Contributions to the neue freie presse 12 страница

¹ Obsessional neurotics are not the only people who are satisfied with euphemisms of this kind.

² That is, ten years ago.

³ There is here an unmistakable indication of an opposition between the two objects of his love, his father and the ‘lady’.5

He admitted that all of this sounded quite plausible, but he was naturally not in the very least convinced by it.¹ He would venture to ask, he said, how it was that an idea of this kind could have remissions, how it could appear for a moment when he was twelve years old, and again when he was twenty, and then once more two years later, this time for good. He could not believe that his hostility had been extinguished in the intervals, and yet during them there had been no sign of self-reproaches. - To this I replied that whenever any one asked a question like that, he was already prepared with an answer; he needed only to be encouraged to go on talking. - He then proceeded, somewhat disconnectedly as it seemed, to say that he had been his father’s best friend, and that his father had been his. Except on a few subjects, upon which fathers and sons usually hold aloof from one another - (What could he mean by that?) -, there had been a greater intimacy between them than there now was between him and his best friend. As regards the lady for whose sake he had sacrificed his father in that idea of his, it was true that he had loved her very much, but he had never felt really sensual wishes towards her, such as he had constantly had in his childhood. Altogether, in his childhood his sensual impulses had been much stronger than during his puberty. - At this I told him I thought he had now produced the answer we were waiting for, and had at the same time discovered the third great characteristic of the unconscious. The source from which his hostility to his father derived its indestructibility was evidently something in the nature of sensual desires, and in that connection he must have felt his father as in some way or other an interference. A conflict of this kind, I added, between sensuality and childish love was entirely typical. The remissions he had spoken of had occurred because the premature explosion of his sensual feelings had had as its immediate consequence a considerable diminution of their violence. It was not until he was once more seized with intense erotic desires that his hostility reappeared again owing to the revival of the old situation. I then got him to agree that I had not led him on to the subject either of childhood or of sex, but that he had raised them both of his own free will. - He then went on to ask why he had not simply come to a decision, at the time he was in love with the lady, that his father’s interference with that love could not for a moment weigh against his love of his father. - I replied that it was scarcely possible to destroy a person in absentia. Such a decision would only have been possible if the wish that he took objection to had made its first appearance on that occasion; whereas, as a matter of fact, it was a long-repressed wish, towards which he could not behave otherwise than he had formerly done, and which was consequently immune from destruction. This wish (to get rid of his father as being an interference) must have originated at a time when circumstances had been very different - at a time, perhaps, when he had not loved his father more than the person whom he desired sensually, or when he was incapable of making a clear decision. It must have been in his very early childhood, therefore, before he had reached the age of six, and before the date at which his memory became continuous; and things must have remained in the same state ever since. - With this piece of construction our discussion was broken off for the time being.

¹ It is never the aim of discussions like this to create conviction. They are only intended to bring the repressed complexes into consciousness, to set the conflict going in the field of conscious mental activity, and to facilitate the emergence of fresh material from the unconscious. A sense of conviction is only attained after the patient has himself worked over the reclaimed material, and so long as he is not fully convinced the material must be considered as unexhausted.

6 At the next session, which was the seventh, he took up the same subject once more. He could not believe, he said, that he had ever entertained such a wish against his father. He remembered a story of Sudermann’s, he went on, that had made a deep impression upon him. In this story there was a woman who, as she sat by her sister’s sick-bed, felt a wish that her sister should die so that she herself might marry her husband. The woman thereupon committed suicide, thinking she was not fit to live after being guilty of such baseness. He could understand this, he said, and it would be only right if his thoughts were the death of him, for he deserved nothing less.¹ - I remarked that it was well known to us that patients derived a certain satisfaction from their sufferings, so that in reality they all resisted their own recovery to some extent. He must never lose sight of the fact that a treatment like ours proceeded to the accompaniment of a constant resistance; I should be repeatedly reminding him of this fact.

