The Problem of Lay-Analyses

THE PROBLEM OF LAY-ANALYSES — I — II — III — IV — V — VI — VII — VIII

It appears to me that the title of this treatise may require an explanation. Let me, therefore, state that the problem of Lay-Analyses expresses itself most succinctly in the question of whether medically untrained laymen should be permitted to practise psychoanalysis.

This problem, timely in general, is subject to national laws.

It is a timely question, in so far as, up to now, apparently nobody ever cared who was practising psychoanalysis. As a matter of fact, too little attention was paid to the question into whose hands the employment of this new science was entrusted, with unanimity prevailing only in reference to a more or less strong tendency to wish that nobody at all should 28practise psychoanalysis. There were different reasons for this well-nigh general aversion.

The demand, then, now put before the legislatures of certain countries, that only physicians be permitted to apply psychoanalysis proves that, after all, a new, and apparently more tolerant opinion is becoming prevalent, as regards the recognition of our science. This new trend of putting the stamp of official and scientific approval on psychoanalysis, by reserving the monopoly of its application to medically trained men, must, however, first successfully clear itself of any and all suspicion of being nothing other than just a modification of the resistance hitherto shown towards psychoanalysis. Today, at last, it is admitted that, under certain circumstances, psychoanalytical treatment is in order. However, if it is to be applied, certain countries stand ready to impose the restriction that licensed physicians only shall be permitted to administer this treatment.

The problem before us right now, then, is why only physicians should be permitted to practise psychoanalysis. This is a problem 29subject to national laws. In the United States and Germany, for example, this problem does not amount to more than just an academic discussion, because in these countries a patient may receive treatment from anybody he chooses. In these countries, anybody who feels the inclination may treat, as a “quack” to be sure, “cases,” provided he stands ready to assume full responsibility for the effect of his treatment. Not before the authorities are actually appealed to to retaliate for such tangible harm as a patient may have suffered from the hands of an unlicensed practitioner of psychoanalysis, does the law interfere in the United States, Germany and many other countries.

In Austria, however, where I am writing this treatise, bearing in mind the special conditions which prevail there, in regard to the administration of psychoanalytical treatment, the authorities employ the law of the country as a preventive. In my country, without considering ultimate results, the law, in sweeping restrictions, enjoins all and sundry laymen from treating ailing people.

30In the Republic of Austria, therefore, there is a very practical aspect to the question of whether laymen should be permitted to treat ailing people with psychoanalysis. As a matter of fact, under present conditions, this question seems to be settled since it is already answered by the wording of the law, now appearing on the statutes of my country: Nervous people are unquestionably sick people; laymen are doubtlessly no licensed physicians; psychoanalysis is a remedy for the healing, or improvement, of nervous disorders. As in the eyes of the law, the latter are considered diseases and the treatment of all such ailments reserved for licensed physicians exclusively, laymen are liable to severe punishment when employing psychoanalysis for the treatment of nervous people.

In view of this plain state of affairs, one scarcely dares to approach the question of permitting the laity to practise psychoanalysis in Austria. However, in spite of the obviousness of the situation as a whole, there are some additional aspects to the question which, 31albeit the law does not take cognisance of them, should nevertheless be considered.

It may develop that in connection with psychoanalysis, people in need of treatment are not sick people, in the broad meaning of this term; laymen not always to be considered laymen, nor physicians what physicians are generally supposed to be—the very premise upon which these physicians base their claims. If such a state of affairs becomes apparent, it would be justifiable to insist upon a modification of the law, prohibiting the unlicensed practise of medicine, as far as the application of psychoanalytic treatment is concerned.

Whether this modification shall be enacted as a law will depend mostly on people who may not be expected to know the peculiarities of analytical treatment. It will be our task, therefore, to instruct these impartial referees, these typical laymen whom we will assume, for the time being, are completely uninformed. It is regrettable that we cannot arrange for them to attend an analytical treatment in the rôle of an observer. It is one of the peculiarities of the “analytical situation” that it will not suffer the presence of a third party.

Moreover, individual sessions are liable to be very unequal, as regards the information they may yield. Mr. Referee happening in at an analytical session, would probably not profit to any great extent. As a matter of fact, he might altogether misinterpret that which is discussed between the analyst and the patient. 33He may even become downright bored with the proceedings. Therefore Mr. Referee must needs be satisfied with the information we shall presently impart to him, endeavoring to set it forth as lucidly as possible.

Let us assume that the patient is suffering from attacks of moodiness, which he is unable to control, or else is the victim of a despondency so depressing as to paralyse his energy, causing him to lose all confidence in himself, manifesting extreme self-consciousness when among strangers. Without grasping the underlying elements of his case, the patient may observe that not only the discharge of his daily duties becomes more and more arduous for him, but also that he experiences difficulties when called upon to make a decision or embark upon some enterprise.

One day—utterly ignorant of the exact cause—he succumbs to an attack of fear. From then on, he is unable to cross a street alone, or board a train, without fighting off a certain inarticulate fear. This condition, as a matter of fact, may even become so pronounced as to render it absolutely impossible for him to 34cross a street, or board a train, unaccompanied.

Or—what appears very peculiar to him—his thoughts “wander”; they are no longer subject to his will. They attach themselves to problems which, in reality, do not interest him at all but which he is, nevertheless, unable to dismiss from his mind. He imposes perfectly ludicrous tasks upon himself, such as counting the windows along the street. When attending to simple functions, such as mailing a letter or turning off the gas, doubts harass him a few moments later, as to whether he has really dropped the letter into the mail box and whether he actually turned off the gas.

Perhaps such a condition is merely annoying at first, but it becomes intolerable when, in advanced stages, it proves impossible to shake off such preposterous ideas as having flung a child under the wheels of a car, or thrown somebody from a bridge into the river, or being haunted by the terrifying doubt of whether he is not in reality the murderer the police are trying to apprehend for the latest spectacular crime.

35All these delusions are utter nonsense, as he himself very well knows. He has never done any harm to anybody, but if he really were a fugitive from justice, this obsession, this feeling of contrition could not be stronger.

To take another case:—this time of a female patient, who is suffering in an entirely different way, presenting entirely different symptoms. We will assume that she is a pianiste, who suddenly experiences cramps in her fingers and discovers herself unable to play. As soon as she thinks of attending a social affair, she immediately feels the necessity of obeying a recurrent natural need, making it impossible for her to leave her own house. Thus, she has been forced to give up mingling with her friends, or attend dances, the theatre, or concerts.

At the most inopportune moments, she becomes the victim of headaches or other painful sensations. Eventually, after meals, she feels impelled to yield to nausea, a condition which, if prolonged, may become dangerous. Finally, she becomes absolutely unable to 36stand any of those little excitements which cannot be eliminated from daily life. Upon such occasions, she readily faints. As these spells are frequently complicated with muscular spasms, such attacks assume the aspect of dreadful afflictions.

Still other patients become subject to disturbances in a sphere where bodily functions coördinate with manifestations of sentiment. If men, they find themselves unable to give physiological expression to those tender urges that induce them to gravitate towards the other sex. On the other hand, all these physiological reactions may be at their command when not aimed at the person they cherish most. Then, there are still other cases, when bonds of sensuality will tie them to persons whom they actually despise and of whom they have the most earnest desire to free themselves. Or their sensuality imposes urges upon them whose fulfillment causes them to shudder.

If they be women, such patients, on account of fear or disgust, or from some other restraint of unknown origin, become unable to perform 37those functions which their sex imposes upon them. In cases where they have yielded to the prompting of passion, they discover that that gratification is withheld from them which nature normally offers as a reward for such complacency.

Sooner or later, all such persons come to consider themselves as sick and appeal to physicians, expecting to be cured of their nervous ailments. Physicians have classified these manifestations, diagnosing them differently, according to their own personal point of view. These ailments are listed under such terms as neurasthenia, psychasthenia, phobias and neuroses of different kinds, and with that sweeping term hysterics. The parts of the body inducing such disturbances are examined: the heart, the stomach, the intestines, the sex organs, and all are found to be in the best of condition. The physician then advises the patient to change his mode of living, to take a vacation, to exercise. Thus, with perhaps the aid of mild stimulants, the patient’s condition may, or may not, be temporarily relieved.

38Eventually, the patient is informed that there are certain practitioners who specialize in the treatment of just such ailments, and thus they come to be psychoanalysed.

Mr. Referee, whom we will assume is present, has impatiently listened, while we have given an account of the nervous disturbances with which one may be afflicted. Mr. Referee suddenly becomes attentive, expressing his growing interest in these words: “Well, now at last we shall see what the psychoanalyst will do with the patient, whom physicians could not help.”

To all appearances, nothing takes place between patient and psychoanalyst except that they talk with each other. The psychoanalyst does not take recourse to any instruments, while examining the patient, nor does he write out prescriptions. If it can be arranged, he will not even take the patient out of his usual surroundings, or upset his daily routine in any way, while treating him. Such a procedure is, of course, not of indispensable necessity, quite frequently proving impossible to arrange. Usually the analyst simply makes an 39appointment with his patient, then lets him talk, listens to him, lets him talk again and listens once more.

Mr. Referee now clearly manifests relief but, at the same time, his face also assumes a disdainful expression. Apparently, he thinks: “Is that all? ‘Words, words, words,’ as Prince Hamlet says. Is psychoanalysis perhaps some sort of magic rite, employing mere words with which to chase away a patient’s ailment?”

Quite right! It surely would be magic if it would only work faster. One of the indispensable essentialities of magic is quickness, sudden results. But psychoanalytical treatment demands months, sometimes even years. Proceeding at such a snail’s pace, it loses the character of anything resembling magic.

As far as “words, words, words” are concerned, they are surely not to be looked down upon. Words, after all, are a powerful instrument, the means by which we express our feelings to each other, the agent through which we influence one another. Words are able to benefit us in the extreme, or liable to hurt us to the quick. Doubtless, “in the beginning was 40the Deed” and the Word came only later. Under certain circumstances, the reduction of the Deed to the mere Word may even prove a cultural achievement. At any rate, the Word was originally an implement of sorcery, a magic manifestation which even today still retains much of its old potency.

Mr. Referee now remarks: “Assuming that the patient is not any better prepared for the understanding of psychoanalytical treatment, than I myself, how are you going to induce him to believe in the Magic of the Word, that is to deliver him from his sufferings?”

Of course, some preparatory work is necessary, but that is easily accomplished in a simple manner. The patient is asked to be absolutely frank with the psychoanalyst, not to withhold intentionally anything that crowds itself into his mind, and to overcome gradually all such influences as may exert themselves to prevent certain of his thoughts or memories from being communicated to the psychoanalyst.

There is not one of us but does not know 41that there are certain things which we hate to tell anybody else, or which we are utterly unable to express at all. These are the so-called “most intimate” things. We also surmise—and this proves the great progress that has been made in the psychological understanding of our Selves—that there are some other things which we hate to admit to ourselves, which we try to hide from ourselves and which, once they are accidentally touched upon, we immediately endeavor to crowd out of our thoughts.

Doubtless, the root of a very remarkable psychological problem manifests itself in the fact that there are certain of our thoughts which we try to hide from our very own Self! That would seem to indicate that our very own Self is not an indivisible unit, as we have always considered it! Rather, that there is a certain something which may rise in opposition to our very own Self! Vaguely, then, we surmise that our own Self and our soul life may be two different things! If, now, the patient submits to the demand of psychoanalysis to express everything in words that comes 42to his mind, he comes to believe that an interchange of thoughts, under such extraordinary conditions, is liable to lead to extraordinary results.

“I understand you very well,” Mr. Referee says. “You simply assume that everybody suffering from a nervous disturbance is harboring something that depresses him, some dark secret, perhaps, and by inducing him to impart this secret to you, you relieve him of that depression, thus alleviating his suffering. That, after all, is the very principle of the Confessional which the Catholic church has employed for centuries to wield her influence over her communicants.”

Yes and no, is our answer to this. The Confessional, to a certain extent, may be considered as belonging into the realm of psychoanalysis; leading up to it, as it were. However, the Confessional as such is far removed from coinciding with the very being of psychoanalysis, and it is unable to explain the results of psychoanalytical treatment. In the Confessional, the sinner tells what he knows, but in the Analysis, the neurotic is expected to reveal 43much more. Besides, there are no known cases where the Confessional proved effective enough to remedy direct symptoms of ailments.

“Then I don’t understand you after all,” Mr. Referee interjects. “What do you mean by stating that the neurotic is ‘expected to reveal more’ in the course of psychoanalytical treatment? Of course, I can very well imagine that you, as a psychoanalyst, may wield a greater influence over your patient than the Father Confessor over a penitent, for the simple reason that you become better acquainted with him, employing your growing influence to talk unhealthy thoughts out of your patient, as it were, disseminating his apprehensions, and so forth. Frankly, it appears most remarkable to me that by such a procedure, it should be possible to alleviate purely physical manifestations, such as nausea, diarrhœa, and cramps. I know that such results are possible by taking recourse to hypnosis. Most probably, through prolonged association with your patient, you gradually succeed in establishing hypnotic relations between you and him. By 44this I mean that you inadvertently come to exert upon him a suggestive influence. Thus, the miracle wrought by your therapy is nothing other than the result of hypnotic suggestion. However, as far as I know, results by hypnotic therapy are procured much quicker than by psychoanalysis which you yourself admit takes months, and sometimes even years.”

After all, Mr. Referee does not seem to be so utterly uninformed and helplessly at sea as we had considered him in the beginning. Doubtless, he is eagerly bent upon grasping the essence of psychoanalysis, on the basis of certain knowledge which he has acquired. He endeavors to connect psychoanalysis with something he already knows.

Thus, he forces upon us the difficult task of explaining to him that he will never succeed in comprehending psychoanalysis in this way, because psychoanalysis is a process sui generis, something new and peculiar, understandable only with the assistance of new conceptions, or presumptions.

However, we still owe our inquisitive friend a reply to a point raised by him.

45What you, Mr. Referee, mentioned before about the personal influence exerted by the psychoanalyst on his patient, should not go without comment. Such an influence actually prevails in the analysis, playing an important rôle. However, this influence is utterly unlike the influence induced by hypnosis.

I shall have to prove to you that the situations in these two cases decidedly differ from each other. However, for the time being, the statement may suffice that this personal influence—this “suggestive element” if you wish—is not drawn upon for the purpose of suppressing symptoms of nervous afflictions analogous to treatment by hypnotic suggestions. Besides, it is absolutely wrong to assume that this “suggestive element” is the agent and promoter of analytical treatment. It may be that such is the case right at the beginning of the treatment. Later, however, this very same “suggestive element” proves itself an opposing factor, forcing us to resort to extensive counter-measures.

Just let me explain to you how thoroughly opposed the technique of analysis is to anything 46and everything resembling the hypnotic technique of diverting or dissipating a patient’s apprehensions.

Assumed that our patient is obsessed with an intense feeling of being guilty of, say, some horrible crime, we do not advise him to stifle the qualms of his conscience simply on the strength of the fact that there is no doubt as to his innocence. He himself has already proceeded along this trend of reasoning, but to no avail. On the contrary, we try to impress him with the possibility that there may be something tangible at the bottom of so profound a feeling of guilt, and that it may be possible to detect this disturbing something.

“I should be greatly astonished,” Mr. Referee interrupts, “if you could really assuage your patient’s feeling of guilt by agreeing that there may be some tangible reason for his apprehension. But what is the mode of procedure which is applied in your analysis, and to what treatment do you subject your patient?”

