The Birth Of Psychoanalysis And The Rejection Of Hypnosis (part 2)

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

The birth of psychoanalysis and the rejection of hypnosis

The conception of psychoanalysis as a psychoanalytic theory, method, research and therapy method

In what sense is psychoanalysis born in studies of hysteria?

First, in the course of describing the case histories of hysterics, a psychoanalytic vocabulary is formed, a conceptual apparatus of future theories. We see how Freud speaks now of a split consciousness, now of an expanded and narrowed consciousness, now of consciousness and the unconscious. The unconscious has not yet become the area that it would like to discover and explore. His task is to penetrate into "deeper layers of consciousness", "to expand the limits of the patient's consciousness." We notice how such fundamental concepts as "repression" and "resistance", "protection" and "transfer" appear in the text, but do not yet acquire terminological stability.

Although the very word psychoanalysis will appear a year later, in 1896, in the article "Further remarks on the psychoneuroses of defense." In addition to the emerging psychoanalytic discourse, there are clear traces of French influence: we will not see so many French terms and references to Charcot, Liebeau, Bernheim in the future.

Secondly, the main work "Investigation of Hysteria" is an account of how the psychoanalytic technique is being worked out, how it is developed in interaction with Joseph Breuer and patients, or rather, in counteracting them. This is the story of discovering the techniques of therapy, the search for an effective method.

Refusal of hypnosis: candy-bouquet period

Although Freud found his treatment of neurotic patients with hypnosis quite successful, this method nevertheless caused certain difficulties. It was hard work, and a large number of patients could not be completely immersed in hypnosis. Those who responded well to hypnosis often experienced recurrence of symptoms, even when the result seemed positive at first. He later wrote:

“I gave up in my practice the technique of suggestion and hypnosis with it so quickly, because I was desperate to make the suggestion strong and long-lasting enough for the cure to be complete. In all severe cases, I saw that the result of the suggestion made disappeared again and again, and the disease or its substitute returned again and again”(Z. Freud, 1905)

Hypnosis Cannot Remove This Force, Called by Freud resistance (most often it is a derivative of the super-ego), hypnosis can only weaken it for the duration of a hypnotic trance. In the weakening of resistance, which allows you to penetrate into the depths of the unconscious - the very principle of hypnosis. But resistance itself is inaccessible to hypnosis. Hypnosis does not eliminate, but only, according to Freud's apt expression, "masks resistance and makes available a certain mental area, but it accumulates resistance at the borders of this area in the form of a shaft, which makes everything further inaccessible." Only by abandoning hypnosis can resistance be detected and analyzed, and therefore the cause of repression can be eliminated. It is the resistance that is unnoticed in the process of hypnotic influence that can revive the disappeared symptoms and generate new ones, again separating the united and continuing to split off emotions when experiencing new events in life. Hypnotic treatment can eliminate long-standing symptoms for a very long time, maybe forever, but sleep treatment cannot teach us how to respond to the new traumas of life that are inevitable in a new, more constructive way.

But it was hypnosis that prompted Freud to abandon hypnosis:

"Since I could not change the mental state of most of my patients at will, I began to work with their normal state. At first it seemed a senseless and unsuccessful undertaking. the patient himself knows. How could one hope to find out yet? Here came to my aid the recollection of a wonderful and instructive experience in which I was present at Brentheim in Nancy. Brentheim showed us then that persons who were brought into a somnambulistic state by him, in which they, on his orders, experienced various experiences, lost the memory of what they experienced in this state only at first glance: it turned out to be possible in a waking state to awaken memories of those experienced in somnambulism. When he asked them about their experiences in a somnambulistic state, they really at first claimed that they did not know anything, but when he did not calm down, insisted on his own, assuring them that they did know, the forgotten memories were revived every time. (Sigmund Freud. "Five Lectures on Psychoanalysis")

Thus, Brentheim's demonstrations gave Freud the idea of treating the patient while awake.

