On the occasion of the opening of the Hebrew University 8 страница

The chief task during the latency period seems to be the fending-off of the temptation to masturbate. This struggle produces a series of symptoms which appear in a typical fashion in the most different individuals and which in general have the character of a ceremonial. It is a great pity that no one has as yet collected them and systematically analysed them. Being the earliest products of the neurosis they should best be able to shed light on the mechanisms employed in its symptom-formation. They already exhibit the features which will emerge so disastrously if a serious illness follows. They tend to become attached to activities (which would later be carried out almost automatically) such as going to sleep, washing, dressing and walking about; and they tend also to repetition and waste of time. Why this should be so is at present not at all clear; but the sublimation of anal-erotic components plays an unmistakable part in it.

The advent of puberty opens a decisive chapter in the history of an obsessional neurosis. The genital organization which has been broken off in childhood starts again with great vigour. But, as we know, the sexual development in childhood determines what direction this new start at puberty will take. Not only will the early aggressive impulses be re-awakened; but a greater or lesser proportion of the new libidinal impulses - in bad cases the whole of them - will have to follow the course prescribed for them by regression and will emerge as aggressive and destructive tendencies. In consequence of the erotic trends being disguised in this way and owing to the powerful reaction-formations in the ego, the struggle against sexuality will henceforward be carried on under the banner of ethical principles. The ego will recoil with astonishment from promptings to cruelty and violence which enter consciousness from the id, and it has no notion that in them it is combating erotic wishes, including some to which it would not otherwise have taken exception. The overstrict super-ego insists all the more strongly on the suppression of sexuality, since this has assumed such repellent forms. Thus in obsessional neurosis the conflict is aggravated in two directions: the defensive forces become more intolerant and the forces that are to be fended off become more intolerable. Both effects are due to a single factor, namely, regression of the libido.

A good deal of what has been said may be objected to on the ground that the unpleasant obsessive ideas are themselves quite conscious. But there is no doubt that before becoming conscious they have been though the process of repression. In most of them the actual wording of the aggressive instinctual impulse is altogether unknown to the ego, and it requires a good deal of analytic work to make it conscious. What does penetrate into consciousness is usually only a distorted substitute which is either of a vague, dream-like and indeterminate nature or so travestied as to be unrecognizable. Even where repression has not encroached upon the content of the aggressive impulse it has certainly got rid of its accompanying affective character. As a result, the aggressiveness appears to the ego not to be an impulsion but, as the patients themselves say, merely a ‘thought’ which awakens no feeling. But the remarkable thing is that this is not the case. What happens is that the affect left out when the obsessional idea is perceived appears in a different place. The super-ego behaves as though repression had not occurred and as though it knew the real wording and full affective character of the aggressive impulse, and it treats the ego accordingly. The ego which, on the one hand, knows that it is innocent is obliged, on the other hand, to be aware of a sense of guilt and to carry a responsibility which it cannot account for. This state of affairs is, however, not so puzzling as it would seem at first sight. The behaviour of the super-ego is perfectly intelligible, and the contradiction in the ego merely shows that it has shut out the id by means of repression while remaining fully accessible to the influence of the super-ego. 1 If it is asked why the ego does not also attempt to withdraw from the tormenting criticism of the super-ego, the answer is that it does manage to do so in a great number of instances. There are obsessional neuroses in which no sense of guilt whatever is present. In them, as far as can be seen, the ego has avoided becoming aware of it by instituting a fresh set of symptoms, penances or restrictions of a self-punishing kind. These symptoms, however, represent at the same time a satisfaction of masochistic impulses which, in their turn, have been reinforced by regression.

¹ Cf. Theodor Reik, 1925, 51.7

Obsessional neurosis presents such a vast multiplicity of phenomena that no efforts have yet succeeded in making a coherent synthesis of all its variations. All we can do is to pick out certain typical correlations; but there is always the risk that we may have overlooked other uniformities of a no less important kind.

I have already described the general tendency of symptom-formation in obsessional neurosis. It is to give ever greater room to substitutive satisfaction at the expense of frustration. Symptoms which once stood for a restriction of the ego come later on to represent satisfactions as well, thanks to the ego’s inclination to synthesis, and it is quite clear that this second meaning gradually becomes the more important of the two. The result of this process, which approximates more and more to a complete failure of the original purpose of defence, is an extremely restricted ego which is reduced to seeking satisfaction in the symptoms. The displacement of the distribution of forces in favour of satisfaction may have the dreaded final outcome of paralysing the will of the ego, which in every decision it has to make is almost as strongly impelled from the one side as from the other. The over-acute conflict between id and super-ego which has dominated the illness from the very beginning may assume such extensive proportions that the ego, unable to carry out its office of mediator, can undertake nothing which is not drawn into the sphere of that conflict.

