Introduction to Psychoanalysis

Chapter 43 The Process of Symptom Formation (1)
Ladies and gentlemen, in the eyes of ordinary people, the symptoms are the root of the disease, and the disappearance of the symptoms indicates that the disease is cured.In medicine, there must be a strict distinction between symptoms and diseases, and the disappearance of symptoms does not mean that the disease is cured.The ability to form new symptoms that remains after symptoms have passed is the only palpable ingredient of the disease.For the present, therefore, we shall take the common man's point of view, and hold that knowing the basis of the symptoms is tantamount to understanding the nature of the disease.

We are, of course, dealing here with psychic symptoms, i.e. psychoses, which are harmful, or at least absolutely unhelpful, to the whole range of activities of life; symptoms are often repulsive and painful to the sufferer.The harm of symptoms to patients lies mainly in the consumption of mental ability, and patients have to consume a lot of energy if they want to resist various symptoms.The range of symptoms is very wide, and the patient's efforts in the above two areas will greatly weaken his mental ability, so that he cannot deal with important events in his life and work.Simply put, this result is based on the weight of energy expended, so you always understand that "disease" is essentially a practical concept.However, if you look at it from an academic point of view and don’t ask questions about the degree, then you can think that we are all mentally ill, and the conditions required for the formation of psychotic symptoms are shared by normal people.

We now understand that psychotic symptoms are the result of psychic conflicts which arise precisely when the patient is seeking new satisfactions of libido.The two forces that resist each other will reunite in the symptom, and on the other hand, they will compromise and give in to each other in the formation of the symptom to achieve the effect of mutual mediation.It is because of this that the symptom has the power of tenacious resistance; as to its persistence and not disappearing, it depends on the opposition of two forces.We are of course aware of these two conflicting elements, one is the unsatisfied libido, which, having been restrained by "reality," has to find another way to satisfy it.If "reality" is inexorable, then even though the libido wants to substitute another object for the one beyond its reach, it ends up having to retreat in search of a previously overcome organization or an abandoned object.The original desire also retreats to the attachment point that was stagnant in the previous development.

The course of a psychosexual disorder is markedly different from that of a psychosis.If the degeneration did not bring about the repression of the instinctual side of the ego, it would not lead to the formation of psychosis; the libido could still obtain a real, abnormal satisfaction.But the ego not only dominates consciousness, but also governs the tendencies of movement and the reality of psychic conflicts, and if it does not approve of these degenerations, contradictions arise as a result.Since the original desire is blocked, it is necessary to find other ways to be satisfied, to follow the requirements of the principle of pleasure; in short, to escape from the self.So on the way of retreating development, return to the previous "repressed" position - on the point of attachment, get rid of the domination of the self and the laws of the self; of course, at the same time, all the training under the guidance of the self has been abandoned .The libido is easy to control if it can be satisfied in front of the eyes; but if it is under the double weight of internal and external deprivation, it will be obstinate and obsessed with past happy times.These are its fundamental, unchanging properties.At this time, the idea attached to the libido belongs to the subconscious system, and has the unique process of this system, that is, condensation and transfer.The conditions of its formation are therefore very similar to those of dreams.The idea to which the libido attaches in the subconscious, the so-called representative of the libido, has to contend with the ego which exists in the preconscious, just as we have said about latent dreams; When dreaming, and satisfying the wish of the unconscious phantasy, it undergoes a preconscious censorship that allows it to form a form of reconciliation in the manifestation of the dream.Since the ego resists the libido so much, the libido has to adopt a special way of expression, so that both sides have a considerable release of power.The symptom thus forms, as the multi-disguised fulfillment of an unconscious libidinal desire, and at the same time as the amalgamation of the clever choice of two conflicting consciousnesses.From this last point alone, the formation of dreams differs from the formation of symptoms; the purpose of all the preconsciousness in dream formation is to protect sleep from the penetration of sleep-disturbing stimuli into consciousness; Will not adopt a strictly prohibited attitude.It is very mild because the danger is so small in sleep, the very condition of sleep which by itself renders the desire invisible to reality.

