THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 LOS ANGELES
 
 THE HISTORY AND PRACTICE OF 
 PSYCHANALYSIS
 
 RATIONAL SEX SERIES 
 
 SAKE SEX LIFE AND SANE SEX LIVIKO, 
 by H. W. Long, M.D. 
 
 BI-SEXUAL LOVE, by Dr. William Stekel. 
 
 THE HOMOSEXUAL NEUROSIS, by Dr. Wil- 
 liam Stekel. 
 
 SEX AND DREAMS, THE LANGUAGE OF 
 DREAMS, by Dr. William Stekel. 
 
 SEX AND THE SENSES, by James 8. Van 
 Teslaar 
 
 THE LAWS OF SEX, by Edith H. Hooker 
 
 MOTHERHOOD, by H. W. Long, MJ). 
 
 CHILDREN BY CHANCE OR BY CHOICE, by 
 William Hawley Smith 
 
 SEX IN PSYCHO-ANALYSIS, by S. Fe- 
 renczi, M.D. 
 
 HISTORY AND PRACTICE OF PSYCHANALY- 
 
 sis, by Poul Bjerre, M.D. 
 TEMPERAMENT AND SEX, by Walter 
 
 Heaton 
 
 SEX AND SOCIETY, by W. I. Thomas 
 
 RICHARD G. BADGER, PUBLISHER, BOSTON
 
 THE 
 
 HISTORY AND PRACTICE 
 OF PSYCHANALYSIS 
 
 BY 
 
 POUL BJERRE, M.D. 
 
 Authorized Translation by 
 ELIZABETH N. BARROW 
 
 REVISED EDITION 
 
 BOSTON 
 
 RICHARD G. BADGER 
 
 THE GORHAM PRESS 
 LONDON: STANLEY PHILLIPS
 
 COPYRIGHT, 1916, BY RICHARD G. BADQEB 
 COPYRIGHT, 1920, BY ELIZABETH N. HARROW 
 
 All Rights Reserved 
 
 Made in the United States of America 
 
 The Gorham Press, Boston, IJ. S. A.
 
 WM 
 
 The translator desires to express- keen appreciation ol 
 
 the valuable assistance given in this work 
 
 by Ebba Tisell
 
 INTRODUCTION 
 
 years ago when this book was written, it 
 ^-^ already seemed to me that its subject matter be- 
 longed to history and now the theories of Freud and 
 Adler appear almost as antiquated as those of 
 Feuchtersleben and Liebault. It was not however 
 because of this historical interest that the book came 
 into being. The present and the future always en- 
 gross me sufficiently to absorb all my attention. But 
 when I took over Wetterstrand's practice as a spe- 
 cialist in psychotherapy in Stockholm, I quickly 
 discovered that I could not keep on where he had 
 left off. Even more impossible did I find it to feel 
 at home in the new systems and methods of treat- 
 ment that had grown up and begun to control psy- 
 chotherapeutic thought. In trying to follow any one 
 of the leaders in psychic treatment, I found my re- 
 sults poor. On the other hand, when I examined each 
 case individually, following only the suggestions 
 which just that case alone presented, my progress 
 was satisfactory. Finally as practical experience ac- 
 cumulated, I found I must try to make it conform to 
 the new theoretical trends of thought. 
 
 7
 
 8 Introduction 
 
 But science is not made up of the experiences and 
 thoughts of solitary investigators. Science is the 
 common spiritual structure of humanity, to which 
 each one must contribute his forces where they are 
 best adapted. It is therefore applicable that each 
 discussion begin with an historical introduction, 
 which step by step leads up to the point where 
 the new effort to solve the problem sets in. When I 
 tried to present my experience in one complete vol- 
 ume, I was forced, in spite of myself, to first look 
 over the ground on which psychotherapy had been 
 built up. 
 
 This work grew into a volume by itself. 
 
 In the history of medicine there is something called 
 odium medicum. Physicians have made a bad repu- 
 tation for themselves by dividing into schools which 
 have struggled so hotly against one another that for 
 the struggle's sake they have lost sight of the com- 
 mon goal that stands above all strife namely, the 
 search for truth. The modern psychotherapeutists 
 have far outstripped their colleagues in this re- 
 spect. Added to this the older academic physicians 
 have spared no pains in the attempt to throw sus- 
 picion on the whole psychotherapeutic movement. 
 Consequently none has calmly considered the vari- 
 ous contributions to this subject, with endeavor to 
 separate the real and lasting from what is worth- 
 less and incidental. Being little interested in the
 
 Introduction 9 
 
 small controversies of the day, I have made attempt 
 to take this task upon myself. Instead of keeping 
 to the historical point of view exclusively, I tried to 
 crystallize from it whatever was likely to attain real 
 value when controversy was over. I kept to few 
 names; originators are rare; not so followers. 
 History deals only with the former. Especially 
 where Freud was concerned have I found it hard to 
 draw the line between what is the out-crop of genius 
 and what is absurdity. Some effort in this direction 
 I made in a lecture delivered in Munich at the Psy- 
 chological Congress, 1913. The gist of this lecture 
 is here given under the caption, "The Conscious 
 Versus the Unconscious." To illustrate how the dif- 
 ferent trends of thought actually assimilate in prac- 
 tice, I added my paper entitled "Extract from a Case 
 History." 
 
 After the historical introduction, I took hold of 
 something that more nearly appealed to me name- 
 ly the revision of the material gathered during prac- 
 tice, from that new standpoint at which I had ar- 
 rived. First of all this meant attempt to give the 
 enduring fundamental idea that firm and monu- 
 mental form the idea must have, if from its height 
 one is to survey anything so extensive as the phe- 
 nomena of mental disease. I was confronted here 
 with a task that was of a philosophical or purely 
 religious nature, rather than a medical one.
 
 10 Introduction 
 
 One thing strikes one forcibly in modern psycho- 
 therapy. It investigates not alone as science the dif- 
 ferent forms in which spiritual decay comes to the 
 surface in anxiety-states, insanity, etc. ; but as 
 therapy too, it attempts to help man overcome that 
 spiritual death and reach harmonious security on 
 the other side of it. It should then be clear that its 
 whole activity circles about the idea of spiritual 
 death; but what strikes one is that instead of domi- 
 nating the scientific literature, this idea has disap- 
 peared from it. This is the more surprising since 
 every unprejudiced observer must at once be aware 
 of this inner struggle between life and death, as soon 
 as he comes into contact with this class of patients. 
 It may be reflected in different ways, but putting 
 aside contingent details, the same essentials are al- 
 ways met with. As a rule, too, it is the more obvious 
 because most patients come for treatment just when 
 they are on the point of succumbing to life's negative 
 forces. 
 
 Unless viewed in connection with the time during 
 which psychotherapy originated, it is hard to un- 
 derstand this peculiarity. It was the materialism of 
 that time, placing its stamp here, as well as upon 
 science and art in general, upon the social struc- 
 ture, indeed upon everything. This fact is sin- 
 gularly grave, because it should be the special duty 
 of psychotherapy to be a powerful means of fight-
 
 Introduction 11 
 
 ing materialism; it teaches exactly that how 
 hopeless it is to try to overcome spiritual death in 
 material ways and by material means. 
 
 When, therefore, one feels driven to again take 
 up the time-honored problem of spiritual death for 
 renewed examination, it is necessary to guard against 
 one danger. This very problem was what formerly 
 gave rise to the different forms of religion, the de- 
 cay of which our day has witnessed. Habits of 
 thought, symbols, phraseology and dogma in which 
 religion was clad, still have great influence over us. 
 We have a natural tendency to slip into old re- 
 ligious ways of speaking and of clinging to its dis- 
 tinctions. But surely this means that by creating 
 anew we shall get beyond what has been, to a new 
 formulation of the old problem, with new distinctions, 
 which can become a guiding force for the future. 
 Science must not be forced back into primitive forms 
 of the spiritual life; on the contrary science must 
 be lifted to a higher plane, that it may grapple with 
 the highest manifest forms of existence, precisely 
 as it took hold of the material world during the past 
 century. Out of inner force it must reach final 
 clearness. 
 
 But this task of drawing a line between life and 
 death in the spiritual meaning from the fully up- 
 to-date standpoint, has grown into a book by itself. 
 It bears the name "DEATH AND REGENERA-
 
 12 Introduction 
 
 TION" and comprises three volumes, of which the 
 first has just been published. In a series of con- 
 centrated aphoristical chapters, I try to make clear 
 the two fundamental phenomena of spiritual death 
 disintegration and mechanization. I characterize 
 the different human types from these standpoints. 
 In another series of chapters, which I have called 
 "Sacrifice and Atonement," I try to show how 
 spiritual death may be overcome. The second volume 
 of this work will treat of the social structure and 
 the third of the last great question of our existence. 
 
 Only from the other side of the viewpoint thus 
 won and from the help thus attained, does it seem 
 possible to me to straighten out the numberless de- 
 tailed problems of nervous disease. The work in 
 which I hope to point the way to this and to which 
 these three volumes also are a kind of introduction, 
 will be entitled "FROM PSYCHOANALYSIS TO 
 PSYCHOSYNTHESIS." With this title I shall 
 have said in advance that the analytical side of the 
 matter is not, to my mind, the most important. Of 
 far greater import is it to obtain clear understand- 
 ing of those forces, due to which man may be built 
 up into a united, harmonious being, bearing witness 
 of the divineness of his inmost nature. 
 
 POUT, BJERRE. 
 Varstavi, Tumba, Jan., 1920.
 
 CONTENTS 
 
 CHAPTEB PAQB 
 
 I. KANT AND FBUCHTERSLEBEN 17 
 
 TI. WETTERSTRAND AND THE NANCT SCHOOL .... 43 
 
 III. PSYCHANALYSIS AH A SCIENCE AND METHOD OF TREAT- 
 
 MENT 88 
 
 IV. THE ADLEH-DOCTRINE CONCERNING NEUROSIS . . 152 
 V. THE NATURE OP HYPNOSIS 198 
 
 VI. THE CONSCIOUS VERSUS THE UNCONSCIOUS . . . 21 
 
 VII. EXTRACT FROM A CASE-HISTORY 248 
 
 VIII. POINTS OF VIEW AND Ourixx>K8 298 
 
 IS
 
 KANT AND FEUCHTERSLEBEN 
 
 KANT suffered from gout. 
 When such an actual illness comes into hu- 
 man life, it means not only the suffering, the lessened 
 power for work, the sleepless nights, the hopeless- 
 ness, but the evil of it spreads to the environment of 
 the victim as well, and this too is gradually sub-; 
 merged beneath an inexorable burden of fatality. 
 Beyond this the illness has also a negative action, 
 outside its immediate boundaries; it endeavors to 
 force the entire life of its victim into its power. And 
 in this lies its more horrifying significance. Instead 
 of being able as hitherto, to direct oneself towards 
 some positive goal, one now before all things, must 
 have the negative purpose in view of becoming free 
 from suffering. Before the occurrence of such a mis- 
 fortune, the victim had been able to turn his activi- 
 ties towards his real desires; now all these must be 
 
 17
 
 18 History and Practice of Psychanalysis 
 
 set aside in order to concentrate his effort towards 
 ridding himself of the guest that comes thus unbid- 
 den. The banal man becomes, in such circumstances, 
 a victim of experimental science, dividing his time 
 between the trial of new methods of treatment and 
 complaint concerning the inability of these to give 
 him the desired help. He looks continually for that 
 marvel which is to bring him salvation. And the 
 more the illness establishes itself as an incurable one, 
 just so much the more inextricably bound up in it, 
 becomes the environment of the invalid. 
 
 But for one who is wise, each new fact becomes a 
 spur to renewed reflection and before each new per- 
 ception, no matter how painful, such a one stops to 
 ask if there is not something to gain from it, some- 
 thing to add to his store of knowledge. If he is 
 successful, then a re-valuation occurs ; even out of 
 the seemingly most negative condition there radiates 
 something of the imperishableness of life. And all 
 that surrounds him takes its part in this. 
 
 When Hufeland wrote his book on the art of pro- 
 longing life, he sent it to Kant as a "token of that 
 appreciation which every thinking human being owes 
 to this wise man;" and also "to cause him to con- 
 sider some ideas therein set forth, which belong to the 
 philosophical tribune." Kant replied with a little 
 pamphlet which he called : "The Power of the Mind, 
 Through Simple Determination, to become Master
 
 Kant and Feuchtersleben 19 
 
 over Morbid Ideas." And in this he devotes one page 
 to the subject of his gout. 
 He relates : 
 
 In order that my sleep should not be interfered 
 with, I at once seized upon my stoical remedy, that of 
 directing with effort, my thoughts towards some 
 chosen indifferent object, for example, towards the 
 many associated ideas brought up by the word 
 Cicero. In this way I led my attention away from 
 every other idea. Thus these became quickly blunted, 
 so that sleepiness could overcome them. And this I 
 am always able to repeat in attacks of this kind with 
 a like good result. That I had not dealt with imagin- 
 ary pain was clearly evident the following morning 
 when I found the toes of my left foot swollen and 
 red. 
 
 His attacks of gout thus became for Kant a source 
 of inner investigation and from this source issued a 
 new stream of wisdom. Nevertheless of any positive 
 signification regarding this illness, no thinker of his 
 time got an intimation; it spread itself far through 
 the time to come, to future generations. I think one 
 may say that no book has had so strong an in- 
 fluence upon the development of psychotherapy as 
 have these few simple pages, acting, as they have 
 done, as an inspiration for many others who since 
 have taken up these studies. I have recently read a 
 paper by one of our most modern writers, in which
 
 20 History and Practice of Psyclianalysis 
 
 he says, that when questioned by patients as to what 
 they ought to read, he answers: Kant and Feuch- 
 tersleben. 
 
 Wherein then lies what is most essential in these 
 experiences of Kant? 
 
 First the title given to his book "The Power of 
 the Mind, Through Simple Determination, to Be- 
 come Master over Morbid Ideas." There exists in 
 other words, the possibility of causing changes in 
 morbid processes, through psychic means. Upon, 
 the unshakableness of this fact all psychotherapy 
 finally depends. And Kant succeeded in driving 
 home this fact for himself with singular surety. 
 Philosophers of a whole century have in vain racked 
 their brains to disprove him on other points. I 
 suspect that all efforts to prove him false on this 
 question will also necessarily come to naught. For 
 Kant has not advanced this as a theory and it has 
 therefore no part in the transitoriness that is in- 
 herent in all theories. Neither did it come about 
 through the casual observation of an objective oc- 
 currence. Those who have been brought up to be- 
 lieve in the prevailing dogma that objective study of 
 material phenomena is the only thing that gives us 
 real knowledge, automatically oppose themselves to 
 everything which implies a glimmer of effort toward 
 a trial to reduce the security upon which such science 
 is founded. But it is all too easy to forget that 
 til objective research is based finally upon our men-
 
 Kant and Feuchtersleben 21 
 
 tal impressions and that some certain amount of illu- 
 sion always remains bound up with these. Partly 
 because they never can be trained to an absolute 
 degree of sharpness; partly and above all, because 
 they never can be wholly isolated from physical oc- 
 currences. No matter how conscientious an investi- 
 gator may be, he never can quite free himself from 
 seeing that which he wishes to see more clearly than 
 that which he does not wish to see. This is one rea- 
 son for the gross mistakes made by science, which 
 have won admittance to the general consciousness. 
 
 The only thing about which we really know some- 
 thing with certainty, is that which we experience in 
 our inner lives. This is true more especially if these 
 experiences are of such vital importance that they 
 take their place as integral constituents in our 
 thought and volitional life. So Kant's fixation of 
 the fundamental fact of psychotherapy occurred 
 as an inner experience. It might have been possible 
 to convince him that the opinion of humanity con- 
 cerning the solar system was faulty: a new cosmic 
 genius might change the prevailing conception re- 
 garding that, just as Copernicus changed the opinion 
 of his time. But no power on earth could have dis- 
 turbed Kant's opinion regarding the functioning of 
 his organism, which had been formed in connection 
 with his experience as above cited. These closely 
 observed inner experiences go to the kernel of that 
 which is out of our reach by any other path. Knowl-
 
 22 History and Practice of Psychanalysis 
 
 edge gained in this way is established unchangeably 
 for the coming centuries, while numberless theories 
 arise and burst like soap-bubbles, and while our con- 
 ception of the whole world may change its form and 
 color. 
 
 If this possibility of causing real changes through 
 inner work did not exist in the whole of that sphere 
 of phenomena which is gathered under the name of 
 disease, the psychic treatment of disease would be 
 nothing but an illusion. That which one believed 
 to be happening would be only imagination, which 
 soon would be put to flight before reality. It is the 
 object of these studies to carry this fundamental 
 fact farther along, to point out some ways in which 
 changes may be brought about and to draw up the 
 limits within which these are possible. I shall occupy 
 myself exclusively with functional disturbances, leav- 
 ing organic diseases to the various branches of medi- 
 cine to which they belong. 
 
 That vulgarizing of psychotherapy which goes 
 under the name of Christian Science, makes an effort 
 to maintain that by looking away from illness, denial 
 of its real existence, the physical destructive proc- 
 esses may be removed. It postulates a universal har- 
 mony; if the one who is ill succeeds in becoming ab- 
 sorbed in this idea, the disturbance of the harmony 
 which we call disease, also disappears. I mention 
 this in passing for it has its interest in showing how 
 thought of the possibility of removing physical suf-
 
 Kant and Feuchtenlcben 23 
 
 fering by means of psychic treatment which had its 
 beginning in Kant, has since continually been veri- 
 fied anew by those who have interested themselves 
 in the subject. Speaking further of his gout, Kant 
 said: "I am sure that many gouty troubles, yes, 
 cramps and even epileptic attacks, also podogra, 
 which is described as incurable, can be warded off 
 by a firm determination to distract the attention 
 from them, and little by little they may even be got 
 rid of." When the Christian Scientist overcomes his 
 pain by reading the effusions of his prophetess, these 
 have for him the same meaning which the word Cicero 
 had for Kant, it implies in both cases the diversion 
 of the attention by the use of something with no 
 especial meaning, but which will awaken many asso- 
 ciated ideas. This is so clear that no further com- 
 ment is necessary. 
 
 Kant's psychological dietetic prescription has a 
 kind of simplicity which really is monumental but 
 which unfortunately is of little use in the complicated 
 conflicts of people of our own times. 
 
 Seen from a psychological point of view it was a 
 tension of the will many times emphasized, through 
 which the attention, by main force, was compelled 
 to take a new direction. It is interesting to note 
 that Liebeault's working out of the idea of sug- 
 gestion, half a century later, was founded on just 
 the same basis. Explained in Liebeault's terjnin- 
 ology, Kant suggested loss of feeling to himself. As
 
 24 History and Practice of PsycJianalysii 
 
 I shall more closely point out in discussing the Nancy 
 School, Liebeault even made of the attention, a kind 
 of creative power, existing within the organism. In 
 this there is a valuable practical truth, even if it by 
 no means exhausts the psychology of the mechanism 
 of suggestion. It is unfortunate that strong-willed 
 concentration of the attention has been made more 
 difficult little by little, as the power of attention has 
 been broken up by the widespread idea-material, 
 which development on all sides, carries with it. It 
 was undoubtedly easier for him who never saw any- 
 thing but Konigsberg to concentrate his mind upon 
 a single point, than it is for one whose consciousness 
 is divided into the millions of shifting scenes and im- 
 pressions gathered from one of our great modern 
 cities. 
 
 Looking at the more philosophical side of Kant's 
 prescription, one sees it stamped with a stoicism 
 which one can scarcely read of without envying this 
 concentrated power of a by-gone type of humanity. 
 Kant relates, for example, how once he was troubled 
 with cold in the head and cough, and that this dis- 
 turbance was the more unpleasant because it started 
 up in the night and prevented him from sleeping. 
 He was "indignant" at being disturbed in his phil- 
 osophical existence by a thing so paltry, just as 
 someone else might be annoyed at being kept awake 
 by a screaming child. Kant decided to force himself 
 to breathe through the nose. In this way he taught
 
 Kant and Feuchtersleben 25 
 
 himself to suppress the irritation of the cough and 
 shortly it no longer had power to prevent him from 
 going quickly to sleep. 
 
 The individual must not permit himself to be 
 imposed upon by any physical condition which at- 
 tempts to disturb his poise, that is Kant's chief 
 point. 
 
 This stoicism celebrates its greatest triumph when 
 that which encroaches upon the well-being of the 
 individual is of a kind which, according to the law of 
 nature, cannot be changed ; in other words, when it is 
 inherent in the constitution itself. That which Kant, 
 in this respect, had most difficulty in reconciling 
 himself to, was his sunken chest. It was a fact that 
 there was insufficient room for free action of the 
 heart and lungs ; he describes how this predestined 
 him to hypochrondria, from which in his youth he 
 suffered almost to the point of a loathing for life. 
 But little by little it became clear to him that 
 nothing could be done to change this and he taught 
 himself to be "calm and clear in the head" although 
 he was "oppressed in the chest." So gradually he 
 became master of this oppression "by leading away 
 the attention from it as if it were no concern of 
 his." 
 
 This is an important point. 
 
 The whole position of man in the universe is such 
 that he is continually under the influence of forces 
 which act in opposition to the goal which he is striv-
 
 6 History and Practice of Psychanalysis 
 
 ing to attain, and over which in accordance to the 
 law of nature he never can be master. These forces 
 are, so to speak, a universally present opposition to 
 the realization of the deepest desire of mankind, 
 that of constituting the personality as a self-deter- 
 minate being. Life in the body itself is one such op- 
 position, continually limiting free movement even in 
 the strongest and soundest individual. Naturally 
 the frailer the body, just so much the more limited 
 is its freedom, at least up to a certain degree. 
 
 This shows itself plainly in the useless struggle 
 against unconquerable opposition which needlessly 
 wears out the powers of so many nervous sufferers. 
 Existence becomes a protest against forces before 
 which one must always go under. There is but one 
 thing to do, viz: to make peace with these forces 
 under as favorable conditions as poseible, if one 
 would become emancipated from their influence. Only 
 when one succeeds in doing this does the constant 
 danger of loss of self-independence cease. Unfortu- 
 nately it is much easier to preach such stoicism than 
 to carry it out. A man like Kant who in calm and 
 peace could sit in his study, laying stone upon stone 
 to his thought structure, could do it. But the suf- 
 ferer of today who is torn between innumerable dif- 
 ferent occupations, and who at the same time must 
 stretch his strength to the utmost in order to keep 
 himself going at all, finds it is more difficult to ad- 
 just himself with courage and equanimity to the all
 
 Kant and Feuchtersleben J7 
 
 too-cramped margin which nature has assigned for 
 his powers. 
 
 The idea which Kant gave out in his reply to 
 Hufeland's book, became incarnated in Ernst von 
 Feuchtersleben. 
 
 Concerning the outward features of this man's 
 life, I will mention here only that he practiced in 
 Vienna from 1830-1840, and that his work is dedi- 
 cated to those "who must fight the struggle of life 
 and who take this to be a serious problem." 
 
 Feuchtersleben wished to found a general psycho- 
 therapy upon inner work directed by human wisdom. 
 In his "Lehrbuch der artzlichen Seelenkunde," he 
 does not connect himself with the history of medicine, 
 but with that of philosophy. And he subsequently 
 tries from this to extract everything that can lay 
 down lines of direction for the attainment of a har- 
 mony against which suffering and sickness shall have 
 no power. In this effort there is much of truth. 
 All learned doctrines point finally towards the over- 
 coming of inner death and towards the attainment of 
 an everlasting harmony with existence in its entirety. 
 It may be a question if the intellectual faculty of the 
 mind itself, when this is not directed towards some 
 outer practical aim, is not in its substance only one 
 of nature's attempts to compensate the disturbed 
 harmony between the human-being and the world ; 
 in other words that nature in a round-about way 
 would try to regain something which had become lost.
 
 28 History and Practice of Psychanalysis 
 
 However that may be, it is certain that wisdom has 
 its importance for everyone who has been forced out 
 in the solitary struggle against spiritual death. But 
 the history of philosophy is, unfortunately, not the 
 history of wisdom ; it is rather a pattern-book of hu- 
 man errors. However hard-pressed, little can be ob- 
 tained from it that will serve as a draught of life- 
 giving water to one who is parched with thirst. Had 
 psychotherapy no other source to rely upon, then 
 would it never have attained the right to exist. The 
 condition of things between it and philosophy must 
 rather be changed about. Psychotherapy must go 
 its own road ; the knowledge its users need, they must 
 try to reach directly through the study of that which 
 they experience among the sick. If it succeeds, little 
 by little in coming upon more generally applicable 
 rules for the breaking up of conflicts, freeing from 
 anxiety, controlling disease, then it is possible that a 
 truer doctrine of wisdom than that of the old phil- 
 osophy can be built up upon this basis of experience, 
 which concerns life and the perils of life. 
 
 What is of most interest about the works of 
 Feuchtersleben is not, however, his attempt to found 
 a new branch of therapy. It is the reflexions he 
 makes concerning disease, with this attempt in mind. 
 And these have greater value as they the more spon- 
 taneously, directly, spring from his own suffering. 
 By far the best thing he wrote seems to me to be his 
 diary. There may be found in short clear sentences,
 
 Kant and Feuchtersleben 29 
 
 most of what has value in all the popular literature 
 concerning nervous diseases, which followed closely 
 upon his work. And what is of far greater inter- 
 est, here are again found very many points which 
 have become fundamental features in this branch of 
 scientific research. Not that he had already solved 
 problems which we are still puzzling over ; but that he 
 obtained with what was often remarkable intuition, 
 an inkling concerning them. 
 
 If I should select a single quotation as an example 
 of this, I think it would be the following : 
 
 Those things which we do physically in order to 
 exist, assimilate and secrete, inhale and exhale, we 
 must spiritually repeat. A systole and diastole, an 
 exchange between expansion and contraction must 
 constitute our inner life, if it is to remain sound. 
 Just as we keep on developing, learning, enjoying, 
 emerging out of ourselves, just so we are forced into 
 ourselves again by the unbroken pulse-beat of fate, 
 and compelled to gather all our powers at one single 
 point, so that from this point we may again send 
 them forth more widely. He who is always elastic is 
 free; he who continually draws himself together, 
 petrifies. 
 
