Appendixmemorandum on the electrical treatment of war neurotics 1 страница

(1955 [1920])

There were plenty of patients even in peace-time who, after traumas (that is, after frightening and dangerous experiences such as railway accidents, etc.) exhibited severe disturbances in their mental life and in their nervous activity, without physicians having reached an agreed judgement on these states. Some supposed that with such patients it was a question of severe injuries to the nervous system, similar to the haemorrhages and inflammations occurring in non-traumatic illnesses. And when anatomical examination failed to establish such processes, they nevertheless maintained their belief that finer changes in the tissues were the cause of the symptoms observed. They therefore classed these traumatic cases among the organic diseases. Other physicians maintained from the first that these states could only be regarded as functional disturbances, and that the nervous system remained anatomically intact. But medical opinion had long found difficulty in explaining how such severe disturbances of function could occur without any gross injury to the organ.

The war that has recently ended produced and brought under observation an immense number of these traumatic cases. In the result, the controversy was decided in favour of the functional view. The great majority of physicians no longer believe that the so-called ‘war neurotics’ are ill as a result of tangible organic injuries to the nervous system, and the more clear-sighted among them have already decided, instead of using the indefinite description of a ‘functional change’, to introduce the unambiguous term ‘mental change’.

Although the war neuroses manifested themselves for the most part as motor disturbances - tremors and paralyses - and although it was plausible to suppose that such a gross impact as that produced by the concussion due to the explosion of a shell near by or to being buried by a fall of earth would lead to gross mechanical effects, observations were nevertheless made which left no doubt as to the psychical nature of the causation of these so-called war neuroses. How could this be disputed when the same symptoms appeared behind the Front as well, far from the horrors of war, or immediately after a return from leave? The physicians were therefore led to regard war neurotics in a similar light to the nervous subjects of peace-time.

What is known as the psycho-analytic school of psychiatry, which was brought into being by me, had taught for the last twenty-five years that the neuroses of peace could be traced back to disturbances of emotional life. This explanation was now applied quite generally to war neurotics. We had further asserted that neurotic patients suffered from mental conflicts and that the wishes and inclinations which were expressed in the symptoms were unknown to the patients themselves - were, that is to say, unconscious. It was therefore easy to infer that the immediate cause of all war neuroses was an unconscious inclination in the soldier to withdraw from the demands, dangerous or outrageous to his feelings, made upon him by active service. Fear of losing his own life, opposition to the command to kill other people, rebellion against the ruthless suppression of his own personality by his superiors - these were the most important affective sources on which the inclination to escape from war was nourished.

A soldier in whom these affective motives were very powerful and clearly conscious would, if he was a healthy man, have been obliged to desert or pretend to be ill. Only the smallest proportion of war neurotics, however, were malingerers; the emotional impulses which rebelled in them against active service and drove them into illness were operative in them without becoming conscious to them. They remained unconscious because other motives, such as ambition, self-esteem, patriotism, the habit of obedience and the example of others, were to start with more powerful until, on some appropriate occasion, they were overwhelmed by the other, unconsciously operating motives.

This insight into the causation of the war neuroses led to a method of treatment which seemed to be well-grounded and also proved highly effective in the first instance. It seemed expedient to treat the neurotic as a malingerer and to disregard the psychological distinction between conscious and unconscious intentions, although he was known not to be a malingerer. Since his illness served the purpose of withdrawing him from an intolerable situation, the roots of the illness would clearly be undermined if it was made even more intolerable to him than active service. Just as he had fled from the war into illness, means were now adopted which compelled him to flee back from illness into health, that is to say, into fitness for active service. For this purpose painful electrical treatment was employed, and with success. Physicians are glossing over the facts in retrospect when they assert that the strength of this electrical current was the same as had always been employed in functional disorders. This would only have been effective in the mildest cases; nor did it fit in with the underlying argument that a war neurotic’s illness had to be made painful so that the balance of his motives would be tipped in favour of recovery.

This painful form of treatment introduced in the German army for therapeutic purposes could no doubt also be employed in a more moderate fashion. If it was used in the Vienna Clinics, I am personally convinced that it was never intensified to a cruel pitch by the initiative of Professor Wagner-Jauregg. I cannot vouch for other physicians whom I did not know. The psychological education of medical men is in general decidedly deficient and more than one of them may have forgotten that the patient whom he was seeking to treat as a malingerer was, after all, not one.

