Contributions to the neue freie presse 15 страница

I have already asserted that obsessional thoughts have undergone a distortion similar to that undergone by dream-thoughts before they become the manifest content of a dream. The technique of this distortion may therefore be of interest to us, and there should be nothing to prevent our exhibiting its various modes by means of a series of obsessions which have been translated and made clear. But here again the conditions governing the publication of this case make it impossible for me to give more than a few specimens. Not all of the patient’s obsessions were so complicated in their structure and so difficult to solve as the great rat idea. In some of the others a very simple technique was employed - namely, that of distortion by omission or ellipsis. This technique is pre-eminently applicable to jokes, but in our present case, too, it did useful work as a means of protecting things from being understood.

For instance, one of the patient’s oldest and favourite obsessions (which corresponded to an admonition or warning) ran as follows: ‘If I marry the lady, some misfortune will befall my father (in the next world).’ If we insert the intermediate steps, which had been skipped but were known to us from the analysis, we get the following train of thought: ‘If my father were alive, he would be as furious over my design of marrying the lady as he was in the scene in my childhood; so that I should fly into a rage with him once more and wish him every possible evil; and thanks to the omnipotence of my wishes¹ these evils would be bound to come upon him.’

Here is another instance in which a solution can be reached by filling out an ellipsis. It is once more in the nature of a warning or an ascetic prohibition. The patient had a charming little niece of whom he was very fond. One day this idea came into his head: ‘If you indulge in intercourse, something will happen to Ella’ (i.e. she will die). When the omissions have been made good, we have: ‘Every time you copulate, even with a stranger, you will not be able to avoid the reflection that in your married life sexual intercourse can never bring you a child (on account of the lady’s sterility). This will grieve you so much that you will become envious of your sister on account of little Ella, and you will grudge her the child. These envious impulses will inevitably lead to the child’s death.’²

¹ This omnipotence is discussed further on.

² An example from another of my works, Jokes and their Relation to the Unconscious, will recall to the reader the manner in which this elliptical technique is employed in making jokes: ‘There is a witty and pugnacious journalist in Vienna, whose biting invective has repeatedly led to his being physically maltreated by the subjects of his attacks. On one occasion, when a fresh misdeed on the part of one of his habitual opponents was being discussed, somebody exclaimed: "If X hears of this, he’ll get his ears boxed again."... The apparent absurdity of this remark disappears if between the two clauses we insert the words: "he’ll write such a scathing article upon the man, that, etc."' - This elliptical joke, we may note, is similar in its content, as well as in its form, to the first example quoted in the text.

The technique of distortion by ellipsis seems to be typical of obsessional neuroses; I have come across it in the obsessional thoughts of other patients as well. One example, a particularly transparent one, is of especial interest on account of a certain structural similarity with the rat idea. It was a case of doubting, and occurred in a lady who suffers principally from obsessional acts. This lady was going for a walk with her husband in Nuremberg, and made him take her into a shop, where she purchased various objects for her child and amongst them a comb. Her husband, finding that the shopping was too long a business for his taste, said that he had noticed some coins in an antique shop on the way which he was anxious to secure, adding that after he had made his purchase he would come and fetch her in the shop in which they at present were. But he stayed away, as she thought, far too long. When he came back she accordingly asked him where he had been. ‘Why,’ he replied, ‘at the antique shop I told you about.’ At the same instant she was seized by a tormenting doubt whether she had not as a matter of fact always possessed the comb which she had just bought for her child. She was naturally quite unable to discover the simple mental link that was involved. There is nothing for it but to regard the doubt as having become displaced, and to reconstruct the complete chain of unconscious thoughts as follows: ‘If it is true that you were only at the antique shop, if I am really to believe that, then I may just as well believe that this comb that I bought a moment ago has been in my possession for years.’ Here, therefore, the lady was drawing a derisive and ironical parallel, just as when our patient thought: ‘Oh yes, as sure as those two’ (his father and the lady) ‘will have children, I shall pay back the money to A.’ In the lady’s case the doubt was dependent upon her unconscious jealousy, which led her to suppose that her husband had spent the interval of his absence in paying a visit of gallantry.