 As I shall more closely write out the subject in 
 the following studies, all nervous ailments are con- 
 nected in a more or less certain way, with the fact 
 that the individual's ability to adapt himself to real- 
 ity has been lost. Since this then has two sides, an 
 outer and an inner, there are two main roads upon
 
 30 History and Practice of Psychanalysis 
 
 which the individual departs from a normal state of 
 life, and enters upon one of disease. In connection 
 with this it is possible to differentiate two fundamen- 
 tal types among the sick. One consists of those who 
 have lost connection with external reality. All that 
 which takes place about this type loses its personal 
 value. The doings of humanity and its desires, are 
 only a meaningless jumble, a chaotic, tormenting 
 noise; to be dragged into this whirl would be, for 
 those of this type, to go under entirely. These peo- 
 ple retire into themselves. They become reserved 
 almost to a state of dumbness ; nobody comprehends 
 them. Because of this very fact they petrify more 
 and more, growing continually more and more incom- 
 prehensible. Gradually as the emotional life loses 
 its plasticity and the feelings and impulses let go 
 their faculty of transformation, the actual restric- 
 tive faculty takes the reins in hand. The individual 
 becomes more and more a creature of habit, of com- 
 pulsory ideas, of hypochondriacal physical sensa- 
 tions, etc. The more line is run out, just so much 
 more stereotyped and automatic does life become. 
 
 The normal psychic life, to which the formation 
 of an illness of this sort, under unfortunate circum- 
 stances is attached, is founded in introspective na- 
 tures, in contemplative minds, in musers. 
 
 The other fundamental type consists of those who 
 have lost connection with what occurs within their 
 own minds. They know of nothing other than the
 
 Kant and Feuchtersleben 81 
 
 world which stirs about them and their mental life 
 is only a disconnected reflection of all this endless 
 display of forces. They are driven like rudderless 
 ships upon a sea of contending desires. Their lives 
 evaporate in activity which has no inner motive; 
 in purposeless reactions against whatever occurs 
 about them ; in compromises ; in every thinkable thing 
 that is unreal. So they grow farther and farther 
 away from that inner centralization that alone can 
 give peace and health of mind. If this line of de- 
 velopment is farther drawn out, the soul life is 
 broken up into emotions, filled with anxiety ; thoughts 
 whirl about each other like grains of sand before 
 the wind, and the will which should lead toward ac- 
 tivity with a conscious purpose, is exhausted in im- 
 pulses that work against one another and make thi 
 adoption of a deliberate aim impossible. 
 
 The normal analogy to this type is found in those 
 shallow, busy human-beings, who never give them- 
 selves time for contemplation. 
 
 In the construction of all outgrowth of disease, 
 there is something both of this process of petrifica- 
 tion and of dissolution, everything corresponding to 
 changes in varying reciprocal proportions. 
 
 Feuchtersleben understood that no one finds the 
 way to true health of mind unless he knows how to 
 dissolve these two fundamental parts into one or- 
 ganic unity. In this thing itself, this tearing apart 
 of existence into an inner and an outer reality, lies
 
 32 History and Practice of Psychanalysis 
 
 the seed for the building up of disease in both direc- 
 tions. 
 
 The only possible way of avoiding this conse- 
 quence is never to lose contact with either the outer 
 or the inner life, to continually maintain that both 
 forms of life are simply different sides of the same 
 unity of occurrence. "Only the spiritually strong, 
 morally educated individual succeeds in preserving 
 a certain inner quietude, which like the point of 
 Archimedes, even in troublous times, still constitutes 
 a place of retirement for the purpose of contempla- 
 tion. Here is the true happiness of mankind." 
 
 It is this spiritual strength and culture in the 
 noblest meaning of the word, which before everything 
 else must be striven after. Let the storms of life rage 
 how they will, let the individual be involved in con- 
 flict upon conflict, let him be dragged out into the 
 mob which, with all its commonness, tries to tear him 
 to pieces and kill every effort that brings him life; 
 he nevertheless will be able to maintain constantly 
 a sacred depth within himself, whither he may with- 
 draw in quietude and where, with eyes unclouded by 
 hate or fear, he will be able with calmness to take 
 note of his surroundings. Only in this way, even 
 under the most adverse circumstances, can he main- 
 tain his connection with an inner reality, of which 
 he himself is but a temporary appearance ; only then 
 is he proof against one principal form of psychic 
 devastation.
 
 Kant and Feuchtersleben 33 
 
 What every doctor most earnestly strives after, 
 or what should be the aim in all isolating treatments 
 is just this, to bring the patient away from the whirl 
 of external life back into inner reality. 
 
 But as strongly as Feuchtersleben points out the 
 necessity of the contemplative life, just as strongly 
 he tries to direct the patient toward the life of 
 activity, and he by no means undervalues the impor- 
 tance of this as a means to freedom. "An able- 
 bodied individual ought always to have an able- 
 bodied work that demands the co-operation of all 
 the forces. Life is only a more or less violent state 
 of tension. All relaxation is sickness or death." It 
 is just this living connection with what occurs about 
 one, that is of importance. Activity absorbs energy, 
 but it also gives it. All those impulses that it con- 
 stantly carries with it, mean just so many new con- 
 tributions to it. One with impaired energy can do 
 without this still less than can one who is strong. 
 There is nothing that Feucjhtersleben so utterly 
 scorns as the hypochondriac, who in his want of will, 
 permits himself to be sucked down into brooding over 
 his own condition. Not even in the deepest inner 
 calm must the tension which during activity is used 
 up in the outward struggle, be allowed to slip en- 
 tirely. Contemplation must always maintain a cer- 
 tain stamp of innate activity, and only because of 
 this, one runs no danger, even in its most profound 
 moments, of gliding awar from that form of reality
 
 34 History and Practice of Psychanalysis 
 
 which is represented in those happenings of the out- 
 side world. 
 
 There are people who have fallen into such a state 
 of inertia that they feel themselves incapable of thd 
 simplest kind of activity. However paradoxical it 
 may seem, the only right method of treatment is often 
 to compel them to do some work which to them ap- 
 pears impossible, the intention being to force them 
 into that circulation of energy which the external life 
 of activity implies. But if this is to succeed the work 
 must not be without meaning, but must have a deep 
 connection with those desires, because of which the 
 individual may have fallen into his state of disability. 
 
 I have made these reflexions upon the foregoing 
 citations from Feuchtersleben's work only to show 
 how his words by themselves give rise to links of 
 associations. If these have free development, they 
 soon reach out to lines of thought and viewpoints, 
 with which we come into constant contact during 
 practice. In his words lay seeds which subsequently 
 have burst forth with immense power for growth. 
 He should be read slowly; the greatest charm in 
 his works is simply the power of awakening thought. 
 In this way it is profitable to stop to consider each 
 and every sentence. 
 
 I give one more example. 
 
 In reading the following lines, one sees the great 
 idea appearing for that which now goes under the
 
 Kant and Feuchtersleben 35 
 
 name of psychanalysis and has in this light, set its 
 stamp upon modern therapeutics: 
 
 If pain is coming upon you, or if it has already 
 reached you, then consider that you do not annihilate 
 it by turning from it. Look it steadily in the eyes as 
 an object for your observation, until you clearly 
 understand if you ought to leave it for what it is 
 worth, or possibly keep it and use it. One must first 
 become master over an object before he can disregard 
 it. That which has in this way been put to one 
 side, constantly forces itself upon one with rigorous 
 defiance. Only the real light of day, by turning its 
 full brightness upon them, conquers the ghosts of the 
 night. 
 
 Psychanalysis is based upon the fundamental fact 
 that the individual does not escape the life he must 
 experience, by turning away from it. On the con- 
 trary it is in this way that he really becomes a prey 
 to the forces of life. For with this effort to escape, 
 all the trouble sinks into the unconscious, and con- 
 tinues therefrom to bind, obstruct, restrain. What 
 makes this change fatal then, is that in the very mo- 
 ment we lose conscious contact with what we have 
 experienced, we also lose our power over it; we are 
 hounded by anxiety or stunned or driven on towards 
 something we do not desire, without even a suspicion 
 as to whence comes this new enemy which haunts, 
 paralyzes and drives us away from our real selves. 
 The psychoanalyst shows how to stop this flight and
 
 36 History and Practice of Psychanalysis 
 
 look the enemy straight in the eyes ; he urges a sound- 
 ing of the depths through which the past may be 
 revealed; he does it because at the same time, the 
 individual control over the life-material expands. It 
 is primarily in the strength of inner masterfulness 
 that we can be successful in throwing off suffering, or 
 in changing the values of life into others of standard 
 worth. In all this I come back to the study of 
 psychanalysis once more ; one might say that this in 
 its entirety is an exposition of the theme which is 
 advanced in these quotations from Feuchtersleben. 
 
 But Feuchtersleben was not only a thinker, he was 
 also a poet. 
 
 And it is in many respects an interesting and im- 
 portant fact, that psychotherapeutics had one of 
 its deepest fundamental roots in the mind of a poet. 
 
 In the idea of a firm directing of the attention, 
 which has several times been spoken of, there is al- 
 ready found an indication of productivity from the 
 inner life. For through this a human being ceases 
 to be simply the outcome of a series of external 
 forces. There is put into motion something which 
 has its central point within himself and which is 
 anticipated by his existence as an independent being. 
 The poet can never be a determinist. The moment 
 an individual loses the feeling of being the ultimate 
 conception for some work of creation which can 
 not go on without him, that moment he ceases to be 
 a poet. It is easy then to see the close connection
 
 Kant and Feuchtersleben 37 
 
 between poetry and psychotherapy. One might also 
 say in the same connection: in that same moment, 
 the individual also ceased to be well. The feeling of 
 happiness, courage, confidence, hope, every- 
 thing that must be found in the healthy psychic life 
 is so closely bound up with the certain knowledge 
 that creation is going on within, that the two things 
 cannot really be separated. 
 
 Feuchtersleben understood this as only the born 
 poet can understand it. And he understood in con- 
 nection with it, how needful it is, that the psycho- 
 therapist should direct the patient towards this idea 
 of creating, towards a positive goal. 
 
 He writes: 
 
 Only by putting something in the place of some- 
 thing else, does the former really become negative 
 a law which not only for the dietitian of the soul, but 
 for all phases of life has most weighty consequences. 
 Everything that is shallow, bad, false and ugly, will 
 be actually denied, only when in its stead it put what 
 is noble, good, true and beautiful. He who considers 
 all these evils as something real and struggles against 
 them, is lost. They must be treated as if they were 
 nothing. 
 
 Only that which plays a role in the creating part 
 of the upbuilding of human life is real. Because of 
 this then the specific qualities of the poet are more 
 essential for the development of health than are
 
 38 History and Practice of Psychanalysis 
 
 those of the logician. "Knowledge does not have the 
 power of instilling us with participation in life. 
 Rather does it exhibit it to us in its nothingness. 
 It is fantasy and feeling which awaken our interest 
 in its fleeting appearances and through these give 
 us happiness. Thus art is a more health-giving aim 
 than philosophy." All the intimate connection be- 
 tween these things really lies in this sentence : "Keep 
 yourself in contact with that which is beautiful. 
 From the beautiful arises that which is good in man- 
 kind, even health itself." 
 
 In order that the inner power of creation may be 
 realized, there exists a demand that tendencies in 
 this direction should not be met with unconquerable 
 opposition. The awakening, releasing stream of 
 thought and feeling must meet a certain plasticity 
 of soul, due to which, that which already has exist- 
 ence becomes transformed and valued anew. If the 
 inner life is petrified by lines of thought that have 
 become habitual and if the feelings are undisturbedly 
 fixed upon definite things and into definite forms, 
 there is nothing to be done. If each new truth and 
 every deepened understanding meets with that kind 
 of skepticism which gives itself out to be ripe su- 
 periority, but which at closer range discloses itself 
 as spiritual death, then the aim of the psychoanalyst 
 becomes a vain one. It is the poet's privilege, more 
 than that of any other, to maintain this mobility of 
 soul. Each true poetical work contains a regenera-
 
 Kant and Feuchtersleben 89 
 
 tion, without which the work would be impossible to 
 achieve, its value for others is accounted in the 
 same degree in which it implies something for them 
 which it implied for the author. Psychotherapy 
 must be considered as a form of poetry in which 
 one is made free from all external technical methods, 
 which otherwise act as intermediaries between that 
 which happens within the poet and that which hap- 
 pens within those who follow him. 
 
 While speaking of Kant I pointed out the impor- 
 tance of his having reached knowledge of the simplest 
 basic facts of psychotherapy, through self-observa- 
 tion; only in that way could it have been stamped 
 with an unshakable surety. Something like this is 
 always the case, when psychotherapy rises from its 
 simplest, to its most complicated analytical-creating 
 forms. In Kant's case, self-observation concerned 
 sensations which followed a partly physical disturb- 
 ance. With his successors who must more and more 
 be drawn toward psychic suffering, this has dealt 
 rather with the critical examination of what happens 
 within the individual when the balances of life be- 
 come disturbed. It is a common saying among 
 psychoanalysts : no one can go farther in the analy- 
 sis of another than he has gone in the analysis of him- 
 self. But the following correlation may be ap- 
 pended without hesitation; no one can go farther 
 toward the redemption of another than he has gone
 
 40 History and Practice of Psychanalysis 
 
 toward the redemption of himself. It is not enough 
 for self-observation to pay attention only to the 
 blasting of destructive powers: it must also and 
 above all follow those lines upon which these are to 
 be conquered and upon which one succeeds in making 
 life worth living. 
 
 It is this idea which is the ultimate reason for 
 that surety with which the psychotherapist defends 
 his ground against all attacks. It is also this which 
 makes this branch of therapeutics remain for so 
 many a kind of mystery and which is the reason why 
 attacks against it are, as a rule, stamped with a 
 kind of stupidity, before which refutation seems of 
 little use. Where inner qualifications for the under- 
 standing of such a conception are lacking, surely no 
 description can make clear what it really means. 
 One whose psychic life has been submerged in purely 
 mechanical processes and who has thus changed into 
 a conglomerate of automatic functional complexes, 
 can scarcely acquire a comprehension of that process 
 of inner emancipation, about which the whole science 
 of psychanalysis revolves. For such a one all this 
 remains the same meaningless nonsense, which higher 
 mathematics means to one who has been unable to 
 teach himself to add. 
 
 But although psychotherapy is in this way finally 
 an inner experience, it is obvious that it is not that 
 alone. It must also, as a foundation, have an ex-
 
 Kant and Feuchtersleben 41 
 
 ternai point of contact upon which medical science 
 comes in as one of the many ingredients. 
 
 I come again to that circumstance upon which I 
 wished to fix attention in this paper, namely, the 
 deep import of the fact that the foremost thinker 
 in history and one of its most renowned poets had 
 a hand in the bringing to light of this branch of 
 science. 
 
 It is the philosopher's task to draw out personal 
 experiences into universal knowledge and in this 
 way to find the connection between that which hap- 
 pens within and without us. One who has nothing 
 of this philosophical spirit remains always shut 
 within himself believing only that that which means 
 good to him means good to others. But for no one 
 is it so important as for the psychotherapist, to 
 keep wide-open eyes for the finest nuances of indi- 
 viduality. He must himself be able to live in that 
 which occurs in the psychic life of others, no mat- 
 ter how different it may be from that which happens 
 within his own. 
 
 But this intimate connection with something for- 
 eign can never take place alone through knowledge 
 and analysis. It needs besides this, something else, 
 it needs a faculty for instinctively feeling a way 
 into that which is not altogether comprehensible 
 by thought. The real poet reacts with his over- 
 sensitivity to everything that comes in his way;
 
 48 History and Practice of Psychanalysis 
 
 with no fixed boundaries he lets himself float out 
 into the world about him and identifies himself with 
 whatever goes on there. 
 
 Without something of this faculty of the poet for 
 taking part, with the whole of his personality, in 
 all that lives and suffers without this, no one is 
 likely to spread a blessing upon the path of psycho- 
 therapy.
 
 n 
 
 WETTERSTKAND AND THE NANCY SCHOOL 
 
 IN front of me lie some of Wetterstrand's letters 
 written to various members of his family. They 
 are yellow with age. I have selected one, dated from 
 Uppsala, September 5th, 1866. He was then twen- 
 ty-one years old and had been a medical student 
 for four years. The letter was written to a younger 
 brother : 
 
 . . . Through a letter from father I have heard 
 that you would like to change your determination 
 about becoming vitae genus. Without wishing in any 
 sense to impose anything upon you or your opinions, 
 for in such matters as this you are, and should be, 
 entirely alone regarding your decision, still I wish 
 to say a few words to you, before you heedlessly 
 start in upon a new track which is doubtless as yet 
 quite unexplored by you. The profession of medi- 
 cine is inexpressibly laborious, both during the period 
 of preparation and throughout the whole life of 
 practice. He who chooses this profession should 
 first consider well. He has dedicated the whole of 
 his life, every minute of it, to the struggle against 
 human suffering in all of its forms, he has conse- 
 
 43
 
 44 History and Practice of Psychanalysis 
 
 crated himself to an unceasing contemplation of la- 
 mentation, misery and death. Not only during the 
 day, but during the night as well, must his work 
 go on. In hospitals, in every kind of emergency, in 
 pest-houses, the material for the building of his life 
 is gathered together. If he desires and that he 
 must do, to advance in science, he must study in- 
 cessantly. He has no moment to himself. If he 
 sometimes thinks: this hour is mine, he thinks what 
 is not true ; the time does not belong to himself, but 
 to those who are in distress and suffering. The 
 practice of this profession demands almost super- 
 human power. The physician must stand ready for 
 everything and everybody. A constant danger 
 threatens him, the sword of Damocles hangs con- 
 tinually over his head ; I mean Death, the inevitable, 
 with which he is always in contact. If one takes into 
 consideration the years of preparation, those of the 
 medical student are quite different from those of 
 students in other fields. In the anatomy class, in 
 the midst of decomposing, mutilated bodies, he has 
 opportunities to think over the passing of life and 
 the certainty of death. It is true that scientific de- 
 sires are here appeased with knowledge concerning 
 the wonders of the construction of the human or- 
 ganism and explanation of the mystery of the phe- 
 nomena of life. But how is this insight reached ? By 
 means of mutilation of bodies like our own and by 
 the dissection of living animals. This is the only 
 path upon which the student of medicine may tread. 
 I myself have experienced inexpressible things. The 
 knife trembled in my hand when I made my first in- 
 cision into a cadavar; how must it then be to use it 
 upon a living subject? The loathsome smell of the
 
 Wetterstrand and the Nancy School 45 
 
 autopsy room, the ever constant danger of being 
 poisoned in the laboratory, still pursue me. The 
 state of mental tension, in which one must contin- 
 ually live, is impossible to describe. 
 
 It would be difficult to find a document that more 
 plainly expresses the sensation of horror, which must 
 present itself to every earnest young man, when the 
 import of a doctor's life is put before him. The 
 banal student puts aside this feeling as one of 
 pure sentimentality and within a few days the whole 
 thing becomes for him a profession, which moves 
 him as little as any other. Death itself, for the most 
 of such students, would become a matter of pure in- 
 difference, unless they were obliged to learn that 
 they must not come unnecessarily into contact with 
 it; otherwise their future reputation as its master 
 would be in jeopardy. How often I have seen hos- 
 pital students examining the dying with the same un- 
 concern as if it were a question of putting a worn- 
 out machine into repair! But the true physician 
 never loses his sensitiveness for suffering and for 
 him life never ceases to be a bitter combat with death. 
 Just as the artist is over-sensitive to certain groups 
 of impressions that continually stream over us all, 
 color, form, moods, conflicts, so is the born physi- 
 cian over-sensitive to suffering. Out of this super- 
 sensitiveness the intuitive "doctor's eye" proceeds. 
 As a musician trembles in response to some tone
 
 46 History and Practice of Psychanalysis 
 
 which passes by the unmusical ear as an indifferent 
 sound, so the born physician perceives a physical or 
 psychical dissonance, which the busy external life 
 hides from others. Because of this faculty, suffer- 
 ing becomes so intimately connected with his own 
 life that he really can make himself free from it 
 just as little as he can separate himself from his 
 own personality. Neither can he ever resign himself 
 to suffering. He must make a struggle against it 
 even if the effort seems a hopeless one. He must 
 try to master it or go under in the attempt. Or 
 more aptly expressed he must dedicate his life to the 
 removal of some small part of the most grievous dif- 
 ficulties that lie in the path of humanity and turn 
 it toward the fulfillment of a more harmonious exist- 
 ence. 
 
 In looking back upon Wetterstrand's life, now 
 since his death, the letter quoted seems full of a 
 kind of fatality. ... It is certain that he himself 
 never had the feeling : "this hour belongs to me, now 
 I shall enjoy it as if no trouble in the world were 
 any concern of mine." During that period when he 
 was at the height of his activity, he scarcely took 
 time for sleep; from half-past five in the morning 
 until far into the night, it was his one continual 
 effort to reach a true understanding of his patients. 
 This broke him down in ten years' time and he took 
 up his own long struggle against death which after 
 ten years more finally conquered him. But up to the
 
 Wetterstrand and the Nancy School 47 
 
 last he tried to keep up his practice. Even when he 
 was so weak that he could have died at any time 
 he forced himself up and out among his sick he 
 was simply unable to let go that hold he had upon 
 suffering and for the assurance of which he had given 
 his own life as security. 
 
 But with Wetterstrand there was also quite an- 
 other feature than this over-sensitiveness for suffer- 
 ing, this compulsion to connect himself with it, this 
 will to struggle against everything that is destruc- 
 tive to life. He was gentle in his manner and there 
 was something strangely quiet and harmonious about 
 his own personality. Even more than for suffer- 
 ing was he sensitive to every living, producing, re- 
 generating force in nature and in humanity. This 
 shows itself continually in the letters I have before 
 me. Most of them are written from Vienna, whither 
 he betook himself after his final examinations, for 
 the purpose of improving his knowledge in diseases 
 of the eye and in surgery. Among his descriptions 
 of hospitals and operating-rooms, one finds him 
 dilating upon the scenery and the works of art which 
 especially fascinated him. It is as if the yearning 
 of a lifetime brimming over in his soul, suddenly 
 broke bonds, in spite of everything that sought to 
 convince him that existence is nothing but a wilder- 
 ness of desolation. I read for example, the follow- 
 ing reflexion: 
 
 So well may the works of poets and artists be com-
 
 48 History and Practice of PsycTianalysis 
 
 pared with the stained glass in these Catholic 
 churches. Looked at from without everything seems 
 dark and dismal! But only go inside and all takes 
 on another aspect ; the glass gives out all the colors 
 of the rainbow and if one has a little imagination, 
 one soon sees the pictures come to life. It is the 
 same way with poetry. It may be written with the 
 pen, painted with the brush or hewn out of stone, 
 but it must not be looked upon from without nor 
 with prosaic eyes. It is because it has been so looked 
 upon that so many have never understood poetry or, 
 upon the whole, disdain all poetical points of view. 
 
 Wetterstrand felt this strong necessity of seeing 
 life from within. The dreadful things he had to ex- 
 perience as a physician never became all that nature 
 had to tell him about human existence. There 
 must be some sanctuary wherein even the most cheer- 
 less and meaningless things change and acquire 
 their inner connection. He who reaches this shrine 
 has overcome suffering by another path than that 
 upon which the usual system of therapeutics has 
 made its struggle on through centuries. For at the 
 same time when there comes a glimmer of poetry, 
 of re-birth over that which looked at from without 
 has seemed the absolute negation of life, at the same 
 time redemption is drawing nigh. Wetterstrand had 
 a strong feeling for this eternal pouring out of life 
 from within, from mysterious depths which we never 
 quite can fathom. From this feeling arose in him 
 appreciation of the faculty of seeing all things with
 
 Wetterstrand and the Nancy School 49 
 
 the poet's eye, which may be observed in this quota- 
 tion from his letter. This feeling was also the basis 
 for his strong belief in the possibility of overcoming 
 disease through some psychic means. No theoretical 
 controversy, no attack, no discouraging experiences 
 could disturb this belief; in it lay his strength. 
 But in it lay also his limitations. 
 
 The work of the practical physician contains 
 however little enough of poetry, no matter if in the 
 depth of his soul he may have never so poetical an 
 outlook upon the world. When Wetterstrand came 
 home from his journey, a position as district physi- 
 cian to the poor awaited him, and there he came 
 into touch with plenty of life's prose. "I begin the 
 day with looking at tongues and curing cases of 
 diarrhea," he writes in one of his following letters. 
 And he continued for fifteen years to fulfill all the 
 dismal duties attached to this office. 
 
 Sometime about 1885, Liebeault's work entitled 
 "Le Sommeil provoque et les etats analogues," fell 
 into the hands of Wetterstrand. Predestined as he 
 was by the whole tendency of his nature for the 
 psychic side of disease, nothing more was needed 
 to cause a complete change in his work. He had in- 
 tended to become a specialist in diseases of the lungs. 
 But now he discovered that he must start out in 
 quite a different direction. 
 
 However much modern medical research may work 
 towards the reduction of the cause of disease to solely
 
 60 History and Practice of P&ychanalysis 
 
 extraneous physical facts, it does not succeed in 
 rooting out of the folk-consciousness the conception, 
 that these causes have in their finality something to 
 do with the conflicts of life. People may have all 
 possible respect for the bacillus of tuberculosis and 
 know what mischief it produces; but they neverthe- 
 less never cease to exclaim: "He worried himself 
 into consumption." If one starts to investigate this 
 postulated connection between life and suffering, a 
 group of disturbances that are called functional, are 
 first met with. Conflict alone can bring only the 
 functions of an organ into a disturbed condition. It 
 can not directly destroy its tissues. To what degree 
 it in time may act injuriously, so that the organ or 
 organism becomes easier prey for further injuries, 
 is a question which just now may be put aside. Tra- 
 ditional medical science has a great inclination to 
 overlook the importance of functional diseases. Even 
 today there are physicians who satisfy themselves 
 with the phrase : "Only hysteria !" if after physical 
 examination they can find nothing upon which to 
 take certain hold. And against this kind of suffer- 
 ing they have the most illusory expedients to recom- 
 mend. Unfortunately the patient can scarcely make 
 such a bagatelle of his suffering as can the doctor; 
 for him the word "only" is small comfort and his 
 pain is as hard to bear as any physical disease. 
 
