Five Lectures on Psycho-analysis, Freud (1909)
First Lecture. Breuer found that Anna O’s symptoms would disappear “if she could be brought to remember under hypnosis, with an accompanying expression of affect, on what occasion and in what connection the symptoms had first appeared.” For example, for six weeks she “was suffering very badly from thirst” but could not bring herself to drink. One day during hypnosis “she grumbled about her English ‘lady-companion’, whom she did not care for, and went on to describe, with every sign of disgust, how she had once gone into this lady's room and how her little dog — horrid creature! — had drunk out of a glass there. The patient had said nothing, as she had wanted to be polite. After giving further energetic expression to the anger she had held back, she asked for something to drink, drank a large quantity of water without any difficulty, and awoke from her hypnosis with the glass at her lips; and thereupon the disturbance vanished, never to return.”
Hysterical patients suffered a traumatic event but suppress the emotion evoked by the event “instead of allowing its discharge in the appropriate signs of emotion, words or action. In the episode of her lady-companion's dog, she suppressed any manifestation of her very intense disgust, out of consideration for the woman's feelings; while she watched at her father's bedside she was constantly on the alert to prevent the sick man from observing her anxiety and her painful depression.” Because her emotions were not discharged, “they underwent a transformation into unusual somatic innervations and inhibitions, which manifested themselves as the physical symptoms of the case,” which became known as “hysterical conversion.” Analogy: “When the bed of a stream is divided into two channels, then, if the current in one of them is brought up against an obstacle, the other will at once be overfilled.”
Second Lecture. Breuer hypnotized his patients because he believed “it was only in a state of hypnosis that [the patient] attained a knowledge of the pathogenic connections which escaped him in his normal state.” Freud gave up on hypnosis because he could not successfully hypnotize most of his patients. Bernheim had shown that when people awake from hypnosis, they only appear to have lost their memory of what they had recalled during hypnosis. When he would question these individuals, “they began by maintaining that they knew nothing about them; but if he refused to give way, and insisted, and assured them that they did know about them, the forgotten experiences always reappeared.”
With this example in mind, Freud did the same thing with his patients. “When I reached a point with them at which they maintained that they knew nothing more, I assured them that they did know it all the same, and that they had only to say it; and I ventured to declare that the right memory would occur to them at the moment at which I laid my hand on their forehead. In that way I succeeded, without using hypnosis, in obtaining from the patients whatever was required for establishing the connection between the pathogenic scenes they had forgotten and the symptoms left over from those scenes.” However, this proved to be “a laborious procedure, and in the long run an exhausting one; and it was unsuited to serve as a permanent technique.”
Freud identified the force that kept these memories from coming to consciousness as “resistance.” “It was on this idea of resistance, then, that I based my view of the course of psychical events in hysteria. In order to effect a recovery, it had proved necessary to remove these resistances.”
He gives an example of how he helped a patient fight through her resistance to recover a repressed memory and regain health. “When the girl reached the bedside of her dead sister, there came to her for a brief moment an idea that might be expressed in these words: ‘Now he is free and can marry me.’ We may assume with certainty that this idea, which betrayed to her consciousness the intense love for her brother-in-law of which she had not herself been conscious, was surrendered to repression a moment later, owing to the revolt of her feelings. The girl fell ill with severe hysterical symptoms; and while she was under my treatment it turned out that she had completely forgotten the scene by her sister's bedside and the odious egoistic impulse that had emerged in her. She remembered it during the treatment and reproduced the pathogenic moment with signs of the most violent emotion, and, as a result of the treatment, she became healthy once more.”
Freud proceeds to give a great analogy of repression. “Let us suppose that in this lecture-room and among this audience, whose exemplary quiet and attentiveness I cannot sufficiently commend, there is nevertheless someone who is causing a disturbance and whose ill-mannered laughter, chattering and shuffling with his feet are distracting my attention from my task. I have to announce that I cannot proceed with my lecture; and thereupon three or four of you who are strong men stand up and, after a short struggle, put the interrupter outside the door. So now he is ‘repressed’, and I can continue my lecture. But in order that the interruption shall not be repeated, in case the individual who has been expelled should try to enter the room once more, the gentlemen who have put my will into effect place their chairs up against the door and thus establish a ‘resistance’ after the repression has been accomplished. If you will now translate the two localities concerned into psychical terms as the ‘conscious’ and the ‘unconscious’, you will have before you a fairly good picture of the process of repression.”
