The medical Review of reviews 6 страница

8 And here, Ladies and Gentlemen, I feel that I must make a pause to take breath - which you too will welcome as a relief - and, before I go on, to apologize to you. My intention is to give you some addenda to the introductory lectures on psycho-analysis which I began fifteen years ago, and I am obliged to behave as though you as well as I had in the interval done nothing but practise psycho-analysis. I know that that assumption is out of place; but I am helpless, I cannot do otherwise. This is no doubt related to the fact that it is in general so hard to give anyone who is not himself a psycho-analyst an insight into psycho-analysis. You can believe me when I tell you that we do not enjoy giving an impression of being members of a secret society and of practising a mystical science. Yet we have been obliged to recognize and express as our conviction that no one has a right to join in a discussion of psycho-analysis who has not had particular experiences which can only be obtained by being analysed oneself. When I gave you my lectures fifteen years ago I tried to spare you certain speculative portions of our theory; but it is precisely from them that are derived the new acquisitions of which I must speak to you to-day.

I return now to our topic. In face of the doubt whether the ego and super-ego are themselves unconscious or merely produce unconscious effects, we have, for good reasons, decided in favour of the former possibility. And it is indeed the case that large portions of the ego and super-ego can remain unconscious and are normally unconscious. That is to say, the individual knows nothing of their contents and it requires an expenditure of effort to make them conscious. It is a fact that ego and conscious, repressed and unconscious do not coincide. We feel a need to make a fundamental revision of our attitude to the problem of conscious-unconscious. At first we are inclined greatly to reduce the value of the criterion of being conscious since it has shown itself so untrustworthy. But we should be doing it an injustice. As may be said of our life, it is not worth much, but it is all we have. Without the illumination thrown by the quality of consciousness, we should be lost in the obscurity of depth-psychology; but we must attempt to find our bearings afresh.

There is no need to discuss what is to be called conscious: it is removed from all doubt. The oldest and best meaning of the word ‘unconscious’ is the descriptive one; we call a psychical process unconscious whose existence we are obliged to assume - for some such reason as that we infer it from its effects -, but of which we know nothing. In that case we have the same relation to it as we have to a psychical process in another person, except that it is in fact one of our own. If we want to be still more correct, we shall modify our assertion by saying that we call a process unconscious if we are obliged to assume that it is being activated at the moment, though at the moment we know nothing about it. This qualification makes us reflect that the majority of conscious processes are conscious only for a short time; very soon they become latent, but can easily become conscious again. We might also say that they had become unconscious, if it were at all certain that in the condition of latency they are still something psychical. So far we should have learnt nothing new; nor should we have acquired the right to introduce the concept of an unconscious into psychology. But then comes the new observation that we were already able to make in parapraxes. In order to explain a slip of the tongue, for instance, we find ourselves obliged to assume that the intention to make a particular remark was present in the subject. We infer it with certainty from the interference with his remark which has occurred; but the intention did not put itself through and was thus unconscious. If, when we subsequently put it before the speaker, he recognizes it as one familiar to him, then it was only temporarily unconscious to him; but if he repudiates it as something foreign to him, then it was permanently unconscious. From this experience we retrospectively obtain the right also to pronounce as something unconscious what had been described as latent. A consideration of these dynamic relations permits us now to distinguish two kinds of unconscious - one which is easily, under frequently occurring circumstances, transformed into something conscious, and another with which this transformation is difficult and takes place only subject to a considerable expenditure of effort or possibly never at all. In order to escape the ambiguity as to whether we mean the one or the other unconscious, whether we are using the word in the descriptive or in the dynamic sense, we make use of a permissible and simple way out. We call the unconscious which is only latent, and thus easily becomes conscious, the ‘preconscious’ and retain the term ‘unconscious’ for the other. We now have three terms, ‘conscious’, ‘preconscious’ and ‘unconscious’, with which we can get along in our description of mental phenomena. Once again: the preconscious is also unconscious in the purely descriptive sense, but we do not give it that name, except in talking loosely or when we have to make a defence of the existence in mental life of unconscious processes in general.