 Many times I have had patients say to me : "If I 
 had cancer and so some hope of death ! But to live
 
 Wetter sir and and the Nancy School 51 
 
 on year after year like this, it is more than I can 
 endure." I recall a young man who came to me 
 suffering from nervous incontinence, and who, as a 
 matter of little importance in comparison, told me 
 that he also had pulmonary tuberculosis. "As for 
 that," he said, "I care very little about it; either I 
 shall get well of it or die and we shall all die some- 
 time. But it is a thousand times worse with the 
 other thing. That makes pretty much every hour 
 one of torment, so that I have not the slightest com- 
 fort in life!" And it is true: in the face of death 
 the healthy individual can be resigned far easier than 
 before a kind of suffering which makes the short time 
 we at best have to live, of no value. 
 
 The physician who is inspired by a genuine feeling 
 for his calling, cannot pass by these functional 
 diseases with such indifference. And if he has dif- 
 ficulty in resigning himself to the limitations of the 
 science of medicine, its powerlessness in this sphere is 
 to him a constant source of worry. And if there is 
 in him a blending of warm feeling for the pathos of 
 life and of that over-sensitiveness for suffering which 
 was so marked in Wetterstrand, this kind of disease 
 and the fight against it must be for him something 
 of the highest importance. 
 
 As for so many others, Libeault was a kind of 
 evangelist for Wetterstrand. His work awakened 
 hope of a possibility of rational attack against func- 
 tional disease. And the way he pointed out was
 
 52 History and Practice of Psychanalyns 
 
 free from all that repellent mystery in which earlier 
 attempts had been enveloped. Without danger of 
 losing its dignity, science might take its stand upon 
 this path. Its fundamental experiments could be 
 again produced, their application to the art of 
 treatment could be worked out and systematized. 
 
 Wetterstrand did not hesitate to put these new 
 ideas to practical proof. It was at that time a 
 fortunate circumstance perhaps, that he already had 
 a large clientele which hitherto he had treated ac- 
 cording to the usual methods and which had un- 
 bounded confidence in him. It was quite plain that 
 these patients were most fertile soil for treatment by 
 suggestion. The rumor spread that wonderful things 
 happened in Wetterstrand's consulting-room. Those 
 unfortunates who formerly had gone away unbene- 
 fitted, returned in the hope that the hour of freedom 
 at last had struck. 
 
 There is certainly no demand so deeply rooted in 
 the mass of humanity as the demand for wonders; 
 indeed is there anyone who can fully give up a hope 
 that the world-regulation so much needed, may some 
 time be accomplished, by a revelation which will solve 
 all, explain all? 
 
 Here it was as if a new Bethesda suddenly had 
 arisen. The news spread throughout the town. A 
 stream of sick people came from all directions. The 
 consultation-room was besieged. People sat outside 
 on the stairs and waited. It was no question of dif-
 
 Wetterstrand and the Nancy School 53 
 
 ferentiation between functional and organic disease, 
 between what could be attacked by this new method 
 and what was inaccessible to it. Delighted over the 
 possibilities that opened before him, Wetterstrand 
 himself did not define so closely as he should have 
 done, in order to preserve the reputation of his 
 method of treatment. He seemed to believe that 
 through suggestion, both tumors and broken legs 
 could be cured. Only by slow degrees did he learn 
 to place the right indications. 
 
 Surely during this early time he had most sur- 
 prising results. I have often heard from entirely re- 
 liable people, case-histories related, which I could not 
 have believed had they reached me in any other way. 
 Judging from all points of view it seems to me that 
 no one has ever succeeded in reaching the results he 
 reached in treatment by suggestion. Physicians of 
 a skeptical type may shrug their shoulders at this 
 and talk of a psychic epidemic. A scornful word 
 nevertheless cannot overthrow what is an absolute 
 matter of fact. And the reply to such objections 
 appears to me self-evident: in like conditions, 
 physicians, with all their might, should seek the con- 
 tinuation of such an epidemic. An epidemic that 
 frees masses of people from suffering, before un- 
 available for treatment, must surely be considered as 
 something inexpressibly good, as well for the physi- 
 cian as for the community. 
 
 This new work forced Wetterstrand to leave his
 
 54 History and Practice of Psychanalysis 
 
 position as district doctor. He moved from his for- 
 mer home to a place more suitable to his special 
 needs. Here, during a period of ten years (1887- 
 1897), was carried on that practice which seems 
 to me to be one of the most interesting in medical 
 history. 
 
 Wetterst rand's reputation during this time spread 
 farther and farther. It was not restricted to his own 
 country nor to Europe itself. His name became 
 the foremost in the cosmopolitan neurotic clientele. 
 Many doctors came from abroad to study this new 
 branch of therapeutics. 
 
 Wetterstrand did not win his reputation through 
 the writings he gave out during this period. This 
 part of his work had relatively slight importance by 
 the side of his practical work. His fame spread from 
 patient to patient. With the same inclination no- 
 toriety has for magnifying faults when propagated 
 by the evil minded, with just the same ease is mag- 
 nified every good thing when spread abroad by those 
 who are thankful and well disposed. From the press 
 also came more or less embellished stories a thing 
 that has little that is agreeable in it for a scientific 
 worker, but which more than anything else con- 
 tributes toward giving the wonder-worker a brighter 
 nimbus. 
 
 Such a description of Wetterstrand's work came 
 out in a book by Ludvig Hevesi, under the title:
 
 Wettentrand cmd the Nancy School 55 
 
 "The Grotto of Sleep." He writes among other 
 things : 
 
 Wetterstrand's house differs in no way from other 
 houses which stand in the beautiful quarter of the 
 town under the shadow of the Royal Library. But 
 in the second story are two large rooms in which 
 lives a wondrous, unbelievable modern wizard. Daily 
 from nine until four o'clock, remarkable magic goes 
 on, while from sixty to seventy people a day are 
 amazed and would not credit the thing if they them- 
 selves had not played a part in it. Silently one 
 enters the place, for heavy reddish-brown rugs cover 
 the floor. A faint light fills the rooms no clocks 
 tick, no flies buzz, no doors creak. The furniture 
 consists only of lounges, sofas, divans and arm 
 chairs. Upon each of these is lying or sitting a 
 motionless figure, a petrified man, a rigid woman 
 or a child. No one of them moves a muscle. There 
 is no snoring, no moaning, as in ordinary sleep. 
 But they really sleep. They sleep as calmly and in- 
 nocently as a child at its mother's breast. A faint 
 smile spreads itself over every face. The harmony 
 of unconsciousness flows over these fortunate ones. 
 Is it an opium dive where one smokes oneself into 
 insensibility? One's eyes seek the door-posts to see 
 if they are of ivory, as in the dream land of Homer. 
 The Silence of Death . . . 
 
 Wetterstrand's reputation as a worker of won- 
 ders has seldom stood so clear before me as when 
 I once after his death read a letter addressed to him
 
 56 History and Practice of Psychanalysis 
 
 which was sent to me to be answered. It was from a 
 man in New York. He was well himself, but he had a 
 wife who was peculiarly fractious; when the storms 
 of temper came upon her she grew so violent that 
 she beat both husband and children. Unfortunately 
 the letter-writer was unable to send her away for 
 treatment. But he wished to inquire if Dr. Wet- 
 terstrand could not teach him a method by which he 
 could quickly hypnotize her whenever the necessity 
 arose, so that in this way he might have peace in his 
 house. 
 
 What took place at this time in Wetterstrand's 
 house was only one part of the movement that had 
 its origin in Liebeault. A few words concerning the 
 historical qualifications of this movement may pos- 
 sibly be of interest. 
 
 It is, upon several points, united with animal 
 magnetism. After this idea lost its energy, the 
 recollection of it still lived among a few investigators, 
 and magnetisers continued to make an effort toward 
 the revival of the study through so-called psychic 
 performances. One of these so-called magnetisers 
 visited Manchester about the year 1870. One even- 
 ing the well known surgeon Braid, happened to be in 
 the audience. He was convinced that these so-called 
 magnetic phenomena were no humbug ; something was 
 hidden behind, but something quite other than the 
 action of a hypnotic fluid. He began to make experi- 
 ments and found that he could put a number of dif-
 
 Wetterstrand and the Nancy School 57 
 
 ferent individuals into a peculiar condition, by com- 
 pelling them to fix the eyes, and in this way the 
 attention also, upon a given point. This condition 
 he first called "nervous sleep" and his book upon the 
 subject was given the title "Neurhypnology" ; from 
 this the word hypnotism, later on, arose. In the writ- 
 ten description of this condition, characteristics of 
 magnetic sleep again came up ; especially he pointed 
 out how a great many different kinds of nervous 
 disturbances disappeared during this sleep, as if by 
 witchcraft. 
 
 Regarding the genesis of this condition he had, at 
 first some physiological ideas. But his town was vis- 
 ited also by an "electro-biologist" and the thoughts 
 brought to him in this way, led him upon another 
 track. 
 
 The phenomena by which this "electro-biologist" 
 entertained the public, in these days would be called 
 something more akin to suggestion in the waking 
 state. 
 
 The performance which they gave was one in 
 which members of the audience were permitted to 
 come up upon the stage, and then false ideas were 
 presented to and accepted by them. In this way peo- 
 ple were induced to mistake potatoes for apples, to be 
 terrified by animals which were not there, etc. Braid 
 took up the study of this phenomena and began 
 to look upon his hypnotic experiments from a more 
 psychological point of view. From the literature
 
 58 History and Practice of Psyclianalysis 
 
 that I have been able to obtain concerning this, I 
 am not fully clear how far he was able to go; it 
 seems to me, however, that he became entangled in a 
 great many contradictions which came up in the 
 course of his work. When Bramwell brought the dis- 
 cussion of the Nancy School into London medical 
 circles, he made an effort to claim that Braid had 
 really anticipated the whole thing. In this there is, 
 without doubt, exaggeration. It is certain, however, 
 that Braid did not succeed in making the phenomena 
 of suggestion a matter of general study. 
 
 Most of his work was submerged in the opposi- 
 tion of traditional medicine. On the other hand it is 
 perhaps true, that the chief importance of the work 
 of the Nancy School lies in the fact that, to a cer- 
 tain degree, it was successful in breaking through 
 this opposition. 
 
 If Liebeault had continued his work alone, he 
 would surely have i>een just as unfortunate as Braid 
 and others of his predecessors. Liebeault was a sim- 
 ple country practitioner in the neighborhood of 
 Nancy and few people paid any attention to his book 
 when it came out about the year 1870. In his youth 
 he had been interested in animal magnetism, but only 
 in riper years did he get the opportunity to occupy 
 himself completely with these studies. He had gone 
 on for about ten years with the investigation of such 
 phenomena from his new viewpoint, before he dared 
 showed himself before the sqientific World. But
 
 Wetterstrand and the Nancy School 59 
 
 neither the thoroughness of his work nor the force 
 of his own conviction could break down the opposi- 
 tion which immediately arose against him. It was 
 only when Bernheim, Professor of Medicine at 
 Nancy, began to intervene for his sake that things 
 came into a more favorable light. This happened in 
 1882. Bernheim and Liebeault were drawn together 
 by a mutual friend. Bernheim came to him a scoffer, 
 but he went away convinced. It was not long before 
 he was deeply plunged into the study of suggestion, 
 nor was it long before his own great work upon that 
 subject came out. That this became the foremost 
 authority for the use of treatment by suggestion 
 has its special reason. Because of his greater scien- 
 tific achievement, Bernheim succeeded in clothing the 
 new ideas in a manner which did much to simplify the 
 amalgamation of them with academic learning. It 
 can by no means be denied that this had great im- 
 portance, but it remains another question, if this by 
 itself was favorable for the highest possible develop- 
 ment of these ideas into clarity of understanding and 
 ability to endure. For my part I believe that the 
 spreading of these ideas was due to a kind of popu- 
 larity which was nevertheless fatal for the future 
 development of the study itself. Another reason 
 for this position which Bernheim obtained as the 
 foremost representative of the new branch of thera- 
 peutics is to be found in his association with the 
 scientific world. It was through Bernheim that
 
 60 History and Practice of Psychanalysls 
 
 Liegeois became interested in the matter and took 
 hold of the investigation of suggestion from a judi- 
 cial standpoint ; and it was on Bernheim's initiative 
 that the Professor of Physiology, Beaunis, applied 
 the ideas to his sphere of activity. Above all it was 
 Bernheim who jumped into the breach in the great 
 battle against Charcot. 
 
 About the same time, that the investigators men- 
 tioned gathered themselves together under the name 
 of the Nancy School, Charcot had arrived at a very 
 similar stage of progress in his own studies among 
 the patients at Salpetrieres. 
 
 The name of this hospital was given to the school 
 that grew up about him. Charcot had begun to 
 study the importance of suggestion in connection 
 with hysterical symptoms. For him the meaning of 
 suggestion and hysteria was so interwoven that he 
 came to look upon the phenomena of suggestion itself 
 as a kind of disease product ; he denied at the same 
 time that any valuable therapeutic method could be 
 based upon it. It was this that called forth the 
 controversy between the two schools. The combin- 
 ing element in the Nancy School, was the assertion 
 of the all powerfulness of the process of suggestion : 
 this was something always present in the psychic life 
 of the human being and it could always be used to 
 bring about a favorable change in the course of func- 
 tional diseases. I shall not take up this controversy 
 which long ago lost its interest. Neither shall I dis-
 
 Wetterstrand and the Nancy School 61 
 
 cuss the differences of opinion which arose within the 
 Nancy School itself; that would go far outside the 
 frame of these studies. I will merely devote a few 
 pages to what I consider the most vital kernels of 
 truth in all which the Nancy School brought out 
 and turned over for further elaboration, to those 
 who came after. And for that I need only confine 
 myself to the fundamental work which has been al- 
 ready mentioned. 
 
 Liebeault tries to explain exactly what he means 
 concerning suggestion in the following sentence : 
 
 An idea that is carried over to a sleeping person 
 by means of a gesture or other communication, with 
 the intention that a physiological, or even more, a 
 psychological phenomenon shall be brought about 
 through this, in his organism, is called suggestion. 
 
 In most of the later efforts to make the idea of 
 suggestion exact, it seems to me two faults have 
 been committed : either this idea has been stretched 
 out to such a degree that the word suggestion nearly 
 becomes a new name for psychic phenomena in gen- 
 eral, or else in order to avoid this, there has been 
 an effort to force it back within limits that are 
 false. Liebeault's carefulness avoids both these dan- 
 gers. An idea, a conception, an experience in gen- 
 eral can, under unique circumstances, be worked out 
 in a peculiar way ; can, so to speak, enter as an in- 
 tegral constituent into the organism and in a cer-
 
 62 History and Practice of Psychanalysis 
 
 tain degree become a deciding factor in its future 
 fate. Suggestion differs in this dynamic respect 
 from the ordinary impression. "It is thus the road 
 from imagination to reality, from appearance to en- 
 tity which in its most inner meaning characterizes 
 suggestion," says Schmidkunz, who has devoted a 
 bulky volume to this question. It might be simply 
 said that suggestion is the word made flesh. The 
 suggestibility is therefore that quality because of 
 which we are able to incorporate within ourselves, to 
 make our own, that which we experience. 
 
 Little by little Liebeault went deeper into this 
 fundamental phenomenon and learned to see various 
 disease conditions from the viewpoint thus obtained, 
 so that the idea for him not only became the preser- 
 vation of life for the organism, but also its forma- 
 tive power. "For us who do not acknowledge the 
 existence of any physical process which is not inter- 
 preted by a thought or fear of this, for us there is 
 nothing repulsive in insisting that it is the outgoing 
 unconscious thought from the brain which constructs 
 and supports the organism; which unceasingly 
 watches over that complicated drivewheel which sus- 
 tains existence." This may sound merely like a para- 
 dox and it is hard to follow Liebeault in his evidence 
 for the correctness of this last sharp point in his 
 opinion. But on the other side there are phenomena 
 of suggestion which only with the greatest difficulty 
 can be interpreted without the supposition that
 
 Wett erst rand and the Nancy School 63 
 
 imagination plays a determining role in the whole 
 life-process. To these phenomena belong, above all, 
 the so-called skin phenomena; for example, the pro- 
 duction of blisters on the skin without external in- 
 fluence. Through these it can be very obviously 
 shown how the suggested ideas produce a decided 
 organic change. In opposing oneself to Liebeault's 
 exaggerated ideas of suggestion, and in trying to be- 
 little them, it is all too easy to forget the unex- 
 plained facts which led him to his opinion. 
 
 Of far greater importance than this physiological 
 side of suggestion is the psychological side. The 
 constructing and regulating of life from within is a 
 fact of unlimited value. "During the waking con- 
 dition the individual is, because of the attention, 
 the author of his own sensations, ideas and plans." 
 
 It is the emphasizing of this active reproductive 
 feature in the process of life which is real. It means 
 a study in detail of the way in which construction 
 occurs under normal circumstances, if one wishes to 
 understand how functional diseases arise through dis- 
 turbances in this condition, through transference and 
 complications of many different kinds. Very much 
 of that which appears to happen automatically, as 
 for example, sleep, really comes about through self- 
 suggestion. In the same way an individual suggests 
 to himself, without at all understanding it, many 
 nervous symptoms. 
 
 When Liebeault later on was called upon to ex-
 
 64 History and Practice of Psychanalyris 
 
 plain the phenomena of suggestion he was altogether 
 wrapped up in the psychology of the attention. Sug- 
 gestion arises through a one-sided direction of an 
 accumulated attention upon a certain point. In 
 explaining this he uses such terms that one may 
 easily get an impression that he is trying to make 
 of the attention, a kind of mystic power. It is this 
 that chiefly gave offense when his book came out. 
 Foville said in "Societe Medico-psychologique," 
 "Does it not seem as if we were carried far back, and 
 as if Liebeault's 'attention' is nothing but a new name 
 for all those dominators of different rank, which ac- 
 cording to Van Helmont should direct our organs 
 and be the prime movers in the discharge of their 
 functions?" Naturally Liebeault intended nothing 
 of the sort ; his expression was purely figurative. But 
 even when times changed and his work was given 
 the appreciation it deserved, people would not con- 
 cur in his effort to explain suggestion absolutely as 
 attention-phenomena. It called forth numberless 
 ideas in other directions ; but all these rather served 
 to make the question more vague than to further 
 elucidate it. An effort toward the disentanglement 
 of all this jumble is not in place here. But if any one 
 succeeds in some time carrying it through, I am con- 
 vinced that it will show that no one has come nearer 
 a true solution of this question than Liebeault him- 
 self. In spite of many defects he had a simple genu- 
 ine grip upon the problem, which may well require to
 
 Wett erst rand cmd the Nancy School 65 
 
 be made more complete and deep, but which never 
 should be disregarded. 
 
 The question concerning the importance of the at- 
 tention carries one directly over to Liebeault's opin- 
 ion regarding hypnosis. 
 
 The attention became for him a kind of bridge by 
 means of which he connected not only suggestion 
 and hypnosis with each other, but also both these 
 phenomena with commonplace, well known things. 
 The line of thought is extraordinarily simple and 
 can be gathered together in a few lines: during the 
 waking life the attention is divided by the sense or- 
 gans and through them, by all the impressions re- 
 ceived from the external world and from the psychic 
 rearrangement of these ; it is not only diffused among 
 all these different objects, it is also bound up in them 
 immovable. Where connection with the external 
 world is cut off through sleep, the organism, so to 
 speak, sinks down into itself. Then a radical change 
 occurs, and the attention which before was bound up, 
 is now made free. It draws itself back therefore, 
 from all those things by which it has been split up, 
 into the organism, into the nervous system. This 
 shows itself in an accumulation of the attention in 
 the brain. And this accumulated attention is used 
 up during sleep in the reconstructing process of the 
 organism. Such regeneration thus, does not happen 
 automatically but is regulated by the nervous system 
 through something which has intimate connection
 
 66 History and Practice of Psychanalyn* 
 
 with the psychic-life. "Due to this accumulation of 
 the attention, the sleeper not only has the faculty of 
 lessening or strengthening the activity of the senses, 
 that is, his forces; he also modifies the fabric of 
 them with a magic power ; he transforms, he creates ; 
 in this way he is able to bring again into harmony 
 the forces, which during the day, have become un- 
 balanced." If it is possible to get into communica- 
 tion with one who is asleep, the attention which has 
 so been made free, may be led into the desired path. 
 It is so possible by suggesting certain ideas, to direct 
 regeneration toward a selected result. During such 
 conditions the power of the imagination over the or- 
 ganism is increased many fold. This is what occurs 
 during hypnotic suggestion. Hypnotism, according 
 to Liebeault, is nothing but a state of sleep, during 
 which the subject comes into rapport with the opera- 
 tor; hypnotic suggestion is only imagination in- 
 creased to a maximum activity, due to the accumula- 
 tion of the attention. It is easy to see how all that 
 evil of mysticism, in which animal magnetism had 
 been wrapt, was torn aside by this simple interpre- 
 tation. It is also easy to see how this became the 
 word of emancipation for many, and how for science 
 it became possible upon such a basis as this, to take 
 hold of the treatment of nervous disturbances from 
 the psychic point of view. 
 
 But unfortunately this view of the matter held
 
 Wetter strand and the Nancy School 67 
 
 also a seed of misconception, which became fatal for 
 its further development. 
 
 Braid had strongly pointed out the difference be- 
 tween sleep and hypnosis and in so doing forcibly laid 
 claim to the proposition that hypnosis might have 
 another and more widely diffused therapeutic value 
 than sleep. This was right. But through Libeault 
 the difference between sleep and hypnosis was more 
 effaced, and with his successors these ideas were 
 entirely fused into one. Hypnosis became nothing 
 but a suggested sleep and had no specific therapeutic 
 action; it was nothing at all which could be made 
 an object for study in itself, it was only a phe- 
 nomenon of suggestion. In accepting this idea the 
 whole line of treatment was directed toward sugges- 
 tion ; the specific action of hypnosis itself was turned 
 away from, denied, and as a result there was no 
 opportunity to ascertain anything further about it. 
 In just this circumstance seems to me to lie one of 
 the reasons why the work done by the Nancy School 
 did not bear the fruit it should have borne. 
 
 But there is also another and s^ill more important 
 reason for this ; namely the distortion of the idea of 
 suggestion. 
 
 In the working out of this idea Liebeault had pro- 
 ceeded from everyday facts. He never neglected, so 
 far as it was possible, to connect his statements with 
 things which every one could prove by one's own
 
 68 History and Practice of Psychanalysis 
 
 experience. But when later he had to bring forth 
 evidence for his statements and to demonstrate sug- 
 gestion with such clearness that it should command 
 respect, he was obliged to take hold of psychological 
 experiment. His followers referred continually to 
 this. For in order to demonstrate the power of sug- 
 gestion, one must experimentally suggest ideas which 
 necessitated the greatest possible opposition to over- 
 come. When the privat docents, for example, saw 
 suggested criminal scenes carried out, in which the 
 subject not only murdered his victim, but also showed 
 the most agonizing remorse for his action, etc., etc., 
 they began to wonder if something was not brought 
 to light therein, which might be worth their study. 
 Unable then to carry their experiments over from the 
 laboratory to real life, they always kept such ex- 
 periments as this in mind when they spoke of sug- 
 gestion. The repellant ideas conveyed to the subject 
 at these experiments, and brought into actuality by 
 him, became for them the general prototype for sug- 
 gestion. And upon this prototype is based the qual- 
 ity of the idea itself. And this went so far that 
 the contrariness of reason became fixed as the most 
 mighty characteristic of suggestion. Theorists have 
 often a remarkable faculty for destroying the work 
 of science. 
 
 For people in general treatment by suggestion re- 
 ceived, in this connection, a smack of the unreal, a 
 method made use of by the uncritical, something con-
 
 Wetterstrand and the Nancy School 69 
 
 trary to logical development, etc., everything that 
 tended to destroy the esteem it merited. To under- 
 go hypnotic treatment was the same thing as to give 
 up one's free will and put one's self wholly under the 
 influence of another. It must also be acknowledged 
 that among those who practiced this treatment there 
 were some who so little understood their work, that 
 they did endeavor to use influence in this banal mean- 
 ing. But it must be decidedly denied that any such 
 thing is in the nature of the method of the treatment 
 itself. All psychic treatment strives after the free- 
 ing of forces that have been bound, and the adjust- 
 ment of the individual to that external reality in 
 which he must live; from this rule, hypnotic treat- 
 ment never in the slightest degree departs. 
 
 The ideas that grew out of the Nancy School 
 spread with rapidity. The new branch of thera- 
 peutics was accepted and took fast root in most of 
 the countries of Europe. In Switzerland it came 
 through Forel, in Holland through Reutergehm and 
 Van Eeden, in England through Bramwell, in Austria 
 through Krafft-Ebing and Freud, in Germany 
 through Moll, Schrenck-Notzing, Hirschloff and 
 others. Everywhere in medical circles arose similar 
 discussions and disagreements as in France. Neurol- 
 ogists in general placed themselves on the side of 
 their master, Charcot, and those who sought to 
 specialize in the new direction lost much strength in 
 strife against his authority.
 
 70 History and Practice of Psychanalyrit 
 
 That suggestive therapeutics, in spite of the lively 
 interest in it, which went on during the decade from 
 1880-1890, did not come to occupy the more import- 
 tant role in medical specialties, which it did occupy 
 later on, seem to me to depend much upon the reasons 
 here given. There is also another reason for this. 
 Traditionally medical science has been directed 
 toward the phenomena of physical disease. This tra- 
 dition may go thousands of years back, possibly even 
 to that period when the original unity between thera- 
 peutics and religion was broken into two spheres of 
 activity, and when the care of mental disturbances 
 and aberrations was relegated to the religious field. 
 In every case it has been so deeply seated in the gen- 
 eral medical consciousness that physicians neither 
 ought nor must be permitted to take charge of the 
 psychic side of disease, that it has needed decades 
 to unsettle this dogma. From my own student days 
 I recall how the professor at once remarked it, if in 
 a case-history a student touched upon those conflict- 
 ing factors out of which a disturbance of this sort 
 arose, although it were in connection with such a 
 common thing as alcoholism, which in no way at all 
 can be understood without knowledge concerning 
 these connections. While every group of purely phy- 
 sical disease is represented at each great seat of 
 learning by its professor and it clinic, up to the pres- 
 ent time there is no professor of psychotherapy in 
 Europe. When physicians take up its practice with-
 
 Wetterttrand and ih Nancy School 71 
 
 out any basic knowledge of this subject, it is natural 
 that they should not show understanding for all those 
 streams of thought that have been set in motion 
 through different sources. In the science of medi- 
 cine, however, co-operation between colleagues is 
 needful, and every branch of it which is lopped away 
 from this co-operation must little by little, wither. 
 The sick often feel only a general diminishing of 
 force, not even knowing if this has physical or 
 psychic significance; it is the physician's duty to 
 make this clear, and it is only the united experience 
 of the different representatives of the medical corps, 
 that can aid in so doing. One reason for the stunted 
 growth of treatment by suggestion seems to me to 
 lie in the simple fact that it lacks fertile soil in the 
 medical corps itself. It is only necessary to glance 
 through the reports of some present day discussion 
 to comprehend this. 
 