VI

In the course of these struggles we come across two activities of the ego which form symptoms and which deserve special attention because they are obviously surrogates of repression and therefore well calculated to illustrate its purpose and technique. The fact that such auxiliary and substitutive techniques emerge may argue that true repression has met with difficulties in its functioning. If one considers how much more the ego is the scene of action of symptom-formation in obsessional neurosis than it is in hysteria and with what tenacity the ego clings to its relations to reality and to consciousness, employing all its intellectual faculties to that end - and indeed how the very process of thinking becomes hypercathected and erotized - then one may perhaps come to a better understanding of these variations of repression.

The two techniques I refer to are undoing what has been done and isolating. The first of these has a wide range of application and goes back very far. It is, as it were, negative magic, and endeavours, by means of motor symbolism, to ‘blow away’ not merely the consequences of some event (or experience or impression) but the event itself. I choose the term ‘blow away’ advisedly, so as to remind the reader of the part played by this technique not only in neuroses but in magical acts, popular customs and religious ceremonies as well. In obsessional neurosis the technique of undoing what has been done is first met with in the ‘diphasic’ symptoms, in which one action is cancelled out by a second, so that it is as though neither action had taken place, whereas, in reality, both have. This aim of undoing is the second underlying motive of obsessional ceremonials, the first being to take precautions in order to prevent the occurrence or recurrence of some particular event. The difference between the two is easily seen: the precautionary measures are rational, while trying to get rid of something by ‘making it not to have happened’ is irrational and in the nature of magic. It is of course to be suspected that the latter is the earlier motive of the two and proceeds from the animistic attitude towards the environment. This endeavour to undo shades off into normal behaviour in the case in which a person decides to regard an event as not having happened. But whereas he will take no direct steps against the event, and will simply pay no further attention to it or its consequences, the neurotic person will try to make the past itself non-existent. He will try to repress it by motor means. The same purpose may perhaps account for the obsession for repeating which is so frequently met with in this neurosis and the carrying out of which serves a number of contradictory intentions at once. When anything has not happened in the desired way it is undone by being repeated in a different way; and thereupon all the motives that exist for lingering over such repetitions come into play as well. As the neurosis proceeds, we often find that the endeavour to undo a traumatic experience is a motive of first-rate importance in the formation of symptoms. We thus unexpectedly discover a new, motor technique of defence, or (as we may say in this case with less inaccuracy) of repression.

The second of these techniques which we are setting out to describe for the first time, that of isolation, is peculiar to obsessional neurosis. It, too, takes place in the motor sphere. When something unpleasant has happened to the subject or when he himself has done something which has a significance for his neurosis, he interpolates an interval during which nothing further must happen - during which he must perceive nothing and do nothing. This behaviour, which seems strange at first sight, is soon seen to have a relation to repression. We know that in hysteria it is possible to cause a traumatic experience to be overtaken by amnesia. In obsessional neurosis this can often not be achieved: the experience is not forgotten, but, instead, it is deprived of its affect, and its associative connections are suppressed or interrupted so that it remains as though isolated and is not reproduced in the ordinary processes of thought. The effect of this isolation is the same as the effect of repression with amnesia. This technique, then, is reproduced in the isolations of obsessional neurosis; and it is at the same time given motor reinforcement for magical purposes. The elements that are held apart in this way are precisely those which belong together associatively. The motor isolation is meant to ensure an interruption of the connection in thought. The normal phenomenon of concentration provides a pretext for this kind of neurotic procedure: what seems to us important in the way of an impression or a piece of work must not be interfered with by the simultaneous claims of any other mental processes or activities. But even a normal person uses concentration to keep away not only what is irrelevant or unimportant, but, above all, what is unsuitable because it is contradictory. He is most disturbed by those elements which once belonged together but which have been torn apart in the course of his development - as, for instance, by manifestations of the ambivalence of his father-complex in his relation to God, or by impulses attached to his excretory organs in his emotions of love. Thus, in the normal course of things, the ego has a great deal of isolating work to do in its function of directing the current of thought. And, as we know, we are obliged, in carrying out our analytic technique, to train it to relinquish that function for the time being, eminently justified as it usually is.

