The psychical disorders of male potency 14 страница

6 The explanation of parapraxes owes its theoretical value to the ease with which they can be solved and their frequency in normal people. But the success of psycho-analysis in explaining them is far surpassed in importance by a further achievement made by it, relating to another phenomenon of normal mental life. What I have in mind is the interpretation of dreams, which brought psycho-analysis for the first time into the conflict with official science which was to be its destiny. Medical research explains dreams as purely somatic phenomena, without meaning or significance, and regards them as the reaction of a mental organ sunk in a state of sleep to physical stimuli which partially awaken it. Psycho-analysis raises the status of dreams into that of psychical acts possessing meaning and purpose, and having a place in the subject’s mental life, and thus disregards their strangeness, incoherence and absurdity. On this view somatic stimuli merely play the part of material that is worked over in the course of the construction of the dream. There is no half-way house between these two views of dreams. What argues against the physiological hypothesis is its unfruitfulness, and what may be argued in favour of the psycho-analytic one is the fact that it has translated and given a meaning to thousands of dreams and has used them to throw light on the intimate details of the human mind.

I devoted a volume published in 1900 to the important subject of dream-interpretation and have had the satisfaction of seeing the theories put forward in it confirmed and amplified by contributions from almost every worker in the field of psycho-analysis.¹ It is generally agreed that dream-interpretation is the foundation stone of psycho-analytic work and that its findings constitute the most important contribution made by psycho-analysis to psychology.

¹ The Interpretation of Dreams (1900a). See also my shorter essay On Dreams (1901a), and other writings by Rank, Stekel, Jones, Silberer, Brill, Maeder, Abraham, Ferenczi, etc.

I cannot enter here into the technique by which an interpretation of dreams is arrived at, nor can I give the grounds for the conclusions to which the psycho-analytic investigation of dreams has led. I must restrict myself to enunciating some new concepts, reporting my findings and stressing their importance for normal psychology.

Psycho-analysis, then, has demonstrated the following facts. All dreams have a meaning. Their strangeness is due to distortions that have been made in the expression of their meaning. Their absurdity is deliberate and expresses derision, ridicule and contradiction. Their incoherence is a matter of indifference for their interpretation. The dream as we remember it after waking is described by us as its ‘manifest content’. In the process of interpreting this, we are led to the ‘latent dream-thoughts’, which lie hidden behind the manifest content and which are represented by it. These latent dream-thoughts are no longer strange, incoherent or absurd; they are completely valid constituents of our waking thought. We give the name of ‘dream-work’ to the process which transforms the latent dream-thoughts into the manifest content of the dream; it is this dream-work that brings about the distortion which makes the dream-thoughts unrecognizable in the content of the dream.

The dream-work is a psychological process the like of which has hitherto been unknown to psychology. It has claims upon our interest in two main directions. In the first place, it brings to our notice novel processes such as ‘condensation’ (of ideas) and ‘displacement’ (of psychical emphasis from one idea to another), processes which we have never come across at all in our waking life, or only as the basis of what are known as ‘errors in thought’. In the second place, it enables us to detect the operation in the mind of a play of forces which was concealed from our conscious perception. We find that there is a ‘censorship’, a testing agency, at work in us, which decides whether an idea cropping up in the mind shall be allowed to reach consciousness, and which, so far as lies within its power, ruthlessly excludes anything that might produce or revive unpleasure. And it will be recalled at this point that in our analysis of parapraxes we found traces of this same intention to avoid unpleasure in remembering things and of similar conflicts between mental impulses.

A study of the dream-work forces on us irresistibly a view of mental life which appears to decide the most controversial problems of psychology. The dream-work compels us to assume the existence of an unconscious

psychical activity which is more comprehensive and more important than the familiar activity that is linked with consciousness. (I shall have some more to say on this point when I come to discuss the philosophical interest of psycho-analysis.) It enables us to dissect the psychical apparatus into a number of different agencies or systems, and shows us that in the system of unconscious mental activity processes operate which are of quite another kind from those perceived in consciousness.

The dream-work has only one function - namely to maintain sleep. ‘Dreams are the guardians of sleep.’ The dream-thoughts themselves may serve the purposes of the most various mental functions. The dream-work accomplishes its task by representing a wish that arises from the dream-thoughts as fulfilled in a hallucinatory fashion.

It may safely be said that the psycho-analytic study of dreams has given us our first insight into a ‘depth-psychology’ whose existence had not hitherto been suspected.¹ Fundamental changes will have to be introduced into normal psychology if it is to be brought into harmony with these new findings.

