Chapter XV: Introduction (11)

In the first place, both patients give us the impression of being _fixated_ upon some very definite part of their past; they are unable to free themselves therefrom, and have therefore come to be completely estranged both from the present and the future. They are now isolated in their ailment, just as in earlier days people withdrew into monasteries there to carry along the burden of their unhappy fates. In the case of the first patient, it is her marriage with her husband, really abandoned, that has determined her lot. By means of her symptoms she continues to deal with her husband; we have learned to understand those voices which plead his case, which excuse him, exalt him, lament his loss. Although she is young and might be coveted by other men, she has seized upon all manner of real and imaginary (magic) precautions to safeguard her virtue for him. She will not appear before strangers, she neglects her personal appearance; furthermore, she cannot bring herself to get up readily from any chair on which she has been seated. She refuses to give her signature, and finally, since she is motivated by her desire not to let anyone have anything of hers, she is unable to give presents.

In the case of the second patient, the young girl, it is an erotic attachment for her father that had established itself in the years prior to puberty, which plays the same role in her life. She also has arrived at the conclusion that she may not marry so long as she is sick. We may suspect she became ill in order that she need not marry, and that she might stay with her father.

It is impossible to evade the question of how, in what manner, and driven by what motives, an individual may come by such a remarkable and unprofitable attitude toward life. Granted of course that this bearing is a general characteristic of neurosis, and not a special peculiarity of these two cases, it is nevertheless a general trait in every neurosis of very great importance in practice. Breuer's first hysterical patient was fixated in the same manner upon the time when she nursed her very sick father. In spite of her recuperation she has, in certain respects, since that time, been done with life; although she remained healthy and able, she did not enter on the normal life of women. In every one of our patients we may see, by the use of analysis, that in his disease-symptoms and their results he has gone back again into a definite period of his past. In the majority of cases he even chooses a very early phase of his life, sometime a childhood phase, indeed, laughable as it may appear, a phase of his very suckling existence.

The closest analogies to these conditions of our neurotics are furnished by the types of sickness which the war has just now made so frequent--the so-called traumatic neuroses. Even before the war there were such cases after railroad collisions and other frightful occurrences which endangered life. The traumatic neuroses are, fundamentally, not the same as the spontaneous neuroses which we have been analysing and treating; moreover, we have not yet succeeded in bringing them within our hypotheses, and I hope to be able to make clear to you wherein this limitation lies. Yet on one point we may emphasize the existence of a complete agreement between the two forms. The traumatic neuroses show clear indications that they are grounded in a fixation upon the moment of the traumatic disaster. In their dreams these patients regularly live over the traumatic situation; where there are attacks of an hysterical type, which permit of an analysis, we learn that the attack approximates a complete transposition into this situation. It is as if these patients had not yet gotten through with the traumatic situation, as if it were actually before them as a task which was not yet mastered. We take this view of the matter in all seriousness; it shows the way to an _economic_ view of psychic occurrences. For the expression "traumatic" has no other than an economic meaning, and the disturbance permanently attacks the management of available energy. The traumatic experience is one which, in a very short space of time, is able to increase the strength of a given stimulus so enormously that its assimilation, or rather its elaboration, can no longer be effected by normal means.

This analogy tempts us to classify as traumatic those experiences as well upon which our neurotics appear to be fixated. Thus the possibility is held out to us of having found a simple determining factor for the neurosis. It would then be comparable to a traumatic disease, and would arise from the inability to meet an overpowering emotional experience. As a matter of fact this reads like the first formula, by which Breuer and I, in 1893-1895, accounted theoretically for our new observations. A case such as that of our first patient, the young woman separated from her husband, is very well explained by this conception. She was not able to get over the unfeasibility of her marriage, and has not been able to extricate herself from this trauma. But our very next, that of the girl attached to her father, shows us that the formula is not sufficiently comprehensive. On the one hand, such baby love of a little girl for her father is so usual, and so often outlived that the designation "traumatic" would carry no significance; on the other hand, the history of the patient teaches us that this first erotic fixation apparently passed by harmlessly at the time, and did not again appear until many years later in the symptoms of the compulsion neurosis. We see complications before us, the existence of a greater wealth of determining factors in the disease, but we also suspect that the traumatic viewpoint will not have to be given up as wrong; rather it will have to subordinate itself when it is fitted into a different context.

Here again we must leave the road we have been traveling. For the time being, it leads us no further and we have many other things to find out before we can go on again. But before we leave this subject let us note that the fixation on some particular phase of the past has bearings which extend far beyond the neurosis. Every neurosis contains such a fixation, but every fixation does not lead to a neurosis, nor fall into the same class with neuroses, nor even set the conditions for the development of a neurosis. Mourning is a type of emotional fixation on a theory of the past, which also brings with it the most complete alienation from the present and the future. But mourning is sharply distinguished from neuroses that may be designated as pathological forms of mourning.

