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to sexual matters, which caused repression of them and contributed to his efforts to maintain his rationalistic power system. The micturition compulsion almost disappeared. He was able to travel long journeys and sit out theatre performances with little or no trouble. At this period he had the following dream.
"I am playing the piano. It seems to be an unusually large one and I can play faster, better and more freely than ever before-such lightning movements."
Associating with piano, he said that he was very fond of playing it, that he had often had recourse to it when hard pressed by obsessions, and that it called forth more feeling in him than many human relations -the piano was larger than usual both in height and compass.
Now here is the idea of greater compass-greater range combined with greater freedom and dexterity. This is exactly what is required psychologically. In my opinion it is the unconscious representation of the potentiality for canalization or differentiation of the crude psychological mass, which I have called the inferior function.
This is most important from the point of view of prognosis. There are neurotics and psychotics whose dreams show the instrument under symbols other than the piano, as being limited or incomplete or feeble. Such dreams may be of great value in indicating how far the psychological condition can be improved by analysis or in indicating a fundamental primary and irremediable defect or deficiency. This important factor in prognosis was pointed out to me by Dr Maurice Nicoll and illustrated by a striking dream of a patient which I am not at libert to quote.
I am aware that a Freudian interpretation of this dream would reduce it to a repressed masturbation complex. This is inevitable, as the Freudian system is based on the theory of sexual determinism. I am far from minimizing the part played by sexuality in this case. I shall emphasize it later. But it must be pointed out that in the course of analysis, masturbation had ceased to be an acute problem. For that reason perhaps the practice had almost ceased. Therefore, as there was no repression, on which the genesis of the dream depends according to the Freudian system, I submit that the significance of this dream does not refer to the sexual history and therefore to the past, but to the psychological potentiality and so to the future. In this connection it may be interesting to quote from a document which the patient brought about this time. Under the heading "Particular results of analysis," two extracts are as follows:
"Whilst walking along Oxford Street yesterday I experienced a feeling as though somewhere inside my brain a new hope were dawning. There was also a physical sensation as though about one square inch of material lifted. I felt this in the left side of my head."
"During the same afternoon I had a picture—a very live one-of a thin snake stretching from the neck to the forehead under the skin. A lid opened. The head appeared and thin sunlight seemed to stream in.” These would appear to be insane phantasies, but I think they have validity as prognostic signs at that time. The first is an unconscious. picture of the lifting of the repression. The second embodies a motif which is universal in mythology-instinctive libido under the symbol of the snake becoming active and moving towards the surface. It probably signifies that amount of energy which through analysis has been released from an unsuitable form.
Let us now turn to the aetiology of the obsessions. "Freud came to the conclusion that obsessive processes represent the return in a distorted guise, of self-reproaches dating from childhood and buried since then until the outbreak of the malady. They always refer to active sexual performances or tendencies." I quote from Dr Ernest Jones's book, Treatment of the Neuroses. This theory of origin holds good in this case. By analysis those obsessions with a manifest sexual content were easily traced back to a specific or a typical episode of adolescent sexual life. For example, he had an obsessive fear that any woman who touched a letter which he had written after an act of masturbation would become pregnant. This made him destroy many letters from time to time. It was traced back to an early sexual misadventure which had caused him great suffering and anxiety. Many other obsessive fears, such as his being the cause of pregnancy or of being the means of transmitting disease in various ways to others were found to have their origin in past sexual incidents.
But the obsessions spread from the purely sexual field to a much wider field of human relations. For instance, on his way home from India, he bargained with an Egyptian boy about some coins. A British comrade remarked that he was rather hard or unfair to the boy. At the same time an older Egyptian beat the boy for making such a noise. The latter ran away. A railway was near, the track of which was used by pedestrians. The patient feared that the boy might be killed by a train and that he would be responsible. This gave rise to one of the worst and most enduring obsessions he ever had. It lasted for about six months.
