Autobiographical note 76 страница

As regards the second kind of emotional reaction, which is not directed against me this time, but against my patient - supposing that my view of her is correct - and which regards the perverse nature of her phantasies as horrible, I should like to say emphatically that a medical man has no business to indulge in such passionate condemnation. I may also remark in passing that it seems to me superfluous for a physician who is writing upon the aberrations of the sexual instincts to seize every opportunity of inserting into the text expressions of his personal repugnance at such revolting things. We are faced by a fact; and it is to be hoped that we shall grow accustomed to it, when we have put our own tastes on one side. We must learn to speak without indignation of what we call the sexual perversions - instances in which the sexual function has extended its limits in respect either to the part of the body concerned or to the sexual object chosen. The uncertainty in regard to the boundaries of what is to be called normal sexual life, when we take different races and different epochs into account, should in itself be enough to cool the zealot’s ardour. We surely ought not to forget that the perversion which is the most repellent to us, the sensual love of a man for a man, was not only tolerated by a people so far our superiors in cultivation as were the Greeks, but was actually entrusted by them with important social functions. The sexual life of each one of us extends to a slight degree - now in this direction, now in that - beyond the narrow lines imposed as the standard of normality. The perversions are neither bestial nor degenerate in the emotional sense of the word. They are a development of germs all of which are contained in the undifferentiated sexual disposition of the child, and which, by being suppressed or by being diverted to higher, asexual aims - by being ‘sublimated’ - are destined to provide the energy for a great number of our cultural achievements. When, therefore, any one has become a gross and manifest pervert, it would be more correct to say that he has remained one, for he exhibits a certain stage of inhibited development. All psychoneurotics are persons with strongly marked perverse tendencies, which have been repressed in the course of their development and have become unconscious. Consequently their unconscious phantasies show precisely the same content as the documentarily recorded actions of perverts - even though they have not read Krafft-Ebing’s Psychopathia Sexualis, to which simple-minded people attribute such a large share of the responsibility for the production of perverse tendencies. Psychoneuroses are, so to speak, the negative of perversions. In neurotics their sexual constitution, under which the effects of heredity are included, operates in combination with any accidental influences in their life which may disturb the development of normal sexuality. A stream of water which meets with an obstacle in the river-bed is dammed up and flows back into old channels which had formerly seemed fated to run dry. The motive forces leading to the formation of hysterical symptoms draw their strength not only from repressed normal sexuality but also from unconscious perverse activities.¹

¹ These remarks upon the sexual perversions had been written some years before the appearance of Bloch’s excellent book (Beiträge zur Äetiologie der Psychopathia sexualis, 1902 and 1903). See also my Three Essays on the Theory of Sexuality, published this year.8

The less repellent of the so-called sexual perversions are very widely diffused among the whole population, as every one knows except medical writers upon the subject. Or, I should rather say, they know it too; only they take care to forget it at the moment when they take up their pens to write about it. So it is not to be wondered at that this hysterical girl of nearly nineteen, who had heard of the occurrence of such a method of sexual intercourse (sucking at the male organ), should have developed an unconscious phantasy of this sort and should have given it expression by an irritation in her throat and by coughing. Nor would it have been very extraordinary if she had arrived at such a phantasy even without having had any enlightenment from external sources - an occurrence which I have quite certainly observed in other patients. For in her case a noteworthy fact afforded the necessary somatic prerequisite for this independent creation of a phantasy which would coincide with the practices of perverts. She remembered very well that in her childhood she had been a thumb-sucker. Her father, too recollected breaking her of the habit after it had persisted into her fourth or fifth year. Dora herself had a clear picture of a scene from her early childhood in which she was sitting on the floor in a corner sucking her left thumb and at the same time tugging with her right hand at the lobe of her brother’s ear as he sat quietly beside her. Here we have an instance of the complete form of self-gratification by sucking, as it has also been described to me by other patients, who had subsequently become anaesthetic and hysterical.