He continues this analogy to explain how repression can lead to symptoms. After removing the man from the lecture-hall, we might at first think that the repression has been successful and that the man will no longer cause trouble. However, in some ways, “the repression has been unsuccessful; for now he is making an intolerable exhibition of himself outside the room, and his shouting and banging on the door with his fists interfere with my lecture even more than his bad behaviour did before. In these circumstances we could not fail to be delighted if our respected president, Dr. Stanley Hall, should be willing to assume the role of mediator and peacemaker. He would have a talk with the unruly person outside and would then come to us with a request that he should be re-admitted after all: he himself would guarantee that the man would now behave better. On Dr. Hall's authority we decide to lift the repression, and peace and quiet are restored. This presents what is really no bad picture of the physician's task in the psycho-analytic treatment of the neuroses.”
Similarly, the analyst can help the patient more than repression can. “There are a number of such opportune solutions, which may bring the conflict and the neurosis to a happy end, and which may in certain instances be combined. The patient's personality may be convinced that it has been wrong in rejecting the pathogenic wish and may be led into accepting it wholly or in part; or the wish itself may be directed to a higher and consequently unobjectionable aim (this is what we call its ‘sublimation’); or the rejection of the wish may be recognized as a justifiable one, but the automatic and therefore inefficient mechanism of repression may be replaced by a condemning judgement with the help of the highest human mental functions —conscious control of the wish is attained.”
Third Lecture. When the patient is in analysis, two internal forces are working against each other, a conscious part striving to make the unconscious memory conscious and the resistance striving to prevent it from becoming conscious. Here Freud defines a complex as “a group of interdependent ideational elements cathected with affect.” We can make the patient’s unconscious complexes conscious if he free associates. When the patient does this, we know that everything he says in some way derives from the unconscious complex we’re trying to make unconscious.
Sometimes the patient stops free associating and says “that he can think of nothing to say, and that nothing whatever occurs to his mind.” Although it might appear that the patient has run out of things to say, the truth is that the patient is simply holding back because the resistances have disguised themselves “as various critical judgements about the value of the idea that has occurred to him.” To prevent this from happening, we should warn patient that this will happen and tell him “to take no notice of such criticisms.” Rather, he must “entirely renounce any critical selection of this kind and say whatever comes into his head, even if he considers it incorrect or irrelevant or nonsensical, and above all if he finds it disagreeable to let himself think about what has occurred to him.”
Another wonderful metaphor: “This associative material, which the patient contemptuously rejects when he is under the influence of the resistance instead of under the doctor's, serves the psycho-analyst, as it were, as ore from which, with the help of some simple interpretative devices, he extracts its content of precious metal.”
We discover the unconscious through the patient’s free associations and also the interpretation of the patient’s dreams and some of our actions. Regarding our actions, he gives these examples: “forgetting things that might be known and sometimes in fact are known (e.g. the occasional difficulty in recalling proper names), slips of the tongue in talking, by which we ourselves are so often affected, analogous slips of the pen and misreadings, bungling the performance of actions, losing objects or breaking them,” as well as “playing about and fiddling with things, humming tunes, fingering parts of one's own body or one's clothing and so on.” Such actions always have meaning, as “there is nothing trivial, nothing arbitrary or haphazard.”
Fourth Lecture. Although we often trace a patient’s symptoms back to traumatic experiences, if we want to understand the ultimate origin of his symptoms, we must go back his childhoodIt is there that we find “the impressions and events which determined the later onset of the illness. It is only experiences in childhood that explain susceptibility to later traumas and it is only by uncovering these almost invariably forgotten memory-traces and by making them conscious that we acquire the power to get rid of the symptoms.”
We are sexual from birth, deriving sexual pleasure from different body parts (erotogenic zones): “apart from the genitals, these are the oral, anal, and urethral orifices, as well as the skin and other sensory orifices.” An example of this is thumb-sucking. This is auto-eroticism. We can also become sexually attached to certain persons.
