« 上一頁繼續 »
an autoplastic modification caused by introjection of incestuous objects into exogamous situations and the substitution (except in hysteria) of pregenital for genital relationships. Put in a general formula: the dynamic task of neurosis is not accomplished, mental tension is not reduced sufficiently; by attempting autoplastic and regressive mastering of instinct the relief of tension in one part of the mental system leads to increase in another. Treatment aims at reestablishing the original instinct-tension and forcing the mental apparatus to make a fresh attempt at instinct gratification, this time in consonance with the ego. Resistances are struggles of the patient against this process, ultimately therefore resistance is directed against exogamous genital activity, i.e. a flight from reality. And what causes the flight?-Frustration, disappointment, trauma and bitter experience cause the individual to give up trying to change the external world and lead him to seek relief from instinct-tension by the apparently less dangerous method of inner discharge (autoplastic, autoerotic changes). This throws light on the nature of regression. When these regressive measures fail the patient experiences anxiety which is the expectation of a 'painful' increase of tension in the psychical system due to the lasting impression of past defeats in the endeavour to remain tensionless. Anxiety, then, is the ultimate cause of resistance, and is the cause of flight from reality, it explains the clinging to autoplastic modes of discharge, but not regression. To explain regression more fully we have to add to the Fechner-Freud principle the Breuer-Freud principle of repetition-compulsion. Returning to first principles: external stimuli produce states of tension which lead to motor innervations, the reflex in short. Reflexes deal with accustomed stimuli adequately; new stimuli require tentative experimental measures involving 'reality testing,' and during this process the mental tension remains, and may indeed increase. Reflexes operate without expenditure of mental energy because the reaction, once tentative, is now stereotyped. There is a tendency, then, to turn free energy into 'tonic or bound' energy, to substitute automatism for experiment. In neurosis reality is only accepted when it can be mastered by automatisms. Cf. functions of cerebrum (reality-testing) and the spinal cord (automatism). Similarly with instinct. We see the individual passing through a series of stages at each of which there is a special type of instinct gratification and instinct-mastery, and at each stage there is a liability to fixation, i.e. to cling to the familiar and avoid the new. But every fixation is a source of relative protection against deeper regression. Neurosis is determined by the relative strength of the different fixation points, by the degree of regression. The cause of regression is always the same rejection of exogamous object choice. Using these notions to review the neurotic symptom, Alexander describes its three main characteristics: autoplastic, regressive and repudiation by the ego. The last needs more elucidation. The ego is oriented to the outer world and reality, the id responds by archaic modes of instinct mastery. Between these two Freud describes a third element, a super-ego; its function is to relieve the ego of the task of investigating instinctual demands. It is perception inwards, the ego's homologous function is perception outwards; it regulates instinctual life on the principle of inertia, not being provided with the function of external perception to any great extent it loses touch with and finally avoids encounters with reality, it is the introjected legal code of former times, of the nursery. It behaves as if the person's environment had not changed since the early days, it behaves 'reflexly,' automatically as though mind had become body. Just as the super-ego has no contact with reality so the ego has none with the
instincts. The ego is not blind to external reality but is deaf to inner (instinctual) stimuli, the super-ego however hears these clearly and behaves like a nursery governess to the id, meting out punishments for wishes (e.g. genital gratification) which present requirements justify but which are banned by the obsolete code. Nevertheless, in its stupidity and old fashionedness, it permits the autoplastic gratification of precisely what it prohibits-it allows incest-wishes provided they take part in symptom formation. Its secret ally is the regressive tendency in the id. The neurotic activity of the super-ego inhibits ego-syntonic behaviour, which is in conformity with reality, and by means of punishments allows autoplastic symbolic gratification of the condemned wishes. E.g. in impotence all exogamous wishes are equated with incest wishes, i.e. the superego acts like a dull witted frontier guard who arrests everyone wearing spectacles because the person 'wanted' wears spectacles. Naturally such a censor can be easily hoodwinked, if it has meted out punishment it allows the crime. Sometimes crime and punishment fuse as in the one-phase symptoms of hysteria, sometimes they are separate as in the two-phase symptoms of obsessional neurosis or manic-depressive disease. Knowing nothing of reality the super-ego sometimes even inhibits ego-syntonic activities. This anachronism in the mental apparatus, this lagger in the rapid advance of civilisation resists changes (as in treatment) because they involve new adaptations. Treatment consists in overcoming the resistances to the ego's taking over the function of the super-ego. For the symptom to cease the ego must give up reality testing or it must force reality on the id by overcoming the super-ego. For the ego there are only two possibilities: accept and carry out or reject and abandon reality. In analysis the former process occurs in two stages. First the analyst takes over the part of the super-ego in the transference but only to shift it back on the patient when interpretation and working through the material from free associations has put the ego in possession of the super-ego. I.e., first the analyst takes control of the patient's instinctual life and then hands it back to the patient gradually-hands it back to the conscious ego. In practice however it is found that when a childhood situation has been resolved by the transference the libido does not take up its normal current at once but regresses to earlier stages of instinctual life under the influence of resistance; by following in the wake of the regressions the layered structure of the super-ego is clearly revealed: first the biological relation between mother and child, later the social relation between father and child. In the treatment the patient sees the way in which his passive relation to his mother at the breast is connected with his passive homosexual relation to his father (nipple--penis, cf. Freud's Leonardo') which is simply the automatising process at work. The patient holds to these regressive modes of behaviour because the super-ego is so automatic. Before he can become detached from the analyst, who, as said above, takes on the super-ego function, he must say good-bye to his parents whom he has introjected and he reacts to this of course under the influence of the inertia principle, often by producing birth-scene phantasies. Treatment then consists in eliminating the automatisms; these are freed through recollections. "To compare memory-material with the testing of reality is the highest achievement of the mental apparatus. Only the ego can remember: the super-ego can only repeat. The dissolution of the super-ego is and will continue to be the task of all future psycho-analytic therapy." Having made these strictures on the super-ego and limiting the term virtually to the unconscious sense of guilt, the author in apology says he was schematic by intention to emphasise two notions,
Fechner-Freud's principle of equilibrium and the Breuer-Freud principle of inertia1.