You will admit, I hope, that so far that is not too bad and allows of convenient handling. Yes, but unluckily the work of psycho-analysis has found itself compelled to use the word ‘unconscious’ in yet another, third, sense, and this may, to be sure, have led to confusion. Under the new and powerful impression of there being an extensive and important field of mental life which is normally withdrawn from the ego’s knowledge so that the processes occurring in it have to be regarded as unconscious in the truly dynamic sense, we have come to understand the term ‘unconscious’ in a topographical or systematic sense as well; we have come to speak of a ‘system’ of the preconscious and a ‘system’ of the unconscious, of a conflict between the ego and the system Ucs., and have used the word more and more to denote a mental province rather than a quality of what is mental. The discovery, actually an inconvenient one, that portions of the ego and super-ego as well are unconscious in the dynamic sense, operates at this point as a relief - it makes possible the removal of a complication. We perceive that we have no right to name the mental region that is foreign to the ego ‘the system Ucs’, since the characteristic of being unconscious is not restricted to it. Very well; we will no longer use the term ‘unconscious’ in the systematic sense and we will give what we have hitherto so described a better name and one no longer open to misunderstanding. Following a verbal usage of Nietzsche’s and taking up a suggestion by Georg Groddeck, we will in future call it the ‘id’. This impersonal pronoun seems particularly well suited for expressing the main characteristic of this province of the mind - the fact of its being alien to the ego. The super-ego, the ego and the id - these, then, are the three realms, regions, provinces, into which we divide an individual’s mental apparatus, and with the mutual relations of which we shall be concerned in what follows.

1 But first a short interpolation. I suspect that you feel dissatisfied because the three qualities of the characteristic of consciousness and the three provinces of the mental apparatus do not fall together into three peaceable couples, and you may regard this as in some sense obscuring our findings. I do not think, however, that we should regret it, and we should tell ourselves that we had no right to expect any such smooth arrangement. Let me give you an analogy; analogies, it is true, decide nothing, but they can make one feel more at home. I am imagining a country with a landscape of varying configuration - hill-country, plains, and chains of lakes -, and with a mixed population; it is inhabited by Germans, Magyars and Slovaks, who carry on different activities. Now things might be partitioned in such a way that the Germans, who breed cattle, live in the hill-country, the Magyars, who grow cereals and wine, live in the plains, and the Slovaks, who catch fish and plait reeds, live by the lakes. If the partitioning could be neat and clear-cut like this, a Woodrow Wilson would be delighted by it; it would also be convenient for a lecture in a geography lesson. The probability is, however, that you will find less orderliness and more mixing, if you travel through the region. Germans, Magyars and Slovaks live interspersed all over it; in the hill-country there is agricultural land as well, cattle are bred in the plains too. A few things are naturally as you expected, for fish cannot be caught in the mountains and wine does not grow in the water. Indeed, the picture of the region that you brought with you may on the whole fit the facts; but you will have to put up with deviations in the details.