It is quite impossible to exhaust the psychological interest of dream-interpretation within the limits of my present paper. Let us bear in mind that what I have so far stressed is merely that dreams have a meaning and are objects for psychological study, and let us now proceed with our consideration of the new territory which has been annexed by psychology in the domain of pathology.

¹ Psycho-analysis does not at present postulate any relation between this psychical topography and anatomical stratification or histological layers.

9 The psychological novelties inferred from dreams and parapraxes must be applicable as an explanation of other phenomena if we are to believe in the value of these novelties, or, indeed, in their existence. And we do in fact find that psycho-analysis has shown that the hypotheses of unconscious mental activity, of censorship and repression and of distortion and substitution, at which we have arrived from our study of these normal phenomena, also afford us a first understanding of a number of pathological phenomena and, as one might say, put into our hands the key to all the riddles of the psychology of the neuroses. Thus dreams are to be regarded as the normal prototypes of all psychopathological structures. Anyone who understands dreams can also grasp the psychical mechanism of the neuroses and psychoses.

Starting from dreams, the investigations of psycho-analysis have enabled it to construct a psychology of the neuroses which is being continuously built up piece by piece. But what we are here concerned with - the psychological interest of psycho-analysis - obliges us to enter more fully into only two sides of this far reaching subject: the evidence that many pathological phenomena which had hitherto been believed to require physiological explanations are in fact psychical acts, and the evidence that the processes which lead to abnormal consequences can be traced back to psychical motive forces.

I will illustrate the first of these theses by a few examples. Hysterical attacks have long been recognized as signs of increased emotional excitement and equated with outbreaks of affect. Charcot attempted to reduce the multiplicity of their modes of manifestation by means of descriptive formulas; Pierre Janet recognized the unconscious ideas operating behind such attacks; while psycho-analysis has shown that they are mimetic representations of scenes (whether actually experienced or only invented) with which the patient’s imagination is occupied without his becoming conscious of them. The meaning of these pantomimes is concealed from the spectators by means of condensations and distortions of the acts which they represent. And this applies equally to what are described as the ‘chronic’ symptoms of hysterical patients. All of them are mimetic or hallucinatory representations of phantasies which unconsciously dominate the subject’s emotional life and which have the meaning of fulfilments of secret and repressed wishes. The tormenting character of these symptoms is due to the internal conflict into which these patients’ minds are driven by the need to combat such unconscious wishes.

In another neurotic disorder, obsessional neurosis, the patients become the victims of distressing and apparently senseless ceremonials which take the form of the rhythmical repetition of the most trivial acts (such as washing or dressing) or of carrying out meaningless injunctions or of obeying mysterious prohibitions. It was nothing less than a triumph of psycho-analytic research when it succeeded in showing that all these obsessive acts, even the most insignificant and trivial of them, have a meaning, and that they are reflections, translated into indifferent terms, of conflicts in the patients’ lives, of the struggle between temptations and moral restraints - reflections of the proscribed wish itself and of the punishment and atonement which that wish incurs. In another form of the same disorder the victim suffers from tormenting ideas (obsessions) which force themselves upon him and are accompanied by affects whose character and intensity are often only quite inadequately accounted for by the terms of the obsessive ideas themselves. Analytic investigation has shown in their case that the affects are entirely justified, since they correspond to self-reproaches which are based on something that is at least psychically real. But the ideas to which these affects are attached are not the original ones, but have found their way into their present position by a process of displacement - by being substituted for something that has been repressed. If these displacements can be reversed, the way is open to the discovery of the repressed ideas, and the relation between affect and idea is found to be perfectly appropriate.

In another neurotic disorder, dementia praecox (paraphrenia or schizophrenia), a condition which is in fact incurable, the patient is left, in the most severe cases, in a state of apparently complete apathy. Often his sole remaining actions are certain movements and gestures which are repeated monotonously and have been given the name of ‘stereotypies’. An analytic investigation of residues of this kind, made by Jung, has shown that they are the remains of perfectly significant mimetic actions, which at one time gave expression to the subject’s ruling wishes. The craziest speeches and the queerest poses and attitudes adopted by these patients become intelligible and can be given a place in the chain of their mental processes if they are approached on the basis of psycho-analytic hypotheses.

