Psychic Trauma. Sigmund Freud

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The concept of "mental trauma" first appeared in the scientific literature at the end of the 19th century. The history of modern psychiatry is usually associated with the name of Emil Kraepelin and the publication in 1900 of his textbook "Introduction to a psychiatric clinic." E. Kraepelin was a student of W. Wundt and created his own concept of psychiatry based on the methods of experimental psychology, in which the key concept of psychiatry becomes “symptom”

Psychiatric disorders came to be seen alongside somatic illnesses, and their cause was seen in external factors such as viruses, toxins and trauma. At the same time, another direction of psychiatry develops - psychoanalysis, which substantiated the idea that all manifestations of mental disorders are determined by the patient's previous experiences (J. Charcot, Z. Freud "Study of hysteria" 1893, C. Jung "Psychosis and its content" 1907, T. Teeling).

Thus, psychiatry was divided into two directions: medical (nosological), which preached the exogenous nature of mental disorders, and constitutional, which defended the idea of the endogenous origin of mental disorders, and in particular the fact that the mental constitution of the personality, individual characteristics and a unique history of development underlie mental illness. … The constitutional direction of psychiatry was based on the phenomenological approach of Karl Jaspers, the main idea of which was that the main attention should be paid not to symptoms, but to the study of the personality of patients, their experiences and life history by "getting used" and "feeling" into their inner world. And what, first of all, a psychiatrist has to deal with when working with patients is a traumatic life experience.

Mental trauma - (trauma in the lane from Greek - "wound", "injury", "the result of violence") - deep and painful experiences of a person associated with traumatic events in his life, the ultimate accumulation of excitement, which he is not able to cope with or which partially overcome by means of unconscious defense mechanisms leading to the formation of neurotic symptoms. Z. Freud in his study of hysteria wrote: “Any event that causes a feeling of horror, fear, shame, mental pain can have a traumatic effect; and, of course, the likelihood of the incident becoming trauma depends on the susceptibility of the victim."

It is specific that the trauma does not always manifest itself in its pure form, as a painful memory or experience, it becomes, as it were, a "causative agent of the disease" and causes symptoms, which then, having gained independence, remain unchanged [12, p. twenty].

The concept of "trauma" in the ordinary sense relates mainly to bodily injury, violation of the integrity of the body.

Injuries are light, severe and incompatible with life, it all depends on the strength of the impact of the source of injury and the protective barrier of the body. According to the laws of homeostasis, everything that disturbs the balance and integrity of the body causes a reaction aimed at restoring a stable state. In this case, all foreign bodies are rejected by the body, that is, they are displaced. By analogy with physical trauma and the body's response to it, mental trauma also functions.

The psyche, as well as the internal environment of the organism, strives to maintain a stable state, and everything that violates this stability is repressed in the terminology of Z. Freud. Unlike physical trauma, which is always external, mental trauma can be of an intrapsychic nature, that is, the psyche has the ability to traumatize itself, producing certain thoughts, memories, experiences and affects.

The second significant difference between mental and physical trauma is that it is invisible and objectified by indirect signs, the main of which is mental pain. Reflex reaction of the body to any pain - withdrawal, avoidance, deliverance.

But the main function of pain is informational, it informs about the presence of damage and triggers a mechanism for the healing and survival of the body.

Mental pain it also informs about psychological distress and launches the mechanism of mental healing - the work of defense mechanisms, in particular the mechanisms of repression and suppression, or a response. The response to the traumatic impact is always present, and the more intense the trauma, the stronger the external action or internal experience. The response can be a retaliation, swearing if the person is hit or humiliated, or there can be a feeling of powerlessness and crying. The response allows for the release of excessive mental excitement that occurs during trauma. In the case when the increased mental excitement due to circumstances cannot be responded (including verbally, as you know, words can replace not only actions, but also experiences), the protective mechanisms of the psyche begin to work, transferring the energy of traumatic excitement into bodily symptoms, and discharge occurs in the somatic sphere.

What happens in psychoanalysis is conversion.

Psychosomatic psychotherapy considers the symbolic meaning of conversion symptoms localized in the body as follows:

- an offense that a person could not "swallow" is localized in the area of swallowing in the form of diseases of the throat, thyroid gland, and the offense that a person could not "digest" - in the area of the gastrointestinal tract;

- "trauma of a broken heart" or a situation taken to heart is localized in the heart;

- the feeling of guilt causes nausea, vomiting, vasospasm, and sexual guilt - frequent urination, enuresis, cystitis;

- “not crying” tears and suppressed crying cause intestinal upset and rhinitis (tears find another way out);

- powerless rage and passive irritability from the life situation, lack of support and support - disorders of the musculoskeletal system;

- traumas of humiliation and blows to pride - problems with blood vessels, headaches, hypertension;

- pre-verbal trauma - speech disorders.