It also happens that men are brought to complete deadlock by a traumatic experience that has so completely shaken the foundations on which they have built their lives that they give up all interest in the present and future, and become completely absorbed in their retrospections; but these unhappy persons are not necessarily neurotic. We must not overestimate this one feature as a diagnostic for a neurosis, no matter how invariable and potent it may be.

Now let us turn to the second conclusion of our analysis, which however we will hardly need to limit subsequently. We have spoken of the senseless compulsive activities of our first patient, and what intimate memories she disclosed as belonging to them; later we also investigated the connection between experience and symptom and thus discovered the purpose hidden behind the compulsive activity. But we have entirely omitted one factor that deserves our whole attention. As long as the patient kept repeating the compulsive activity she did not know that it was in any way related with the experience in question. The connection between the two was hidden from her, she truthfully answered that she did not know what compelled her to do this. Once, suddenly, under the influence of the cure, she hit upon the connection and was able to tell it to us. But still she did not know of the end in the service of which she performed the compulsive activities, the purpose to correct a painful part of the past and to place the husband, still loved by her, upon a higher level. It took quite a long time and a great deal of trouble for her to grasp and admit to me that such a motive alone could have been the motive force of the compulsive activity.

The relation between the scene after the unhappy bridal night and the tender motive of the patient yield what we have called the meaning of the compulsive activity. But both the "whence" and the "why" remained hidden from her as long as she continued to carry out the compulsive act. Psychological processes had been going on within her for which the compulsive act found an expression. She could, in a normal frame of mind, observe their effect, but none of the psychological antecedents of her action had come to the knowledge of her consciousness. She had acted in just the same manner as a hypnotized person to whom Bernheim had given the injunction that five minutes after his awakening in the ward he was to open an umbrella, and he had carried out this order on awakening, but could give no motive for his so doing. We have exactly such facts in mind when we speak of the existence of _unconscious psychological processes_. Let anyone in the world account for these facts in a more correct scientific manner, and we will gladly withdraw completely our assumption of unconscious psychological processes. Until then, however, we shall continue to use this assumption, and when anyone wants to bring forward the objection that the unconscious can have no reality for science and is a mere makeshift, (_une facon de parler_), we must simply shrug our shoulders and reject his incomprehensible statement resignedly. A strange unreality which can call out such real and palpable effects as a compulsion symptom!

In our second patient we meet with fundamentally the same thing. She had created a decree which she must follow: the pillow must not touch the head of the bed; yet she does not know how it originated, what its meaning is, nor to what motive it owes the source of its power. It is immaterial whether she looks upon it with indifference or struggles against it, storms against it, determines to overcome it. She must nevertheless follow it and carry out its ordinance, though she asks herself, in vain, why. One must admit that these symptoms of compulsion neurosis offer the clearest evidence for a special sphere of psychological activity, cut off from the rest. What else could be back of these images and impulses, which appear from one knows not where, which have such great resistance to all the influences of an otherwise normal psychic life; which give the patient himself the impression that here are super-powerful guests from another world, immortals mixing in the affairs of mortals. Neurotic symptoms lead unmistakably to a conviction of the existence of an unconscious psychology, and for that very reason clinical psychiatry, which recognizes only a conscious psychology, has no explanation other than that they are present as indications of a particular kind of degeneration. To be sure, the compulsive images and impulses are not themselves unconscious--no more so than the carrying out of the compulsive-acts escapes conscious observation. They would not have been symptoms had they not penetrated through into consciousness. But their psychological antecedents as disclosed by the analysis, the associations into which we place them by our interpretations, are unconscious, at least until we have made them known to the patient during the course of the analysis.

Consider now, in addition, that the facts established in our two cases are confirmed in all the symptoms of all neurotic diseases, that always and everywhere the meaning of the symptoms is unknown to the sufferer, that analysis shows without fail that these symptoms are derivatives of unconscious experiences which can, under various favorable conditions, become conscious. You will understand then that in psychoanalysis we cannot do without this unconscious psyche, and are accustomed to deal with it as with something tangible. Perhaps you will also be able to understand how those who know the unconscious only as an idea, who have never analyzed, never interpreted dreams, or never translated neurotic symptoms into meaning and purpose, are most ill-suited to pass an opinion on this subject. Let us express our point of view once more. Our ability to give meaning to neurotic symptoms by means of analytic interpretation is an irrefutable indication of the existence of unconscious psychological processes--or, if you prefer, an irrefutable proof of the necessity for their assumption.