I shall not in the present paper attempt any discussion of the psychological significance of obsessional thinking. Such a discussion would be of extraordinary value in its results, and would do more to clarify our ideas upon the nature of the conscious and the unconscious than any study of hysteria or the phenomena of hypnosis. It would be a most desirable thing if the philosophers and psychologists who develop brilliant theoretical views on the unconscious upon a basis of hearsay knowledge or from their own conventional definitions would first submit to the convincing impressions which may be gained from a first-hand study of the phenomena of obsessional thinking. We might almost go to the length of requiring it of them, if the task were not so far more laborious than the methods of work to which they are accustomed. I will only add here that in obsessional neuroses the unconscious mental processes occasionally break through into consciousness in their pure and undistorted form, that such incursions may take place at every possible stage of the unconscious process of thought, and that at the moment of the incursion the obsessional ideas can, for the most part, be recognized as formations of very long standing. This accounts for the striking circumstance that, when the analyst tries, with the patient’s help, to discover the date of the first occurrence of an obsessional idea, the patient is obliged to place it further and further back as the analysis proceeds, and is constantly finding fresh ‘first’ occasions for the appearance of the obsession.

(B) SOME PSYCHOLOGICAL PECULIARITIES OF OBSESSIONAL NEUROTICS:

THEIR ATTITUDE TOWARD REALITY, SUPERSTITION AND DEATH

In this section I intend to deal with a few mental characteristics of obsessional neurotics which, though they do not seem important in themselves, nevertheless lie upon the road to a comprehension of more important things. They were strongly marked in our present patient; but I know that they are not attributable to his individual character, but to his disorder, and that they are to be met with quite typically in other obsessional patients.

Our patient was to a high degree superstitious, and this although he was a highly educated and enlightened man of considerable acumen, and although he was able at times to assure me that he did not believe a word of all this rubbish. Thus he was at once superstitious and not superstitious; and there was a clear distinction between his attitude and the superstition of uneducated people who feel themselves at one with their belief. He seemed to understand that his superstition was dependent upon his obsessional thinking, although at times he gave way to it completely. The meaning of this inconsistent and vacillating behaviour can be most easily, grasped if it is regarded in the light of a hypothesis which I shall now proceed to mention. I did not hesitate to assume that the truth was not that the patient still had an open mind upon this subject, but that he had two separate and contradictory convictions upon it. His oscillation between these two views quite obviously depended upon his momentary attitude towards his obsessional disorder. As soon as he had got the better of one of these obsessions, he used to smile in a superior way at his own credulity, and no events then occurred that were calculated to shake his firmness; but the moment he came under the sway of another obsession which had not been cleared up - or, what amounts to the same thing, of a resistance - the strangest coincidences would happen, to support him in his credulous belief.

His superstition was nevertheless that of an educated man, and he avoided such vulgar prejudices as being afraid of Friday or of the number thirteen, and so on. But he believed in premonitions and in prophetic dreams; he would constantly meet the very person of whom, for some inexplicable reason, he had just been thinking; or he would receive a letter from some one who had suddenly come into his mind after being forgotten for many years. At the same time he was honest enough - or rather, he was loyal enough to his official conviction - not to have forgotten instances in which he strangest forebodings had come to nothing. On one occasion, for instance, when he went away for his summer holidays, he had felt morally certain that he would never return to Vienna alive. He also admitted that the great majority of his premonitions related to things which had no special personal importance to him, and that, when he met an acquaintance of whom, until a few moments previously, he had not thought for a very long time, nothing further took place between himself and the miraculous apparition. And he naturally could not deny that all the important events of his life had occurred without his having had any premonition of them, and that, for instance, his father’s death had taken him entirely by surprise. But arguments such as these had no effect upon the discrepancy in his convictions. They merely served to prove the obsessional nature of his superstitions, and that could already be inferred from the way in which they came and went with the increase and decrease of his resistance.