At the end of puberty, these sexual instincts “become subordinated to the dominance of the genital zone, so that the whole sexual life enters the service of reproduction.” Additionally, “object-choice pushes auto-erotism into the background, so that in the subject's erotic life all the components of the sexual instinct now seek satisfaction in relation to the person who is loved.” However, some of these instincts do not become subordinated to the genital zone. Society pressured children to repress these instincts, especially our coprophilic impulses and our “fixation to the figures to which the child’s original object-choice was attached.”
Children’s relations to their parents contain “elements of accompanying sexual excitation. The child takes both of its parents, and more particularly one of them, as the object of its erotic wishes. In so doing, it usually follows some indication from its parents, whose affection bears the clearest characteristics of a sexual activity, even though of one that is inhibited in its aims. As a rule a father prefers his daughter and a mother her son; the child reacts to this by wishing, if he is a son, to take his father's place, and, if she is a daughter, her mother’s. The feelings which are aroused in these relations between parents and children and in the resulting ones between brothers and sisters are not only of a positive or affectionate kind but also of a negative or hostile one. The complex which is thus formed is doomed to early repression; but it continues to exercise a great and lasting influence from the unconscious. It is to be suspected that, together with its extensions, it constitutes the nuclear complex of every neurosis, and we may expect to find it no less actively at work in other regions of mental life.”
Fifth Lecture. Psychopathology can be described as follows. Step #1: We cannot get our erotic needs satisfied in reality. Step #2: We engage in fantasies that contain many of our repressed impulses.
In psychoanalysis, the patient inevitably engages in transference. The patient “directs towards the physician a degree of affectionate feeling (mingled, often enough, with hostility) which is based on no real relation between them” but can be “traced back to old wishful phantasies of the patient's which have become unconscious.” “Thus the part of the patient's emotional life which he can no longer recall to memory is re-experienced by him” in the transference, and it is in this re-experiencing that the patient becomes convinced “of the existence and of the power of these unconscious sexual impulses.”
People are often resistant to psychoanalysis because they’re afraid to bring “the repressed sexual instincts into the patient's consciousness.” He continues: “People notice that the patient has sore spots in his mind, but shrink from touching them for fear of increasing his sufferings. We can accept this analogy. It is no doubt kinder not to touch diseased spots if it can do nothing else but cause pain. But, as we know, a surgeon does not refrain from examining and handling a focus of disease, if he is intending to take active measures which he believes will lead to a permanent cure.”
By making the patient’s repressed sexual impulses conscious, we’re healing him. An impulse “is far stronger if it is unconscious than if it is conscious; so that to make it conscious can only be to weaken it. An unconscious wish cannot be influenced and it is independent of any contrary tendencies, whereas a conscious one is inhibited by whatever else is conscious and opposed to it. Thus the work of psycho-analysis puts itself at the orders of precisely the highest and most valuable cultural trends, as a better substitute for the unsuccessful repression.”
When wishes are made conscious, there are three positive consequences. First, these wishes “are destroyed by the rational mental activity of the better impulses that are opposed to them. Repression is replaced by a condemning judgement carried out along the best lines.” Second, the now conscious instincts can now “be employed for the useful purposes which they would have found earlier if development had not been interrupted.” One example of this is sublimation, where “the energy of the infantile wishful impulses is not cut off but remains ready for use — the unserviceable aim of the various impulses being replaced by one that is higher, and perhaps no longer sexual.” Freud believes that it is “probable that we owe our highest cultural successes to the contributions of energy made in this way to our mental functions. Premature repression makes the sublimation of the repressed instinct impossible; when the repression is lifted, the path to sublimation becomes free once more.”
Third, “[a] certain portion of the repressed libidinal impulses has a claim to direct satisfaction and ought to find it in life. Our civilized standards make life too difficult for the majority of human organizations. Those standards consequently encourage the retreat from reality and the generating of neuroses, without achieving any surplus of cultural gain by this excess of sexual repression. We ought not to exalt ourselves so high as completely to neglect what was originally animal in our nature. Nor should we forget that the satisfaction of the individual's happiness cannot be erased from among the aims of our civilization.”