He then went on to say that he would like to speak of a criminal act, whose author he did not recognize as himself, though he quite clearly recollected committing it. He quoted a saying of Nietzsche’s:² ‘"I did this," says my Memory. "I cannot have done this," says my Pride and remains inexorable. In the end - Memory yields.’ ‘Well,’ he continued, ‘my memory has not yielded on this point.’ - ‘That is because you derive pleasure from your self-reproaches as a means of self-punishment.’ - ‘My younger brother - I am really very fond of him now, and he is causing me a great deal of worry just at present, for he wants to make what I consider a preposterous match; I have thought before now of going and killing the person concerned so as to prevent his marrying her -well, my younger brother and I used to fight a lot when we were children. We were very fond of each other at the same time, and were inseparable; but I was plainly filled with jealousy, as he was the stronger and better-looking of the two and consequently the favourite.’ - ‘Yes. You have already given me a description of a scene of jealousy in connection with Fräulein Lina.’ - ‘Very well then, on some such occasion (it was certainly before I was eight years old, for I was not going to school yet, which I began to do when I was eight) - on some such occasion, this is what I did. We both had toy guns of the usual make. I loaded mine with the ram rod and told him that if he looked up the barrel he would see something. Then, while he was looking in, I pulled the trigger. He was hit on the forehead and not hurt; but I had meant to hurt him very much indeed. Afterwards I was quite beside myself, and threw myself on the ground and asked myself however I could have done such a thing. But I did do it.’ - I took the opportunity of urging my case. If he had preserved the recollection of an action so foreign to him as this, he could not, I maintained, deny the possibility of something similar, which he had now forgotten entirely, having happened at a still earlier age in relation to his father. - He then told me he was aware of having felt other vindictive impulses, this time towards the lady he admired so much, of whose character he painted a glowing picture. It might be true, he said, that she could not love easily; but she was reserving her whole self for the one man to whom she would some day belong. She did not love him. When he had become certain of that, a conscious phantasy had taken shape in his mind of how he should grow very rich and marry some one else, and should then take her to call on the lady in order to hurt her feelings. But at that point the phantasy had broken down, for he had been obliged to own to himself that the other woman, his wife, was completely indifferent to him; then his thoughts had become confused, till finally it had been clearly borne in upon him that this other woman would have to die. In this phantasy, just as in his attempt upon his brother, he recognized the quality of cowardice which was so particularly horrible to him.³ - In the further course of our conversation I pointed out to him that he ought logically to consider himself as in no way responsible for any of these traits in his character; for all of these reprehensible impulses originated from his infancy, and were only derivatives of his infantile character surviving in his unconscious; and he must know that moral responsibility could not be applied to children. It was only by a process of development, I added, that a man, with his moral responsibility, grew up out of the sum of his infantile predispositions.4 He expressed a doubt, however, whether all his evil impulses had originated from that source. But I promised to prove it to him in the course of the treatment.

He went on to adduce the fact of his illness having become so enormously intensified since his father’s death; and I said I agreed with him in so far as I regarded his sorrow at his father’s death as the chief source of the intensity of his illness. His sorrow had found, as it were, a pathological expression in his illness. Whereas, I told him, a normal period of mourning would last from one to two years, a pathological one like this would last indefinitely.

This is as much of the present case history as I am able to report in a detailed and consecutive manner. It coincides roughly with the expository portion of the treatment; this lasted in all for more than eleven months.

¹ This sense of guilt involves the most glaring contradiction of his opening denial that he had ever entertained such an evil wish against his father. This is a common type of reaction to repressed material which has become conscious: the ‘No’ with which the fact is first denied is immediately followed by a confirmation of it, though, to begin with, only an indirect one.

² Jenseits von Gut und Böse, iv. 68.

³ This quality of his will find an explanation later on.

4 I only produced these arguments so as once more to demonstrate to myself their inefficacy. I cannot understand how other psychotherapists can assert that they successfully combat neuroses with such weapons as these.7

(E) SOME OBSESSIONAL IDEAS AND THEIR EXPLANATION

Obsessional ideas, as is well known, have an appearance of being either without motive or without meaning, just a dreams have. The first problem is how to give them a sense and a status in the subject’s mental life, so as to make them comprehensible and even obvious. The problem of translating them may seem insoluble; but we must never let ourselves be misled by that illusion. The wildest and most eccentric obsessional ideas can be cleared up if they are investigated deeply enough. The solution is effected by bringing the obsessional ideas into temporal relationship with the patient’s experiences, that is to say, by enquiring when a particular obsessional idea made its first appearance and in what external circumstances it is apt to recur. When, as so often happens, an obsessional idea has not succeeded in establishing itself permanently, the task of clearing it up is correspondingly simplified. We can easily convince ourselves that, when once the interconnections between an obsessional idea and the patient’s experiences have been discovered, there will be no difficulty in obtaining access to whatever else may be puzzling or worth knowing in the pathological structure we are dealing with - its meaning, the mechanism of its origin, and its derivation from the preponderant motive forces of the patient’s mind.

