Introduction to Psychoanalysis

Chapter 34 The Persistence of Trauma——The Subconscious (2)
There is one point, however, which we consider to be Breuer's second discovery, which belongs to him alone, and which I consider to be more important than the first, in that it enables us to better understand the relationship between the unconscious and the symptoms of psychosis. .It turns out that not only does the meaning of various symptoms always belong to the subconscious domain, but also there is a mutual substitution relationship between the symptoms and the subconscious; and the result of this subconscious activity leads to the formation of various symptoms.You will soon understand this.Breuer agrees with me in one proposition, that is: whenever a symptom is encountered, it can be inferred that there is an unconscious activity in the patient's heart, which contains the meaning of the symptom.On the contrary, this meaning must first be unconscious before it can produce symptoms.Therefore, the symptoms do not originate in conscious mental processes; as soon as the unconscious mental processes are converted into conscious ones, the symptoms must disappear.This is the way out of the psychoanalytic treatment you are looking for, a way of eliminating symptoms.Breuer has used this method to restore health to patients, or to remove the shackles of various symptoms.He discovered that this method enabled the patient to bring into consciousness the subconscious mental processes, including the meaning of the symptoms, which then disappeared.

Breuer's discovery was not the result of reasoning, but the cooperation of the patient that led to this fortunate observation.You must not try to compare this matter with what you already know, in order to increase your understanding; you should admit that this is basically a new thing, so as to explain many other facts.Therefore, we will make the following extensions on this matter.

The formation of symptoms is actually a substitute for something else in the subconscious.Under normal circumstances, some psychological processes must develop until they are clearly understood in the patient's consciousness.If this development is interrupted, or if these psychic processes are suddenly blocked and become unconscious, symptoms follow.The symptoms are therefore a substitute; if we can reconstruct this process psychoanalytically, we shall succeed in eliminating the symptoms.

Breuer's discoveries remain the cornerstone of psychoanalytic therapy.From the results of subsequent research, it can be confirmed that the disappearance of symptoms is due to the subconscious psychological process becoming a conscious psychological process, although it will inevitably encounter unexpected difficulties to achieve it.It is our therapeutic work to transform what is subconscious into something conscious; after this change has taken place, our work is done.

Now, I will make a brief digression, in the hope that you will not imagine the effects of this treatment too easily.As far as we know, psychosis is the result of inadvertent ignorance of psychic processes which should be known.This sounds a lot like Socrates' famous saying that evil comes from ignorance.It is often easy for experienced analysts to understand what kind of subconscious emotion the patient is in when analyzing.Therefore, it should be said that the treatment is not difficult, because you have to tell him this knowledge, and it is enough to eliminate his ignorance.The subconscious meaning of its symptoms is at least on the one hand easier to use this therapy, but on the other hand, the relationship between the past life of the patient and the symptoms is not easy to deduce from it; since all the life experiences of the patient are unknown to the analyst. , I have to wait for the patient to remember and tell me.However, from this point of view, in many cases, falsehoods can be obtained.We can ask the patient's relatives and friends about his past life; these people often know what caused his trauma; or we can tell the patient's forgotten facts, because these events happened in his early childhood.If we apply these two methods comprehensively now, it may not be difficult to overcome the causes of diseases that patients do not understand in a short time.

If so, you are lucky!Things often go beyond our expectations.This knowing is not the same thing as that knowing.If they are of different kinds, they never have equal value psychologically.What Molière said about "everyone is different" is really good!The doctor's knowledge is different from the patient's knowledge, and the effect is certainly not the same.If the doctor tells the patient what he knows, it will also have no effect.This statement may not be accurate enough.We can also say that this method is accurate and cannot relieve the symptoms of psychosis; but it has another effect, that is, it allows the analysis to continue, and often the first result obtained here is a firm denial.The patient has understood the meaning of the symptoms, but her knowledge is limited.Thus, we understand that ignorance is not the only one.We need a deeper understanding of psychology to discern the difference between these ignorances.However, the saying "understanding the meaning of the symptoms can relieve the symptoms" is still true.However, its necessary condition is: this "knowledge" must be based on the patient's inner change, and the inner change can only point to the spiritual treatment of this goal.We thus run into problems that will soon become the dynamics of symptom formation.

At this point, I want to stop and ask you, do you think what I have said is obscure and disorganized?Do I often point out the limitations after I have said a paragraph; draw out many thoughts and let them fall; make you feel bewildered?If this is the case, I will feel very sorry.However, I would rather you feel fully the complexity and difficulty of the subject than sacrifice simplicity at the expense of confusion, and I believe that you will do no harm in temporarily rejecting what I tell you.I understand that listeners and readers can organize and summarize the information they hear and read to suit their own tastes, cut long into short, complex into simple, and summarize what they think and remember.Generally speaking, this statement is correct: the more you listen to at first, the richer you will get in the end.Therefore, although my words are complicated, you have understood many points such as the subconscious mind, the meaning of symptoms, and the relationship between the two.Perhaps you also understand that we will try to follow two directions in the future: first, to understand the source of the patient's disease and how to adopt a sick life attitude: this is a clinical problem; Symptoms of morbidity are formed; this is a psychodynamic problem, and the two problems must meet and meet at a point somewhere.