H. NUNBERG: 'On the wish for recovery.' KARL LANDAUER: 'Equivalents of grief.' CLARA HAPPEL: 'From the analysis of a case of pederasty.' WM. REICH: An hysterical psychosis in statu nascendi.' KARL ABRAHAM: 'Coinciding phantasies in mother and son.' HELENE DEUTSCH: 'Contribution to the psychology of sport.' OTTO FENICHEL: 'Material in dreams that is foreign to consciousness." M. WULFF: 'Analysis of a symptomatic act.'
NEGATION. Sigm. Freud. Imago. 1925. Bd. XI. Heft 3.
In analysis we meet with negation in this form, for instance, "You ask who is this person in the dream-it is'nt my mother!" The analyst concludes that it is the mother. It is as if the patient were to say "I certainly thought of my mother in connection with this person but had no pleasure in acknowledging it." If the patient is asked to say what he regards as the most unlikely thing in any situation he always says the right thing. An idea, then, can thrust up into consciousness provided that it is denied. Denial is a manner of becoming acquainted with the repressed, in fact a release of repression without acceptance of the idea, or rather, since here the intellectual is separated from the affective function, of intellectual acceptance of the repressed with the continuation of the essentials still under repression.
The task of intellectual judgement is to affirm or deny the content of thought, denial is therefore that which the thinker would rather repress; judgement is the intellectual substitute of repression, 'no' is an indicator of repression and labels its origin. By negation thought is freed from the limitations of repression and catches at ideas which it could not tolerate if they were allowed positive expression. Judgement resolves itself into the decision whether a thing is good or bad, useful or noxious-in ‘oral terms' whether it shall be eaten or spat out, more generally whether it shall be 'in me' or 'outside of me.' The primal Pleasure-Ego introjects what is good and rejects what is bad. The Bad and that which is Strange are to the Ego, then, identical.
The other function of judgement is to decide whether a presentation has real existence. This is the function of the Real-Ego which develops from the Pleasure Ego. It is now no longer a question whether a thing be acceptable or not but whether the presentation of the thing be found in reality (by perception) or not-again a case of outer and inner. Experience teaches that it does not suffice for an object of gratification to have good qualities but that it must exist as well in the outer world so that man can of his need overcome it. Originally before the antithesis subjective-objective was established what was perceived came again to presentation through reproduction [memory]. The function of reality-testing is not to find an object corresponding to a presentation in the field of perception but to find it again and to convince oneself that it is still there, unchanged and undistorted by condensations of different [memory] elements. Reality-testing has to control the extent of these distortions so that lost objects can be regained with the qualities they once had for giving gratification.
1 This and the preceding paper appear in translation in The International Journal of Psycho-Analysis, Vol. VI, Part I,
Judgement is an intellectual action to decide on the choice of motor action, it sets an end to the flow of thought and leads over from thought to movement; thought is a motor action with a minimum of expenditure of energy. Perception is a purely passive process but the Ego sends periodically small waves of cathexis to the perceptual system to taste the outer world, and having tasted it withdraws the cathexis. At the stage of judgement we get the first insight into the development of the intellectual functions. Judgement proceeds from the inclusion or expulsion of a thing into or from the Ego. Affirmation-substitute for union-derives from eros, denial from the impulse of destruction. Negativism is thus a mark of blending of impulses. By the creation of the negative symbol thought is freed from its dependence on the consequences of repression and the sway of the pleasure principle. [In the process of abstracting the qualifying adverbs 'perhaps' and the like have been omitted so the paper may appear to be more dogmatic than it really is.] J. R.