He ends with this story. “The citizens of Schilda, so we are told, possessed a horse with whose feats of strength they were highly pleased and against which they had only one objection—that it consumed such a large quantity of expensive oats. They determined to break it of this bad habit very gently by reducing its ration by a few stalks every day, till they had accustomed it to complete abstinence. For a time things went excellently: the horse was weaned to the point of eating only one stalk a day, and on the succeeding day it was at length to work without any oats at all. On the morning of that day the spiteful animal was found dead; and the citizens of Schilda could not make out what it had died of.
“We should be inclined to think that the horse was starved and that no work at all could be expected of an animal without a certain modicum of oats.”
Hysterical patients suffered a traumatic event but suppress the emotion evoked by the event “instead of allowing its discharge in the appropriate signs of emotion, words or action. In the episode of her lady-companion's dog, she suppressed any manifestation of her very intense disgust, out of consideration for the woman's feelings; while she watched at her father's bedside she was constantly on the alert to prevent the sick man from observing her anxiety and her painful depression.” Because her emotions were not discharged, “they underwent a transformation into unusual somatic innervations and inhibitions, which manifested themselves as the physical symptoms of the case,” which became known as “hysterical conversion.” Analogy: “When the bed of a stream is divided into two channels, then, if the current in one of them is brought up against an obstacle, the other will at once be overfilled.”
Second Lecture. Breuer hypnotized his patients because he believed “it was only in a state of hypnosis that [the patient] attained a knowledge of the pathogenic connections which escaped him in his normal state.” Freud gave up on hypnosis because he could not successfully hypnotize most of his patients. Bernheim had shown that when people awake from hypnosis, they only appear to have lost their memory of what they had recalled during hypnosis. When he would question these individuals, “they began by maintaining that they knew nothing about them; but if he refused to give way, and insisted, and assured them that they did know about them, the forgotten experiences always reappeared.”
With this example in mind, Freud did the same thing with his patients. “When I reached a point with them at which they maintained that they knew nothing more, I assured them that they did know it all the same, and that they had only to say it; and I ventured to declare that the right memory would occur to them at the moment at which I laid my hand on their forehead. In that way I succeeded, without using hypnosis, in obtaining from the patients whatever was required for establishing the connection between the pathogenic scenes they had forgotten and the symptoms left over from those scenes.” However, this proved to be “a laborious procedure, and in the long run an exhausting one; and it was unsuited to serve as a permanent technique.”
Freud identified the force that kept these memories from coming to consciousness as “resistance.” “It was on this idea of resistance, then, that I based my view of the course of psychical events in hysteria. In order to effect a recovery, it had proved necessary to remove these resistances.”
He gives an example of how he helped a patient fight through her resistance to recover a repressed memory and regain health. “When the girl reached the bedside of her dead sister, there came to her for a brief moment an idea that might be expressed in these words: ‘Now he is free and can marry me.’ We may assume with certainty that this idea, which betrayed to her consciousness the intense love for her brother-in-law of which she had not herself been conscious, was surrendered to repression a moment later, owing to the revolt of her feelings. The girl fell ill with severe hysterical symptoms; and while she was under my treatment it turned out that she had completely forgotten the scene by her sister's bedside and the odious egoistic impulse that had emerged in her. She remembered it during the treatment and reproduced the pathogenic moment with signs of the most violent emotion, and, as a result of the treatment, she became healthy once more.”
Freud proceeds to give a great analogy of repression. “Let us suppose that in this lecture-room and among this audience, whose exemplary quiet and attentiveness I cannot sufficiently commend, there is nevertheless someone who is causing a disturbance and whose ill-mannered laughter, chattering and shuffling with his feet are distracting my attention from my task. I have to announce that I cannot proceed with my lecture; and thereupon three or four of you who are strong men stand up and, after a short struggle, put the interrupter outside the door. So now he is ‘repressed’, and I can continue my lecture. But in order that the interruption shall not be repeated, in case the individual who has been expelled should try to enter the room once more, the gentlemen who have put my will into effect place their chairs up against the door and thus establish a ‘resistance’ after the repression has been accomplished. If you will now translate the two localities concerned into psychical terms as the ‘conscious’ and the ‘unconscious’, you will have before you a fairly good picture of the process of repression.”