His work in psychoanalysis grew out of the technique of hypnosis. He explained it this way:

“It seemed more difficult than putting them into hypnosis, but it could be very instructive. So I abandoned hypnosis, retaining in my practice only the requirement that the patient lay on the couch, and I would sit behind him and see him, but he would not”(Freud, 1925).

He argued:

“In addition to all this, I have one more reproach to this method (hypnosis), namely, that it hides from our sight the entire play of psychic forces; does not allow us, for example, to recognize the resistance with which the patient clings to his illness and thereby fights against his own recovery; and yet it is precisely the phenomenon of resistance that alone makes it possible to understand such behavior in everyday life”(Freud, 1905).

Only when you rule out hypnosis can you notice resistances and repressions and get a truly correct understanding of the pathogenic process. Hypnosis masks resistance and makes a certain soul area available, but it builds up resistance at the boundaries of this area in the form of a shaft, which makes everything further inaccessible.

Pipe cleaning

"… fairy tales speak of evil spirits, whose power disappears as soon as you call them by their real name, which they keep secret." Sigmund Freud, "Methodology and Technique of Psychoanalysis".

"The content of the psyche, which possessed her during the states of confusion and to which the aforementioned individual words belonged. Having told a number of such fantasies, the patient seemed to be freed and returned to a normal mental life. Such a good state lasted for many hours, but the next day it was replaced by a new one. a fit of confusion, which in turn ended in exactly the same way after the newly formed fantasies were expressed.”One could not get rid of the impression that the changes in the psyche that manifested themselves in the state of confusion were the result of irritation emanating from these highly affective formations. The patient herself, who during this period of her illness surprisingly spoke and understood only English, gave this new method of treatment a name, talking cure "or jokingly called this treatment, chimney sweeping." 34]

Cathartic method

This method consisted in the analysis of the causes of a particular symptom (psychological trauma) in a patient in a hypnotic state. In the process of discovering such causes, the patient reacted very violently emotionally to the memory of a forgotten traumatic situation (response to trauma), and upon awakening, the symptom disappeared. Here verbalization appears as an exit to a more mature level of mental protection and a prerequisite for the psychoanalytic method. "Be quiet and listen to me!" - Emmy Von N.

Soon, as if by chance, it turned out that with the help of such a purification of the soul, more can be achieved than the temporary elimination of constantly recurring disorders of consciousness. If the patient, with an expression of passion, recalled in hypnosis for what reason and in what connection the known symptoms first appeared, then it was possible to completely eliminate these symptoms of the disease (A case with the inability to drink water). The fate of these affects, which can be regarded as shifting quantities, was a defining moment for both illness and recovery.

If, in the treatment with directive hypnosis, before awakening, the patient, as a rule, was given the instruction to forget everything that happened to him in the process of the hypnotic state, then in the treatment with the cathartic method the task was to preserve the forgotten (repressed) traumatic experiences that are the cause of the symptom. The pathogenic memories that disappeared from the memory were brought to the patient's consciousness, which led to the disappearance of the symptom, the task was to identify the causes of their occurrence. A traumatic situation is a given that the patient had to re-experience in order to react to it properly (without suppressing emotions), to release restrained feelings, thereby relieving the pathogenic tension that causes the symptom.

Freud, disillusioned with hypnosis, began to practice Breuer's cathartic method himself and achieved amazing results in curing many patients with hysteria, which made it possible to draw some theoretical conclusions:

"We can put everything we have learned so far in a formula: our hysterical patients suffer from memories. Their symptoms are remnants and symbols of memories of known (traumatic) experiences."

The entire chain of pathogenic memories had to be recalled in chronological sequence and, moreover, in the reverse order: the last trauma at first and the first at the end, and it was impossible to jump over subsequent traumas directly to the first, often the most effective.

