Necessity is the birth of invention
The birth of psychology, like most sciences, started in necessity. Just like today, when doctors cannot find a physical problem, they defer to counsellors and psychologists to find psychological reasons for the patient’s malady. In Freud’s time the pressure was larger in that there was no profession to rely on. Freud said in Psychical Treatment in 1890, “This one-sided attitude of medicine towards the body has undergone a gradual change in the course of the last decade and a half, a change brought about directly by clinical experience. There are a large number of patients, suffering from affections of greater or less severity, whose disorders and complaints make great demands on the skill of their physicians, but in whom no visible or observable signs of a pathological process can be discovered either during their life or after their death, in spite of all the advances in the methods of investigation made by scientific medicine.”
Hypnotism
Even if the pain was only psychological pain, it’s still pain nonetheless and the patient would often exhaust all avenues before seeking the help of a hypnotist for example. Here the results depended on the suggestibility of the patient, and their faith in the status of the hypnotist in having a history of helping others. The typical method of the hypnotist was to suggest that there was no mental illness, and through the patient’s belief system, the patient could recover. Some patients improved enormously, but in some patients there were only temporary improvements leading to a repeated need for the hypnotist, and a possible addiction forming to hypnotherapy. [See: A modern example of hypnotism: https://youtu.be/nFe3mvCnfO4?list=PL0AM6Men8OrNt5Qi4t_iBNdLXwPSCbi7b]
Repressed expression
Freud detected early on that long-term improvements in patients undergoing hypnotherapy was not completely clear. In his work with hysterical patients he found that they suffered from “incompletely [expressed emotions from] psychical traumas.” If hypnotherapy couldn’t get into these thoughts or experiences then the patient would need to quit treatment altogether. Freud found that defensiveness was a key part of why these traumas and concurrent emotions were not completely expressed. In Neuro-psychoses of Defense (1894), Freud said, “for these patients whom I analysed [and who] had enjoyed good mental health up [until now, they experienced] an occurrence of incompatibility [that] took place in their ideational life – that is to say, their ego was faced with an experience, an idea or a feeling which aroused such a distressing affect that the subject decided to forget about it because he had no confidence in his power to resolve the contradiction between that incompatible idea and his ego by means of thought-activity.”
Ego
What Freud termed as Ego, in his early formulation, was tension from emotionally invested neurons looking for release, either from achieving external goals, or achieved through dreams. This hydraulic model was put forth in an unpublished manuscript called a Project for a Scientific Psychology (1895), where Freud hoped he could measure a quantity of energy passing through neurons that were either easy to pass through, or could pass through only with difficulty. Theoretically, the former type were involved in energy discharge, and the latter type were involved in storing memories. Another set of theoretical neurons, that Freud elaborated on, were responsible for perception, and for comparing mental experience to perceptual reality. Of course confusion could occur when the emotional investments prioritize mental projections over perceptual reality. These theoretical neurons couldn’t be measured quantitatively so Freud decided to follow a philosophical path instead.
Sexual stigma
As described in Studies in Hysteria, these difficult thoughts and emotions could then influence the body causing some of the symptoms of hysteria, which included motor difficulties, and repetitive escapes into obsessive thoughts to avoid the distressing subject matter of the trauma. These distressing thoughts for Freud’s sample of patients usually involved some sexual seduction before the appropriate age, or guilt over indulging in sexual thoughts and masturbation, which in Freud’s time was more stigmatizing than it is today. With some patients these early sexual traumas did not affect the patient until they were reaching puberty and could infuse their old memories into shame and disgust. Sometimes these memories would be transformed into screen memories, as Freud called them, where they are reworked into pleasant narratives that were easier to accept.
Dreams
Sigmund Freud after the Studies in Hysteria was motivated to move beyond his childhood sexual abuse theory and look into the Phantasies, or dreams, of his clients to add another layer of understanding for why in some cases neurosis didn’t arise from an actual sexual seduction. Often these adult children hated their parents, and had a different reason for their neurosis. In a letter to his confidant Wilhelm Fliess Freud wrote in 1897:
“Hostile impulses against parents (a wish that they should die) are also an integral constituent of neurosis…It seems as though this deathwish is directed in sons against their father and in daughters against their mother.”
To investigate this further Freud chose to analyze himself as well as his patients. Especially analyzing sleep and dreams.
Sleep
Freud looked at sleeping similar to being in the womb, “somatically, sleep is a reactivation of intrauterine existence, fulfilling as it does the conditions of repose, warmth and exclusion of stimulus; indeed, in sleep many people resume the fetal posture. The psychical state of a sleeping person is characterized by an almost complete withdrawal from the surrounding world and a cessation of all interest in it.” The libido instincts for Freud were at the level of what he calls “primitive narcissism”, and the Ego in sleep is reduced to a hallucinatory satisfaction of wishes.
