Introduction to Psychoanalysis

Chapter 51 Transfer Effect (1)
Ladies and gentlemen, now that our discussion is drawing to a close, you must have an expectation, but it must not be misleading.Maybe you think that after discussing various complicated problems of psychoanalysis, I will definitely not end without talking about therapy. The work of psychoanalysis is ultimately about therapy.As a matter of fact, I will never omit this question; for I have yet to tell you a new fact connected with the phenomenon of healing.Without this understanding, it will be very difficult for you to gain a deep understanding of the various diseases that you have been studying before.

I think that what you are eager to know is not the actual technical guidance of psychoanalytic treatment, but to understand the general method content and general achievements of psychoanalytic treatment.Of course, no one can deny that you have the right to know these things; however, I don't want to tell you, I prefer that you find out for yourself.

Everyone, please think about it, but you have already understood all the important facts, from the various causes of the disease to the various symptoms and the internal factors of the patient.So, at what point is the influence of analytical treatment acceptable?The first is the hereditary tendency, which has been dealt with enough in other disciplines, and we will not go into details, and there is nothing new to discuss.Do not, however, think that we can take it lightly; we who study psychoanalysis are naturally quite aware of the influence of this question.In any case, we cannot alter heredity; it is an established fact that limits the scope of our efforts.Next, there are the influences of childhood experiences, which are often the most important material in psychoanalysis; they are all in the past tense, and there is nothing we can do about them.The third is all the unfortunate encounters in his life, that is, "real setbacks", which cause the lack of love in the life process, such as poverty, family disharmony, marriage failure, cynicism and moral demanding, etc.Although good therapeutic effects can be received in these aspects, it must also follow the old method of King Joseph in Vienna legend to bestow favors and disasters, pointing people to the way can make people obey, and the disaster will disappear; but we are all What kind of person can also spread the grace of healing to patients?We only rely on medical skills to make a living. We are neither powerful nor powerful in society, and we don’t treat the poor like other doctors. Our treatment methods take a long time and energy.However, you firmly believe that the various factors we have mentioned before must have a possibility of acceptable treatment.If it is social morality that deprives the patient of happiness, we can inform and encourage the patient to break through these barriers during treatment, and give up ideals in exchange for happiness and health. people.Health, however, may be obtained by "living willfully," and psychoanalysis is necessarily tainted by it with the taint of immorality: benefiting the individual at the detriment of society.

Where did you get this false impression about psychoanalysis?Of course, there is a part in psychoanalytic therapy that persuades people to "live as they please", because for patients, there is a conflict between the desire of libido and the suppression of sex, or the sensory conflict between indulgence and abstinence.This kind of contradiction cannot be resolved by one side overriding the other.For the mentally ill, although asceticism wins for a while, those neglected repressive forces of life turn to the illness for satisfying compensation; and vice versa.Neither of these two methods can resolve the contradiction in the heart, and there is always one party who cannot be satisfied.Those cases in which the conflicts are not severe and the doctor's advice is somewhat effective are rare, and psychoanalysis is not necessary in such cases.Those who are susceptible to the doctor's influence, if not influenced, are bound to find their own way.In fact, if an abstinent man wants illicit intercourse, or a sexually dissatisfied wife wants a lover, they never need permission from a doctor or a psychoanalyst.

Often, people tend to overlook the crux of the whole issue when discussing this issue, that is, the contradictions caused by mental patients are different from the conflicts and conflicts of normal people, and the two opposite impulses of normal balance are in the same psychological sphere, and in the paradoxes that give rise to psychosis, one of the two forces must enter the preconscious or conscious plane, while the other is forbidden in the subconscious realm.Therefore, this contradiction cannot be resolved by either side; these two hostile forces, in fact, are no different from one heaven south and one earth north.If the contradiction is to be resolved, the two must meet in the same field.I think this is the job of psychoanalysis.

Moreover, if you also believe that psychoanalytic treatment is also indispensable for instructing life or directing behavior, you are inevitably walking into another misunderstanding.In fact, we go out of our way to avoid the role of mentor and instead expect the patient to help himself.To achieve this goal, we often persuade patients not to make decisions about major life events, such as career, marriage or divorce, while they are undergoing analytic therapy, until the treatment is over.Perhaps you have not thought of this.Naturally, there is no such restriction for those who are young or unable to support themselves.What they need is the role of a doctor and an educator, and we have no choice but to make it difficult. At this time, we should know that we have a heavy responsibility to shoulder, and we should be extra cautious in dealing with problems.