Today we will not continue the discussion in our lecture; however, it is not time for the end of the get out of class, so I invite you to pay attention to another feature of the above two analyzes: the loss of memory or amnesia, which is again an important point that will not be fully understood until later.You have learned that psychoanalytic treatment can be summed up by the formula: whatever is the cause of a disease which is in the unconscious must enter the conscious.Now this formula can be replaced by another formula: all the missing memories of the patient must be completed, in other words, we must find ways to relieve the patient's amnesia; it will surprise you to hear this.Actually, its meaning has not changed; we must affirm that there is an important connection between the development of symptoms and amnesia.However, if you study the patient in the first case of the above analysis, you will see that it is no easy matter to confirm this idea of ​​amnesia; for the patient does not forget the situation of the compulsive behavior recalled, but remembers it very well; Other factors causing the disease have not been forgotten.As for the second case, in the case of the girl with the obsessive rite, the memory is the same, though a little less clear.She has never really forgotten the behaviors of a few years ago, such as forcing the door between her parents and her bedroom to be opened, so that her mother cannot sleep with her father, etc. She does remember, but she just feels a little uneasy.Special attention should be paid to the first patient, who, although she had practiced the compulsive behavior numerous times, had never noticed that it was similar to the situation on the wedding night, that is, when she was asked to directly seek the source of the compulsive behavior. When she was there, she forgot about it.In the same way, the girl in the second case not only rehearsed her ritual every night as usual, but also the circumstances that caused this ritual.Neither had true amnesia or amnesia; however, the cues that should have been present and used to elicit memories were clipped.It is a disturbance of memory, from which it is sufficient to form an obsessional psychosis; hysteria is somewhat different from this.Hysteria is usually characterized by widespread amnesia.The effect is that the analysis of any single symptom of hysteria brings up a whole thread of past impressions; which are, so to speak, truly forgotten until they are recalled.On the one hand, this clue can be traced back to the earliest childhood, i.e., the amnesia of infancy; If you forget everything, you must not remember at least some of it.Some important details are either completely forgotten or replaced with illusions.In general, the recollection of some recent lived experience escapes the analyst's attention, leaving an interesting gap in the patient's whole experience; can emerge in consciousness.

We have said that the destruction of the faculties of memory is characteristic of hysteria, and that sometimes symptomatic states are hysterical manifestations which, although they occur, need not leave traces in the memory.Since obsessive-compulsive psychosis is different from it, we can infer that the phenomenon of forgetting is one of the psychological characteristics of hysteria, but it is not common to general psychosis.The importance of this distinction will be reduced by the discussion below.The meaning of a symptom is formed by a mixture of two factors, source and tendency or cause, that is to say, the first is the impression and experience that triggers the symptom, and the second is the goal that the symptom aims to achieve.The source of the symptoms can be analyzed into a multitude of impressions, all of which come from the outside world, are at first conscious, and later become unconscious through forgetting.The cause or tendency that is the symptom is often an inner process, which may or may not be conscious at first, but which lingers in the unconscious.It does not matter, therefore, whether the source of the symptoms, or the impressions on which they are based, are forgotten, as in hysteria; the same.

Because we put so much emphasis on the subconscious of spiritual life, it is bound to arouse people's resistance to psychoanalysis.You don't have to be surprised by this, because they feel that such resistance is because they don't understand the subconscious mind, or find it difficult to find the basis for the existence of the subconscious mind, but I think there must be a deeper motive.Human self-esteem has been hit twice by science.For the first time, we realized that our earth is not the center of the universe, but just a small speck in the vast system of the universe. This discovery should be attributed to Copernicus, although Alexander's theory had a similar view.The second time is that the development of biology reduces human beings to a species in the animal world, depriving human beings of the privileges of being above all things and created by God, and human beings also have an indestructible animal nature: this "revaluation of human value" " should be attributed to the joint advocacy of contemporary Darwin, Wallace and predecessors, and it has also been the most violent protest of contemporary people.Now, people's self-esteem will suffer the third most serious insult and blow because of the research of modern psychology.This kind of research will tell everyone what the "self" really looks like, and prove that we can't dominate the self even in our own room.And one can be proud of having even a little information about subconscious mental processes.In fact, we did not begin to look into the human heart, nor did we only psychoanalysts;Most people in the world criticize psychoanalysis, and what's more, they ignore the attitude and rigorous logic as a scholar. Of course, this is also the main reason.Moreover, we have been compelled to disturb the peace of the world in other ways, as we shall discuss shortly.

(End of this chapter)