This therapeutic procedure, however, bore a stigma from the very first. It did not aim at the patient’s recovery, or not in the first instance; it aimed, above all, at restoring his fitness for service. Here Medicine was serving purposes foreign to its essence. The physician himself was under military command and had his own personal dangers to fear - loss of seniority or a charge of neglecting his duty - if he allowed himself to be led by considerations other than those prescribed for him. The insoluble conflict between the claims of humanity, which normally carry decisive weight for a physician, and the demands of a national war was bound to confuse his activity.

Moreover, the successes of treatment by a strong electric current, which were brilliant to begin with, turned out afterwards not to be lasting. A patient who, having been restored to health by it, was sent back to the Front, could repeat the business afresh and have a relapse, by means of which he at least gained time and escaped the danger which was at the moment the immediate one. If he was once more under fire his fear of the electric current receded, just as during the treatment his fear of active service had faded. In the course of the war years, too, a rapidly increasing fatigue in the popular spirit made itself felt more and more, and a growing dislike of fighting, so that the treatment I have described began to fail in its effects. In these circumstances some of the army doctors gave way to the inclination, characteristic of Germans, to carry through their intentions regardless of all else - which should never have happened. The strength of the current, as well as the severity of the rest of the treatment, were increased to an unbearable point in order to deprive war neurotics of the advantage they gained from their illness. The fact has never been contradicted that in German hospitals there were deaths at that time during treatment and suicides as a result of it. I am quite unable to say, however, whether the Vienna Clinics, too, passed through this phase of therapy.

I am in a position to bring forward conclusive evidence of the final break-down of the electrical treatment of the war neuroses. In 1918 Dr. Ernst Simmel, head of a hospital for war neuroses at Posen, published a pamphlet in which he reported the extraordinarily favourable results achieved in severe cases of war neurosis by the psychotherapeutic method introduced by me. As a result of this publication, the next Psycho-Analytical Congress, held in Budapest in September 1918, was attended by official delegates of the German, Austrian and Hungarian Army Command, who promised that Centres should be set up for the purely psychological treatment of war neuroses. This promise was made although the delegates can have been left in no doubt that with this considerate, laborious and tedious kind of treatment it was impossible to count on the quickest restoration of these patients to fitness for service. Preparations for the establishment of Centres of this kind were actually under way, when the revolution broke out and put an end to the war and to the influence of the administrative offices which had hitherto been all-powerful. But with the end of the war the war neurotics, too, disappeared - a final but impressive proof of the psychical causation of their illnesses.

Vienna, 23. 2. 20. 3

THE ‘UNCANNY’ (1919)

I

It is only rarely that a psycho-analyst feels impelled to investigate the subject of aesthetics, even when aesthetics is understood to mean not merely the theory of beauty but the theory of the qualities of feeling. He works in other strata of mental life and has little to do with the subdued emotional impulses which, inhibited in their aims and dependent on a host of concurrent factors, usually furnish the material for the study of aesthetics. But it does occasionally happen that he has to interest himself in some particular province of that subject; and this province usually proves to be a rather remote one, and one which has been neglected in the specialist literature of aesthetics.

The subject of the ‘uncanny’ is a province of this kind. It is undoubtedly related to what is frightening - to what arouses dread and horror; equally certainly, too, the word is not always used in a clearly definable sense, so that it tends to coincide with what excites fear in general. Yet we may expect that a special core of feeling is present which justifies the use of a special conceptual term. One is curious to know what this common core is which allows us to distinguish as ‘uncanny’ certain things which lie within the field of what is frightening.

As good as nothing is to be found upon this subject in comprehensive treatises on aesthetics, which in general prefer to concern themselves with what is beautiful, attractive and sublime - that is, with feelings of a positive nature - and with the circumstances and the objects that call them forth, rather than with the opposite feelings of repulsion and distress. I know of only one attempt in medico-psychological literature, a fertile but not exhaustive paper by Jentsch (1906). But I must confess that I have not made a very thorough examination of the literature, especially the foreign literature, relating to this present modest contribution of mine, for reasons which, as may easily be guessed, lie in the times in which we live; so that my paper is presented to the reader without any claim to priority.

