Difficulty of demarcation in border-line cases between epilepsy, hysteria, and mental deficiency—Somnambulism an hysterical manifestation—A case of spontaneous somnambulism, with some characters of protracted hysterical delirium—Other cases quoted—Charcot's classification of somnambulism—Naefs and Azam's cases of periodic amnesia—Proust's and Boileau's wandering-impulse cases—William James' case of Rev. Ansel Bourne—Other examples showing changes in consciousness—Hypnagogic hallucinations—Neurasthenic mental deficiency, Bleuler's case—Summing up of Miss Elsie K.'s case—Need of further scientific investigation in the field of psychological peculiarities.
Case of Somnambulism in a Person with Neuropathic Inheritance (Spiritualistic Medium)
History of case—Accidental discovery of her mediumistic powers—Her somnambulic attacks, "attitudes passionelles," catalepsy, tachypnœa, trance speeches, etc.—Ecstasies—Her conviction of the reality of her visions—Her dreams, hypnagogic and hypnopompic visions—The elevation of her somnambulic character—Mental thought transference—S. W.'s double life—Psychographic communications—Description of séances—The Prophetess of Prevorst—Automatic writing—The two grandfathers—Appearance of other somnambulic personalities.
The psychograph and spiritualistic wonders—The grandfather the medium's "guide" or "control"—Ulrich von Gerbenstein—The somnambulic personalities have access to the medium's memory—Ivenes—S. W.'s amnesia for her ecstasies—Later séances—Her journeys on the other side—Oracular sayings—Conventi—Ivenes' dignity and superiority to her "guides"—Her previous incarnations—Her race-motherhood.
Table movements—Unconscious motor phenomena—Verbal suggestion and auto-suggestion—The experimenter's participation—The medium's unconscious response—Thought-reading—Table-tilting experiment, illustrated—Experiments with beginners—Myers' experiments in automatic writing—Janet's conversation with Lucie's subconsciousness—Example of the way the subconscious personality is constructed—Hallucinations appear with deepening hypnosis; some contributing factors—Comparison between dream symbols and appearance of somnambulic personalities—Extension of the unconscious sphere—The somnambulist's thinking is in plastic images, which are made objective in hallucinations—Why visual and not auditory hallucinations occur—Origin of hypnagogic hallucinations—Those of Jeanne d'Arc and others.
Noticeable in S. W.'s case, also in Mary Reynolds'—Association with amnesic disturbances—Influence of puberty in our case—S. W.'s systematic anæsthesia—Ivenes not so much a case of double consciousness as one in which she dreams herself into a higher ideal state—Similar pathological dreaming found in the lives of saints—Mechanism of hysterical identification—S. W.'s dreams break out explosively—Their origin and meaning, and their subjective roots.
In considering the origin of attack, two moments, viz. irruption of hypnosis, and the psychic stimulation, must be taken into account—In susceptible subjects relatively small stimuli suffice to bring about somnambulism—Our case approaches to hysterical lethargy—The automatisms transform lethargy into hypnosis—Her ego-consciousness is identical in all states—Secondary somnambulic personalities split off from the primary unconscious personality—All group themselves under two types, the gay-hilarious, and serio-religious—The automatic speaking occurs—This facilitates the study of the subconscious personalities—Their share of the consciousness—The irruption of the hypnosis is complicated by an hysterical attack—The automatism arising in the motor area plays the part of hypnotist—When the hypnotism flows over into the visual sphere the hysterical attack occurs—Grandfathers I. and II.—Hysterical dissociations belong to the superficial layers of the ego-complex—There are layers beyond the reach of dissociation—Effect of the hysterical attack.
The serio-religious and the gay-hilarious explained by the anamnesis—Two halves of S. W.'s character—She is conscious of the painful contrast—She seeks a middle way—Her aspirations bring her to the puberty dream of the ideal Ivenes—The repressed ideas begin an autonomous existence—This corroborates Freud's disclosures concerning dreams—The relation of the somnambulic ego-complex and the waking consciousness.
