IDO not know how familiar some of you may be, either from your reading or from hearsay, with psychoanalysis. But, in keeping with the title of these lectures—A General Introduction to Psychoanalysis—I am obliged to proceed as though you knew nothing about this subject, and stood in need of preliminary instruction.
To be sure, this much I may presume that you do know, namely, that psychoanalysis is a method of treating nervous patients medically. And just at this point I can give you an example to illustrate how the procedure in this field is precisely the reverse of that which is the rule in medicine. Usually when we introduce a patient to a medical technique which is strange to him we minimize its difficulties and give him confident promises concerning the result of the treatment. When, however, we undertake psychoanalytic treatment with a neurotic patient we proceed differently. We hold before him the difficulties of the method, its length, the exertions and the sacrifices which it will cost him; and, as to the result, we tell him that we make no definite promises, that the result depends on his conduct, on his understanding, on his adaptability, on his perseverance. We have, of course, excellent motives for conduct which seems so perverse, and into which you will perhaps gain insight at a later point in these lectures.
Do not be offended, therefore, if, for the present, I treat you as I treat these neurotic patients. Frankly, I shall dissuade you from coming to hear me a second time. With this intention I shall show what imperfections are necessarily involved in the teaching of psychoanalysis and what difficulties stand in the way of gaining a personal judgment. I shall show you how the whole trend of your previous training and all your accustomed mental habits must unavoidably have made you opponents of psychoanalysis, and how much you must overcome in yourselves in order to master this instinctive opposition. Of course I cannot predict how much psychoanalytic understanding you will gain from my lectures, but I can promise this, that by listening to them you will not learn how to undertake a psychoanalytic treatment or how to carry one to completion. Furthermore, should I find anyone among you who does not feel satisfied with a cursory acquaintance with psychoanalysis, but who would like to enter into a more enduring relationship with it, I shall not only dissuade him, but I shall actually warn him against it. As things now stand, a person would, by such a choice of profession, ruin his every chance of success at a university, and if he goes out into the world as a practicing physician, he will find himself in a society which does not understand his aims, which regards him with suspicion and hostility, and which turns loose upon him all the malicious spirits which lurk within it.
However, there are always enough individuals who are interested in anything which may be added to the sum total of knowledge, despite such inconveniences. Should there be any of this type among you, and should they ignore my dissuasion and return to the next of these lectures, they will be welcome. But all of you have the right to know what these difficulties of psychoanalysis are to which I have alluded.
First of all, we encounter the difficulties inherent in the teaching and exposition of psychoanalysis. In your medical instruction you have been accustomed to visual demonstration. You see the anatomical specimen, the precipitate in the chemical reaction, the contraction of the muscle as the result of the stimulation of its nerves. Later the patient is presented to your senses; the symptoms of his malady, the products of the pathological processes, in many cases even the cause of the disease is shown in isolated state. In the surgical department you are made to witness the steps by which one brings relief to the patient, and are permitted to attempt to practice them. Even in psychiatry, the demonstration affords you, by the patient’s changed facial play, his manner of speech and his behavior, a wealth of observations which leave far-reaching impressions. Thus the medical teacher preponderantly plays the role of a guide and instructor who accompanies you through a museum in which you contract an immediate relationship to the exhibits, and in which you believe yourself to have been convinced through your own observation of the existence of the new things you see.
Unfortunately, everything is different in psychoanalysis. In psychoanalysis nothing occurs but the interchange of words between the patient and the physician. The patient talks, tells of his past experiences and present impressions, complains, confesses his wishes and emotions. The physician listens, tries to direct the thought processes of the patient, reminds him of things, forces his attention into certain channels, gives him explanations and observes the reactions of understanding or denial which he calls forth in the patient. The uneducated relatives of our patients—persons who are impressed only by the visible and tangible, preferably by such procedure as one sees in the moving picture theatres—never miss an opportunity of voicing their scepticism as to how one can “do anything for the malady through mere talk.” Such thinking, of course, is as shortsighted as it is inconsistent. For these are the very persons who know with such certainty that the patients “merely imagine” their symptoms. Words were originally magic, and the word retains much of its old magical power even to-day. With words one man can make another blessed, or drive him to despair; by words the teacher transfers his knowledge to the pupil; by words the speaker sweeps his audience with him and determines its judgments and decisions. Words call forth effects and are the universal means of influencing human beings. Therefore let us not underestimate the use of words in psychotherapy, and let us be satisfied if we may be auditors of the words which are exchanged between the analyst and his patient.
But even that is impossible. The conversation of which the psychoanalytic treatment consists brooks no auditor, it cannot be demonstrated. One can, of course, present a neurasthenic or hysteric to the students in a psychiatric lecture. He tells of his complaints and symptoms, but of nothing else. The communications which are necessary for the analysis are made only under the conditions of a special affective relationship to the physician; the patient would become dumb as soon as he became aware of a single impartial witness. For these communications concern the most intimate part of his psychic life, everything which as a socially independent person he must conceal from others; these communications deal with everything which, as a harmonious personality, he will not admit even to himself.
