Introduction to Psychoanalysis

Chapter 45 General Nervousness (1)
everyone.In the last lecture, I talked about a lot of content that was difficult to understand, so let’s leave this topic for the time being and see what your opinions are.

I understand that you are not very satisfied.Psychoanalysis in your imagination is very different from what I have described.What you expect is not a theory, but an example in your life. Maybe you want to tell me that the story of the two children upstairs and downstairs may be used to explain the cause of mental illness. Unfortunately, it is my fabrication, not the reality. example of.Perhaps you will also tell me that you also hope that the two symptoms described at the beginning are not imaginary, but that when you explain their course and the relationship between the patient's life, you have a little understanding of the meaning of the symptoms. go on.But instead of doing this, I have given you a lot of long and difficult theories, but I can't finish them, I always have to add; we discussed many concepts that you have never heard before; I put aside Instead of a narrative explanation, adopting a dynamic point of view, then getting rid of the dynamic point of view, and replacing it with a so-called economic point of view, so that it is difficult for you to understand how many of these academic terms have the same meaning, or just to Pleasant and interchangeable.In addition, I enumerated some extravagant concepts, such as the hedonic principle, the reality principle, and the inheritance of the development of species, etc., and threw them far away before explaining them.

We are going to talk about the problem of psychosis, so why not talk about neuroticism, which is known and interesting to everyone, or the characteristics of neurotics, such as incomprehensible reactions to people and their agitation, suspicion and inability to do anything. talk.Why didn't we start with the simple neuroses and other issues in daily life, and gradually talk about those incomprehensible extreme manifestations?
Of course, I don't deny that there are many, many, and I can't say it's your fault.Nor do I dare to boast of my narrative ability, imagining that every defect has its own special purpose.Frankly speaking, I did think so at first, and I thought it might be more beneficial to you to proceed in a different way.However, a man is often unable to carry out a rational plan, and the material itself often suddenly intervenes with many facts, causing him to change his original intention unconsciously.The material is very familiar, but the narration is not satisfactory; often the words have been said and they are puzzled, why they should be said this way and not that way.

There may be a reason, however: that my thesis, an introduction to psychoanalysis, does not contain this account of psychosis.The introduction to psychoanalysis includes the study of faults and dreams; the theory of psychosis belongs to the main treatise of psychoanalysis.I don't think that in such a short period of time I can expound any material on the theory of psychosis, I can only give a brief statement so that you can understand the meaning of the symptoms, all the conditions and mechanisms in vitro and in vivo when they form, in a considerable context.This is what we have to do, and this is what psychoanalysis is now about.So I have to discuss a lot of libido and libidinal development and ego development, and after you have heard a few lectures, you will be able to understand the important principles of psychoanalysis, the unconscious and the concepts of repression, resistance, etc. generalize.In the next lecture you will find out what exactly the work of psychoanalysis is and where you find its organic connections.I have stated clearly before that all our results lead to knowledge of only one group of psychoses, the study of obsessive-compulsive psychoses;Although you have not yet acquired a more thorough understanding and detailed knowledge of it, I hope that you have some understanding of the method of psychoanalysis' work, the problems it intends to solve, and the theory that has been contributed.

Would you like me to begin my lecture on mental illness by first describing what a mentally ill person does, what causes it, how he tries to resist it, and finally how he manages to adapt?It is true that this is an interesting question, not too difficult to state but also worth studying; but there are many reasons why I have not taken it as my starting point.In this way, the unconscious will be neglected, the importance of the libido will be underestimated, and everything must be judged according to the patient's ego point of view.The patient's ego lacks credibility and is notoriously biased.Where the ego always denies the existence of the subconscious and thus represses it, how can we trust in the fidelity of the ego where the subconscious is concerned?What's more, the most repressed thing is the negated sexual requirement. Therefore, if one adopts the ego point of view, one cannot understand these categories and their meanings, which is the most obvious.If we understood the nature of repression, we would of course not allow this ego, the victor, to be the judge of the balance.What the ego tells us, we must be vigilant against being deceived.If it presents the evidence by itself, it is the dominant player from beginning to end, so the symptoms may also be caused by its desire and will; we know that the ego is mostly in a passive position, but it tries to hide this fact.It cannot, however, maintain this hypocrisy for long, and in the case of obsessive-compulsive psychosis the ego has to admit that it has encountered certain forces which it must struggle to resist.