I was not in a position, of course, to give a rational explanation of all the miraculous stories of his remoter past. But as regards the similar things that happened during the time of his treatment, I was able to prove to him that he himself invariably had a hand in the manufacture of these miracles, and I was able to point out to him the methods that he employed. He worked by means of peripheral vision and reading, forgetting, and, above all, errors of memory. In the end he used himself to help me in discovering the little sleight-of-hand tricks by which these wonders were performed. I may mention one interesting infantile root of his belief that forebodings and premonitions came true. It was brought to light by his recollection that very often, when a date was being fixed for something, his mother used to say: ‘I shan’t be able to on such-and-such a day. I shall have to stop in bed then.’ And in fact when the day in question arrived she had invariably stayed in bed!

There can be no doubt that the patient felt a need for finding experiences of this kind to act as props for his superstition, and that it was for that reason that he occupied himself so much with the inexplicable coincidences of everyday life with which we are all familiar, and helped out their shortcomings with unconscious activity of his own. I have come across a similar need in many other obsessional patients and have suspected its presence in many more besides. It seems to me easily explicable in view of the psychological characteristics of the obsessional neurosis. In this disorder, as I have already explained (p. 2155), repression is effected not by means of amnesia but by a severance of causal connections brought about by a withdrawal of affect. These repressed connections appear to persist in some kind of shadowy form (which I have elsewhere compared to an endopsychic perception),¹ and they are thus transferred, by a process of projection, into the external world, where they bear witness to what has been effaced from consciousness.

¹ The Psychopathology of Everyday Life (1901b), Chapter XII, Section C (b).2 Another mental need, which is also shared by obsessional neurotics and which is in some respects related to the one just mentioned, is the need for uncertainty in their life, or for doubt. An enquiry into this characteristic leads deep into the investigation of instinct. The creation of uncertainty is one of the methods employed by the neurosis for drawing the patient away from reality and isolating him from the world - which is among the objects of every psychoneurotic disorder. Again, it is only too obvious what efforts are made by the patients themselves in order to be able to avoid certainty and remain in doubt.. Some of them, indeed, give a vivid expression to this tendency in a dislike of clocks and watches (for these at least make the time of day certain), and in the unconscious artifices which they employ in order to render these doubt removing instruments innocuous. Our present patient had developed a peculiar talent for avoiding a knowledge of any facts which would have helped him in deciding his conflict. Thus he was in ignorance upon those matters relating to his lady which were the most relevant to the question of his marriage: he was ostensibly unable to say who had operated upon her and whether the operation had been unilateral or bilateral. He had to be forced into remembering what he had forgotten and into finding out what he had overlooked.

The predilection felt by obsessional neurotics for uncertainty and doubt leads them to turn their thoughts by preference to those subjects upon which all mankind are uncertain and upon which our knowledge and judgements must necessarily remain open to doubt. The chief subjects of this kind are paternity, length of life, life after death, and memory - in the last of which we are all in the habit of believing, without having the slightest guarantee of its trustworthiness.¹

¹ As Lichtenberg says, ‘An astronomer knows whether the moon is inhabited or not with about as much certainty as he knows who was his father, but not with so much certainty as he knows who was his mother’. A great advance was made in civilization when men decided to put their inferences upon a level with the testimony of their senses and to make the step from matriarchy to patriarchy. The prehistoric figures which show a smaller person sitting upon the head of a larger one are representations of patrilineal descent; Athena had no mother, but sprang from the head of Zeus. A witness who testifies to something before a court of law is still called ‘Zeuge’ [literally, ‘begetter’] in German, after the part played by the male in the act of procreation; so too in hieroglyphics the word for a ‘witness’ is written with a representation of the male organ.

