Only after the preparation of these lectures did Adler’s book, “Ueber den nervösen Character,” become known to me, in the summer of 1912. I recognize that he and I have reached similar conclusions on various points, but here is not the place to go into a more intimate discussion of the matter; that must take place elsewhere.
CHAPTER I
Consideration of Early Hypotheses
It is not an easy task to speak about psychoanalysis in these days. I am not thinking, when I say this, of the fact that psychoanalysis in general—it is my earnest conviction—is among the most difficult scientific problems of the day. But even when we put this cardinal fact aside, we find many serious difficulties which interfere with the clear interpretation of the matter. I am not capable of giving you a complete doctrine elaborated both from the theoretical and the empirical standpoint. Psychoanalysis has not yet reached such a point of development, although a great amount of labor has been expended upon it. Neither can I give you a description of its growth ab ovo, for you already have in your country, with its great regard for all the progress of civilization, a considerable literature on the subject. This literature has already spread a general knowledge of psychoanalysis among those who have a scientific interest in it.
You have had the opportunity of listening to Freud, the real explorer and founder of this method, who has spoken in your own country about this theory. As for myself, I have already had the honor of speaking about this work in America. I have discussed the experimental foundation of the theory of complexes and the application of psychoanalysis to pedagogy.
It can be easily understood that under these circumstances I fear to repeat what has already been said, or published in many scientific journals in this country. A further difficulty lies in the fact that in very many quarters there are already prevailing quite extraordinary conceptions of our theory, conceptions which are often absolutely wrong, and unfortunately wrong just in that which touches the very essence of psychoanalysis. At times it seems nearly impossible to grasp even the meaning of these errors, and I am constantly astonished to find any one with a scientific education ever arriving at ideas so divorced from all foundations in fact. Obviously it would be of no importance to cite examples of these curiosities, and it will be more valuable to discuss here those questions and problems of psychoanalysis which really might provoke misunderstanding.
A Change in the Theory of Psychoanalysis
Although it has very often been repeated, it seems to be still an unknown fact to many people, that in these last years the theory of psychoanalysis has changed considerably. Those, for instance, who have only read the first book, “Studies in Hysteria,” by Breuer and Freud, still believe that psychoanalysis essentially consists in the doctrine that hysteria, as well as other neuroses, has its root in the so-called “traumata,” or shocks, of earliest childhood. They continue to condemn this theory, and have no idea that it is fifteen years since this conception was abandoned and replaced by a totally different one. This change is of such great importance in the whole development of psychoanalysis, as well for its technique as for its theory, that I must give it in some detail. That I may not weary you with the complete recitation of cases already well known, I will only just refer to those in Breuer and Freud’s book, which I shall assume are known to you, for the book has been translated into English.[[1]] You will there have read that case of Breuer’s, to which Freud referred in his lectures at Clark University. You will have found that the hysterical symptom has not some unknown organic source, but is based on certain highly emotional psychic events, so-called injuries of the heart, traumata or shocks. I think that now-a-days every careful observer of hysteria will acknowledge from his own experience that, at the root of this disease, such painful events are to be found. This truth was already known to the physicians of former days.
The Traumatic Theory
So far as I know it was really Charcot who, probably under the influence of Page’s theory of nervous shock, made this observation of theoretical value. Charcot knew, by means of hypnotism, at that time not understood, that hysterical symptoms could be called forth by suggestion as well as made to disappear through suggestion. Charcot believed that he saw something like this in those cases of hysteria caused by accident, cases which became more and more frequent. The shock can be compared with hypnosis in Charcot’s sense. The emotion provoked by the shock causes a momentary complete paralysis of will-power, during which the remembrance of the trauma can be fixed as an auto-suggestion. This conception gives us the original theory of psychoanalysis. Etiological investigation had to prove whether this mechanism, or a similar one, was also to be found in those cases of hysteria which could not be called traumatic. This lack of knowledge of the etiology of hysteria was supplied by the discovery of Breuer and Freud. They proved that even in those ordinary cases of hysteria which cannot be said to be caused by shock the same trauma-element was to be found, and seemed to have an etiological value. It is natural that Freud, a pupil of Charcot, was inclined to suppose that this discovery in itself confirmed the ideas of Charcot. Accordingly the theory elaborated out of the experience of that period, mainly by Freud, received the imprint of a traumatic etiology. The name of trauma-theory is therefore justified; nevertheless this theory had also a new aspect. I am not here speaking of the truly admirable profoundness and precision of Freud’s analysis of symptoms, but of the relinquishing of the conception of auto-suggestion, which was the dynamic force in the original theory, and its substitution by a detailed exposure of the psychological and psycho-physical effects caused by the shock. The shock, the trauma, provokes a certain excitation which, under normal circumstances, finds a natural outlet (“abreagieren”). In hysteria it is only to a certain extent that the excitation does find a natural outlet; a partial retention takes place, the so-called blocking of the affect (“Affecteinklemmung”). This amount of excitation, which can be compared with an amount of potential energy, is transmuted by the mechanism of conversion into “physical” symptoms.
The Cathartic Method.—According to this conception, therapy had to find the means by which those retained emotions could be brought to a mode of expression, thereby setting free from the symptoms that amount of repressed and converted feeling. Hence this was called the cleansing, or cathartic method; its aim was to discharge the blocked emotions. From this it follows that analysis was then more or less closely concerned with the symptoms, that is to say, the symptoms were analyzed—the work of analysis began with the symptoms, a method abandoned to-day. The cathartic method, and the theory on which it is based, are, as you know, accepted by other colleagues, so far as they are interested at all in psychoanalysis, and you will find some appreciation and quotation of the theory, as well as of the method, in several text-books.