The progress of this affection reached its maximum in 4-8 weeks—Thenceforth a decline in the plasticity of the phenomena—All degrees of somnambulism were observable—Her manifest character improved—Similar improvements seen in certain cases of double consciousness—Conception that this phenomenon has a teleological meaning for the future personality—As seen in Jeanne d'Arc and Mary Reynolds II.
S. W. shows primary susceptibility of the unconscious—Binet affirms the susceptibility of the hysteric is fifty times greater than that of normal—Cryptomnesia, a second additional creation—Cryptomnesic picture may enter consciousness intra-physically—Unconscious plagiarism explained—Zarathustra example—Glossolalia—Helen Smith's Martian language—The names in Ivenes' mystic system show rudimentary glossolalia—The Cryptomnesic picture may enter consciousness as a hallucination—Or arrive at consciousness by motor automatism—By automatisms regions formerly sealed are made accessible—Hypermnesia—Thought-reading a prototype for extraordinary intuitive knowledge of somnambulists and some normal persons—Association-concordance—Possibility that concept and feeling are not always clearly separated in the unconscious—S. W.'s mentality must be regarded as extraordinary.
Lecture I.—Formula for test—Disturbances of reaction as complex-indicators—Discovery of a culprit by means of test—Disturbances of reaction show emotional rather than intellectual causes—Principal types—Value of the experiment in dealing with neurotics.
Dr. Fürst's researches—Effect of environment and education on reactions—Effect of parental discord on children—Unconscious tendency to repetition of parental mistakes—Case of pathological association-concordance between mother and daughter—Neurosis, a counter-argument against the personality with which the patient is most nearly concerned—How to free the individual from unconscious attachments to the milieu.
Lecture III.—Experiences concerning the Psychic Life of the Child
Importance of emotional processes in children—Little Anna's questions—Arrival of the baby brother—Anna's embarrassment and hostility—Introversion of the child—Of the adolescent—Her pathological interest in the Messina earthquake—The meaning of her fear—Anna's theories of birth—Meaning of her questions—Her father tells her something of origin of her little brother—Her fears now subside—The unconscious meaning of the child's wish to sit up late—Anna's equivalent to the "lumpf-theory" of little Hans—The stork-theory again—Author's remarks on the sexual enlightenment of the child.
Psychosexual relationship of child to father—Fürst's experiments quoted—The association experiment typical for man's psychological life—Adaptation to father—Father-complex productive of neurosis—Father-complex in man with masochistic and homosexual trends—Peasant woman "her father's favourite," tragic effect of the unconscious constellation—Case of eight-year-old boy with enuresis—Enuresis a sexual surrogate—Importance of infantile sexuality in life—Hence necessity for psychoanalytic investigation—The Jewish religion and the father-complex—Parental power guides the child like a higher controlling fate—The conflict for the development of the individual—Father-complex in Book of Tobias.
Investigation of a rumour in a girls' school—The rumour arose from a dream—Teacher's suspicions—Was the rumour an invention and not, as alleged, the recital of a dream?—Interpolations in dreams—Collection of evidence—Duplication of persons an expression of their significance both in dreams and in dementia præcox—The additions and interpolations represent intensive unconscious participation—Hearsay evidence—Remarks.
The dream is analysed by rumour—Psychoanalysis explains the construction of rumour—The dream gives the watchword for the unconscious—It brings to expression the ready-prepared sexual complexes—Marie X.'s unsatisfactory conduct brought her under reproof—Her indignation and repressed feelings lead to the dream—She uses this as an instrument of revenge against the teacher—More investigation needed in the field of rumour.
Symbolism of numbers has acquired fresh interest from Freud's investigations—Example of number dream of middle-aged man—How the number originates—A second dream also contains a number—Analysis—The wife's dream "Luke 137"—This dream is an example of cryptomnesia.
Bleuler's concept of ambivalency and ambitendency—Every tendency balanced by its opposite—Schizophrenic negativism—Bleuler's summary of its causes—The painfulness of the complex necessitates a censorship of its expression—Thought disturbance the result of a complex—Thought pressure due to schizophrenic introversion—Resistance springs from peculiar sexual development—Schizophrenia shows a preponderance of introversion mechanisms—The value of the complex theory concept.