One of these patients gave me a piece of information which sheds a clear light on the origin of this curious habit. This young woman had never broken herself of the habit of sucking. She retained a memory of her childhood, dating back, according to her, to the first half of her second year, in which she saw herself sucking at her nurse’s breast and at the same time pulling rhythmically at the lobe of her nurse’s ear. No one will feel inclined to dispute, I think, that the mucous membrane of the lips and mouth is to be regarded as a primary ‘erotogenic zone’, since it preserves this earlier significance in the act of kissing, which is looked upon as normal. An intense activity of this erotogenic zone at an early age thus determines the subsequent presence of a somatic compliance on the part of the tract of mucous membrane which begins at the lips. Thus, at a time when the sexual object proper, that is, the male organ, has already become known, circumstances may arise which once more increase the excitation of the oral zone, whose erotogenic character has, as we have seen, been retained. It then needs very little creative power to substitute the sexual object of the moment (the penis) for the original object (the nipple) or for the finger which does duty for it, and to place the current sexual object in the situation in which gratification was originally obtained. So we see that this excessively repulsive and perverted phantasy of sucking at a penis has the most innocent origin. It is a new version of what may be described as a prehistoric impression of sucking at the mother’s or nurse’s breast - an impression which has usually been revived by contact with children who are being nursed. In most instances a cow’s udder has aptly played the part of an image intermediate between a nipple and a penis.

The interpretation we have just been discussing of Dora’s throat symptoms may also give rise to a further remark. It may be asked how this sexual situation imagined by her can be compatible with our other explanation of the symptoms. That explanation, it will be remembered, was to the effect that the coming and going of the symptoms reflected the presence and absence of the man she was in love with, and, as regards his wife’s behaviour, expressed the following thought: ‘If I were his wife, I should love him in quite a different way; I should be ill (from longing, let us say) when he was away, and well (from joy) when he was home again.’ To this objection I must reply that my experience in the clearing-up of hysterical symptoms has shown that it is not necessary for the various meanings of a symptom to be compatible with one another, that is, to fit together into a connected whole. It is enough that the unity should be constituted by the subject-matter which has given rise to all the various phantasies. In the present case, moreover, compatibility even of the first kind is not out of the question. One of the two meanings is related more to the cough, and the other to the aphonia and the periodicity of the disorder. A closer analysis would probably have disclosed a far greater number of mental elements in relation to the details of the illness.

We have already learnt that it quite regularly happens that a single symptom corresponds to several meanings simultaneously. We may now add that it can express several meanings in succession. In the course of years a symptom can change its meaning or its chief meaning, or the leading role can pass from one meaning to another. It is as though there were a conservative trait in the character of neuroses which ensures that a symptom that has once been formed shall if possible be retained, even though the unconscious thought to which it gave expression has lost its meaning. Moreover, there is no difficulty in explaining this tendency towards the retention of a symptom upon a mechanical basis. The production of a symptom of this kind is so difficult, the translation of a purely psychical excitation into physical terms - the process which I have called ‘conversion’ - depends on the concurrence of so many favourable conditions, the somatic compliance necessary for conversion is so seldom forthcoming, that an impulsion towards the discharge of an unconscious excitation will so far as possible make use of any channel for discharge which may already be in existence. It appears to be far more difficult to create a fresh conversion than to form paths of association between a new thought which is in need of discharge and the old one which is no longer in need of it. The current flows along these paths from the new source of excitation to the old point of discharge - pouring into the symptom, in the words of the Gospel, like new wine into an old bottle. These remarks would make it seem that the somatic side of a hysterical symptom is the more stable of the two and the harder to replace, while the psychical side is a variable element for which a substitute can more easily be found. Yet we should not try to infer anything from this comparison as regards the relative importance of the two elements. From the point of view of mental therapeutics the mental side must always be the more significant.

1 Dora’s incessant repetition of the same thoughts about her father’s relations with Frau K. made it possible to derive still further important material from the analysis.

A train of thought such as this may be described as excessively intense, or better reinforced, or ‘supervalent’ [‘überwertig’] in Wernicke’s sense. It shows its pathological character in spite of its apparently reasonable content, by the single peculiarity that no amount of conscious and voluntary effort of thought on the patient’s part is able to dissipate or remove it. A normal train of thought, however intense it may be, can eventually be disposed of. Dora felt quite rightly that her thoughts about her father required to be judged in a special way. ‘I can think of nothing else’, she complained again and again. ‘I know my brother says we children have no right to criticize this behaviour of Father’s. He declares that we ought not to trouble ourselves about it, and ought even to be glad, perhaps, that he has found a woman he can love, since Mother understands him so little. I can quite see that, and I should like to think the same as my brother, but I can’t. I can’t forgive him for it.’¹