To make myself perfectly plain to you, it will be necessary for me to acquaint you with certain psychological teachings which are not known beyond the circle of analysts and accordingly, not appreciated beyond this group. On the basis of this theory, it will be easy for you to deduce what we expect of the patient and how we go about obtaining it.

In explaining matters to you, I will allude to our theory dogmatically, as if it already were an accepted doctrine. Nevertheless, I do not want you to assume that our theory, as I shall presently put it before you, came into being as a fully developed, well-rounded out philosophical system. The development of our theory came about only very gradually, little by little, and was built up through continuous contact with observations. Moreover, our theory, in accordance with these observations, was continually modified until it 48finally evolved in a manner apparently satisfactory for our purposes.

Only so short a time as a few years back, it would have been necessary for me to express this theory in somewhat different terms. And even today, I cannot guarantee that the terms I am using are definitely fixed and will not be modified again. You know very well that scientific truths do not burst upon us with the unexpectedness of a sudden phenomenon. As a rule, any science, long after its early stages, lacks the character of definiteness, unchangeability, and infallibility for which our human way of thinking longs so intensely. However, any science, as it presents itself to contemporaries, is science as its best, so far as contemporaries are able to judge.

My introductory remarks, I hope, will assist you in gaining a correct perspective in reference to psychoanalysis, especially when I ask you to bear in mind that our specific science is still very young—hardly as old as our century, as a matter of fact—and deals with about the most difficult matter presenting itself to human research. Let me therefore 49encourage you to interrupt me unabashedly in my explanations, when you do not grasp the full meaning of my words and require further elucidation.

“I am already interrupting you, even before you really start. You say that you are going to acquaint me with a new psychology. But I was always under the impression that psychology as such is no new science. As a matter of fact, it seems to me there always has been enough psychology and enough psychologists. In college, I learned of the great things achieved in this realm of human endeavor.”

Far be it from me to deny these achievements. However, scrutinizing them closely, you will find that they rather belong in the category of sensory psychology. A doctrine of soul life never had a chance for development, because its conception was obstructed by one very essential misunderstanding. After all, what does psychology embrace today, as it is taught in colleges? Aside from a few important sensorimotoric perceptions, there are just a number of classifications and definitions referring to certain processes of the soul 50which, thanks to the fact that these terms have become a part of our living language, are now the common property of all educated people. To all appearances, such limited information does not enable us to clearly grasp our soul life.

Did you ever notice that every philosopher, poet, historian and biographer evolves his own psychology, based on individual presumptions, in regard to the connection and the ultimate purpose of psychological phenomena, all of which are more or less acceptable but altogether and equally unreliable? Seemingly, a common foundation is missing. Thus it happens that in the realm of psychology, there is an utter lack of respect and authority. There, obviously, anybody is permitted to “poach” or “freelance” to his heart’s content.

If you touch upon a question of physiology or chemistry, nobody will dare speak up, unless he is in possession of authentic information. However, when discussing psychological questions, you may expect everybody to venture an opinion, or raise his voice in protest. 51Evidently, there is no “professional knowledge” in his realm! Inasmuch as everybody has a soul life, everybody considers himself a born psychologist.

There is a story of an old woman who offered her services to take care of babies. When asked whether she knew anything about babies, her answer was: Why, sure, haven’t I been a baby myself once?

“And this common foundation of soul life, overlooked by all psychologists, you claim to have discovered through the observation of ailing people?”

I do not believe that the origin of our findings minimizes their value. Embryology, for example, would not enjoy any confidence as a science if it were unable to explain clearly the origin of pre-natal deformities.

You will remember that I have mentioned before persons whose thoughts insist upon travelling their own way. To such an extent as a matter of fact, that such persons are forced to ponder about problems which do not interest them at all.

Do you believe that psychology, as generally 52taught, will be in a position to render even so much as the slightest assistance for the explanation of such anomalies? And after all, there is not one of us whose thoughts, during the night, do not travel their very own way, creating visions which we are unable to interpret, which we are at a loss to understand, and which frequently appear to be, to an almost disquieting extent, products of morbidity.

I am now referring to our dream life! Among the majority of people, the opinion always prevailed, and still prevails, that there is an inherent meaning to dreams, that some attention ought to be paid to our nocturnal visions, that a certain interpretative value is attached to them. Orthodox psychologists have never been able to interpret the meaning of dreams. To them, dreams were something with which they did not know what to do. And as soon as orthodox psychology tried to interpret our dream life, their explanations ventured far afield from psychology proper. Dreams, according to them, were nothing other than the result of physiological sensations, originating from an unequal soundness 53of sleep in different parts of the brain. I venture to state right here, that any psychology unable to explain the essence of our dreams is also inapplicable to the understanding of normal soul life and cannot be expected to be recognized as science.

“You are becoming so aggressive that I surmise one of your sensitive spots has been touched upon. I have heard before that in psychoanalysis great value is attached to dreams, that dreams are interpreted and behind them old memories of actual events are sought. On the other hand, I also know that the interpretation of dreams is left to the arbitrary conception of the analyst and that the analysts between themselves have frequent squabbles, in regard to the question of how to interpret a certain dream and the justification of arriving at certain conclusions. If this is really the case, I do not think you should stress the advantage of psychoanalysis, in regard to orthodox psychology.”

There you have said something very appropriate. It is only too true that the interpretation of dreams in theory, as well as practice of 54psychoanalysis, has achieved incomparable importance.

If at this point, I appear to be aggressive to you, this must be looked upon as a defense mechanism. When I reflect upon all the nuisance brought about by some of our analysts in connection with the interpretation of dreams, I could despair. I feel like quoting the pessimistic truism of our great satirist Nestroy, who once said: “Any progress is only half as great as it seems to be in the beginning!” But haven’t you noticed that we mortals are always bent upon confounding everything and distorting it? Nevertheless, with a little caution and self-training, most of the dangers lurking behind the interpretation of dreams can be avoided.

But it will never be possible for me to get down to the explanation of our new science which I promised you, if we continually digress.

“If I understood you correctly, you were going to speak about the fundamental presumptions underlying the new psychology.”

It was not my intention to start with that. 55Rather, I intend to tell you what we have learned of the soul apparatus, in the course of our analytical studies.

“What do you mean by ‘soul apparatus’ and what is it made of, may I ask?”

You will soon enough see what the soul apparatus is. It is irrelevant to ask of what material it is made, as this question has no psychological interest. As far as psychology is concerned, the question of material is just as unimportant as the question would be in the realm of optic, of whether a telescope is made of metal or cardboard. The question of matter does not enter here at all, but there is great importance attached to the aspect of space.

This obscure soul apparatus, which serves as the agent for all processes of our soul, is conceived by us as an instrument consisting of several parts. Each of these parts we shall call a stage. There is an individual function attached to each of these stages, and all of them are correlated to each other in reference to space. Aspects of space like “near” and “far,” and “above” and “below,” for the time being, only serve to illustrate the regular sequence of 56the functions allotted to the different stages of the soul apparatus.—Do you still follow me?

“Hardly! However, I hope I will understand you eventually. At any rate, your explanation appeals to me as a somewhat peculiar description of the anatomy of the soul, which, according to biologists, is nonexistent.”

I will grant that what you call my “somewhat peculiar description of the anatomy of the soul,” is merely a parallel drawn upon for the purpose of elucidation, as is so often done in sciences. In the early stages of a new science such parallels have always been quite primitive,—open to revision, as it were. I consider it superfluous to strengthen my argument by referring to the frequently applied “if,” as is quite popular in such cases. The actual value of such “if” argumentations—“fiction” the philosopher Vaihinger would call it—greatly depends on how advantageously this argumentation may be applied to the case in question.

However, for argument’s sake, let us accept the popular conception and assume that within 57us there is a psychical organization, recording sensations and perceptions of physical wants on one hand, and releasing motoric actions on the other. This medium for establishing this definite coöperation we call the “I.”

Of course, this is nothing new. Each one of us takes this for granted, if he is not a philosopher, and some despite being philosophers. However, our description of the psychical apparatus is not by far complete.

Aside from the “I,” we perceive another region of the soul, much more extensive, much more impressive, and much more obscure than the “I,” which we designate the “It.”

It is the relation between the “I” and the “It” upon which we shall dwell first.

Doubtless, you will raise an objection against our intention to refer to these two regions or stages of the soul with simple pronouns, instead of giving them beautiful euphonious Greek names. However, in psychoanalysis, we prefer to remain in contact with the popular way of thinking, and attach commonplace terms to our scientific conceptions, rather than look upon such nomenclature in 58contempt. We do not expect to receive credit for this popularization of psychoanalytical terms, inasmuch as we are forced to do this in order to make ourselves plain to our patients who are frequently very intelligent, but not always exactly learned people.

The impersonal pronoun “It” is most appropriate for our purposes, as is plainly proved by the fact that we frequently speak of something, averring that “‘It’ came to me quite suddenly”; “‘It’ gave me a shock”; “‘It’ was stronger than I.” “C’était plus fort que moi.”

In the realm of psychology, we can only make ourselves understood by taking recourse to comparisons. This, after all, is no special peculiarity of psychology, inasmuch as other sciences also find it necessary to avail themselves of analogous expedients. These comparisons, however, must be modified time and again, as their application generally proves too limited. If you are seeking an explanation of the relation of the “I” to the “It,” it would be well to remember that the “I” serves as a foreground to the “It.” The “I” is, as it were, the outer, front layer of the “It.” We may so 59much more readily accept this comparison, inasmuch as layers—say, of a tree—owe their peculiar characteristics to the modifying influence of that exterior medium with which they are in contact. Thus, we visualize that the “I,” being the outer layer of the psychical apparatus, is the “It,” modified in accordance with the influence which the outer world exerts upon it.

Here you will perceive how conceptions of space apply to psychoanalysis. To all intents and purposes, the “I” is actually the front layer, the obvious, whereas the “It” is the inner layer, the hidden. To make it even more plain: The “I” is inserted between the reality of the outer world and the “It,” the latter constituting the soul proper, the essence of the soul, as it were.

“I am not going to inquire how you came to know all this. I should first like to know how this differentiation between the ‘I’ and the ‘It’ assists you in your psychoanalytical work, and why you need it.”

Your question clearly shows me how to proceed.

60It is most important and extremely valuable to know that the “I” and the “It,” in many instances, greatly differ from each other. As far as the “I” is concerned, psychical activations are subject to a different rule than the one applying to the “It.” The “I” has different intentions from the “It,” availing itself of means other than those resorted to by the “It.”

Of course, much could be said in this respect, but perhaps it will be best if I give you a new comparison and a new example. Just remember the differences which developed, during the late war, between the actual front and the hinterland. We were apparently never surprised to observe that there were certain things going on at the front, utterly different from analogous developments in the hinterland, and that in the hinterland many a thing was permissible which had to be strictly prohibited at the front. In the war, the deciding factor, of course, was the proximity of the enemy. In our psychical life, the deciding factor is the proximity of the outer world. Remember that in ancient times “outside,” “strange,” “hostile,” used to be identical conceptions.

61And now, the example I promised you: The “It” is never assailed by any conflicts. Within the “It,” contradiction and opposition dwell undisturbed in close proximity to each other, frequently equalizing one another by means of compromise. However, while the “It” thus remains undisturbed, the “I” cannot avoid facing conflicts, and the only way for the “I” to escape the dilemma is by renouncing some particular intention, or urge, for the benefit of the other.

The “I” is controlled by a very remarkable trend for unification, for synthesis—a characteristic utterly lacking in the “It.” The latter never manifests such unity of intention, but rather displays a tendency towards dissipation and a diversity of aims, utterly independent of one another, and without regard to each other.

“If there really is such an important hinterland of the soul, how do you explain the fact that it was never discovered before the advent of psychoanalysis?”

By this question, you are leading us back to one of your former inquiries. Let me advise 62you, then, that orthodox psychology blocked its own way to the “It,” by holding on tenaciously to a presumption which, in itself, seemed obviously enough but which, nevertheless, cannot be successfully sustained any more. It was presumed that all psychical activations are conscious, that consciousness is the characteristic of any psychological process, and that if there really were unconscious processes of our brain, these processes did not deserve to be termed psychological processes, having nothing at all to do with psychology proper.

“I should say that this is self-evident!”

Of course. That is exactly what all the orthodox psychologists claim. However, it is easy enough to prove that such a view is incorrect, or rather amounts to an impractical separation. Observing ourselves, we easily perceive that many of our thoughts could not have arisen unless they were induced by certain premises. However, of the preparatory stages of these thoughts, which must have been psychical, too, we are unaware, inasmuch as only 63the complete result enters into our consciousness. Once in a while, it may be possible for us to reconstruct the development of a thought by retrospective contemplation.

“Most probably, our attention had been diverted so that we missed observing the development of the thought in the making, so to speak.”

That’s just an obvious excuse!—insufficient to obscure the fact that quite frequently psychical activations—and often highly complicated ones, too—may occur in our soul life without our becoming actually aware of them. Alas, you may be ready to accept the hypothesis that just a little more or less of your “attention” may prove sufficient to transmute a non-psychical action into a psychical one. But why squabble? The existence of unconscious thoughts has been proven in hypnotic experiments, time and again, to the satisfaction of everybody.

“I don’t wish to deny that, and I actually believe I am now beginning to understand you at last. What you are terming the ‘I’ is the 64Conscious while the ‘It’ describes the so-called Subconscious, which is so much discussed just now. But why, pray, this masquerade of new terms, if I may ask?”

This is no masquerade, inasmuch as other terms cannot be employed here properly. Besides, let me ask you not to substitute literature for science. If somebody refers to the Subconscious, I don’t know whether he is alluding to it as a stratum, that is, something dwelling in the soul beneath the Conscious, or whether he refers to it as to quality, that is, another consciousness, a subterranean one, so to say. To be sure, the greatest probability seems to be that anybody juggling such terms is himself not at all sure of what he really means. The only permissible differentiation is one between Conscious and Unconscious.

Nevertheless, it would be a severe error to believe that a differentiation between Conscious and Unconscious would be analogous to a differentiation between the “I” and the “It.” It would be too wonderful, if it were as simple as all that, and it would be easy going for our theory then. But, it is not so 65simple! Correct only is that everything that occurs within the “It” is and remains unconscious, and that only activities of the “I” may become conscious. However, not all these activities are conscious, nor are they always conscious, nor do they necessarily have to become conscious. Parts of the “I” may remain permanently unconscious.

The penetration into Consciousness of a psychical process is quite complicated. I cannot avoid demonstrating to you—dogmatically once more—what our hypothesis is in this respect. You will remember that the “I” is the outer, peripheral layer of the “It.” We now assume that on this outermost surface of the “I,” there is a peculiar device, a system, an organ if you wish, by whose exclusive actuation that phenomenon is created which we call Consciousness. This organ may be actuated from the outside—that is, our sensory nerves may convey to it sensations of an outer world—as well as from the inside, where first it may perceive the sensations from the “It” and, later on, the processes of the “I.”

“This is getting worse and worse, and more 66and more beyond my understanding. Did you not invite me to discuss with you the question of whether or no, medically trained laymen should be permitted to apply psychoanalysis? Why, then, all these ramblings of vague and dark theories, whose correctness you will be unable to prove to me?”

Only too well do I realize that I cannot convince you. As that would be beyond all possibilities, I have, therefore, surrendered such intentions. Even when instructing our own disciples in the theory of psychoanalysis, we always observe how little impression we make on them in the beginning. They accept the analytical teachings with just as much equanimity as any other abstractions which have been fed to them. Some of them may have the earnest desire to be convinced, but there is no trace that they ever really are convinced.