Doctors know too little of psychology, and psychologists of medicine—Strong prejudice aroused by Freud's conception of the importance of the sexual moment—The commoner prejudices discussed—Psychoanalysis not a method of suggestion or reasoning—The unconscious content is reached via the conscious—Case of neurotic man with ergophobia for professional work—Case of neurotic woman who wants another child—Resistances against the analyst—Dream analysis the efficacious instrument of analysis—The scientist's fear of superstition—The genesis of dreams—Dream material is collected according to scientific method—The rite of baptism analysed—When the unconscious material fails, use the conscious—The physician's own complexes a hindrance—Interpretations of Viennese School too one-sided—Sexual phantasies both realistic and symbolic—The dream the subliminal picture of the individual's present psychology—Symbolism a process of comprehension by analogy—Analysis helps the neurotic to exchange his unconscious conflict for the real conflict of life.
Difficulties of public discussion—Competence to form an opinion presupposes a knowledge of the fundamental literature—The abandoned trauma theory—Fixation—The importance of the infantile past—Analysis discloses existence of innumerable unconscious phantasies—Œdipus complex—Fixation discussed—The critical moment for the outbreak of the neurosis—Predisposition—Author's energic view point—Application of the libido to the obstacle—Repression—Neurosis an act of adaptation that has failed—The energic view does not alter the technique of analysis—Analysis re-establishes the connection between the conscious and unconscious—Is a constructive task of great importance.
For the patient any method that works is good, though some more valuable than others—The doctor must choose what commends itself to his scientific conscience—Why the author gave up the use of hypnotism—Three cases quoted—Breuer and Freud's method a great advance in psychic treatment—Evolution of author's views—Importance of conception that behind the neurosis lies a moral conflict—Divergence from Freud's sexual theory of neurosis—The doctor's responsibility for the cleanliness of his own hands—Necessity that the psychoanalyst should be analysed—He is successful in so far as he has succeeded in his own moral development.
Opportunism v. scientific honour—Psychoanalysis no more than hypnotism gets rid of "transference"—Cases of enuresis nocturna, and of washing-mania treated by hypnosis—On what grounds should such useful treatment be dispensed with?—The difficulty of finding a rational solution for the moral conflict—The doctor's dilemma of the two consciences.
Author's standpoint that of the scientist, not practical physician—The analyst works in spite of the transference—Psychoanalysis not the only way—Sometimes less efficacious than any known method—Cases must be selected—For the author and his patients it is the best way—The real solution of the moral conflict comes from within, and then only because the patient has been brought to a new standpoint.
"What is truth?"—Parable of the prism—All man attains is relative truth—Fanaticism is the enemy to science—Psychoanalysis a method of dealing with basic motives of the human soul—Must not each case be treated individually?—Morals are above all relative.
Definition of psychoanalysis—Technique—So-called chance is the law—Rules well-nigh impossible—The patients' unconscious is the analysts' best confederate—Questions of morality and education find solutions for themselves in later stages of analysis.
Different view-points in psychoanalysis—Vide Freud's causality and Adler's finality—Discussion of meaning of transference—The meaning of "line of least resistance"—Man as a herd-animal—Rich endowment with social sense—Should take pleasure in life—Error as necessary to progress as truth—Patient must be trained in independence—Analyst is caught in his own net if he makes hard-and-fast rules—Through the analyst's suggestion only the outer form, never the content, is determined—The patient may mislead the doctor, but this is disadvantageous and delays him.
Transference is the central problem of analysis—It may be positive or negative—Projection of infantile phantasies on the doctor—Biological "duties"—The psyche does not only react, but gives its individual reply—We have an actual sexual problem to-day—Evidences thereof—We have no real sexual morality, only a legal attitude—Our moral views are too undifferentiated—The neurotic is ill not because he has lost his faith in morality, but because he has not found the new authority in himself.