 In our own medical society the subject of hypno- 
 tism was first brought forward by Bjornstrom in 
 February, 1885. The chief inducement for this was 
 that he wished to fix the attention of his colleagues 
 upon the danger of public performances like those 
 which a Danish magnetiser, named Sixtus, was giv- 
 ing. For the first time, the subject came into general 
 discussion in February, 1885. Here Wetterstrand 
 made his appearance and presented some practical 
 experiments. He referred to the work which had 
 already begun to appear in print in "Hygiea" and
 
 72 History and Practice of Psychanalysis 
 
 which the same year came out in book form under 
 the title "The Use of Hypnotism in Practical Medi- 
 cine." 
 
 But Wetterstrand, unfortunately, was not the 
 type of man to break through the opposition which 
 here, as elsewhere, arose against the new experiment. 
 Admitting that the unpretentious way in which he 
 presented his observations commanded the respect 
 of a number of his hearers and inspired a few to 
 themselves make a trial, little more came of it. Into 
 an integral constituent of therapeutics, which it is 
 each practitioner's duty to know just as well as 
 every other branch, he was unable to bring treat- 
 ment by suggestion, no matter how earnestly he 
 strove. And this was not only because of circum- 
 stances in general but because of personal qualities 
 in Wetterstrand himself. 
 
 Science demands exact evidence before accepting 
 new ideas. It concerns itself only with final obvious 
 causal connections, and it tolerates neither wavering 
 indecisions nor incompleteness. Where it concerns a 
 therapeutic process it means nothing to say : the pa- 
 tient was so and so, I have done this and now he is 
 well. Science demands the laying forth of a neces- 
 sary causal connection between the first state and 
 the last. It must give the observer an insight into 
 that play of forces out of which the disease grew and 
 show how these forces, which by some therapeutic 
 means are set in motion, counteract and overcome it.
 
 Wetter strand and the Nancy School 78 
 
 Wetterstrand's case histories are singularly naive. 
 They give rise to numberless questions that remain 
 unanswered and by criticism nothing is easier than 
 to crumble them to pieces one after the other. It 
 was not in Wetterstrand to work out, in a logical, 
 scientific way, that which he saw take place in his 
 treatment rooms. He was a practitioner who acted 
 on the spur of the moment, intuitively, and he had 
 intellectually about as little understanding of that 
 which was evident in his methods, as an artist has 
 for that which happens when a living work grows 
 beneath his hands. Spontaneous action is one thing 
 and the conscious laying clear of the inner progress 
 of it is quite another. Qualifications in both direc- 
 tions may possibly be united in one individual; but 
 it is sure that they were not so united in Wetter- 
 strand. One of his patients has told me, when he 
 felt the chaotic disturbance of his mind clear away 
 in a wonderful manner during his treatment, that 
 he could not withstand the temptation to ask : "But 
 tell me, doctor, how does this strange thing happen?" 
 Wetterstrand answered with a kind of waggish smile, 
 that was peculiar to him: "That is my own secret. 
 But if you promise not to give it away I will tell 
 you : I do not know myself !" In this way his treat- 
 ment often went on, with little reflection on his part. 
 So it was but a natural consequence that he was af- 
 terwards unable to demonstrate scientifically what he 
 accomplished, in such a way as to convince a sceptic
 
 74 History and Practice of Psychanalysis 
 
 from the outside. The whole thing must often re- 
 main a secret between him and the patient. 
 
 Even if Wetterstrand's work thus did not con- 
 struct any valuable stratum in the scientific archives, 
 it is far beyond all doubt that he was a tower of 
 strength on the road to health for innumerable peo- 
 ple. His great reputation was not an accidental 
 one but was based upon genuine ability. The foun- 
 dation for it is to be found finally in those features 
 of his nature, which I pointed out in the beginning 
 of this paper. Only one who is so over-sensitive to 
 suffering as he was, can teach himself to intuitively 
 understand the sick. And it is in this understand- 
 ing that the mystery of suggestion to a great degree 
 is to be found. Everyone knows the marvelous re- 
 sult achieved by finding some one who really under- 
 stands that which lies nearest his heart. When this 
 happens the whole attention expands and the indi- 
 vidual is really stirred by what he hears. The more 
 thoroughly one human being understands another, 
 just so much more sensitive that one becomes to the 
 other's judgment and just so much greater power 
 is awarded the one over the other's life. This hap- 
 pens instinctively. For to give some one who under- 
 stands power over one's life, is actually the same as 
 to will added power over it for one's self. The out- 
 sider thus plays only the role of a sounding-board 
 which strengthens, supports, lifts up, the one who is 
 struggling, the one who left to himself would wither
 
 Wetterstrand and the Nancy School 75 
 
 and dry like a leaf before the wind. Suggestion is 
 the strengthening of this central point in the individ- 
 ual, through which he may be lifted to the dominat- 
 ing reality of life. In Wetterstrand this under- 
 standing, by means of which he won suggestive power 
 over the sick, remained more a thing of feeling. We 
 stumble upon a factor in his method of treatment 
 here, which cannot be more closely cleared up. Life 
 itself is not accessible to scientific analysis and never 
 will be; with the very analysis, that unity which is 
 its innermost essence, falls asunder, it starts up nejv 
 spheres of phenomena which may be further worked 
 out by thought, but which never by this means can 
 be carried back to the uncomplicated origin of it. It 
 is the same in greater or less degree, with everything 
 that has to do with those central occurrences in the 
 individual's inner life, or in the mutual circumstances 
 of life between individuals. The same thing applies 
 also to that which happens when one's understanding 
 of the emotions releases forces which have been im- 
 prisoned and when contact with an unfamiliar will 
 serves to drive the personal development on toward* 
 a more harmonious state of existence. 
 
 It is not only in this way that there is difficulty in 
 molding such thoughts into scientific form. Even 
 more each effort in this direction acts as an ob- 
 struction. Every artist knows that when reflexion 
 blends itself in with the work in hand, there is an 
 end to inspired creation. Something like this holds
 
 76 History and Practice of Psychanalysis 
 
 good here too. In order to reach this power of un- 
 derstanding over another, that other must be ap- 
 proached with confidence. His point of view and his 
 actions must be accepted. And this acceptance must 
 be so far reaching that it will appear a self-evident 
 proposition that he could not have seen or acted 
 otherwise. To this, nothing can be more opposed 
 than that critical sharpness with which every in- 
 vestigator must approach his object. "I cannot ex- 
 pect a patient to have confidence in me, if I have none 
 in him," I heard Wetterstrand say one day. But 
 to have confidence in a morphinist is about the same 
 as to "be pulled by the leg.'* The physician easily 
 comes upon the following dilemma ; either unbounded 
 confidence and happy results, of which a few are 
 perhaps illusory ; or a critical unbelief and practical 
 experience, which surely are discouraging, but as a 
 reward are just so much more scientifically sure. 
 Wetterstrand chose unhesitatingly the former. 
 
 Another of Wetterstrand's characteristics, which 
 has importance for a comprehension of his work, 
 was a warm feeling for life and belief in its power, 
 an inexhaustible stream of hope and confidence in the 
 victory of what is good. Thanks to this he could 
 reconstruct many a broken life and conjure forth 
 some glimmer of light for the future, even in the most 
 despairing. But also because of this was the value 
 of his scientific work largely reduced ; his case-his- 
 tories sometimes bear rather the imprint of that
 
 Wetterstrand and the Nancy School 77 
 
 which he himself wished to see, than of the sad 
 reality. I heard once one of his patients say : "He 
 asked me if I had had any fits and I answered no; 
 it was impossible for me to admit that I had had, 
 when I know how depressed the truth would make 
 him." Nowhere is the difference between the prac- 
 tical physician and the scientific researcher so clear 
 as here. The physician must with all his forces 
 turn both himself and the patient in the direction of 
 life and seize every hint it gives, with eagerness. He 
 must cherish each thing which contains the seed of 
 something which may be worth while, so that its 
 growth may not be checked. He must augment each 
 impulse towards victory so that a belief in the power 
 to be victorious may be enhanced, for without this 
 one can do nothing. And in a similar way he must 
 belittle all signs of the disease. Suffering is some- 
 thing unreal that should disappear before the only 
 reality that exists, the everlasting regeneration of 
 life. It will not do to accord this unreality any at- 
 tention. But such ideas have nothing to do with 
 the objective investigation. This must not be mixed 
 up with any such estimation of value. For it, each 
 phenomenon is quite simply a thing to be inquired 
 into ; it is a matter of indifference whither the inquiry 
 leads. If the phenomenon of disease is the object 
 of research, it is only necessary to verify it and to 
 make clear all its details. 
 
 For Wetterstrand it would have been just as im-
 
 78 History and Practice of Psychanalysis 
 
 possible to reduce a sick person to an object for 
 study, as it would have been for Charcot to keep 
 from doing this. As a consequence also, Wetter- 
 strand never won the confidence that was accorded 
 Charcot by his fellow practitioners. This hurt him. 
 And he never quite succeeded in resigning himself 
 to it. 
 
 Besides his book on "The Use of Hypnotism in 
 Practical Medicine," Wetterstrand has published 
 only a few shorter articles ; the most valuable of these 
 seems to me to be "Ueber den Kiinstlich Verlangerten 
 Schlaf." Even if these works had no great scientific 
 value, they are of interest in some respects. 
 
 Because of his intuitive faculty it not infrequently 
 happened that Wetterstrand hit the mark, no matter 
 if his argument was very halting. As an example it 
 is enough to cite the epilepsy question. When he 
 came forward and, supported by a series of cases, 
 declared that epilepsy could be radically cured by 
 means of hypnotism, he was met only with disbelief. 
 In medical circles it was curtly asserted that the 
 cases in question had nothing in common with true 
 epilepsy, and the authorities with one voice, declared 
 the whole thing contrary to their experience. Fur- 
 ther researches have, however, shown, that even such 
 interruptions of the continuity of consciousness, which 
 have the perfect epileptic type, may be of psychic 
 origin and so be cured through psychic treatment. 
 It is true that this treatment is in these days, used
 
 Wetterstrand and the Nancy School 79 
 
 according to quite other principles than those by 
 which Wetterstrand was led to his conclusions; but 
 with the accumulation of new experiments, no one 
 may put Wetterstrand's statements aside as absurd- 
 ities. It will always remain of interest that he dared 
 protest against the dogma of the incurability of epi- 
 lepsy, when all the rest of the medical world still 
 believed in it. 
 
 Another thing is of even greater interest. 
 
 As one of the reasons why suggestive-therapeutics 
 did not become what it should have become, I have 
 pointed out in the preceding pages, a certain twist- 
 ing about of facts concerning it, to which the funda- 
 mental principles themselves were subjected, chiefly 
 because science, on account of this, was driven into 
 a cul-de-sac. Wetterstrand did not permit himself 
 to be dragged into this epochal current of thought 
 in the same way as did the others. His ideas con- 
 cerning suggestion, he always brought out of what 
 was real about him, that which flowed past him in 
 his actual practice; it was never changed into a 
 dead product of the laboratory. Even more Wetter- 
 strand's independence upon the question of his idea 
 of hypnotism, advanced. Bernheim was coming more 
 and more to interpret all phenomena belonging there- 
 to as expressions of suggestion. Hypnosis itself was 
 to him only a phenomena of suggestion. On account 
 of his authority this idea impressed itself upon the 
 scientific consciousness. His categorical sentence,
 
 80 History and Practice of Psychanalysis 
 
 "There is no hypnotism. There is only suggestion !" 
 became a kind of byword. But Wetterstrand's work 
 reached out towards quite an opposite direction. 
 The more he saw, just the more plain it became to 
 him that there existed a peculiar condition of con- 
 sciousness, which has a specific therapeutic action 
 upon the organism. In this he was closer to Braid 
 than to the Nancy School and constructed a point 
 of contact with the older opinions, whose abandon- 
 ment had been altogether too brutally brought about. 
 The great basic problem for him was to find a way 
 in which one might systematically make use of the 
 therapeutic value of hypnosis in the highest possible 
 degree. His book was an effort towards the solution 
 of this problem. Theoretically this thing appears 
 simple: an effort should be made to prolong the 
 hypnotic condition not only for hours but for days 
 and weeks. It is a pity that the practical demon- 
 stration of such an effort meets with great dif- 
 ficulties. It demands, to begin with, a place where 
 the patient can, during sleep, be kept free from all 
 disturbing influences; this cannot be done either in 
 a home or in an ordinary sanitarium. If the method 
 is taken up on a larger scale, a house must be built 
 for that purpose. Even under such circumstances 
 one must struggle with another difficulty, viz: that 
 the method places unusually great demands upon 
 the doctor. As a rule it does not mean one or two 
 visits a day; it needs three or four in order to con-
 
 Wetter strand and the Nancy School 81 
 
 tinue the hypnotic condition and prevent awaken- 
 ing. 
 
 But when it came to practically prove his ideaa 
 and make plain the effectiveness of them, all such 
 hindrances gave way in front of Wetterstrand's 
 energy. He succeeded under the most unfavorable 
 conditions in keeping patients asleep for a whole 
 month at a stretch. It must be acknowledged above 
 all doubt that inestimable results were obtained in 
 this way. That the method was not taken up by 
 others except in isolated cases, may thus, very prob- 
 ably depend upon the practical difficulties attached 
 to it. 
 
 Through his independence regarding these two 
 basic questions of this way of treating disease, it 
 seems to me that Wetterstrand has made a contribu- 
 tion which must not be underestimated. 
 
 Far from leading to a reduction of their value, 
 the lines he followed point straight towards greater 
 possibilities. Whither a consequent use of the or- 
 ganism's function of regeneration, such as is appar- 
 ent in hypnosis, may lead, no one can prophesy, 
 only practical experience in time to come, can show 
 this. But it is certain that few things are so suited 
 for setting a physician's imagination in motion as 
 
 just this. 
 
 * * * 
 
 Wetterstrand died in the summer of 1907. 
 Later years have carried with them a whole series
 
 82 History and Practice of Psychanalyris 
 
 of new ideas which from the very foundation have 
 transformed psychotherapeutics. This could not be 
 lastingly built up upon relatively undecided and un- 
 certain experiences, such as came out in the hypnotic 
 literature. It demanded a far firmer grip upon the 
 whole of medical psychology and a stronger scientific 
 working out of the processes which lead to disease 
 and to health. The hopeful nai'vity of the practi- 
 tioner had to give way before the cold eye of re- 
 search. Only in this way could an undisturbed basis 
 be reached such as science must and does demand. 
 
 The development of the subject has brought all 
 the old disputes into a new position and has given 
 rise to many others. 
 
 My effort in the following studies will be to give 
 an idea of this development and afterwards to try 
 to show whither psychotherapy, after passing 
 through this state of scientific growth, seems to me 
 to lead.
 
 m 
 
 PSYCHANALYSIS AS A SCIENCE AND METHOD OP 
 TEEATMENT 
 
 MEDICAL psychology finds itself at the pres- 
 ent time in an especially notable period of 
 development. Historically there are only two epochs 
 which can be compared in importance with it, viz: 
 that of somnambulism in the beginning of the nine- 
 teenth century and of hypnotism in 1880. Looked 
 at from a distance it seems as if the movement in the 
 midst of which we now are, had a great many points 
 of comparison in common with these earlier ones. 
 Like them the movement has in this case chiefly pro- 
 ceeded from a single man, about whom a great many 
 disciples have gathered with an admiration rare in 
 scientific circles. This man's name is Sigmund Freud. 
 He is a professor in Vienna. 
 
 If one reads the old literature one cannot help 
 being struck by a certain eagerness displayed there- 
 in for new and peculiar experiences along with a 
 corresponding neglect of critical purging of mate- 
 rial. New literature can scarcely be made free from 
 a tendency in a similar direction. 
 
 83
 
 84 History and Practice of Psychanalysis 
 
 During the earlier state of any science very much 
 will be brought forth which later shows itself of no 
 decided value; but the haste with which doctrines 
 here follow one another is almost enervating. Just 
 as when academic medicine stood in its time as a com- 
 pact majority against the old schools, must be re- 
 peated here the same thing. Everywhere the new 
 school meets with an intense opposition. At the as- 
 semblage of German Neurologists in October, 1910, 
 physicians belonging to sanatoria were obliged to 
 officially give out a declaration that they had noth- 
 ing to do with psychanalysis, and Raimann sug- 
 gested that neurologists should agree among them- 
 selves upon the publication of every case in which it 
 could possibly be suspected that psychanalytical 
 treatment had done the patient harm. At the con- 
 vention of alienists in Breslau in the Spring of 
 1913, the discussion was more heated. Here the op- 
 position was led by Hoche who declared that the 
 whole idea of psychanalysis was to be considered as 
 a psychic epidemic among physicians. Such "intel- 
 lectual rooting like a pig" ought to be repulsive to 
 everybody. He summed up his attack with the fol- 
 lowing sentence: "The only lasting interest to be 
 found in the psychanalytical episode, is its connec- 
 tion with the sphere of the history of culture." 
 
 On the one side, its partisans believe in the thing 
 almost to the point of fanaticism ; on the other, the 
 attacks of its opponents against it often seem like a
 
 Science and Method of Treatment 85 
 
 revival of the inquisition. But this is also true with 
 doctrines, which not only are of fundamental im- 
 portance for the development of medicine. They 
 reach out into one field after another connected with 
 human life, and if they prove to be true, changes 
 cannot be avoided ; they must in such case, with time, 
 also obtain a widespread general cultural import- 
 ance. 
 
 I shall in a few words point out how these new 
 opinions fitted themselves into historical develop- 
 ment. 
 
 About the beginning of 1880 the Vienna physician 
 Breuer had under treatment a case of severe hal- 
 lucinatory hysteria. He used hypnotism in order to 
 suggest the symptoms away in the usual manner. In 
 the somnambulistic state the patient began to talk 
 about the origin of the symptoms and little by lit- 
 tle her consciousness stretched out over a mass of 
 forgotten circumstances which therein played a role. 
 She, herself, noticed that the symptoms disappeared 
 as soon as their hidden causal connection was 
 brought into consciousness. This patient is thus the 
 true discoverer of the psychanalytical method. 
 Breuer understood at once how to use the hints 
 given and carried out the consequent treatment un- 
 til the patient by means of this "talking cure" as
 
 86 Hittory and Practice of Psychanalysit 
 
 she called it, was made free of all her symptoms. 
 For those who have been interested in this much writ- 
 ten about case-history, I can add that the patient 
 had to undergo a severe crisis in addition to what 
 was given out in the description of the case. Since 
 then, however, she has lived and still lives, in the best 
 health and in widespread activity. 
 
 For private reasons Breuer, however, did not go 
 any further in his following out of the beginning he 
 had made. He even let his notes lie untouched upon 
 his desk. And they would probably still be lying 
 there, if he had not come into a dispute about the 
 thing with his younger colleague Freud. Freud im- 
 mediately suspected the importance of the matter 
 and when he went to Paris to study he talked it over 
 with Charcot. But Charcot, who then was deep in 
 his work concerning the phenomena of hysteria and 
 the experimental causes of it, had no interest in any 
 new experiments. This however did not prevent 
 Freud from coming into close touch with Charcot, 
 whereof the memoirs inspired by gratitude and ad- 
 miration, which he dedicated to him, bear witness. 
 In spite of all his approbation however, Freud could 
 not help pointing out the faultiness in Charcot's idea 
 of hypnotism. Upon this question Freud united 
 himself with the Nancy School and translated Bern- 
 heim's book into German. During the first year of 
 his practice as a physician Freud also devoted him- 
 self to hypnotic treatment; but his attention wai
 
 Science and Method of Treatment 87 
 
 drawn more and more to those points of view which 
 had come to him through Breuer's case. In the 
 year 1893, he published the first results of his psych- 
 analytic experiments, and he then wholly gave up 
 the practice of hypnotism in order to devote himself 
 absolutely to the working out of the psychanalytical 
 method. In the year 1895 he began, his lectures 
 upon this subject before an audience consisting of 
 three persons. One of these, Sadger, has since fol- 
 lowed him steadily and practices as an analyst in 
 Vienna. Later the other two, Adler and Stekel, al- 
 lied themselves to him, but retained their independ- 
 ence as original investigators. The Vienna group 
 grew until after a time it comprised four persons. 
 In the beginning of the year 1900, a branch arose 
 in Zurich, under the leadership of Jung, who up to 
 that time, next to Freud, had made most numerous 
 literary contributions to the subject. One of the 
 members of the Zurich colony, Abraham, settled 
 down in Berlin, and has there gathered a group of 
 followers about him. Since 1906, the movement has 
 come into an acute state. The number of those who 
 have officially allied themselves with the School, is, it 
 is true, not so great. But nevertheless during the 
 last year most neurologists have been in some de- 
 gree feeling their way along Freud's road. The 
 questions are discussed everywhere; one is obliged 
 to take a standpoint and it is difficult to do this 
 without at least some apparent personal experience.
 
 88 History and Practice of Psychanalysis 
 
 Interest has spread itself far outside German speak- 
 ing boundaries ; to Italy, Russia, France and Amer- 
 ica. An international congress is held yearly. Dur- 
 ing the whole of this development there has been 
 great difficulty in keeping the members together on 
 any kind of united scientific program. And this dif- 
 ficulty finally became overwhelming. In the Sum- 
 mer of 1911, Adler separated himself completely 
 from the rest and built up his own group under the 
 name "Verein fur freie psychoanalytische For- 
 schung" which later on was changed to "Verein fur 
 Individual psychologic." It was decreed that one 
 could not be a member of both schools, and the strife 
 arose that still is going on. What this means I will 
 more closely point out in the next paper. Most of 
 those interested, allied themselves with either the one 
 or the other group. Some preferred to keep them- 
 selves more at a distance and to avail themselves of 
 anything essential which proceeded from either side. 
 Just now there is going on a new division. It seems 
 to be harder and harder for the Vienna school and 
 the school at Ziirich to work together ; I shall touch 
 upon the most important questions between them 
 in my last study. 
 
 In connection with this schism the editing of the 
 psychanalytical movement's journal during the 
 course of three years, had undergone much change. 
 "Jahrbuch fur psychoanalystiche Forschungen' 1 
 which is intended to take up greater original work
 
 Science and Method of Treatment 89 
 
 has hitherto been looked after by Jung, but with this 
 year he steps out of the editorial chair. "Zentral- 
 blatt fiir Psychoanalyse," was founded by Stekel 
 and Adler. The latter went out at the time of the 
 rupture with Freud, but when Freud some time after 
 also tried to get rid of Stekel, the result instead 
 was that he himself had to step back. 
 
 The paper continues to be edited by Stekel and 
 bears a strong mark of Adler's spirit. The Freud 
 dogmatism has now as its chief organ "Inter- 
 nationale Zeitschrift fiir Artzliche Psychoanalyse" 
 which is edited by Ferenczi and Rank. Freud also 
 issues a periodical called "Imago" with Rank and 
 Sachs as editors; the object of this is to apply 
 Freud's doctrines to the humanistic sciences in gen- 
 eral. Besides this a continual series of detached 
 works come out under the name : "Freud's Schriften 
 zur Angewandten Seelenkunde." And Adler has 
 under his patronage a similar series : "Schriften des 
 Vereins fiir freie psychoanalytische Forschung." In 
 addition to these a great many psychanalytical 
 articles appear in the usual medical and pedagogical 
 journals. 
 
 A gigantic work is produced by the psychanaly- 
 tical investigators which carries the movement not- 
 ably ahead both in inner and outer development, 
 not only for every year but even for every month. 
 One would have to be especially blinded by his 
 academical conservatism in order to find, with this
 
 90 History and Practice of Psychanalysis 
 
 work before him, that psychanalysis is in its death 
 throes, as Hoche declared it to be, at the Congress 
 before mentioned. In this declaration he had in 
 mind all the various schisms that were within the 
 movement; but far from bearing witness to any 
 loss of strength, the movement's power of expansion 
 is, on the contrary, plainly to be seen. Yet this 
 makes it almost an impossibility to give a united 
 picture of the whole. In order to simplify the 
 problem to some degree I shall in this paper, deal 
 exclusively with Freud and with the work of his 
 immediate pupils who round him out on one point or 
 the other. And in order to at least reach an ap- 
 pearance of lucidity I shall confine myself to main 
 characteristics. I intend to do this as objectively 
 as possible without unnecessarily mixing in my own 
 ideas. 
 
 The first difficulty met with concerning Freud's 
 teachings is, that they by no means constitute a 
 system which may be lightly glanced over. They 
 are rather a chaos of efforts to explain and fix enor- 
 mous masses of results of experiments. Antagonists 
 often remark that it is altogether a theory ; but this 
 objection is quite out of place here. 
 
 The synopsis is, on the contrary, difficult of at- 
 tainment just because the theoretical construction
 
 Science and Method of Treatment 91 
 
 work has been so much put aside. This may seem 
 like a defect when it comes to giving a connected 
 presentation; but really it is an advantage. It is 
 all too easy to forget that the object of the psychol- 
 ogist, the human mind, is filled up with contradic- 
 tions which amalgamate in actual life, but which 
 never could be theoretically explained together. In 
 the face of every psychology, which does not reflect 
 the nature of its object, it is easy to be suspicious, 
 to notice quickly that those concerned have not gone 
 empirically about it, but have let themselves be led 
 by prejudiced ideas. Besides, Freud, in the whole of 
 his makeup is no theorist, and least of all a philos- 
 opher. He is an unusually clear-minded modern in- 
 vestigator, for whom only the discovery of new facts 
 has value. 
 
 In order to counteract all those criticisms and mis- 
 understandings to which Freud's psychology, be- 
 cause of its many changing forms, has been sub- 
 jected, Hitschmann has published a book which may 
 be called the first text book in psychanalysis. But 
 it is scarcely anything more than a reference to 
 Freud's most important writings, with connecting 
 remarks concerning them. 
 