We have all found by experience that it is especially difficult for an obsessional neurotic to carry out the fundamental rule of psycho-analysis. His ego is more watchful and makes sharper isolations, probably because of the high degree of tension due to conflict that exists between his super-ego and his id. While he is engaged in thinking, his ego has to keep off too much - the intrusion of unconscious phantasies and the manifestation of ambivalent trends. It must not relax, but is constantly prepared for a struggle. It fortifies this compulsion to concentrate and to isolate by the help of the magical acts of isolation which, in the form of symptoms, grow to be so noticeable and to have so much practical importance for the patient, but which are, of course, useless in themselves and are in the nature of ceremonials.

But in thus endeavouring to prevent associations and connections of thought, the ego is obeying one of the oldest and most fundamental commands of obsessional neurosis, the taboo on touching. If we ask ourselves why the avoidance of touching, contact or contagion should play such a large part in this neurosis and should become the subject-matter of complicated systems, the answer is that touching and physical contact are the immediate aim of the aggressive as well as the loving object- cathexes. Eros desires contact because it strives to make the ego and the loved object one, to abolish all spatial barriers between them. But destructiveness, too, which (before the invention of long-range weapons) could only take effect at close quarters, must presuppose physical contact, a coming to grips. To ‘touch’ a woman has become a euphemism for using her as a sexual object. Not to ‘touch’ one’s genitals is the phrase employed for forbidding auto-erotic satisfaction. Since obsessional neurosis begins by persecuting erotic touching and then, after regression has taken place, goes on to persecute touching in the guise of aggressiveness, it follows that nothing is so strongly proscribed in that illness as touching nor so well suited to become the central point of a system of prohibitions. But isolating is removing the possibility of contact; it is a method of withdrawing a thing from being touched in any way. And when a neurotic isolates an impression or an activity by interpolating an interval, he is letting it be understood symbolically that he will not allow his thoughts about that impression or activity to come into associative contact with other thoughts.

1 This is as far as our investigations into the formation of symptoms take us. It is hardly worth while summing them up, for the results they have yielded are scanty and incomplete and tell us scarcely anything that we do not already know. It would be fruitless to turn our attention to symptom-formation in other disorders besides phobias, conversion hysteria and obsessional neurosis, for too little is known about them. But in reviewing those three neuroses together we are brought up against a very serious problem the consideration of which can no longer be put off. All three have as their outcome the destruction of the Oedipus complex; and in all three the motive force of the ego’s opposition is, we believe, the fear of castration. Yet it is only in the phobias that this fear comes to the surface and is acknowledged. What has become of it in the other two neuroses? How has the ego spared itself this fear? The problem becomes accentuated when we recall the possibility, already referred to, that anxiety arises directly, by a kind of fermentation, from a libidinal cathexis whose processes have been disturbed. Furthermore, is it absolutely certain that fear of castration is the only motive force of repression (or defence)? If we think of neuroses in women we are bound to doubt it. For though we can with certainty establish in them the presence of a castration complex, we can hardly speak with propriety of castration anxiety where castration has already taken place.

VII

Let us go back again to infantile phobias of animals; for, when all is said and done, we understand them better than any other cases. In animal phobias, then, the ego has to oppose a libidinal object-cathexis coming from the id - a cathexis that belongs either to the positive or the negative Oedipus complex - because it believes that to give way to it would entail the danger of castration. This question has already been discussed, but there still remains a doubtful point to clear up. In ‘Little Hans’s’ case - that is, in the case of a positive Oedipus complex - was it his fondness for his mother or was it his aggressiveness towards his father which called out the defence by the ego? In practice it seems to make no difference, especially as each set of feelings implies the other; but the question has a theoretical interest, since it is only the feeling of affection for the mother which can count as a purely erotic one. The aggressive impulse flows mainly from the destructive instinct; and we have always believed that in a neurosis it is against the demands of the libido and not against those of any other instinct that the ego is defending itself. In point of fact we know that after ‘Hans’s’ phobia had been formed, his tender attachment to his mother seemed to disappear, having been completely disposed of by repression, while the formation of the symptom (the substitutive formation) took place in relation to his aggressive impulses. In the ‘Wolf Man’ the situation was simpler. The impulse that was repressed - his feminine attitude towards his father - was a genuinely erotic one; and it was in relation to that impulse that the formation of his symptoms took place.