2 You will not expect me to have much to tell you that is new about the id apart from its new name. It is the dark, inaccessible part of our personality; what little we know of it we have learnt from our study of the dream-work and of the construction of neurotic symptoms, and most of that is of a negative character and can be described only as a contrast to the ego. We approach the id with analogies: we call it a chaos, a cauldron full of seething excitations. We picture it as being open at its end to somatic influences, and as there taking up into itself instinctual needs which find their psychical expression in it, but we cannot say in what substratum. It is filled with energy reaching it from the instincts, but it has no organization, produces no collective will, but only a striving to bring about the satisfaction of the instinctual needs subject to the observance of the pleasure principle. The logical laws of thought do not apply in the id, and this is true above all of the law of contradiction. Contrary impulses exist side by side, without cancelling each other out or diminishing each other: at the most they may converge to form compromises under the dominating economic pressure towards the discharge of energy. There is nothing in the id that could be compared with negation; and we perceive with surprise an exception to the philosophical theorem that space and time are necessary forms of our mental acts. There is nothing in the id that corresponds to the idea of time; there is no recognition of the passage of time, and - a thing that is most remarkable and awaits consideration in philosophical thought - no alteration in its mental processes is produced by the passage of time. Wishful impulses which have never passed beyond the id, but impressions, too, which have been sunk into the id by repression, are virtually immortal; after the passage of decades they behave as though they had just occurred. They can only be recognized as belonging to the past, can only lose their importance and be deprived of their cathexis of energy, when they have been made conscious by the work of analysis, and it is on this that the therapeutic effect of analytic treatment rests to no small extent.

Again and again I have had the impression that we have made too little theoretical use of this fact, established beyond any doubt, of the unalterability by time of the repressed. This seems to offer an approach to the most profound discoveries. Nor, unfortunately, have I myself made any progress here.

The id of course knows no judgements of value: no good and evil, no morality. The economic or, if you prefer, the quantitative factor, which is intimately linked to the pleasure principle, dominates all its processes. Instinctual cathexes seeking discharge - that, in our view, is all there is in the id. It even seems that the energy of these instinctual impulses is in a state different from that in the other regions of the mind, far more mobile and capable of discharge; otherwise the displacements and condensations would not occur which are characteristic of the id and which so completely disregard the quality of what is cathected - what in the ego we should call an idea. We would give much to understand more about these things! You can see, incidentally, that we are in a position to attribute to the id characteristics other than that of its being unconscious, and you can recognize the possibility of portions of the ego and super-ego being unconscious without possessing the same primitive and irrational characteristics.

We can best arrive at the characteristics of the actual ego, in so far as it can be distinguished from the id and from the super-ego, by examining its relation to the outermost superficial portion of the mental apparatus, which we describe as the system Pcpt.-Cs. This system is turned towards the external world, it is the medium for the perceptions arising thence, and during its functioning the phenomenon of consciousness arises in it. It is the sense-organ of the entire apparatus; moreover it is receptive not only to excitations from outside but also to those arising from the interior of the mind. We need scarcely look for a justification of the view that the ego is that portion of the id which was modified by the proximity and influence of the external world, which is adapted for the reception of stimuli and as a protective shield against stimuli, comparable to the cortical layer by which a small piece of living substance is surrounded. The relation to the external world has become the decisive factor for the ego; it has taken on the task of representing the external world to the id - fortunately for the id, which could not escape destruction if, in its blind efforts for the satisfaction of its instincts, it disregarded that supreme external power. In accomplishing this function, the ego must observe the external world, must lay down an accurate picture of it in the memory-traces of its perceptions, and by its exercise of the function of ‘reality-testing’ must put aside whatever in this picture of the external world is an addition derived from internal sources of excitation. The ego controls the approaches to motility under the id’s orders; but between a need and an action it has interposed a postponement in the form of the activity of thought, during which it makes use of the mnemic residues of experience. In that way it has dethroned the pleasure principle which dominates the course of events in the id without any restriction and has replaced it by the reality principle, which promises more certainty and greater success.5

The relation to time, which is so hard to describe, is also introduced into the ego by the perceptual system; it can scarcely be doubted that the mode of operation of that system is what provides the origin of the idea of time. But what distinguishes the ego from the id quite especially is a tendency to synthesis in its contents, to a combination and unification in its mental processes which are totally lacking in the id. When presently we come to deal with the instincts in mental life we shall, I hope, succeed in tracing this essential characteristic of the ego back to its source. It alone produces the high degree of organization which the ego needs for its best achievements. The ego develops from perceiving the instincts to controlling them; but this last is only achieved by the representative of the instinct being allotted its proper place in a considerable assemblage, by its being taken up into a coherent context. To adopt a popular mode of speaking, we might say that the ego stands for reason and good sense while the id stands for the untamed passions.