As a particularly clear example I will begin with one of the suicidal impulses which appeared so frequently in our patient. This instance almost analysed itself in the telling. He had once, he told me, lost some weeks of study owing to his lady’s absence: she had gone away to nurse her grandmother, who was seriously ill. Just as he was in the middle of a very hard piece of work the idea had occurred to him: ‘If you received a command to take your examination this term at the first possible opportunity, you might manage to obey it. But if you were commanded to cut your throat with a razor, what then?’ He had at once become aware that this command had already been given, and was hurrying to the cupboard to fetch his razor when he thought: ‘No, it’s not so simple as that. You must¹ go and kill the old woman.’ Upon that, he had fallen to the ground, beside himself with horror.

In this instance the connection between the compulsive idea and the patient’s life is contained in the opening words of his story. His lady was absent, while he was working very hard for an examination so as to bring the possibility of an alliance with her nearer. While he was working he was overcome by a longing for his absent lady, and he thought of the cause of her absence. And now there came over him something which, if he had been a normal man, would probably have been some kind of feeling of annoyance with her grandmother: ‘Why must the old woman get ill just at the very moment when I’m longing for her so frightfully?’ We must suppose that something similar but far more intense passed through our patient’s mind - an unconscious fit of rage which could combine with his longing and find expression in the exclamation: ‘Oh, I should like to go and kill that old woman for robbing me of my love!’ Thereupon followed the command: ‘Kill yourself, as a punishment for these savage and murderous passions!’ The whole process then passed into the obsessional patient’s consciousness accompanied by the most violent affect and in a reverse order - the punitive command coming first, and the mention of the guilty outburst afterwards. I cannot think that this attempt at an explanation will seem forced or that it involves many hypothetical elements.

¹ The sense requires that the word ‘first’ should be interpolated here.8

Another impulse, which might be described as indirectly suicidal and which was of longer duration, was not so easily explicable. For its relation to the patient’s experiences succeeded in concealing itself behind one of those purely external associations which are so obnoxious to our consciousness. One day while he was away on his summer holidays the idea suddenly occurred to him that he was too fat [German ‘dick’] and that he must make himself slimmer. So he began getting up from table before the pudding came round and tearing along the road without a hat in the blazing heat of an August sun. Then he would dash up a mountain at the double, till, dripping with perspiration, he was forced to come to a stop. On one occasion his suicidal intentions actually emerged without any disguise from behind this mania for slimming: as he was standing on the edge of a steep precipice he suddenly received a command to jump over, which would have been certain death. Our patient could think of no explanation of this senseless obsessional behaviour until it suddenly occurred to him that at that time his lady had also been stopping at the same resort; but she had been in the company of an English cousin, who was very attentive to her and of whom the patient had been very jealous. This cousin’s name was Richard, and, according to the usual practice in England, he was known as Dick. Our patient, then, had wanted to kill this Dick; he had been far more jealous of him and enraged with him than he could admit to himself, and that was why he had imposed on himself this course of slimming by way of a punishment. This obsessional impulse may seem very different from the directly suicidal command which was discussed above, but they have nevertheless one important feature in common. For they both arose as reactions to a tremendous feeling of rage, which was inaccessible to the patient’s consciousness and was directed against some one who had cropped up as an interference with the course of his love.¹

¹ Names and words are not nearly so frequently or so recklessly employed in obsessional neuroses as in hysteria for the purpose of establishing a connection between unconscious thoughts (whether they are impulses or phantasies) and symptoms. I happen, however, to recollect another instance in which the very same name, Richard, was similarly used by a patient whom I analysed a long time since. After a quarrel with his brother he began brooding over the best means of getting rid of his fortune, and declaring that he did not want to have anything more to do with money, and so on. His brother was called Richard, and ‘richard’ is the French for ‘a rich man’.