He continues this analogy to explain how repression can lead to symptoms. After removing the man from the lecture-hall, we might at first think that the repression has been successful and that the man will no longer cause trouble. However, in some ways, “the repression has been unsuccessful; for now he is making an intolerable exhibition of himself outside the room, and his shouting and banging on the door with his fists interfere with my lecture even more than his bad behaviour did before. In these circumstances we could not fail to be delighted if our respected president, Dr. Stanley Hall, should be willing to assume the role of mediator and peacemaker. He would have a talk with the unruly person outside and would then come to us with a request that he should be re-admitted after all: he himself would guarantee that the man would now behave better. On Dr. Hall's authority we decide to lift the repression, and peace and quiet are restored. This presents what is really no bad picture of the physician's task in the psycho-analytic treatment of the neuroses.”
Similarly, the analyst can help the patient more than repression can. “There are a number of such opportune solutions, which may bring the conflict and the neurosis to a happy end, and which may in certain instances be combined. The patient's personality may be convinced that it has been wrong in rejecting the pathogenic wish and may be led into accepting it wholly or in part; or the wish itself may be directed to a higher and consequently unobjectionable aim (this is what we call its ‘sublimation’); or the rejection of the wish may be recognized as a justifiable one, but the automatic and therefore inefficient mechanism of repression may be replaced by a condemning judgement with the help of the highest human mental functions —conscious control of the wish is attained.”
Third Lecture. When the patient is in analysis, two internal forces are working against each other, a conscious part striving to make the unconscious memory conscious and the resistance striving to prevent it from becoming conscious. Here Freud defines a complex as “a group of interdependent ideational elements cathected with affect.” We can make the patient’s unconscious complexes conscious if he free associates. When the patient does this, we know that everything he says in some way derives from the unconscious complex we’re trying to make unconscious.
Sometimes the patient stops free associating and says “that he can think of nothing to say, and that nothing whatever occurs to his mind.” Although it might appear that the patient has run out of things to say, the truth is that the patient is simply holding back because the resistances have disguised themselves “as various critical judgements about the value of the idea that has occurred to him.” To prevent this from happening, we should warn patient that this will happen and tell him “to take no notice of such criticisms.” Rather, he must “entirely renounce any critical selection of this kind and say whatever comes into his head, even if he considers it incorrect or irrelevant or nonsensical, and above all if he finds it disagreeable to let himself think about what has occurred to him.”
Another wonderful metaphor: “This associative material, which the patient contemptuously rejects when he is under the influence of the resistance instead of under the doctor's, serves the psycho-analyst, as it were, as ore from which, with the help of some simple interpretative devices, he extracts its content of precious metal.”
We discover the unconscious through the patient’s free associations and also the interpretation of the patient’s dreams and some of our actions. Regarding our actions, he gives these examples: “forgetting things that might be known and sometimes in fact are known (e.g. the occasional difficulty in recalling proper names), slips of the tongue in talking, by which we ourselves are so often affected, analogous slips of the pen and misreadings, bungling the performance of actions, losing objects or breaking them,” as well as “playing about and fiddling with things, humming tunes, fingering parts of one's own body or one's clothing and so on.” Such actions always have meaning, as “there is nothing trivial, nothing arbitrary or haphazard.”
Fourth Lecture. Although we often trace a patient’s symptoms back to traumatic experiences, if we want to understand the ultimate origin of his symptoms, we must go back his childhoodIt is there that we find “the impressions and events which determined the later onset of the illness. It is only experiences in childhood that explain susceptibility to later traumas and it is only by uncovering these almost invariably forgotten memory-traces and by making them conscious that we acquire the power to get rid of the symptoms.”
We are sexual from birth, deriving sexual pleasure from different body parts (erotogenic zones): “apart from the genitals, these are the oral, anal, and urethral orifices, as well as the skin and other sensory orifices.” An example of this is thumb-sucking. This is auto-eroticism. We can also become sexually attached to certain persons.
At the end of puberty, these sexual instincts “become subordinated to the dominance of the genital zone, so that the whole sexual life enters the service of reproduction.” Additionally, “object-choice pushes auto-erotism into the background, so that in the subject's erotic life all the components of the sexual instinct now seek satisfaction in relation to the person who is loved.” However, some of these instincts do not become subordinated to the genital zone. Society pressured children to repress these instincts, especially our coprophilic impulses and our “fixation to the figures to which the child’s original object-choice was attached.”
