Архитектура-(3434)Астрономия-(809)Биология-(7483)Биотехнологии-(1457)Военное дело-(14632)Высокие технологии-(1363)География-(913)Геология-(1438)Государство-(451)Демография-(1065)Дом-(47672)Журналистика и СМИ-(912)Изобретательство-(14524)Иностранные языки-(4268)Информатика-(17799)Искусство-(1338)История-(13644)Компьютеры-(11121)Косметика-(55)Кулинария-(373)Культура-(8427)Лингвистика-(374)Литература-(1642)Маркетинг-(23702)Математика-(16968)Машиностроение-(1700)Медицина-(12668)Менеджмент-(24684)Механика-(15423)Науковедение-(506)Образование-(11852)Охрана труда-(3308)Педагогика-(5571)Полиграфия-(1312)Политика-(7869)Право-(5454)Приборостроение-(1369)Программирование-(2801)Производство-(97182)Промышленность-(8706)Психология-(18388)Религия-(3217)Связь-(10668)Сельское хозяйство-(299)Социология-(6455)Спорт-(42831)Строительство-(4793)Торговля-(5050)Транспорт-(2929)Туризм-(1568)Физика-(3942)Философия-(17015)Финансы-(26596)Химия-(22929)Экология-(12095)Экономика-(9961)Электроника-(8441)Электротехника-(4623)Энергетика-(12629)Юриспруденция-(1492)Ядерная техника-(1748)
THE PSYCHICAL DISORDERS OF MALE POTENCY 29 страница
To sum up: exemption from mutual contradiction, primary process (mobility of cathexes), timelessness, and replacement of external by psychical reality - these are the characteristics which we may expect to find in processes belonging to the system Ucs.¹
Unconscious processes only become cognizable by us under the conditions of dreaming and of neurosis - that is to say, when processes of the higher, Pcs., system are set back to an earlier stage by being lowered (by regression). In themselves they cannot be cognized, indeed are even incapable of carrying on their existence; for the system Ucs. is at a very early moment overlaid by the Pcs. which has taken over access to consciousness and to motility. Discharge from the system Ucs. passes into somatic innervation that leads to development of affect; but even this path of discharge is, as we have seen, contested by the Pcs. By itself, the system Ucs. would not in normal conditions be able to bring about any expedient muscular acts, with the exception of those already organized as reflexes.
¹ We are reserving for a different context the mention of another notable privilege of the Ucs.1
The full significance of the characteristics of the system Ucs. described above could only be appreciated by us if we were to contrast and compare them with those of the system Pcs. But this would take us so far afield that I propose that we should once more call a halt and not undertake the comparison of the two till we can do so in connection with our discussion of the higher system. Only the most pressing points of all will be mentioned at this stage.
The processes of the system Pcs. display - no matter whether they are already conscious or only capable of becoming conscious - an inhibition of the tendency of cathected ideas towards discharge. When a process passes from one idea to another, the first idea retains a part of its cathexis and only a small portion undergoes displacement. Displacements and condensations such as happen in the primary process are excluded or very much restricted. This circumstance caused Breuer to assume the existence of two different states of cathectic energy in mental life: one in which the energy is tonically ‘bound’ and the other in which it is freely mobile and presses towards discharge. In my opinion this distinction represents the deepest insight we have gained up to the present into the nature of nervous energy, and I do not see how we can avoid making it. A metapsychological presentation would most urgently call for further discussion at this point, though perhaps that would be too daring an undertaking as yet.
Further, it devolves upon the system Pcs. to make communication possible between the different ideational contents so that they can influence one another, to give them an order in time, and to set up a censorship or several censorships; ‘reality testing’ too, and the reality-principle, are in its province. Conscious memory, moreover, seems to depend wholly on the Pcs. This should be clearly distinguished from the memory-traces in which the experiences of the Ucs. are fixed, and probably corresponds to a special registration such as we proposed (but later rejected) to account for the relation of conscious to unconscious ideas. In this connection, also, we shall find means for putting an end to our oscillations in regard to the naming of the higher system - which we have hitherto spoken of indifferently, sometimes as the Pcs. and sometimes as the Cs.
