Sigmund Freud (1856–1939). Selected Papers on Hysteria and Other Psychoneuroses. 1912.
The chapters contained in this book were taken from three different volumes of the author’s works, published at different intervals within the last fifteen years. Although the first four chapters appear in the “Studien über Hysterie,” which was published by Breuer and Freud, still only the first chapter, “The Psychic Mechanism of Hysterical Phenomena,” was written conjointly by both authors. The authorship of the other three chapters belongs exclusively to Freud. The remaining six chapters of the book were taken from Freud’s Collection of short papers.
It was by no means an easy task to compile in a single limited volume Freud’s theories of the actual- and psychoneuroses. Freud’s views are not only new and revolutionary, being based on an entirely new psychology, but unless one is thoroughly familiar with their development one is apt to misunderstand them. To obviate this it was thought best to collect those chapters from the author’s works which fully illustrate his theories and at the same time show the gradual evolution of his psychology.
That Freud’s views have undergone some changes, or rather modifications, within the last fifteen years we readily admit; but who will blame the surgeon for modifying or rejecting some technique of his operation, if after years of careful work he feels justified in so doing? Surely such an action merits applause rather than reproach. It was only after carefully investigating for years that Freud saw fit to change some of his views, yet nothing was really totally discarded.
It is quite unnecessary to discuss here the whys and wherefores of the modifications in question, these are fully explained in the text. But it will not be mal à propos to say a few words concerning the technique of the treatment.
For reasons given in the book the author has abandoned hypnotism and used the pressure procedure, but this in turn was given up because it was cumbersome for both doctor and patient and proved to be utterly needless.
The technique is as follows: The patient lies on his back on a lounge, the physician sitting behind the patient’s head at the head of the lounge. In this way the patient remains free from all external influences and impressions. The object is to avoid all muscular exertion and distraction, thus allowing thorough concentration of attention on the patient’s own psychic activities. The patient is then asked to give a detailed account of his troubles, after having been told before to repeat everything that occurs to his mind, even such thoughts as may cause him embarrassment or mortification. On listening to such a history one invariably notices many memory gaps, both in reference to time and causal relations. These the patient is urged to fill in by concentration of attention on the subject in question, and by repeating all the unintentional thoughts originating in this connection. This is the so-called method of “free association!” The patient is required to relate all his thoughts in the order of their sequence even if they seem irrelevant to him. He must do away with all critique and remain perfectly passive. It is in this way that we fathom the original meaning of the symptom. But as the thoughts which originate in this manner are of a disagreeable and painful nature they are pushed back with the greatest resistance. This is further enhanced by the fact that the hysterical symptom is the symbolic expression of the realization of a repressed wish, and serves as a gratification for the patient. He strives very hard, unconsciously of course, to retain the symptom, as it is the only thing left to him from his former unattainable conscious wishes and strivings. The object of the psychoanalytic treatment is to overcome all these resistances, and to reconduct to the patient’s consciousness the thoughts underlying the symptoms. Here lies the greatest difficulty, for just as in the normal life and the dream, a psychoneurotic symptom is merely a symbolic or cryptic expression of the original repressed thoughts. Every hysterical symptom, every obsession, and every phobia, has a definite meaning, and as was shown by Bleuler, Jung, Riklin, and others, the same holds true for the psychoses proper.
To discover the hidden mechanism, one must make use of the author’s developed method of interpretation, that is, one must look for symbolic actions, lapses in speech, memory, etc., and above all, one must resort to the analysis of dreams, as they give the most direct access to the unconscious. No one is really qualified to use or judge Freud’s psychoanalytic method who has not thoroughly mastered the Traumdeutung, the Psychopathologie des Alltagsleben, and the Drei Abhandlungen zur Sexualtheorie, and has not had considerable experience in analyzing his own and other’s dreams and psychopathological actions. It is especially in the Traumdeutung that Freud has fully developed his psychoanalytic technique and a perfect knowledge of which is the sine qua non in the treatment. It is only by following Freud in this manner that one can hope to solve the hitherto unsolved riddles of the psychoneuroses and psychoses.
This treatment is more difficult than one can describe in a preface. It not only presupposes a thorough knowledge of Freud but an equal knowledge of normal and abnormal psychology. Those who have not acquired this knowledge by reason of time or otherwise may remember the words of the younger Pliny: Ut enim de pictore scalptore fictore nisi artifex iudicare, ita nisi sapiens non potest perspicere sapientem.