Now what is one to do in the face of a supervalent thought like this, after one has heard what its conscious grounds are and listened to the ineffectual protests made against it? Reflection will suggest that this excessively intense train of thought must owe its reinforcement to the unconscious. It cannot be resolved by any effort of thought, either because it itself reaches with its root down into unconscious, repressed material, or because another unconscious thought lies concealed behind it. In the latter case, the concealed thought is usually the direct contrary of the supervalent one. Contrary thoughts are always closely connected with each other and are often paired off in such a way that the one thought is excessively intensely conscious while its counterpart is repressed and unconscious. This relation between the two thoughts is an effect of the process of repression. For repression is often achieved by means of an excessive reinforcement of the thought contrary to the one which is to be repressed. This process I call reactive reinforcement, and the thought which asserts itself with excessive intensity in consciousness and (in the same way as a prejudice) cannot be removed I call a reactive thought. The two thoughts then act towards each other much like the two needles of an astatic galvanometer. The reactive thought keeps the objectionable one under repression by means of a certain surplus of intensity; but for that reason it itself is ‘damped’ and proof against conscious efforts of thought. So that the way to deprive the excessively intense thought of its reinforcement is by bringing its repressed contrary into consciousness.

¹ A supervalent thought of this kind is often the only symptom, beyond deep depression, of a pathological condition which is usually described as ‘melancholia’, but which can be cleared up by psycho-analysis like a hysteria.2

We must also be prepared to meet with instances in which the supervalence of a thought is due not to the presence of one only of these two causes but to a concurrence of both of them. Other complications, too, may arise, but they can easily be fitted into the general scheme.

Let us now apply our theory to the instance provided by Dora’s case. We will begin with the first hypothesis, namely, that her preoccupation with her father’s relations to Frau K, owed its obsessive character to the fact that its root was unknown to her and lay in the unconscious. It is not difficult to divine the nature of that root from her circumstances and her conduct. Her behaviour obviously went far beyond what would have been appropriate to filial concern. She felt and acted more like a jealous wife - in a way which would have been comprehensible in her mother. By her ultimatum to her father (‘either her or me’), by the scenes she used to make, by the suicidal intentions she allowed to transpire, - by all this she was clearly putting herself in her mother’s place. If we have rightly guessed the nature of the imaginary sexual situation which underlay her cough, in that phantasy she must have been putting herself in Frau K.’s place. She was therefore identifying herself both with the woman her father had once loved and with the woman he loved now. The inference is obvious that her affection for her father was a much stronger one than she knew or than she would have cared to admit: in fact, that she was in love with him.

I have learnt to look upon unconscious love relations like this (which are marked by their abnormal consequences) - between a father and a daughter, or between a mother and a son - as a revival of germs of feeling in infancy. I have shown at length elsewhere¹ at what an early age sexual attraction makes itself felt between parents and children, and I have explained that the legend of Oedipus is probably to be regarded as a poetical rendering of what is typical in these relations. Distinct traces are probably to be found in most people of an early partiality of this kind - on the part of a daughter for her father, or on the part of a son for his mother; but it must be assumed to be more intense from the very first in the case of those children whose constitution marks them down for a neurosis, who develop prematurely and have a craving for love. At this point certain other influences, which need not be discussed here, come into play, and lead to a fixation of this rudimentary feeling of love or to a reinforcement of it; so that it turns into something (either while the child is still young or not until it has reached the age of puberty) which must be put on a par with a sexual inclination and which, like the latter, has the forces of the libido at its command.² The nature of her disposition had always drawn her towards her father, and his numerous illnesses were bound to have increased her affection for him. In some of these illnesses he would allow no one but her to discharge the lighter duties of nursing. He had been so proud of the early growth of her intelligence that he had made her his confidante while she was still a child. It was really she and not her mother whom Frau K.’s appearance had driven out of more than one position.

¹ In my Interpretation of Dreams, 1900a, and in the third of my Three Essays, 1905d.

² The decisive factor in this connection is no doubt the early appearance of true genital sensations, either spontaneously or as a result of seduction or masturbation. (See below.)4

When I told Dora that I could not avoid supposing that her affection for her father must at a very early moment have amounted to her being completely in love with him, she of course gave me her usual reply: ‘I don’t remember that.’ But she immediately went on to tell me something analogous about a seven-year-old girl who was her cousin (on her mother’s side) and in whom she often thought she saw a kind of reflection of her own childhood. This little girl had (not for the first time) been the witness of a heated dispute between her parents, and, when Dora happened to come in on a visit soon afterwards, whispered in her ear: ‘You can’t think how I hate that person!’ (pointing to her mother), ‘and when she’s dead I shall marry Daddy.’ I am in the habit of regarding associations such as this, which bring forward something that agrees with the content of an assertion of mine, as a confirmation from the unconscious of what I have said. No other kind of ‘Yes’ can be extracted from the unconscious; there is no such thing at all as an unconscious ‘No’.¹