We demand that anyone who intends to analyse somebody else, should first submit to an analysis. Only if in the course of this “self-analysis”—as it is usually incorrectly called—a 67disciple experiences the truth of psychoanalytical teachings on his own body—or rather on his own soul—then, and only then, he gains those convictions which later on will guide him in his work as an analyst.

How, then, may I expect to convince you, Mr. Referee, of the correctness of our theories, especially as I can only give you an incomplete, abbreviated, and, therefore, none too lucid outline of psychoanalytical teachings, without your being able to corroborate it through your own experiences?

But such is not my intention at all! We are not discussing here the question of whether psychoanalysis is sense or nonsense, nor whether the premises of psychoanalysis are correct or full of grave fallacies. I am simply presenting our theories to you, because in this way it seems easiest to me to explain to you what is the real essence of psychoanalysis, what are its premises in reference to individual patients, and just what the treatment is that is administered to them. In this way, the problem of lay-analyses is projected in a striking 68light. If you have followed me up to now, you may rest assured that the worst is over and that from now on, everything will be much more comprehensible to you.

And now let me pause for a moment.

“I expect that, on the basis of psychoanalytical theories, you will explain to me how the development of a nervous ailment may be conceived!”

I shall try. For this purpose, however, it is necessary that we study our “I” and “It” from a new point of view. We shall have to look upon these two factors as to their dynamic values, that is, in regard to the forces active in and between them. You will remember that previously we restricted ourselves to the description of the psychical apparatus.

“I am only hoping that things won’t be so impossible to grasp.”

I do not think so. As a matter of fact, I believe that you will soon comprehend the whole system. To start with, let us assume that those forces which actuate the soul apparatus are generated by the different organs of our system, 70as the result of important needs of our body. Don’t forget what the poet-philosopher Schiller once said:

Hunger and Passion are two very powerful agents!

The needs of our body which stimulate the soul into action—actuate the soul, as I referred to it before—we call urges.

It is these urges which fill the “It.” All energies generated by the “It” were incepted by these urges. The powers of the “I” have no other origin either, inasmuch as they are derived from the “It.”

What, now, do these urges want?

They want to be satisfied, that is, they endeavor to create such situations whereby the needs of our body are gratified.

As soon as any tension, created by our urges, slackens simultaneously with the satisfied cravings of our body, our Consciousness experiences 71a pleasurable sensation, whereas an intensification of our urges will soon enough result in decided displeasure. In accordance with these fluctuations of pleasurable and distressing sensations, our soul apparatus regulates its activity. Thus, the rule of the Pleasure Principle manifests itself.

Intolerable conditions develop in case the urges of the “It” are not satisfied. Experience proves that situations of complete gratification can only be achieved in contact with the outer world. Thus, that part of the “It” which faces the outer world, i. e., the “I,” assumes its functions. While the driving power is produced by the “It,” it is the “I” which then assumes the management, takes the steering wheel in hand, so to speak, without which the coveted goal could never be reached.

It is characteristic of the urges of the “It” that they are always bent upon immediate, rash gratification without ever attaining their ends, but frequently exposing themselves to severe harm. Therefore, it devolves upon the “I” to forestall such failure, by mediating between the reckless demands of the “It” and 72the practical outer world. Thus, the censorial activity of the “I” makes itself felt in two different directions.

On one hand, the “I,” assisted by that organ which conveys to it the reactions of an outer world, scans the horizon, as it were, in an attempt to seize upon the most opportune moment for a harmless gratification of the urges prompting it. On the other hand, the “I” exerts a restraining influence on the “It,” controlling its “passions” and inducing its urges to postpone their gratification, or modify them, or renounce them for some compensation, as the case may be.

Restraining the reckless “It” in such a way, the “I” replaces the formerly predominant Pleasure Principle with the so-called Reality Principle which, although striving for the same ends as the Pleasure Principle, nevertheless considers such practical necessities as the outer world imposes.

Later on, the “I” discovers that there is another way of insuring gratification of urges than adaptation to the outer world. This newly discovered method consists of changing conditions 73in the outer world in such a way as to bring about circumstances favorable for gratification. This activity of the “I” constitutes its most supreme achievement. Sufficient discernment to perceive when it is opportune to stifle passions and when it is opportune to either face or fight the realities of the outer world is, after all, the Alpha and Omega of practical wisdom.

“As I understand you, the ‘It’ is by far the stronger of the two. How, then, is it possible that the ‘It’ will permit the weaker ‘I’ to hold sway over it?”

The “I” is well in a position to exert such influence over the “It,” provided its organization and efficiency is in no way hampered. Besides, access to all parts of the “It” must be such as to enable the “I” to bear sufficient influence on the “It.” There is no inherent opposition between the “I” and the “It,” both belonging together. In cases of normal health, it is practically impossible to distinguish between the two.

“All this appears quite clear to me. However, what I cannot understand is that under 74such ideal conditions, there could be any chance at all for disturbances to arise?”

You are perfectly right! As long as the “I” discharges its duties fully, and its relations to the “It” are maintained in a satisfactory manner, no nervous disturbances will develop. However, disturbances are liable to arise at some unsuspected spot. This will not surprise the well-informed pathologist, but merely confirms the fact that the most essential developments and evolvements contain the very germ for diseased conditions and the break down of functions.

“This is too learned for me! I cannot follow you any more!”

I shall have to digress for a little. You will admit that a human being is a puny, helpless thing in comparison to that tremendous outer world, full of destructive agencies. Any primitive being who did not develop a sufficiently strong “I” organisation, is subject to all these “traumata.” Such a primitive being will achieve no more than just a “blind” gratification of its urges, frequently to be destroyed in this way.

75The evolvement of an “I” is, most of all, a step towards insuring maintenance of life. Destruction as such does not teach anything. But after overcoming a trauma successfully, attention will be attracted by similar situations and danger will be signalized by a fear affect—a shortened reproduction of what was lived through during the trauma. This reaction to approaching danger results in an attempt at flight, which is maintained until sufficient strength is generated to oppose the danger arising from the outer world in an active manner, perhaps even by taking recourse to aggression.

“All this seems to be far, far different from what you promised me.”

You don’t realize how close I have already come to the fulfillment of my promise to you. Even in such living beings who later on develop an efficient “I” organisation, this “I” is quite weak in the years of childhood and only slightly different from the “It.”

And now, I ask you to visualize what would happen in case this powerless “I” is actuated by an urge arising from the “It”—an urge 76which the weak “I” would like to resist, because it feels that a gratification of this urge may involve danger, may result in a traumatic situation, a collision with the outer world.

Alas, the weak “I” cannot sum up enough strength to resist.

Then what?

Then, the “I” deals with the danger, arising from an “It”-inspired urge, in exactly the same way that an exterior danger would have to be faced. The “I” makes an attempt at flight, deserting this specific part of the “It” and leaving it to its fate. It refuses all such assistance as it usually renders to urges arising from the “It.” We refer to such a case as a repression of urges by the “I.”

For the time being, danger is thus parried, but to confound inner and outer world is certain to invite punishment. Running away from oneself is a thing that cannot be done! In a case of repression, the “I” succumbs to the Pleasure Principle which it otherwise strives to correct. Thus, it is the “I” upon which damage is inflicted in such cases of repression. This damage consists of the “I” 77experiencing a lasting restriction in its own sphere of rule. The repressed urge is now isolated, left to itself, unapproachable, and cannot be influenced. The repressed urge now goes its own way. Frequently, even after the “I” has attained power, it proves impossible to release this repression. With its synthesis disturbed, a part of the “It” remains forbidden ground to the “I.”

The isolated urge does not remain idle, however. Because normal gratification was denied it, it contrives to compensate itself by engendering psychical derivates which take its place and, connecting with other psychical activations, estrange them to the “I.” Finally, in the form of an unrecognizable substitute, the isolated urge penetrates to the “I” and to consciousness, presenting itself as what is known as a “symptom.”

We now become aware of what a nervous disturbance is. We perceive an “I” hampered in its synthesis, unable to exert any influence on certain parts of the “It.” In addition, the “I” must renounce some of its inherent activities, to avoid new collisions with the repressed 78urge. We perceive an “I” exhausting itself in mostly unavailing defensive measures against symptoms that are nothing other than results of the repression. Moreover, it becomes evident now that in the “It,” some urges have assumed independence. They aim at their own gratification without any concern for the whole, subject only to such primitive psychology as reigns in the lowermost depths of the “It.”

Observing such a state of affairs, we face the quite simple situation in which the “I,” attempting to repress certain parts of the “It,” proceeded in an utterly unsuitable manner. Consequently, the “I” has failed in its intention and now the “It” is taking revenge on the “I.” This revenge of the “It” on the “I” resulted in nothing less than a neurosis.

Accordingly, a neurosis is the result of a conflict between the “I” and the “It,” a conflict—as investigations will show—forced upon the “I,” because the latter insisted on maintaining its state of pliability, in reference to an outer world. The conflict, in fact, is one between the “It” and the outer world. However, 79because the “I,” faithful and true, takes sides with the outer world, it becomes entangled in this conflict of the “It” with the outer world.

Note that the condition of nervous disturbances is not induced by the conflict between the “I” and the “It” but rather by the fact that the “I,” for the purpose of settling this conflict, availed itself of the unsuitable agent of repression. As a rule, conflicts between reality and the “It” are unavoidable, and it is a routine task for the “I” to act as a mediator in such cases. That in the case of this specific conflict which we have under observation just now, the “I” took recourse to repression as agent, is due to the fact that at this time the “I” was powerless and immature. After all, repressions of lasting importance occur exclusively during early childhood!

“What a roundabout route you are taking! However, I shall heed your advice and will try not to criticize you. You were going to explain to me what psychoanalysis assumes to be the reason for neurosis and how such conditions may be combated. There are quite a number 80of questions which I shall ask you later on. At present, I am tempted to venture a theory based on your own trend of thought.

“You have pointed out to me this interrelation between outer world, and the ‘I’ and the ‘It.’ As an indispensable condition for the development of a neurosis, you have mentioned the fact that the ‘I,’ on account of its dependency on the outer world, opposes the ‘It.’ However, is not some other course for the ‘I’ possible? For example, could not the ‘I,’ in such a conflict be simply swept off its feet by the ‘It,’ so to speak, renouncing all dependency on the outer world?

“What, then, happens in such a case?

“Of course, I have merely the conception of the typical lay mind when it comes to visualizing the development of mental diseases, but it seems to me that such diseases may be easily induced if the ‘I’ would really decide to side with the ‘It.’ To all appearances, such disregard for realities is the very reason for mental diseases!”

Of course, I have thought of this myself. I 81even believe this assumption to be correct. But in order to prove this hypothesis, quite a complicated discussion would be necessary. Neurosis and Psychosis, to all appearances, are closely related to one another. However, at some important point, they widely diverge from each other. The partisanship of the “I” with the “It,” in a case of conflict, may prove to be the crossroad where the two seek different directions. In both cases, the “It” would persist in its character of blind obstinacy.

“But, pray, tell me what advice your theory offers for the treatment of neurotic conditions?”

It is quite simple to describe our therapeutic goal: We aim at restituting the “I” and liberating it from its restrictions, restoring to the “I” once more the sovereignty over the “It” which it lost, on account of early repressions. Psychoanalysis, in general, aims at this goal; our whole technique strives for this end. It is up to us to discover those repressions, to induce the “I” to correct them with our assistance, and to settle conflicts more satisfactory than 82by a mere flight. Inasmuch as these repressions are part of our early childhood, psychoanalysis must needs go back to those years of our life.

The way to those mostly forgotten conflict situations, which we must revive in the memory of our “cases,” is pointed out to us by symptoms, dreams, and “free associations” of the patient. Of course, all these hints must first be interpreted, translated, as it were, because these symptoms and dreams, under the influence of the psychology of the “It,” have assumed various disguises which it is our purpose to penetrate.

If a patient communicates to us certain ideas, thoughts and memories after long hesitation only, we feel safe in assuming that they have some connection with his early repressions, or are, at least, derivates of such. By encouraging the patient to conquer his hesitancy when talking to us, we are training his “I” to overcome its tendency to “run away” and rather face that early repression. At the end, after we have been successful in reproducing the situation which originally induced his repression, 83the complacency of the patient is splendidly rewarded. The number of years that have meanwhile elapsed prove to be all in favor of the patient. What once scared his immature “I” and threw it into panic and flight, appears to the adult-strengthened “I” nothing more than just a childish bugaboo.

“Everything you spoke of so far pertained to psychology. Frequently it sounded somewhat strange and far-fetched to me and altogether none too clear. But at any rate, everything you said was, if I may say so, clean! I admit, without hesitation, that I have never had more than just superficial information in regard to psychoanalysis. However, I have been told, time and again, that your psychoanalysis deals for the most part, with things to which generally the word ‘clean’ may not be applied readily.

“To be quite frank with you: I have a slight suspicion that, up to now, you have intentionally avoided to touch upon this phase of psychoanalysis.

“There is still another doubt in my mind which I cannot suppress:—Neuroses, as you said yourself, are the result of disturbances of our soul life. How is it possible, then, that such 85important factors as our ethics, our conscience, our ideals, apparently do not enter at all into the development of these far-reaching disturbances?”

I understand you quite well. It appears to you that in the information I have given you so far, I have attached insufficient importance to the most vulgar, as well as the most sublime aspects of the matter. The reason for this is simply that, up to now, we have not spoken about the substance of psychical life at all.

For once, permit me to delay the progress of our conversation.

I have told you so much about psychology, in order that you may see that our analysis is just a part of applied psychology; to be sure, that part of psychology which is unknown beyond the field of analysis. From this, it follows that it must be the first task of the Analyst to become acquainted with the Psychology of the Depths, or Psychology of the Unconscious, to the very extent it is known today. It will be well to bear this fact in mind, as we shall later on refer to it.

And now, I wish you would explain what 86you meant when referring to the lack of “cleanliness” in psychoanalysis?

“Well, the general impression which prevails is that, in the course of the analysis; the most intimate and the most revolting phases of sex life are aired with all their sordid details. Of course, I do not draw this conclusion from the lecture on psychology you have given me so far! But if this is really true, it would constitute a strong argument in favor of the demand that the practice of psychoanalysis should be restricted to physicians. How else would it be possible to confide such details to persons whose discretion may be open to doubt, and whose character may not warrant such frankness on the part of a patient?”

It is true enough that physicians are privileged characters, as regards sexual matters. In our times, physicians may even examine sex organs, a prerogative denied to them in the dark ages.

However, you wished to know whether sexual matters play an important part in psychoanalysis.

They do!

87There is a necessity for this because, in the first place, frankness is an indispensable condition for the efficacy of the analysis. But don’t forget that, in the course of an analysis, the patient will be just as frank in financial matters. He will give details which he otherwise would withhold, not only from the tax collector and his competitors, but practically from everybody. That such frankness on the part of the patient puts the analyst under a heavy obligation, imposing upon him a severe moral responsibility, I surely do not deny, but rather stress energetically.

The second necessity for airing the sex life in psychoanalysis is proved by the established fact that, among the reasons and causes for nervous disturbances, phases of the sex life play a tremendously important, a most essential part; they may even prove to be the specific reason of such disturbances.