Content of the unconscious—Defined as sum of all psychical processes below the threshold of consciousness—Answer to question how does the unconscious behave in neurosis found in its effect on normal consciousness—Example of a merchant—Compensating function of the unconscious—Symptomatic acts—Nebuchadnezzar's dream discussed—Intuitive ideas, and insane manifestations both emanate from the unconscious—Eccentricities pre-exist a breakdown—In mental disorder unconscious processes break-through into consciousness and disturb equilibrium—True also in fanaticism—Pathological compensation in case of paranoia—Unconscious processes have to struggle against resistances in the conscious mind—Distortion—In morbid conditions the function of the unconscious is one of compensation.
Striking contrast between hysteria and dementia præcox—Extroversion and Introversion—Repression—Hysterical transference and repression the mechanism of extroversion—Depreciation of the external world the mechanism of introversion—The nervous temperament pre-exists the illness—Examples of the two types from literature—James's Tough and Tender-minded—Warringer's Sympathy and Abstraction—Schiller's Naïf and Sentimental—Nietzsche's Apollien and Dionysian—Gross's Weakness and Reinforcement of Consecutive Function—Freud and Adler's Causalism and Finality—The fundamental need for further study of the two types.
Psychic structure of dream contrasted with that of conscious thought—Why a dream seems meaningless—Freud's empirical evidence—Technique, analysis of a dream—The causal and teleological view of the dream—A typical dream with mythological content—Compensating function of dreams—Phallic symbols.
Discussion of psychological v. physical origin of mental disease—Mediæval conception of madness as work of evil spirits—Development of materialistic idea that diseases of the mind are diseases of the brain—Psychiatrists have come to regard function as accessory to the organ—Analysis of patients entering Burgholzi Asylum—A quarter only show lesions of the brain—The psychiatry of the future must advance by way of psychology—Cases of dementia præcox illustrating recent methods in psychiatry—The development of the outbreak at a moment of great emotion—Delusions determined by deficiencies in the patient's personality—Difficulties of investigation—Temporary remission of mental symptoms proves that reason survives in spite of preoccupation with diseased thoughts—Case of dementia præcox, showing exceeding richness of phantasy formations, and the continuity of ideas.
Freud's case of paranoid dementia—(Schreber case)—Two ways of regarding Goethe's "Faust"—Retrospective and prospective understanding—The scientific mind thinks causally—This is but one half of comprehension—Pathological and mythological formations, both structures of the imagination—Flournoy's case—Misunderstanding of author's analysis of it—Adaptations only possible to the introverted type by means of a world-philosophy—The extroverted type always arrives at a general theory subsequently—Psychasthenia is the neurosis of introversion, hysteria of extroversion—These diseases typify the general attitude of the types to the phenomena of the external world—The extreme difference in type a great obstacle to common understanding—The general result of the constructive method is a subjective view, not a scientific theory.
The evolution of psychology—How little it has had to offer to the psychiatrist till Freud's discoveries—The origin and reception of psychoanalysis—The prejudiced attitude of certain physicians—Freud's view that his best work arouses greatest resistances—The Nancy School—Breuer's first case—"The talking cure"—The English "shock theory"—Followed by the trauma theory—Discussion of predisposition—Author's case of hysteria following fright from horses—The pathogenic importance of the hidden erotic conflict.—Humanity evolves its own restrictions on sexuality for the sake of the advance of civilisation—The presence of a grave sexual problem testifies to the need of more differentiated conceptions—The erotic conflict largely unconscious—Neurosis represents the[xxv] unsuccessful attempt of the individual to solve the problem in his own case—To understand the idea of the dream as a wish-fulfilment the manifest and latent content must be taken in review—The nature of unconscious wishes—Dream analysis leads to the deepest recesses of the unconscious—The analyst compared to the accoucheur—Comparison with Socrates' technique—The highest development of the individual is sometimes in complete conflict with the herd-morality—Psychoanalysis provides the patient with a philosophy of life founded upon insight—The violent reactions raging round psychoanalysis is a proof of its importance.