So far we have allowed ourselves to be impressed by the merits and capabilities of the ego; it is now time to consider the other side as well. The ego is after all only a portion of the id, a portion that has been expediently modified by the proximity of the external world with its threat of danger. From a dynamic point of view it is weak, it has borrowed its energies from the id, and we are not entirely without insight into the methods - we might call them dodges - by which it extracts further amounts of energy from the id. One such method, for instance, is by identifying itself with actual or abandoned objects. The object-cathexes spring from the instinctual demands of the id. The ego has in the first instance to take note of them. But by identifying itself with the object it recommends itself to the id in place of the object and seeks to divert the id’s libido on to itself. We have already seen that in the course of its life the ego takes into itself a large number of precipitates like this of former object-cathexes. The ego must on the whole carry out the id’s intentions, it fulfils its task by finding out the circumstances in which those intentions can best be achieved. The ego’s relation to the id might be compared with that of a rider to his horse. The horse supplies the locomotive energy, while the rider has the privilege of deciding on the goal and of guiding the powerful animal’s movement. But only too often there arises between the ego and the id the not precisely ideal situation of the rider being obliged to guide the horse along the path by which it itself wants to go.

There is one portion of the id from which the ego has separated itself by resistances due to repression. But the repression is not carried over into the id: the repressed merges into the remainder of the id.6

We are warned by a proverb against serving two masters at the same time. The poor ego has things even worse: it serves three severe masters and does what it can to bring their claims and demands into harmony with one another. These claims are always divergent and often seem incompatible. No wonder that the ego so often fails in its task. Its three tyrannical masters are the external world, the super-ego and the id. When we follow the ego’s efforts to satisfy them simultaneously - or rather, to obey them simultaneously - we cannot feel any regret at having personified this ego and having set it up as a separate organism. It feels hemmed in on three sides, threatened by three kinds of danger, to which, if it is hard pressed, it reacts by generating anxiety. Owing to its origin from the experiences of the perceptual system, it is earmarked for representing the demands of the external world, but it strives too to be a loyal servant of the id, to remain on good terms with it, to recommend itself to it as an object and to attract its libido to itself. In its attempts to mediate between the id and reality, it is often obliged to cloak the Ucs. commands of the id with its own Pcs. rationalizations, to conceal the id’s conflicts with reality, to profess, with diplomatic disingenuousness, to be taking notice of reality even when the id has remained rigid and unyielding. On the other hand it is observed at every step it takes by the strict super-ego, which lays down definite standards for its conduct, without taking any account of its difficulties from the direction of the id and the external world, and which, if those standards are not obeyed, punishes it with tense feelings of inferiority and of guilt. Thus the ego, driven by the id, confined by the super-ego, repulsed by reality, struggles to master its economic task of bringing about harmony among the forces and influences working in and upon it; and we can understand how it is that so often we cannot suppress a cry: ‘Life is not easy!’ If the ego is obliged to admit its weakness it breaks out in anxiety - realistic anxiety regarding the external world, moral anxiety regarding the super-ego and neurotic anxiety regarding the strength of the passions in the id.

I should like to portray the structural relations of the mental personality, as I have described them to you, in the unassuming sketch which I now present you with:7

As you see here, the super-ego merges into the id; indeed, as heir to the Oedipus complex it has intimate relations with the id; it is more remote than the ego from the perceptual system. The id has intercourse with the external world only through the ego - at least, according to this diagram. It is certainly hard to say to-day how far the drawing is correct. In one respect it is undoubtedly not. The space occupied by the unconscious id ought to have been incomparably greater than that of the ego or the preconscious. I must ask you to correct it in your thoughts.