But that is not all. Thanks to a second discovery of Breuer's, for which he alone deserves credit and which appears to me to be even more far-reaching, we are able to learn still more concerning the relationship between the unconscious and the neurotic symptom. Not alone is the meaning of the symptoms invariably hidden in the unconscious; but the very existence of the symptom is conditioned by its relation to this unconscious. You will soon understand me. With Breuer I maintain the following: Every time we hit upon a symptom we may conclude that the patient cherishes definite unconscious experiences which withhold the meaning of the symptoms. Vice versa, in order that the symptoms may come into being, it is also essential that this meaning be unconscious. Symptoms are not built up out of conscious experiences; as soon as the unconscious processes in question become conscious, the symptom disappears. You will at once recognize here the approach to our therapy, a way to make symptoms disappear. It was by these means that Breuer actually achieved the recovery of his patient, that is, freed her of her symptoms; he found a technique for bringing into her consciousness the unconscious experiences that carried the meaning of her symptoms, and the symptoms disappeared.

This discovery of Breuer's was not the result of a speculation, but of a felicitous observation made possible by the cooperation of the patient. You should therefore not trouble yourself to find things you already know to which you can compare these occurrences, rather you should recognize herein a new fundamental fact which in itself is capable of much wider application. Toward this further end permit me to go over this ground again in a different way.

The symptom develops as a substitution for something else that has remained suppressed. Certain psychological experiences should normally have become so far elaborated that consciousness would have attained knowledge of them. This did not take place, however, but out of these interrupted and disturbed processes, imprisoned in the unconscious, the symptom arose. That is to say, something in the nature of an interchange had been effected; as often as therapeutic measures are successful in again reversing this transposition, psychoanalytic therapy solves the problem of the neurotic symptom.

Accordingly, Breuer's discovery still remains the foundation of psychoanalytic therapy. The assertion that the symptoms disappear when one has made their unconscious connections conscious, has been borne out by all subsequent research, although the most extraordinary and unexpected complications have been met with in its practical execution. Our therapy does its work by means of changing the unconscious into the conscious, and is effective only in so far as it has the opportunity of bringing about this transformation.

Now we shall make a hasty digression so that you do not by any chance imagine that this therapeutic work is too easy. From all we have learned so far, the neurosis would appear as the result of a sort of ignorance, the incognizance of psychological processes that we should know of. We would thus very closely approximate the well-known Socratic teachings, according to which evil itself is the result of ignorance. Now the experienced physician will, as a rule, discover fairly readily what psychic impulses in his several patients have remained unconscious. Accordingly it would seem easy for him to cure the patient by imparting this knowledge to him and freeing him of his ignorance. At least the part played by the unconscious meaning of the symptoms could easily be discovered in this manner, and it would only be in dealing with the relationship of the symptoms to the experiences of the patient that the physician would be handicapped. In the face of these experiences, of course, he is the ignorant one of the two, for he did not go through these experiences, and must wait until the patient remembers them and tells them to him. But in many cases this difficulty could be readily overcome. One can question the relatives of the patient concerning these experiences, and they will often be in a position to point out those that carry any traumatic significance; they may even be able to inform the analyst of experiences of which the patient knows nothing because they occurred in the very early years of his life. By a combination of such means it would seem that the pathogenic ignorance of the patient could be cleared up in a short time and without much trouble.

If only that were all! We have made discoveries for which we were at first unprepared. Knowing and knowing is not always the same thing; there are various kinds of knowing that are psychologically by no means comparable. "_Il y a fagots et fagots_,"[39] as Moliere says. The knowledge of the physician is not the same as that of the patient and cannot bring about the same results. The physician can gain no results by transferring his knowledge to the patient in so many words. This is perhaps putting it incorrectly, for though the transference does not result in dissolving the symptoms, it does set the analysis in motion, and calls out an energetic denial, the first sign usually that this has taken place. The patient has learned something that he did not know up to that time, the meaning of his symptoms, and yet he knows it as little as before. So we discover there is more than one kind of ignorance. It will require a deepening of our psychological insight to make clear to us wherein the difference lies. But our assertion nevertheless remains true that the symptoms disappear with the knowledge of their meaning. For there is only one limiting condition; the knowledge must be founded on an inner change in the patient which can be attained only through psychic labors directed toward a definite end. We have here been confronted by problems which will soon lead us to the elaboration of a dynamics of symptom formation.

I must stop to ask you whether this is not all too vague and too complicated? Do I not confuse you by so often retracting my words and restricting them, spinning out trains of thought and then rejecting them? I should be sorry if this were the case. However, I strongly dislike simplification at the expense of truth, and am not averse to having you receive the full impression of how many-sided and complicated the subject is. I also think that there is no harm done if I say more on every point than you can at the moment make use of. I know that every hearer and reader arranges what is offered him in his own thoughts, shortens it, simplifies it and extracts what he wishes to retain. Within a given measure it is true that the more we begin with the more we have left. Let me hope that, despite all the by-play, you have clearly grasped the essential parts of my remarks, those about the meaning of symptoms, about the unconscious, and the relation between the two. You probably have also understood that our further efforts are to take two directions: first, the clinical problem--to discover how persons become sick, how they later on accomplish a neurotic adaptation toward life; secondly, a problem of psychic dynamics, the evolution of the neurotic symptoms themselves from the prerequisites of the neuroses. We will undoubtedly somewhere come on a point of contact for these two problems.