However, when we are accused of encouraging the mentally ill to "live as they please," please don't misunderstand us as defenders of traditional morality.None of them are relevant to our therapeutic purposes.We are just observers, not social reformers; so-called observation is of course inseparable from criticism, so it is impossible for us to uphold traditional moral staunchly or praise society's treatment of sexual problems.It is not difficult for us to understand that the so-called social morality often involves too many sacrifices, and we also understand that the so-called moral behavior must inevitably be hypocritical and ignorant.We do not hide moral deceit from our patients, but we must make them think about sex problems like other problems, and get used to thinking about problems without prejudice; If the time is moderate, no matter what the result is, we will not be condemned by conscience.Any man who has been trained to know the truth may be able to resist the dangerous forces of immorality, and may have some aspect of his moral standard that does not agree with others.We do not need to overestimate the psychosis caused by abstinence; and the few symptoms caused by the accumulation of libido can be solved by sexual intercourse without exertion.

We cannot, therefore, assume that the therapeutic effect of psychoanalysis entails the indulgence of the patient's sexual life; we must seek other explanations.I still remember that when I defended your imagination, I said this sentence, which may enable you to gain a correct understanding.Psychoanalysis works because it substitutes a conscious thing for something subconscious, and thus converts subconscious thoughts into conscious ones.If you think this way, you have grasped the key to the problem.We transform the subconscious mind into consciousness, that is, the subconscious mind expands and enters the realm of consciousness, so the repression is eliminated, and the symptoms are eliminated. Then the two pathogenic conflicting forces can always become a contradiction in a normal state.What psychoanalysis does is to bring about this kind of psychological transformation in the patient. To the extent that such transformation can be achieved, the patient will also benefit to the same extent.If the repression disappears or if all the psychological processes similar to repression are also relieved, our treatment will be declared complete.

Now, we express the goal of our efforts in various formulas: the transformation of the unconscious into consciousness, the release of repression, or the filling of missing memories, etc., all of which actually refer to the same thing.Perhaps you are not satisfied with this statement, thinking that the recovery of a psychotic patient should be quite different, and that after psychoanalysis he should become a completely different person; The material is slightly less than before, and the material of consciousness is only slightly increased.Maybe you don't know much about the importance of this inner transformation.The analytic psychopath is essentially the same as before, but he does become a different person, that is, he is now able to transform into the best possible state for his own conditions.This is no longer an insignificant event.If, knowing all of our achievements, you can understand that we do our best to bring about this seemingly insignificant transformation of the mind, then you will understand the importance of the psychological differences of the various stages.

Now, let me leave the subject for a moment and tell you what is the meaning of the so-called "reason therapy".A treatment method that seeks an entry point to eliminate the source of the disease regardless of the external manifestations of the disease is called "causal therapy".Is psychoanalysis, then, a causal therapy?Answering this question is not easy, but it also convinces us of the impracticality of such questions.The purpose of psychoanalytic treatment is naturally not to eliminate the symptoms of the disease directly, which is roughly consistent with the implementation of causal therapy.In other respects, however, the two are different. When we seek the etiology of the disease, we must go far beyond the repression itself and go deep into its instinctive tendencies and structures, down to the abnormality of the development of these instincts, etc.If we can carry out the transformation of the psychological mechanism by chemical methods, we can increase or decrease the weight of libido at any time, or sacrifice one impulse to strengthen another impulse. This is the real cause therapy, and our psychoanalysis becomes observation. The cause is an indispensable first step in the work.You also know, however, that at present there is no psychic process that affects libido; psychoanalytic therapy has chosen to attack another point in the causal series, not above the symptoms, but in the more distant symptoms. The lower floors; this place we can only approach them in a very special case.