Could psychoanalysis, under such circumstances, do anything else than adapt itself to this state of affairs? The analyst never persuades his patient to venture into the realm of sex. He will never tell a patient in advance: 88intimacies of your sex life are involved here! The analyst permits the patient to start where he feels inclined to start, encouraging him to roam in any fashion that suits his fancy, waiting calmly for the patient himself to touch upon sex matters.

It is one of my strictest rules to remind my disciples time and again: Our opponents are reiterating continuously that we shall run across cases in which the sexual moment does not play any part whatever. Therefore, beware of introducing it into the analysis! Do not let us spoil the possibility of really discovering cases, in which there is no sexual moment. To be sure, up to now, we have never been fortunate enough to detect such a case.

Of course, I know very well that the recognition we give sex life is—admitted or not—the strongest argument of those who oppose the analysis. But is this fact liable to make us waver in our scientific convictions? An argument of this kind only proves how widespread neurosis is in civilized life, when allegedly normal people behave so very much like nervous people.

89At a time when learned societies, with much pomp and circumstance, used to sit in judgment on psychoanalysis—they are not doing it so frequently today!—one of the speakers once commanded special attention as an authority because, according to his statement, he permitted his patients to talk about their ailments. Apparently, he indulged in such tolerance for reasons of diagnosis, and for the purpose of checking up analytical claims. But, this great authority added, as soon as patients start to discuss sex matters, I shut them up!

How does such a procedure strike you?

I regret to report that the learned audience applauded the great authority fervently, instead of denouncing him, which would have been more fitting. That loose logic in which the aforementioned authority permitted himself to revel, I can only explain by assuming that he was all puffed up with that strength which the knowledge of mutual prejudice lent him.

In the course of years, some of my disciples, following a popular trend, undertook to liberate the world from the bonds of sex which 90psychoanalysis is supposed to force upon it. One of them came out with the pronunciamento that sex, in the broad meaning of the term, does not mean sexuality as such, but rather something abstract, something quite mysterious. Another even emphatically declared that sex life was just one of the different phases in which man manifests his inherent driving force for power and rule. These new doctrines received public acclaim—at least for a time.

“I strongly feel like taking sides in this issue. It seems somewhat far-fetched to me to insist that sexuality is not a natural, innate necessity for all living beings, but rather the expression for something else. Just look upon the animal world!”

That does not matter! There is nothing absurd enough that society would not gleefully swallow, if it only pretends to be an antidote against the overpowering might of sex.

By the way, may I not tell you that, to my mind, your present status as an impartial listener, a lay arbitrator, as it were, should not permit you to betray the strong prejudice you 91yourself are manifesting, in regard to the great part the sexual moment plays in the development of neurotic conditions! Do you not think that such a strongly emphasized prejudice may make it impossible for you to render a just verdict?

“I am very sorry to hear you say that! Apparently, you have lost confidence in me. But, pray, tell me, why did you not appeal to some other impartial referee?”

For the simple reason that this other impartial referee would not have thought any differently from you. And in case he would have been ready to admit at once the importance of sex life, everybody would have howled: He is no impartial referee at all! He is one of your own camp followers!

No, I am not the least discouraged and I am not abandoning hope that I shall ultimately succeed in influencing your views. I will admit, however, that the present case is different from the one I have previously alluded to. As far as orthodox psychological argumentation was concerned, it did not matter much for me whether you believed what I 92said or not. It was merely important to impress you with the fact that purely psychological problems were being dealt with. However, when the question of sex is raised, it seems important to prove to you that the strongest reason for your opposition is nothing but a general animosity toward sex, which you have in common with many others.

“Do not forget that I lack the experiences upon which your firm convictions are based.”

Very well, then. I shall proceed.

Sex life is not only something piquant, but also a very serious scientific problem. Many new facts had to be ascertained in this phase of life, many peculiarities. I have already explained to you that it is necessary for the analysis to go back to the years of early childhood because at this time, with an immature “I,” still weak, the essential repressions of a patient are incepted. But childhood has no sex life;—sex life enters with puberty only, is the general claim.

Wrong!

We have discovered that sexual tendencies 93permeate life from very birth. We also ascertained that it is to combat these urges that the infantile “I” resorts to repressions. It is indeed remarkable, is it not, that even the wee babe fights against the very same sexuality against which that learned great authority talked before an equally learned audience;—and later on, those of my own disciples, even, who compiled some new theories!

How is that possible?

The most platitudinous explanation would be that our whole civilization unfolded at the expense of sexuality. However, there is much more to be said about this.

That only now the sexuality of the child has been discovered, ought to drive the blush of shame into our faces. Of course, there were always some specialists of children’s diseases, some baby-wise nurses who knew about it. On the other hand, men, calling themselves “child psychologists,” in the face of these findings, raised a hue and cry and, wringing their hands in desperation, spoke reproachfully of the “Defloration of Childhood!”

94Again and again, sentiment instead of argument! Such tactics are generally resorted to in the course of political discussions.

Of course, the sex life of the child is different from that of the adult. Sexual functions, from the very beginning until they assume those ultimate forms which are well known to us, undergo a process of complicated development. Many component urges, each driving in a different direction, eventually consolidate, ultimately to serve the purpose of propagation.

Not all of the individual component urges prove of equal value, in view of the ultimate task they are called upon to serve. Many of them have to be “re-routed,” refashioned, partially subdued. Such a protracted process of development cannot always be pursued smoothly, without obstacles arising here and there and without engendering partial fixations in the course of the earlier stages. Wherever, in later life, sexual functions are blocked by obstacles of some kind, sexuality—the libido, as we call it—will show a decided 95tendency to gravitate towards such early fixations.

The study of the sex life of the child and its transformations, until full maturity, has also yielded to us the key for the understanding of so-called sexual perversions. These, while generally spoken of with profound disgust, up to then had remained obscure as to their origin. Although this phase of sex life is extraordinarily interesting, it does not serve our present purpose to dwell upon it in detail. To understand all these ramifications of sex life, it is not only necessary to possess sufficient anatomical and physiological information, but also that knowledge which cannot be acquired in medical schools, i. e., a thorough acquaintance with the history of civilization and mythology.

“Up to now, I am still unable to gain a clear conception of the sex life of the child.”

I shall, then, dwell on this phase further. To be perfectly frank with you, I should really hate not to go into it further.

The most remarkable thing in the sex life 96of the child, to my mind, is the fact that its whole, extensive development is completed in the course of the first five years of life. From then, until the beginning of puberty, there is a time when sex remains latent, a time during which—normally—sexuality is not progressing but rather losing in intensity. During these years, the child is liable to abandon and forget much that he has practised and known before.

It is during this period after the first bloom of sex life has withered, that such conceptions of the “I” develop as shame, disgust, morality, destined to serve as support later on, in the storm and stress of puberty, and to direct newly awakened sexual tendencies. This new, second phase of sex life plays a very important part in the inception of nervous disturbances. Apparently, it is only in man that this twofold onset of sex life prevails. It is, perhaps, this which is one of the contributing factors to the truly human prerogative to indulge in neuroses.

Before the advent of psychoanalysis, the early period of sex life had been overlooked, 97just as had the unconscious background of conscious soul life. If you should now suspect that both belong together, you have guessed correctly.

There is abundant material, of the greatest interest as to contents, manifestations, and performances of this early period of sex life,—material, as a matter of fact, that would prove most astonishing.

For example: It will amaze you, no doubt, when I tell you that the baby boy is frequently afraid of being devoured by his father. (Does it not surprise you that I list this fear among the manifestations of sex?)

Let me remind you here of the mythological character of the god Cronus, who eats his own children. How this myth must have astounded you, when it was related to you for the first time! Most probably, you, like the rest of us, did not pause to ponder over it.

Today, we frequently recognize, in such fairytale characters as the carnivorous wolf in Little Red Riding Hood, the child-devouring father in disguise. Let me assure 98you that mythology, as well as the world of fairytales, can be understood only on the basis of the sex life of the child.

It may also surprise you to learn that the male child is beset with fears of having his father rob him of his sex organ, and that this fear of being castrated is of the greatest influence, in connection with the general development of a male child’s character and his sexual tendencies, in later life.

Here is another case where psychoanalysis may draw upon mythology for support. Remember that the same Cronus who devoured his own children, also emasculated his own father Uranos, to be castrated, in revenge, by his son Zeus, who had been saved through the perspicacity of his mother.

In case you are inclined to believe that all that which has been said about the early sexuality of children is just a phantasmagoria of the wild fancies of a psychoanalyst, you must nevertheless admit that these wild fancies are very similar to those ideas which permeated the phantasy of primitive man, of 99which myths and fairytales are the tangible record.

Does it not seem more acceptable and more probable that in the soul life of present-day children, the same archaic moments still prevail, which generally prevailed at the time of primitive civilization? To all appearances, the child, in the development of his soul, simply recapitulates the evolution of his species, analogous to the recapitulation of his physical development, which has long since been accepted by embryology.

Another characteristic of the early sexual life of the male child is that the female sex organ as such does not play any part in it; it has not been discovered for him yet. All interest is directed to the male organ, all attention concentrated on the question of whether this organ is really existent.

We know less about the early sex life of the female child than about that of the male offspring,—a fact not so surprising since the sex life of even the mature woman still presents a “dark continent” to psychology. Nevertheless, 100we know that the female child is extremely sensitive about the lack of a sex organ equal to that of the male child. Accordingly, the girl comes to consider herself inferior to the boy, developing a condition of “Penis Envy,” from which may be traced a whole chain of reactions characteristic of the female.

Another characteristic of the child is that excremental discharges of the body are drawn into the sphere of sexual interest. To be sure, education eventually draws a strict line of demarkation here. Later in life, however, this demarkation line is wiped out, when the stage of “off-color jokes” sets in. Although this may be distasteful to us it is, nevertheless, well known that the child requires some time, before he develops a sense of disgust. Even those who insist upon the seraphic purity of a child’s soul have never dared to deny this fact.

No other manifestation in the sex life of the child is more important than the fact that sexual desires of a child always aim at persons most closely related to him. Such inclinations lean primarily toward the father and the mother; secondarily, toward sisters and brothers. 101While for the boy, the mother is the first object of love, for the girl it is the father, unless bisexual tendencies favor different inclinations. That parent toward whom the sexual tendencies of the child do not gravitate, comes to be considered a disturbing rival and thus, not too rarely, becomes the object of intense enmity.

Be sure to understand me correctly. I do not mean to say that the child is bent upon receiving from the favored parent, only such demonstrations of affection which we adults are wont to consider the very essence of a beautiful relationship between parent and child. In the light of psychoanalysis, there is no doubt that the child desires much more than merely these demonstrations of parental affection. As a matter of fact, the child desires that which we conceive as sensual gratification, though naturally, only to the limited extent of the child’s understanding.

It is obvious enough that the child never surmises the real facts as to the actual physical relations of the sexes, but this ignorance is compensated by impressions and experiences 102deducted from his own observations. Usually, a child’s desires culminate in the wish to give birth to a baby, or beget one, in some vague manner.

Even the little boy, in his ignorance, has this desire to give birth to a child.

Such manifestations, in their entirety, are termed, in accordance with Greek mythology, Œdipus Complex.

Normally, an Œdipus Complex should be abandoned or thoroughly changed, simultaneously with the termination of early sex life. The results of this transformation of the Œdipus Complex are destined to bring about great achievements, to play a big part in later soul life.

As a rule, this transformation is not thorough enough. Therefore, during the period of puberty, the Œdipus Complex may be revived, in which case it is liable to induce dire results.

I am very much surprised that you are still silent. Could this mean agreement?

No doubt, if psychoanalysis maintains that the first sexual desires of a child are of incestuous 103nature, to apply a technical term, there is no question that psychoanalysis has again trodden upon humanity’s holiest feelings, thus once more incurring accusations, disbelief, and opposition.

Psychoanalysis always had to face grave incriminations, but nothing has robbed psychoanalysis of a favorable opinion on the part of its contemporaries more than the conception of the Œdipus Complex, as a general human characteristic, decreed by fate.

To be sure, Greek mythology must have similarly interpreted the Œdipus situation, but the majority of our contemporaries—be they learned or not—prefer to believe that nature herself has endowed us with an inborn disgust, as a protection against the possibility of an incestuous trend.

But here we may refer to history for corroboration. When Cæsar met Egypt’s youthful queen, soon to play such an important part in his life, Cleopatra was married to her younger brother Ptolemy. This was nothing extraordinary in Egyptian dynastic tradition. The Ptolemæëns, originally of Greek extraction, 104had simply continued a custom practised for thousands of years by their predecessors, the old Pharaohs. Incestuous relationships, a common practice at that time, were after all, only between brother and sister, which even today evokes a comparatively mild judgment. But let us turn to our most important witness—mythology—for conditions, as they prevailed in primitive times.

Mythology records that the myths, not only of the Greeks, but of all nations, supply an over-abundance of amorous relations between father and daughter, and even between mother and son; cosmology, as well as genealogy, of royal families was founded on incest.

According to your mind, what was the underlying reason for the creation of this lore? Was it to brand gods and kings as criminals, to invite the disgust of mankind upon their heads?

It was rather that the gratification of incestuous desires—an ancient, human heritage, never completely overcome—was still permissible for gods and their offspring, although renounced by the majority of common mortals.

105From this, it would appear, that incestuous desires, in the childhood of the individual, are in complete harmony with the teachings of history and mythology.

“I am glad that you did not stand by your original intention to withhold from me all this information, in regard to the sex life of the child, inasmuch as it throws a very interesting light on the more primitive stage of humanity.”

I was afraid that in so doing, I might digress too far. But, after all, it may prove of advantage that you have these informations now.

“But tell me, what proofs have you, from an analytical point of view, of the sex life of the child? Is your conviction founded merely on the corroboration that mythology and history offer?”

Not at all! Our conviction rests upon direct observations. Here is how we arrived at our conclusions:—In the first place, sex life of childhood was revealed to us in the analysis of adults, who volunteered this information. Then, we proceeded to analyse children, and it was no small triumph when we succeeded in 106proving everything which we had deducted from the information of adults, despite the fact that as regarded the adults, twenty to forty years had passed, during which time these memories had been submerged and undergone substantial changes.

“What! You really ventured to analyse little children, tots of less than six years? How could such a thing be done at all? And wasn’t that hazardous, as far as the children were concerned?”

It was easy enough to do.

You would hardly believe what takes place in the brain of a child of four or five years. At this age, children are mentally very alert. For them, the period of early sexuality is also a period of intellectual bloom. I am under the impression that children, with the beginning of the period of latency, experience a mental let-down; grow temporarily dull, so to speak. During this period, many children also begin to lose their physical charm.

As far as possible damage, arising from an early analysis is concerned, let me assure you that the first child to undergo this experiment—about 107twenty years ago—has meanwhile grown up to be a sound and efficient young man who, despite severe psychological traumata, passed through his pubescent period without complaint. This fact encourages me to expect that all the other “victims” will not fare any worse.

Analyses of children yield various interesting results. Possibly, in future, they will grow in importance. As far as theoretical findings are concerned, there can be no doubt as to the value of these analyses. As children give unequivocal information on questions which only yield hazy results in the analyses of adults, the analyst is protected against mistakes which might have proved to be serious. Analyses of children have the added advantage, in that those moments are seized upon unaware, when a neurosis is in the process of development. There can be no mistake about such observations in children.