 Unfortunately critics have not been able to con- 
 tribute anything toward elucidating what is really 
 essential in this new direction. Even where the work 
 has fallen into such good hands as, e. g. Isserlin's, 
 it has remained pretty sterile. On the one hand
 
 92 History and Practice of Psyclianalysis 
 
 Freud's adherents say: "If you insist that we are 
 mistaken, give us evidence of it." On the other hand 
 his antagonists say, "It is not for us to prove fal- 
 lacies, but for you to prove the truth." And there 
 it remains. The usual way in which each empirical 
 fact which an investigator declares he has arrived 
 at, gives cause for after-examination by others be- 
 fore opinions are expressed concerning it, seems here 
 to have little validity. During the last few years I 
 have myself carried out many, more or less deep- 
 going, analyses. I have in this way found confir- 
 mation of several opinions which a priori, seemed to 
 me unbelievable; but, there are many others about 
 which I hesitate, or which I am inclined to reject. 
 Yet in every case Freud's great ingeniousness and 
 sweeping importance have been more and more made 
 clear to me. 
 
 To return to the case of Breuer, which laid the 
 foundation for Freud's research, it will be remem- 
 bered that it succeeded in making the patient free 
 from severe hysterical symptoms by means of tracing 
 their hidden casual-connections and bringing them 
 back into her consciousness. Closer study led to the 
 following general opinion regarding hysteria; the 
 symptoms arise through the fact that in the con- 
 sciousness, intolerable, emotionally emphasized ex- 
 periences and imaginations are forced away, denied 
 and made unconscious. This process Freud calls 
 "Verdrangung." The term has since found its way
 
 Science and Method of Treatment 93 
 
 out into everyday speech and there keeps exactly 
 the value Freud gave it. It is difficult to find a 
 word which so exactly expresses his meaning in an- 
 other language, but "repression" seems most suitably 
 to convey the meaning in English, although it misses 
 a little touch of the unconscious which lies in the 
 word "Verdrangung." If one classes it as an indi- 
 cation for the process itself, a special word is needed 
 to indicate the summing up of that which is forced 
 out of the consciousness. It may be best to keep, in 
 this connection, to the prevailing German term, com- 
 plex. When in ordinary conversation we say that 
 we force away our anger, it simply implies that 
 we try to hinder its normal outlet. And it is just 
 in this prevention of a releasing outlet, after which 
 with innate power, the emotion immediately strives, 
 that the building up of neurosis lies. Instead of 
 breaking forth, being aired, being "abreacted," the 
 emotion is suppressed. In its simpler form this proc- 
 ess belongs to the experiences of everyday life. 
 After some earnest discussion, it has surely happened 
 to us all, that we have clenched our hands and gone 
 away, smothering by sheer force of will, our desire 
 to give our opponent a box on the ear. But the 
 road from such everyday experiences, to a state of 
 ill health is long. Many different circumstances 
 must unite before a functional disease can be con- 
 stituted upon the foundation of a repression. Above 
 all the repression must come into conflict with some
 
 94 History and Practice of Psyclianalysis 
 
 sphere which has for the individual, the highest life- 
 interest. Freud believes that there exists only one 
 such sphere, viz, the sexual-life. Furthermore the 
 complex must fall into soil fertile for the progress 
 of disease. Here we reach the grave question of 
 the importance of heredity for neurosis, of which 
 Freud treats in a separate work. He therein opposes 
 himself to what originated in Charcot's one-sided 
 assertion, to the effect that heredity is the only 
 essential cause of neurosis. Here there clearly exists 
 a relative condition. The stronger the burden the 
 less is needed to produce an illness. With a strong 
 and thoroughly healthy individual, not even the most 
 forceful sexual repression need mean illness. Ac- 
 cording to circumstances it may lead to the building 
 of character, to artistic production, or something 
 else of the kind. In other words, the forces which 
 have been discarded to a place in the unconscious 
 mind, need not seek a way out on the path of disease. 
 They may rather be used in the service of life. This 
 is the process which goes under the name sublima- 
 tion. I shall refer to this later on. 
 
 Suppose now that an individual inclined to nerv- 
 ous suffering becomes subjected to sexual experiences 
 from which he must free himself if he wishes to save 
 his emotional life from becoming a prey to them. 
 He believes he has succeeded when, in the struggle 
 within himself, he arrives at that point where he no 
 longer is consciously reminded of what has occurred ;
 
 Science and Method of Treatment 95 
 
 when in other words, he separates the experience 
 from the complex of memories, illusions, feelings, 
 etc., which, collected, are called the ego. But in the 
 hidden mind the overcome emotion may live on and 
 its expansive forces may stretch their activities up 
 into the consciousness and reach it in such form, that 
 the connection between cause and effect is not even 
 conjectured by the sufferer. Hence all that indeter- 
 minate restlessness, which so often strikes one as 
 soon as one begins to talk with a neurotic ; hence the 
 sleeplessness, the anxiety dreams, the state of de- 
 pression, etc. 
 
 Of especially great importance now, we must re- 
 member, is the fact that the tension on its way from 
 its unconscious source to its release in disease, may 
 undergo many alterations. The tension is in a way 
 disconnected from the self; neither does it neces- 
 sarily at its release, break out in those parts of the 
 nervous system, the activity of which has intimate 
 connection with conscious processes; it may imme- 
 diately radiate upon nerve courses and show itself 
 there in functional pains, paralyses, cramps, diges- 
 tive disturbances, etc. Freud calls this process 
 Conversion. No matter whether the disturbance in 
 a given case, remains in the psychic sphere, or is 
 transplanted to the nervous system, Freud carries 
 it back to a constitutional moment. He says much 
 about greater or lesser conversion-tendency. It is a 
 matter of much consequence then, if, so to speak,
 
 96 History and Practice of Psychanalysis 
 
 any organic grip is given to the unconscious tension. 
 The organic path must in a way be staked out for 
 the conversion ; the organism must come to meet the 
 strain. Through such conversion, for example, a 
 lifelong neuralgia may start from a temporary 
 toothache. I recall a patient who for six years was 
 continually under local treatment by noted special- 
 ists, but who, nevertheless, grew continually worse. 
 The psychic origin of the illness was entirely clear. 
 The local changes had as a matter of fact played 
 no other part than that of directing the conversion 
 to the facial nerves. 
 
 Particularly often do the pains of occasional 
 rheumatism play a part in such conversion. I had 
 another patient who suffered from severe headaches, 
 which she thought were of rheumatic origin, as she 
 actually did suffer from that disease; but the chief 
 cause of the headaches was sorrow for the loss of a 
 sister. This sister had been afflicted with headaches 
 caused by pernicious aenemia and my patient iden- 
 tified herself unconsciously with her. Always when 
 local treatment for such suffering is not followed 
 by freedom from pain, one should suspect that some- 
 thing psychic lies behind. 
 
 This conversion doctrine may seem strange to 
 those who assume absolutely the physical point of 
 view of all nervous disturbances. I will therefore 
 say that I sometimes find patients who for themselves 
 are successful in penetrating such connections. I
 
 Science and Method of Treatment 97 
 
 began once, e. g., to explain this thing to an intelli- 
 gent woman, who suffered from severe neurotic pain. 
 She interrupted me immediately by objecting: "That 
 you do not have to explain, for I already under- 
 stand it. I am unhappy and my mental suffering 
 must localize somewhere; during my courses the 
 pain localizes in those special parts: if anyone of- 
 fends me I get palpitation of the heart, so the pain 
 finds a place in the heart ; if there is no other place 
 where it can settle its attacks my arm, because I 
 broke it when a child and was tormented with mas- 
 sage for a whole year." 
 
 The repression doctrine originally concerned it- 
 self only with hysteria, but soon began to be ap- 
 plied also to other diseases, compulsion-neuroses, 
 anxiety-neuroses, perversities and dementia-praecox, 
 among others. It was found upon investigation of 
 these that analogous mechanisms play a great part 
 in the repression. In these disturbances they would 
 be more difficult to discover, partly because the re- 
 pressed material undergoes greater changes before it 
 arrives at its definite form as a disease symptom; 
 partly because sick people of this kind are less ap- 
 proachable for deep-going psychic investigation ; and 
 before all because the repression as a cause of dis- 
 ease is here so interwoven with many other causal 
 threads. 
 
 The whole of this doctrine was, as Freud himself 
 pointed out, nothing new in principle. "The fact
 
 98 History and Practice of Psychanalysit 
 
 is that the middle ages chose this solution when they 
 declared possession of a devil as the cause for hys- 
 terical phenomena. It was only necessary therefore 
 to insert modern scientific terminology in place of the 
 religious expressions which were in use during this 
 dark and superstitious time." So simultaneously 
 with the scientific work there must also be founded 
 a method of treatment better suited to our times than 
 the medieval way of driving out evil spirits. 
 
 In the first stadium of the psychanalytical method 
 of treatment the effort was to "abreact the repressed 
 affect." Unconscious causes of illness should be 
 traced and made conscious. The patient should 
 again unite the ego-complex with what he had tried 
 to force out of it. This could not often happen 
 without suffering; the emotion bound up in the 
 symptom was often made free; the anxiety, which 
 had been, for example converted into neuralgia, 
 again became anxiety. The treatment, therefore, 
 often temporarily produced a change for the worse, 
 sometimes led to serious crises. But it must at last 
 lead to health; the symptom surely had its possi- 
 bility for existence in the quality of the unconscious 
 mind. 
 
 The original somewhat naive belief in the abso- 
 lutely saving virtue of the unconscious mind no long- 
 er holds together. On the contrary most people have 
 a certain tendency to exaggerate in the opposite 
 direction and throw awav even what is valuable
 
 Science and Method of Treatment 99 
 
 and lasting in such an idea. To me, however, there 
 seems no doubt that the consciousness has an im- 
 portance of this kind in mankind's struggle against 
 destructive experiences. The effort so common with 
 many people to flee away from life in fear, often 
 leads them, without doubt, to a flight into illness, 
 as Freud expresses it. By freeing them from this 
 fear, teaching them to look everything, even the most 
 tragic experiences of life, straight in the eyes and to 
 meet new misfortunes with open mind, by so doing, 
 one surely will have made them stronger and sounder 
 individuals. But naturally such a method of treat- 
 ment has its decided limits. It, like every other 
 one-sided attempt, must sooner or later be reduced 
 to one of the many constituents of which general 
 psychotherapy is made up. 
 
 As to psychanalysis as a method, it is particularly 
 difficult to give a clear presentation. To afford 
 anyone a genuine conception of a technical method, 
 with no material for demonstration, but solely by 
 means of description, may perhaps be possible, in 
 for instance, a case of intubation or some other 
 operation, provided those concerned have all the 
 anatomical and physiological fore-knowledge. But 
 the situation is more difficult when the most com- 
 plicated psychological interference is brought into
 
 100 History and Practice of Psychanalysis 
 
 question. Without doubt much misdirected criti- 
 cism has arisen through the fact that neurologists 
 have looked at the matter solely as neurologists and 
 so have been unable to judge this special field, which 
 really has little to do with the pedagogic practice 
 of neurology. Here comes in an important thing: 
 it is by no means given to everybody to advance 
 to genuine understanding of this subject. Psychol- 
 ogy is finally based upon introspection. Objective 
 experiences may complete our subjective experience 
 but taken solely by themselves they can never give 
 us real psychological knowledge. Without the natural 
 analytical inclination and without having been accus- 
 tomed since childhood in some degree, to make clear 
 one's own life analytically, nobody can be taught to 
 understand psychanalysis. It is often pointed out 
 by analysts that no one ever goes farther in the 
 analysis of another than he has gone in the analysis 
 of himself. Where one is- blocked in an analysis 
 before clear comprehension has been gained, it is 
 sometimes found that it does not depend upon the 
 opposition of the patient, but upon the opposition 
 within the analyst; the analyst has, in other words, 
 come in contact with a common circumstance of life, 
 which he has not dared to drag out into the light 
 of day for himself, but before which he has fled in 
 the usual neurotic way. Analytical practice de- 
 mands of the doctor not only a highly intensified 
 faculty for self-analysis but also a highly intensified
 
 Science and Method of Treatment 101 
 
 faculty for self-honesty. There are doubtless many 
 who, because of this fact, beat a retreat in fright at 
 the first collision with the difficulties that this method 
 carries with it, and thereafter turn angrily against 
 it. The great opposition toward the whole trend of 
 the matter very likely has its root partly in this very 
 fact. Here it is not a question of trying to break 
 through opposition but of the making of conditions 
 clear. Perhaps the originality of the procedure in 
 some degree may be made more distinct for those 
 analytically disposed ; for the rest, this presentation 
 of it will remain only a "jumble" as Ziehen expressed 
 it, regarding psychanalysis in general. 
 
 As has already been mentioned, the first analyses 
 were made during hypnosis and a few writers, as for 
 instance, Muthmann, still ascribe to hypnosis a cer- 
 tain importance in this respect. Freud, however, 
 soon entirely gave up hypnosis and most of his pupils 
 have followed his example. The reason for this is 
 as follows : the most difficult thing about analysis is 
 the overcoming of the inner opposition behind which 
 the unconscious seeds of illness lie defended. During 
 hypnosis part of this opposition disappears. This 
 is true. But the old opinion that the unconscious 
 mind becomes approachable, without the control of 
 the patient's will, is a great mistake. The laws of 
 the conscious life continue to hold valid even in the 
 deepest state of hypnosis. In using hypnosis it may 
 easily happen that external opposition is passed by ;
 
 102 History and Practice of Psychanalysis 
 
 but afterwards there arises a wall which cannot be 
 broken through. In carrying on analysis in the 
 waking state it is true that in the beginning the prog- 
 ress is slow, but the way is thus better paved for a 
 deeper advance. 
 
 During the waking life a stream of associations 
 continually flows through the consciousness. This 
 stream is more sharply defined the more the attention 
 is directed upon one decided thing, but even during 
 the most purposeful concentration, strange links of 
 association often present themselves; solitary pic- 
 tures which have nothing to do with our line of 
 thought, become suddenly conspicuous and then 
 again disappear. The more we dissociate the atten- 
 tion, just so much more numerous these uninten- 
 tional thought-pictures become, and during sleep 
 they take possession of our consciousness in the 
 form of dreams. Generally we consider them as 
 psychological accidents not worthy our attention, 
 but they are the blending in of our unconscious life 
 with the conscious actions and as such they are often 
 worth the greatest interest. They often originate 
 from repressed experiences which have maintained 
 such a strong inner tension that they have power to 
 break through even the strongest conscious thought- 
 concentration. When during psychanalysis it sim- 
 ply means the bringing of these experiences to light, 
 the ordinary streams of association are looked away
 
 Science and Method of Treatment 103 
 
 from and instead, attention is fixed upon those that 
 are blended in with them. 
 
 To begin with, one tries to get the patient to dis- 
 connect the attention and to relate that which in a- 
 given moment, passed through his head. It was 
 Freud's custom to lay his hand upon the patient's 
 head and say "Now when I press with my hand a 
 thought picture will present itself." By thus letting 
 him search from one thought-picture to another he 
 gradually got the chain of associations. He called 
 this the "cathartic method." The first principle in 
 such procedure, is the avoidance of the usual anam- 
 nestic cross-questioning as soon as the contour of the 
 neurosis becomes clear. The patient is encouraged to 
 speak freely about himself. It is explained to him 
 that his illness is nothing but his unsuccessful effort 
 to solve the conflicts of his life. It is wise, as quickly 
 as possible, to obtain a fairly clear insight into this 
 connection, in order that the patient may have a 
 feeling that he is understood. This often solves the 
 problem. "Whereof the heart is full thereof the 
 mouth speaketh;" and the more the patient speaks, 
 the better. When words run out of the patient with- 
 out connection, one thing after the other, it is neces- 
 sary to follow with the greatest care and sharpness, 
 all links of associations in order to be able to select 
 just those through which, without intention, he re- 
 veals something of import. It will not do to let such
 
 104 History and Practice of Psychanalysis 
 
 material be lost and the patient must be encouraged 
 to follow it up. One picture presents itself after an- 
 other until recollections which have lain buried in the 
 mind for decades again live before him. It strikes him 
 that these had an importance of which he hitherto 
 had not had the slightest inkling and this importance 
 must be interpreted to him in detail. In this way one 
 shadow after another is evoked from the hidden past. 
 Told in this way, here in a few lines, the thing seems 
 very simple. But in reality it often meets with the 
 greatest difficulties for the very reason that it lies 
 in the nature of neurosis to guard, with all the force 
 of the patient's reserve, those secrets that lie at the 
 foundation of the trouble. Opposition belongs to the 
 disease. It is a common objection that one is act- 
 ing against the will of the patient in trying to break 
 through this opposition. On the contrary. He is 
 helped to what he most earnestly desires, but which 
 he cannot by himself attain. The neurotic is in the 
 position of one who wants, but is unable, to love 
 another ; an indeterminate something hinders the free 
 action of the feeling which really is there. Just as 
 little as the opposition in such a case can be broken 
 through by sheer force of will, just as little can this 
 be done with the neurotic. The psychological prob- 
 lem is more involved than this. 
 
 For the purpose of facilitating the bringing to 
 light of material which is the cause of a psycho- 
 neurosis, there are a few technical means of help at
 
 Science and Method of Treatment 105 
 
 our disposal. The most important among these is 
 the dream-interpretation. 
 
 It is well known that those things which we try to 
 suppress during the day, often come back in the 
 dreams at night. So one initiated in dream inter- 
 pretation, may often even find traces of things he 
 has suppressed in the course of life. It was there- 
 fore natural that Freud in his search for inadvertant 
 outbreaks of the unconscious life, should turn his at- 
 tention especially to dreams. And so much the more 
 because he was continually meeting with the rela- 
 tion of dreams during his analyses. Patients brought 
 them to him in the same way they brought their 
 real experiences. He also soon found that dreams 
 were established in psychological processes as de- 
 termining structures, like any other thought struc- 
 ture, only with the difference that they were built 
 according to other principles than those which have 
 to do with the waking life. The thing then was to 
 discover these principles and learn how to decipher 
 this strange sign-language. So originated that 
 work, based upon far-reaching and tedious research, 
 to which Freud gave the name "Traumdeutung." 
 This has been followed, one might almost say, by 
 nearly a whole library of the same description. The 
 work is such a foundation for psychanalysis that it 
 may be said that in its entirety the subject is encom- 
 passed in this single book. The ideas therein ex- 
 pressed have been worked out and applied in mani-
 
 106 History and Practice of Psychanalysis 
 
 fold ways by his pupils; some lines even have been 
 elaborated into a whole book, for example, The 
 Jones-Hamlet interpretation.* 
 
 If one considers the dream as it immediately ap- 
 pears before the consciousness, it ordinarily seems 
 quite meaningless. This has given rise to all the 
 old teachings, according to which the dream is only 
 a conglomeration of dissociated ideas, originating 
 through the fact that the somatic processes tempo- 
 rarily put the ruling mental apparatus into a state 
 of irritation. If the dream is subjected to analysis, 
 it takes on another signification. Dogmatic ideas 
 concerning its want of meaning disappear and the 
 importance of the body processes in the construc- 
 tion of dreams is considerably reduced. 
 
 If a person relates a dream and if he is then ques- 
 tioned as to what comes into his mind when he thinks 
 of it, he will, as a rule, reply: nothing. But cir- 
 cumstances are changed if the dream is separated 
 into its elemental parts, and the person is then asked 
 to think over each and every detail and to relate 
 what each implies. It will so be seen that every 
 dream-element will awaken lines of association out of 
 the waking life's experiences. This is something 
 which everyone may try for himself ; there is no way 
 in which it is possible to easier obtain a first insight 
 into the nature of analysis. If an anxiety-dream is 
 chosen, one gets at the same time some inkling of its 
 *See Freud, "Traumdeutung."
 
 Science and Method of Treatment 107 
 
 action ; one experiences in this way how the anxiety 
 disappears without a trace of it being left, during 
 the analysis. After dissolving one element after the 
 other, instead of the original meaningless dream-pic- 
 ture, there accumulates vastly multiplied psychic- 
 material ; and it is found that this dove-tails into an 
 ingenious thought-structure, perhaps sometimes, at 
 first, with the help of a certain fantasy and always 
 with certain flaws. Instead of the manifest dream- 
 picture we now have the latent dream-content or 
 dream-thoughts. When Freud arrived at this point 
 in his investigations, he threw aside the original pic- 
 ture and the whole of his further study concerned 
 itself with the at first unconscious, but now con- 
 scious, material, so changed about through analysis. 
 This is something that must be constantly kept in 
 mind, when Freud speaks about dreams. When, for 
 example he declares that every dream is a sexual 
 dream, he means only that the sexual life always 
 hides itself in the depths of the constructive forces 
 under the manifest pictures. 
 
 It would carry us much too far here to go farther 
 into Freud's dream psychology. For the sake of 
 connection, however, I must touch upon two ques- 
 tions with which it especially is concerned: 1. 
 Whence originates the latent dream-material? 2. 
 How are the manifest dream-pictures constructed 
 out of this? 
 
 "V, The material changes of course, to a great
 
 108 History and Practice of Psychanalysts 
 
 extent in different dreams, but it is a thing to lay 
 stress upon that it often, to an astonishing degree, 
 originates in the childhood. Through this fact the 
 dream attains a practical importance in being sin- 
 gularly able to complete that part of life which 
 contains the largest gaps in memory. 
 
 2. Concerning the construction of dreams, it is 
 first and foremost to be noted that the dream is not 
 logically descriptive, but is symbolically represented : 
 A simple picture of the difference between the way 
 in which the waking consciousness relates something, 
 and the dream way of so doing, may be obtained if 
 the difference between a modern monument and one 
 of the ancient Egyptian type is thought of. Upon 
 the former is found an inscription of that which the 
 stone commemorates, upon the latter is only a mass 
 of figures and lines without evident connection; the 
 meaning of these is only apparent when one learns 
 how to interpret the pictures one by one and then 
 puts the whole together. The dream in the same 
 way draws one picture after another. Therefore a 
 study of the dream-content means first the con- 
 struction of the picture in itself and finally of the 
 meaning hidden behind the symbol. 
 
 In regard to the first of these two points Freud 
 considers that the construction of the dream arises 
 through four psychological processes: 1. Conden- 
 sation. 2. Displacement. 3. Dramatization. 4. 
 Censoring.
 
 Science and Method of Treatment 109 
 
 Even with the most casual observation most peo- 
 ple have probably noticed how, in a dream, two or 
 more people commonly are fused into one. We may 
 for instance, recognize some one in the dream whom 
 we have seen the previous day, but while in reality 
 he had a black mustache, in the dream he appears 
 with a blond one and we find that the mustache is 
 taken from some other man. In a similar way in 
 the dream, a pair of eyes belonging to an animal may 
 be seen in connection with a human being. The con- 
 densing process may be yet more involved; a land- 
 scape, a person, a piece of furniture, etc., may for 
 instance, all be condensed in the same picture. 
 
 Displacement shows itself particularly in the^fact 
 that that which plays the chief role in the manifest 
 dream-picture by no means has the same importance 
 in the dream-thought, and, therefore in reality. 
 This is most marked in the sphere of affects. Every 
 one knows how an unimportant thing in the dream 
 can be bound up with the strongest kind of an emo- 
 tion, and how again one may in a dream, appear 
 quite naked among others, without feeling the slight- 
 est disgrace. The affect is loosed from its real 
 connection, transferred to some indifferent subject 
 and fixed upon it. 
 
 The dream has an inclination to present every- 
 thing in acoustic and visual pictures. It does not 
 approve of the narrative form but is, in its essentials, 
 dramatic.
 
 110 History and Practice of Psychanalysis 
 
 Freud lays great stress upon the fourth point, 
 censoring; although others especially Bleuler, finds 
 its importance more doubtful. That a higher psychic 
 court of appeal, censors that which a lower court 
 produces, belongs to the experience of every day 
 life. As an illustration, the following example may 
 serve; a writer feels himself inspired and lets all 
 that forces itself up through his consciousness flow 
 forth from his pen. When later on he reads over 
 what he has written he notices that it reveals his in- 
 timate life more closely than he desires. He then 
 scores through a line here and there, replaces that 
 which he had expressed directly, by symbols, hides 
 himself behind fictitious figures, etc. His reflecting 
 ego censors his spontaneous productive ego. In 
 the same manner we always conduct ourselves when 
 the outbreaks of the unconscious life during sleep, 
 seek an outlet in our consciousness in the form of 
 dreams. Even during the deepest sleep of the night, 
 the sentries that guard our consciousness from re- 
 pressed experiences do not slumber; if they cannot 
 prevent these experiences from forcing a way in, they 
 at least play such havoc with them that we no longer 
 recognize them. This same inclination to censor, 
 continues in the conscious mind when it is fully 
 awake. If a person relates a dream, and if later 
 on he is asked to write it down, it is a foregone con- 
 clusion that the written description will be more 
 strongly censored than the related one. It is this
 
 Science and Method of Treatment 111 
 
 censoring which puts the keenness of the dream-in- 
 terpreter to hardest proof. 
 
 But what complicates dream-construction most of 
 all is the use of symbols. The study of symbolic 
 presentations has more and more come into promi- 
 nence. Freud soon discovered, when he turned his 
 attention in this direction that symbolic speech by 
 no means applies only to the dream. It is a common 
 ingredient in the conscious mind and presents itself 
 now here now there, in folk-lore, in witticisms, in 
 slang, etc. Closer investigation has led to the fol- 
 lowing general opinion, the accounting for which I 
 must here pass by: primitive man made use of sym- 
 bols as a means of expression ; later, our logical, de- 
 scriptive speech was built up as a cultural super- 
 structure upon this foundation. With this, however, 
 the use of symbols has not disappeared. It remains 
 in the waking consciousness as a fragmentary admix- 
 ture ; and what is far more important, it has re- 
 mained in the unconscious mind as its means of 
 expression. During sleep it again takes the lead in 
 the presentation of our experiences. And when the 
 developed consciousness is relaxed during periods 
 of mental dullness it becomes once more the ruling 
 force for the life of imagination. A significant point 
 in the development of psychanalysis was Jung's 
 presentation of the analogies between the fantasies 
 of dements and the mythologidal and totemistic 
 thought-products of primitive peoples.
 