3 In obsessional neuroses the uncertainty of memory is used to the fullest extent as a help in the formation of symptoms; and we shall learn directly the part played in the actual content of the patients’ thoughts by the questions of length of life and life after death. But as an appropriate transition I will first consider one particular superstitious trait in our patient to which I have already alluded (p. 2176) and which will no doubt have puzzled more than one of my readers.

I refer to the omnipotence which he ascribed to his thoughts and feelings, and to his wishes, whether good or evil. It is, I must admit, decidedly tempting to declare that this idea was a delusion and that it oversteps the limits of obsessional neurosis. I have, however, come across the same conviction in another obsessional patient; and he was long ago restored to health and is leading a normal life. Indeed, all obsessional neurotics behave as though they shared this conviction. It will be our business to throw some light upon these patients’ over-estimation of their powers. Assuming, without more ado, that this belief is a frank acknowledgement of a relic of the old megalomania of infancy, we will proceed to ask our patient for the grounds of his conviction. In reply, he adduces two experiences. When he returned for a second visit to the hydropathic establishment at which his disorder had been relieved for the first and only time, he asked to be given his old room, for its position had facilitated his relations with one of the nurses. He was told that the room was already taken and that it was occupied by an old professor. This piece of news considerably diminished his prospects of successful treatment, and he reacted to it with the unamiable thought: ‘I wish he may be struck dead for it!’ A fortnight later he was woken up from his sleep by the disturbing idea of a corpse; and in the morning he heard that the professor had really had a stroke, and that he had been carried up into his room at about the time he himself had woken up. The second experience related to an unmarried woman, no longer young, though with a great desire to be loved, who had paid him a great deal of attention and had once asked him point blank whether he could not love her. He had given her an evasive answer. A few days afterwards he heard that she had thrown herself out of a window. He then began to reproach himself, and said to himself that it would have been in his power to save her life by giving her his love. I n this way he became convinced of the omnipotence of his love and of his hatred. Without denying the omnipotence of love we may point out that both these instances were concerned with death, and we may adopt the obvious explanation that, like other obsessional neurotics, our patient was compelled to overestimate the effects of his hostile feelings upon the external world, because a large part of their internal, mental effects escaped his conscious knowledge. His love - or rather his hatred - was in truth overpowering; it was precisely they that created the obsessional thoughts, of which he could not understand the origin and against which he strove in vain to defend himself.¹

¹ [Footnote added 1923:] The omnipotence of thoughts, or, more accurately speaking, of wishes, has since been recognized as an essential element in the mental life of primitive people. See Totem and Taboo (1912-13).4 Our patient had a quite peculiar attitude towards the question of death. He showed the deepest sympathy whenever any one died, and religiously attended the funeral; so that among his brothers and sisters he earned the nickname of ‘carrion crow’. In his imagination, too, he was constantly making away with people so as to show his heartfelt sympathy for their bereaved relatives. The death of an elder sister, which took place when he was between three and four years old, played a great part in his phantasies, and was brought into intimate connection with his childish misdemeanours during the same period. We know, moreover, at what an early age thoughts about his father’s death had occupied his mind, and we may regard his illness itself as a reaction to that event, for which he had felt an obsessional wish fifteen years earlier. The strange extension of his obsessional fears to the ‘next world’ was nothing else than a compensation for these death-wishes which he had felt against his father. It was introduced eighteen months after his father had died, at a time when there had been a revival of his sorrow at the loss, and it was designed - in defiance of reality, and in deference to the wish which had previously been showing itself in phantasies of every kind - were intended to undo the fact of his father’s death. We have had occasion in several places (pp. 2173idh_p2173, and 2176) to translate the phrase ‘in the next world’ by the words ‘if my father were still alive’.