Freud says, “…dreams are completely egoistic and the person who plays the chief part in their scenes is always to be recognized as the dreamer. Narcissism and egoism, indeed, coincide; the word ‘narcissism’ is only intended to emphasize the fact that egoism is a libidinal phenomenon as well; or, to put it another way, narcissism may be described as the libidinal complement of egoism.” The libido is providing energy to the ego. Freud goes on to say, “the wish to sleep endeavours to draw in all the [emotional investments] sent out by the ego and to establish an absolute narcissism. This can only partly succeed, for what is repressed in the system [Unconscious] does not obey the wish to sleep. A part of [dispassion] has therefore to be maintained, and the censorship between the [Unconscious] and the [Preconscious] must remain, even if not at its full strength. So far as the dominance of the ego extends, all the systems are emptied of [emotional investments]. The stronger the [Unconscious] instinctual [emotional investments] are, the more unstable is sleep. We are acquainted, too, with the extreme case where the ego gives up the wish to sleep, because it feels unable to inhibit the repressed impulses set free during sleep – in other words, where it renounces sleep because of its fear of dreams.”
As Freud explains the activity in sleep, he also introduces a theoretical topography of the mind that unlocks unconscious motivations.
The Psychical Apparatus
For Freud there are 3 states of human experience. The 1st is the Unconscious, then 2nd the Preconscious, and then 3rd, our Conscious state. In the unconscious resides the Libido, which Freud described as a mental energy. It is also like a physical energy, that circulates within a closed system. Satisfaction is discharging this energy through the fulfillment of wishes. During his period where hydraulic systems were popular, Freud felt that the mind was similar in that energy requires release somewhere. It flows freely when unconnected with the outside world, like in dreaming. Desire without reality could go anywhere, but desire with reality always involves a compromise where resistances appear with waking. It’s all about controlling stress and achieving goals.
Oedipus
Inside our dreams were socially unacceptable desires redacted by ego censors to prevent anxiety in the conscious mind. Some of these dreams come from the material of childhood. These childhood memories involved, what Freud thought at the time, actual sexual seductions, or fantasies of the child to sleep with the opposite sex parent and kill the same sex parent to satisfy the envy to replace him or her.
This was the Oedipus Complex based on the story of Oedipus Rex, where Oedipus unknowingly kills his father and marries his mother. At some point the child would need to have a resolution of this complex by seeing that their parent wasn’t a viable solution and so then imitate the parent of their same desire instead. This involved a huge suppression in the mind of the child of this incident, due to its embarrassing qualities. Freud recounts seeing his young mother in the nude and his desire for her as an example. These desires according to Freud don’t disappear completely. They remain as unfulfilled wishes called Latent Content in a dream. The latent content is full of unconscious urges making efforts to have hallucinatory fulfillment if not fulfillment in reality. The dream itself is called Manifest Content, which is full of disguises to prevent anxiety in the subject.
The Unconscious
As the censorship deals with these energies, it cannot remove them completely, so it has to disguise them in 4 methods typical of dreams, displacement, condensation, symbolization, and dramatization:
- Displacement – is the transferring of the emotional investment from one mental content to another. One idea can stand for another, as long as there is an associative link. This explains how some content that is mundane can have a lot of emotional affect attached to it. Through repression and forgetting, the subject unconsciously pushes their emotional investment of the socially unacceptable desire to related content that has no embarrassment.
- Condensation – is the the amalgamation of two or more ideational elements emotionally invested by the same charge of instinctual energy. Freud explains how this is done, “when there is nothing in common between the dream thoughts, the dream work takes the trouble to create a something, in order to make a common presentation feasible in the dream. The simplest way to approximate two dream thoughts, which have as yet nothing in common, consists in making such a change in the actual expression of one idea as will meet a slight responsive recasting in the form of the other idea.”
- Symbolization – is a disguise of the instinctual wish in a symbol. As important as symbols are in our legends in myths, Freud looks at them more as a useful tool for the censorship to use. He says, “the dream makes use of any symbolizations already present and waiting in unconscious thinking, because these satisfy the requirements of dream-formation better, both on account of their representability and also in most cases on account of their freedom from censorship.”
- Dramatization – is a transformation of these emotional investments into a reenactment.
Preconscious
As the content gets transformed it reaches the Preconscious, which is closer to the waking state but still quite unconscious. This is a second censor that adds logic and coherence to the latent dream material that distorts the meaning further. This happens when the dream approaches the waking state, and thus creating the Manifest Content. The misplaced emotions, the composite characters, the strange symbols all put together in a mysterious dramatization, leaving the patient unaware of what is bothering them and leaving the psychoanalyst a puzzle to work out.
To unlock the mystery, Freud used free-association where the client communicates to the analyst what naturally comes up to consciousness, without any censorship. What comes up can then be slowly pieced together by finding all the associations related to symbols, condensed dream content, and displacements, leading eventually to the traumatic core of a real memory. Then the client can release the emotion related to the trauma, or if there is a missing emotional need, they try to alter their life to get their needs met in socially acceptable ways.