If one does not heed these warnings and is willing to be deceived by the apparent errors of the ego, then obviously all can go well; the psychoanalytic emphasis on the unconscious, the sexual life, and the resistances of the ego's passivity are all avoided.Adler agreed with the statement that nervousness was the cause, not the effect, of psychosis, but he was still unable to explain the details of a dream or symptom.

If you ask me, can we give weight to both the role of the ego in neurotic and symptom formation and the factors found in psychoanalysis?My answer is that of course yes, it is a matter of time; but what psychoanalysis is now studying is less suitable for this purpose as a starting point.We might as well point this out in advance and include the question.There is a "narcissistic psychosis" in which the ego is more deeply involved than in any other psychosis we have studied.The analysis of the studies of these psychoses has allowed us to have accurate and plausible considerations of the place of the ego in them.

There is, however, an obvious and obvious relationship between the ego and psychosis.This relationship seems to be common to all psychoses, but it is especially characteristic of traumatic psychoses and is poorly understood.You should understand that the same factors are present in the cause and mechanism of every psychosis; One factor is particularly important.Just like an idol theater troupe, each actor will play a special role, such as protagonist, friend, villain, etc.; everyone chooses a different role that suits their own performance characteristics.Symptomatic phantasies are thus less pronounced than in hysteria; the "reaction" or resistance of the ego is most important in obsessive-compulsive psychosis, and the delusions of paranoia are characterized by the mechanism of "secondary embellishment" in dreams.

For traumatic psychosis, especially traumatic psychosis caused by war, we are most impressed by self-defense, egoistic motives and efforts for self-interest; if these alone are not enough to cause disease, but after the disease has formed depends on them for maintenance.The object of this tendency is to preserve the self and avoid the danger of inducing disease; it is unwilling to recover health unless the danger is unlikely to strike again, or if, despite the danger, it can be fairly compensated.

The ego has a similar interest in the cause and maintenance of all other psychoses; we have seen before that psychotic symptoms are gratified by repressing the ego and are thus protected by the ego.Symptoms can save the self from psychological pain, so it is a very convenient way to resolve psychological conflicts through the formation of symptoms, and it is most in line with the principle of enjoyment.In fact, even doctors must admit that for some mental illnesses, using psychosis to resolve conflict is the most harmless and socially acceptable.Doesn’t it surprise you that doctors sometimes admit that they feel sympathy for the patients they are treating?In fact, a person does not have to regard health as the most important thing in all life situations; because they understand that people have other sufferings besides suffering from mental illness, and sometimes some needs may be paid for by health ; they also know that if they suffer from this disease, they are often spared all other pains.So, while it may be that the psychopath absconds into the disease, we have to admit that in many cases the patient has reason to do so, and the doctor, aware of the situation, has to acquiesce.

But we can move on without these special cases.Generally speaking, when the ego escapes into a mental illness, there is a psychological feeling of "benefits from the illness". In some cases, there may also be specific external benefits, which have some practical value.We cite one of the most common examples.For example, a woman who is violently abused by her husband will flee to the sick if she has a tendency to be nervous in her personality; Resist the attacks of the outside world and dare not divorce her husband; if she can't support herself independently, she can't expect to find a better husband; finally, if she is very dependent on the rough man in her sex life, she can't escape the disease , she has nowhere to go.At this time, the disease is her tool against her husband, in self-defense or revenge.Although she did not dare to complain about her marriage, she could openly complain about the pain of her illness; the doctor was her good friend, and even her violent husband had to forgive her, spend money for her, and allow her to leave home, and she was no longer hurt. oppression.If the external "accidental" benefit brought about by the disease is very significant, then you should not expect that the symptom will be cured.

I have objected to the theory that psychosis arises from self-wish and self-creation; you will think that my present discussion of "benefits from illness" is undoubtedly a defense of this.But let me warn you that what I say can only be interpreted in the following way: that the ego welcomes the insanity it cannot avoid, or that it makes use of it where it is available.This is one aspect of the problem.If psychosis is beneficial to the ego, the ego is of course at peace with it, but we have to take into account the disadvantages of the benefits.In general, there is clearly a loss for the ego to endure psychosis.The cost of using it to resolve conflicts is too great; the ego wants to avoid the pain caused by symptoms, but is unwilling to give up the benefits it has gained, which is exactly what it can't do both.The ego, therefore, does not always occupy the active position it has acquired at this point.We must understand and remember this question.

(End of this chapter)