Nor will it be out of place here to utter a warning against any over-hasty generalization of what we have brought to light concerning the distribution of the various mental functions between the two systems. We are describing the state of affairs as it appears in the adult human being, in whom the system Ucs. operates, strictly speaking, only as a preliminary stage of the higher organization. The question of what the content and connections of that system are during the development of the individual, and of what significance it possesses in animals - these are points on which no conclusion can be deduced from our description: they must be investigated independently. Moreover, in human beings we must be prepared to find possible pathological conditions under which the two systems alter, or even exchange, both their content and their characteristics.
VI. COMMUNICATION BETWEEN THE TWO SYSTEMS
It would nevertheless be wrong to imagine that the Ucs. remains at rest while the whole work of the mind is performed by the Pcs. - that the Ucs. is something finished with, a vestigial organ, a residuum from the process of development. It is wrong also to suppose that communication between the two systems is confined to the act of repression, with the Pcs. casting everything that seems disturbing to it into the abyss of the Ucs. On the contrary, the Ucs. is alive and capable of development and maintains a number of other relations with the Pcs., amongst them that of co-operation. In brief, it must be said that the Ucs. is continued into what are known as derivatives, that it is accessible to the impressions of life, that it constantly influences the Pcs., and is even, for its part, subjected to influences from the Pcs.
Study of the derivatives of the Ucs. will completely disappoint our expectations of a schematically clear-cut distinction between the two psychical systems. This will no doubt give rise to dissatisfaction with our results and will probably be used to cast doubts on the value of the way in which we have divided up the psychical processes. Our answer is, however, that we have no other aim but that of translating into theory the results of observation, and we deny that there is any obligation on us to achieve at our first attempt a well-rounded theory which will commend itself by its simplicity. We shall defend the complications of our theory so long as we find that they meet the results of observation, and we shall not abandon our expectations of being led in the end by those very complications to the discovery of a state of affairs which, while simple in itself, can account for all the complications of reality.
Among the derivatives of the Ucs. instinctual impulses, of the sort we have described, there are some which unite in themselves characters of an opposite kind. On the one hand, they are highly organized, free from self-contradiction, have made use of every acquisition of the system Cs. and would hardly be distinguished in our judgement from the formations of that system. On the other hand they are unconscious and are incapable of becoming conscious. Thus qualitatively they belong to the system Pcs., but factually to the Ucs. Their origin is what decides their fate. We may compare them with individuals of mixed race who, taken all round, resemble white men, but who betray their coloured descent by some striking feature or other, and on that account are excluded from society and enjoy none of the privileges of white people. Of such a nature are those phantasies of normal people as well as of neurotics which we have recognized as preliminary stages in the formation both of dreams and of symptoms and which, in spite of their high degree of organization, remain repressed and therefore cannot become conscious. They draw near to consciousness and remain undisturbed so long as they do not have an intense cathexis, but as soon as they exceed a certain height of cathexis they are thrust back. Substitutive formations, too, are highly organized derivatives of the Ucs. of this kind; but these succeed in breaking through into consciousness, when circumstances are favourable - for example, if they happen to join forces with an anticathexis from the Pcs.
When, elsewhere, we come to examine more closely the preconditions for becoming conscious, we shall be able to find a solution of some of the difficulties that arise at this juncture. Here it seems a good plan to look at things from the angle of consciousness, in contrast to our previous approach, which was upwards from the Ucs. To consciousness the whole sum of psychical processes presents itself as the realm of the preconscious. A very great part of this preconscious originates in the unconscious, has the character of its derivatives and is subjected to a censorship before it can become conscious. Another part of the Pcs. is capable of becoming conscious without any censorship. Here we come upon a contradiction of an earlier assumption. In discussing the subject of repression we were obliged to place the censorship which is decisive for becoming conscious between the systems Ucs. and Pcs.. Now it becomes probable that there is a censorship between the Pcs. and the Cs. Nevertheless we shall do well not to regard this complication as a difficulty, but to assume that to every transition from one system to that immediately above it (that is, every advance to a higher stage of psychical organization) there corresponds a new censorship. This, it may be remarked, does away with the assumption of a continuous laying down of new registrations.
