The most direct way into the complexities of the unconscious mental processes of a person is afforded by a study of his more “unusual” actions and thoughts. For few persons are so completely adapted to their environment or so perfectly balanced that moments never arise in which their mental behaviour is not surprising, either to themselves or to others. And even the Admirable Crichtons of our acquaintance are not entirely immune from errant moments—at least in their sleep. The dream, then, is the chief gate by which we can enter into the knowledge of the unconscious. For in sleep, the relatively considerable control which most of us in waking life possess over the coming and going of mental events is almost if not entirely abrogated. Thoughts and desires, which, if they attempted to dominate consciousness in waking life, would be promptly suppressed, arise, develop and expand to an astounding extent in the dream.
This statement, of course, is entirely independent of the implications of any one “theory of dreams.” Its truth is evident to anyone who has honestly recorded or considered his own dreams for even a short period.
Other unusual mental processes are manifested in such events as “slips of the tongue,” “slips of the pen,” the mislaying of important objects, the forgetting of significant facts, or conversely the inability to get an apparently unimportant memory out of one’s mind. All these phenomena, common enough in the normal individual, are usually more frequent in the abnormal mind. Besides the patient’s voluntary account of, and comments upon, these events,[42] other methods of obtaining data are possible to the physician. He will note the matters about which in conversation the patient is apt to become silent, embarrassed or inexplicably irritated, to hesitate, to say he has forgotten, or even to lie. All these sidelights upon the mental make-up are carefully noted by the physician and the deductions from them compared, not only with the patient’s accounts of himself on different days—narratives which when put together may show important discrepancies and thin places—but also with the information obtainable from his family. These devices serve to bring to light in an extraordinary manner a whole number of memories, many of them of immense significance for the comprehension of the patient’s present mental state, which it would be utterly impossible to discover in mere conversation or even by cross-questioning.
It is sometimes felt that these methods which savour strongly of catching the patient tripping, while they may unearth some interesting details of his past life, do no more than exhibit under a strong magnifying glass a few minute excrescences upon his otherwise fair mental countenance. But it should be pointed out that nobody who has ever honestly collected together and compared the memories which have coalesced to compose a dozen of his dreams—especially if he has done so with the help and under the cross-examination of a candid friend who knows him well—will maintain that the material thus found is unimportant. As Professor Freud says, “The dream never occupies itself with trifles.” It is probably just because the thoughts and desires underlying the dreams have been refused their normal outlet, that they express themselves in such bizarre forms.
Moreover, the fact should not be overlooked that in other sciences—including the most exact, the physical sciences—the most profoundly important general conclusions are often arrived at by the examination of unusual phenomena, of nature “caught tripping.” The study of the thunderstorm was the foundation of our present knowledge of that great force which is active not only in thunderstorms but throughout all matter. Observation of the sporadic and relatively unusual volcanic eruptions of the mind may prove to be an important foundation of our future knowledge of general psychology. As in the inorganic, so in the organic world, there is no sharp line dividing normal from abnormal, and the unusual phenomenon is sometimes simpler and more easily studied than the usual, as “Sherlock Holmes” was so fond of demonstrating.[43] From a scientific standpoint, then, we have every justification for pressing to the utmost our study of the unusual mental phenomena exhibited by the patient, and for our belief that their nature is not unimportant, but highly significant for therapeutical purposes.
Another objection, however, is frequently levelled against such a procedure, from quite a different direction, or rather from a number of directions. This objection can be expressed simply in words, such as “One ought not to probe so deeply into a patient’s innermost mental life,” and is not to be met by a single argument. The reason is that it is polyhedral in form, and that each of its faces or aspects must be considered separately. For it should be obvious to everyone that such an objection cannot be flippantly waved away.
The aspects of this question which seem to have more particularly appealed to the critics of the method which we are describing, are at least four in number, which we may describe as the æsthetic, social, medical and moral.
The origin of the first, the æsthetic aspect, is easily seen. It is quite clear that in the investigation of the inmost secrets of a person’s life (and particularly of a life which has become so entangled and complicated that the help of another is sought for its restoration to ‘mental tidiness’) there must emerge frequently much that the patient finds unpleasant to relate. When we remember that a neurosis often (perhaps always) occurs as a result of the patient’s inability to adjust his instinctive demands to the opportunities of his environment, it becomes clear that in the investigation of his history discussion is inevitable of mental events in which the fundamental instincts have played a great part. Now, of those important instinctive impulses, it is obvious that in a civilised community few are so often thwarted, deliberately repressed, or otherwise obstructed as the powerful one of sex. It therefore follows that in a large number of cases the discussion of sexual matters becomes unavoidable. Some critics have seized on this point as the weak spot against which to launch their attacks, descanting upon the unpleasantness, even the nauseousness, of such discussion. Not all of them, however, make it clear whether in their opinion it is the patient or the doctor who should be shielded from such unpleasant experiences. If the latter, the verdict of society would probably be that the sooner a man requiring such protection was excused not only from these uncongenial duties, but from all medical obligations whatever, the better for the community. If the former, it may be pointed out that every reasonable person will agree that the man who does not tell the whole truth to his doctor or his lawyer is a fool. Furthermore, even under present conditions, if it be considered advisable in the interests of the patient’s bodily health, the doctor does not hesitate to ask, and the patient to answer, questions about the most intimate matters, some of them literally and not merely metaphorically nauseous.
We may therefore dismiss the æsthetic objection as unworthy of the consideration either of a conscientious doctor, or of a reasonable patient.
We may turn now to what we have designated the social aspect of the objection. It should need little explanation. There has arisen a convention, subscribed to consciously or unconsciously by many, that the doctor shall ask and the patient answer quite freely questions relating to the patient’s bodily well-being, but that any unusual mental occurrences must be considered the patient’s private affair into which it is not the business of the doctor to pry.