 History and Practice of Psychanalysis 
 
 In settling upon one single point in the Freud doc- 
 trines, which, in importance, exceeds all others he has 
 brought to light, I should suggest his clear presen- 
 tation of the connection between dream psychology 
 and the process of the construction of neurosis. It 
 has always been suspected that dreams had some- 
 thing to do with insanity. But until Freud's re- 
 searches, this remained only a suspicion. His in- 
 genuity was the first that succeeded in seizing upon 
 and working out in detail this apparently inacces- 
 sible empirical material. Psychoneurosis is a flight 
 away from reality into a world of illusion. And the 
 neurotic takes with him into his waking life a part 
 of this world of illusion; he finally at one point or 
 another becomes influenced by the forces which rule 
 this world. Some part of his psyche is not con- 
 structed according to the laws of the waking con- 
 sciousness, but according to those rules which deter- 
 mine dream construction. 
 
 By giving the subject close attention, it will al- 
 ways be found that just those processes mentioned 
 above, continually come back in the psychology of 
 neurosis. 
 
 Condensation implies a synthesis between things 
 that have no connection in substance, but are only 
 united through more or less temporary associations. 
 Such syntheses play a great part in thelife of the neu- 
 rotic, and treatment must often be directed toward
 
 Science and Method of Treatment 118 
 
 an effort to dissolve them, just as a mere temporary 
 synthesis is broken up in the dream interpretation. 
 
 In the same way in which, during a dream, an 
 affect is made free from its actual connection and 
 transferred upon some indifferent thing, a neurotic 
 becomes anxious if he is obliged to cross an open 
 space, touch certain objects, be left alone in a room, 
 etc. In what has been the usual treatment the effort 
 has been to convince the patient that his anxiety is 
 groundless, a way that has nothing of the desired 
 result, when the connection of the anxiety with the 
 illusion in question has not at all been made clear in 
 a logical manner. The psychanalyst first discovers 
 where the anxiety had its origin and then makes 
 clear why it has been loosed from this origin and in 
 what way transferred upon some other unconcerned 
 thing. 
 
 As to the dream's inclination to present everything 
 in pictures, this also comes back here in a variety of 
 ways. It is most striking in the question of the 
 hallucination. The transference between hallucina- 
 tion and particularly vivid dream-pictures is often 
 obvious. 
 
 That the neurotic in his struggle against the strain 
 of repressed experiences, unconsciously makes use of 
 the censor in a far reaching degree, is manifest. I 
 recall for example, an elderly widow who had a per- 
 petual hallucination of snakes ; she suffered especially 
 because the snake forced itself into her abdomen,
 
 114 History and Practice of Psychanalysis 
 
 wriggled through the body up to her mouth and 
 from there spat out its poison. The genuine suffer- 
 ing which she censored in this way, is so clear that 
 it does not need to be pointed out. From this coars- 
 est form there is a continual transference to that 
 general mendacity which is so often met with in hys- 
 teria. This woman had so accustomed herself to 
 unconsciously clear herself from her varied experi- 
 ences by means of lies, that at last she was neither 
 able to feel nor tell anything which was not entwined 
 in lies. In coming across patients of this kind, the 
 first thing to do is to make an effort to introduce 
 truth into their lives. 
 
 The most weighty analogy between dream and neu- 
 rosis-construction, according to Freud, lies in the 
 wish motive. He is of the opinion that the dream 
 always contains the realization of an unconscious 
 wish, and, more decidedly, of a sexual wish. And 
 he believes that the neurotic in a similar way, lives 
 out his repressed impulses in the form of nervous 
 symptoms. Unfortunately I can not here take up 
 this point, which at first glance seems preposterous. 
 It must be handled in a far broader connection and 
 with a far deeper investigation into Freud's line 
 of thought, than is possible here, in order to get 
 any clear conception of what it implies. There is 
 the less reason to stop at this disputed question, as 
 the researches of later years seem to me to show 
 the impossibility of supporting the idea as Freud
 
 Science and Method of Treatment 115 
 
 formulated it. I shall return to the subject in my 
 last study. 
 
 In the present condition of things I believe it 
 would be too rash to attempt to give a general 
 verdict concerning psychanalysis as a method of 
 treatment. Altogether too much is going on in 
 that direction to make possible a centralization of 
 one's impressions. I shall therefore confine myself 
 to certain comments. 
 
 Above all I believe that it is a fallacy not to 
 separate psychanalysis as a science from psych- 
 analysis as a method of treatment. 
 
 While it is now called a therapeutic agent, it is 
 nevertheless of a kind that also yields scientific 
 fruit. So it may easily happen sometimes, that it is 
 the deference to science and not to the patient which 
 is the deciding factor in the use of this method; 
 when the psychanalysis of a single case is spoken 
 of as something which must stretch itself out over 
 years, this point of view must be taken into consid- 
 eration. The thing is placed in quite another light, 
 if treatment of the patient is altogether the ob- 
 ject in view. When analysis fits itself in as a mo- 
 ment in that unfoldment which is expected from 
 the treatment, even if this moment in a given case, 
 is the chief thing, still it is not necessary to go to
 
 116 History and Practice of Psychanalysis 
 
 those lengths described in the literature upon the 
 subject, nor is it necessary to overload the analysis 
 with all those details which only serve to make it 
 repellant. 
 
 It has already been pointed out that a kind of 
 uncertainty is inherent in this method of treatment 
 and that it can scarcely be freed from the subjec- 
 tive element. In this respect psychanalysis has, and 
 probably always will have, a stamp of art. The 
 sculptor may hit upon a likeness, which will aston- 
 ish everyone who has any feeling for art; but he 
 cannot, by measuring, weighing, registering, etc., 
 demonstrate that likeness. In a similar way, the 
 psychanalyst may give a picture of the whole play 
 of unconscious forces, of which the visible result is a 
 sick human life, and those concerned may in their 
 innermost hearts, feel that this picture is the true 
 one. It is in this feeling that the criterion of truth 
 finally lies. All efforts to attain other, more scien- 
 tific evidence become more or less illusory. This may 
 seem a weak point which would plainly reduce the 
 value of psychanalysis. But it is a question if the 
 same weak point does not and must not always be 
 incidental to all higher psychology. Just as soon 
 as we try, for example, to force it into the physio- 
 logical method we put it into a kind of straight- 
 jacket within which it must be stifled. If this is true, 
 generally speaking, it must be especially so when 
 investigation tries to reach out toward the almost
 
 Science and Method of Treatment 117 
 
 inaccessible domain of the unconscious mind. For 
 here furthermore, are complicated all those circum- 
 stances, which make it impossible to fix a measurable 
 value upon the inconsistencies of the human mind; 
 here all the different expressions of the struggling 
 forces cross each other in such confusion, that pro- 
 cedures which are admirable in the simple phenomena 
 of life, become unfit for use. The mapping out of 
 the unconscious world must be done in accordance 
 with personal methods. 
 
 It is wise to keep always in mind that the scientific 
 purpose of psychanalysis, is simply the conquest of 
 the unconscious world and the thorough investiga- 
 tion of it in all directions. In making a comparison 
 of the earlier works concerning this unconscious 
 world, it is soon noticeable that to the investigator 
 it was the great mystery, out of which peculiar phe- 
 nomena such as automatic writing, the speaking 
 with tongues, etc., broke forth into consciousness 
 and were thus made approachable for research. 
 Psychanalysis is the unveiling of the mystery. The 
 analyst strives to find the connection between the 
 unconscious forces and the shaping of life in general. 
 In an educational way, his goal is nothing less than 
 to make free the individual from all that obscurity 
 and uncertainty which entangles his life. 
 
 The opposition which the ordinary psychanaly- 
 tical results of research awaken at first acquaint- 
 ance, may ver} r largely depend upon the difficulty of
 
 118 History and Practice of Psychanalysis 
 
 keeping in mind that they concern unconscious con- 
 ditions. If a person, who neither in thought nor in 
 action is guilty of misdemeanor, should be accused 
 for example, of being homosexual, it would seem in- 
 famous. But it takes on quite another aspect if the 
 accusation only implies that in the depths of the 
 unconscious life, there exists a difficulty in freeing 
 the sexual life from the sex of the person in question, 
 a difficulty which, in a very roundabout way, has 
 come into the consciousness in the form of attacks 
 of anxiety, the connection of which with the sexual 
 life, neither the patient himself nor his friends have 
 in the slightest degree suspected. Before Freud's 
 declaration that the child is a polymorphic pervert, 
 everyone shrinks back as from a horrible attack upon 
 the much prized innocence of childhood. But noth- 
 ing hinders a child, so far as its consciousness 
 reaches, from being lovable, well brought up, free 
 from any exhibition of sexuality in the usual mean- 
 ing of the word and yet analysis may nevertheless 
 show traces of polymorphic perversity in the depths 
 of the unconscious mind. Far more offensive than 
 such declarations in themselves, I consider the scien- 
 tific light-mindedness with which they are sometimes 
 given out. In reading over the literature on this 
 subject, one not infrequently is amazed at the rash- 
 ness with which so-called authorities proclaim, that 
 behind this and that conscious product must be hid- 
 den, this or that unconscious circumstance. It is
 
 Science and Method of Treatment 119 
 
 true that in psychanalysis it is very hard always 
 to drag along the proof-material one has at hand; 
 on this account a better idea of responsibility is ob- 
 tained through personal discussion than through the 
 literature. But it surely would be beneficial to 
 science if more careful, slower consideration were 
 accorded the subject. 
 
 It is necessary to rightly comprehend the method 
 with all its peculiarities, defects and merits, before 
 making an estimation of the doctrines of psych- 
 analysis. Because those are, (and this fact cannot 
 be too strongly emphasized), no theories, but the 
 method's direct empirical result. In order not to be 
 overwhelmed by their many changing forms and con- 
 stantly growing mass, I shall touch only upon some 
 single and relatively settled points. 
 
 As has been said already the system arose in con- 
 nection with the study of the mechanism of repres- 
 sion. Its further development and application have 
 also primarily dealt with this. This has, however, 
 led to the discovery of a number of other psychic- 
 mechanisms, which have importance in the construc- 
 tion of neurosis and appear to be fruitful for the 
 study of the subject. 
 
 The technical term used to signify the psychic 
 material which differs from repression is, as I have
 
 120 History and Practice of Psycli analysis 
 
 said, complex. Further study has to do with the 
 structure of complexes. Just as the conscious af- 
 fect in a certain degree is a psychic principle of con- 
 struction, in that it directs the attention toward a 
 decided point, gathers to itself associations from 
 some sources, with the passing over of others, so the 
 repressed affect from the conscious mind may be the 
 starting point for psychic productions. In the 
 course of passing years, far reaching changes occur 
 in this way. 
 
 Freud considers that the characteristics for hys- 
 teria lie in the fact that the repression had its place 
 farther back in life and underwent changes before 
 it became constituted as a disease. He separates 
 therefrom those conditions in which the patient 
 reacts with nervous symptoms against an actual 
 checking of the sexual relief. Through analytical 
 research it has thus come to light, that the starting 
 point for a neurosis may be far removed from its 
 point of out-break and that the original injury may 
 be so widely separated from the neurotic symtoma- 
 tology, that no one before-hand can suspect the con- 
 nection. In traumatic neurosis the chain of circum- 
 stances between the trauma and the nervous symp- 
 toms are, as a rule, obvious. But if the trauma lies 
 twenty years back and psychically changes during 
 the stress of this period's mental-stratification, the 
 causation threads may be a very much entangled 
 skein. It is one of Freud's greatest merits that he
 
 Science and Method of Treatment 121 
 
 has succeeded in bringing about the first effort 
 toward the disentanglement of this skein. 
 
 In beginning the examination of a neurotic, it is 
 soon noticeable that the trouble did not originate 
 according to the manner in which the patient first 
 makes explanation of it. Every symptom has had 
 some prior disturbance upon which it has taken hold. 
 Disease must, like everything else, have some founda- 
 tion upon which to build ; otherwise every attempt at 
 construction would collapse. Suppose as an exam- 
 ple that a person is exposed to some affect which 
 makes him a victim to insomnia. As soon as the 
 affect disappears, sleep again returns ; the disturb- 
 ance cannot constitute itself as an illness unless it 
 can revive the hidden traces of an earlier disturbance 
 and add itself to these. It may seem as if the step 
 were a very long one from such an experience as 
 this to Freud's categorical sentence: "All neuroses 
 have their foundations laid before the fifth year of 
 life." Nevertheless there may be much truth in his 
 opinion. It seems very probable that life must al- 
 ready in the earliest years of childhood, have been 
 misdirected, if one later on becomes a victim to 
 serious neurosis. However this does not mean as 
 much as it may appear to mean. There are surely 
 not many children who escape injuries and conflicts 
 and yet whose lives from the beginning take the right 
 track. And naturally Freud's proposition must not 
 be turned around. By far the greater number of
 
 History and Practice of Psych-analysis 
 
 infantile injuries are compensated for during de- 
 velopment or at least remain somnolent, unless they 
 are brought to life again by later deep-seated suffer- 
 ing. 
 
 For the sake of greater clearness it may be suitable 
 to illustrate the connection between infantile trauma 
 and neurosis with an example. I shall choose one 
 which has the advantage of being schematically sim- 
 ple. 
 
 I was once consulted by an unmarried woman 
 of twenty-two years of age. She looked well and had 
 no appearance of hysteria in the usual meaning of 
 the word. She complained of a series of nervous 
 symptoms; general restlessness, at times amounting 
 to anxiety, especially connected with thoughts con- 
 cerning her heart which she feared would suddenly 
 stop beating, the attacks coming on with lack 
 of breath and strangling, choking feeling in the 
 throat; after eating she was overcome by a painful 
 sensation of heat in the whole body which lasted for 
 hours at a stretch; difficulty in walking any dis- 
 tance, as her legs gave way beneath her so that she 
 was obliged to quickly board a street-car in order to 
 get home. Regarding the origin of these symptoms 
 she knew nothing more than that two years before 
 she had been to the theatre with a cousin and was 
 there suddenly overcome by a feeling of suffocation. 
 Since then the symptoms had accumulated one after 
 the other. All inquiries after further causation were
 
 Science and Method of Treatment 
 
 fruitless. All treatment had been, hitherto, unsuc- 
 cessful. 
 
 The result of the analysis was as follows: when 
 the patient was between four and five years old, 
 her family dwelt in the fourth story of a house in 
 the city. One afternoon there was an explosion, fire 
 broke out on the ground floor and spread terror 
 through the whole house. The smoke forced itself 
 up the stairway. The patient remembers how her 
 father carried her out upon the stairs and kicked 
 out a pane of glass that, they might not be smothered 
 by the smoke. 
 
 In realizing how a sensitive child reacts from such 
 a shock, it is easy to see that the patient's whole 
 symptom-complex is nothing but a reproduction of 
 this experience. The fear of strangling, the breath- 
 lessness, the choking, the attacks of heat, every- 
 thing is a direct copy. The shock also had had a 
 paralyzing effect, so that her legs gave way under 
 her. The fact that the father carried her, perhaps 
 also had been brought in, to suggest the feeling that 
 she could not walk. 
 
 How is one now to be sure that such interpreta- 
 tion is right? In the first place the patient recog- 
 nized the connections. She experienced a feeling 
 of relaxation similar to that one has if one has for- 
 gotten a word and then suddenly recalls it. In the 
 second place I was able to find a whole series of 
 symptoms and accidental sensations to which the
 
 124 History and Practice of Psyclianalysis 
 
 patient attached little importance, but which proved 
 that this childhood trauma had lead up to the con- 
 dition of illness. In the third and most important 
 place; ex juvantibus. Simultaneously with this 
 clearing up of the past, the symptoms underwent 
 an important change. They diminished or entirely 
 disappeared; even if a few continued to be recalled, 
 they had not the same power over her, but were 
 looked upon by her as mere unimportant matters. 
 
 The significance of the origin of this neurosis, 
 must not however be exaggerated. Underneath it 
 very probably, lay still deeper infantile sources and 
 it is certain that during adolescence injuries had 
 been added, due to which, the already suggested 
 shock was able to bring about the neurotic condition. 
 In the investigation of these things, we must always 
 come into touch with the most intimate life of the 
 patient and that this must be handled with the 
 greatest delicacy of feeling is self-evident. The 
 youth of this patient had been made unhappy be- 
 cause of her father's infidelity to her mother, con- 
 cerning which, just at the time of the outbreak of 
 the neurosis, she had become fully aware. At this 
 outbreak, there occurred accidentally a union of 
 this source with that derived from childhood. Upon 
 the evening in question at the theatre, the patient 
 had seen Ibsen's "Ghosts." No play can be more 
 suited to stir up the despair of a young girl over 
 the infidelity and frivolity of a father. When I now
 
 Science and Method of Treatment 125 
 
 asked at what part in the play she had had her 
 first attack, she burst into a hearty laugh, as if in 
 relief at seeing some clear light ahead. She plainly 
 recalled that it was at that part where the fire ac- 
 cident is spoken of. The theme of the play itself 
 had thus set the patient's own suffering in a quiver, 
 causing a mental tension of such force that it had to 
 have outlet. When therefore came a cue which, 
 through associations, disrupted those nervous sen- 
 sations originating from the fire-complex, the strain 
 broke out on the path already staked out for it and 
 converted this at the same time, into a channel for 
 suffering; every new strain was thus converted in a 
 similar way, that is to say, it sought an outlet on 
 the road of least resistance. Instead of for example, 
 being accompanied now by sorrow and repulsion, 
 every meeting with her father was followed by an 
 attack, such as has been described in the symptom- 
 atology of the case. 
 
 The construction of the neurosis had surely not 
 come about so simply as it appears from this descrip- 
 tion. Just as behind the childhood-trauma might 
 have been found a deeper source for it, so behind 
 the experience during adolescence, might the same 
 thing have been discovered. The determining im- 
 portance of this fact is obtained at the instant when 
 these experiences could be connected with the pa- 
 tient's own inner conflicts. Freud believes that back 
 of every neurosis, without a single exception, lies the
 
 126 History and Practice of Psychanalysi* 
 
 sexual-life ; that this is the only real producing force 
 in life; that without the assistance of its piled-up 
 energy, no circumstance could cause permanent dis- 
 turbance of the soul-life or of the nervous system. 
 The patient returned to me some months after the 
 treatment which I gave her, complaining of a con- 
 dition of general restlessness. She herself under- 
 stood, or at any rate suspected, the connection of 
 this restlessness with a restraint of the course of 
 her sexual-life; she had been engaged to be married 
 for some months but there was no prospect of the 
 marriage taking place for years to come. I had no 
 doubt that these facts had a determining value in 
 regard to the return of the hysterical symptoms. 
 
 It is not possible to understand Freud's asser- 
 tion of the great importance of the sexual life in the 
 building up of neuroses, without first having a com- 
 prehension of his sexual doctrine in its whole mean- 
 ing. 
 
 Freud believes that sexual impulses originally arise 
 through the spontaneous yearning back of the child 
 to the mother-body from which it came. 
 
 No doubt most of those to whom this cardinal 
 proposition is new, are at once ready to condemn 
 the whole doctrine as an absurdity. It can surely 
 not be his meaning that the sexual-life itself has its 
 root in an incestuous impulse which we are accus- 
 tomed to consider as the extreme of sexual path- 
 ology! Nevertheless that is what he means. In
 
 Science and Method of Treatment 127 
 
 passing I may mention that I have discovered a pre- 
 decessor of Freud's in this dreadful modern idea. 
 Our great master, Luther, who in matters sexual 
 was a man extraordinarily experienced, expresses 
 himself in Chap. 20, 27 in Tischreden : "So wenig 
 man des Essens und Trinkens entbehren und gera- 
 then kann, so unmoglich ist es auch, sich von Weibern 
 zu enthalten: denn wir ko'nnen durch natiirliche 
 Begierde allermassen uns nicht davon entaussern. 
 Die Ursache ist, dass wir in die Weiber Leibe empf an- 
 gen, darinnen ernahrt, davon geboren, gezeugt und 
 erzogen werden, also, dass unser Fleisch das meiste 
 Theil Weiberfleisch ist, und ist unmoglich uns von 
 ihnen ganz abzusondern." 
 
 In this utterance is already found the connection 
 between the sexual-life of the adult and all that 
 sphere of phenomena which concerns the child's orig- 
 inal connection in regard to the mother. It is here 
 that the center of gravity of Freud's sexual doctrine 
 lies. According to Luther, the impulse has its cause 
 in the fact that, figuratively speaking, we are never 
 able to entirely cut off the navel-string. For Freud 
 this prolonged resolvent of the bodily connection and 
 all the complications that may arise therefrom, plays 
 a dominating role. 
 
 The intense longing of the child for the mother, 
 its anxiety in the mother's absence, its refusal to 
 sleep if it cannot rest in the mother's arms, etc., 
 all these features which with the new-born always
 
 128 History and Practice of Psychanalysis 
 
 crop up, are thus an expression of the primary 
 sexual-life. Over the abyss which separates this from 
 the turbulent longing of the man and the woman 
 for each other, Freud has thrown the bridge of 
 sexual development. I must limit myself to a 
 schematic description of the most significant steps 
 upon this bridge. 
 
 The first attempt toward disentanglement from 
 the mother occurs when the child teaches itself to 
 give way on its own account to those pleasurable 
 sensations, which hitherto it has felt only in con- 
 nection with the mother's body; when e. g. it sticks 
 its thumb into its mouth in place of the nipple and 
 so learns to go to sleep alone. Through this act the 
 ground is broken for that phenomenon, for which 
 Freud accepted Havelock Ellis' term "autoerotism." 
 Under this caption are gathered together all efforts 
 to set free sensations of pleasure, with the assistance 
 of the own body. This occurs in many different 
 ways. Freud has especially pointed out the im- 
 portance of the anal region in this respect and 
 created that esthetically extraordinarily revolting 
 idea of the analerotic. For the child everything it 
 discovers and every new sensation, has interest. In 
 its unconscious innocence it defines nothing, as an 
 adult does. That the anal function as a source of 
 pleasure with children is often much accentuated, 
 is something that has come to the notice of many who
 
 Science and Method of Treatment 129 
 
 have had to do with children. And that a false syn- 
 thesis may be formed between this source of pleasure 
 and the sexual sources, is not astonishing if the close 
 bodily connection of the organs is considered it 
 means only a psychic analogy to the physical fact. 
 It is also indubitable that in neurosis one meets rela- 
 tively often with such a synthesis existing from the 
 childhood and that it plays a certain part, not only 
 in the formation of symptoms, but also in the devel- 
 opment of character. There is some truth in Freud's 
 opinion that certain features of character may be 
 taken as reactions against this disturbance. The hot 
 attack to which Freud was subjected on account of 
 his doctrines regarding analerotism may perhaps in 
 a measure be authorized. He makes himself guilty 
 of some exaggeration. But on the other hand this 
 attack against him was made very largely because 
 he touched upon an especially sensitive point in the 
 emotional life. The question may be raised, if just 
 this contact between the lowest impulses, the most 
 material sphere, and that other sphere in which our 
 highest, most sublime emotions are bound up, is not 
 one of the foundations for man's burdensome feeling 
 of being earth-bound. Does not all talk of the erotic 
 as something foul, originate through a lack of under- 
 standing of this tragedy? Whatever may be said 
 about Freud's position in the question, it will al- 
 ways be counted to his credit, that he did not hesi-
 
 130 History and Practice of Psyclianalysis 
 
 tate to present, with indomitable scientific honesty, 
 what he believed he had discovered in this appalling 
 abyss of the psychic life. 
 
 The first step toward disentanglement from auto- 
 erotism is taken when the individual begins to search 
 after an external object, with the help of which the 
 sexual forces may be outwardly projected. That a 
 strong attraction to the opposite sex may arise dur- 
 ing early life is well known. But usually only cer- 
 tain phases of development can be traced before the 
 hetero-sexual pursuit becomes of chief importance. 
 The sexual-life first seizes what lies nearest at hand, 
 that is to say, the general objectification of the 
 own personality in the ego. This period is called 
 "narcissism." It reveals itself consciously through 
 the flaming up of the "I" complex, that overestima- 
 tion of self, that loss of consideration for others, 
 that is characteristically woven into the critical 
 period of youth. 
 
 The next step makes an attempt to compensate 
 this objectification of self with an unfamiliar person. 
 There is still shyness and backwardness between the 
 sexes, but there is the beginning of the feeling of ad- 
 miration in the being together with comrades. Ex- 
 ternally the sexual undercurrent reveals itself 
 through enthusiastic admiration of friends, teachers 
 and so on. 
 
 Puberty here first comes upon that great revolu- 
 tion through which the infantile sexual sources are
 
 Science and Method of Treatment 131 
 
 gathered together into one single channel, and life 
 takes on definite form ; all sensations of pleasure, all 
 emotional inclination to over-estimate, all enthusias- 
 tic devotion, is bound up in the opposite sex. 
 
 Hand in hand with this development proceed three 
 processes of basic importance: repression, trans- 
 ference, sublimation. Each change occurs because 
 the individual represses the dominating sexual form, 
 transfers the sexual impulses to a new object and 
 changes a part of them to a source of energy for 
 remote cultural purposes. 
 
 That sexual development is the hardest test for a 
 human being must indeed be considered a universally 
 accepted truth. Looked at from this point of view 
 an answer as to why conditions are as they are, is 
 given. The enormous unconscious work each one must 
 accomplish in order to lead unfoldment toward its 
 goal, is then understood, as well as what danger there 
 is that all this work may go astray. The danger lies 
 not only in the fact that the repression may thus 
 fix upon one or another perversity ; it also lies in the 
 fact that the individual in this struggle must use 
 up so large a part of his forces, that little power 
 remains for the rest of life. The most common dis- 
 turbances arise because of partial failure. The re- 
 pression appears to be carried out, but it is so weak- 
 ly organized that it again works loose because of 
 conditions from without, which threaten to break 
 through; the individual must time after time assem-
 
 132 History and Practice of Psychanalysis 
 
 ble his forces in order to reinforce them. It may 
 perhaps, without exaggeration, be said, that unfold- 
 ment never comes about in an ideal way. In each 
 one is left some unhealed wound, some weak point. 
 Only the very strong reach a point where the im- 
 pulses are centralized and that entire emancipation 
 which is the final goal. And what here gives aid is a 
 constitutional transcendency in transference and 
 sublimation. On the other hand it is lack of these 
 qualities that above all are distinguishing marks in 
 the weak and that more than anything else pre- 
 destines them to insanity. 
 