I do not wish to go any further to-day, but since our time is not yet up I intend to call your attention to another characteristic of our two analyses, namely, the memory gaps or amnesias, whose full appreciation will be possible later. You have heard that it is possible to express the object of psychoanalytic treatment in a formula: all pathogenic unconscious experience must be transposed into consciousness. You will perhaps be surprised to learn that this formula can be replaced by another: all the memory gaps of the patient must be filled out, his amnesias must be abolished. Practically this amounts to the same thing. Therefore an important role in the development of his symptoms must be accredited to the amnesias of the neurotic. The analysis of our first case, however, will hardly justify this valuation of the amnesia. The patient has not forgotten the scene from which the compulsion act derives--on the contrary, she remembers it vividly, nor is there any other forgotten factor which comes into play in the development of these symptoms. Less clear, but entirely analogous, is the situation in the case of our second patient, the girl with the compulsive ritual. She, too, has not really forgotten the behavior of her early years, the fact that she insisted that the door between her bedroom and that of her parents be kept open, and that she banished her mother out of her place in her parents' bed. She recalls all this very clearly, although hesitatingly and unwillingly. Only one factor stands out strikingly in our first case, that though the patient carries out her compulsive act innumerable times, she is not once reminded of its similarity with the experience after the bridal-night; nor was this memory even suggested when by direct questions she was asked to search for its motivation. The same is true of the girl, for in her case not only her ritual, but the situation which provoked it, is repeated identically night after night. In neither case is there any actual amnesia, no lapse of memory, but an association is broken off which should have called out a reproduction, a revival in the memory. Such a disturbance is enough to bring on a compulsion neurosis. Hysteria, however, shows a different picture, for it is usually characterized by most grandiose amnesias. As a rule, in the analysis of each hysterical symptom, one is led back to a whole chain of impressions which, upon their recovery, are expressly designated as forgotten up to the moment. On the one hand this chain extends back to the earliest years of life, so that the hysterical amnesias may be regarded as the direct continuation of the infantile amnesias, which hides the beginnings of our psychic life from those of us who are normal. On the other hand, we discover with surprise that the most recent experiences of the patient are blurred by these losses of memory--that especially the provocations which favored or brought on the illness are, if not entirely wiped out by the amnesia, at least partially obliterated. Without fail important details have disappeared from the general picture of such a recent memory, or are placed by false memories. Indeed it happens almost regularly that just before the completion of an analysis, certain memories of recent experiences suddenly come to light. They had been held back all this time, and had left noticeable gaps in the context.

We have pointed out that such a crippling of the ability to recall is characteristic of hysteria. In hysteria symptomatic conditions also arise (hysterical attacks) which need leave no trace in the memory. If these things do not occur in compulsion-neuroses, you are justified in concluding that these amnesias exhibit psychological characteristics of the hysterical change, and not a general trait of the neuroses. The significance of this difference will be more closely limited by the following observations. We have combined two things as the meaning of a symptom, its "whence," on the one hand, and its "whither" or "why," on the other. By these we mean to indicate the impressions and experiences whence the symptom arises, and the purpose the symptom serves. The "whence" of a symptom is traced back to impressions which have come from without, which have therefore necessarily been conscious at some time, but which may have sunk into the unconscious--that is, have been forgotten. The "why" of the symptom, its tendency, is in every case an endopsychic process, developed from within, which may or may not have become conscious at first, but could just as readily never have entered consciousness at all and have been unconscious from its inception. It is, after all, not so very significant that, as happens in the hysterias, amnesia has covered over the "whence" of the symptom, the experience upon which it is based; for it is the "why," the tendency of the symptom, which establishes its dependence on the unconscious, and indeed no less so in the compulsion neuroses than in hysteria. In both cases the "why" may have been unconscious from the very first.

By thus bringing into prominence the unconscious in psychic life, we have raised the most evil spirits of criticism against psychoanalysis. Do not be surprised at this, and do not believe that the opposition is directed only against the difficulties offered by the conception of the unconscious or against the relative inaccessibility of the experiences which represent it. I believe it comes from another source. Humanity, in the course of time, has had to endure from the hands of science two great outrages against its naive self-love. The first was when humanity discovered that our earth was not the center of the universe, but only a tiny speck in a world-system hardly conceivable in its magnitude. This is associated in our minds with the name "Copernicus," although Alexandrian science had taught much the same thing. The second occurred when biological research robbed man of his apparent superiority under special creation, and rebuked him with his descent from the animal kingdom, and his ineradicable animal nature. This re-valuation, under the influence of Charles Darwin, Wallace and their predecessors, was not accomplished without the most violent opposition of their contemporaries. But the third and most irritating insult is flung at the human mania of greatness by present-day psychological research, which wants to prove to the "I" that it is not even master in its own home, but is dependent upon the most scanty information concerning all that goes on unconsciously in its psychic life. We psychoanalysts were neither the first, nor the only ones to announce this admonition to look within ourselves. It appears that we are fated to represent it most insistently and to confirm it by means of empirical data which are of importance to every single person. This is the reason for the widespread revolt against our science, the omission of all considerations of academic urbanity, and emancipation of the opposition from all restraints of impartial logic. We were compelled to disturb the peace of the world, in addition, in another manner, of which you will soon come to know.