You should understand that when encountering conflicts, libido can escape just because of the existence of obsession.Since the original desire retreated to these attachment points, it cleverly bypassed the repressive effect, and obtained a kind of satisfaction or vent while maintaining compromise.So, in a roundabout way, through the subconscious mind and previous attachment points, it finally obtains a real, albeit very limited, satisfaction, although this satisfaction is extremely limited and difficult to recognize.Regarding this question, there are still two points worthy of our attention.First, notice how intimately the libido and the unconscious, on the one hand, and the ego, consciousness, and reality are related, even though in the first place there was no such relationship between them; The questions that will be discussed in the future will all refer to hysteria.

Where, then, does libido find the point of attachment it needs to escape repression?It is in the sexual life and experience of infancy, and among those forgotten partial tendencies and objects in childhood.Thus the libido finds its satisfaction in these places.The significance of childhood is two-fold. First, it is the time when the innate instinctive tendencies are first revealed; second, other instincts are awakened and activated for the first time after external influences and accidental events.Personally, I believe that this double distinction is well founded.We admit that inner tendencies can be expressed in external forms; but the results of analysis and observation force us to assume that accidental experiences in childhood can also give rise to libidinal attachments.In theory, we see nothing wrong with this question.The inclinations to innateness naturally arise from the heritage of our ancestry's experience, and they are also learned at a certain period; without this learnedness, so-called heredity would certainly not exist.How can it be imagined that the acquired characteristics that can be passed on to future generations will suddenly disappear?However, it is often because we pay attention to the experience of our ancestors and the experience of adult life that we completely ignore the importance of childhood experience; in fact, it is this factor that is more likely to cause disease.The studies of the mechanism by Ruth et al. show us that if a steel needle is penetrated into a dividing cell mass, it can cause a major disturbance of development; conversely, the same injury can be done to larvae or growing animals without injury .

We have pointed out before that the obsession with libido in adults is an etiological and constitutional factor in psychosis.We now divide it into two components: endowed dispositions and childhood acquired dispositions.Most of the students like the tabular recording method, so the list of these relationships is as follows.

The cause of psychosis = tendency generated by libidinal attachment + accidental (traumatic) experience

Sexual Organization Childhood Experiences
ancestral experience

The hereditary constitution of sex lays particular stress on different points, sometimes for one part of the impulse, sometimes for the other; sometimes there is only one impulse, and sometimes several impulses are mixed; thus various tendencies appear. .The sexual organization and the child's experience form another "complementary series" very similar to that formed by the adult's disposition and accidental experience.In each series, there are similar extreme examples, and similar degrees and relations between the various components.At this point we should ask whether the more pronounced of the two libidinal regressions, the regression to an earlier sexual organization, is governed by hereditary constitutional elements; Explanation follows after discussion of the various forms of psychosis.

For the moment we shall focus on the fact that psychoanalytic research has shown that the libido of psychotic patients is attached to their childhood sexual experiences.From this we see that these experiences are very important in adult life and illness; they are not less important even for the therapeutic work of psychoanalysis.Looking at it from another angle, however, we find that this problem is also in danger of being misunderstood, which allows us to view life entirely from the point of view of the psychotic situation.The importance of the infantile experience would be diminished if we regressed to the infantile experience every time the libido left its new position.Or it follows, on the contrary, that the moment of libidinal experience is not important, but its importance is acquired by subsequent regression.You will recall that we discussed similar either/or issues earlier when we were talking about the Oedipus complex.

In fact, it is not difficult to solve this problem.Regression greatly enhances the libido of children's experience, and thus strengthens the pathogenic factors; this sentence is certainly true, but if it is only used as a determining factor, it will inevitably lead to misunderstanding.Other points of view must also be addressed.In the first place, the analysis of observations leads to the belief in the special importance of experience in childhood, a tendency which is evident in childhood.In fact, children may also develop psychosis. For child psychosis, since the onset should immediately follow the traumatic experience, the inversion component in time must be greatly reduced or completely absent.Our study of the dreams of infants may insure us against the danger of being misunderstood for adult psychosis, just as we understand the dreams of adults by the dreams of children.Childhood psychosis is very common, more common than we think.We tend to dismiss psychosis in children as merely a sign of naughtiness or badness, often manifested in kindergarten as domination by authority; but in retrospect it is easily recognizable.Most of its manifestations are anxiety hysteria, and its significance was not known until later.If the psychotic attack occurs at a slightly older age, the results of its analysis show that this disease is a direct continuation of the childhood psychosis; however, the psychosis in childhood is relatively hidden or just in its infancy.As has already been discussed, in some instances the neurotic hypersensitivity of children remains unchanged throughout life.As for a few of these cases, of course, we can analyze a child's mental illness, but in more cases we have to infer the possible mental illness of the child from the adult patient, and special care must be taken in order to avoid it. mistake.