But the behaviour of other obsessional neurotics does not differ greatly from that of our present patient, even though it has not been their fate to come face to face with the phenomenon of death at such an early age. Their thoughts are unceasingly occupied with other people’s length of life and possibility of death; their superstitious propensities have had no other content to begin with, and have perhaps no other source whatever. But these neurotics need the help of the possibility of death chiefly in order that it may act as a solution of conflicts they have left unsolved. Their essential characteristic is that they are incapable of coming to a decision, especially in matters of love; they endeavour to postpone every decision, and, in their doubt which person they shall decide for or what measures they shall take against a person, they are obliged to choose as their model the old German courts of justice, in which the suits were usually brought to an end, before judgement had been given, by the death of the parties to the dispute. Thus in every conflict which enters their lives they are on the look out for the death of some one who is of importance to them, usually of some one they love - such as one of their parents, or a rival, or one of the objects of their love between which their inclinations are wavering. But at this point our discussion of the death-complex in obsessional neuroses touches upon the problem of the instinctual life of obsessional neurotics. And to this problem we must now turn.

(C) THE INSTINCTUAL LIFE OF OBSESSIONAL NEUROTICS,

AND THE ORIGINS OF COMPULSION AND DOUBT

If we wish to obtain a grasp of the psychical forces whose interplay built up this neurosis, we must turn back to what we have learnt from the patient on the subject of the precipitating causes of his falling ill as a grown-up man and as a child. He fell ill when he was in his twenties on being faced with a temptation to marry another woman instead of the one whom he had loved so long; and he avoided a decision of this conflict by postponing all the necessary preliminary actions. The means for doing this was given him by his neurosis. His hesitation between the lady he loved and the other girl can be reduced to a conflict between his father’s influence and his love for his lady, or, in other words, to a conflicting choice between his father and his sexual object, such as had already subsisted (judging from his recollections and obsessional ideas) in his remote childhood. All through his life, moreover, he was unmistakably victim to a conflict between love and hatred, in regard both to his lady and to his father. His phantasies of revenge and such obsessional phenomena as his obsession for understanding and his exploit with the stone in the road bore witness to his divided feelings; and they were to a certain degree comprehensible and normal, for the lady by her original refusal and subsequently by her coolness had given him some excuse for hostility. But his relations with his father were dominated by a similar division of feeling, as we have seen from our translation of his obsessional thoughts; and his father, too, must have given him an excuse for hostility in his childhood, as indeed we have been able to establish almost beyond question. His attitude towards the lady - a compound of tenderness and hostility - came to a great extent within the scope of his conscious knowledge; at most he deceived himself over the degree and violence of his negative feelings. But his hostility towards his father, on the contrary, though he had once been acutely conscious of it, had long since vanished from his ken, and it was only in the teeth of the most violent resistance that it could be brought back into his consciousness. We may regard the repression of his infantile hatred of his father as the event which brought his whole subsequent career under the dominion of the neurosis.

The conflicts of feeling in our patient which we have here enumerated separately were not independent of each other, but were bound together in pairs. His hatred of his lady was inevitably coupled with his attachment to his father, and inversely his hatred of his father with his attachment to his lady. But the two conflicts of feeling which result from this simplification - namely, the opposition between his relation to his father and to his lady, and the contradiction between his love and his hatred within each of these relations - had no connection whatever with each other, either in their content or in their origin. The first of these two conflicts corresponds to the normal vacillation between male and female which characterizes every one’s choice of a love-object. It is first brought to the child’s notice by the time-honoured question: ‘Which do you love most, Daddy or Mummy?’ and it accompanies him through his whole life, whatever may be the relative intensity of his feelings to the two sexes or whatever may be the sexual aim upon which he finally becomes fixed. But normally this opposition soon loses the character of a hard-and-fast contradiction, of an inexorable ‘either-or’. Room is found for satisfying the unequal demands of both sides, although even in a normal person the higher estimation of one sex is always thrown into relief by a depreciation of the other.