Internationale Zeitschrift für Psychoanalyse. 1925. Bd. xI. Heft 3. FERENZI 'Charcot-an appreciation.
OTTO FENICHEL: "Introjection and Castration-complex." A case history showing how twice a disappointment in love lead to a melancholic grief with introjection of the object, further that the disappointment was not determined by external factors but by repetition-compulsion (internal factors). The case shows the 'metapsychological' difference between melancholia and oral hysteria to be this: identification is not only a means of regaining the lost object into the ego, it is also a means of destroying the object by oral-sadism, the distinction between the two types of illness is to be made on economic grounds.
WILHELM REICH: "Further Remarks on the Therapeutic Significance of Genital-libido." In an earlier paper the author put forward the view that the prognosis in transference-neuroses was the more favourable the more completely infantile genital primacy had been attained, and genital object love will be reached more completely the freer the patient is from pre-genital complications. This is all right in theory but in practice a 'pure' genital primacy is not found. Mixtures and decompositions of impulses complicate the situation so that one is forced to ask oneself in regard to every patient in analysis not one but a number of questions on the question of libido organisation: (1) is genital libido repressed or unrepressed, or in what degree is it hindered from free manifestation by feelings of guilt? (2) is it replaced by pre-genital libido, and in what amount and by what tendencies? (3) if the libido structure as presented by the patient is preponderatingly pre-genital, has the infantile genital organisation been attained and later abandoned or has there been an inhibition of development due to pre-genital fixations? I. Orgastic Potency. To limit the discussion Reich confines himself to the questions of orgastic potency. How far, then, do we find symptoms of a disturbed 'psycho-genitality' among neurotics, or put the other way round do we ever meet a case of neurosis without sexual conflict? or putting the barriers still more narrowly about his theme: do we ever meet with a case of neurosis without a disturbance of genital function? Hysteria for example is
regarded psycho-analytically as an illness at the genital stage of libido, obsessional neurosis is a regression from that stage to the sadistic-anal one, i.e. sadism (or masochism) and 'anality' are the dominating libidinal tendencies of this disorder. The so-called psycho-paths show invariably a picture of completely disordered libido arrangement, in the rarest cases a genital primacy. Therefore is a neurosis with intact genital function theoretically thinkable? This leads to discussion of the theory and observations on which it is based: erection and ejaculation are somatic in nature but released psychically. The peripheral and central paths of excitation must be unified, the entire personality must take part in the act. In every form of impotence the paths of discharge are disturbed, e.g., by repressed ideas (castration-anxiety, anal ideas of the vagina or disgust for the same, homosexuality, etc.). Admixtures of non-genital phantasies with genital libido are found, e.g. the man who in coitus had active homosexual phantasies was completely potent, the ejaculative function was in order but the orgasm was weak. Reich postulates that ejaculation and orgasm are united only loosely. The man above did not go to woman for deep union, he had no orgastic potency with the opposite sex, and in spite of erective and ejaculatory power had a damming up of libido (anxiety neurosis), which mere ejaculation of semen did not remove. In female patients it is simply a question of the orgastic potency, for they can have pleasurable genital sensations without orgasm. In forming a judgement on genital function the following points have to be considered: (1) the acts of forepleasure should not be too prolonged, this weakens orgasm; (2) fatigue or bodily sleepiness afterwards and strong desire for sleep; (3) among women with full orgastic potency there is often a need to cry out at the acme; (4) a light clouding of consciousness is the rule in complete orgastic potency unless the act is done too often; (4) disgust, aversion or weakening of tender impulses to the partner after the act argues against an intact orgastic potency and therefore that conflict and inhibition was present during the act; (6) the anxiety of many women during the act that the penis will relax too soon before they are 'ready' also speaks against their orgastic potency (castration complex); (7) disregard on the part of the man for the woman's gratification bespeaks a lack of tenderness in the bonds between them; (8) the postures should be studied: incapability to perform rhythmic movement hinders orgasm and wide opening of legs and firm rest for the back is indispensable for the woman. The next question is: what is the fate of the genital libido in those who are abstinent but who appear to be psychically healthy. On this we can say nothing from analytical experience, indeed it would not be absolutely false to assert that continuous complete abstinence rests on a neurotic basis, because we can scarcely think of a biological function like the sexual one remaining inhibited except by repression, and it is equally hard to imagine repression producing no effects; nor does it do to over-estimate the capacity for sublimation, greatly though that varies from case to case. II. Gratification of Genital Libido as Defence against Relapse. One of the main features of psycho-analytical therapy is that it lays stress on removal of neurotic reactions to instinct activity. The patients have to traverse the path of development from pre-genital to genital stage, the aim is always the same because it is a biological one-to complete genital orgastic potency. Ferenczi's description of 'genitality' as 'erotic sense of reality' is however only a portion of the reality-principle. Genitality must not be taken to include homosexuality or other perversions because these are neuroses with special mechanisms; further