NINETEENTH LECTURE

GENERAL THEORY OF THE NEUROSES

_Resistance and Suppression_

In order to progress in our understanding of the neuroses, we need new experiences and we are about to obtain two. Both are very remarkable and were at the time of their discovery, very surprising. You are, of course, prepared for both from our discussions of the past semester.

In the first place: When we undertake to cure a patient, to free him from the symptoms of his malady, he confronts us with a vigorous, tenacious resistance that lasts during the whole time of the treatment. That is so peculiar a fact that we cannot expect much credence for it. The best thing is not to mention this fact to the patient's relatives, for they never think of it otherwise than as a subterfuge on our part in order to excuse the length or the failure of our treatment. The patient, moreover, produces all the phenomena of this resistance without even recognizing it as such; it is always a great advance to have brought him to the point of understanding this conception and reckoning with it. Just consider, this patient suffers from his symptoms and causes those about him to suffer with him. He is willing, moreover, to take upon himself so many sacrifices of time, money, effort and self-denial in order to be freed. And yet he struggles, in the very interests of his malady, against one who would help him. How improbable this assertion must sound! And yet it is so, and if we are reproached with its improbability, we need only answer that this fact is not without its analogies. Whoever goes to a dentist with an unbearable toothache may very well find himself thrusting away the dentist's arm when the man makes for his sick tooth with a pair of pincers.

The resistance which the patient shows is highly varied, exceedingly subtle, often difficult to recognize, Protean-like in its manifold changes of form. It means that the doctor must become suspicious and be constantly on his guard against the patient. In psychoanalytic therapy we make use, as you know, of that technique which is already familiar to you from the interpretation of dreams. We tell the patient that without further reflection he should put himself into a condition of calm self-observation and that he must then communicate whatever results this introspection gives him--feelings, thoughts, reminiscences, in the order in which they appear to his mind. At the same time, we warn him expressly against yielding to any motive which would induce him to choose or exclude any of his thoughts as they arise, in whatever way the motive may be couched and however it may excuse him from telling us the thought: "that is too unpleasant," or "too indiscreet" for him to tell; or "it is too unimportant," or "it does not belong here," "it is nonsensical." We impress upon him the fact that he must skim only across the surface of his consciousness and must drop the last vestige of a critical attitude toward that which he finds. We finally inform him that the result of the treatment and above all its length is dependent on the conscientiousness with which he follows this basic rule of the analytic technique. We know, in fact, from the technique of interpreting dreams, that of all the random notions which may occur, those against which such doubts are raised are invariably the ones to yield the material which leads to the uncovering of the unconscious.

The first reaction we call out by laying down this basic technical rule is that the patient directs his entire resistance against it. The patient tries in every way to escape its requirements. First he will declare that he cannot think of anything, then, that so much comes to his mind that it is impossible to seize on anything definite. Then we discover with no slight displeasure that he has yielded to this or that critical objection, for he betrays himself by the long pauses which he allows to occur in his speaking. He then confesses that he really cannot bring himself to this, that he is ashamed to; he prefers to let this motive get the upper hand over his promise. He may say that he did think of something but that it concerns someone else and is for that reason exempt. Or he says that what he just thought of is really too trivial, too stupid and too foolish. I surely could not have meant that he should take such thoughts into account. Thus it goes on, with untold variations, in the face of which we continually reiterate that "telling everything" really means telling everything.

One can scarcely find a patient who does not make the attempt to reserve some province for himself against the intrusion of the analysis. One patient, whom I must reckon among the most highly intelligent, thus concealed an intimate love relation for weeks; and when he was asked to explain this infringement of our inviolable rule, he defended his action with the argument that he considered this one thing was his private affair. Naturally, analytic treatment cannot countenance such right of sanctuary. One might as well try in a city like Vienna to allow an exception to be made of great public squares like the Hohe Markt or the Stephans Platz and say that no one should be arrested in those places--and then attempt to round up some particular wrong-doer. He will be found nowhere but in those sanctuaries. I once brought myself around to permit such an exception in the case of a man on whose capacity for work a great deal depended, and who was bound by his oath of service, which forbade him to tell anyone of certain things. To be sure, he was satisfied with the results--but not I; I resolved never to repeat such an attempt under these conditions.