In his study of the ‘uncanny’ Jentsch quite rightly lays stress on the obstacle presented by the fact that people vary so very greatly in their sensitivity to this quality of feeling. The writer of the present contribution, indeed, must himself plead guilty to a special obtuseness in the matter, where extreme delicacy of perception would be more in place. It is long since he has experienced or heard of anything which has given him an uncanny impression, and he must start by translating himself into that state of feeling, by awakening in himself the possibility of experiencing it. Still, such difficulties make themselves powerfully felt in many other branches of aesthetics; we need not on that account despair of finding instances in which the quality in question will be unhesitatingly recognized by most people.

Two courses are open to us at the outset. Either we can find out what meaning has come to be attached to the word ‘uncanny’ in the course of its history; or we can collect all those properties of persons, things, sense-impressions, experiences and situations which arouse in us the feeling of uncanniness, and then infer the unknown nature of the uncanny from what all these examples have in common. I will say at once that both courses lead to the same result: the uncanny is that class of the frightening which leads back to what is known of old and long familiar. How this is possible, in what circumstances the familiar can become uncanny and frightening, I shall show in what follows. Let me also add that my investigation was actually begun by collecting a number of individual cases, and was only later confirmed by an examination of linguistic usage. In this discussion, however, I shall follow the reverse course.

The German word ‘unheimlich’ is obviously the opposite of ‘heimlich’ [‘homely’], ‘heimisch’ [‘native’] - the opposite of what is familiar; and we are tempted to conclude that what is ‘uncanny’ is frightening precisely because it is not known and familiar. Naturally not everything that is new and unfamiliar is frightening, however; the relation is not capable of inversion. We can only say that what is novel can easily become frightening and uncanny; some new things are frightening but not by any means all. Something has to be added to what is novel and unfamiliar in order to make it uncanny.

On the whole, Jentsch did not get beyond this relation of the uncanny to the novel and unfamiliar. He ascribes the essential factor in the production of the feeling of uncanniness to intellectual uncertainty; so that the uncanny would always, as it were, be something one does not know one’s way about in. The better orientated in his environment a person is, the less readily will he get the impression of something uncanny in regard to the objects and events in it.

It is not difficult to see that this definition is incomplete, and we will therefore try to proceed beyond the equation ‘uncanny’ = ‘unfamiliar’. We will first turn to other languages. But the dictionaries that we consult tell us nothing new, perhaps only because we ourselves speak a language that is foreign. Indeed, we get an impression that many languages are without a word for this particular shade of what is frightening.

I should like to express my indebtedness to Dr. Theodor Reik for the following excerpts:-

LATIN: (K. E. Georges, Deutchlateinisches Wörterbuch, 1898). An uncanny place: locus suspectus; at an uncanny time of night: intempesta nocte.

GREEK: (Rost’s and Schenkl’s Lexikons). îÝõïò (i. e. strange, foreign).

ENGLISH: (from the dictionaries of Lucas, Bellows, Flügel and Muret-Sanders). Uncomfortable, uneasy, gloomy, dismal, uncanny, ghastly; (of a house) haunted; (of a man) a repulsive fellow.

FRENCH: (Sachs-Villatte). Inquiétant, sinistre, lugubre, mal à son aise.

SPANISH: (Tollhausen, 1889). Sospechoso, de mal aguëro, lúgubre, siniestro.

The Italian and Portuguese languages seem to content themselves with words which we should describe as circumlocutions. In Arabic and Hebrew ‘uncanny’ means the same as ‘daemonic’, ‘gruesome’.8

Let us therefore return to the German language. In Daniel Sanders’s Wörterbuch der Deutschen Sprache (1860, 1, 729), the following entry, which I here reproduce in full, is to be found under the word ‘heimlich’. I have laid stress on one or two passages by italicizing them.

Heimlich, adj., subst. Heimlichkeit (pl. Heimlichkeiten): I. Also heimelich, heimelig, belonging to the house, not strange, familiar, tame, intimate, friendly, etc.

(a) (Obsolete) belonging to the house or the family, or regarded as so belonging (cf. Latin familiaris, familiar): Die Heimlichen, the members of the household; Der heimliche Rat (Gen. xli, 45; 2 Sam. xxiii. 23; 1 Chron. xii. 25; Wisd. viii. 4), now more usually Geheimer Rat [Privy Councillor].