To be sure, in the interest of the child, it is necessary to combine analytical influence with educational measures. This is a technique still to be perfected. There is practical interest attached 108to this problem, because observations prove that a great number of our children, during their period of development, pass through a clearly discernable neurotic phase. Ever since we perceived these things more keenly, we have been tempted to venture that neurotic conditions of children are not the exception, but rather the rule. It appears that in view of infantile tendencies to neuroses, such trend of developments cannot be avoided in the course of civilisatoric progress. In most cases, such neurotic taints are spontaneously thrown off during childhood. The question remains, however, whether traces of them are not frequently left, even in such individuals as are considered of average health.

On the other hand, there is no neurotic adult in whom infantile tendencies toward neuroses cannot be discerned, although originally they may not necessarily have been so very obvious. Analogous to this, specialists for internal diseases claim, I believe, that every individual during the time of his childhood passes through a tubercular condition.

Let me return to your question of proofs.

109From direct analytical observation of children, we concluded that in general the information which adults had given us, in reference to their childhood, had been correctly interpreted by us. In some cases, it was even possible to obtain confirmation of a different kind. For example:—From material unearthed by the analysis, it was possible to reconstruct certain occurrences and impressive events of childhood, of which the conscious memory of the patient was no longer aware. Fortunate accidents or information supplied by parents and educators yielded unquestionable proof that the analyst had correctly reconstructed these impressions and experiences of childhood.

Such proof, of course, could not be obtained very frequently, but whenever it was obtained, it created an overpowering impression. You must know that the correct reconstruction of such forgotten experiences of childhood always results in a tremendous therapeutic effect, no matter whether such reconstructions may be objectively confirmed or not. The importance attached to these events is naturally 110derived from the fact that these experiences occurred in early childhood, when they could still affect the feeble “I” traumatically.

“What may those events be which analysis must unearth for therapeutic purposes?”

Events of various nature.

In the first place, impressions strong enough to permanently influence the awakening sex life of the child, such as observation of sexual intercourse between adults or personal sexual experiences with an adult or some other child—occurrences not at all rare. Then, overhearing the conversation of adults, at a time when the child did not fully comprehend the significance, but which, when the child came to grasp the real meaning, conveyed to him knowledge to be coveted because of the air of secrecy and mystery attached to it. Furthermore, utterances and actions of the child himself, demonstrating a decidedly tender or else hateful inclination toward other persons. It is of special importance, in the course of the analysis, to revive cases of forgotten personal sexual indulgence, and the interference of 111adults which served to terminate these habits.

“It seems to be my turn, now, to ask a question which I have had on my mind for a long time. What do you call ‘sexual indulgence’ of a child, during his period of early sexuality which, as you say, is a time that was completely overlooked before the advent of psychoanalysis?”

Of course that which is usual and essential in this indulgence had not been overlooked. This is not so remarkable, because it simply couldn’t be overlooked. Sexual tendencies of the child find their expression mainly in masturbation. That this childish “naughtiness” is extraordinarily common was always known to adults. It is considered a grave sin, to be energetically suppressed.

But please do not ask me how such “immoral” tendencies in children—and children admit that they indulge in them because they give them pleasure!—can co-exist with that inborn purity and non-sensuality of which we love to prate. You had better ask our opponents to solve this puzzle for you.

112A much more important problem is facing us now:—What is the position to take towards sexual indulgence in early childhood?

There is not the slightest doubt as to the responsibility incurred by suppressing such actions and, on the other hand, one dare not permit it to go on, limitless.

It appears that sexuality of children is unrestricted among peoples of low civilization and in the lower strata of civilized people. Such tolerance may amount to a strong protection against the possibility of neuroses cropping up in later years, but the question is whether there does not then remain a concurrent, extraordinary loss in regard to an individual’s aptness for cultural achievements. It seems we are facing a case of Scylla and Charybdis there.

However, I shall leave it to you to decide whether such interest, as the study of sex life may have for neurotics, would tend to create an atmosphere, favorable for the awakening of libidinous desires.

“I think I know now what your intentions are:—You wish to show me just what knowledge is necessary for the practice of psychoanalysis, so that I may be able to judge whether physicians alone shall be permitted to apply this method. Up to now, you have mainly discussed psychology, and a little biology or sex science, without a decided medical slant. However, I may not have heard everything yet.”

Certainly not. There are still a number of gaps to be filled. But may I ask you a favor? Will you be good enough to describe to me how you imagine psychoanalytical treatment is applied? Just pretend as if it were up to you to analyse a patient.

“Well, I may make quite a mess of this! It is surely not my intention to settle the argument between us, on the basis of such an experiment. However, I shall do as you ask. 114After all, the responsibility falls upon your shoulders.

“Now then: I assume that the patient comes to see me and embarks upon a recital of his complaints. I promise him to cure, or at least improve, his condition, provided that he will follow my instructions. Then, I would ask him to tell me, in all frankness, what he knows, what ideas enter his mind. I should also request him to make a clean breast of everything, even though there may be things which he would hate to mention. Am I adhering to your methods?”

You are! But, in addition you should have the patient tell you all his thoughts, even if they seem unimportant to him or lacking in sense.

“Very well.—The patient, then, starts to relate his story and I listen. And what next? Oh, yes, his information will make it possible for me to conclude what impressions, experiences and desires he may have repressed, because he came face to face with them at a time when his ‘I’ was still weak and too intimidated to face the dilemma squarely.

115“After I have told that to the patient, he will reconstruct the old situations and correct his reactions to them with my assistance. Thus, the repressions, his ‘I’ had been forced to resort to, will disappear and he is cured.—Is that correct?”

Very good, indeed.—I already foresee that more people are going to reproach me for having trained a non-medical man to practise psychoanalysis. I surely must admit that you digested what I told you.

“I have only repeated what you told me, like reciting something that has been committed to memory.

“But I do not feel able to clearly visualize how I really would go about it. I cannot understand why such an analysis should require an hour or more a day, for a period of months. As a rule, the average human being has not met with so many experiences. And as far as repressions during childhood are concerned, I assume that these are probably identical in all cases.”

There are many new experiences to make in the course of an analysis.

116For example: You would find that it is not so simple at all, from the information a patient may volunteer, to draw conclusions as to those of his experiences which he has forgotten, the urges which he once repressed.

A patient may tell you something which, at the moment, has just as little sense for you as for him. You will have to make up your mind that the material which the patient lays before you, in accordance with the instruction you gave him, must be interpreted in a special way. Analogous, perhaps, to the treatment iron ore receives for the purpose of extracting from it valuable steel by some special process. In retaining this picture, for the purpose of comparison, you must know that tons and tons of iron ore contain only very little of the valuable steel for which you are looking. This is one reason which would account for the fact that psychoanalytical treatment is such a long drawn-out process.

“But how is this ‘iron ore’ to be converted, to apply your comparison once more?”

By assuming that the information and ideas of a patient are nothing but distorted pictures 117of those impressions and experiences you are trying to unearth. Hints, as it were, from which you would have to conclude what is really behind them. To press it into a formula: the information a patient yields, be it memories, ideas or dreams, will have to be interpreted first. This interpretation, of course, must be guided by the expectations you formed of the case on the basis of professional knowledge, while listening to the patient’s recital.

“‘Interpretation’! What a dreadful word! I do not like to hear this term because, in applying it, you are depriving me of all confidence. If everything depends on my interpretation, who is going to assure me that my interpretation is correct? Such a state of affairs, according to my mind, simply means that everything is left to fancies and whims.”

Just a moment, now! Things are not as bad as all that. Why exclude processes of your own soul from the same rule which you are ready to admit to that of others?

Provided you have acquired a certain self-discipline and are in the possession of sufficient 118information, your interpretations will not be influenced by personal peculiarities, and are bound to prove correct.

Do not draw the conclusion from this that it is my opinion that the personality of the analyst does not make any difference, for this phase of the analysis. A certain sensitiveness for that which was unconsciously repressed, is necessary; also an aptness with which everybody is not equally endowed. Most of all, it is here where the absolute necessity for a thorough and searching self-analysis of the analyst is proved, for the purpose of precluding any prejudice that may drag a distorted element into the interpretation.

One thing, of course, still remains: Personal Equation, which, as an element of individuality, is destined to play a much more important part in psychoanalysis than anywhere else. Although an abnormal man may develop into an expert physicist, an analyst will always be handicapped by his own anomalies, when it comes to conceive pictures of soul life, free from distortions.

Inasmuch as it is impossible to prove to 119anybody his anomalies, general unanimity in the matter of Psychology of the Depths will prove especially difficult to achieve. There are even a handful of psychologists who claim it to be practically impossible ever to achieve such unanimity, and who also insist that every fool is entitled to proclaim his special brand of foolishness as wisdom.

I admit I am more optimistically inclined. After all, our experiences prove that, even in psychology, harmony of opinion may be achieved to a tolerably satisfactory degree. No doubt, each individual realm of science presents its own individual difficulties which have to be eliminated. Moreover, there are some aspects of the art of interpretation, as applied in analysis which, like some other knowledge, may be acquired by study. For example, those aspects pertaining to the peculiarly indirect representation by symbols.

“To be frank with you: I have lost all ambition, even to dabble theoretically with the application of psychoanalysis. Heaven knows what further surprises are still in store for me!”

120You are perfectly correct to abandon such an intention.

You have already convinced yourself how much training and practice is necessary. And once you have found the correct interpretations, a new problem presents itself. It is then up to you to lay in wait and virtually pounce upon the correct, the psychological moment, if you wish to acquaint your patient of your interpretations with the idea of benefiting him.

“How to tell what is the psychological moment?”

That is a matter of extreme tact which, by the way, may be greatly improved through experience. You would commit a very grave error if you would fling your interpretation, as soon as it had been ascertained, at the patient. This would only lead to resistance, refusal, indignation, but never result in his “I” getting a firm hold of whatever it was that caused his repressions. It is an iron clad rule to permit your patient to approach this elusive cause of repression close enough, to make it possible for him to obtain an immediate and strong 121grip on it, under the correctly timed guidance of the interpretation you may suggest.

“I am very much afraid that I would never master this art. But suppose that I observe this rule strictly, then what?”

Then it will be your lot to make a discovery which you did not expect to make.

“What kind of a discovery?”

That you had an entirely wrong opinion about your patient. That there is no reason in the world for you to depend on his coöperation or complacency. That, as a matter of fact, your patient is resolved to raise as many obstacles as possible against your combined exertions. With one word: that he does not altogether want to get well!

“Well, that is about the most ludicrous statement you have made so far! I simply don’t believe it! The patient, suffering so intensely, complaining so heartrendingly, sacrificing so much to be cured, actually does not want to get well! Is it possible you really mean what you say?”

I mean every word of it! What I have just stated is the truth. Not the whole truth, but a 122good deal of it. The patient wants, yet does not want, to get well. Because his “I” has lost its unity of purpose, it is preventing him from summing up undivided will power. Were the state of affairs a different one, our patient would not be a neurotic!

The results of his repression have simply invaded his “I,” firmly holding their ground there, so to speak. The “I” is wielding just as little influence over these effects as over the repression itself. Usually, the “I” is not at all aware of the prevailing state of affairs. These patients are of a peculiar type, putting difficulties in our way which we do not expect to encounter. All our social institutions are organized to fit individuals with a unified, normal “I,” which may be classified as either good or bad. This “I” either functions properly, or is impeded by some overwhelming influence. Thus, the forensic alternative: mentally responsible or not responsible.

But all these standard terms do not fit the neurotic!

Doubtless, it is difficult to adapt the demands of social life to their psychological condition. 123During the War, this was proved to a great extent.

Were those neurotics who shirked from military duty, pretending illness, simulants or not?

They were both!

As soon as such patients were treated as simulants, by making it uncomfortable for them to indulge in sickness, they recuperated; and as soon as allegedly cured patients had been returned to the rank and file, they once more became ill. There was simply no way to deal effectively with them.

Analogous to this is the case of the neurotic in everyday life.

They complain about their sickness, at the same time exploiting it to the limit. As a matter of fact, if an attempt is made to cure them of their ailment, they will protect this most cherished possession of theirs with the selfsame fervor with which a lioness defends her offspring. But there would be no sense in blaming neurotics for the contradictory behavior they display.

“Would it not be best, then, not to treat such 124difficult people at all? Simply leave them to themselves? It seems to me that it cannot possibly be worthwhile to spend as much effort on them as appears necessary, according to what you say.”

I do not agree with you on this point.

Doubtless, it seems wiser to simply submit to the complications which life presents, rather than to fight them. Not each and every one of the neurotics we treat may be worth the exertions of an analysis, but there are surely enough worthwhile individuals among them. It must be our goal to decrease the number of persons who are forced to face the exasperations of civilized life with a soul insufficiently prepared. To this end, we must collect experience upon experience, and come to fully grasp many problems. Every analysis is bound to prove instructive, yielding new knowledge, aside from the personal benefit it may confer upon an individual patient.

“Supposing that the ‘I’ of a patient developed such tendencies which would make him wish to retain the sickness of which he complains, would not these tendencies be justified, 125on the basis of certain reasons and motives? It is impossible for me to understand why somebody should want to be sick. What satisfaction could he derive from that?”

Just remember the war neurotics who were exempt from duty, because they were considered sick. In everyday life, sickness may be successfully employed as a screen, behind which to hide professional insufficiencies, or—in the circle of family life—as a means to induce relatives to make sacrifices, demonstrations of affection, or to foist one’s will upon them, generally. All this is quite obvious and comes under the term “sickness profit” (analogous to war profit). It is remarkable, however, that the neurotic, or rather his “I,” proves unable to grasp the connection of such motives with their logical consequences.

The influence of such tendencies to gain “sickness profit” is combated, by forcing the “I” to become aware of them. But there are still other, more obscure motives, for holding on to sickness, which cannot be disposed so easily. As a matter of fact, these reasons cannot be understood, without venturing once 126more into the sphere of psychological theories.

“Oh, go right ahead! A little theory, more or less—what does it matter?”

When I explained to you the relations between the “I” and the “It,” I withheld from you an important part of the soul apparatus. You see, within the “I” itself, there persists a particular faction which we call the “Super-Ego.”

This “Super-Ego” enjoys a privileged position between the “I” and the “It.” It belongs to the “I,” sharing with it its intricate psychological make-up. On the other hand, it entertains very close relations with the “It.” The “Super-Ego” is in reality the record of first impressions as conceived by the “It”; it is the heir of the dissolved Œdipus Complex.

This “Super-Ego,” as a matter of fact, is able to oppose the “I,” act towards it as if it were something inferior and, in general, treat it almost with contempt. For the “I” it is just as important to remain in agreement with the “Super-Ego” as with the “It.” Disagreement between the “Super-Ego” and the “I” is of far-reaching consequences for the soul life.

127Doubtless, you have already surmised that the “Super-Ego” is the agent of that phenomenon which we call our conscience.

For the maintenance of healthy soul life, it is very important that the “Super-Ego” develop normally, that is, becomes sufficiently impersonal. It is just this development which is insufficient in the neurotic, because his Œdipus Complex was not properly transformed. His “Super-Ego,” in regard to the “I,” still assumes the rôle of the strict father to the child, with the morality of the “I” manifesting itself in a primitive manner by meekly submitting to punishment, meted out by the “Super-Ego.” Sickness is resorted to, as the means of this “self-punishment.” The neurotic, behaving as if under a burden of guilt accepts sickness as a punishment to assuage this feeling of delinquency.

“That sounds very mysterious. But the most remarkable thing seems to be that the patient remains unconscious of the power of his conscience.”

Well, we are only now beginning to appreciate the importance of all these vital conditions. 128That is the reason why my explanations were so puzzling to you. But now, I believe I can continue.