 According to Freud, one always in analysis comes 
 upon some disturbance of the sexual unfoldment 
 which is the nucleus of the complex. The farther the 
 analysis is carried, just so much more established 
 becomes the fact that the disturbance is one of pri- 
 mary sexuality. He has even declared that the most 
 remote thread may always be traced back to the orig- 
 inal incestuous desire, and he has therefore called 
 this the nucleus complex of neurosis. 
 
 It would thus appear that neuroses in their deep- 
 est state of existence ought to be built up of pretty 
 much the same material. The great, apparent fer- 
 tility of variation in them, might thus arise because 
 similar complexes grow out in different ways accord- 
 ing to individuality and contingencies, before they 
 acquire conscious formation. Upon the basis of this 
 opinion Freud has also tried to work out the symp-
 
 Science and Method of Treatment 183 
 
 tomatology of neuroses. Earlier, when the sexual 
 trauma of childhood held his special interest, he 
 probed the doctrine that the passive experience 
 seduction, led to hysteria the active experience 
 i. e. the aggression to compulsion-neuroses. He 
 tried in this way to explain why hysteria is more 
 usual among women, compulsion-neuroses among 
 men. He wished to make probable that the libidinous 
 fixation upon a certain point of the scale of un- 
 foldment led to a certain form of disease. If the 
 individual does not succeed in lifting himself out of 
 autoerotism, or if he uses up all his vitality in the 
 struggle against it, a blockade from without takes 
 place, because it is chiefly through the projecting of 
 the sexuality outwards, that we learn to direct our 
 forces towards the external world; thus the unsuc- 
 cessful individual is doomed to burn up these forces 
 within himself ; the final result being dementia. 
 This is only a hint of that remodelling of diagnoses, 
 which more profound insight into functional disease 
 processes may finally carry with it. 
 
 If this sexual teaching is true, we should here 
 stand before the disclosure of something so fearful, 
 that a parallel has hitherto surely never been found 
 in the development of human knowledge. Thus each 
 one who is born possesses, according to nature's 
 own order, in-dwelling powers, which may cast him 
 into crime, perversity, insanity and nervous suffer- 
 ing, unless, after a struggle of decades, he succeeded
 
 134 History and Practice of Psychanalysis 
 
 in becoming master. And in case he does succeed, 
 he nevertheless wanders upon a thin crust of earth, 
 over volcanic forces, which, under unfavorable con- 
 ditions, may give way and undo all the work he had 
 accomplished. Is it strange that the whole world 
 of learning hurled anathema upon the author of such 
 a doctrine? 
 
 I shall point out in passing that a kind of inkling 
 of this same idea has, however, been buried in the 
 folk-consciousness, from very ancient times. It is 
 most plainly traceable in tragic poetry. Freud has 
 done nothing but take the scientific road to the same 
 goal, which in former times was taken by intuition, 
 self-analysis, and fantasy. I shall give the most com- 
 mon example of this. 
 
 The nucleus complex of neurosis in the literature, 
 also is given the name CEdipus-complex, because this 
 old tragedy is only a plastic presentation of the 
 incestuous primary impulse and the succumbing of 
 the hero to it. As is well known, the circumstances 
 are as follows : 
 
 Laius, King of Thebes, was expecting a child by his 
 Queen, Jocasta. The oracle was consulted concern- 
 ing this event. The answer given was that the child 
 must be exposed to the elements as otherwise he 
 would grow up to murder his father and marry his 
 mother. As soon as CEdipus was born, he was thus 
 exposed. But his life was saved by a chance and 
 he was brought up at a foreign court. When he was
 
 Science and Method of Treatment 135 
 
 grown, he started out upon a wandering journey, 
 was attracted toward Thebes, and upon the road fell 
 in with a man, with whom he picked a quarrel and 
 whom he, as a consequence, murdered. This man 
 was Laius. (Edipus went on to Thebes, succeeded in 
 solving the riddle of the Sphinx, and was proclaimed 
 king by the Thebans. He married the widow of 
 Laius, his own mother. A pestilence then broke out 
 in the land, and when questioned as to what should 
 be done, the oracle replied that the murderer of 
 Laius should be traced and driven away. Thus every- 
 thing came to light. In despair CEdipus put out his 
 eyes, etc. 
 
 Back of this symbol is discovered a fearful poten- 
 tiality within the man, CEdipus, which contrary to 
 all human actions and all his conscious effort, drove 
 him straight to a certain point. This power has 
 been called fate and the meaning of the tragedy has 
 been considered to be the impotence of mankind 
 against fate. But analysis removes this blind com- 
 pelling force, from the sphere of the external world 
 to that of the human mind; fate is nothing but the 
 most deeply hidden unconscious complex. CEdipus 
 was engulfed in it because he neither succeeded in 
 forcing it so deep down into Orcus that its power 
 was stifled, nor in throwing his consciousness about 
 it in such a way that he became its master. 
 
 In paying close attention to children, it is some- 
 times possible to discern detached remnants of this
 
 136 History and Practice of Psychanalysis 
 
 motif back of their chatter and games. It is not so 
 uncommon, I have at least heard several examples 
 of it that a small boy lets something like this 
 escape him: "When I am big I am going to marry 
 mother." And if anyone then explains that such a 
 thing will be impossible because father is already 
 married to mother, the answer very often will be: 
 "Then I shall kill father!" The child does not ap- 
 preciate life and death in the same way we do. It 
 looks upon these things rather as our earliest an- 
 cestors did. "Out of the way" it shouts from the 
 saddle of its rocking horse, "or I'll ride over you !" 
 
 As a rule we laugh at such episodes of the nursery. 
 But behind them may lurk complexes with which the 
 grown boy or girl must fight, and which later on 
 may throw a shadow over the whole life, break- 
 ing out at last perhaps, in the form of neurotic 
 symptoms. 
 
 That we still today can be seized by the CEdipus 
 tragedy and react to it, Freud believes to be depend- 
 able upon the idea that it touches that portion of 
 our inner selves, which in spite of thousands of years 
 of repression work, cannot be wholly brought into 
 a state of rest. 
 
 * 
 
 Against the background of these suggestions con- 
 cerning psychanalysis as a science, I shall now at-
 
 Science and Method of Treatment 187 
 
 tempt to indicate a few of the most valuable thera- 
 peutic points of view. 
 
 Since, where science was concerned it showed that, 
 in conformity with all higher psychology, it could 
 not free itself from a certain subjective-artistic qual- 
 ity, so this must be all the more pronounced where 
 therapy is concerned. Psychotherapy generally is 
 something different in the hands of every physician, 
 unless he limits his activity to dogmatic plagiarizing 
 from some predecessor. Some "authorities" con- 
 tinue to totally condemn psychanalysis. In so doing 
 they place themselves outside the development of 
 the science of medicine. Already this thing has 
 reached a point where each one must reckon with 
 it, just as with suggestion. The question is then, 
 where and how it should be installed in the therapeu- 
 tic procedure. The most earnest disciples of Freud 
 are entirely taken up in the analysing; for those 
 who go to the opposite extreme, psychanalysis means 
 only a throwing aside of the usually accepted form, 
 and an effort to look upon case-histories from the 
 patient's own standpoint ; i. e. from within. Freud's 
 enemies are not likely to dispute his merit in teaching 
 us to look upon neuroses and insanity in their con- 
 nection with life and its conflicts. 
 
 As has been said before, the idea of abreaction 
 was originally the fundamental principle of this 
 therapy. It was chiefly the developing of the sexual
 
 138 History and Practice of Psychanalysis 
 
 doctrine that brought a new point of view to this 
 method of treatment. If it is true that a represented 
 sexual desire always lies at the base of a neurosis, 
 how then can any psychic treatment at all be taken 
 into consideration ? Even if a clear understanding is 
 to be preferred to all that tangle of lies and illu- 
 sions, in which people become enmeshed in order to 
 escape the fact of sexuality, this, as such, does not 
 permit itself to be "abreacted." It is very easy to 
 suspect that analysts might, in such case, choose a 
 way out, by advising, as many physicians do ad- 
 vise, sexual congress at any and all times as a cure 
 for neurosis. It is indeed possible that such advice 
 sometimes is given by analysts. But Freud himself 
 believes that advice of this kind very seldom may be 
 suitable. He cautions against what he calls "wild 
 analyzing" and holds himself strongly aloof from 
 those followers of his teachings who offend him in 
 this respect. For my own part I believe that this 
 brutal simplification of the problem is absolutely 
 condemnable from a therapeutic point of view. The 
 sexual act is relieving only if it is called forth by an 
 inner yearning, and if it is accompanied by a feeling 
 of joy, not if it is practiced by command. I recall 
 a woman of twenty-one years of age, who had suf- 
 fered for six years from a nervous disturbance of the 
 bladder and who was advised by a doctor to try this 
 means of relief. She came to a colleague after a 
 while, this time afflicted with gonorrhea. The blad-
 
 Science and Method of Treatment 189 
 
 der trouble had become plainly more pronounced. 
 After some weeks of suggestive treatment it entirely 
 disappeared. In this case the sexual act had only 
 been a shock, as it may often be under similar cir- 
 cumstances. 
 
 It is not at all upon the gross material liberation 
 of the sexual impulses that relief depends. What 
 essentially brings about forms of neuroses is not 
 direct sexual restraint ; it is the conflict between the 
 inclination and the inner opposition, that stands in 
 the way of freedom; the conflict between the will to 
 love and the incapacity to love. As long as this in- 
 ner opposition exists, every physical sexual act is 
 only something more overwhelming, which adds to 
 the nervous tension and becomes manifested in neu- 
 rotic symptoms. This opposition is often a psycho- 
 logical product that is accessible for analytical dis- 
 solution. There is thus a point upon which the 
 physician may apply his aid. The breaking down 
 of inner opposition is also a valuable part of the 
 treatment. But this is not the place to further en- 
 large upon this fact. However there is one objec- 
 tion which is often made upon which I must touch. 
 The very word "opposition" arouses in many people 
 the idea of compulsion, and they look upon the whole 
 thing as if it were some form of spiritual torture. A 
 psychologist who believes that psychic opposition 
 may be broken by means of harsh treatment, is surely 
 not an analyst. Even if this could happen, it would
 
 140 History and Practice of Psychanalysis 
 
 never be a question of any other harshness than that 
 which was in accord with the patient's own innermost 
 desire. One patient who could speak of himself only 
 with the greatest difficulty, begged me to promise 
 never to let him go before he had said all those 
 things which he was incapable of saying by him- 
 self. 
 
 But this inner resolution is only a part. Sup- 
 posing it is successful, the forces thus made free 
 must have some outlet in order that they may be 
 prevented from again turning themselves back 
 towards the production of disease. 
 
 In speaking about the sexual unfoldment, I said 
 that it goes hand in hand with three psychological 
 processes, viz : repression, transference, and sublima- 
 tion. Upon the first of these the ordinary sugges- 
 tion-treatment gets in its work. This means often 
 only a support of the normal repression, so that it 
 may become successful. The patient may thus be 
 able to force away thought-pictures, forget sorrows, 
 concentrate the mind upon work, etc. 
 
 Freud places the therapeutic center of gravity 
 upon the second point. All psychological curative 
 action takes place through transference, according 
 to his belief. The cramped and erring sexual im- 
 pulses must be carried over upon new objects. Oth- 
 ers believe that all psychic treatment ought to be 
 concentrated upon the last point sublimation. The 
 sexual-life can not be definitely forced back ; its di-
 
 Science and Method of Treatment 141 
 
 rect liberation can occur only through circumstances 
 of life which lie outside the physicians' field of ac- 
 tion. The only way in which the individual, inde- 
 pendent of outside conditions, can save himself, is 
 through turning his forces toward cultural ends. 
 
 The simplest and purest form of sublimation is 
 poetry. Its connection with the deepest of earthly 
 forces has indeed, been well known in all times. What 
 poets do, that is to say, what those who write 
 because some power within drives them to it, is 
 only to bring repressed desires to light by means 
 of self-analysis, and to make them sublime in 
 thoughts,dramatic figures, legendary symbols, etc. 
 
 Sophocles was able through some such process to 
 free himself from his (Edipus-complex. If we, as 
 physicians, are consulted by an individual, who is 
 about to give way before some unconscious force, it 
 is our duty to help that one to some similar kind of 
 inner redemption. Naturally we can not make every 
 one a poet in the usual meaning, but the rescue may 
 be brought about in many ways. In poetry the com- 
 plexes are transplanted directly to an external work, 
 which gives a clear vision and upon which the pas- 
 sions, so made free, are directly transferred. This 
 combination is certainly not a necessity. The ex- 
 ternal labor may be of any kind suited to the indi- 
 vidual. Thus analytical treatment and the thera- 
 peutics of work, here form a point of contact. A 
 clear out-look is obtained through conversation with
 
 History and Practice of Psychanalysts 
 
 the analyst. As to the passions which have been 
 made free, they should as directly as possible seek 
 a natural outlet. The analytical disentanglement 
 should so work out that the patient's love may be- 
 come stronger than ever for all that he has once loved 
 before; thus a married woman may, with renewed 
 earnestness, turn to the guardianship of her home, 
 her children, etc. 
 
 With this treatment therefore, the effort is one of 
 instructing the patient regarding the freedom of the 
 inner-self, the difficult art of spiritual emancipa- 
 tion. The part here played by the personality of 
 the analyst ought to be the same as that played by 
 instructors in general. 
 
 Medical research has its greatest importance in 
 the fact, that because of added knowledge concern- 
 ing the inception of disease, we are able to take means 
 towards its prevention. In single, fully developed 
 cases, conditions are often such that no retracing of 
 steps is possible. But by obtaining accurate infor- 
 mation about such cases we may perhaps prevent a 
 similar state in some other individual. This is par- 
 ticularly true in the research of psychanalysis. The 
 prophylactic hope it awakens is of several kinds. 
 
 If, as Freud believes, a great many neurotic 
 symptoms are only sexual symbols, through which 
 patients procure for themselves a kind of freedom
 
 Science and Method of Treatment 145 
 
 from suffering, the symptoms must disappear with 
 the unveiling of the condition. Freud points out 
 that we have seen something like this in the Madonna- 
 hallucinations of Roman Catholic countries. A 
 long as people generally credited the reality of these 
 visions they were common; when the phenomenon is 
 now put under the rubic of hysteria it has lost it? 
 value and disappeared; the way for the outlet of 
 the unconscious forces is thus destroyed. Naturally 
 the suffering itself does not disappear, but only that 
 form of it capable of being explained. 
 
 Application of these new experiences to pedagog- 
 ics, seems to be more momentous. Now that it p 
 shown that neurosis begins in childhood, it must 
 become one of the first duties, in the bringing-up 
 of the child, to keep it free from the mass of injurious 
 influences, the import of which hitherto has not been 
 estimated. For example a woman of forty-seven 
 years came to me, who had suffered periodically from 
 insomnia during her whole life. As a little child 
 she had wakened in the night in terror and could not 
 again go to sleep, unless she was allowed to creep 
 into her sister's bed. Here insomnia was founded 
 because the child was not taught from the very start 
 to sleep alone, and this mistake had never after- 
 wards been rectified. When she came to me, the last 
 period had lasted without relief for the three years 
 during which she had been a widow. In the constant 
 contact with such circumstances, which easily might
 
 144 History and Practice of Psychanalyris 
 
 have been changed in childhood, it is not possible to 
 avoid the feeling that much suffering could be pre- 
 vented. I also recall a girl of ten, who lay sleep- 
 less night after night in the greatest anxiety, unless 
 the mother sat beside her and held her hand until 
 she fell asleep. After one week's hypnotic treatment 
 this habit was broken and the child had learned to 
 go to sleep alone. The importance of this treatment 
 chiefly lay in the fact that a foundation was taken 
 away upon which otherwise, in all probability, a 
 chronic insomnia would have grown up. I could 
 easily present many such examples from my own 
 experience. 
 
 To me the most important of the means we 
 have for forestalling neuroses, seems to be an early 
 training in the exercise of a capacity for sublimation. 
 A person, in whose nature the different roads upon 
 which his forces may find an outlet have been broken 
 open ever since childhood, and who can reach a cer- 
 tain degree of freedom in tune with his surroundings, 
 in feeling for others, work, etc., has quite different 
 means at hand for overcoming destructive forces, 
 than has one who is dominated by the compulsion of 
 sexuality. And that it is possible here to find a de- 
 cided line of direction for the wavering pedagogics of 
 
 our times, I have a lively conviction. 
 
 * * * 
 
 After these hints concerning psychanalysis in its 
 scientific and in its therapeutic form, I shall pass on
 
 Science and Method of Treatment 145 
 
 to a part which has to do with the pressing question 
 of the practical physician; the indications for such 
 treatment, the results hitherto reached, eventual dan- 
 gers, etc. These questions, however, even less than 
 the foregoing, can be handled to any great degree 
 of satisfaction in the present state of affairs. 
 
 Concerning indications for treatment, it is above 
 all to be remembered, that this, far more than with 
 any psychic method, is arranged according to the 
 individuality of the patient and not according to his 
 illness. All who have not, like the insane, lost con- 
 tact with the world, ought to be approachable in 
 some degree by suggestive influence. But many less 
 can be inspired with the clear and conscious outlook 
 upon life, which is the purpose of psychanalysis. 
 This method puts considerable demand upon the in- 
 telligence and character of the patient, upon his will 
 to be well. Those whose education is superficial, who 
 think themselves capable of understanding every- 
 thing, but who have not the ability of penetrating to 
 the bottom of anything, are eliminated as a matter 
 of course. The most suitable patient for this method 
 of treatment is the cultured individual who has 
 reached a dead-lock half-way in the inner struggle 
 after clearness and truth. 
 
 The neuroses which hitherto have accorded the 
 best results from this treatment, fall chiefly within 
 the rather diffused limits of hysteria, and compul- 
 sion and anxiety neuroses. Of these results no precise
 
 148 History and Practice of Psychanalysis 
 
 statistics can be obtained and if one searches dili- 
 gently it is even difficult to place them in the ordinary 
 medical columns under "cured, improved, unim- 
 proved." Most of those who come for treatment 
 have been ill since childhood, and their nervous sys- 
 tems have been powerless to bear the burden of all 
 that has been heaped upon them during the course 
 of years. Through analysis much of this burden 
 falls away and at the same time, through an ex- 
 tension of the consciousness, comes an added power 
 to bear. In the best cases this may mean health. 
 At least some times I have heard patients say that 
 after the treatment they have grown healthier than 
 at any time before it. But in most cases it means 
 only an aid and it may have great importance in- 
 deed, as such, if it implies a regained faculty for 
 work, even if the suffering remains. Nevertheless 
 we can already assert, that illnesses are cured by 
 analysis which formerly were considered hopeless. 
 I have myself, for example, published the descrip- 
 tion of one case, wherein a paranoical system of per- 
 secution of ten years' standing, was entirely broken 
 up, and of which not a trace of recurrence has ap- 
 peared, during the six years which have elapsed since 
 the conclusion of the treatment.* 
 
 The hot opposition with which psychanalysis 
 meets, is most often accounted for by the idea that 
 it implies great danger. People are of the opinion 
 * See pp. 248-297.
 
 Science and Method of Treatment 147 
 
 that this prolonged digging into sexual details must 
 do harm, that changes for the worse are seen very 
 frequently after treatment and that these have di- 
 rectly led to suicide, etc. 
 
 How this may be is difficult to decide. It is in the 
 nature of the treatment that it can not always pro- 
 gress as happily as, for example, does the ordinary 
 treatment by suggestion. A clear vision cannot be 
 won sometimes without severe crises of self-examina- 
 tion, revealed in a commotion, which superficially 
 observed may be looked upon as a change for the 
 worse. It may easily happen that during such times, 
 the ground sways under the patient, and he blames 
 the doctor for robbing him of that upon which he 
 had lived, without giving him anything in its stead. 
 It may also easily happen that the doctor over- 
 estimates his ability for bringing about the desired 
 evolution. And it must be remembered that some- 
 times the neurosis itself is the best of those evil 
 possibilities, from which the patient had to choose, in 
 a determining situation in his life. By depriving him 
 of this, conditions are not bettered in such cases. 
 The whole opens out only a deeper understanding 
 of life's tragedy ; and the value of this may perhaps 
 be open to doubt. 
 
 Naturally suicide has been committed during the 
 course of psychanalytical treatment, just as it has 
 during care in sanatoria or during rest-cures. The 
 question is, if the suicide can be brought into psycho-
 
 148 History and Practice of Psychanalysis 
 
 logical connection with the treatment. I have my- 
 self, lacked experience in this field. Theoretically it 
 should be acknowledged that this possibility is not 
 precluded. The neurosis, as has been said, sometimes 
 may be a kind of safety-wall against worst eventuali- 
 ties than itself ; to these eventualities suicide belongs. 
 It may therefore be thinkable that after the de- 
 struction of the safety-wall, the forces could compel 
 such a catastrophe. I have difficulty however in 
 believing that in reality, any such thing could be 
 met with. If such a danger were imminent, the pa- 
 tient would instinctively guard himself against the 
 analysis, so that no analyst would be able to go on 
 with it. During the early time of the teaching of 
 suggestion there was a belief in the possibility of 
 suggesting crime, among other things. Critical study 
 has led to that point now, where we believe only in 
 the realization of such suggestions as are in har- 
 mony with the innermost desires of the individual. It 
 is somewhat the same with psychanalysis. 
 
 Apropos of suggestion, analysts are often accused 
 of suggesting to the patient sexual ideas, and things 
 pertaining thereto, through faulty interpretations. 
 Analysts object that if the interpretation is faulty 
 the patient will turn from it, without in the slightest 
 degree, being touched by it ; if he reacts he shows in 
 this way that the interpretation is true. There is 
 therefore, they explain, no danger. Theoretically 
 the objection is valid enough, but I doubt if its prae-
 
 Science and Method of Treatment 149 
 
 tical application is so free from danger as it is de- 
 clared to be. It seems to me that analysts often 
 without necessity awake the sleeping lion ; especially 
 when they force sexual symbols out of dreams which 
 scarcely can have any importance for the treat- 
 ment. 
 
 Taken all in all psychanalysis cannot be made free 
 from the accusation that it involves dangers. With 
 added knowledge, with careful selection of suitable 
 cases, with discretion and foresight, these dangers 
 ought, however, to be reduced to a minimum. And 
 naturally with the supposition that this method of 
 treatment shall be handled only by physicians who 
 are fully masters of its difficulties. 
 
 In order to avoid misunderstandings I must once 
 more emphasize the fact that what I have put down 
 must be considered only as a fragmentary guide 
 through the most essential portions of the teachings 
 of Freud. Psychanalysis is already so wide-spread 
 a subject that a text book thereon could scarcely be 
 limited to a volume similar in size to one concerning 
 other special branches of medicine. And in less than 
 three years' special application no one can learn 
 to master the subject. I will also repeat that I have 
 tried to make the presentation of the matter as ob- 
 jective as possible. In spite of this, however, my own
 
 150 History and Practice of Psychanalysis 
 
 opinion concerning it may be apparent here and 
 there. That I consider the teachings far more val- 
 uable than the shallow criticisms which have been 
 directed against them, I will not deny. But their 
 value for me lies more in the great possibilities, the 
 fruitful suggestions, the bold overturning of new 
 ground, than in that which already has been pro- 
 duced. If then, such rich promises are to be ful- 
 filled, much depends upon the coming of the move- 
 ment into the right line of development instead of 
 going astray upon the quick sands that threaten it. 
 One such danger I must now finally point out. 
 
 What disturbs me most in Freud's writings is an 
 occasional brutal disregard of the importance of the 
 conscious life. When Freud, in his study of dreams, 
 had extracted the latent-content of the dream, he 
 threw away the manifest dream-picture and all fur- 
 ther investigations had to do with that which was 
 brought to light through analysis. This may be 
 done because the manifest dream-picture is in itself 
 an unimportant product of life. But Freud has an 
 inclination also to throw aside the manifest content 
 of life, as something of indifferent value. He is so 
 fascinated by all that new, unconscious world he 
 has discovered that he is entirely lost in it. This 
 is, to say the least, one-sidedness. 
 
 In its last analysis all our study has to do with 
 the conscious life; the unconscious has interest only 
 in so far as it contributes to our knowledge about the
 
 Science and Method of Treatment 151 
 
 conscious, not at all in, and for, itself. One easily 
 gets the conception that Freud is of the opinion that 
 illnesses are entirely determined by unconscious 
 processes. He is himself quite satisfied with this one- 
 sidedness ; to him it is a means of opening the eyes of 
 his contemporaries to the importance of the uncon- 
 scious forces. This concept implies a certain self- 
 limitation. But those of his followers who distin- 
 guish themselves more by dogmatism and enthusiasm 
 than by self-criticism and objectivity, fall victims to 
 the danger of driving this one-sidedness to absurdity. 
 This seems to me, for example, to be the case with 
 Ferenczi, when he makes an attempt to interpret sug- 
 gestion through an unconscious basis of explanation 
 (the transference of the father-complex upon the 
 physician), and when he does this with the support of 
 only three cases. For here if anywhere, the highest 
 conscious powers of life must be taken into ac- 
 count. 
 
 In that degree to which psychanalysis can ad- 
 vance toward knowledge of the unconscious forces, 
 without dimming the vision, because of this, to the 
 importance of the conscious feelings, conflicts and 
 thoughts, it seems to be to be upon the right road 
 of development.
 
 IV 
 
 THE ABLER-DOCTRINE CONCERNING NEUROSIS 
 
 I MENTIONED, in the foregoing chapter, that 
 Alfred Adler was one of the first to break with 
 Freud. It is with his name that the strong opposi- 
 tion against Freud is connected, which during the 
 past few years has given psychanalysis a general 
 tendency to divide into lines diverging in accord with 
 individual ideas. After a long period during which 
 Adler strongly contended for a new series of points 
 of view, he separated himself entirely from Freud in 
 the year 1911. He established his own circle for 
 discussion. Within this, development has gone on in 
 as directly opposed a line as possible, to all that 
 which, during the prosperity of Freud's doctrine con- 
 cerning neurosis, seemed on the road to vindication. 
 Every effort to bridge over the abyss which separates 
 the two groups from each other, has been unsuc- 
 cessful. 
 