Children’s relations to their parents contain “elements of accompanying sexual excitation. The child takes both of its parents, and more particularly one of them, as the object of its erotic wishes. In so doing, it usually follows some indication from its parents, whose affection bears the clearest characteristics of a sexual activity, even though of one that is inhibited in its aims. As a rule a father prefers his daughter and a mother her son; the child reacts to this by wishing, if he is a son, to take his father's place, and, if she is a daughter, her mother’s. The feelings which are aroused in these relations between parents and children and in the resulting ones between brothers and sisters are not only of a positive or affectionate kind but also of a negative or hostile one. The complex which is thus formed is doomed to early repression; but it continues to exercise a great and lasting influence from the unconscious. It is to be suspected that, together with its extensions, it constitutes the nuclear complex of every neurosis, and we may expect to find it no less actively at work in other regions of mental life.”
Fifth Lecture. Psychopathology can be described as follows. Step #1: We cannot get our erotic needs satisfied in reality. Step #2: We engage in fantasies that contain many of our repressed impulses.
In psychoanalysis, the patient inevitably engages in transference. The patient “directs towards the physician a degree of affectionate feeling (mingled, often enough, with hostility) which is based on no real relation between them” but can be “traced back to old wishful phantasies of the patient's which have become unconscious.” “Thus the part of the patient's emotional life which he can no longer recall to memory is re-experienced by him” in the transference, and it is in this re-experiencing that the patient becomes convinced “of the existence and of the power of these unconscious sexual impulses.”
People are often resistant to psychoanalysis because they’re afraid to bring “the repressed sexual instincts into the patient's consciousness.” He continues: “People notice that the patient has sore spots in his mind, but shrink from touching them for fear of increasing his sufferings. We can accept this analogy. It is no doubt kinder not to touch diseased spots if it can do nothing else but cause pain. But, as we know, a surgeon does not refrain from examining and handling a focus of disease, if he is intending to take active measures which he believes will lead to a permanent cure.”
By making the patient’s repressed sexual impulses conscious, we’re healing him. An impulse “is far stronger if it is unconscious than if it is conscious; so that to make it conscious can only be to weaken it. An unconscious wish cannot be influenced and it is independent of any contrary tendencies, whereas a conscious one is inhibited by whatever else is conscious and opposed to it. Thus the work of psycho-analysis puts itself at the orders of precisely the highest and most valuable cultural trends, as a better substitute for the unsuccessful repression.”
When wishes are made conscious, there are three positive consequences. First, these wishes “are destroyed by the rational mental activity of the better impulses that are opposed to them. Repression is replaced by a condemning judgement carried out along the best lines.” Second, the now conscious instincts can now “be employed for the useful purposes which they would have found earlier if development had not been interrupted.” One example of this is sublimation, where “the energy of the infantile wishful impulses is not cut off but remains ready for use — the unserviceable aim of the various impulses being replaced by one that is higher, and perhaps no longer sexual.” Freud believes that it is “probable that we owe our highest cultural successes to the contributions of energy made in this way to our mental functions. Premature repression makes the sublimation of the repressed instinct impossible; when the repression is lifted, the path to sublimation becomes free once more.”
Third, “[a] certain portion of the repressed libidinal impulses has a claim to direct satisfaction and ought to find it in life. Our civilized standards make life too difficult for the majority of human organizations. Those standards consequently encourage the retreat from reality and the generating of neuroses, without achieving any surplus of cultural gain by this excess of sexual repression. We ought not to exalt ourselves so high as completely to neglect what was originally animal in our nature. Nor should we forget that the satisfaction of the individual's happiness cannot be erased from among the aims of our civilization.”
He ends with this story. “The citizens of Schilda, so we are told, possessed a horse with whose feats of strength they were highly pleased and against which they had only one objection—that it consumed such a large quantity of expensive oats. They determined to break it of this bad habit very gently by reducing its ration by a few stalks every day, till they had accustomed it to complete abstinence. For a time things went excellently: the horse was weaned to the point of eating only one stalk a day, and on the succeeding day it was at length to work without any oats at all. On the morning of that day the spiteful animal was found dead; and the citizens of Schilda could not make out what it had died of.
“We should be inclined to think that the horse was starved and that no work at all could be expected of an animal without a certain modicum of oats.”
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