Z. Freud pointed out that, despite the fact that somatization contributes to the release of the arisen mental stress, a specific “mental core” or “switching point” is formed in the psyche, associated with all the “attributes” of the received mental trauma. And this "mental core" will be activated whenever the situation resembles traumatic experiences, while simultaneously triggering pathological response mechanisms. Z. Freud calls this process the phenomenon of "obsessive repetition." Thus, trauma has a very "good memory", and its victims suffer mainly from memories and pathological patterns of response, realized unconsciously. Z. Freud noted that his patients are not only in captivity of painful experiences of the distant past, but also desperately cling to them, because they have some special value, there is a fixation on the trauma, which can last a lifetime [12].

Trauma theory, which played a prominent role in the early stages of psychoanalysis, has been linked to trauma as a cause of mental disorders. This idea arose in Z. Freud during the period of using the cathartic method of treatment in the treatment of hysteria.

Initially, Z. Freud believed that the sexual harassment reported to him by his patients did indeed take place and so traumatized the child's psyche that subsequently led to neurotic disorders.

Unpleasant painful experiences are repressed, and the affects associated with them do not find expression, continue to develop unconsciously and begin to manifest themselves in the form of psychosomatic symptoms. Z. Freud believed that using the psychoanalytic method, with the help of memories, it is possible to bring repressed traumatic experiences to a conscious level. And if you show a suppressed affect and steadfastly overcome it, then it is possible to get rid of both the trauma and the symptom. This happened to the first patient of psychoanalysis, Anna O., who, while caring for her terminally ill father, could not realize her sexual and aggressive impulses, because she was afraid to upset him. She repressed these impulses, due to which she developed a number of symptoms: paralysis, convulsions, inhibition, mental disorder.

As soon as she relived and brought to resolution the corresponding affects, the symptoms disappeared, which proved the existence of cause-and-effect relationships between suppressed impulses and neurosis as their consequence. Thus, it became clear that the external situation (trauma, fear of losing the father) and internal motives (the desire to become close to him, perhaps even sexually, and at the same time the desire for his death) are equally responsible for the appearance of a neurosis.

Later, Z. Freud noticed that the stories of patients about sexual harassment often turn out to be fiction and fantasy, which gave rise to the transition to the position of the theory of instincts (drives). Z. Freud's new hypothesis boiled down to the following: the sexually colored stories of patients are the product of their painful fantasies, but these fantasies, albeit in a distorted form, reflect their actual desires and inclinations.

Returning to Freud's theory of trauma, it should be noted that cases of sexual abuse by adults so injure the child's psyche that they are unable to endure these terrible and frightening experiences, which as a result are repressed into the unconscious, and then presented in the form of psychopathology. At the same time, the situation is not only and not so much in the mental trauma itself, received in early childhood, as in pathogenic memories of it, which remain unconscious, but cause sexual arousal during puberty and at a later age. Simultaneously, Z. Freud believed that one should not expect the presence of one traumatic memory and, as its nucleus, the only pathogenic representation, but one should be prepared for the presence of several series of partial injuries and couplings of pathogenic train of thought.

In "Lectures on an introduction to psychoanalysis" Z. Freud showed that the so-called "traumatic neuroses", which are the result of railway and other disasters, as well as the result of war, are in close analogy with the neuroses. At the heart of these neuroses lies the fixation on the moment of trauma. The traumatic situation is constantly repeated in the dreams of patients and it seems that it remains an insoluble urgent problem for them.

The very concept of trauma acquires an economic meaning, i.e. turns out to be related to the amount of energy. Therefore, Z. Freud calls an experience traumatic, which in a short time leads the psyche to such a strong increase in excitement that its normal processing or getting rid of it becomes impossible, as a result of which long-term disturbances in energy expenditure may occur. The psychodynamics of mental trauma is such that even long-standing experiences have a tangible effect on the psyche, and the memory of them does not become less significant and painful over the years. Z. Freud noted that a decrease in the severity of traumatic experiences depends on whether an energetic reaction (motor and emotional) followed immediately after the traumatic impact or there was no possibility for such a reaction, and it was suppressed. In this regard, early childhood traumas have such a strong pathological effect on the psyche, since the child is not able to vigorously respond to the traumatic effect. The response to trauma has a wide range of responses: from immediate to delayed for many years and even decades, from ordinary crying to violent acts of revenge and retaliatory aggression. And only when the person has fully reacted to the traumatic event, the affect gradually diminishes. Z. Freud characterizes this with the expressions “to throw out feelings” or “cry out” and emphasizes that the insult to which it was possible to respond is remembered differently than the one that had to be endured [12].