The reason for all these difficulties is to be found in the circumstance that the attribute of being conscious, which is the only characteristic of psychical processes that is directly presented to us, is in no way suited to serve as a criterion for the differentiation of systems. Apart from the fact that the conscious is not always conscious but also at times latent, observation has shown that much that shares the characteristics of the system Pcs. does not become conscious; and we learn in addition that the act of becoming conscious is dependent on the attention of the Pcs. being turned in certain directions. Hence consciousness stands in no simple relation either to the different systems or to repression. The truth is that it is not only the psychically repressed that remains alien to consciousness, but also some of the impulses which dominate our ego - something, therefore, that forms the strongest functional antithesis to the repressed. The more we seek to win our way to a metapsychological view of mental life, the more we must learn to emancipate ourselves from the importance of the symptom of ‘being conscious’.
So long as we still cling to this belief we see our generalizations regularly broken through by exceptions. On the one hand we find that derivatives of the Ucs. become conscious as substitutive formations and symptoms - generally, it is true, after having undergone great distortion as compared with the unconscious, though often retaining many characteristics which call for repression. On the other hand, we find that many preconscious formations remain unconscious, though we should have expected that, from their nature, they might very well have become conscious. Probably in the latter case the stronger attraction of the Ucs. is asserting itself. We are led to look for the more important distinction as lying, not between the conscious and the preconscious, but between the preconscious and the unconscious. The Ucs. is turned back on the frontier of the Pcs. by the censorship, but derivatives of the Ucs. can circumvent this censorship, achieve a high degree of organization and reach a certain intensity of cathexis in the Pcs. When, however, this intensity is exceeded and they try to force themselves into consciousness, they are recognized as derivatives of the Ucs. and are repressed afresh at the new frontier of censorship, between the Pcs. and the Cs. Thus the first of these censorships is exercised against the Ucs. itself, and the second against its Pcs. derivatives. One might suppose that in the course of individual development the censorship had taken a step forward.
In psycho-analytic treatment the existence of the second censorship, located between the systems Pcs. and Cs., is proved beyond question. We require the patient to form numerous derivatives of the Ucs., we make him pledge himself to overcome the objections of the censorship to these preconscious formations becoming conscious, and by overthrowing this censorship, we open up the way to abrogating the repression accomplished by the earlier one. To this let us add that the existence of the censorship between the Pcs. and the Cs. teaches us that becoming conscious is no mere act of perception, but is probably also a hypercathexis, a further advance in the psychical organization.
Let us turn to the communications between the Ucs. and the other systems, less in order to establish anything new than in order to avoid omitting what is most prominent. At the roots of instinctual activity the systems communicate with one another most extensively. One portion of the processes which are there excited passes through the Ucs., as through a preparatory stage, and reaches the highest psychical development in the Cs.; another portion is retained as Ucs. But the Ucs. is also affected by experiences originating from external perception. Normally all the paths from perception to the Ucs. remain open, and only those leading on from the Ucs. are subject to blocking by repression.
It is a very remarkable thing that the Ucs. of one human being can react upon that of another, without passing through the Cs. This deserves closer investigation, especially with a view to finding out whether preconscious activity can be excluded as playing a part in it; but, descriptively speaking, the fact is incontestable.
The content of the system Pcs. (or Cs.) is derived partly from instinctual life (through the medium of the Ucs.), and partly from perception. It is doubtful how far the processes of this system can exert a direct influence on the Ucs.; examination of pathological cases often reveals an almost incredible independence and lack of susceptibility to influence on the part of the Ucs. A complete divergence of their trends, a total severance of the two systems, is what above all characterizes a condition of illness. Nevertheless, psycho-analytic treatment is based upon an influencing of the Ucs. from the direction of the Cs., and at any rate shows that this, though a laborious task, is not impossible. The derivatives of the Ucs. which act as intermediaries between the two systems open the way, as we have already said, towards accomplishing this. But we may safely assume that a spontaneously effected alteration in the Ucs. from the direction of the Cs. is a difficult and slow process.