(b) Of animals: tame, companionable to man. As opposed to wild, e. g. ‘Animals which are neither wild nor heimlich’, etc. ‘Wild animals... that are trained to be heimlich and accustomed to men.’ ‘If these young creatures are brought up from early days among men they become quite heimlich, friendly’ etc. - So also: ‘It (the lamb) is so heimlich and eats out of my hand.’ ‘Nevertheless, the stork is a beautiful, heimelich bird.’

(c) Intimate, friendlily comfortable; the enjoyment of quiet content, etc., arousing a sense of agreeable restfulness and security as in one within the four walls of his house. ‘Is it still heimlich to you in your country where strangers are felling your woods?’ ‘She did not feel too heimlich with him.’ ‘Along a high, heimlich, shady path..., beside a purling, gushing and babbling woodland brook.’ ‘To destroy the Heimlichkeit of the home,’ ‘I could not readily find another spot so intimate and heimlich as this.’ ‘We pictured it so comfortable, so nice, so cosy and heimlich.’ ‘In quiet Heimlichkeit, surrounded by close walls.’ ‘A careful housewife, who knows how to make a pleasing Heimlichkeit (Häuslichkeit) out of the smallest means.’ ‘The man who till recently had been so strange to him now seemed to him all the more heimlich.’ ‘The protestant land-owners do not feel... heimlich among their catholic inferiors.’ ‘When it grows heimlich and still, and the evening quiet alone watches over your cell.’ ‘Quiet, lovely and heimlich, no place more fitted for their rest.’ ‘He did not feel at all heimlich about it.’ - Also, ‘The place was so peaceful, so lonely, so shadily-heimlich.’ ‘The in- and outflowing waves of the current, dreamy and lullaby-heimlich.’ Cf. in especial Unheimlich. Among Swabian Swiss authors in especial, often as a trisyllable: ‘How heimelich it seemed to Ivo again of an evening, when he was at home.’ ‘It was so heimelig in the house.’ ‘The warm room and the heimelig afternoon.’ ‘When a man feels in his heart that he is so small and the Lord so great - that is what is truly heimelig.’ ‘Little by little they grew at ease and heimelig among themselves.’ ‘Friendly Heimeligkeit.’ ‘I shall be nowhere more heimelich than I am here.’ ‘That which comes from afar... assuredly does not live quite heimelig (heimatlich, freundnachbarlich) among the people.’ ‘The cottage where he had once sat so often among his own people, so heimelig, so happy.’ ‘The sentinel’s horn sounds so heimelig from the tower, and his voice invites so hospitably.’ ‘You go to sleep there so soft and warm, so wonderfully heim’lig.’ - This form of the word deserves to become general in order to protect this perfectly good sense of the word from becoming obsolete through an easy confusion with II. Cf.: ‘"The Zecks are all ‘heimlich’." (in sense II) "‘Heimlich’?... What do you understand by ‘heimlich’?" "Well,... they are like a buried spring or a dried-up pond. One cannot walk over it without always having the feeling that water might come up there again." "

Oh, we call it ‘unheimlich’; you call it ‘heimlich’. Well, what makes you think that there is something secret and untrustworthy about this family?"’ (Gutzkow).

(d) Especially in Silesia: gay, cheerful; also of the weather.