¹ [Footnote added 1923:] There is another very remarkable and entirely trustworthy form of confirmation from the unconscious, which I had not recognized at the time this was written: namely, an exclamation on the part of the patient of ‘I didn’t think that’, or ‘I didn’t think of that’. This can be translated point-blank into: ‘Yes, I was unconscious of that.’5 For years on end she had given no expression to this passion for her father. On the contrary, she had for a long time been on the closest terms with the woman who had supplanted her with her father, and she had actually, as we know from her self-reproaches, facilitated this woman’s relations with her father. Her own love for her father had therefore been recently revived; and, if so, the question arises to what end this had happened. Clearly as a reactive symptom, so as to suppress something else - something, that is, that still exercised power in the unconscious. Considering how things stood, I could not help supposing in the first instance that what was suppressed in this manner was her love of Herr K. I could not avoid the assumption that she was still in love with him, but that, for unknown reasons, since the scene by the lake her love had aroused in her violent feelings of opposition, and that the girl had brought forward and reinforced her old affection for her father in order to avoid and further necessity for paying conscious attention to the love which she had felt in the first years of her girlhood and which had now become distressing to her. In this way I gained an insight into a conflict which was well calculated to unhinge the girl’s mind. On the one hand she was filled with regret at having rejected the man’s proposal, and with longing for his company and all the little signs of his affection; while on the other hand these feelings of tenderness and longing were combated by powerful forces, amongst which her pride was one of the most obvious. Thus she had succeeded in persuading herself that she had done with Herr K. - that was the advantage she derived from this typical process of repression; and yet she was obliged to summon up her infantile affection for her father and to exaggerate it, in order to protect herself against the feelings of love which were constantly pressing forward into consciousness. The further fact that she was almost incessantly a prey to the most embittered jealousy seemed to admit of still another determination.¹

¹ We shall come upon this.6

My expectations were by no means disappointed when this explanation of mine was met by Dora with a most emphatic negative. The ‘No’ uttered by a patient after a repressed thought has been presented to his conscious perception for the first time does no more than register the existence of a repression and its severity; it acts, as it were, as a gauge of the repression’s strength. If this ‘No’, instead of being regarded as the expression of an impartial judgement (of which, indeed, the patient is incapable), is ignored, and if work is continued, the first evidence soon begins to appear that in such a case ‘No’ signifies the desired ‘Yes’. Dora admitted that she found it impossible to be as angry with Herr K. as he had deserved. She told me that one day she had met Herr K. in the street while she was walking with a cousin of hers who did not know him. The other girl had exclaimed all at once: ‘Why, Dora, what’s wrong with you? You’ve gone as white as a sheet!’ She herself had felt nothing of this change of colour; but I explained to her that the expression of emotion and the play of features obey the unconscious rather than the conscious, and are a means of betraying the former.¹ Another time Dora came to me in the worst of tempers after having been uniformly cheerful for several days. She could give no explanation of this. She felt so contrary to-day, she said; it was her uncle’s birthday, and she could not bring herself to congratulate him, she did not know why. My powers of interpretation were at a low ebb that day; I let her go on talking, and she suddenly recollected that it was Herr K.’s birthday too - a fact which I did not fail to use against her. And it was then no longer hard to explain why the handsome presents she had had on her own birthday a few days before had given her no pleasure. One gift was missing, and that was Herr K.’s, the gift which had plainly once been the most prized of all.

Nevertheless Dora persisted in denying my contention for some time longer, until, towards the end of the analysis, the conclusive proof of its correctness came to light.

¹ Compare the lines:

Ruhig mag ich Euch erscheinen,

Ruhig gehen sehn.

[Quiet can I watch thy coming,

Quiet watch thee go.]7 I must now turn to consider a further complication to which I should certainly give no space if I were a man of letters engaged upon the creation of a mental state like this for a short story, instead of being a medical man engaged upon its dissection. The element to which I must now allude can only serve to obscure and efface the outlines of the fine poetic conflict which we have been able to ascribe to Dora. This element would rightly fall a sacrifice to the censorship of a writer, for he, after all, simplifies and abstracts when he appears in the character of a psychologist. But in the world of reality, which I am trying to depict here, a complication of motives, an accumulation and conjunction of mental activities - in a word, overdetermination - is the rule. For behind Dora’s supervalent train of thought which was concerned with her father’s relations with Frau K. there lay concealed a feeling of jealousy which had that lady as its object - a feeling, that is, which could only be based upon an affection on Dora’s part for one of her own sex. It has long been known and often been pointed out that at the age of puberty boys and girls show clear signs, even in normal cases, of the existence of an affection for people of their own sex. A romantic and sentimental friendship with one of her school friends, accompanied by vows, kisses, promises of eternal correspondence, and all the sensibility of jealousy, is the common precursor of a girl’s first serious passion for a man. Thenceforward, in favourable circumstances, the homosexual current of feeling often runs completely dry. But if a girl is not happy in her love for a man, the current is often set flowing again by the libido in later years and is increased up to a greater or lesser degree of intensity. If this much can be established without difficulty of healthy persons, and if we take into account what has already been said about the fuller development in neurotics of the normal germs of perversion, we shall expect to find in these latter too a fairly strong homosexual predisposition. It must, indeed, be so; for I have never yet come through a single psycho-analysis of a man or a woman without having to take into account a very considerable current of homosexuality. When, in a hysterical woman or girl, the sexual libido which is directed towards men has been energetically suppressed, it will regularly be found that the libido which is directed towards women has become vicariously reinforced and even to some extent conscious.