Compulsion neurotics are exceedingly adept at making this technical rule almost useless by bringing to bear all their over-conscientiousness and their doubts upon it. Patients suffering from anxiety-hysteria sometimes succeed in reducing it to absurdity by producing only notions so remote from the thing sought for that analysis is quite unprofitable. But it is not my intention to go into the way in which these technical difficulties may be met. It is enough to know that finally, by means of resolution and perseverance, we do succeed in wresting a certain amount of obedience from the patient toward this basic rule of the technique; the resistance then makes itself felt in other ways. It appears in the form of an intellectual resistance, battles by means of arguments, and makes use of all difficulties and improbabilities which a normal yet uninstructed thinking is bound to find in the theory of analysis. Then we hear from one voice alone the same criticisms and objections which thunder about us in mighty chorus in the scientific literature. Therefore the critics who shout to us from outside cannot tell us anything new. It is a veritable tempest in a teapot. Still the patient can be argued with, he is anxious to persuade us to instruct him, to teach him, to lead him to the literature, so that he may continue working things out for himself. He is very ready to become an adherent of psychoanalysis on condition that analysis spare him personally. But we recognize this curiosity as a resistance, as a diversion from our special objects, and we meet it accordingly. In those patients who suffer from compulsion neuroses, we must expect the resistance to display special tactics. They frequently allow the analysis to take its way, so that it may succeed in throwing more and more light on the problems of the case, but we finally begin to wonder how it is that this clearing up brings with it no practical progress, no diminution of the symptom. Then we may discover that the resistance has entrenched itself in the doubts of the compulsion neurosis itself and in this position is able successfully to resist our efforts. The patient has said something like this to himself: "This is all very nice and interesting. And I would be glad to continue it. It would affect my malady considerably if it were true. But I don't believe that it is true and as long as I don't believe it, it has nothing to do with my sickness." And so it may go on for a long time until one finally has shaken this position itself; it is then that the decisive battle takes place.

The intellectual resistances are not the worst, one can always get ahead of them. But the patient can also put up resistances, within the limits of the analysis, whose conquest belongs to the most difficult tasks of our technique. Instead of recalling, he actually goes again through the attitudes and emotions of his previous life which, by means of the so-called "transference," can be utilized as resistances to the physician and the treatment. If the patient is a man, he takes this material as a rule from his relations to his father, in whose place he now puts the physician, and in so doing constructs a resistance out of his struggle for independence of person and opinion; out of his ambition to equal or to excel his father; out of his unwillingness to assume the burden of gratitude a second time in his life. For long times at a stretch one receives the impression that the patient desires to put the physician in the wrong and to let him feel his helplessness by triumphing over him, and that this desire has completely replaced his better intention of making an end to his sickness. Women are adepts at exploiting, for the purposes of the resistance, a tender, erotically tinged transference to the physician. When this leaning attains a certain intensity, all interest for the actual situation of the treatment is lost, together with every sense of the responsibility which was assumed by undertaking it. The never-failing jealousy as well as the embitterment over the inevitable repudiation, however gently effected, all must serve to spoil the personal understanding between patient and physician and thus to throw out one of the most powerful propelling forces of the analysis.

Resistances of this sort must not be narrow-mindedly condemned. They contain so much of the most important material of the patient's past and reproduce it in such a convincing manner, that they become of the greatest aid to the analysis, if a skillful technique is able to turn them in the right direction. It is only remarkable that this material is at first always in the service of the resistance, for which it serves as a barrier against the treatment. One can also say that here are traits of character, adjustments of the ego which were mobilized in order to defeat the attempted change. We are thus able to learn how these traits arose under the conditions of the neurosis, as a reaction to its demands, and to see features more clearly in this character which could otherwise not have shown up so clearly or at least not to this extent, and which one may therefore designate as latent. You must also not get the impression that we see an unforeseen endangering of the analytic influence in the appearance of these resistances. On the contrary, we know that these resistances must come to light; we are dissatisfied only when we do not provoke them in their full strength and so make them plain to the patient Indeed, we at last understand that overcoming these resistances is the essential achievement of analysis and is that portion of the work which alone assures us that we have accomplished something with the patient.