In the theory of trauma, external trauma and the accompanying internal psychological shock play a special role, while in the theory of instincts, internal motives and conflicts dominate. In the first case, a person is a victim of external circumstances, in the second - their culprit. In the first case, the cause of neurotic disorders is real events, in the second - fictional (fantasy). An outstanding achievement of Z. Freud is that he, through trial and error, came to the conclusion that along with trauma there are instincts and internal psychological motives that govern people's behavior. Modern psychoanalysis adheres to both the theory of trauma and the theory of instincts in explaining the cause of neuroses, believing that both theories are correct. Many people do suffer from their instinctual impulses, which make them feel overwhelmed, but also many mental disorders are observed from inadequate parent-child relationships, in which parents either did not respond to the needs of their children, or unconsciously used them or were simply abused.

Z. Freud pointed out that not always psychic trauma contributes to the emergence of neuroses. There are times when tremendous traumatic events knock a person out so much that he loses interest in life, but such a person does not necessarily become neurotic. In the formation of neurosis, various factors play a significant role, including constitutional features, infantile experiences, fixation on memories, regression, and internal conflicts.

In his work "On the Other Side of Pleasure" S. Freud correlated mental trauma with the mechanisms of protection of the human body from the dangers that threaten him. He called traumatic such strong excitations from the outside that are capable of breaking through the protection against irritation. External trauma causes a breakdown in the energy of the body and sets in motion the defense mechanisms. But irritations can be so strong that the body is unable to contain the overflow of the mental apparatus with a large number of irritations. The last line of defense of the body against irritants is fear. Z. Freud put forward the position of a close connection between trauma and fear. He viewed fear from the point of view of the reproduction of affective states corresponding to the person's memories. These affective states are embodied in mental life as sediments of traumatic experiences of the past and in situations corresponding to these experiences are reproduced as symbols of memories.

According to Freud, real fear is fear of a certain danger, while neurotic fear is fear of a danger that is unknown to man. In the case when a person experiences physical helplessness in front of a real danger or mental helplessness in front of the danger of his drives, trauma occurs. Self-preservation of a person is connected with the fact that he does not wait for the onset of a traumatic situation of danger, but foresees, anticipates it. An expectation situation becomes a situation of danger, at the onset of which a signal of fear arises, which resembles a previously experienced traumatic experience. Therefore, fear is, on the one hand, the expectation of trauma, and on the other hand, a softened reproduction of it, which, when danger comes, is given as a signal for help.

In the understanding of the founder of psychoanalysis, there is another close relationship between trauma and neurosis, which is rooted in the past in the relationship of the child with the mother. Thus, a situation in which the mother is absent turns out to be traumatic for the child, especially when the child has a need that the mother must satisfy. This situation simply turns into danger, if this need is urgent, then the child's fear becomes the reaction to danger. Subsequently, the loss of his mother's love becomes for him a stronger danger and a condition for the development of fear.

From the point of view of S. Freud, the decisive moment for the outcome and consequences of trauma is not its strength, but the preparedness or unpreparedness of the organism, which is expressed in its potential. Specifically, the trauma does not always manifest itself in its pure form, as a painful memory or experience. It becomes, as it were, a "causative agent of the disease" and causes various symptoms (phobias, obsessions, stuttering, etc.). According to his own observations, Z. Freud noticed that symptoms can disappear when it is possible with all emotionality to revive in memory, relive and articulate a traumatic event. Later, these observations formed the basis of psychoanalytic psychotherapy and debriefing of work with mental trauma [11].

The main provisions of the theory of trauma Z. Freud:

- mental trauma plays an important role in the etiology of neuroses;

- the experience becomes traumatic due to the quantitative factor;

- with a certain psychological constitution, a trauma becomes something that would not cause similar consequences with another;

- all mental trauma belongs to early childhood;

- mental traumas are either experiences of one's own body, or sensory perceptions and impressions;

- the consequences of trauma are of two kinds - positive and negative;

- the positive consequences of trauma are associated with an effort to return its weight, i.e. remember a forgotten experience, make it real, relive its repetition again, let it be reborn to some other person (fixation on the trauma and its obsessive repetition);

- the negative consequences of trauma are associated with protective reactions in the form of avoidance and phobias;

- neurosis - an attempt to heal from trauma, the desire to reconcile the parts of "I" that have broken away under the influence of trauma with the rest of the parts.

An excerpt from the book: "The Psychology of Experiences" by A. S. Kocharyan, A. M. Fox