So, how on earth can we make the patient's subconscious enter into consciousness?Previously we thought it was a simple matter of telling the patient this subliminal material and that's it.However, we now understand that this was a fallacy, a result of short-sightedness.What we know of his unconscious is not the same as what the patient himself knows.Even if we tell the patient these subconscious information, it is impossible for him to assimilate it to replace his own subconscious thoughts, at best it is only compatible, and in fact there is little change.Therefore, we have to look to other points of view such as the situation to deal with the unconscious information; to seek from the patient's memory the factors that originally produced the repressive effect.First of all this repression must be dissipated, and then the transformation of subconscious thoughts into conscious thoughts is immediately completed.However, how to make the depressive effect disappear?Our work then proceeds to the next stage, that of eliminating the resistance on which repression depends.Thus, the first stage finds repression, and the second removes it.

So, how can this resistance be eliminated?The method is still to first find out the source of resistance and inform the patient.All about resistance is caused by resisting an uncomfortable impulse, or a repression we want to eliminate, or a repression that was active earlier.Therefore, what we have to do is to repeat the previous method, that is, to inform patients after analysis and verification.However, at this time we have to act in the right way.Those resistances are ego instincts, not subconscious, so ego instincts must cooperate with us, even if they are not conscious.Earlier we learned that "subconscious mind" has two meanings here: one refers to a phenomenon, and the other refers to a system.It sounds vague, but it's just repeating what we said earlier.We have already mentioned in the previous lectures that if we find out the location of this resistance through analysis, it is expected that this resistance will disappear, and the resistance will be eliminated.Yet what instinctive drive do we have at our disposal to make this a success?The first is the patient's desire to restore health, so that he is willing to cooperate with us; the second is the role of reason, and our analysis can strengthen the power of the patient's reason.If we give him a little hint, he can easily use his intellect to discover the resistance, and thus find the idea equivalent to the resistance in the subconscious.If I tell you: "Look up at the sky, you will see a hydrogen balloon", or if I just ask you to look up at the sky and ask what you can see, it is of course under the former condition that it is easier to see a hydrogen balloon .Just as a student uses a microscope to observe things for the first time, the professor must tell him what he is looking at, otherwise, even if there is something under the microscope, he will not be able to see anything.

Now, let's discuss some facts.With regard to the various forms of psychosis, e.g., hysteria, anxiety psychosis, obsessive-compulsive psychosis, etc., our theories are very solid.Wherever the repressions, resistances, and ideas controlled by repressions we find in this way, the resistances and repressions disappear and the subconscious thoughts come into consciousness.When we implement this method, we immediately feel that whenever a resistance is overcome, there is a fierce duel in the patient's heart, and the normal balance of psychological conflicts in the same field is the driving force for aiding resistance. , the other side is the motivation to dispel resistance.We hope to resolve this contradiction and eliminate the symptoms.We have thus succeeded in reviving as our new contribution a strife which had previously been temporarily reconciled by repression.That is: first of all, to make the patient understand that the old method is enough to cause disease, and the new method will inevitably restore health; secondly, to inform the patient that the situation is very different after those instinctive impulses are resisted.The ego was weak then, and tried to recoil in fear of the many dangers of libido; now the ego is strong and experienced, and has the help of a doctor.We wish, therefore, to reintroduce this contradiction to a more satisfactory result than repression; and if you doubt it, we cite successful cases of treatment in hysteria, anxiety psychoses, and obsessive-compulsive psychoses.

In addition, with respect to other types of mental illness, although the situation is similar, our treatment methods are not effective.In these diseases, too, there arises a conflict between ego and libido which forms repression, and this conflict which forms repression differs somewhat in situation from that of transference psychosis.In the same way we go back in the patient's life to the point at which the repression occurred; The gap happens to be good for a good ending to the conflict.But we have not succeeded in overcoming a hindrance, in making a resistance disappear.For example, patients with paranoia, depression, and schizophrenia may not be affected by psychoanalysis.What is the reason?Is it because of lack of intelligence?A certain amount of intellect is required for psychoanalytic treatment, but is it inferior to the brightest paranoiacs who can make deductive inferences?The other dynamics were not lacking; the depressive, unlike the delusional, had a deep awareness of his own suffering, but this did not make him susceptible to the influence of psychoanalysis.So, we come across something we don't understand at all, and we can't help but wonder if we're really capable of understanding and treating other mental illnesses.

(End of this chapter)