I shall not in this place go any further into this important subject, which is especially indispensable to an understanding of hysteria in men, because Dora’s analysis came to an end before it could throw any light on this side of her mental life. But I should like to recall the governess, whom I have already mentioned, and with whom Dora had at first enjoyed the closest interchange of thought, until she discovered that she was being admired and fondly treated not for her own sake but for her father’s; whereupon she had obliged the governess to leave. She used also to dwell with noticeable frequency and a peculiar emphasis on the story of another estrangement which appeared inexplicable even to herself. She had always been on particularly good terms with the younger of her two cousins the girl who had later on become engaged - and had shared all sorts of secrets with her. When, for the first time after Dora had broken off her stay by the lake, her father was going back to B--, she had naturally refused to go with him. This cousin had then been asked to travel with him instead, and she had accepted the invitation. From that time forward Dora had felt a coldness towards her, and she herself was surprised to find how indifferent she had become, although, as she admitted, she had very little ground for complaint against her. These instances of sensitiveness led me to inquire what her relations with Frau K. had been up till the time of the breach. I then found that the young woman and the scarcely grown girl had lived for years on a footing of the closest intimacy. When Dora stayed with the K.’s she used to share a bedroom with Frau K., and the husband used to be quartered elsewhere. She had been the wife’s confidante and adviser in all the difficulties of her married life. There was nothing they had not talked about. Medea had been quite content that Creusa should make friends with her two children; and she certainly did nothing to interfere with the relations between the girl and the children’s father. How Dora managed to fall in love with the man about whom her beloved friend had so many bad things to say is an interesting psychological problem. We shall not be far from solving it when we realize that thoughts in the unconscious live very comfortably side by side, and even contraries get on together without disputes - a state of things which persists often enough even in the conscious.

When Dora talked about Frau K., she used to praise her ‘adorable white body’ in accents more appropriate to a lover than to a defeated rival. Another time she told me, more in sorrow than in anger, that she was convinced the presents her father had brought her had been chosen by Frau K., for she recognized her taste. Another time, again, she pointed out that, evidently through the agency of Frau K., she had been given a present of some jewellery which was exactly like some that she had seen in Frau K.’s possession and had wished for aloud at the time. Indeed, I can say in general that I never heard her speak a harsh or angry word against the lady, although from the point of view of her supervalent thought she should have regarded her as the prime author of her misfortunes. She seemed to behave inconsequently; but her apparent inconsequence was precisely the manifestation of a complicating current of feeling. For how had this woman to whom Dora was so enthusiastically devoted behaved to her? After Dora had brought forward her accusation against Herr K., and her father had written to him and had asked for an explanation, Herr K. had replied in the first instance by protesting sentiments of the highest esteem for her and by proposing that he should come to the manufacturing town to clear up every misunderstanding. A few weeks later, when her father spoke to him at B--, there was no longer any question of esteem. On the contrary, Herr K. spoke of her with disparagement, and produced as his trump card the reflection that no girl who read such books and was interested in such things could have any title to a man’s respect. Frau K., therefore, had betrayed her and had calumniated her; for it had only been with her that she had read Mantegazza and discussed forbidden topics. It was a repetition of what had happened with the governess: Frau K. had not loved her for her own sake but on account of her father. Frau K. had sacrificed her without a moment’s hesitation so that her relations with her father might not be disturbed. This mortification touched her, perhaps, more nearly and had a greater pathogenic effect than the other one, which she tried to use as a screen for it, - the fact that she had been sacrificed by her father. Did not the obstinacy with which she retained the particular amnesia concerning the sources of her forbidden knowledge point directly to the great emotional importance for her of the accusation against her upon that score, and consequently to her betrayal by her friend?

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