Co-operation between a preconscious and an unconscious impulse, even when the latter is intensely repressed, may come about if there is a situation in which the unconscious impulse can act in the same sense as one of the dominant trends. The repression is removed in this instance, and the repressed activity is admitted as a reinforcement of the one intended by the ego. The unconscious becomes ego-syntonic in respect of this single conjunction without any change taking place in its repression apart from this. In this co-operation the influence of the Ucs. is unmistakable: the reinforced tendencies reveal themselves as being nevertheless different from the normal; they make specially perfect functioning possible, and they manifest a resistance in the face of opposition which is similar to that offered, for instance, by obsessional symptoms.
The content of the Ucs. may be compared with an aboriginal population in the mind. If inherited mental formations exist in the human being - something analogous to instinct¹ in animals - these constitute the nucleus of the Ucs. Later there is added to them what is discarded during childhood development as unserviceable; and this need not differ in its nature from what is inherited. A sharp and final division between the content of the two systems does not, as a rule, take place till puberty.
¹ [The German word here is ‘Instinkt’, not the usual ‘Trieb’.]8
VII. ASSESSMENT OF THE UNCONSCIOUS
What we have put together in the preceding discussions is probably as much as we can say about the Ucs. so long as we only draw upon our knowledge of dream-life and the transference neuroses. It is certainly not much, and at some points it gives an impression of obscurity and confusion; and above all it offers us no possibility of co-ordinating or subsuming the Ucs. into any context with which we are already familiar. It is only the analysis of one of the affections which we call narcissistic psychoneuroses that promises to furnish us with conceptions through which the enigmatic Ucs. will be brought more within our reach and, as it were, made tangible.
Since the publication of a work by Abraham (1908) - which that conscientious author has attributed to my instigation - we have tried to base our characterization of Kraepelin’s ‘dementia praecox’ (Bleuler’s ‘schizophrenia’) on its position with reference to the antithesis between ego and object. In the transference neuroses (anxiety hysteria, conversion hysteria and obsessional neurosis) there was nothing to give special prominence to this antithesis. We knew, indeed, that frustration in regard to the object brings on the outbreak of the neurosis and that the neurosis involves a renunciation of the real object; we knew too that the libido that is withdrawn from the real object reverts first to a phantasied object and then to one that had been repressed (introversion). But in these disorders object-cathexis in general is retained with great energy, and more detailed examination of the process of repression has obliged us to assume that object-cathexis persists in the system Ucs. in spite of - or rather in consequence of - repression. Indeed, the capacity for transference, of which we make use for therapeutic purposes in these affections, presupposes an unimpaired object-cathexis.
In the case of schizophrenia, on the other hand, we have been driven to the assumption that after the process of repression the libido that has been withdrawn does not seek a new object, but retreats into the ego; that is to say, that here the object-cathexes are given up and a primitive objectless condition of narcissism is re-established. The incapacity of these patients for transference (so far as the pathological process extends), their consequent inaccessibility to therapeutic efforts, their characteristic repudiation of the external world, the appearance of signs of a hypercathexis of their own ego, the final outcome in complete apathy - all these clinical features seem to agree excellently with the assumption that their object-cathexes have been given up. As regards the relation of the two psychical systems to each other, all observers have been struck by the fact that in schizophrenia a great deal is expressed as being conscious which in the transference neuroses can only be shown to be present in the Ucs. by psycho-analysis. But to begin with we were not able to establish any intelligible connection between the ego-object relation and the relationships of consciousness.