So, in practice, the free association method appears:

"If this path of finding the repressed seems too difficult for you, then I can at least assure you that this is the only possible path. Processing the thoughts that arise in the patient if he fulfills the basic rule of psychoanalysis is not the only technique for studying the unconscious Two other means serve the same purpose: the interpretation of the patient's dream and the use of his erroneous and accidental actions. When I am asked how one can become a psychoanalyst, I always answer: by studying my own dreams. " Z. Freud.

The symptom makes sense

At this point we meet with one of the most important Freudian discoveries, namely that each symptom is, first of all, an attempt to heal, an attempt to ensure the stability of a given psychic structure. [4]

No one has yet eliminated hysterical symptoms in this way, and no one has penetrated so deeply into understanding their causes. It turned out that almost all the symptoms were formed as remnants, like sediments, of affective experiences, which later began to be called "Mental trauma" often repeated traumatic scenes and represented the remnants of memories of these scenes.

"Hysterical conversion exaggerates this part of the flow of the affective mental process; it corresponds to a more intense expression of affect, directed towards new paths. When a river flows through two channels, there will always be an overflow of one, as soon as the flow along the other meets any obstacle. You see, we are ready to come to a purely psychological theory of hysteria, and we put affective processes in the first place. " Z. Freud

Here is the beginning of the formation of the method of free associations and ideas about trauma theorythat once actually took place (Katarina's case: trauma as an after-effect awareness, fantasy reality). The role of trauma can only be monitored in aftereffect.

"This fixation of mental life on pathogenic trauma is one of the most important characteristics of neurosis, which is of great practical importance." Z. Freud

Further Freud will come to the conclusion that one should work not with the symptom itself, but with its cause. The symptom performs an important economic function in the work of the mental apparatus: it seeks to reduce excitement and at the same time to satisfy all instances of the psyche (Super-I, It and the outside world). The symptom is a part of a person's “I” and before getting rid of it, it is important to find an alternative way to redistribute mental stress. Sometimes this work takes a long time, since the psyche was formed for a long period and it takes effort and time to rebuild the system and the way it works.

Psychoanalysis on the couch

Elisabeth von R.'s couch - Freud's first couch used in psychoanalysis - has been photographed many times and remains today in London, an object of incessant curiosity.

The couch as a way to avoid the piercing glances of the analysands, to help them relax, to take the position most favorable for immersion in the process of continuous free associations or even regression of the psyche. [29]

Although the popular belief is that Freud was the first therapist to use the couch for psychoanalysis, Halpern states otherwise:

The first records of psychoanalytic treatment do not refer to the well-furnished Viennese study on the Berggasse, but to the Dionysium, an open theater located on the southeastern slope of the Athenian Acropolis. On the couch, instead of the aristocratic Elizabeth von Ritter, was reclining the artless figure of an Attician farmer, Strepsiades; and behind the patient was not the bearded, impeccable Herr Doctor Professor Sigmund Freud, but the barefoot, satyr-faced Socrates."

Today, in the classical psychoanalytic technique, the couch continues to remain in the arsenal of psychoanalysts, however, many modern techniques tend to avoid conversations when the analysand is lying down and the analyst is in a chair behind him. Indeed, not every client is suitable for this method and way of working, since it involves regression, which can lead to increased anxiety. Also, the couch is not suitable for use in working with certain personality structures, in such situations it is better to stay in the “face-to-face” position. Modern trends in the development of technical capabilities for remote work and sessions on the Internet, of course, reduce efficiency, since in this case a lot of valuable information for the psychoanalyst escapes. For this reason, many experts consider psychoanalysis a "luxury" today, since going to a psychoanalyst involves a whole process: the need to agree on the day, time and place of the meeting, get ready, get dressed, get to the office where the session is scheduled, be on time. Such work presupposes eye contact, presence in a certain place, in the office "on the territory" of a specialist, and many other moments on the way to the psychoanalyst and on the way back from him. Some professionals refuse to work online today, however, this modern society and the development of technology sooner or later overtakes this area too. Freud corresponded with many of his analysands and colleagues, and this, too, can in part be compared to remote work on the Internet today.

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