All those agents which oppose the recuperation of a patient, we term the “resistance” of the patient. While “sickness profit” is the source of such resistance, the “unconscious feeling of guilt” represents the resistance of the “Super-Ego” of which, as the strongest factor, we are very much in fear.

But there are other manifestations of resistance which become evident in the process of treatment.

If the “I,” at an early period, was induced through fear, to take recourse to a repression, this fear still persists, manifesting itself now as a resistance, as soon as the “I” approaches that which was repressed. It is easy enough to realize that difficulties may be encountered, if a certain tendency, which for decades has proceeded along a specific course, is suddenly expected to swing into a new path opened to it.

Such a condition may be termed the resistance of the “It.”

The battle against all these resistances is our 129main work during the analytical treatment, in comparison with which the task of interpretation almost fades into insignificance. But by this battle and the ensuing defeat of resistances, the “I” of the patient is so transformed and strengthened that his future behavior, after the termination of the treatment, may be regarded with complete equanimity.

On the other hand, you will understand now why our treatment is so protracted. Expanse and multifariousness of the material are not as decisive factors as the question of whether the way is clear. Remember that the same course, which in times of peace, may be traveled in a few hours by railroad, may take an army, during wartime, weeks and weeks, because the resistance of the enemy must first be overcome. Battles to overcome resistance require time in soul life also. I am sorry to say that, up to now, all exertions to shorten the duration of analytical treatments to any appreciable degree, have proved unavailing. It seems that the best way to shorten the length of the treatment, is simply to apply it as correctly as possible.

130“If I ever felt the temptation to dabble with your science and to attempt to analyze a patient, your information in reference to those resistances, that may be encountered, cured me thoroughly of any such ambition.

“But, tell me about the element of personal influence which you have admitted is present in the analysis. Is this not a valuable factor in the battle against resistance?”

I am glad that you bring this question up. This personal influence is our strongest dynamic weapon; it is the agent which we introduce as something new, into the analytical situation, thus lending it impetus.

This could never be accomplished by the intellectual substance of our interpretation alone because the patient, sharing all the prejudices of his environment, need not have more faith in us than our scientific critics. The neurotic coöperates with the analyst simply because he believes in him, and he believes in him because he gradually develops a certain sentimental trend toward the analyst. A child, also, believes only persons to whom it is attached.

131I have already told you how we employ this especially great “suggestive” influence. Not to suppress the symptoms—it is here where the analytical method is utterly unlike any other psycho-therapeutical method!—but as a driving power to induce the “I” of the patient to defeat his resistances.

“And suppose you succeed? Would that insure easy sailing from then on?”

Such ought to be the case. But an unexpected complication arises.

It was perhaps the greatest surprise for the analyst to observe that the sentimental relations which the patient endeavors to establish, are of a very particular nature. Already the first physician who attempted analysis—it was not I—discovered this phenomenon, which served to bewilder him intensely. These sentimental relations are, to express it bluntly, of an amorous nature. Remarkable, isn’t it, if you take into consideration the fact that the analyst does nothing to invite such emotions, but rather endeavors to maintain distance, sentimentally speaking, between the patient and himself.

132All this is so much more remarkable, as these odd sentimental relations utterly disregard all such obstacles, as difference in age, sex, and social strata. This amorousness appears fated. Not that it constitutes a characteristic otherwise alien to spontaneous love. You are well aware that the contrary of this may be only too frequently observed. Although it is the rule in the analytical situation, the latter, as such, cannot serve as a rational explanation for this development. To all appearances, nothing else should result from the relation between the patient and the analyst, than just a certain measure of respect, confidence, gratitude and humane sympathy. However, what really results from it is this condition of attachment, which in itself gives the impression of being some disorder.

“Well, I should say that such a development would tend to favor analytical purposes. If one is enamoured, one is complacent and ready to do almost anything for love’s sweet sake.”

Of course, in the beginning, this condition favors the analysis, but later on, when these sentimental relations gradually become intensified, 133displaying their inherent nature, difficulties crop up which do not promote the aim of the analysis. You see, an enamoured patient is not satisfied merely to obey the analyst. The patient becomes presumptuous, demanding tenderness and sensual gratification. Eventually, jealousy develops and the lovelorn patient gradually arrives at a stage where more and more clearly, a preparedness for enmity and revenge is shown. Simultaneously, analogous to any other form of love, all other impulses of the soul are repressed, submerging the interest in treatment and recuperation. There is no doubt that love has assumed the place of the neurosis, and that our labors have simply resulted in substituting one disturbance for another.

“That sounds hopeless. What can be done? Perhaps analysis in such a case should be discarded. But since you say that every case yields this result, then analysis in general would have to be discarded.”

First, let us take stock of the situation in order to learn from it. Whatever is thus gained may assist us in mastering the situation. After 134all, is it not quite remarkable that we should succeed in transforming a neurotic condition into a state of unwholesome attachment?

Our conviction that neurotic conditions arise partly from abnormally directed sentimental tendencies, gains unquestionable corroboration by our findings. Ascertaining these facts, we feel more assured and dare to make this enamoured condition the object of analysis.

We also make another observation. This condition of amorousness, as part of the analysis, is not always so apparent in all cases, as I have tried to picture it to you.

And why isn’t that the case? We shall soon see.

In the same measure as the sensual and hostile aspects of a patient’s attachment endeavor to manifest themselves, the inherent opposition of the patient against such tendencies asserts itself. He combats them and attempts to repress them, before our very eyes. Thus we come to comprehend the whole development:—The patient merely repeats, in the form of being enamoured with the analyst, experiences 135of his soul life of days gone by. Certain tendencies of his soul, ready to burst forth, and closely connected with the inception of his neurosis, have simply been transferred by him to the analyst. He also repeats before our eyes all those gestures of opposition, gone through before, and would like nothing so much as to repeat in his relations with the analyst, all the phases of that forgotten period of his life.

What the patient is showing us now is accordingly the very nucleus of the most intimate story of his life. He is reproducing this nucleus in a tangible form, as if actual, instead of just remembering this incipient stage of his condition. Thus, the riddle of transferred love has been solved and the analysis, with the assistance of this new discovery which, for a time, almost seemed to wreck it, may be continued.

“That is surely complicated. Does the patient believe so easily that he is not in love, and merely feels forced to revive an old episode, as it were?”

Everything now depends upon the greatest dexterity in handling this “transference,” to 136achieve our objective. You will easily see that the demands of the analytical technique at this point are very exacting. It is here where the most serious mistakes may be committed, or the most splendid results achieved. Any attempt to evade these difficulties, by suppressing or neglecting the transference, would be senseless. Such evasion would not be deserving of the term of analysis. To send a patient home, as soon as the discomfort of a transference neurosis manifests itself, would also be senseless and would amount to cowardice. It would be approximately analogous to calling forth spirits and then running away, as soon as they put in their appearance.

Of course, there is no other way out sometimes. There are cases in which it is impossible to master an unshackled transference, and the analysis must then be terminated. But at least one should wrestle with these evil spirits to the best of one’s ability.

To give in to the demands of a transference—the desires of a patient for tenderness or sensual gratification—is impossible, not only for moral reasons but also as it would prove 137impractical, if resorted to as a means to achieve a successful analysis. A neurotic cannot be healed, by being permitted to indulge in uncorrected repetitions of situations which he unconsciously prepared. When making a compromise with a neurotic, by meeting him halfway, it is necessary to take care not to be manœuvred into the ludicrous position of the clergyman, who tried to convert the insurance agent with the result that the insurance agent did not join the church, but the clergyman took out a policy.

The only way out of the dilemma of transference is to delve into the past of the patient and reconstruct events as they were actually lived through by the patient, or else only pictured, with the assistance of his urge-stimulated imagination. For all this, the analyst requires much dexterity, patience, calmness and self-effacement.

“And where, do you think, did the neurotic meet the original of this transference love?”

In his childhood, and, as a rule, in one of his parents. You will readily remember how much importance we had to attach to these 138earliest of all sentimental relations. Here, the circle is completed.

“You have finished, then? To be frank with you, I am quite bewildered by all you have told me. But, now pray tell me, where to study all that is necessary to practise analysis?”

Two institutes serve this purpose by giving instruction in psychoanalysis. The first is in Berlin, in charge of Dr. Max Eitigon of the local organization. The second is maintained by the Vienna Psychoanalytical Society, with great sacrifice. The authorities, up to now, have thrown many obstacles in the path of the young institute. A third institute will be opened in London, by the local organization there and will be under the direction of Dr. E. Jones.

In all these institutes, the disciples themselves are analysed, and are then given theoretical instruction in all subjects important for them. When permitted to analyse their first, simple cases, they have the advantage of being under the supervision of more experienced analysts. The course usually requires about two years, but even after this period, a disciple 139is still a beginner, and not by far to be considered a master. What else the young analyst needs, he acquires thorough practice, and by intercourse with older colleagues.

The preparatory work for the analytical training is not at all simple: the work is hard, the responsibility tremendous.

Whoever attended such a course, has been analysed himself, has grasped the Psychology of the Unconscious, as far as it can be taught today, is sufficiently versed in the science of sex, and has acquired the difficult technique of psychoanalysis, including the art of interpretation, the method of combating resistances and the manner in which to handle transferences, can no longer be considered a layman, in the field of psychoanalysis. He is able to treat neurotic disturbances and will, in time, be in a position to achieve all that may be expected of this therapy.

“You have explained to me, at great length, what psychoanalysis is, and what knowledge is necessary to practise it with a chance for success. It certainly could not have hurt me to listen to you.

“However, I do not see how your informations are expected to influence my personal view. Neuroses, it would appear, are a certain form of disturbance, and psychoanalysis a certain method to treat such cases—a special medical treatment, as it were.

“I understand that it is the rule that any physician who intends to specialize in the one phase or the other of his science is not satisfied with the training he received before winning his diploma, but rather goes on studying the intricacies of his special field. This is especially a necessity, in case he intends to establish himself in a big city, the only place which opens a satisfactory field for specialists. Anybody 141who is going to specialize in surgical work, will practise, for a few years, in the surgical ward. Corresponding specialized work will be taken up by the eye or the nose and throat specialist, and the psychiatrist may forever remain on the staff of a city or county institution or a private sanitarium.

“The same method of development may be expected of the psychoanalyst. Whoever decides to take up this new medical specialty, after finishing his studies proper, will have to attend those institutes, for the duration of two years, which you have mentioned before, provided it really takes as long as that to gain the necessary knowledge. He will then also learn that it would be to his advantage to join a psychoanalytical society, in order to remain in contact with his colleagues.

“I really cannot understand why there is any necessity for raising this question of lay-analyses?”

Any physician, proceeding along the lines you suggested, shall be welcome to us. As a matter of fact, four-fifths of those whom I consider my disciples, are physicians. However, 142permit me to enlighten you as to relations, as they actually developed between physicians and psychoanalysis, and what development they appear to be taking in the future.

Past developments do not give physicians any right to claim a monopoly of psychoanalysis. As a matter of fact, physicians, in the past, have done about everything to damage psychoanalysis, beginning with superficial mockery and going even so far as to indulge in serious defamation. Of course, you may correctly say that all this belongs to the past, and should not have any influence on the future. I fully agree, but I am afraid that the future will not live up to your expectations.

At this point, permit me to interpret for you the term of “quack,” not in the way it is legally employed, but rather in the sense in which it should be logically applied. As far as the law is concerned, a “quack” is an individual who treats sick people, without being in the possession of a diploma. I, however, would rather qualify the term “quack” in this way: A “quack” is anybody who undertakes the treatment 143of a disease, without having the indispensable knowledge and ability.

On the basis of this definition, I venture to assert that—not only in the European countries—physicians, as far as psychoanalysis is concerned, constitute the majority of “quacks.” Frequently, physicians will employ psychoanalysis, without having studied it, and without sufficiently understanding it.

Do not tell me that this would display a lack of conscience, which you would not suspect in any physician. You might be tempted to say that, after all, a physician ought to know that a medical diploma does not constitute a “Letter of Marque,” and that a sick person should not be considered outlawed. As far as a physician is concerned, it should be taken for granted that he is proceeding in good faith, even if he makes a mistake.

However, facts are facts. Let us hope that it will be possible to explain these facts in a manner, which you apparently wish. I, for my part, shall try to explain to you how it is possible that a physician, in matters of psychoanalysis, 144takes liberties he would carefully avoid in any other specialized field.

In the first place, it must be taken in consideration that the training the medical student received is almost the very opposite of that which would be required of him, as a preparation for psychoanalysis. His attention has simply been focused upon facts which may be objectively ascertained, such as present themselves in anatomy, physics, and chemistry, and which must be understood properly and applied correctly, to achieve results.

As far as the psychological aspects of life are concerned, no interest is created in the medical student. The study of higher mental achievements is not considered to belong within the field of medicine, but rather into the realm of another science. Psychiatry alone is supposed to attend to disturbances of psychological functions, and it is only too well known in which way, and with what objective in view this is done: psychiatry simply tries to discover the physical reasons for psychological disturbances, treating them in turn like any other ailment.

145Psychiatry is correct in that respect, and medical training apparently excellent. Should it be maintained that psychiatry is one-sided, it will be necessary to fix the point of view from which such a reproach may arise.

Inherently, all science is one-sided, and must be one-sided, inasmuch as any science is limited to certain subjects, points of view, and methods. It is a nonsense which I do not wish to support that one science may be played against any other. Physics after all, does not minimize the value of chemistry; it cannot replace the latter nor be substituted for it. And, surely, psychoanalysis is especially one-sided, as the science of the psychological Unconscious.

Thus, the right to one-sidedness should not be denied to medicine.

However, a more practical point of view is gained if observations are not made as to scientific medicine, but rather as to practical healing. Sick people, presenting complicated problems, should impress upon us the fact that psychological manifestations—be they ever so hard to comprehend—cannot be simply eliminated 146from the picture. The neurotic, more than any other patient, presents an undesirable complication. He offers a dilemma, not less embarrassing to medicine than to law. However, as long as such cases exist, they are a responsibility especially of medicine. Nevertheless, medical training, sorry to say, is not paying sufficient attention to such conditions,—doing nothing for them. Absolutely nothing at all!

As there are very close inter-relations between those things we consider physical and those which we look upon as psychological, it may be expected that the day will come when organic biology and chemistry will finally approach the understanding of neurotic manifestations. This day, to be sure, seems to be in the distant future. At present, such ailments are still unapproachable, from a medical angle.

If medical training would only deny information to the student in the field of neurosis, this would be tolerable. But medical training is doing more. It implants into the young student an incorrect and harmful point of 147view. Physicians, whose interest for psychological facts has not been awakened, have naturally a tendency of making little of such facts, going even so far as to decry them as unscientific. Conditions of neurotic character are hardly ever taken seriously by them, while their lack of knowledge serves to breed disrespect for psychological research. Thus, neurosis is not accorded sufficient attention.

Of course, these neurotics must be treated when they consult physicians, and new discoveries must be tried out right along. But why go in for a protracted period of preparation? It can be done without that! After all, who knows whether there is really any value to that which is taught in psychoanalytical institutes?

Thus, as usual, lack of information results in a most daring spirit of enterprise. Only true initiates are modest, because they realize how insufficient their knowledge is!

From all this, it follows that it is impossible to draw upon a comparison of psychoanalysis with other branches of medicine, as you attempted to do.