II. Concealed, kept from sight, so that others do not get to know of or about it, withheld from others. To do something heimlich, i.e. behind someone’s back; to steal away heimlich; heimlich meetings and appointments; to look on with heimlich pleasure at someone’s discomfiture; to sigh or weep heimlich; to behave heimlich, as though there was something to conceal; heimlich love-affair, love, sin; heimlich places (which good manners oblige us to conceal) (1 Sam. v. 6). ‘The heimlich chamber’ (privy) (2 Kings x. 27.). Also, ‘the heimlich chair’. ‘To throw into pits or Heimlichkeiten’. - ‘Led the steeds heimlich before Laomedon.’ - ‘As secretive, heimlich, deceitful and malicious towards cruel masters... as frank, open, sympathetic and helpful towards a friend in misfortune.’ ‘You have still to learn what is heimlich holiest to me.’ ‘The heimlich art’ (magic). ‘Where public ventilation has to stop, there heimlich machinations begin.’ ‘Freedom is the whispered watchword of heimlich conspirators and the loud battle-cry of professed revolutionaries.’ ‘A holy, heimlich effect.’ ‘I have roots that are most heimlich. I am grown in the deep earth.’ ‘My heimlich pranks.’ ‘If he is not given it openly and scrupulously he may seize it heimlich and unscrupulously.’ ‘He had achromatic telescopes constructed heimlich and secretly.’ ‘Henceforth I desire that there should be nothing heimlich any longer between us.’ - To discover, disclose, betray someone’s Heimlichkeiten; ‘to concoct Heimlichkeiten behind my back’. ‘In my time we studied Heimlichkeit’ ‘The hand of understanding can alone undo the powerless spell of the Heimlichkeit (of hidden gold).’ ‘Say, where is the place of concealment... in what place of hidden Heimlichkeit?’ ‘Bees, who make the lock of Heimlichkeiten’ (i. e. sealing-wax). ‘Learned in strange Heimlichkeiten (magic arts).

For compounds see above, Ic. Note especially the negative ‘un-’: eerie, weird, arousing gruesome fear: ‘Seeming quite unheimlich and ghostly to him.’ ‘The unheimlich, fearful hours of night.’ ‘I had already long since felt an unheimlich, even gruesome feeling.’ ‘Now I am beginning to have an unheimlich feeling.’... ‘Feels an unheimlich horror.’ ‘Unheimlich and motionless like a stone image.’ ‘The unheimlich mist called hill-fog.’ ‘These pale youths are unheimlich and are brewing heaven knows what mischief.’ ‘"Unheimlich" is the name for everything that ought to have remained... secret and hidden but has come to light’ (Schelling). - ‘To veil the divine, to surround it with a certain Unheimlichkeit.’ - Unheimlich is not often used as opposite to meaning II (above).

9 What interests us most in this long extract is to find that among its different shades of meaning the word ‘heimlich’ exhibits one which is identical with its opposite, ‘unheimlich’. What is heimlich thus comes to be unheimlich. (Cf. the quotation from Gutzkow: ‘We call it "unheimlich"; you call it "heimlich".’) In general we are reminded that the word ‘heimlich’ is not unambiguous, but belongs to two sets of ideas, which, without being contradictory, are yet very different: on the one hand it means what is familiar and agreeable, and on the other, what is concealed and kept out of sight. ‘Unheimlich’ is customarily used, we are told, as the contrary only of the first signification of heimlich’, and not of the second. Sanders tells us nothing concerning a possible genetic connection between these two meanings of heimlich. On the other hand, we notice that Schelling says something which throws quite a new light on the concept of the Unheimlich, for which we were certainly not prepared. According to him, everything is unheimlich that ought to have remained secret and hidden but has come to light.

Some of the doubts that have thus arisen are removed if we consult Grimm’s dictionary. (1877, 4, Part 2, 873 ff.)

We read:

Heimlich; adj. and adv. vernaculus, occultus; MHG. heimelîch, heimlîch.

(P. 874.) In a slightly different sense: ‘I feel heimlich, well, free from fear.’...

(b) Heimlich is also used of a place free from ghostly influences... familiar, friendly, intimate.

(P. 875: â) Familiar, amicable, unreserved.

4. From the idea of ‘homelike’, ‘belonging to the house’, the further idea is developed of something withdrawn from the eyes of strangers, something concealed, secret; and this idea is expanded in many ways...

(P. 876.) ‘On the left bank of the lake there lies a meadow heimlich in the wood.’ (Schiller, Wilhelm Tell, I. 4.)... Poetic licence, rarely so used in modern speech... Heimlich is used in conjunction with a verb expressing the act of concealing: ‘In the secret of his tabernacle he shall hide me heimlich.’ (Ps. xxvii. 5.)... Heimlich parts of the human body, pudenda... ‘the men that died not were smitten on their heimlich parts.’ (1 Samuel v. 12.)...

(c) Officials who give important advice which has to be kept secret in matters of state are called heimlich councillors; the adjective, according to modern usage, has been replaced by geheim [secret]... ‘Pharaoh called Joseph’s name "him to whom secrets are revealed"‘ (heimlich councillor). (Gen. xli. 45.)