The other conflict, that between love and hatred, strikes us more strangely. We know that incipient love is often perceived as hatred, and that love, if it is denied satisfaction, may easily be partly converted into hatred, and poets tell us that in the more tempestuous stages of love the two opposed feelings may subsist side by side for a while as though in rivalry with each other. But the chronic co-existence of love and hatred, both directed towards the same person and both of the highest degree of intensity, cannot fail to astonish us. We should have expected that the passionate love would long ago have conquered the hatred or been devoured by it. And in fact such a protracted survival of two opposites is only possible under quite peculiar psychological conditions and with the co-operation of the state of affairs in the unconscious. The love has not succeeded in extinguishing the hatred but only in driving it down into the unconscious; and in the unconscious the hatred, safe from the danger of being destroyed by the operations of consciousness, is able to persist and even to grow. In such circumstances the conscious love attains as a rule, by way of reaction, an especially high degree of intensity, so as to be strong enough for the perpetual task of keeping its opponent under repression. The necessary condition for the occurrence of such a strange state of affairs in a person’s erotic life appears to be that at a very early age, somewhere in the prehistoric period of his infancy, the two opposites should have been split apart and one of them, usually the hatred, have been repressed.¹

¹ Compare the discussion on this point during one of the first sessions. - (Added 1923:) Bleuler subsequently introduced the appropriate term ‘ambivalence’ to describe this emotional constellation. See also a further development of this line of thought in my paper ‘The Predisposition to Obsessional Neurosis’ (1913I).7

If we consider a number of analyses of obsessional neurotics we shall find it impossible to escape the impression that a relation between love and hatred such as we have found in our present patient is among the most frequent, the most marked, and probably, therefore, the most important characteristics of obsessional neurosis. But however tempting it may be to bring the problem of the ‘choice of neurosis’ into connection with instinctual life, there are reasons enough for avoiding such a course. For we must remember that in every neurosis we come upon the same suppressed instincts behind the symptoms. After all, hatred, kept suppressed in the unconscious by love, plays a great part in the pathogenesis of hysteria and paranoia. We know too little of the nature of love to be able to arrive at any definite conclusion here; and, in particular, the relation between the negative factor¹ in love and the sadistic components of the libido remains completely obscure. What follows is therefore to be regarded as no more than a provisional explanation. We may suppose, then, that in the cases of unconscious hatred with which we are concerned the sadistic components of love have, from constitutional causes, been exceptionally strongly developed, and have consequently undergone a premature and all too thorough suppression, and that the neurotic phenomena we have observed arise on the one hand from conscious feelings of affection which have become exaggerated as a reaction, and on the other hand from sadism persisting in the unconscious in the form of hatred.

¹ Alcibiades says of Socrates in the Symposium: ‘Many a time have I wished that he were dead, and yet I know that I should be much more sorry than glad if he were to die: so that I am at my wits’ end,’8

But in whatever way this remarkable relation of love and hatred is to be explained, its occurrence is established beyond any possibility of doubt by the observations made in the present case; and it is gratifying to find how easily we can now follow the puzzling processes of an obsessional neurosis by bringing them into relation with this one factor. If an intense love is opposed by an almost equally powerful hatred, and is at the same time inseparably bound up with it, the immediate consequence is certain to be a partial paralysis of the will and an incapacity for coming to a decision upon any of those actions for which love ought to provide the motive power. But this indecision will not confine itself for long to a single group of actions. For, in the first place, what actions of a lover are not brought into relation with his one principal motive? And secondly a man’s attitude in sexual things has the force of a model to which the rest of his reactions tend to conform. And thirdly, it is an inherent characteristic in the psychology of an obsessional neurotic to make the fullest possible use of the mechanism of displacement. So the paralysis of his powers of decision gradually extends itself over the entire field of the patient’s behaviour.

Дата добавления: 2014-12-23