Malpractice
Ironically, the famous Irma dream published in The Interpretation of Dreams (1900), is a perfect example of disguising the embarrassing content with a comfortable sounding cover-up. The Irma dream brought up Freud’s feelings of guilt over accepting Fliess’s naso-genital theory, where a link between the nose and genitals had to be severed to relieve the patient’s neurosis. In 1895 Freud accepted a patient Emma Eckstein for treatment for her suspected hysteria. Assuming that her hysteria was sexual in origin he thought Fliess could operate on her nose. A couple of weeks after the operation she had a near fatal hemorrhage. Another doctor examined her and found a half a metre of gauze left there by Fliess. Freud called it a minimal oversight and blamed the nosebleeds on Emma’s desire for the doctor as the main reason, covering up the malpractice.
After this knowledge, the dream becomes disturbing and can appear like a symbolic male gang rape with all the poking and prodding with needles in the dream, along with the real life cover-up. This was one of the most vile periods of Psychoanalysis. It shows that power is corrupting in that it removes accountability, and it strips the victim of humanity. Just like the insight by Henri Ellenberger in The Discovery of the Unconscious, all our mental health treatments were open to ignorance, and abuse.
As mental health practices changed with cultural changes, it followed a path of reducing the power of the practitioner. People who were sick always searched for practitioners who were “the best” in their day and age, and would quickly switch methods when a new method was invented to escape these risks. Despite these advances there is always a dyad of practitioner and patient requiring ethical guidelines to maintain trust.
…silent chambers of the mind
Unfortunately for Emma, she was permanently disfigured, but due to ignorance and the barbarity of medicine at those times, she maintained her trust in Freud and continued being a colleague of his as the first female psychoanalyst. Freud’s Irma dream is a great lesson that when you abuse people, it doesn’t go away in your mind. It just gets repressed, festers and comes out displaced, condensed, symbolized, and dramatized; an accumulation of anxiety looking for forgiveness.
Past, present, and future
Freud’s explorations and discoveries provided new avenues to pursue using dream interpretation. This method provided more scope than relying only on past sexual trauma, but also the trauma of frustrated wishes. Freud says, “and what of the value of dreams for our knowledge of the future? Of course that is out of the question. Instead, one should rather ask: for our knowledge of the past. For in every sense, dreams come from the past…[Yet] the ancient belief that dreams show us the future is not entirely without some truth. For by representing a wish as fulfilled, a dream does indeed take us into the future; but this future, taken by the dreamer to be in the present, is shaped by the indestructible wish into the image of that past.”
The Discovery of the Unconscious – Henri Ellenberger: https://www.isbns.net/isbn/9780465016730/
Studies in Hysteria – Sigmund Freud and Joseph Breuer: https://www.isbns.net/isbn/9781420948608/
The Interpretation of Dreams – Sigmund Freud: https://www.isbns.net/isbn/9780199537587/
On Dreams – Sigmund Freud: https://www.isbns.net/isbn/9780393001440/
On Metapsychology (A metapsychological supplement to the theory of dreams) – Sigmund Freud: https://www.isbns.net/isbn/9780140138016/
Psychical (or mental) treatment – Sigmund Freud: https://www.isbns.net/isbn/9781473319936/
On The Psychical Mechanism Of Hysterical Phenomena – Sigmund Freud: https://www.isbns.net/isbn/9781473319905/
The Neuro-Psychoses Of Defence – Sigmund Freud: https://www.isbns.net/isbn/9781473319974/
Project for Scientific Psychology – Sigmund Freud: https://www.isbns.net/isbn/9781573310635/
Freud’s 1895 Project – From Mind to Brain and Back Again – Zvi, Lothane: http://www.its.caltech.edu/~squartz/lothane.pdf
Obsessions And Phobias – Sigmund Freud: https://www.isbns.net/isbn/9781473319875/
Sexuality In The Aetiology Of The Neuroses – Sigmund Freud: https://www.isbns.net/isbn/9781473319950/
The Psychical Mechanism of Forgetfulness – Sigmund Freud: https://www.isbns.net/isbn/9781473319981/
Screen Memories – Sigmund Freud: https://www.isbns.net/isbn/9781782200550/
John Launer, The case of Emma Eckstein, Postgraduate Medical Journal, Volume 92, Issue 1083, January 2016, Pages 59–60
Freud’s Models of the Mind: An Introduction by Joseph Sandler: https://www.isbns.net/isbn/9781855751675/
Reading Freud: A Chronological Exploration of Freud’s Writings by Jean-Michel Quinodoz: https://www.isbns.net/isbn/9781583917473/
Freud: A Life for Our Time by Peter Gay: https://www.isbns.net/isbn/9780393328615/
Psychology: https://psychreviews.org/category/psychology01/