148As far as surgery, and ophthalmology, are concerned, medical schools and post graduate courses offer sufficient opportunities for training. The psychoanalytical institutes are limited in number, young in years, and lack the aureola of authority. Medical science has not recognized them, nor does it give a hoot about them. On the other hand, the young physician who has been forced to believe his teachers, to such a degree, that he hardly ever had a chance to form his own judgment, will only be too glad to try his hand at playing the critic, in a field where there is no established authority as yet.

There are still other circumstances which favor the mushroom-like increase of young physicians as psychoanalytical “quacks.”

If a physician would undertake cataract operations, without sufficient training as an eye specialist, he would soon enough lose his patients. Compared to this, the application of psychoanalysis hardly involves any danger. The public, generally observing effective cataract operations, expects results from a physician pretending to be an eye specialist. However, 149if a nerve specialist does not achieve results, apparently nobody is surprised. We surely have not been spoiled by the efficacy of therapeutical treatment of nerve cases, and it seems to suffice that the physician “tried everything.” Nature must simply assert herself and time exert its healing propensities.

If the patient happens to be a young girl, it is first the menstruation which is expected to work wonders, then marriage, and in later years, change of life. In the end, death itself may finally prove the great healer.

Moreover, whatever the medical analyst employed in the treatment of such a case, is so inconspicuous, as to offer no cause for reproach. After all, he did not resort to instruments, nor did he write prescriptions. He just talked and talked, trying either to talk something into the patient, or out of the patient.

How could such treatment do any damage, especially as extreme care had been taken not to touch upon painful or exciting matters? The medical analyst, once he has thrown the strict instructions overboard that were given to him, will surely have tried to improve upon 150psychoanalysis by extracting from it certain features—poisonous fangs, as it were—to make analysis more acceptable to the patient. How splendid, if he really went only as far as that and not so far as to awaken resistances which he would be unable to cope with. He would be apt to make himself disliked in such a case!

Justice demands that it be admitted that an untrained analyst cannot do as much harm to a patient, as an untrained surgeon. The possible injury may amount to unnecessary expenditure of money and time, and chances for a cure may have either been destroyed, or else spoilt to a certain degree. In addition to this, the reputation of psychoanalytical therapy as a whole would suffer. All this is quite undesirable, but surely not as serious as the damage that may arise from the knife of a surgical “quack.” According to my observations, permanent aggravation of an ailment is not to be expected from the incorrect application of psychoanalysis. Reactions of an undesirable nature disappear quickly. In comparison to the traumata inflicted by life itself, which resulted 151in the disturbances, a little incorrect treatment does not amount to anything. The unsuitable therapeutical attempt has simply not benefited the patient.

“I have listened to your description of the ‘quack’ without interrupting you, and have gained the impression that your position in regard to physicians is barbed with hostility. The reason for this enmity is obvious, from the many hints you have dropped. At any rate, I am of the opinion that as long as psychoanalysis is to be employed, it should be only by such persons as are thoroughly trained for it. But it seems that you believe that even those physicians who may take up psychoanalysis, in the course of time, will not go in for the necessary thorough training?”

Exactly! As long as the relation between the medical schools and the psychological institutes prevail as they do today, I do not think that young physicians will resist the temptation of making things easy for themselves.

“It appears to me that you constantly avoid making any direct statement in regard to the problem of lay-analyses. Apparently, what 152you wish me to surmise now is that it would be your suggestion to withhold, as a means of revenge, as an act of punishment, so to speak, the monopoly of practising psychoanalysis from physicians, because such physicians as employ analysis, are beyond control. You would, however, permit the application of such medical activity to laymen.”

I am not so sure that you surmised my motives correctly. Perhaps, I may later on be in a position to prove to you that my point of view is not as partial as all that. But be that as it may, I strongly emphasize my demand that nobody should be permitted to practise psychoanalysis, unless he has obtained this privilege on the basis of thorough training. Whether such a person is a qualified physician or not does not seem important to me.

“What, then, are your practical suggestions?”

I am not as far as that yet. I don’t even know whether I shall ever get that far. There is some other question which I wish to take up with you, and by way of introduction, touch upon a certain point.

153It is reported that the authorities, on the strength of suggestions made by medical bodies, may put a sweeping prohibition for the practise of psychoanalysis by laymen on the statute books. Such prohibition would naturally also hit the non-medical members of psychoanalytical societies—men and women who have undergone a very thorough training and improved themselves greatly by practice. Should such a sweeping prohibition become an actual fact, the incongruous condition would then present itself whereby people really capable of applying psychoanalysis properly, would be excluded from this practice, while on the other hand, this privilege would be extended to individuals insufficiently informed, and not specially trained for such work.

Of course, no legislature aims at so absurd an effect.

But the dilemma that presents itself with this piece of legislature, is neither important nor difficult. It would concern only a handful of people who would not even suffer appreciably. Analogous to measures enacted by 154monarchical Austria, republican Austria could also resort to exception laws. Under the Hapsburg régime, it happened that certain “quacks” whose ability in the treatment of certain diseases was convincing, were privileged ad personam to treat sick people. These were mostly cases of rustic healers, who enjoyed the recommendation of one of those exalted, once so plentiful, archduchesses. However, it should be possible to assume that the benefit of such exception laws should also pertain to city inhabitants, who are recommended by mere experts.

Of course, if the law is put on the statutes in accordance with the wording of the bill now pending, the Vienna Psychoanalytical Institute, for example, would no longer be permitted to accept students, unless they belonged to the medical profession. All these endeavors to restrict the application of psychoanalysis hark back, more or less, to obsolete legislature, dealing with quackery as such. This seems anachronistic, inasmuch as at the time of the enactment of these anti-quackery laws, the 155particular nature of neurotic disturbances had not yet been discovered and psychoanalysis did not yet exist.

I am now approaching the question which appears most essential to me: Is the practice of psychoanalysis of such a nature as to lend itself to the interference of legislative authorities, or would it not be much better to leave psychoanalysis to its natural development?

Of course, I shall not decide this question, but I am taking the liberty of submitting it to you. It appears that in Austria, not unlike other countries, by the way, there prevails a real furor prohibendi, a veritable mania for prohibition and general interference, a trend which usually, as is only too well known, makes for unsatisfactory results. According to my own personal view, a superabundance of ordinances and prohibitions will only serve to injure the dignity of the law. It may usually be observed that wherever there are just a few laws, these laws are strictly adhered to, whereas where laws exist in great numbers, the temptation arises to break them.

156Furthermore, a man cannot be considered an anarchist, simply because he believes that legislative statutes—in the view of their very origin—cannot very well be regarded as something holy that must never be touched. Legislative measures sometimes are insufficient, or gradually become that, at the same time outraging our innate sense for justice and common sense. Then the time is on hand, where there is no other means of correcting such unbearable conditions than to simply trespass against such laws. It seems advisable, for the purpose of maintaining respect for laws and ordinances, not to enact any which may be difficult to enforce.

Much of what has been said here about the application of psychoanalysis by physicians would have to be repeated with regard to lay-analyses proper, which the legislatures of some countries are now prepared to prohibit. In view of the fact that the application of the analysis is a very simple procedure, consisting merely of conversation without resorting to instruments or prescriptions, it would be rather difficult to prove that a layman actually 157employed psychoanalysis, if he stoutly maintained that he had merely benefited a person by administering a good “talking to.” Such assistance, to a person in need of it, could not very well be prohibited simply because a physician may once in a while resort to the identical thing!

In English speaking countries, Christian Science has gained tremendous popularity. To my mind, it constitutes a dialectic abnegation of such evils as life presents, by resorting to the teaching of Christian religion. I do not hesitate to state that such measures strike me as a regrettable fallacy of the human mind. But who in the United States or England would ever think of prohibiting Christian Science or seek to punish its followers?

Generally speaking, is governmental authority always so certain to be on the right side? Assumed even that many, left to their own devices, would encounter danger and experience harm, would it not just the same be much better if governmental authority would merely indicate dangerous ground, but on the whole leave it to the individual to be 158taught by experience and mutual influence?

Psychoanalysis is so new, the broad masses so insufficiently informed about it, the official view of science still so vacillating, that it appears to me as premature to impede its progress by legislative measures.

Why not leave it to the patients themselves to learn that it is dangerous for them to apply for psychological assistance to persons who are not sufficiently informed?

If people are sufficiently enlightened and warned, prohibition will surely prove superfluous.

On Italian highways, poles, carrying high tension electric power, display this warning: “Chi tocca, muore!” Which has proven perfectly sufficient. In contrast to this, in other countries, for example Austria and Germany, this warning is of an insulting verbosity:— “Inasmuch as touching these high tension wires is dangerous to life, it is herewith strictly prohibited to meddle with them!” Why this prohibition? Whoever cherishes his life will not touch them, and whoever wants 159to commit suicide will surely not be detained by the warning.

“But there are cases which may be quoted as precedent for the prohibition of lay-analyses. For example, the law against the practice of hypnosis by laymen, and another enacted against occult séances and the organization of spiritualistic societies.”^[1]

I must admit that it is beyond me to admire these measures. As far as the last mentioned prohibition is concerned, it surely constitutes a case of grave over-officiousness, encroaching upon intellectual freedom. As far as I am personally concerned, I do not think that anybody would suspect me of having faith in occult phenomena, or of being interested in its general acceptance. However, such prohibitive measures will never serve to stifle the interest that some people manifest for the alleged secrets of an occult world. Such officious interference may do a lot of damage by preventing impartial seekers for truth to arrive at a finding which would do away with 160occult misconceptions. Here also, we observe the fact that other countries do not interfere with so-called “parapsychic” research, but only Austria.

As far as hypnosis is concerned, it is somewhat different from analysis. Hypnosis is nothing else but induction of an abnormal condition of the soul, serving the layman merely as a means of entertainment. Had hypnotic therapy fulfilled its early promise, conditions would have evolved similar to those now prevailing in psychoanalysis.

Aside from this, the history of hypnosis contributes another precedent for the fate of psychoanalysis. When I was still a young instructor of neuropathology, physicians fervently fought against hypnosis, claiming it to be nothing but a fake, an infernal delusion, a most dangerous practice. Today, this same hypnosis has been monopolized by them. They are resorting to it as a method of examination. For some nerve specialists, hypnosis is their most important stock in trade.

However, I have already told you that I 161do not intend to discuss whether restriction by law or a hands-off policy would be the most correct procedure, concerning psychoanalysis. I know very well that this is a question of principle which will be decided by the inclination of influential people rather than by strict argumentation. What seems to me to suggest a policy of laissez faire I have already mentioned. But if the decision should be one for active interference, then, to be sure, it would appear to me as a one-sided and unjust measure to enact a sweeping prohibition against the practice of psychoanalysis by laymen. Then, it would be up to the legislature to fix the conditions under which the application of psychoanalysis would be permissible for those who would be privileged to employ it. It would also be necessary to appoint an authority who could be appealed to for information, who would decide what constitutes psychoanalysis, what the training would be, and how to administer it.

Thus, things must either be left alone or else order must be created and the situation, 162in general, clarified. But there is no use in simply interfering with a complicated situation, by means of a prohibition, which is based without much discretion, upon obsolete acts of an antiquated legislature.

“But the physicians! It seems I am really unable to bring you to the main point of our conversation. You are continually evading me. After all, the question before us is whether physicians should be given the exclusive right to employ psychoanalysis, that is, after they have fulfilled certain conditions, if you should insist upon such. According to your own statement, the majority of ‘quacks,’ dabbling with psychoanalysis, does not consist of physicians. You also admit that the greatest number of your disciples and followers are physicians. I have heard that these do not share your point of view, in regard to lay-analyses.

“Of course, it is to be expected that your disciples agree with you in the question of sufficient training. Just the same, they hold the laymen should be excluded from the practice of psychoanalysis. Is that really the case? And if so, how do you account for it?”

164You are correctly informed. Not all, but a great number of my medically trained collaborators do not side with me in this matter, but insist that psychoanalytical treatment of neurotics be exclusively reserved for physicians. From this, you may gather that even within the limits of our own camps, there prevails a difference of opinion. Although my point of view is very well known, the divergence of opinion in matters of lay-analyses, in no way interferes with an otherwise splendid harmony.

How to explain this position of some of my disciples?

I am not so sure, but I assume that professional pride is behind it. You see, their process of development has been different from mine. That they find themselves somewhat isolated from their colleagues, is still annoying them. They would like to be considered, by the profession as a whole, as members in good standing, so to say. Thus, in order to win the tolerance of their Æsculapian brothers, they are willing to make a sacrifice, whose value is apparently not clear to them.

165Of course, I may be wrong here. To assume that fear of competition is dictating their position, would not only amount to suspecting them of a low motive, but also condemn them for a peculiar shortsightedness. After all, as long as they are ready to initiate colleagues into psychoanalysis, it can be of no importance to them whether they will have to share prospective patients with them, or with laymen.

Probably, there is something else to be considered. They may be impressed by certain features which, in the practice of psychoanalysis assure the physician of an unquestionable advantage over the layman.

“There you are:—‘Assure the advantage’! At last, you admit this advantage! I should think this admission settles our argument.”

I admit this advantage. Perhaps by doing so I shall prove to you that I am not as passionately deluded as you think. I postponed mentioning these conditions, because in airing them, additional theoretical discussion is necessary.

“What are you driving at now?”

There is first the question of diagnosis. Before 166admitting a patient, suffering from nervous disturbances, to psychoanalytical treatment, one naturally desires to have as much assurance as possible that this therapy is suitable in that particular case, that is, that the patient has a good chance of being benefited by psychoanalysis. This can only be the case, if he is actually suffering from neurosis.

“I should think that would be easily ascertained, by the symptoms he complains about.”

You are putting your finger just on the point, where new complications may arise. It is not always possible to be perfectly sure of such a case. The patient, in spite of displaying all the visible symptoms of neurosis, may actually be suffering from something else. The incipient stage of a mental disease, for example, or the beginning of a process destroying his brain. To distinguish between such symptoms is not always easy or possible. Responsibility for such a decision must naturally be assumed by the physician alone. And as mentioned before, it is not so easy for him. For the longest time, an ailment may appear absolutely 167harmless, until finally manifesting its malignant character. Nervous people, as a rule, fear that they may be on the road to some mental disease.

Assumed that a physician has not correctly diagnosed a case, or has been unable to discover its true nature, nothing has been lost, no damage has been done. Analytical treatment, although not doing any harm to the patient, would have been superfluous in such a case. It might have given any number of people a chance to lay the blame for the unfortunate development of the case at the door of psychoanalysis. Unjustly so, to be sure, but such a likelihood should be avoided nevertheless.

“That sounds hopeless. It apparently tears out, by the very roots, everything you told me about the nature and development of a neurosis.”

Not at all. It only strengthens the fact that neurotics are a nuisance and a dilemma for all parties concerned, including the psychoanalysts. I may be able to alleviate your new apprehensions if I make myself clearer. Probably it would be more correct to say of such 168cases, as we now have under discussion, that they actually present neuroses. However, these neuroses are not psychic but rather somatic, that is, they do not originate from the soul, but rather from the body. Do you understand me?

“I do. But I am at a loss to connect all this with the psychological aspect.”

That can easily be done, if only complications of the living substance are sufficiently taken into consideration. What was the inherent feature of a neurosis? That the “I,” constituting the very essence of the soul, so to speak, developed and improved by the influence of the outer world, proved unable to fulfill its mediating functions between the “It” and reality; that the “I,” on account of its weakness, shirked its duties in regard to the “It,” thus incurring repressions from which it suffers. It is because such weakness of the “I” regularly takes place in all of us in childhood that events of our tender years exert such great importance in later life.