What we are seeking seems to present itself in the following unexpected way. In schizophrenics we observe - especially in the initial stages, which are so instructive - a number of changes in speech, some of which deserve to be regarded from a particular point of view. The patient often devotes peculiar care to his way of expressing himself, which becomes ‘stilted’ and ‘precious’. The construction of his sentences undergoes a peculiar disorganization, making them so incomprehensible to us that his remarks seem nonsensical. Some reference to bodily organs or innervations is often given prominence in the content of these remarks. To this may be added the fact that in such symptoms of schizophrenia as are comparable with the substitutive formations of hysteria or obsessional neurosis, the relation between the substitute and the repressed material nevertheless displays peculiarities which would surprise us in these two forms of neurosis.
Dr. Victor Tausk of Vienna has placed at my disposal some observations that he has made in the initial stages of schizophrenia in a female patient, which are particularly valuable in that the patient was ready to explain her utterances herself. I will take two of his examples to illustrate the view I wish to put forward, and I have no doubt that every observer could easily produce plenty of such material.0
A patient of Tausk’s, a girl who was brought to the clinic after a quarrel with her lover, complained that her eyes were not right, they were twisted. This she herself explained by bringing forward a series of reproaches against her lover in coherent language. ‘She could not understand him at all, he looked different every time; he was a hypocrite, an eye-twister,¹ he had twisted her eyes; now she had twisted eyes; they were not her eyes any more; now she saw the world with different eyes.’
The patient’s comments on her unintelligible remark have the value of an analysis, for they contain the equivalent of the remark expressed in a generally comprehensible form. They throw light at the same time on the meaning and the genesis of schizophrenic word-formation. I agree with Tausk in stressing in this example the point that the patient’s relation to a bodily organ (the eye) has arrogated to itself the representation of the whole content. Here the schizophrenic utterance exhibits a hypochondriac trait: it has become ‘organ-speech’.
A second communication by the same patient was as follows: ‘She was standing in church. Suddenly she felt a jerk; she had to change her position, as though somebody was putting her into a position, as though she was being put in a certain position.’
Now came the analysis of this through a fresh series of reproaches against her lover. ‘He was common, he had made her common, too, though she was naturally refined. He had made her like himself by making her think that he was superior to her; now she had become like him, because she thought she would be better if she were like him. He had given a false impression of his position; now she was just like him’ (by identification), ‘he had put her in a false position’.
The physical movement of ‘changing her position’, Tausk remarks, depicted the words ‘putting her in a false position’ and her identification with her lover. I would call attention once more to the fact that the whole train of thought is dominated by the element which has for its content a bodily innervation (or, rather, the sensation of it). Furthermore, a hysterical woman would, in the first example, have in fact convulsively twisted her eyes, and, in the second, have given actual jerks, instead of having the impulse to do so or the sensation of doing so: and in neither example would she have any accompanying conscious thoughts, nor would she have been able to express any such thoughts afterwards.
¹ [The German ‘Augenverdreher’ has the figurative meaning of ‘deceiver’.]1
These two observations, then, argue in favour of what we have called hypochondriacal speech or ‘organ-speech’. But, what seems to us more important, they also point to something else, of which we have innumerable instances (for example, in the cases collected in Bleuler’s monograph) and which may be reduced to a definite formula. In schizophrenia words are subjected to the same process as that which makes the dream images out of latent dream-thoughts - to what we have called the primary psychical process. They undergo condensation, and by means of displacement transfer their cathexes to one another in their entirety. The process may go so far that a single word, if it is specially suitable on account of its numerous connections, takes over the representation of a whole train of thought. The works of Bleuler, Jung and their pupils offer a quantity of material which particularly supports this assertion.¹