You must also take into account the fact that any accidental occurrences which arise during the treatment will be made use of by the patient as a disturbance--every diverting incident, every statement about analysis from an inimical authority in his circle, any chance illness or any organic affection which complicates the neurosis; indeed, he even uses every improvement of his condition as a motive for abating his efforts. You will then have gained an approximate, though still an incomplete picture of the forms and devices of the resistance which must be met and overcome in the course of every analysis. I have given this point such detailed consideration because I am about to inform you that our dynamic conception of the neurosis is based on this experience with the resistance of neurotic patients against the banishment of their symptoms. Breuer and I both originally practiced psycho-therapy by means of hypnosis. Breuer's first patient was treated throughout under a condition of hypnotic suggestibility, and I at first followed his example. I admit that my work at that time progressed easily and agreeably and also took much less time. But the results were capricious and not permanent; therefore I finally gave up hypnotism. Then only did I realize that no insight into the forces which produce these diseases was possible as long as one used hypnotism. The condition of hypnosis could prevent the physician from realizing the existence of a resistance. Hypnosis drives back the resistance and frees a certain field for the work of analysis, but similarly to the doubt in the compulsion neurosis, in so doing it clogs the boundaries of this field till they become impenetrable. That is why I can say that true psychoanalysis began when the help of hypnotism was renounced.

But if the establishment of the resistance thus becomes a matter of such importance, then surely we must give our caution full rein, and follow up any doubts as to whether we are not all too ready in our assumption of their existence. Perhaps there really are neurotic cases in which associations appear for other reasons, perhaps the arguments against our hypothesis really deserve more consideration and we are unjustified in conveniently rejecting all intellectual criticisms of analysis as a resistance. Indeed, ladies and gentlemen, but our judgment was by no means readily arrived at. We had opportunity to observe every critical patient from the first sign of the resistance till after its disappearance. In the course of the treatment, the resistance is moreover constantly changing in intensity. It is always on the increase as we approach a new theme, is strongest at the height of its elaboration, and dies down again when this theme has been abandoned. Furthermore, unless we have made some unusual and awkward technical error, we never have to deal with the full measure of resistance of which the patient is capable. We could therefore convince ourselves that the same man took up and discarded his critical attitude innumerable times in the course of the analysis. Whenever we are on the point of bringing before his consciousness some piece of unconscious material which is especially painful to him, then he is critical in the extreme. Even though he had previously understood and accepted a great deal, nevertheless all record of these gains seems now to have been wiped out. He may, in his desire to resist at any cost, present a picture of veritable emotional feeblemindedness. If one succeeds in helping him to overcome this new resistance, then he regains his insight and his understanding. Thus his criticism is not an independent function to be respected as such; it plays the role of handy-man to his emotional attitude and is guided by his resistance. If something displeases him, he can defend himself against it very ingeniously and appear most critical. But if something strikes his fancy, then he may show himself easily convinced. Perhaps none of us are very different, and the patient under analysis shows this dependence of the intellect on the emotional life so plainly only because, under the analysis, he is so hard pressed.

In what way shall we now account for the observation that the patient so energetically resists our attempts to rid him of his symptoms and to make his psychic processes function in a normal way? We tell ourselves that we have here come up against strong forces which oppose any change in the condition; furthermore, that these forces must be identical with those which originally brought about the condition. Some process must have been functional in the building up of these symptoms, a process which we can now reconstruct by means of our experiences in solving the meaning of the symptoms. We already know from Breuer's observations that the existence of a symptom presupposes that some psychic process was not carried to its normal conclusion, so that it could not become conscious. The symptom is the substitute for that which did not take place. Now we know where the forces whose existence we suspect must operate. Some violent antagonism must have been aroused to prevent the psychic process in question from reaching consciousness, and it therefore remained unconscious. As an unconscious thought it had the power to create a symptom. The same struggle during the analytic treatment opposes anew the efforts to carry this unconscious thought over into consciousness. This process we felt as a resistance. That pathogenic process which is made evident to us through the resistance, we will name _repression_.

We are now ready to obtain a more definite idea of this process of repression. It is the preliminary condition for the formation of symptoms; it is also a thing for which we have no parallel. If we take as prototype an impulse, a psychological process which is striving to convert itself into action, we know that it may succumb before a rejection, which we call "repudiation" or "condemnation." In the course of this struggle, the energy which the impulse had at its disposal was withdrawn from it, it becomes powerless; yet it may subsist in the form of a memory. The whole process of decision occurs with the full knowledge of the ego. The state of affairs is very different if we imagine that this same impulse has been subjected to repression. In that case, it would retain its energy and there would be no memory of it left; in addition, the process of repression would be carried out without the knowledge of the ego. Through this comparison, however, we have come no nearer understanding the nature of repression.