Second, if there is nothing in childhood to attract the libido, why does the libido always revert to childhood?This question is very puzzling.A point of attachment at a certain stage of development is of considerable significance only if we assume that it has a certain weight of libido attached to it.Finally, I may point out that there is a complementary relation between the intensity and pathogenic importance of experiences in infancy and thereafter, analogous to the relation between the other two series previously described.There are cases where the cause of the disease lies entirely in childhood experiences; those impressions undoubtedly have a traumatic effect, and it only needs to be supplemented by the general sexual organization and immature development to cause the disease.In other cases, the cause of the disease is entirely due to later conflicts, and the emphasis of the analysis on impressions from childhood is due only to regressive effects.We have, therefore, two extreme cases, namely "stagnant development" and "degeneration," with varying degrees of admixture between the two.

Those who believe that mental illness can be prevented by education if it intervenes in time in the sexual development of children; they are very interested in these events.To be honest, if one focuses only on the infant's sexual experience, one might think that such sexual development is delayed, that the child is not deluded by the experience, and that psychosis is prevented.However, our understanding of the pathogenic conditions of psychosis is far more complex than these, and if we only focus on a certain factor, it is often not easy to achieve results.Severe examination in childhood is ineffective, and innate factors are often easy to get out of control.It is not so easy to control as education imagines; and the two dangers arising from this cannot be ignored.If the control is too tight, the child will suppress his sexuality too much, which is also harmful and not beneficial, and the urgent sexual demands of puberty are also powerless to resist.So it is very questionable whether it is more beneficial to prevent mental illness in childhood, or to change attitudes towards reality.

Now, let us return to the problem of symptoms.Symptoms can make the patient feel the lack of satisfaction in reality; and the method of satisfaction is to degenerate the libido into the past life, because it is inseparable from the regression, that is, to return to the earlier sexual object selection or the original sexual organization. stage.We now know that psychotics are often unable to escape a certain period of their past life, which was when their libido was fulfilled and they were happy.He recalls the history of the past, and constantly seeks this period, even with the help of memory or imagination, in order to return to infancy.Symptoms, which to some extent reproduce the early infantile mode of satisfaction, although this mode has to be disguised because of the censorship caused by the conflict, or although it is often transformed into a painful feeling, it contains pathogenic factors. .Regarding the satisfaction brought by the symptoms, patients not only do not know that it is satisfaction, but feel pain deeply, and are afraid to avoid it.This transformation stems from the conflict of the spirit, and the symptom is formed under the pressure of this contradictory impulse; therefore, what was regarded as satisfaction before has to arouse his resistance and even fear.Here is an example, the emotional changes in this case are simple and interesting, and we are all familiar with it: a child likes to suck the mother's breast, but after a few years, he hates the milk very much, and it is not easy to disappear after several trainings. ; If a film forms on the surface of the milk or the liquid containing it, this aversion may become a fear.This film may have reminded him of his love for his mother's breasts, and the traumatic experience of weaning will also add to it, so the situation changes.

There is more than enough to make us think that the symptom as a method of libidinal gratification is strange and even incomprehensible.Nothing in our daily life that we regard as contentment turns out to be a symptom.Moreover, symptoms are largely object-independent and therefore have no contact with external reality.This is the result of the abandonment of the reality principle and the return to the jouissance principle, but a return to an extended autoeroticism is also one of the earliest means of satisfying the sexual instinct.Changes in the external situation have nothing to do with them, they only seek changes in the body, that is to say, replace the external behavior with the internal behavior to adapt to the replaced activity; from the perspective of species evolution history, this is another very important of degradation.This will become clearer if we combine a new factor which has emerged in the analytical study of symptom formation with degeneration.Furthermore, we recalled that the formation of symptoms, like that of dreams, involves unconscious processes, condensation and diversion.Symptoms and dreams alike represent a childish satisfaction which, however, due to extreme compression, can be transformed into a single sensation or impulse; Complexes become small details.It is not surprising, therefore, that our libido is fulfilled in the symptoms, although we often attest to its existence.

(End of this chapter)