It is almost humiliating that, after working so long, we should still be having difficulty in understanding the most fundamental facts. But we have made up our minds to simplify nothing and to hide nothing. If we cannot see things clearly we will at least see clearly what the obscurities are. What is hampering us here is evidently some hitch in the development of our theory of the instincts. We began by tracing the organization of the libido through its successive stages - from the oral through the sadistic-anal to the genital - and in doing so placed all the components of the sexual instinct on the same footing. Later it appeared that sadism was the representative of another instinct, which was opposed to Eros. This new view, that the instincts fall into two groups, seems to explode the earlier construction of the successive stages of libidinal organization. But we do not have to break fresh ground in order to find a way out of the difficulty. The solution has been at hand for a long time and lies in the fact that what we are concerned with are scarcely ever pure instinctual impulses but mixtures in various proportions of the two groups of instincts. If this is so, there is no need to revise our view of the organizations of the libido. A sadistic cathexis of an object may also legitimately claim to be treated as a libidinal one; and an aggressive impulse against the father can just as well be subjected to repression as a tender impulse towards the mother. Nevertheless we shall bear in mind for future consideration the possibility that repression is a process which has a special relation to the genital organization of the libido and that the ego resorts to other methods of defence when it has to secure itself against the libido on other levels of organization. To continue: a case like ‘Little Hans’s’ does not enable us to come to any clear conclusion. It is true that in him an aggressive impulse was disposed of by repression, but this happened after the genital organization had been reached.

This time we will not lose sight of the part played by anxiety. We have said that as soon as the ego recognizes the danger of castration it gives the signal of anxiety and inhibits through the pleasure-unpleasure agency (in a way which we cannot as yet understand) the impending cathectic process in the id. At the same time the phobia is formed. And now the castration anxiety is directed to a different object and expressed in a distorted form, so that the patient is afraid, not of being castrated by his father, but of being bitten by a horse or devoured by a wolf. This substitutive formation has two obvious advantages. In the first place it avoids a conflict due to ambivalence (for the father was a loved object, too), and in the second place it enables the ego to cease generating anxiety. For the anxiety belonging to a phobia is conditional; it only emerges when the object of it is perceived - and rightly so, since it is only then that the danger-situation is present. There is no need to be afraid of being castrated by a father who is not there. On the other hand one cannot get rid of a father; he can appear whenever he chooses. But if he is replaced by an animal, all one has to do is to avoid the sight of it - that is, its presence - in order to be free from danger and anxiety. ‘Little Hans’, therefore, imposed a restriction upon his ego. He produced the inhibition of not leaving the house, so as not to come across any horses. The young Russian had an even easier time of it, for it was hardly a privation for him not to look at a particular picture-book any more. If his naughty sister had not kept on showing him the book with the picture of the wolf standing upright in it, he would have been able to feel safe from his fear.

On a previous occasion I have stated that phobias have the character of a projection in that they replace an internal, instinctual danger by an external, perceptual one. The advantage of this is that the subject can protect himself against an external danger by fleeing from it and avoiding the perception of it, whereas it is useless to flee from dangers that arise from within. This statement of mine was not incorrect, but it did not go below the surface of things. For an instinctual demand is, after all, not dangerous in itself; it only becomes so inasmuch as it entails a real external danger, the danger of castration. Thus what happens in a phobia in the last resort is merely that one external danger is replaced by another. The view that in a phobia the ego is able to escape anxiety by means of avoidance or of inhibitory symptoms fits in very well with the theory that that anxiety is only an affective signal and that no alteration has taken place in the economic situation.

The anxiety felt in animal phobias is, therefore, an affective reaction on the part of the ego to danger; and the danger which is being signalled in this way is the danger of castration. This anxiety differs in no respect from the realistic anxiety which the ego normally feels in situations of danger, except that its content remains unconscious and only becomes conscious in the form of a distortion.

The same will prove true, I think, of the phobias of adults, although the material which their neuroses work over is much more abundant and there are some additional factors in the formation of the symptoms. Fundamentally the position is identical. The agoraphobic patient imposes a restriction on his ego so as to escape a certain instinctual danger - namely, the danger of giving way to his erotic desires. For if he did so the danger of being castrated, or some similar danger, would once more be conjured up as it was in his childhood. I may cite as an instance the case of a young man who became agoraphobic because he was afraid of yielding to the solicitations of prostitutes and of contracting a syphilitic infection from them as a punishment.

