to understand those
voices which plead his case, which excuse him, exalt him, lament his
loss. Although she is young and might be coveted by other men, she has
seized upon all manner of real and imaginary (magic) precautions to
safeguard her virtue for him. She will not appear before strangers, she
neglects her personal appearance; furthermore, she cannot bring herself
to get up readily from any chair on which she has been seated. She
refuses to give her signature, and finally, since she is motivated by
her desire not to let anyone have anything of hers, she is unable to
give presents.
In the case of the second patient, the young girl, it is an erotic
attachment for her father that had established itself in the years prior
to puberty, which plays the same role in her life. She also has arrived
at the conclusion that she may not marry so long as she is sick. We may
suspect she became ill in order that she need not marry, and that she
might stay with her father.
It is impossible to evade the question of how, in what manner, and
driven by what motives, an individual may come by such a remarkable and
unprofitable attitude toward life. Granted of course that this bearing
is a general characteristic of neurosis, and not a special peculiarity
of these two cases, it is nevertheless a general trait in every neurosis
of very great importance in practice. Breuer's first hysterical patient
was fixated in the same manner upon the time when she nursed her very
sick father. In spite of her recuperation she has, in certain respects,
since that time, been done with life; although she remained healthy and
able, she did not enter on the normal life of women. In every one of our
patients we may see, by the use of analysis, that in his
disease-symptoms and their results he has gone back again into a
definite period of his past. In the majority of cases he even chooses a
very early phase of his life, sometime a childhood phase, indeed,
laughable as it may appear, a phase of his very suckling existence.