LADIES AND GENTLEMEN, – I cannot tell how much knowledge about psycho-analysis each one of you has already acquired from what you have read or from hearsay. But the wording of my prospectus – ‘Elementary Introduction to Psycho-Analysis’ – obliges me to treat you as though you knew nothing and stood in need of some preliminary information.
I can, however, assume this much – that you know that psycho-analysis is a procedure for the medical treatment of neurotic patients. And here I can at once give you an instance of how in this field a number of things take place in a different way – often, indeed, in an opposite way – from what they do elsewhere in medical practice. When elsewhere we introduce a patient to a medical technique which is new to him, we usually minimize its inconveniences and give him confident assurances of the success of the treatment. I think we are justified in this, since by doing so we are increasing the probability of success. But when we take a neurotic patient into psycho-analytic treatment, we act differently. We point out the difficulties of the method to him, its long duration, the efforts and sacrifices it calls for; and as regards its success, we tell him we cannot promise it with certainty, that it depends on his own conduct, his understanding, his adaptability and his perseverance. We have good reasons, of course, for such apparently wrong-headed behaviour, as you will perhaps come to appreciate later on.
Do not be annoyed, then, if I begin by treating you in the same way as these neurotic patients. I seriously advise you not to join my audience a second time. To support this advice, I will explain to you how incomplete any instruction in psycho-analysis must necessarily be and what difficulties stand in the way of
your forming a judgement of your own upon it. I will show you how the whole trend of your previous education and all your habits of thought are inevitably bound to make you into opponents of psycho-analysis, and how much you would have to overcome in yourselves in order to get the better of this instinctive opposition. I cannot, of course, foretell how much understanding of psycho-analysis you will obtain from the information I give you, but I can promise you this: that by listening to it you will not have learnt how to set about a psycho-analytic investigation or how to carry a treatment through. If, however, there should actually turn out to be one of you who did not feel satisfied by a fleeting acquaintance with psycho-analysis but was inclined to enter into a permanent relationship to it, I should not merely dissuade him from doing so but actively warn him against it. As things stand at present, such a choice of profession would ruin any chance he might have of success at a University, and, if he started in life as a practising physician, he would find himself in a society which did not understand his efforts, which regarded him with distrust and hostility, and unleashed upon him all the evil spirits lurking within it. And the phenomena accompanying the war that is now raging in Europe will perhaps give you some notion of what legions of these evil spirits there may be.
Nevertheless, there are quite a number of people for whom, in spite of these inconveniences, something that promises to bring them a fresh piece of knowledge still has its attraction. If a few of you should be of this sort and in spite of my warnings appear here again for my next lecture, you will be welcome. All of you, however, have a right to learn the nature of the difficulties of psycho-analysis to which I have alluded.
I will begin with those connected with instruction, with training in psycho-analysis. In medical training you are accustomed to see things. You see an anatomical preparation, the precipitate of a chemical reaction, the shortening of a muscle as a result of the stimulation of its nerves. Later on, patients are demonstrated before your senses – the symptoms of their illness, the products of the pathological process and even in many cases the agent of the disease in isolation. In the surgical departments you are witnesses of the active measures taken to bring help to patients, and you may yourselves attempt to put them into effect.
Even in psychiatry the demonstration of patients with their altered facial expressions, their mode of speech and their behaviour, affords you plenty of observations which leave a deep impression on you. Thus a medical teacher plays in the main the part of a leader and interpreter who accompanies you through a museum, while you gain a direct contact with the objects exhibited and feel yourselves convinced of the existence of the new facts through your own perception.
In psycho-analysis, alas, everything is different. Nothing takes place in a psycho-analytic treatment but an interchange of words between the patient and the analyst. The patient talks, tells of his past experiences and present impressions, complains, confesses to his wishes and his emotional impulses. The doctor listens, tries to direct the patient’s processes of thought, exhorts, forces his attention in certain directions, gives him explanations and observes the reactions of understanding or rejection which he in this way provokes in him. The uninstructed relatives of our patients, who are only impressed by visible and tangible things – preferably by actions of the sort that are to be witnessed at the cinema – never fail to express their doubts whether ‘anything can be done about the illness by mere talking’. That, of course, is both a short-sighted and an inconsistent line of thought. These are the same people who are so certain that patients are ‘simply imagining’ their symptoms. Words were originally magic and to this day words have retained much of their ancient magical power. By words one person can make another blissfully happy or drive him to despair, by words the teacher conveys his knowledge to his pupils, by words the orator carries his audience with him and determines their judgements and decisions. Words provoke affects and are in general the means of mutual influence among men. Thus we shall not depreciate the use of words in psychotherapy and we shall be pleased if we can listen to the words that pass between the analyst and his patient. But we cannot do that either. The talk of which psycho-analytic treatment consists brooks no listener; it cannot be demonstrated. A neurasthenic or hysterical patient can of course, like any other, be introduced to students in a psychiatric lecture. He will give an account of his complaints and symptoms, but of nothing else. The information required by analysis will be given by him only on condition of his having a special emotional attachment to the doctor; he would become silent as soon as he observed a single witness to whom he felt indifferent. For this information concerns what is most intimate in his mental life, everything that, as a socially independent person, he must conceal from other people, and, beyond that, everything that, as a homogeneous personality, he will not admit to himself.
