Introduction to Psychoanalysis

Chapter 29 Psychoanalysis and Psychiatry (1)
Guys, I am very happy to see you continue to come to my lectures after a year.The subject of my lectures last year was the psychoanalytic interpretation of dreams and errors; this year I am going to enable you to understand a series of phenomena of psychosis which have much in common with dreams and errors, which you will soon see.Before I start my speech, I have to say again that the attitude of speaking this year will inevitably be different from last year.In the past year, every time I took a step forward, I would ask for your opinions, discuss with you more, and let your doubts go. In short, I decided the elements of choice with your "healthy understanding".Not so this year, for one simple reason.You are also very familiar with dreams and mistakes, and your experience is not inferior to mine, or even if you lack this experience, it is easy to obtain it.But the phenomena of psychosis are very foreign to you; you are not doctors, and have no access to them except from my reports; , what's the use?
But you must not assume from this statement that I will speak as an authority, and you can only accept it unconditionally.If you misunderstand like this, then I am too wronged.My purpose is to arouse the interest of research, eliminate stereotypes, and absolutely dissuade you from superstition.Since you don't know anything about neuropathy and don't have the ability to judge, you don't have to believe it for the time being, and don't refute it.All you have to do is listen and let my speech gradually take effect in your minds.Faith is not easy to come by, and getting something for nothing quickly loses its value.You do not have the right to believe in these issues, because you do not have my many years of research and novel discoveries about neurosis.However, we don't have to be credulous, lightly judged, or presumptuously dissent when dealing with learning.Don't you understand that the love of "love at first sight" all stems from the psychological effect of a very special feeling?Nor do we ask patients to have faith in psychoanalysis and to embrace it.Because fanatical belief makes us doubt.I am also deeply comforted by your legitimate skepticism.Therefore, I hope that you will also slowly develop the theory of psychoanalysis in your mind, so that it can interact with the general point of view of psychiatric medicine to form a firm view.

Conversely, you should not assume that the psychoanalytic theory I have presented is an imaginary point of view.In fact, this point of view is the crystallization of experience, and it is based either on direct observation or on the conclusions drawn from observation.The soundness of this conclusion depends on the development of psychoanalysis; I have been working on it for twenty-five years, counting my age, and frankly these observations have been extremely difficult and demanding.I often think that those critics don't discuss the basis of our theory at all, and just blame it arbitrarily, as if the theory is derived from our subjective imagination.We certainly do not condone such critical attitudes.Or because doctors do not pay enough attention to mental patients and are willing to tend to their complaints, they cannot conduct detailed observations and make discoveries.I take this opportunity to say to you that in all my speeches I will not mention personal criticism.As for the saying that "debate is the source of truth", I think it is not the case. This is what the Sophists of Greek philosophy said. The mistake of the Sophists is that they exaggerated the value of debate skills too much.I don't think even scientific debates are effective, let alone purely personal debates.I once had a formal scientific debate in my life, and the opponent was Lowenfeld of the University of Munich. Later, we became good friends and have been to this day.For many years, I dare not try this way again, and no one can guarantee the outcome of the debate.

Now that I have so openly refused to discuss it, you may think I am too stubborn and not modest.If you have such a view, I will make the following reply: If you have acquired a belief through hard research, you must also have the right to insist on your opinion.And I can also say that since the beginning of the research, I have repeatedly refined the main points of my opinions, deleted or added, and published them according to the facts.And what was the result of my confession?Regardless of whether my theory has been revised or not, some people still slander it with past opinions, while some people ridicule it for being changeable and unreliable--the one who changes from day to day is naturally not trustworthy, and his final revision may still be wrong; but insist In my own opinion, those who are unwilling to make concessions will inevitably be said to be stubborn and immodest. Isn't this the case?There is no better way than to be content with such conflicting accusations.This is my attitude; I will still be constantly revising my doctrine in the light of my experience.However, the basic point of view here, so far I think there is no need to change, and I hope that it will be the same in the future.