And here is another warning, to conclude these remarks, which have certainly been exacting and not, perhaps, very illuminating. In thinking of this division of the personality into an ego, a super-ego and an id, you will not, of course, have pictured sharp frontiers like the artificial ones drawn in political geography. We cannot do justice to the characteristics of the mind by linear outlines like those in a drawing or in primitive painting, but rather by areas of colour melting into one another as they are presented by modern artists. After making the separation we must allow what we have separated to merge together once more. You must not judge too harshly a first attempt at giving a pictorial representations of something so intangible as psychical processes. It is highly probable that the development of these divisions is subject to great variations in different individuals; it is possible that in the course of actual functioning they may change and go through a temporary phase of involution. Particularly in the case of what is phylogenetically the last and most delicate of these divisions - the differentiation between the ego and the super-ego - something of the sort seems to be true. There is no question but that the same thing results from psychical illness. It is easy to imagine, too, that certain mystical practices may succeed in upsetting the normal relations between the different regions of the mind, so that, for instance, perception may be able to grasp happenings in the depths of the ego and in the id which were otherwise inaccessible to it. It may safely be doubted, however, whether this road will lead us to the ultimate truths from which salvation is to be expected. Nevertheless it may be admitted that the therapeutic efforts of psycho-analysis have chosen a similar line of approach. Its intention is, indeed, to strengthen the ego, to make it more independent of the super-ego, to widen its field of perception and enlarge its organization, so that it can appropriate fresh portions of the id. Where id was, there ego shall be. It is a work of culture - not unlike the draining of the Zuider Zee.

LECTURE XXXII ANXIETY AND INSTINCTUAL LIFE

LADIES AND GENTLEMEN, - You will not be surprised to hear that I have a number of novelties to report to you about our conception of anxiety and of the basic instincts of mental life; nor will you be surprised to learn that none of these novelties can claim to offer a final solution of these still unsettled problems. I have a particular reason for using the word ‘conception’ here. These are the most difficult problems that are set to us, but their difficulty does not lie in any insufficiency of observations; what present us with these riddles are actually the commonest and most familiar of phenomena. Nor does the difficulty lie in the recondite nature of the speculations to which they give rise; speculative consideration plays little part in this sphere. But it is truly a matter of conceptions - that is to say, of introducing the right abstract ideas, whose application to the raw material of observation will produce order and clarity in it.

I devoted a lecture (the twenty-fifth) to anxiety in my previous series; and I must briefly recapitulate what I said in it. We described anxiety as an affective state - that is to say, a combination of certain feelings in the pleasure-unpleasure series with the corresponding innervations of discharge and a perception of them, but probably also the precipitate of a particular important event, incorporated by inheritance - something that may thus be likened to an individually acquired hysterical attack. The event which we look upon as having left behind it an affective trace of this sort is the process of birth, at the time of which the effects upon the heart’s action and upon respiration characteristic of anxiety were expedient ones. The very first anxiety would thus have been a toxic one. We then started off from a distinction between realistic anxiety and neurotic anxiety, of which the former was a reaction, which seemed intelligible to us, to a danger - that is, to an expected injury from outside - while the latter was completely enigmatic, and appeared to be pointless.

In an analysis of realistic anxiety we brought it down to the state of increased sensory attention and motor tension which we describe as ‘preparedness for anxiety’. It is out of this that the anxiety reaction develops. Here two outcomes are possible. Either the generation of anxiety - the repetition of the old traumatic experience - is limited to a signal, in which case the remainder of the reaction can adapt itself to the new situation of danger and can proceed to flight or defence; or the old situation can retain the upper hand and the total reaction may consist in no more than a generation of anxiety, in which case the affective state becomes paralysing and will be inexpedient for present purposes.