I am well aware that a number of cases exhibit a more complicated structure and that many other repressed instinctual impulses can enter into a phobia. But they are only tributary streams which have for the most part joined the main current of the neurosis at a later stage. The symptomatology of agoraphobia is complicated by the fact that the ego does not confine itself to making a renunciation. In order to rob the situation of danger it does more: it usually effects a temporal regression to infancy (in extreme cases, to a time when the subject was in his mother’s womb and protected against the dangers which threaten him in the present). Such a regression now becomes a condition whose fulfilment exempts the ego from making its renunciation. For instance, an agoraphobic patient may be able to walk in the street provided he is accompanied, like a small child, by someone he knows and trusts; or, for the same reason, he may be able to go out alone provided he remains within a certain distance of his own house and does not go to places which are not familiar to him or where people do not know him. What these stipulations are will depend in each case on the infantile factors which dominate him through his neurosis. The phobia of being alone is unambiguous in its meaning, irrespective of any infantile regression: it is, ultimately, an endeavour to avoid the temptation to indulge in solitary masturbation. Infantile regression can, of course, only take place when the subject is no longer a child.

A phobia generally sets in after a first anxiety attack has been experienced in specific circumstances, such as in the street or in a train or in solitude. Thereafter the anxiety is held in ban by the phobia, but it re-emerges whenever the protective condition cannot be fulfilled. The mechanism of phobia does good service as a means of defence and tends to be very stable. A continuation of the defensive struggle, in the shape of a struggle against the symptom, occurs frequently but not invariably.

What we have learnt about anxiety in phobias is applicable to obsessional neuroses as well. In this respect it is not difficult for us to put obsessional neuroses on all fours with phobias. In the former, the mainspring of all later symptom-formation is clearly the ego’s fear of its super-ego. The danger-situation from which the ego must get away is the hostility of the super-ego. There is no trace of projection here; the danger is completely internalized. But if we ask ourselves what it is that the ego fears from the super-ego, we cannot but think that the punishment threatened by the latter must be an extension of the punishment of castration. Just as the father has become depersonalized in the shape of the super-ego, so has the fear of castration at his hands become transformed into an undefined social or moral anxiety. But this anxiety is concealed. The ego escapes it by obediently carrying out the commands, precautions and penances that have been enjoined on it. If it is impeded in doing so, it is at once overtaken by an extremely distressing feeling of discomfort which may be regarded as an equivalent of anxiety and which the patients themselves liken to anxiety.

The conclusion we have come to, then, is this. Anxiety is a reaction to a situation of danger. It is obviated by the ego’s doing something to avoid that situation or to withdraw from it. It might be said that symptoms are created so as to avoid the generating of anxiety. But this does not go deep enough. It would be truer to say that symptoms are created so as to avoid a danger-situation whose presence has been signalled by the generation of anxiety. In the cases that we have discussed, the danger concerned was the danger of castration or of something traceable back to castration.

If anxiety is a reaction of the ego to danger, we shall be tempted to regard the traumatic neuroses, which so often follow upon a narrow escape from death, as a direct result of a fear of death (or fear for life) and to dismiss from our minds the question of castration and the dependent relationships of the ego. Most of those who observed the traumatic neuroses that occurred during the last war took this line, and triumphantly announced that proof was now forthcoming that a threat to the instinct of self-preservation could by itself produce a neurosis without any admixture of sexual factors and without requiring any of the complicated hypotheses of psycho-analysis. It is in fact greatly to be regretted that not a single analysis of a traumatic neurosis of any value is extant. And it is to be regretted, not because such an analysis would contradict the aetiological importance of sexuality - for any such contradiction has long since been disposed of by the introduction of the concept of narcissism, which brings the libidinal cathexis of the ego into line with the cathexes of objects and emphasizes the libidinal character of the instinct of self-preservation - but because, in the absence of any analyses of this kind, we have lost a most precious opportunity of drawing decisive conclusions about the relations between anxiety and the formation of symptoms. In view of all that we know about the structure of the comparatively simple neuroses of everyday life, it would seem highly improbable that a neurosis could come into being merely because of the objective presence of danger, without any participation of the deeper levels of the mental apparatus. But the unconscious seems to contain nothing that could give any content to our concept of the annihilation of life. Castration can be pictured on the basis of the daily experience of the faeces being separated from the body or on the basis of losing the mother’s breast at weaning. But nothing resembling death can ever have been experienced; or if it has, as in fainting, it has left no observable traces behind. I am therefore inclined to adhere to the view that the fear of death should be regarded as analogous to the fear of castration and that the situation to which the ego is reacting is one of being abandoned by the protecting super-ego - the powers of destiny - so that it has no longer any safeguard against all the dangers that surround it. In addition, it must be remembered that in the experiences which lead to a traumatic neurosis the protective shield against external stimuli is broken through and excessive amounts of excitation impinge upon the mental apparatus; so that we have here a second possibility - that anxiety is not only being signalled as an affect but is also being freshly created out of the economic conditions of the situation.

Дата добавления: 2014-12-23