Similar considerations apply to the deliria and hallucinations, as well as to the delusional systems, exhibited by various psychotic patients. Where hitherto nothing but the most freakish capriciousness has seemed to prevail, psycho-analytic research has introduced law, order and connection, or has at least allowed us to suspect their presence where its work is still incomplete. The most heterogeneous forms of mental disorder are revealed as the results of processes which are at bottom identical and which can be understood and described by means of psychological concepts. What had already been discovered in the formation of dreams is operative everywhere - psychical conflict, the repression of certain instinctual impulses which have been pushed back into the unconscious by other mental forces, reaction formations set up by the repressing forces, and substitutes constructed by the instincts which have been repressed but have not been robbed of all their energy. The accompanying processes of condensation and displacement, so familiar to us in dreams, are also to be found everywhere. The multiplicity of clinical pictures observed by psychiatrists depends upon two other things: the multiplicity of the psychical mechanisms at the disposal of the repressive process and the multiplicity of developmental dispositions which give the repressed impulses an opportunity for breaking through into substitutive structures.

Psycho-analysis points to psychology for the solution of a good half of the problems of psychiatry. It would nevertheless be a serious mistake to suppose that analysis favours or aims at a purely psychological view of mental disorders. It cannot overlook the fact that the other half of the problems of psychiatry are concerned with the influence of organic factors (whether mechanical, toxic or infective) on the mental apparatus. Even in the case of the mildest of these disorders, the neuroses, it makes no claim that their origin is purely psychogenic but traces their aetiology to the influence upon mental life of an unquestionably organic factor to which I shall refer later.

The number of detailed psycho-analytic findings which cannot fail to be of importance for general psychology is too great for me to enumerate them here. I will only mention two other points: psycho-analysis unhesitatingly ascribes the primacy in mental life to affective processes, and it reveals an unexpected amount of affective disturbance and blinding of the intellect in normal no less than in sick people.3

PART II THE CLAIMS OF PSYCHO-ANALYSIS TO THE INTEREST OF

THE NON-PSYCHOLOGICAL SCIENCES(A) THE PHILOLOGICAL INTEREST OF PSYCHO-ANALYSIS

I shall no doubt be overstepping common linguistic usage in postulating an interest in psycho-analysis on the part of philologists, that is of experts in speech. For in what follows ‘speech’ must be understood not merely to mean the expression of thought in words but to include the speech of gesture and every other method, such, for instance, as writing, by which mental activity can be expressed. That being so, it may be pointed out that the interpretations made by psycho-analysis are first and foremost translations from an alien method of expression into the one which is familiar to us. When we interpret a dream we are simply translating a particular thought-content (the latent dream-thoughts) from the ‘language of dreams’ into our waking speech. In the course of doing so we learn the peculiarities of this dream language and it is borne in upon us that it forms part of a highly archaic system of expression. Thus, to take an instance, there is no special indication for the negative in the language of dreams. Contraries may stand for each other in the dream’s content and may be represented by the same element. Or we may put it like this: concepts are still ambivalent in dream-language, and unite within themselves contrary meanings - as is the case, according to the hypotheses of philologists, in the oldest roots of historical languages.¹ Another striking feature of our dream-language is its extremely frequent use of symbols, which make us able to some extent to translate the content of dreams without reference to the associations of the individual dreamer. Our researches have not yet sufficiently elucidated the essential nature of these symbols. They are in part substitutes and analogies based upon obvious similarities; but in some of these symbols the tertium comparationis which is presumably present escapes our conscious knowledge. It is precisely this latter class of symbols which must probably originate from the earliest phases of linguistic development and conceptual construction. In dreams it is above all the sexual organs and sexual activities which are represented symbolically instead of directly. A philologist, Hans Sperber, of Uppsala, has only recently (1912) attempted to prove that words which originally represented sexual activities have, on the basis of analogies of this kind, undergone an extraordinarily far-reaching change in their meaning.

¹ Cf. Abel on the antithetical meaning of primal words, and my review of his paper.4

If we reflect that the means of representation in dreams are principally visual images and not words, we shall see that it is even more appropriate to compare dreams with a system of writing than with a language. In fact the interpretation of dreams is completely analogous to the decipherment of an ancient pictographic script such as Egyptian hieroglyphs. In both cases there are certain elements which are not intended to be interpreted (or read, as the case may be) but are only designed to serve as ‘determinatives’, that is to establish the meaning of some other element. The ambiguity of various elements of dreams finds a parallel in these ancient systems of writing; and so too does the omission of various relations, which have in both cases to be supplied from the context. If this conception of the method of representation in dreams has not yet been followed up, this, as will be readily understood, must be ascribed to the fact that psycho-analysts are entirely ignorant of the attitude and knowledge with which a philologist would approach such a problem as that presented by dreams.