I now go into the theoretical ideas which alone have shown themselves useful in making the conception of repression more definite. It is above all necessary that we progress from a purely descriptive meaning of the word "unconscious" to its more systematic meaning; that is, we come to a point where we must call the consciousness or unconsciousness of a psychic process only one of its attributes, an attribute which is, moreover, not necessarily unequivocal. If such a process remained unconscious, then this separation from consciousness is perhaps only an indication of the fate to which it has submitted and not this fate itself. To bring this home to us more vividly, let us assume that every psychological process--with one exception, which I will go into later--first exists in an unconscious state or phase and only goes over from this into a conscious phase, much as a photographic picture is first a negative and then becomes a picture by being printed. But not every negative need become a positive, and just as little is it necessary that every unconscious psychological process should be changed into a conscious one. We find it advantageous to express ourselves as follows: Any particular process belongs in the first place to the psychological system of the unconscious; from this system it can under certain conditions go over into the system of the conscious. The crudest conception of these systems is the one which is most convenient for us, namely, a representation in space. We will compare the system of the unconscious to a large ante-chamber, in which the psychic impulses rub elbows with one another, as separate beings. There opens out of this ante-chamber another, a smaller room, a sort of parlor, which consciousness occupies. But on the threshold between the two rooms there stands a watchman; he passes on the individual psychic impulses, censors them, and will not let them into the parlor if they do not meet with his approval. You see at once that it makes little difference whether the watchman brushes a single impulse away from the threshold, or whether he drives it out again after it has already entered the parlor. It is a question here only of the extent of his watchfulness, and the timeliness of his judgment. Still working with this simile, we proceed to a further elaboration of our nomenclature. The impulses in the ante-chamber of the unconscious cannot be seen by the conscious, which is in the other room; therefore for the time being they must remain unconscious. When they have succeeded in pressing forward to the threshold, and have been sent back by the watchman, then they are unsuitable for consciousness and we call them _suppressed_. Those impulses, however, which the watchman has permitted to cross the threshold have not necessarily become conscious; for this can happen only if they have been successful in attracting to themselves the glance of the conscious. We therefore justifiably call this second room the system of the _fore-conscious_. In this way the process of becoming conscious retains its purely descriptive sense. Suppression then, for any individual impulse, consists in not being able to get past the watchman from the system of the unconscious to that of the fore-conscious. The watchman himself is long since known to us; we have met him as the resistance which opposed us when we attempted to release the suppression through analytic treatment.

Now I know you will say that these conceptions are as crude as they are fantastic, and not at all permissible in a scientific discussion. I know they are crude--indeed, we even know that they are incorrect, and if we are not very much mistaken we have a better substitute for them in readiness. Whether they will continue then to appear so fantastic to you I do not know. For the time being, they are useful conceptions, similar to the manikin _Ampere_ who swims in the stream of the electric current. In so far as they are helpful in the understanding of our observation, they are by no means to be despised. I should like to assure you that these crude assumptions go far in approximating the actual situation--the two rooms, the watchman on the threshold between the two, and consciousness at the end of the second room in the role of an onlooker. I should also like to hear you admit that our designations--_unconscious_, _fore-conscious_, and _conscious_ are much less likely to arouse prejudice, and are easier to justify than others that have been used or suggested--such as _sub-conscious_, _inter-conscious_, _between-conscious_, etc.

This becomes all the more important to me if you should warn me that this arrangement of the psychic apparatus, such as I have assumed in the explanation of neurotic symptoms, must be generally applicable and must hold for normal functioning as well. In that, of course, you are right. We cannot follow this up at present, but our interest in the psychology of the development of the symptom must be enormously increased if through the study of pathological conditions we have the prospect of finding a key to the normal psychic occurrences which have been so well concealed.

You will probably recognize what it is that supports our assumptions concerning these two systems and their relation to consciousness. The watchman between the unconscious and the fore-conscious is none other than the censor under whose control we found the manifest dream to obtain its form. The residue of the day's experiences, which we found were the stimuli which set off the dream, are fore-conscious materials which at night, during sleep, had come under the influence of unconscious and suppressed wishes. Borne along by the energy of the wish, these stimuli were able to build the latent dream. Under the control of the unconscious system this material was worked over, went through an elaboration and displacement such as the normal psychic life or, better said, the fore-conscious system, either does not know at all or tolerates only exceptionally. In our eyes the characteristics of each of the two systems were betrayed by this difference in their functioning. The dependent relation between the fore-conscious and the conscious was to us only an indication that it must belong to one of the two systems. The dream is by no means a pathological phenomenon; it may appear in every healthy person under the conditions of sleep. Any assumption as to the structure of the psychic apparatus which covers the development of both the dream and the neurotic symptom has also an undeniable claim to be taken into consideration in any theory of normal psychic life.

So much, then, for suppression. It is, however, only a prerequisite for the evolution of the symptom. We know that the symptom serves as a substitute for a process kept back by suppression. Yet it is no simple matter to bridge this gap between the suppression and the evolution of the substitute. We have first to answer several questions on other aspects of the problem concerning the suppression and its substantiation: What kind of psychological stimuli are at the basis of the suppression; by what forces is it achieved; for what motives? On these matters we have only one insight that we can go by. We learned in the investigation of resistance that it grows out of the forces of the "I," in other words from obvious and latent traits of character. It must be from the same traits also that suppression derived support; at least they played a part in its development. All further knowledge is still withheld from us.