We then turned to neurotic anxiety and pointed out that we observe it under three conditions. We find it first as a freely floating, general apprehensiveness, ready to attach itself temporarily, in the form of what is known as ‘expectant anxiety’, to any possibility that may freshly arise - as happens, for instance, in a typical anxiety neurosis. Secondly, we find it firmly attached to certain ideas in the so-called ‘phobias’, in which it is still possible to recognize a relation to external danger but in which we must judge the fear exaggerated out of all proportion. Thirdly and lastly, we find anxiety in hysteria and other forms of severe neurosis, where it either accompanies symptoms or emerges independently as an attack or more persistent state, but always without any visible basis in an external danger. We then asked ourselves two questions: ‘What are people afraid of in neurotic anxiety?’ and ‘How are we to bring it into relation with realistic anxiety felt in the face of external dangers?’

Our investigations were far from remaining unsuccessful: we reached a few important conclusions. In regard to anxious expectation clinical experience revealed that it had a regular connection with the libidinal economics of sexual life. The commonest cause of anxiety neurosis is unconsummated excitation. Libidinal excitation is aroused but not satisfied, not employed; apprehensiveness then appears instead of this libido that has been diverted from its employment. I even thought I was justified in saying that this unsatisfied libido was directly changed into anxiety. This view found support in some quite regularly occurring phobias of small children. Many of these phobias are very puzzling to us, but others, such as the fear of being alone and the fear of strangers, can be explained with certainty. Loneliness as well as a strange face arouse the child’s longing for his familiar mother; he is unable to control this libidinal excitation, he cannot hold it in suspense but changes it into anxiety. This infantile anxiety must therefore be regarded not as of the realistic but as of the neurotic kind. Infantile phobias and the expectation of anxiety in anxiety neurosis offer us two examples of one way in which neurotic anxiety originates: by a direct transformation of libido. We shall at once come to know of a second mechanism, but it will turn out not to be very different from the first.

For we consider that what is responsible for the anxiety in hysteria and other neuroses is the process of repression. We believe it is possible to give a more complete account of this than before, if we separate what happens to the idea that has to be repressed from what happens to the quota of libido attaching to it. It is the idea which is subjected to repression and which may be distorted to the point of being unrecognizable; but its quota of affect is regularly transformed into anxiety - and this is so whatever the nature of the affect may be, whether it is aggressiveness or love. It makes no essential difference, then, for what reason a quota of libido has become unemployable: whether it is on account of the infantile weakness of the ego, as in children’s phobias, or on account of somatic processes in sexual life, as in anxiety neurosis, or owing to repression, as in hysteria. Thus in reality the two mechanisms that bring about neurotic anxiety coincide.

In the course of these investigations our attention was drawn to a highly significant relation between the generation of anxiety and the formation of symptoms - namely, that these two represent and replace each other. For instance, an agoraphobic patient may start his illness with an attack of anxiety in the street. This would be repeated every time he went into the street again. He will now develop the symptom of agoraphobia; this may also be described as an inhibition, a restriction of the ego’s functioning, and by means of it he spares himself anxiety attacks. We can witness the converse of this if we interfere in the formation of symptoms, as is possible, for instance, with obsessions. If we prevent a patient from carrying out a washing ceremonial, he falls into a state of anxiety which he finds hard to tolerate and from which he had evidently been protected by his symptom. And it seems, indeed, that the generation of anxiety is the earlier and the formation of symptoms the later of the two, as though the symptoms are created in order to avoid the outbreak of the anxiety state. This is confirmed too by the fact that the first neuroses of childhood are phobias - states in which we see so clearly how an initial generation of anxiety is replaced by the later formation of a symptom; we get an impression that it is from these interrelations that we shall best obtain access to an understanding of neurotic anxiety. And at the same time we have also succeeded in answering the question of what it is that a person is afraid of in neurotic anxiety and so in establishing the connection between neurotic and realistic anxiety. What he is afraid of is evidently his own libido. The difference between this situation and that of realistic anxiety lies in two points: that the danger is an internal instead of an external one and that it is not consciously recognized.

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