The language of dreams may be looked upon as the method by which unconscious mental activity expresses itself. But the unconscious speaks more than one dialect. According to the differing psychological conditions governing and distinguishing the various forms of neurosis, we find regular modifications in the way in which unconscious mental impulses are expressed. While the gesture-language of hysteria agrees on the whole with the picture-language of dreams and visions, etc., the thought-language of obsessional neurosis and of the paraphrenias (dementia praecox and paranoia) exhibits special idiomatic peculiarities which, in a number of instances, we have been able to understand and interrelate. For instance, what a hysteric expresses by vomiting an obsessional will express by painstaking protective measures against infection, while a paraphrenic will be led to complaints or suspicions that he is being poisoned. These are all of them different representations of the patient’s wish to become pregnant which have been repressed into the unconscious, or of his defensive reaction against that wish.

(B) THE PHILOSOPHICAL INTEREST OF PSYCHO-ANALYSIS

Philosophy, in so far as it is built on psychology, will be unable to avoid taking the psycho-analytic contributions to psychology fully into account and reacting to this new enrichment of our knowledge just as it has to every considerable advance in the specialized sciences. In particular, the setting up of the hypothesis of unconscious mental activities must compel philosophy to decide one way or the other and, if it accepts the idea, to modify its own views on the relation of mind to body so that they may conform to the new knowledge. It is true that philosophy has repeatedly dealt with the problem of the unconscious, but, with few exceptions, philosophers have taken up one or other of the two following positions. Either their unconscious has been something mystical, something intangible and undemonstrable, whose relation to the mind has remained obscure, or they have identified the mental with the conscious and have proceeded to infer from this definition that what is unconscious cannot be mental or a subject for psychology. These opinions must be put down to the fact that philosophers have formed their judgement on the unconscious without being acquainted with the phenomena of unconscious mental activity, and therefore without any suspicion of how far unconscious phenomena resemble conscious ones or of the respects in which they differ from them. If anyone possessing that knowledge nevertheless holds to the conviction which equates the conscious and the psychical and consequently denies the unconscious the attribute of being psychical, no objection can, of course, be made except that such a distinction turns out to be highly unpractical. For it is easy to describe the unconscious and to follow its developments if it is approached from the direction of its relation to the conscious, with which it has so much in common. On the other hand, there still seems no possibility of approaching it from the direction of physical events. So that it is bound to remain a matter for psychological study.

There is yet another way in which philosophy can derive a stimulus from psycho-analysis, and that is by itself becoming a subject of psycho-analytic research. Philosophical theories and systems have been the work of a small number of men of striking individuality. In no other science does the personality of the scientific worker play anything like so large a part as in philosophy. And now for the first time psycho-analysis enables us to construct a ‘psychography’ of a personality. (See the sociological section below, p. 2824.) It teaches us to recognize the affective units - the complexes dependent on instincts - whose presence is to be presumed in each individual, and it introduces us to the study of the transformations and end-products arising from these instinctual forces. It reveals the relations of a person’s constitutional disposition and the events of his life to the achievements open to him owing to his peculiar gifts. It can conjecture with more or less certainty from an artist’s work the intimate personality that lies behind it. In the same way, psycho-analysis can indicate the subjective and individual motives behind philosophical theories which have ostensibly sprung from impartial logical work, and can draw a critic’s attention to the weak spots in the system. It is not the business of psycho-analysis, however, to undertake such criticism itself, for, as may be imagined, the fact that a theory is psychologically determined does not in the least invalidate its scientific truth.

(C) THE BIOLOGICAL INTEREST OF PSYCHO-ANALYSIS

It has not been the fate of psycho-analysis to be greeted (like other young sciences) with the sympathetic encouragement of those who are interested in the advance of knowledge. For a long time it was disregarded, and when at last it could no longer be neglected it became, for emotional reasons, the object of the most violent attacks from people who had not taken the trouble to become acquainted with it. It owed this unfriendly reception to a single circumstance: for at an early stage of its researches psycho-analysis was driven to the conclusion that nervous illnesses are an expression of a disturbance of the sexual function and it was thus led to devote its attention to an investigation of that function - one which had been far too long neglected. But anyone who respects the rule that scientific judgement should not be influenced by emotional attitudes will assign a high degree of biological interest to psycho-analysis on account of these very investigations and will regard the resistances to it as actual evidence in favour of the correctness of its assertions.