Thus you cannot be present as an audience at a psycho-analytic treatment. You can only be told about it; and, in the strictest sense of the word, it is only by hearsay that you will get to know psycho-analysis. As a result of receiving your instruction at second hand, as it were, you find yourselves under quite unusual conditions for forming a judgement. That will obviously depend for the most part on how much credence you can give to your informant.
Let us assume for a moment that you were attending a lecture not on psychiatry but on history, and that the lecturer was telling you of the life and military deeds of Alexander the Great. What grounds would you have for believing in the truth of what he reported? At a first glance the position would seem to be even more unfavourable than in the case of psycho-analysis, for the Professor of History no more took part in Alexander’s campaigns than you did. The psycho-analyst does at least report things in which he himself played a part. But in due course we come to the things that confirm what the historian has told you. He could refer you to the reports given by ancient writers, who were either themselves contemporary with the events under question or, at any rate, were comparatively close to them – he could refer you, that is to say, to the works of Diodorus, Plutarch, Arrian, and so on. He could put reproductions before, you of coins and statues of the king which have survived and he could hand round to you a photograph of the Pompeian mosaic of the battle of Issus. Strictly speaking, however, all these documents only prove that earlier generations already believed in Alexander’s existence and in the reality of his deeds, and your criticism might start afresh at that point. You would then discover that not all that has been reported about Alexander deserves credence or can be confirmed in its details; but nevertheless I cannot think that you would leave the lecture-room in doubts of the reality of Alexander the Great. Your decision would be determined essentially by two considerations: first, that the lecturer had no conceivable motive for assuring you of the reality of something he himself did not think real, and secondly, that all the available history books describe the events in approximately similar terms. If you went on to examine the older sources, you would take the same factors into account the possible motives of the informants and the conformity of the witnesses to one another. The outcome of your examination would undoubtedly be reassuring in the case of Alexander, but would probably be different where figures such as Moses or Nimrod were concerned. Later opportunities will bring to light clearly enough what doubts you may feel about the credibility of your psycho-analytic informant.
But you will have a right to ask another question. If there is no objective verification of psycho-analysis, and no possibility of demonstrating it, how can one learn psycho-analysis at all, and convince oneself of the truth of its assertions? It is true that psycho-analysis cannot easily be learnt and there are not many people who have learnt it properly. But of course there is a practicable method none the less. One learns psycho-analysis on oneself, by studying one’s own personality. This is not quite the same thing as what is called self-observation, but it can, if necessary, be subsumed under it. There are a whole number of very common and generally familiar mental phenomena which, after a little instruction in technique, can be made the subject of analysis upon oneself. In that way one acquires the desired sense of conviction of the reality of the processes described by analysis and of the correctness of its views. Nevertheless, there are definite limits to progress by this method. One advances much further if one is analysed oneself by a practised analyst and experiences the effects of analysis on one’s own self, making use of the opportunity of picking up the subtler technique of the process from one’s analyst. This excellent method is, of course, applicable only to a single person and never to a whole lecture room of students together Psycho-analysis is not to be blamed for a second difficulty in your relation to it; I must make you yourselves responsible for it, Ladies and Gentlemen,at least in so far as you have been students of medicine. Your earlier education has given a particular direction to your thinking, which leads far away from psycho-analysis. You have been trained to find an anatomical basis for the functions of the organism and their disorders, to explain them chemically and physically and to view them biologically. But no portion of your interest has been directed to psychical life, in which, after all, the achievement of this marvellously complex organism reaches its peak. For that reason psychological modes of thought have remained foreign to you. You have grown accustomed to regarding them with suspicion, to denying them the attribute of being scientific, and to handing them over to laymen, poets, natural philosophers and mystics. This limitation is without doubt detrimental to your medical activity, since, as is the rule in all human relationships, your patients will begin by presenting you with their mental façade, and I fear that you will be obliged as a punishment to leave a part of the therapeuticinfluence you are seeking to the lay practitioners, nature curers and mystics whom you so much despise.
I am not unaware of the excuse that we have to accept for this defect in your education. No philosophical auxiliary science exists which could be made of service for your medical purposes. Neither speculative philosophy, nor descriptive psychology, nor what is called experimental psychology (which is closely allied to the physiology of the sense-organs), as they are taught in the Universities, are in a position to tell you anything serviceable of the relation between body and mind or to provide you with the key to an understanding of possible disturbances of the mental functions. It is true that psychiatry, as a part of medicine, sets about describing the mental disorders it observes and collecting them into clinical entities; but at favourable moments the psychiatrists themselves have doubts of whether their purely descriptive hypotheses deserve the name of a science. Nothing is known of the origin, the mechanism or the mutual relations of the symptoms of which these clinical entities are composed; there are either no observable changes in the anatomical organ of the mind to correspond to them, or changes which throw no light upon them. These mental disorders are only accessible to therapeutic influence when they can be recognized as subsidiary effects of what is otherwise an organic illness.