Before we draw any conclusion from impressions such as these, let us consider further the distinctions between the formation of substitutes in schizophrenia on the one hand, and in hysteria and obsessional neurosis on the other - subtle distinctions which nevertheless make a strange impression. A patient whom I have at present under observation has allowed himself to be withdrawn from all the interests of life on account of a bad condition of the skin of his face. He declares that he has black heads and deep holes in his face which everyone notices. Analysis shows that he is playing out his castration complex upon his skin. At first he worked at these blackheads remorselessly; and it gave him great satisfaction to squeeze them out, because, as he said, something spurted out when be did so. Then he began to think that a deep cavity appeared wherever he had got rid of a blackhead, and he reproached himself most vehemently with having ruined his skin for ever by ‘constantly fiddling about with his hand’. Pressing out the content of the blackheads is clearly to him a substitute for masturbation. The cavity which then appears owing to his fault is the female genital, i.e. the fulfilment of the threat of castration (or the phantasy representing that threat) provoked by his masturbating. This substitutive formation has, in spite of its hypochondriacal character, considerable resemblance to a hysterical conversion; and yet we have a feeling that something different must be going on here, that a substitutive formation such as this cannot be attributed to hysteria, even before we can say in what the difference consists. A tiny little cavity such as a pore of the skin would hardly be used by a hysteric as a symbol for the vagina, which he is otherwise ready to compare with every imaginable object that encloses a hollow space. Besides, we should expect the multiplicity of these little cavities to prevent him from using them as a substitute for the female genital. The same applies to the case of a young patient reported by Tausk some years ago to the Vienna Psycho-Analytical Society. This patient behaved in other respects exactly as though he were suffering from an obsessional neurosis; he took hours to wash and dress, and so on. It was noticeable, however, that he was able to give the meaning of his inhibitions without any resistance. In putting on his stockings, for instance, he was disturbed by the idea that he must pull apart the stitches in the knitting, i.e. the holes, and to him every hole was a symbol of the female genital aperture. This again is a thing which we cannot attribute to an obsessional neurotic. Reitler observed a patient of the latter sort, who also suffered from having to take a long time over putting on his stockings; this man, after overcoming his resistances, found as the explanation that his foot symbolized a penis, that putting on the stocking stood for a masturbatory act, and that he had to keep on pulling the stocking on and off, partly in order to complete the picture of masturbation, and partly in order to undo that act.
¹ The dream-work, too, occasionally treats words like things, and so creates very similar ‘schizophrenic’ utterances or neologisms.2
If we ask ourselves what it is that gives the character of strangeness to the substitutive formation and the symptom in schizophrenia, we eventually come to realize that it is the predominance of what has to do with words over what has to do with things. As far as the thing goes, there is only a very slight similarity between squeezing out a blackhead and an emission from the penis, and still less similarity between the innumerable shallow pores of the skin and the vagina; but in the former case there is, in both instances, a ‘spurting out’, while in the latter the cynical saying, ‘a hole is a hole’, is true verbally. What has dictated the substitution is not the resemblance between the things denoted but the sameness of the words used to express them. Where the two - word and thing - do not coincide, the formation of substitutes in schizophrenia deviates from that in the transference neuroses.
If now we put this finding alongside the hypothesis that in schizophrenia object-cathexes are given up, we shall be obliged to modify the hypothesis by adding that the cathexis of the word-presentations of objects is retained. What we have permissibly called the conscious presentation of the object can now be split up into the presentation of the word and the presentation of the thing; the latter consists in the cathexis, if not of the direct memory-images of the thing, at least of remoter memory-traces derived from these. We now seem to know all at once what the difference is between a conscious and an unconscious presentation. The two are not, as we supposed, different registrations of the same content in different psychical localities, nor yet different functional states of cathexis in the same locality; but the conscious presentation comprises the presentation of the thing plus the presentation of the word belonging to it, while the unconscious presentation is the presentation of the thing alone. The system Ucs. contains the thing-cathexes of the objects, the first and true object-cathexes; the system Pcs. comes about by this thing-presentation being hypercathected through being linked with the word-presentations corresponding to it. It is these hypercathexes, we may suppose, that bring about a higher psychical organization and make it possible for the primary process to be succeeded by the secondary process which is dominant in the Pcs. Now, too, we are in a position to state precisely what it is that repression denies to the rejected presentation in the transference neuroses: what it denies to the presentation is translation into words which shall remain attached to the object. A presentation which is not put into words, or a psychical act which is not hypercathected, remains thereafter in the Ucs. in a state of repression.
Дата добавления: 2014-12-23; Просмотров: 352; Нарушение авторских прав?