You cannot, therefore, “listen in” on a psychoanalytic treatment. You can only hear of it. You will get to know psychoanalysis, in the strictest sense of the word, only by hearsay. Such instruction even at second hand, will place you in quite an unusual position for forming a judgment. For it is obvious that everything depends on the faith you are able to put in the instructor.
Imagine that you are not attending a psychiatric, but an historical lecture, and that the lecturer is telling you about the life and martial deeds of Alexander the Great. What would be your reasons for believing in the authenticity of his statements? At first sight, the condition of affairs seems even more unfavorable than in the case of psychoanalysis, for the history professor was as little a participant in Alexander’s campaigns as you were; the psychoanalyst at least tells you of things in connection with which he himself has played some role. But then the question turns on this—what set of facts can the historian marshal in support of his position? He can refer you to the accounts of ancient authors, who were either contemporaries themselves, or who were at least closer to the events in question; that is, he will refer you to the books of Diodor, Plutarch, Arrian, etc. He can place before you pictures of the preserved coins and statues of the king and can pass down your rows a photograph of the Pompeiian mosaics of the battle of Issos. Yet, strictly speaking, all these documents prove only that previous generations already believed in Alexander’s existence and in the reality of his deeds, and your criticism might begin anew at this point. You will then find that not everything recounted of Alexander is credible, or capable of proof in detail; yet even then I cannot believe that you will leave the lecture hall a disbeliever in the reality of Alexander the Great. Your decision will be determined chiefly by two considerations; firstly, that the lecturer has no conceivable motive for presenting as truth something which he does not himself believe to be true, and secondly, that all available histories present the events in approximately the same manner. If you then proceed to the verification of the older sources, you will consider the same data, the possible motives of the writers and the consistency of the various parts of the evidence. The result of the examination will surely be convincing in the case of Alexander. It will probably turn out differently when applied to individuals like Moses and Nimrod. But what doubts you might raise against the credibility of the psychoanalytic reporter you will see plainly enough upon a later occasion.
At this point you have a right to raise the question, “If there is no such thing as objective verification of psychoanalysis, and no possibility of demonstrating it, how can one possibly learn psychoanalysis and convince himself of the truth of its claims?” The fact is, the study is not easy and there are not many persons who have learned psychoanalysis thoroughly; but nevertheless, there is a feasible way. Psychoanalysis is learned, first of all, from a study of one’s self, through the study of one’s own personality. This is not quite what is ordinarily called self-observation, but, at a pinch, one can sum it up thus. There is a whole series of very common and universally known psychic phenomena, which, after some instruction in the technique of psychoanalysis, one can make the subject matter of analysis in one’s self. By so doing one obtains the desired conviction of the reality of the occurrences which psychoanalysis describes and of the correctness of its fundamental conception. To be sure, there are definite limits imposed on progress by this method. One gets much further if one allows himself to be analyzed by a competent analyst, observes the effect of the analysis on his own ego, and at the same time makes use of the opportunity to become familiar with the finer details of the technique of procedure. This excellent method is, of course, only practicable for one person, never for an entire class.
There is a second difficulty in your relation to psychoanalysis for which I cannot hold the science itself responsible, but for which I must ask you to take the responsibility upon yourselves, ladies and gentlemen, at least in so far as you have hitherto pursued medical studies. Your previous training has given your mental activity a definite bent which leads you far away from psychoanalysis. You have been trained to reduce the functions of an organism and its disorders anatomically, to explain them in terms of chemistry and physics and to conceive them biologically, but no portion of your interest has been directed to the psychic life, in which, after all, the activity of this wonderfully complex organism culminates. For this reason psychological thinking has remained strange to you and you have accustomed yourselves to regard it with suspicion, to deny it the character of the scientific, to leave it to the laymen, poets, natural philosophers and mystics. Such a delimitation is surely harmful to your medical activity, for the patient will, as is usual in all human relationships, confront you first of all with his psychic facade; and I am afraid your penalty will be this, that you will be forced to relinquish a portion of the therapeutic influence to which you aspire, to those lay physicians, nature-cure fakers and mystics whom you despise.
I am not overlooking the excuse, whose existence one must admit, for this deficiency in your previous training. There is no philosophical science of therapy which could be made practicable for your medical purpose. Neither speculative philosophy nor descriptive psychology nor that so-called experimental psychology which allies itself with the physiology of the sense organs as it is taught in the schools, is in a position to teach you anything useful concerning the relation between the physical and the psychical or to put into your hand the key to the understanding of a possible disorder of the psychic functions. Within the field of medicine, psychiatry does, it is true, occupy itself with the description of the observed psychic disorders and with their grouping into clinical symptom-pictures; but in their better hours the psychiatrists themselves doubt whether their purely descriptive account deserves the name of a science. The symptoms which constitute these clinical pictures are known neither in their origin, in their mechanism, nor in their mutual relationship. There are either no discoverable corresponding changes of the anatomical organ of the soul, or else the changes are of such a nature as to yield no enlightenment. Such psychic disturbances are open to therapeutic influence only when they can be identified as secondary phenomena of an otherwise organic affection.