(P. 878.) 6. Heimlich, as used of knowledge - mystic, allegorical: a heimlich meaning, mysticus, divinus, occultus, figuratus.

(P. 878.) Heimlich in a different sense, as withdrawn from knowledge, unconscious... Heimlich also has the meaning of that which is obscure, inaccessible to knowledge... ‘Do you not see? They do not trust us; they fear the heimlich face of the Duke of Friedland.’ (Schiller, Wallensteins Lager, Scene 2.)

9. The notion of something hidden and dangerous, which is expressed in the last paragraph, is still further developed, so that ‘heimlich’ comes to have the meaning usually ascribed to ‘unheimlich’. Thus: ‘At times I feel like a man who walks in the night and believes in ghosts; every corner is heimlich and full of terrors for him’. (Klinger, Theater, 3. 298.)

Thus heimlich is a word the meaning of which develops in the direction of ambivalence, until it finally coincides with its opposite, unheimlich. Unheimlich is in some way or other a sub-species of heimlich. Let us bear this discovery in mind, though we cannot yet rightly understand it, alongside of Schelling’s definition of the Unheimlich. If we go on to examine individual instances of uncanniness, these hints will become intelligible to us.

0II

When we proceed to review the things, persons, impressions, events and situations which are able to arouse in us a feeling of the uncanny in a particularly forcible and definite form, the first requirement is obviously to select a suitable example to start on. Jentsch has taken as a very good instance ‘doubts whether an apparently animate being is really alive; or conversely, whether a lifeless object might not be in fact animate’; and he refers in this connection to the impression made by wax-work figures, ingeniously constructed dolls and automata. To these he adds the uncanny effect of epileptic fits, and of manifestations of insanity, because these excite in the spectator the impression of automatic, mechanical processes at work behind the ordinary appearance of mental activity. Without entirely accepting this author’s view, we will take it as a starting-point for our own investigation because in what follows he reminds us of a writer who has succeeded in producing uncanny effects better than anyone else.

Jentsch writes: ‘In telling a story, one of the most successful devices for easily creating uncanny effects is to leave the reader in uncertainty whether a particular figure in the story is a human being or an automaton, and to do it in such a way that his attention is not focused directly upon his uncertainty, so that he may not be led to go into the matter and clear it up immediately. That, as we have said, would quickly dissipate the peculiar emotional effect of the thing. E. T. A. Hoffmann has repeatedly employed this psychological artifice with success in his fantastic narratives.’

This observation, undoubtedly a correct one, refers primarily to the story of ‘The Sand-Man’ in Hoffmann’s Nachtstücken,¹ which contains the original of Olympia, the doll that appears in the first act of Offenbach’s opera, Tales of Hoffman. But I cannot think - and I hope most readers of the story will agree with me - that the theme of the doll Olympia, who is to all appearances a living being, is by any means the only, or indeed the most important, element that must be held responsible for the quite unparalleled atmosphere of uncanniness evoked by the story. Nor is this atmosphere heightened by the fact that the author himself treats the episode of Olympia with a faint touch of satire and uses it to poke fun at the young man’s idealization of his mistress. The main theme of the story is, on the contrary, something different, something which gives it its name, and which is always re-introduced at critical moments: it is the theme of the ‘Sand-Man’ who tears out children’s eyes.

This fantastic tale opens with the childhood recollections of the student Nathaniel. In spite of his present happiness, he cannot banish the memories associated with the mysterious and terrifying death of his beloved father. On certain evenings his mother used to send the children to bed early, warning them that ‘the Sand-Man was coming’; and, sure enough, Nathaniel would not fail to hear the heavy tread of a visitor, with whom his father would then be occupied for the evening. When questioned about the Sand-Man, his mother, it is true, denied that such a person existed except as a figure of speech; but his nurse could give him more definite information: ‘He’s a wicked man who comes when children won’t go to bed, and throws handfuls of sand in their eyes so that they jump out of their heads all bleeding. Then he puts the eyes in a sack and carries them off to the half-moon to feed his children. They sit up there in their nest, and their beaks are hooked like owls’ beaks, and they use them to peck up naughty boys’ and girls’ eyes with.’

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