In the few years of our childhood, we have to cover the enormous distance of development 169from primitive man of the Stone Age to civilized man of today. In addition to this tremendous burden, the child has to ward off the urges of an early sexuality. Small wonder, then, that our “I” takes recourse to repressions, thus exposing itself to childhood neuroses, the effects of which in turn furnish the disposition for nervous disturbances in more mature years.

Everything now depends upon how the growing up individual will be treated by fate. If life is too hard, the divergence between urges and the opposition of reality too great, the “I” may remain unsuccessful in its endeavors to mediate between the two. This is the more probable, the more the “I” is encroached upon by such infantile dispositions as it may have acquired in tender years. Thus, the process of repression is repeated; urges tear themselves free from the sovereignty of the “I” to gain, by way of regression, a substitute for the gratification they crave, while the poor “I” has become helplessly neurotic.

Let us hold on firmly to this: that the most important, the pivotal point in the whole situation, 170so to speak, is the relative strength of the “I” in all its phases. It is easy, then, to complete our whole etiological survey, that is our endeavor to assign causes to the phenomena observed. We already know the normal causes for nervousness to be the infantile weakness of the “I,” the checking of early sexual urges, and the influence of chance episodes in our childhood.

But is there no possibility that there are also some other contributory factors, antedating childhood? For example, an inborn strength and unruliness of those urges which constitute the “It,” presenting right from the very start a task much too difficult for the “I”? Or could a certain weakness, existing for reasons unknown, in the development of the “I” be held responsible? Of course, all these possibilities will exert an etiological importance, in some cases of surpassing value.

The specific driving power of the “It” must always be taken into consideration, and wherever it is developed to an excessive degree, there are only meagre chances for a successful application of our therapy. Of the reasons 171that block the development of the “I,” we still know too little to account for such cases of neurosis which arise on a constitutional basis. It may be assumed that neurosis hardly ever develops unless there are constitutional or congenital factors increasing the possibility for such a condition. However, if it is correct that the relative weakness of the “I” is the deciding factor for the development of neuroses, then it would also appear possible that later, physical disturbances may result in a neurosis provided it also results in a weakening of the “I.”

This happens only too frequently. Such a physical disturbance may aim at the “It,” intensifying its urges to an extent where the “I” is not able to cope with them any more. As an example for such developments, the changes induced in woman by the disturbances of menstruation and menopause could perhaps be drawn upon. Other reasons that may weaken the “I” are general physical disturbances, organic diseases of the central nervous system. All of these may result in interference with those sources from which the soul apparatus 172draws its strength, to lead, in turn, to an encroachment of its more delicate functions, which are necessary to maintain unimpaired the whole “I” organization. In all these cases, neurosis presents about the same picture. However, while manifesting the same psychological mechanism, neuroses develop on the basis of a multifarious, frequently highly complicated etiology; that is, they arise from a great number of various causes.

“That suits me better. At last you have spoken like a physician. And now I am waiting for you to admit that so complicated a condition as a neurosis should only be treated by a physician.”

I am afraid you are expecting too much. What we have just discussed belonged in the realm of pathology. Psychoanalysis, however, is a therapeutical process. I admit, no, I even insist, that a physician should first diagnose each and every case where psychoanalysis seems applicable. Fortunately, the greater number of neuroses are of a psychical nature and not pathologically induced. As soon as the physician has ascertained this, he may safely 173leave the treatment to the lay-analyst. We have always followed this procedure within our analytical societies. Thanks to this close coöperation between the medically trained and non-trained members, errors almost never occur.

There is another emergency when the analyst has to invite the assistance of a physician. It is possible that, in the course of psychoanalytical treatment, symptoms—mostly of physical nature—appear which may either be part of the neurosis, or else manifestations of independent, organic disturbances. Here, the decision must once more be left to the physician.

“From all this, there follows that the analysts, even during the analysis, cannot dispense with the physician. This is another argument against lay-analyses.”

No, this possibility cannot be drawn upon as an argument against lay-analyses, because in an analogous case the medically trained analyst would not proceed any differently.

“I do not understand that.”

There is a rule that even a medically trained analyst, running across such dubious symptoms 174in the course of the treatment, is not to depend on his own judgment, but to consult some colleague, preferably a specialist of internal diseases.

“Why this rule, apparently so superfluous?”

This rule is not superfluous at all. There are several reasons for it. In the first place, it is hard to combine organic and psychical treatment. In the second place, the particular condition of transference frequently prevailing in analyses may make it inadvisable for the analyst to subject his patient to physical examination. In the third place, there are all the reasons in the world for the analyst to doubt his own opinion, inasmuch as he is so intensely interested in the psychical aspects of the case.

“I now understand your position towards lay-analyses. You insist that there must be lay-analysts. However, as you have to admit their insufficiency for the task, you compile everything that could serve to excuse them, and make things in general easier for them. To be frank with you, I cannot understand why we should have lay-analysts at all, inasmuch as they would never be more than second-class 175therapeutists. This need not include those few laymen who have already received their training, but institutes for psychological training should not accept laymen any more.”

I would assent to all this, if I could be shown that such restrictions would benefit all parties interested. You will admit that these interests are tri-fold:—There is the interest of the patient, the interest of the physicians, and last but not least, the interest of science which, in turn, includes the interest of all patients of the future. Let us investigate these three points.

It does not matter whether the patient be analysed by a physician or a layman, as long as any danger of mistaking his condition is excluded by being properly examined by a physician before the beginning of the treatment, or re-examined as soon as developments, in the course of the analysis, make this advisable. It is much more important for the patient that the analyst possesses those personal qualities which invite full confidence, and that he has that knowledge and experience which alone qualify him to apply psychoanalysis. To some 176people, it may seem that it might undermine the authority of the analyst to have his patient know that he is no physician and must obtain the advice of a medically trained expert in certain matters. However, although we have never kept a patient in the dark, as to the qualifications of an analyst, we have come to the conclusion that the patients have no prejudice against a non-medically trained analyst; they are only too glad to accept the benefits of treatment, wherever they offer themselves—a fact resented by the medical profession for the longest time.

It also must be considered that analysts, practising today, are men and women with academic training and degrees, pedagogues, of great experience and impressive personality. The analysis, to which all candidates of psychoanalytical institutes are required to submit, is the best means of testing their personal suitability for the performance of so exerting an activity as an analysis presents.

In reference to the interest of the physicians, I do not believe that medicine has anything to gain by annexing psychoanalysis. Today, medical 177training requires five years, with almost a whole sixth year taken up with examinations. Ever so often, new demands in regard to training are made with which the young student must comply, if his medical education is to be considered adequate. Generally speaking, while it is difficult today to enter the medical profession, the practice of medicine is neither very satisfactory nor very advantageous. And as soon as the undoubtedly justified necessity is realized that the physician be also informed of the psychological aspects of diseases, thus including in medical training a partial preparation for psychoanalysis, there would follow an extension of the medical curriculum and a corresponding extension of the period of training. I do not know how physicians would like such a development, arising from the monopoly they claim on psychoanalysis. But these demands would then have to be fulfilled and at a time when, in general, the material aspects of those strata of society which contribute the greatest contingent to the medical profession, are such that young physicians must establish a practice, as soon as possible.

178However, the medical profession may not intend to include preparation for psychoanalysis into the medical curriculum proper. The general opinion may be that it is much more practical for the young physician to acquire psychoanalytical knowledge only after having completed his medical education. It may be said that such a procedure would not involve any actual loss of time, inasmuch as a young man under thirty never gains that confidence of patients which is an indispensable condition for benefiting a patient psychoanalytically. Of course, it could be said that a young physician, too, who has just won his diploma, cannot command too much respect, as regards his opinion of the physical ailments of his patients, and that the young analyst could very well utilize his time, by working in a psychological clinic, under the supervision of an experienced practitioner.

It seems to me that the aforementioned demand amounts to a waste of energy which, in view of economic conditions, does not seem justified. Although analytical training invades the field of medical training, it neither includes 179this training, nor is included by it. If a psychoanalytical college were to be organized, which today may strike one as being a fantastic idea, the curriculum of this institution would have to include much of what is taught in medical schools. Aside from the Psychology of the Depths, which would naturally always be the main subject taught, Biology would have to be included in the course, and Science of Sex would also be one of the major subjects. In addition, adequate instruction would have to be given on such disturbances which belong in the realm of Psychiatry. Psychoanalytical training would have to include a number of subjects which have no connection with medicine, and never enter the physician’s practice, such as History of Civilization, Mythology, Psychology of Religion, and Literature. Without being well acquainted with these subjects, the analyst will be unable to grasp the problems that will face him in the course of his practice.

Most of the subjects, however, belonging to medical training, will not be of any use to him and although all this knowledge is highly 180valuable for those who need it, it would not assist the analyst to understand a neurotic condition nor to alleviate it. In case the objection is made here that specialists in other fields of medical endeavor, also do not need all the details they acquire in the course of their training, it must be said that such a case could not be considered analogous. For many branches of medicine, such facts as, for example, Pathology presents, are of great importance. The analyst, however, reaches out for a variety of experiences, with different phenomena, underlying different laws. Although philosophy may succeed in bridging the chasm between body and soul, as far as our own experience is concerned, this chasm, nevertheless, exists, presenting itself in an especially striking light, as regards our practical endeavors.

It seems unjust and impractical to force a person to take a roundabout route via medical training, if this person be bent upon relieving another individual from the agonies of a phobia or a fixed idea. Moreover, such a procedure would be ineffective, as long as psychoanalysis in general is not suppressed.

181Just imagine that somewhere in the country, there is a certain mountain top that can be reached by two different roads, the one being short and straight, and the other long and winding. An attempt is made to block the short road by a “no-trespass” sign. There is some chance of this sign being respected, if the short road is steep and difficult to climb, whereas the long road is easy to travel. However, if the detour should be the more difficult road, you can easily surmise how little the trespassing sign would be respected.

I am very much afraid it will be just as difficult to force the laymen to study medicine, as it is for me to induce physicians to study psychoanalysis. Human nature is like that.

“If you are correct in your assumption that analytical treatment cannot be administered without a special training, but that on the other hand the medical curriculum could not bear the burden of psychoanalytical training, and that medical knowledge, to the greatest extent, is superfluous for the analyst, how will we ever achieve the ideal medical personality, 182the physician who can cope with all the demands of his profession?”

I am unable to foresee how to solve these difficulties, and I do not feel called upon to make any suggestions. I only perceive two things clearly: firstly, that the analysis seems to constitute a dilemma, but certainly the neurotic is also a dilemma; secondly, that for the time being, all interests would be served if physicians resolve to tolerate a class of therapeutists who will relieve them of the arduous treatment of those tremendously frequent psychical neuroses, in addition benefiting the patients by remaining in constant contact with them.

“Is that your last word in reference to the problem of lay-analyses, or is there something else?”

There is a third interest to be considered:—that of science. Although what I have to say in that respect may not mean much to you, it nevertheless means a good deal to me.

We do not consider it advisable that psychoanalysis be swallowed up by medicine, finally to be shelved in a text-book of psychiatry, 183under the chapter heading of Therapy, together with such other treatments as Hypnotic Suggestion, Auto Suggestion, Persuasion which, due to lack of knowledge, were indebted for their short lives to the indolence and ignorance of the broad masses. Psychoanalysis deserves a better fate, which, let us hope, it will really attain.

As the Psychology of the Depths, the teaching of the Unconscious, psychoanalysis may prove indispensable to all sciences which deal with the development of human culture, and such of its great achievements as art, religion, and civilized society. Psychoanalysis has already appreciably assisted these sciences in the solution of their problems. But all this is insignificant, compared to what may be achieved through psychoanalysis in the future, when students of History, Psychology of Religion, and Etymology, will avail themselves to the fullest extent of the assistance psychoanalysis will be able to render them.

The employment of psychoanalysis for the treatment of neuroses is only one of its possibilities, and time may yet prove that this is 184not even the most important of them. At any rate, it would be unfair to sacrifice all other advantages of psychoanalysis, simply because there is just one phase where the application of psychoanalysis encroaches upon the preserves of medicine.

Here another aspect manifests itself which cannot be interfered with, without causing damage. If the representatives of the different sciences should really take up the study of psychoanalysis, to apply it in their own spheres of interest, it would not suffice for them to merely avail themselves of such results as have been recorded in psychoanalytical literature. They will have to come to an understanding of psychoanalysis in the only way possible, that is, by submitting themselves to analysis.

Thus, to the neurotics in need of analysis, a second class of persons would be added: those who undergo analysis for intellectual reasons and who would welcome that intensification of their efficiency which would result incidentally from analysis. To undertake these analyses, a number of analysts would be necessary for whom medical knowledge would be of 185specially limited importance. However, these instructor-analysts—as they ought to be called—are in need of an especially thorough training, which they can only obtain if they are given opportunities to study interesting and convincing cases. Inasmuch as healthy persons do not feel the necessity and curiosity to be analysed, neurotics would have to be the objects of study for the instructor-analysts. Their study would be guided by expert analysts, with a special eye to their future, non-medical work. Of course, all this necessitates a certain amount of freedom of action, and would not brook petty interference.

Perhaps you do not believe in these strictly theoretical endeavors of psychoanalysis, and are not ready to admit their importance, in connection with the practical side of the problem of lay-analyses. In that case, let me remind you that there is another field for the application of psychoanalysis, outside the hunting ground of the “quack”—a field which physicians will hardly claim as their own. I allude to the application of psychoanalysis to pedagogy.

186As soon as a child manifests the first signs of an undesirable development, by being moody, stubborn and inattentive, neither the child specialist nor the school physician will be able to do anything for him; not even when a child shows such clear signs of nervous disturbances as timidity, lack of appetite, vomiting, and sleeplessness. A treatment which combines analytical influence with pedagogic measures and is applied by persons who are not above delving into the child’s own world and who understand how to penetrate the soul life of the child, will succeed not only in dissolving nervous disturbances, but also in reversing incipient traits of character.

The importance which we were forced to attach to apparently unimportant neurotic conditions of children, in view of the fact that they very often serve as a disposition for disturbances in later life, would prove that the analyses of children constitute a splendid means of prophylaxis. Although psychoanalysis still has its enemies, I do not know what means are at their disposal to hinder the activity of a pedagogic analyst, or analytical 187pedagogue, and I doubt whether this could be done so easily.

To return once more to the problem of the analytical treatment of adults, suffering from nervous disturbances, we have not yet exhausted all points of view. Civilized life of today exerts an almost unbearable pressure, which necessitates corrective measures. Does it seem too fantastic to expect that psychoanalysis, in spite of the many difficulties it encounters, should be called upon to furnish this corrective agent? Maybe some American millionaire will one day donate enough money for the psychoanalytical training of the social workers of his country, thus creating an emergency corps, to fight neurotic conditions brought about by present-day life.

“You mean some sort of a new Salvation Army?”

Why not? After all, our fancy always follows existing patterns. The stream of eager students that will then flood towards Europe, will, of course, have to pass Vienna, because there the development of psychoanalysis may have prematurely died, on account of governmental 188interference. You smile? I’m not saying this to sway your judgment. I know you don’t believe me, and I surely cannot guarantee that my predictions will come true. But there is one thing I know: it is not at all important what the opinions of individuals and of individual governments may be, in respect to the problem of lay-analyses. All this can only have limited effects. What is really important is that potentialities for the development of psychoanalysis cannot be affected by ordinances and prohibitions.