This is the gap which psycho-analysis seeks to fill. It tries to give psychiatry its missing psychological foundation. It hopes to discover the common ground on the basis of which the convergence of physical and mental disorder will become intelligible. With this aim in view, psycho-analysis must keep itself free from any hypothesis that is alien to it, whether of an anatomical, chemical or physiological kind, and must operate entirely with purely psychological auxiliary ideas; and for that very reason, I fear, it will seem strange to you to begin with.
I shall not hold you, your education or your attitude of mind responsible for the next difficulty. Two of the hypotheses of psycho-analysis are an insult to the entire world and have earned its dislike. One of them offends against an intellectual prejudice, the other against an aesthetic and moral one. We must not be too contemptuous of these prejudices; they are powerful things, precipitates of human developments that were useful and indeed essential. They are kept in existence by emotional forces and the struggle against them is hard.
The first of these unpopular assertions made by psycho-analysis declares that mental processes are in themselves unconscious and that of all mental life it is only certain individual acts and portions that are conscious. You know that on the contrary we are in the habit of identifying what is psychical with what is conscious. We look upon consciousness as nothing more nor less than the defining characteristic of the psychical, and psychology as the study of the contents of consciousness. Indeed it seems to us so much a matter of course to equate them in this way that any contradiction of the idea strikes us as obvious nonsense. Yet psycho-analysis cannot avoid raising this contradiction; it cannot accept the identity of the conscious and the mental. It defines what is mental as processes such as feeling, thinking and willing, and it is obliged to maintain that there is unconscious thinking and unapprehended willing. In saying this it has from the start frivolously forfeited the sympathy of every friend of sober scientific thought, and laid itself open to the suspicion of being a fantastic esoteric doctrine eager to make mysteries and fish in troubled waters. But you, Ladies and Gentlemen, naturally cannot understand as yet what right I have to describe as a prejudice a statement of so abstract a nature as ‘what is mental is conscious’. Nor can you guess what development can have led to a denial of the unconscious – should such a thing exist – and what advantage there may have been in that denial. The question whether we are to make the psychical coincide with the conscious or make it extend further sounds like an empty dispute about words; yet I can assure you that the hypothesis of there being unconscious mental processes paves the way to a decisive new orientation in the world and in science.
You cannot have any notion, either, of what an intimate connection there is between this first piece of audacity on the part of psycho-analysis and the second one, which I must now tell you of. This second thesis, which psycho-analysis puts forward as one of its findings, is an assertion that instinctual impulses which can only be described as sexual, both in the narrower and wider sense of the word, play an extremely large and never hitherto appreciated part in the causation of nervous and mental diseases. It asserts further that these same sexual impulses also make contributions that must not be underestimated to the highest cultural, artistic and social creations of the human spirit.
In my experience antipathy to this outcome of psycho-analytic research is the most important source of resistance which it has met with. Would you like to hear how we explain that fact? We believe that civilization has been created under the pressure of the exigencies of life at the cost of satisfaction of the instincts;(and we believe that civilization is to a large extent being constantly created anew, since each individual who makes a fresh entry into human society repeats this sacrifice of instinctual satisfaction for the benefit of the whole community. Among the instinctual forces which are put to this use the sexual impulses play an important part; in this process they are sublimated – that is to say, they are diverted from their sexual aims and directed to others that are socially higher and no longer sexual. But this arrangement is unstable; the sexual instincts are imperfectly tamed, and, in the case of every individual who is supposed to join in the work of civilization, there is a risk that his sexual instincts may refuse to be put to that use.
Society believes that no greater threat to its civilization could arise than if the sexual instincts were to be liberated and returned to their original aims. For this reason society does not wish to be reminded of this precarious portion of its foundations. It has no interest in the recognition of the strength of the sexual instincts or in the demonstration of the importance of sexual life to the individual. On the contrary, with an educational aim in view, it has set about diverting attention from that whole field of ideas. That is why it will not tolerate this outcome of psycho-analytic research and far prefers to stamp it as something aesthetically repulsive and morally reprehensible, or as something dangerous. But objections of this sort are ineffective against what claims to be an objective outcome of a piece of scientific work; if the contradiction is to come into the open it must be restated in intellectual terms. Now it is inherent in human nature to have an inclination to consider a thing untrue if one does not like it, and after that it is easy to find arguments against it. Thus society makes what is disagreeable into what is untrue. It disputes the truths of psycho-analysis with logical and factual arguments; but these arise from emotional sources and it maintains these objections as prejudices, against every attempt to counter them.
We, however, Ladies and Gentlemen, can claim that in asserting this controversial thesis we have had no tendentious aim in view. We have merely wished to give expression to a matter of fact which we believe we have established by our painstaking labours. We claim, too, the right to reject without qualification any interference by practical considerations in scientific work, even before we have enquired whether the fear which seeks to impose these considerations on us is justified or not.
Such, then, are a few of the difficulties that stand in the way of your interest in psycho-analysis. They are perhaps more than enough for a start. But if you are able to overcome the impression they make on you, we will proceed.