Here is the gap which psychoanalysis aims to fill. It prepares to give psychiatry the omitted psychological foundation, it hopes to reveal the common basis from which, as a starting point, constant correlation of bodily and psychic disturbances becomes comprehensible. To this end, it must divorce itself from every anatomical, chemical or physiological supposition which is alien to it. It must work throughout with purely psychological therapeutic concepts, and just for that reason I fear that it will at first seem strange to you.
I will not make you, your previous training, or your mental bias share the guilt of the next difficulty. With two of its assertions, psychoanalysis offends the whole world and draws aversion upon itself. One of these assertions offends an intellectual prejudice, the other an aesthetic-moral one. Let us not think too lightly of these prejudices; they are powerful things, remnants of useful, even necessary, developments of mankind. They are retained through powerful affects, and the battle against them is a hard one.
The first of these displeasing assertions of psychoanalysis is this, that the psychic processes are in themselves unconscious, and that those which are conscious are merely isolated acts and parts of the total psychic life. Recollect that we are, on the contrary, accustomed to identify the psychic with the conscious. Consciousness actually means for us the distinguishing characteristic of the psychic life, and psychology is the science of the content of consciousness. Indeed, so obvious does this identification seem to us that we consider its slightest contradiction obvious nonsense, and yet psychoanalysis cannot avoid raising this contradiction; it cannot accept the identity of the conscious with the psychic. Its definition of the psychic affirms that they are processes of the nature of feeling, thinking, willing; and it must assert that there is such a thing as unconscious thinking and unconscious willing. But with this assertion psychoanalysis has alienated, to start with, the sympathy of all friends of sober science, and has laid itself open to the suspicion of being a fantastic mystery study which would build in darkness and fish in murky waters. You, however, ladies and gentlemen, naturally cannot as yet understand what justification I have for stigmatizing as a prejudice so abstract a phrase as this one, that “the psychic is consciousness.” You cannot know what evaluation can have led to the denial of the unconscious, if such a thing really exists, and what advantage may have resulted from this denial. It sounds like a mere argument over words whether one shall say that the psychic coincides with the conscious or whether one shall extend it beyond that, and yet I can assure you that by the acceptance of unconscious processes you have paved the way for a decisively new orientation in the world and in science.
Just as little can you guess how intimate a connection this initial boldness of psychoanalysis has with the one which follows. The next assertion which psychoanalysis proclaims as one of its discoveries, affirms that those instinctive impulses which one can only call sexual in the narrower as well as in the wider sense, play an uncommonly large role in the causation of nervous and mental diseases, and that those impulses are a causation which has never been adequately appreciated. Nay, indeed, psychoanalysis claims that these same sexual impulses have made contributions whose value cannot be overestimated to the highest cultural, artistic and social achievements of the human mind.
According to my experience, the aversion to this conclusion of psychoanalysis is the most significant source of the opposition which it encounters. Would you like to know how we explain this fact? We believe that civilization was forged by the driving force of vital necessity, at the cost of instinct-satisfaction, and that the process is to a large extent constantly repeated anew, since each individual who newly enters the human community repeats the sacrifices of his instinct-satisfaction for the sake of the common good. Among the instinctive forces thus utilized, the sexual impulses play a significant role. They are thereby sublimated, i.e., they are diverted from their sexual goals and directed to ends socially higher and no longer sexual. But this result is unstable. The sexual instincts are poorly tamed. Each individual who wishes to ally himself with the achievements of civilization is exposed to the danger of having his sexual instincts rebel against this sublimation. Society can conceive of no more serious menace to its civilization than would arise through the satisfying of the sexual instincts by their redirection toward their original goals. Society, therefore, does not relish being reminded of this ticklish spot in its origin; it has no interest in having the strength of the sexual instincts recognized and the meaning of the sexual life to the individual clearly delineated. On the contrary, society has taken the course of diverting attention from this whole field. This is the reason why society will not tolerate the above-mentioned results of psychoanalytic research, and would prefer to brand it as aesthetically offensive and morally objectionable or dangerous. Since, however, one cannot attack an ostensibly objective result of scientific inquiry with such objections, the criticism must be translated to an intellectual level if it is to be voiced. But it is a predisposition of human nature to consider an unpleasant idea untrue, and then it is easy to find arguments against it. Society thus brands what is unpleasant as untrue, denying the conclusions of psychoanalysis with logical and pertinent arguments. These arguments originate from affective sources, however, and society holds to these prejudices against all attempts at refutation.
However, we may claim, ladies and gentlemen, that we have followed no bias of any sort in making any of these contested statements. We merely wished to state facts which we believe to have been discovered by toilsome labor. And we now claim the right unconditionally to reject the interference in scientific research of any such practical considerations, even before we have investigated whether the apprehension which these considerations are meant to instil are justified or not.
These, therefore, are but a few of the difficulties which stand in the way of your occupation with psychoanalysis. They are perhaps more than enough for a beginning. If you can overcome their deterrent impression, we shall continue.
Categories: English Literature