Psycho-analysis has done justice to the sexual function in man by making a detailed examination of its importance in mental and practical life - an importance which has been emphasized by many creative writers and by some philosophers, but which has never been recognized by science. But in the first place it was necessary to enlarge the unduly restricted concept of sexuality, an enlargement that was justified by reference to the extensions of sexuality occurring in the so called perversions and to the behaviour of children. It turned out to be impossible to maintain any longer that childhood was asexual and was invaded for the first time by a sudden inrush of sexual impulses at the age of puberty. On the contrary, when once the blinkers of partiality and prejudice had been removed, observation had no difficulty in revealing that sexual interests and activities are present in the human child at almost every age and from the very first. The importance of this infantile sexuality is not impaired by the fact that we cannot everywhere draw a clear line between it and a child’s asexual activity. It differs, however, from what is described as the ‘normal’ sexuality of adults. It includes the germs of all those sexual activities which in later life are sharply contrasted with normal sexual life as being perversions, and as such bound to seem incomprehensible and vicious. The normal sexuality of adults emerges from infantile sexuality by a series of developments, combinations, divisions and suppressions, which are scarcely ever achieved with ideal perfection and consequently leave behind predispositions to a retrogression of the function in the form of illness.

Infantile sexuality exhibits two other characteristics which are of importance from a biological point of view. It turns out to be put together from a number of component instincts which seem to be attached to certain regions of the body (‘erotogenic zones’) and some of which emerge from the beginning in pairs of opposites - instincts with an active and a passive aim. Just as in later life what is loved is not merely the object’s sexual organs but his whole body, so from the very first it is not merely the genitals but many other parts of the body which are the seat of sexual excitation and respond to appropriate stimuli with sexual pleasure. This fact is closely related to the second characteristic of infantile sexuality - namely that to start with it is attached to the functions of nutrition and excretion, and, in all probability, of muscular excitation and sensory activity.

If we examine sexuality in the adult with the help of psycho-analysis, and consider the life of children in the light of the knowledge thus gained, we perceive that sexuality is not merely a function serving the purposes of reproduction, on a par with digestion, respiration, etc. It is something far more independent, which stands in contrast to all the individual’s other activities and is only forced into an alliance with the individual’s economy after a complicated course of development involving the imposition of numerous restrictions. Cases, theoretically quite conceivable, in which the interests of these sexual impulses fail to coincide with the self-preservation of the individual seem actually to be presented by the group of neurotic illnesses. For the final formula which psycho-analysis has arrived at on the nature of the neuroses runs thus: The primal conflict which leads to neuroses is one between the sexual instincts and those which maintain the ego. The neuroses represent a more or less partial overpowering of the ego by sexuality after the ego’s attempts at suppressing sexuality have failed.

We have found it necessary to hold aloof from biological considerations during our psycho-analytic work and to refrain from using them for heuristic purposes, so that we may not be misled in our impartial judgement of the psycho-analytic facts before us. But after we have completed our psycho-analytic work we shall have to find a point of contact with biology; and we may rightly feel glad if that contact is already assured at one important point or another. The contrast between the ego instincts and the sexual instinct, to which we have been obliged to trace back the origin of the neuroses, is carried into the sphere of biology in the contrast between the instincts which serve the preservation of the individual and those which serve the survival of the species. In biology we come upon the more comprehensive conception of an immortal germ-plasm to which the different transitory individuals are attached like organs that develop successively. It is only this conception which enables us rightly to understand the part played by the sexual instinctual forces in physiology and psychology.

In spite of all our efforts to prevent biological terminology and considerations from dominating psycho-analytic work, we cannot avoid using them even in our descriptions of the phenomena that we study. We cannot help regarding the term ‘instinct’ as a concept on the frontier between the spheres of psychology and biology. We speak, too, of ‘masculine’ and ‘feminine’ mental attributes and impulses, although, strictly speaking, the differences between the sexes can lay claim to no special psychical characterization. What we speak of in ordinary life as ‘masculine’ or ‘feminine’ reduces itself from the point of view of psychology to the qualities of ‘activity’ and ‘passivity’ - that is, to qualities determined not by the instincts themselves but by their aims. The regular association of these ‘active’ and ‘passive’ instincts in mental life reflects the bisexuality of individuals, which is among the clinical postulates of psycho-analysis.

I shall be satisfied if these few remarks have drawn attention to the many respects in which psycho-analysis acts as an intermediary between biology and psychology.9

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