Some other of the patient’s obsessions, however, though they too were centred upon his lady, exhibited a different mechanism and owed their origin to a different instinct. Besides his slimming mania he produced a whole series of other obsessional activities at the period during which the lady was stopping at his summer resort; and, in part at least, these directly related to her. One day, when he was out with her in a boat and there was a stiff breeze blowing, he was obliged to make her put on his cap, because a command had been formulated in his mind that nothing must happen to her.¹ This was a kind of obsession for protecting, and it bore other fruit besides this. Another time, as they were sitting together during a thunderstorm, he was obsessed, he could not tell why, with the necessity for counting up to forty or fifty between each flash of lightning and its accompanying thunder-clap. On the day of her departure he knocked his foot against a stone lying in the road, and was obliged to put it out of the way by the side of the road, because the idea struck him that her carriage would be driving along the same road in a few hours’ time and might come to grief against this stone. But a few minutes later it occurred to him that this was absurd, and he was obliged to go back and replace the stone in its original position in the middle of the road. After her departure he became a prey to an obsession for understanding, which made him a curse to all his companions. He forced himself to understand the precise meaning of every syllable that was addressed to him, as though he might otherwise be missing some priceless treasure. Accordingly he kept asking: ‘What was it you said just then?‘ And after it had been repeated to him he could not help thinking it had sounded different the first time, so he remained dissatisfied.

¹ The words ‘for which he might be to blame’ must be added to complete the sense.0

All of these products of his illness depended upon a certain circumstance which at that time dominated his relations to his lady. When he had been taking leave of her in Vienna before the summer holidays, she had said something which he had construed into a desire on her part to disown him before the rest of the company; and this had made him very unhappy. During her stay at the holiday resort there had been an opportunity for discussing the question, and the lady had been able to prove to him that these words of hers which he had misunderstood had on the contrary been intended to save him from looking ridiculous. This made him very happy again. The clearest allusion to this incident was contained in the obsession for understanding. It was constructed as though he were saying to himself: ‘After such an experience you must never misunderstand any one again, if you want to spare yourself unnecessary distress.’ This resolution was not merely a generalization from a single occasion, but it was also displaced - perhaps on account of the lady’s absence - from a single highly valued individual on to all the remaining inferior ones. And the obsession cannot have arisen solely from his satisfaction at the explanation she had given him; it must have expressed something else besides, for it ended in an unsatisfying doubt as to whether what he had heard had been correctly repeated.

The other compulsive commands that have been mentioned put us upon the track of this other element. His obsession for protecting can only have been a reaction - as an expression of remorse and penitence - to a contrary, that is a hostile, impulse which he must have felt towards his lady before they had their éclaircissement. His obsession for counting during the thunderstorm can be interpreted, with the help of some material which he produced, as having been a defensive measure against fears that some one was in danger of death. The analysis of the obsessions which we first considered has already warned us to regard our patient’s hostile impulses as particularly violent and as being in the nature of senseless rage; and now we find that even after their reconciliation his rage against the lady continued to play a part in the formation of his obsessions. His doubting mania as to whether he had heard correctly was an expression of the doubt still lurking in his mind, whether he had really understood his lady correctly this time and whether he had been justified in taking her words as a proof of her affection for him. The doubt implied in his obsession for understanding was a doubt of her love. A battle between love and hate was raging in the lover’s breast, and the object of both these feelings was one and the same person. The battle was represented in a plastic form by his compulsive and symbolic act of removing the stone from the road along which she was to drive, and then of undoing this deed of love by replacing the stone where it had lain, so that her carriage might come to grief against it and she herself be hurt. We shall not be forming a correct judgement of this second part of the compulsive act if we take it at its face value as having merely been a critical repudiation of a pathological action. The fact that it was accompanied by a sense of compulsion betrays it as having itself been a part of the pathological action, though a part which was determined by a motive contrary to that which produced the first part.

Compulsive acts like this, in two successive stages, of which the second neutralizes the first, are a typical occurrence in obsessional neuroses. The patient’s consciousness naturally misunderstands them and puts forward a set of secondary motives to account for them - rationalizes them, in short. (Cf. Jones, 1908.) But their true significance lies in their being a representation of a conflict between two opposing impulses of approximately equal strength: and hitherto I have invariably found that this opposition has been one between love and hate. Compulsive acts of this sort are theoretically of special interest, for they show us a new type of method of constructing symptoms. What regularly occurs in hysteria is that a compromise is arrived at which enables both the opposing tendencies to find expression simultaneously - which kills two birds with one stone;¹ whereas here each of the two opposing tendencies finds satisfaction singly, first one and then the other, though naturally an attempt is made to establish some sort of logical connection (often in defiance of all logic) between the antagonists.²

¹ Cf. ‘Hysterical Phantasies and their Relation to Bisexuality’ (Freud, 1908a).