What is it that determines this enlargement of the obsessive field beyond the purely sexual? According to the Freudian teaching these obsessions are the results of displacement of affect on to non-sexual themes. It follows that if all sexual repressions are brought into consciousness, there should be no more obsessions of any kind whatsoever. Now in this case I think that after six months of analysis all sexual repressions had been brought into consciousness. Yet obsessions still occurred, particularly those of self-reproach, although not with such overpowering force. If he borrowed money and was not able to pay it back because the lender was out of reach, he became quite distressed. It was as if he felt himself at the mercy of the world because he was a borrower. It was not consistent with his conscious estimate of himself as an upright citizen. His infantile power system kicked and screamed because his integrity was in danger. His rationalism cannot accept a situation which is incomplete or dubious. It is irrational for him and the principle which is common to all the obsessional ideas, whether sexual or not, is the irrational. From this point of view the obsession may be said to be due to the fact that the superior function (the rational) gets its teeth into the irrational event or possibility and will not let go. There comes a deadlock in the psyche, which monopolizes the whole of consciousness. The question may now be asked, does it help the patient to attribute the meticulous accuracy, the tyrannical scrupulosity of the last-mentioned obsession to a mechanism of sexual repression? Will such knowledge in itself suffice to release the patient from the power of the obsession? I think not. I think that this accuracy or scrupulosity with regard to money to which I have just referred is something important in itself. It is due to that attitude which embodied the crude parental philosophy. I do not think that to reduce this characteristic down to a repressed infantile anal eroticism helps to rob it of its power. I think the redemption from the distressing psychological impasse which so often occurs is through the differentiation of the inferior function of feeling. This can only be brought about by a constructive technique directed to broadening the patient's outlook and philosophy of life, which we have seen to be so limited. The differentiation of feeling proceeds hand in hand with the broadening of the basis of personality. The possibility of this broadening was indicated in the dream of the piano and the process has proceeded steadily and I think satisfactorily. His obsessions now take no organic form whatever and the intensity of the purely ideational ones is greatly diminished. He is able on many occasions to feel that what he fears may happen, has every right to
happen, must have happened to other people, and so on. When he really feels this the obsession loses its force. It is significant that the unconscious has been much occupied with religion, particularly with oriental forms, the symbols being often reminiscent of his experiences in India. A short time ago he dreamt the following.
"I was in a strange house. I heard a great noise, shouting and the clanging of a bell. A big strong man wished to come in. He called out 'I declare unto you a new religion. I can quiet you and change your present mode of life.' But I was afraid of him and he passed away.”
This dream speaks for itself. It may be that if the patient can incorporate the feeling values which are symbolized by the man of the dream he will be delivered from the tyranny of the superior function, and so cease to suffer from that God-Almightiness which has crippled his life.
LA TENSION PSYCHOLOGIQUE, SES
PAR PIERRE JANET.
LA HIERARCHIE DES TENDANCES2
IL est facile d'affirmer d'une manière générale que la force et la tension psychologique jouent un rôle considérable dans la conduite humaine et qu'il serait nécessaire de les apprécier pour se rendre compte de la nature et de la gravité d'une maladie mentale. Mais en pratique il est extrêmement difficile de mesurer ces qualités de l'action, car nous connaissons bien mal les caractères qui mettent en évidence la force et l'élévation d'un acte. Sans doute de belles études dont plusieurs ont été faites ici même ont permis de classer quelques-unes des actions les plus élémentaires. M. Sherrington nous a appris à distinguer parmi les réflexes ceux qui sont prochains et ceux qui sont lointains, ceux qui sont simples et ceux qui dépendent d'une intégration plus avancée du système nerveux. M. Head nous a montré des sensations primitives et d'autres plus évoluées en rapport avec l'activité de l'écorce cérébrale. Mais ces notions fondamentales qui rendent de grands services dans le diagnostic des lésions élémentaires sont encore bien peu applicables aux troubles de la conduite qui se présentent dans les névroses et dans les psychoses. Pour comprendre ceux-ci il nous faudrait établir les mêmes classements dans les actions bien plus compliquées qui constituent les relations sociales, qui remplissent la vie humaine de chaque jour; il faudrait établir non seulement le tableau hiérarchique des réflexes élémentaires, mais le tableau hiérarchique de toutes les actions humaines, même de celles qui entrent dans les conduites morales ou scientifiques. Cela est évidemment aujourd'hui un rêve bien téméraire, mais l'utilité d'un tel tableau fait excuser les tentatives trop audacieuses. C'est pourquoi je vais essayer de vous présenter une esquisse rapide d'un tableau hiérarchique des actions humaines que depuis bien des années je m'efforce de construire dans mes cours au Collège de France.
1 Three lectures delivered before the University of London.
2 Second lecture delivered May 12, 1920.