We shall now discuss the psychoanalytic theory of psychotic symptoms.Therefore, the simplest method is to give an example similar to faults and dreams to illustrate, in order to achieve this purpose, and it is more convenient for analogy and comparison.There is a behavior in psychosis called "symptomatic behavior" that is not uncommon in my consulting room.In the consulting room, the patient tells of his years of suffering, and the psychoanalyst, as usual, says nothing.Others can express their opinion that those people are not sick at all and need only receive mild "water therapy"; psychoanalysts are well-educated and can't have this attitude.Someone once asked a colleague of mine how they treat patients who come to see a doctor. The colleague shrugged and said, "Fix them a lot of money to compensate for my lost time." So, you may have heard that even the busiest It is not surprising that psychoanalysts rarely have patients for consultation.There is a door between my waiting room and the consultation room, and another door in the consultation room, and the interior is carpeted.The reason for this arrangement is self-explanatory.When I let patients in from the waiting room, they often forget to close the door, and sometimes both doors are left open.Seeing this situation, I always tell them to go back and close the door, whether he is a decent gentleman or a fashionable lady.Of course my behavior at this time was very arrogant, and sometimes I also understood that this was a misunderstanding.For the most part, I'm fine, because a person who leaves the doctor's consultation and waiting room doors open or not is regarded as inferior and despised by people.Therefore, don't misunderstand me until you have listened to my words.A patient may enter the consultation room with the door open only if there is no one else waiting in the waiting room; if a stranger is also waiting, this negligence must not be done.Because he knew that it was in his own interest that the doctor's conversation with him should not be heard by a third person; so he always took care to close the doors on both sides.

Therefore, it is not accidental or meaningless for the patient to forget to close the door, let alone indifference, which exposes the attitude of the interviewer towards the doctor.This is just as the world goes to visit people of high social status to ask for their help or protection; perhaps he wants to make an appointment on the phone to make an appointment at the other party's convenience, and at the same time he hopes that the visitors will gather, just like meeting at the grocery store during the European War. that situation.Unexpectedly, he entered and found an empty room, which was very plainly furnished, and he was disappointed.He thought that since the doctor was so disrespectful, he wanted to punish him with revenge; so he deliberately left the door between the waiting room and the consulting room open.As if to say, "Phew! There's no one else here now, and no matter how long I'm going to sit here, I'm sure no one else will come in." Put on an arrogant and disrespectful face.

After analyzing this simple symptomatic behavior, you will find that you already know its conclusions: first, this behavior is not accidental, and has its own motivation, meaning and purpose; All psychological situations can be deduced; third, a very important psychological activity can be inferred from this inconspicuous behavior.But there is another point, namely, that the perpetrator is not aware of this gesture; the one who leaves both doors open certainly does not admit it, and by this he despises me.Many people may not forget their disappointment when they saw the waiting room was empty, but the connection between this impression and the subsequent symptomatic behavior was indeed beyond their awareness.

We shall now compare the analysis of this symptomatic behavior with the observation of a patient.I am going to cite a recent incident, which is simple and convenient for narrative, and I have chosen it.However, there are naturally many details that are indispensable in this narrative.

A young officer came home from a short leave and asked me to treat his mother-in-law.The old woman's family was very happy, but she had a boring thought in her heart, which made herself and her family very distressed.I met her, 53 years old, normal body, good-natured and honest.She told me about her condition without hesitation: she was happily married, and her husband was the manager of a large factory, and lived with her in the country.She narrated that her husband loved her very much and cared for her so much that it was hard to describe. They have lived together for more than 30 years since they fell in love and got married, and they have never had a quarrel, change of heart, or even a moment of jealousy.Their two sons are also married, but the husband is very responsible and continues to work.A year ago, something happened suddenly that puzzled her.She received an anonymous letter saying that her husband was having an affair with a teenage girl, and she immediately believed it.After that, her happiness was ruined.The details of the incident are as follows: She had a very trusted maid, and at that time there was a woman who was of the same background as the young maid, but fortunately, by God's favor, she had received a kind of commercial training, so she could enter the factory to serve.She was promoted to a high position and paid well because all the male staff went to serve in the military.She lives in the factory, and all the male employees know her well, and respectfully call her "Madam".The frustrated servant girl, therefore, hated her so much from jealousy that every possible crime was imposed on her at the first opportunity.One day, the old woman was chatting with her maid about an old man who had visited.It is said that the old man did not live with his wife, but raised a concubine.The old woman said: "How could his wife not know?" Suddenly she continued: "It would be terrible if I heard that my husband had a concubine outside." The next day, she received a An anonymous letter, apparently forged, said exactly what she was worried about.She asserted that it might be true that the letter was written by the wicked maid, and that the husband's concubine was the woman whom the maid detested.Although the old woman knew the deceit and did not believe it, she fell ill because of it.She was deeply irritated, and immediately called her husband to scold him.Her husband laughs and denies it, and handles it well.He invited the doctor in the factory, who is also a family doctor, to his home and tried his best to comfort his wife.Then they fired the maid instead of the supposed concubine, which was very right.Afterwards, the old woman claimed to have thought deeply about the matter and no longer believed the content of the letter, but her suspicions were still on the verge of breaking out.Whenever he hears the woman's name, or encounters him on the road, he will become suspicious and anxious, even resentful and cursing.

(End of this chapter)