² Another obsessional patient once told me the following story. He was walking one day in the park at Schönbrunn when he kicked his foot against a branch that was lying on the ground. He picked it up and flung it into the hedge that bordered the path. On his way home he was suddenly seized with uneasiness that the branch in its new position might perhaps be projecting a little from the hedge and might cause an injury to some one passing by the same place after him. He was obliged to jump off his tram, hurry back to the park, find the place again, and put the branch back in its former position - although any one else but the patient would have seen that, on the contrary, it was bound to be more dangerous to passers-by in its original position than where he had put it in the hedge. The second and hostile act, which he carried out under compulsion, had clothed itself to his conscious view with the motives that really belonged to the first and philanthropic one.

The conflict between love and hatred showed itself in our patient by other signs as well. At the time of the revival of his piety he made up prayers for himself, which took up more and more time and eventually lasted for an hour and a half. The reason for this was that he found, like an inverted Balaam, that something always inserted itself into his pious phrases and turned them into their opposite. E.g., if he said, ‘May God protect him’, an evil spirit would hurriedly insinuate a ‘not’.¹ On one such occasion the idea occurred to him of cursing instead, for in that case, he thought, the contrary words would be sure to creep in. His original intention, which had been repressed by his praying, was forcing its way through in this last idea of his. In the end he found his way out of his embarrassment by giving up the prayers and replacing them by a short formula concocted out of the initial letters or syllables of various prayers. He then recited this formula so quickly that nothing could slip into it.

He once brought me a dream which represented the same conflict in relation to his transference on to the physician. He dreamt that my mother was dead; he was anxious to offer me his condolences, but was afraid that in doing so he might break into an impertinent laugh, as he had repeatedly done on similar occasions in the past. He preferred, therefore, to leave a card on me with ‘p. c.’ written on it; but as he was writing them the letters turned into ‘p. f.’²

¹ Compare the similar mechanism in the familiar case of sacrilegious thoughts entering the minds of devout persons.

² [The customary abbreviations for ‘pour condoler’ and ‘pour féliciter’ respectively.] This dream provides the explanation of the compulsive laughter which so often occurs on mournful occasions and which is regarded as such an unaccountable phenomenon.3

The mutual antagonism between his feelings for his lady was too marked to have escaped his conscious perception entirely, although we may conclude from the obsessions in which it was manifested that he did not rightly appreciate the depth of his negative impulses. The lady had refused his first proposal, ten years earlier. Since then he had to his own knowledge passed through alternating periods, in which he either believed that he loved her intensely, or felt indifferent to her. Whenever in the course of the treatment he was faced by the necessity of taking some step which would bring him nearer the successful end of his courtship, his resistance usually began by taking the form of a conviction that after all he did not very much care for her - though this resistance, it is true, used soon to break down. Once when she was lying seriously ill in bed and he was most deeply concerned about her, there crossed his mind as he looked at her a wish that she might lie like that for ever. He explained this idea by an ingenious piece of sophistry: maintaining that he had only wished her to be permanently ill so that he might be relieved of his intolerable fear that she would have a repeated succession of attacks!¹ Now and then he used to occupy his imagination with day-dreams, which he himself recognized as ‘phantasies of revenge’ and felt ashamed of. Believing, for instance, that the lady set great store by the social standing of a suitor, he made up a phantasy in which she was married to a man of that kind, who was in some government office. He himself then entered the same department, and rose much more rapidly than her husband, who eventually became his subordinate. One day, his phantasy proceeded, this man committed some act of dishonesty. The lady threw herself at his feet and implored him to save her husband. He promised to do so, and informed her that it had only been for love of her that he had entered the service, because he had foreseen that such a moment would occur; and now that her husband was saved, his own mission was fulfilled and he would resign his post.

He produced other phantasies in which he did the lady some great service without her knowing that it was he who was doing it. In these he only recognized his affection, without sufficiently appreciating the origin and aim of his magnanimity, which was designed to repress his thirst for revenge, after the manner of Dumas’ Count of Monte-Cristo. Moreover he admitted that occasionally he was overcome by quite distinct impulses to do some mischief to the lady he admired. These impulses were mostly in abeyance when she was there, and only appeared in her absence.

¹ It cannot be doubted that another contributory motive to this compulsive idea was a wish to know that she was powerless against his designs.4

(F) THE PRECIPITATING CAUSE OF THE ILLNESS

One day the patient mentioned quite casually an event which I could not fail to recognize as the precipitating cause of his illness, or at least as the immediate occasion of the attack which had begun some six years previously and had persisted to that day. He himself had no notion that he had brought forward anything of importance; he could not remember that he had ever attached any importance to the event; and moreover he had never forgotten it. Such an attitude on his part calls for some theoretical consideration.

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