 There can scarcely be anyone, who has come into 
 contact with Freud's writings, who has not felt some 
 inner revolt against his doctrines. I myself have 
 at the same time been both charmed by his ingenuity 
 
 152
 
 The Adler-Doctrine Concerning Neurosis 153 
 
 and distressed by the distorted pictures of life which 
 proceed out of his sexual-monomania. But to more 
 clearly explain the reason for this double feeling is by 
 no means as easy as one would think. The followers 
 of Freud assert that all opposition against him exists 
 only because of incapacity to endure the hard truths 
 he brings to light. Undoubtedly there is something 
 in this. But not everything. Even one who will 
 not let the dissecting knife spare his own heart for 
 the purpose of coming nearer to truth, may be re- 
 volted by Freud. Perhaps such a one most of all. 
 The reason lies deeper and must be sought in the fact 
 that Freud unconsciously must have violated some 
 one of life's fundamental truths. The question is 
 which one? 
 
 The intention of the foregoing pages was to give 
 as impartial a glance as possible over the manner 
 in which the Freud doctrines were formulated. But 
 I could not therein pass over Freud's undervaluation 
 of the determining importance of the conscious life. 
 For him the whole of our existence is built up of 
 unconscious forces before which we are driven, 
 without, by means of conscious consideration, being 
 able to regulate and direct their play. Over the 
 whole of his teaching lies something of that concursu 
 atamorum, which is inherent to all materialistic 
 points of view, only with the difference that here 
 there is no meaningless whirl of atoms, but a whirl
 
 104 History and Practice of Psychanaly$is 
 
 of impulses, thoughts, actions. He speaks especially 
 about the dream carrying with it the fulfillment of a 
 wish and one who superficially considers this idea, 
 from many points which are similar in his system of 
 teaching, gets an idea that he actually reckons with 
 some out-going effort of the individual towards a 
 purpose. But the wish in the dream, according to 
 Freud, has always a sexual content, it is, in other 
 words, not the longing of the human mind towards 
 some illusive goal that wishes; it is the body that 
 wishes. The fulfillment of the wish does not contain 
 the attainment of something which one, as a human 
 being, desires; it contains only the satisfaction of 
 something which one has in common with all the 
 rest of organic nature, an expansion of forces that 
 have their origin elsewhere than in the human mind. 
 A patient who already had undergone three Freud 
 analyses said to me: "Nothing exasperated me so 
 as this constant talk of sexual desires. That my 
 dreams often did concern themselves with erotic 
 things, I freely admit. But there was not one trace 
 of desire in it. The whole of my life on the con- 
 trary, was directed towards a single wish, to become 
 free from that which forced itself upon me like some 
 strange hostile power." Always when Freud talks 
 about the wish, it really means something which has 
 nothing to do with the human strife toward an 
 intentional purpose. It will be a difficult matter
 
 The Adler-Doctrme Concerning Neurosis 155 
 
 to find anything in all that he has written which 
 contains finality in its essential meaning. 
 
 This general feature has greater possibilities than, 
 at first glance, might be believed. It cannot be un- 
 derstood unless it is seen in connection with science 
 as a whole. In an earlier stadium we had a belief 
 that science could give an answer to the great prob- 
 lem of life, that it would be able to unveil the 
 mystery as to whence we came, and make plain the 
 nature of our being; that it would be able to find 
 some common intention in existence, a goal towards 
 which all forms of life strove. Since science took on 
 its modern form we have, however, left all such ideas 
 behind. All questions about aims, purposes, etc., 
 have been banished from scientific research and it has 
 been limited to the application of causal-laws to ob- 
 servable phenomena; science has only to do with 
 facts and the verification of the causal relations in 
 which these facts stand to one another. It was un- 
 doubtedly due to the consistent pursuit of this line 
 of development, that modern science reached its great 
 upward swing. It has thus been shown, that nothing 
 was so stupefying and misleading for original re- 
 search in natural science, as the blending into its 
 work of questions concerning aims, purposes, etc. It 
 is often hard to avoid stopping at such questions 
 when they force themselves upon us ; but in so doing 
 research is soon broken up into a subjective philos- 
 ophising which leads away from the objective clear-
 
 156 History and Practice of Psychanalysis 
 
 ing up of the world of phenomena after which we 
 strive. 
 
 Freud is an unusually true child of his time, who 
 is quite ruled by the modern principles of research 
 in natural science. As I already have said, he began 
 his work in the school of Charcot; and this he did 
 not do for nothing. Charcot's greatest service lies 
 in the fact that he, more than any other, contributed 
 to draw the hitherto wavering sphere of the neurolo- 
 gist within the boundaries of exact research. When 
 Freud's interest was turned in the direction of psy- 
 chology, it was his effort in the same way to draw 
 this into the main channel of scientific unfoldment. 
 This meant an unchanged application of the same 
 fundamental principles. On the one hand he endeav- 
 ored to separate psychology from biology, study of 
 the brain, psycho-physics, metaphysics, philosophy 
 and other fields, with which it hitherto had been en- 
 cumbered, in order, in this way, to constitute it as an 
 independent science; on the other hand he tried to 
 eliminate from this new science every point of view 
 other than the purely causal, in order that it might 
 thus be installed in the ranks of science as a totality. 
 Every inner phenomenon became for Freud only the 
 result of pre-existant forces and could be disposed of 
 in the same way a physical phenomenon is disposed 
 of, (as for example an eclipse of the sun), in decided 
 force-qualifications. And as little as nature in an
 
 The Adler-Doctrine Concerning Neurosis 157 
 
 eclipse of the sun is struggling after anything, or 
 has any aim in view with this phenomenon, just as 
 little was there any momentum of strife after a pur- 
 pose in anything that happens in the human soul. 
 The secret of Freud's sexual doctrine is only that he 
 would arrange every phenomenon of the soul-life 
 according to that power which most strongly rules 
 organic nature. At the same time the way in which 
 the mentality works is also stamped with the mean- 
 ingless unintentional character, which is inextricably 
 bound up in the idea. The psychic-life of humanity 
 is deprived of all the special functions which we are 
 accustomed to connect with the meaning of humanity. 
 It seems to me to be this, which above everything else 
 makes one instinctively rebel against the psychology 
 of Freud. And rebel with right, for human life does 
 not allow itself to be once for all solved solely from 
 causal postulations. 
 
 Against this one-sidedness of Freud's, sooner or 
 later there must have come a revolt. 
 
 This revolt is embodied in Alfred Adler. 
 
 I shall now try to make plain his starting point 
 and show how from this point he arrived at a general 
 psychology and characterology, on the foundation 
 of which he believed he would be able to solve the 
 difficult problem of the doctrine concerning neuroses. 
 I shall afterwards point out how, from his stand- 
 point, he tried to put a different value on those facts,
 
 158 History and Practice of Psyclianalysis 
 
 which psychanalytical research brought to light and 
 in which Freud sees examples of the all-pervading 
 force of sexuality. 
 
 In separating from Freud, Adler had a purely 
 biological starting point. While Freud began his 
 activity by translating into his own tongue the works 
 of the French hypnotists and practicing his profes- 
 sion in accordance with their methods, Adler's most 
 important first work was his article "Studien iiber 
 Minderwertigkeit von Organen." In this he consid- 
 ered all the usual imperfections in the organism of 
 the child and tried to interpret their origin from 
 the biological point of view. It is not my purpose to 
 take up this important matter more closely ; in this 
 connection, it is only of interest to see how from such 
 a starting point, he came to the study of neuroses. 
 The way for it was staked out already in the article 
 mentioned and Adler's subsequent work has consisted 
 in further elaboration of this. 
 
 How nature tries to make redress if an organ sus- 
 tains an injury, by some process of organic develop- 
 ment which compensates for the disturbance originat- 
 ing through the injury, is a well understood phe- 
 nomenon. If, for example, some of the valves of 
 the heart are destroyed, the heart must then perform 
 additional work; as a consequence the muscular ac-
 
 The Adler-Doctrine Concerning Neurosis 159 
 
 tivity increases, so that it can fully carry out the 
 new demands upon it. Or if one kidney is removed, 
 the remaining one enlarges, so that it can do the 
 work of both. Adler points out another kind of com- 
 pensatory arrangement of nature and an understand- 
 ing of this is, according to his meaning, very im- 
 portant, because only by means of it as a starting 
 point is it possible to comprehend the building up of 
 neuroses. 
 
 An organ's capacity for work depends not only 
 upon its physical condition but even more decidedly 
 upon the nerve impulses which go out to it from the 
 central nervous system. Everybody knows how by 
 means of a vigorous tension of will it is possible to 
 accomplish work which under ordinary conditions 
 one is powerless to perform. Accordingly a physic- 
 ally defective organ can be made to function nor- 
 mally by means of augmented nerve impulses. The 
 physical deficiency is compensated, in other words, 
 by an energetic over-efficiency. But this arrange- 
 ment of nature easily carries with it an over-sensi- 
 tiveness in the weakened organ, and it is this which 
 lays the foundation for nervous suffering. In exam- 
 ining, for instance, an adult who is subject to nervous 
 diarrhoea, it is almost invariably found that before 
 this particular disturbance began, he had had some 
 physical trouble in the intestinal tract. This may 
 lie far back in his past, e. g., it may have lasted 
 for some months during the first years of life. Even
 
 160 History and Practice of Psychanalysw 
 
 if it had apparently been cured, it may have left be- 
 hind it a weakness, or an oversensitiveness, which a 
 few decades later may appear in some form of neu- 
 rosis. What is thus true concerning an organ or 
 organic system, is also true when it concerns the 
 organism as a whole. If the subject of the childhood 
 is brought up when a neurotic is examined, the fol- 
 lowing will often be heard: "I was weak and tired 
 even at that time, was quite done up with my school 
 work, was tormented by a disability that put me be- 
 hind," etc. In the same way in which a single weak- 
 ened organic function may be sustained on account of 
 dynamic compensation, so is it also with the whole 
 of a poorly equipped organism. This explains too, 
 an apparently paradoxical circumstance, how one 
 often finds great feats of strength emanating from 
 individuals of relatively weak physical development. 
 They are obliged to keep their will-tension in con- 
 stant training, in order to keep up at all; and be- 
 cause of this unnaturally disciplined power they are 
 able sporadically to accomplish amazing things. To 
 this class belongs that spasmodic manner of working 
 so characteristic of the nervous sufferer; after a 
 sporadic flaming up of the forces, this class of pa- 
 tients may at once sink back into a state of exhaus- 
 tion. They are well known for their good begin- 
 nings, good ideas, but they are unable to carry 
 anything through to the end. The over-sensitiveness 
 of neurotics belongs to the same category. Every
 
 The Adler-Doctrine Concerning Neurosis 161 
 
 part of the organism responds with exaggerated vi- 
 brations to whatever takes place about this class of 
 patients. Of course the results of these arrange- 
 ments of nature may be, in different cases, extremely 
 changeable, dependable partly upon the high degree 
 of original impairment, partly upon the degree to 
 which compensation has succeeded. Adler places be- 
 side one another the three conceptions : degeneration 
 neurosis genius. In the first case the compensa- 
 tion has been unsuccessful, just as much as it has 
 fully succeeded in the last. The degenerate sinks out 
 of life in the same way that genius lifts itself up to 
 capability for fitting itself to a new type of life. The 
 neurotic, in more or less heterogeneous blending, 
 shows features of both, he wavers between the two 
 extremes, unable to find a permanent resting-place. 
 
 From the biological starting point, Adler came 
 over to the psychology of neurosis-formation, by 
 going more deeply into the question as to how or- 
 ganic deficiency acts upon the sufferer's mental life 
 and character-development. He in this way, discov- 
 ered many interesting things. 
 
 The most apparent consequence of an organic 
 weakness is that it attracts attention to itself and 
 demands a certain interest. If one has a weak heart, 
 one must think about it and be on guard continually 
 to take proper care of it ; it cannot be left to itself 
 as if it were in a state of health. Because of this 
 directing of the attention upon an over-sensitive or-
 
 162 History and Practice of Psych analysis 
 
 gan its sensitiveness is drawn farther along the path 
 of auto-suggestion. I have already in another con- 
 nection pointed out the importance of the attention 
 for the formation of suggestions. Here the way lies 
 open for hypochondriacal puttering with the body 
 and its pains. Disturbances of this nature may be 
 quite amenable to suggestive treatment. 
 
 But far more serious than the exaggerated cher- 
 ishing of the weak organ and of the enfeebled organ- 
 ism are the more special psychic reactions which 
 the enfeeblement forces to the surface. It not only 
 strives to imprison the sufferer's faculty of interest, 
 it tries also to put its stamp upon his emotional 
 life, to annihilate its free activity and to drive it 
 into a road of compulsion, which is fatal to any fur- 
 ther development. The organic defect produces a 
 feeling of deficiency, a feeling that the sufferer is 
 worth less than his fellows; and this fundamental 
 impression of the feelings in its turn, forces out dis- 
 placements in development along different lines, the 
 result being nervous types of character and disease. 
 
 It may be easier to make all this plain by means 
 of a simple example. 
 
 Suppose a strong, energetic, happy boy becomes 
 suddenly ruptured. He is taken to a physician, is 
 examined and given careful orders; he must keep 
 out of the gymnasium, must give up athletics, must 
 not run, must not fight ; he must pay such attention 
 to himself that never will he thoughtlessly forget to 
 follow the doctor's directions. For if he should for*
 
 The Adler-Docttine Concerning Neurotit 168 
 
 get, something dangerous might happen, he might 
 have to be operated upon at once in order to save his 
 life, etc. The boy is thus compelled to divide his 
 attention between the rupture and everything which 
 hitherto has been a source of pleasure to him. He 
 no longer can devote himself to anything with the 
 same undisturbed interest as before; the fact of the 
 illness forces itself continually upon him. He has 
 always to be on his guard. In this last circum- 
 stance perhaps, lies by far the more significant mo- 
 ment. For it means that the hitherto spontaneous, 
 self-evident connection with the surrounding world 
 has been broken. A human being lives only through 
 reciprocal action between himself and the external 
 world; if life goes on harmoniously this reciprocal 
 action is so self-evident that it is never even a sub- 
 ject for reflection. This is the state of the child 
 who still keeps a dim memory of its condition in the 
 mother's body, where it was completely at one with 
 its surroundings. The boy who formerly had gone 
 his way without extra consideration as an established 
 part of the family, in the circle of his comrades, 
 in school, now feels that danger threatens him every- 
 where. Instead of being taken up and cherished as 
 heretofore by the world about him, it has now be- 
 come an enemy which meets him at every turn. "You 
 must not go with the others to the gymnasium." He 
 is weaker than the others, incapable of doing the 
 same things they do; he is put aside, alone. The 
 restraint he must constantly lay upon himself
 
 164 History and Practice of Psychanalysis 
 
 awakens in him as constantly, a feeling of being out 
 of sorts. Those things which formerly delighted 
 him no longer please him. Everything that had 
 amused him he now must guard himself against; 
 pleasure itself becomes an enemy. He feels himself 
 obliged to find some means of getting out of this 
 condition ; and as this thought forces itself upon him, 
 life becomes a problem, a problem that the more 
 perplexes him, becomes the more insolvable, the more 
 he broods over it. 
 
 All this has to do with a case in which the child 
 comes upon a defect during its development, which 
 places it in a difficult situation. Almost the same 
 thing takes place when a person enfeebled from the 
 very start, becomes conscious of his inferiority. 
 
 As a rule we take for granted that the life of a 
 child is very simple. If an adult could recall every- 
 thing experienced during the first ten years of life, 
 other conclusions would be reached. All the strug- 
 gle after favor, the effort to keep up on a level with 
 others, to overreach competition, all these things 
 which rule the greater part of the life of the adult, 
 are by no means unknown to the child. Rather the 
 contrary. The child who cannot stand on his own 
 legs is absolutely dependent upon surroundings ; their 
 verdict becomes of radical importance. If the child 
 loses the good graces of those nearest it, goes under 
 in the competition with brothers, sisters or comrades, 
 it is a far more miserable experience than a grown
 
 The Adler-Doctrine Concerning Neurosis 165 
 
 person as a rule, can imagine. What despair and 
 oppression then it must be, to be from the very be- 
 ginning oppressed by a feeling of inferiority. Con- 
 sider a little girl when she discovers that she does not 
 possess the beauty or lovableness, by means of which 
 she naturally would win all hearts. This is so much 
 the worse when the feeling of aloofness, which such 
 an experience carries with it cannot be cleared away ; 
 how can a child explain to a grown person what 
 it suffers under such circumstances, it does not even 
 understand itself what is going on within it. 
 
 There arises now a serious question as to what a 
 child may do when it has thus come askew with life 
 and when this state becomes an insolvable problem. 
 
 The answer is simple: the child exchanges the 
 real world it has lost, for a world of illusion. 
 
 The old legend of Paradise is capable of many 
 interpretations of which one and all may contain a 
 seed of truth. But I wonder whether just that sec- 
 ond in which this change takes place, does not con- 
 struct the most material boundary between the orig- 
 inal relative state of harmony and its breaking up 
 into turbulent dissension. Paradise that is the 
 world into which, without reflection we flow together 
 with the whole, in which each one is a part and of 
 which each life is a symbol. Happiness that is the 
 feeling when our forces radiate without obstruction, 
 touching into life all with which they come in con- 
 tact, as we are borne on by the creating power
 
 166 History and Practice of Psychanalytis 
 
 Into the world of the damned comes he who no longer 
 is a partaker in all this joy, who withers within him- 
 self, longing only after fantasies that fade into 
 nothingness as he tries to grasp them. 
 
 We may be pretty sure that the child to whom the 
 real world becomes an affliction, will try to find its 
 way out of its trouble by living more and more deeply 
 in the world of fantasy. All those desires which 
 could not find realization in actuality, become ful- 
 filled in imagination. If a boy gets the worst of it in 
 a fight with some comrade, he unfailingly constructs 
 afterwards, a fantasy in which he is the rightful 
 victor. The more evident the whipping was, just 
 the more unrestrained works his imagination, in or- 
 der that his humiliation may thus be counteracted. 
 The notoriously weak and feeble, in their dreams, 
 become great soldiers who crush hordes of enemies 
 and let the sun of their own power shine upon poor 
 human slaves. The little girl, ugly even to disfigure- 
 ment, becomes a great enchantress, whom no one can 
 resist. 
 
 Most of those who have had to do with children 
 have undoubtedly noticed sometime how a formerly 
 sound and happy child changes and grows shy and 
 reserved, reticent and irritable. The inner change 
 makes its appearance externally in this way. The 
 child wants to be left in peace with its fantasies, re- 
 acting with irritability against everything which 
 would detach it from them. It cannot speak about
 
 The Adler-Doctrvne Concerning Neurosis 167 
 
 the things which fill its thoughts, therefore it does 
 not, as a rule, speak at all. The fatality in this 
 displacement lies simply in the fact that it is so 
 difficult to right, when it takes place in this early 
 stadium. Grown people too, may occasionally fill 
 up the gap left by some disappointment, by means 
 of imagination, in this manner retrieving the loss. 
 But if one has been firmly set on the path of reality 
 it is not hard to return to it again. Entirely dif- 
 ferent however, is the case of a child who has not yet 
 fitted itself into that reality, in which it is to live, nor 
 acquired a connection with it. If imagination takes 
 possession of it, this may all too easily become the 
 world in which it truly lives. It is by no means 
 unusual that a child is not even able to separate 
 fantasy from reality, but with entire sincerity be- 
 lieves in its imaginings rather than in its real experi- 
 ences. 
 
 All this however, carries along with it under dif- 
 ferent circumstances, widely different consequences. 
 The matter is best understood if Adler*s grouping of 
 terms is kept in mind: degeneration neurosis 
 genius. The difference in these three instances 
 depends upon the degree to which the enfeebled 
 individual has been able to conpensate for his en- 
 feeblement. It thus finally means the inner power 
 of production. But because the whole of that proc- 
 ess through which a compensation is produced, has 
 so much to do with fantasy, it is scarcely possible to
 
 168 History and Practice of Psychanalysis 
 
 get a true conception of it without having in mind 
 the excessively great part which fantasy plays for 
 any one who is burdened with the feeling of inferior- 
 
 ity- 
 
 What is most characteristic about the mental life 
 of the degenerate, is that mass of shadowy fantasies 
 upon which he lets himself weakly be carried away. 
 The baron .in Gorki's "Night Refuge" is a charac- 
 teristic type; he has slipped down, from the aristo- 
 cratic position in which he was born, into the most 
 wretched dregs of society, without knowing how he 
 got there. The whole of the external world has had 
 for him so little reality-value, that passage through 
 it was not even registered as a mechanical memory; 
 only empty fantasies altogether, fantasies that 
 broke before his eyes like soap-bubbles, without his 
 lifting a hand to try to grasp them. At the same 
 time that this moving along on the formless stream of 
 imagination disintegrates the inner life into unreal- 
 ity, it carries the individual farther and farther 
 away from the outside reality. This is fatal simply 
 because the degenerate^ through it, is deprived of 
 all necessity for that adaptation, which the outside 
 world always means to the sound mind. Everyone 
 may chance to go astray; but when one least sus- 
 pects it one feels the iron grip of necessity. And 
 this carries one back where one must go. But for 
 the degenerate, that must of outside necessity, re- 
 mains an unreality like all the rest.
 
 The Adler-Doctrine Concerning Neurosis 169 
 
 Things take on another aspect when an abyss 
 yawns beneath a strong, talented child and that 
 world in which it has lived hitherto as a homoge- 
 neous part. It also may be pushed back by its sur- 
 rounding circumstances and overwhelmed by their 
 verdict: "You are lazy," we say, "You have a 
 poor memory. You can never learn to parse verbs 
 as well as others;" even such little things may be 
 pressed down into the feeling of inferiority. But 
 when a child must admit its disadvantage it always 
 does so with certain reservations : "In other ways," 
 it says to itself, "I am superior. Just wait and Fll 
 show you what I can do !" The most gifted likewise 
 may be forced out of the world of reality into that of 
 fantasy. But for them from the very beginning, fan- 
 tasies have had a stamp of higher reality. Out of 
 such fantasies presently proceed a form of life that 
 in its deepest significance comes nearer to the real 
 than that from which it has been separated ; it may 
 mean the inventor's improvement of material condi- 
 tions, the politician's solution of municipal problems, 
 or the poet's revelation of a world of inner beauty. In 
 a word, the instant a creative genius is thrown out of 
 banal reality, forces within are set in motion which 
 sometime may become the source of new life and 
 due to which a nobler human type may be created. 
 If a person, as a rule, is to become anything else 
 than one ingredient in the mass, stamped by its af- 
 fects and with all its lack of spirituality, he must
 
 170 History and Practice of Psyclianalysis 
 
 at a very early stage have been left alone to face the 
 difficulties of life. No work bears the imprint of 
 genius, unless already in childhood the worker learned 
 to take hold of existence in an original way and to 
 solve its conflicts by means of his original qualifica- 
 tions. The whole of this process of individualizing 
 and independent productivity which, in the adult, 
 breaks forth in a life of action and at the same time 
 frees himself and draws others towards a higher 
 form of life, all this process must have had its 
 foundation laid almost simultaneously with the dawn 
 of consciousness and must then have developed dur- 
 ing the whole period of growth; only then is it 
 genuine. 
 
 The neurotic, as I have said already, occupies a 
 place between the two extremes. He keeps himself 
 within the framework of the outside reality ; but he 
 lives either upon fantasies which have nothing to do 
 with reality, or else makes continual unsuccessful 
 efforts to overcome it as a creator. To Adler, 
 Strindberg is the embodiment of this conception. It 
 is well known how, in childhood, Strindberg suffered 
 from an over- ruling feeling of inferiority ; and all his 
 after life was a series of desperate efforts to work 
 himself, in the most widely separated ways, up out 
 of this. All that he aimed to construct to this end, 
 soon collapsed and he again stood in the same place 
 as before. In spite of all his unprecedented power for 
 creating, he never succeeded in bringing out one sin-
 
 The Adler-Doctrine Concerning Neurosis 171 
 
 gle value that became established for himself or 
 could show a way on for others ; it all dissolved in 
 chaos. Finally he succumbed to the feeling of in- 
 feriority, with which he had started out, dying with 
 the cross before his eyes and hate in his heart; 
 the cross, which is the everlasting symbol of inability 
 to master the earthly life, and hate, which is only the 
 negation of all emotional value. 
 
 From this general standpoint let us go on to a 
 more critical examination of the formation of neu- 
 roses in detail, according to Adler's opinions. Ad- 
 ler's strength lies in his limitations and in his logi- 
 calness. The whole of his work consists of a study 
 of those different ways, by which compensation-for- 
 mations seek a way out. All this may be gathered 
 together in two broad strokes ; one Adler called 
 "die Sicherung," the other he called "der mannliche 
 Protest." 
 
 Freud had already pointed out that neurosis is a 
 flight away from life into the realm of disease. Ad- 
 ler has laid stress upon the way in which life, for 
 him who is burdened with a feeling of inferiority, 
 comes to be looked upon as one big danger. It is 
 not enough to flee continually from this danger, one 
 must always try as well, to guard one's self against 
 it. As little as the weak can go to meet trouble with 
 an open mind, in order through these troubles, as 
 through hell-fire, to arrive at abiding harmony, just 
 as little is such a one able to make himself secure be-
 
 172 History and Practice of Psychanalysis 
 
 forehand, by building life up upon a genuine founda- 
 tion of truth and undisturbed reality. He tries 
 instead to defend himself by means of various strata- 
 gems. Adler has a great faculty for catching, be- 
 hind all neurotic symptoms, a glimpse of diverse delu- 
 sions, illusions, poses, attitudes ; tersely, unrealities 
 behind which the neurotic tries to defend himself 
 from the unmercifulness of reality. He solves a 
 great part of the symptomatology by this rearing 
 up of sham barricades. 
 
 There is no doubt that the defense-mechanism 
 plays a main part in a great number of neurotic con- 
 ditions. The man who struggles with his polygamous 
 tendencies and wishes to escape prostitution, rears 
 up in his mind the syphilis-phobia syndrome, and be- 
 hind this wall feels himself safe; because he is over- 
 come with anxiety and thinks only of this deadly 
 peril into which he might fall merely through one 
 kiss, he never needs to fear that he will become the 
 victim of venality. The wife who wishes to escape 
 the marriage connection and the bearing of many 
 children, notices some vague, uncomfortable feelings 
 in her reproductive organs ; she grasps these feelings 
 as a drowning man grasps a straw, she makes as 
 much as she can of them until they become an actual 
 pain which necessitates long-standing local-treatment 
 from a clever specialist, it may even happen that 
 she has her home in a country town, but that the 
 specialist can be seen only in a metropolis where she
 
 The Adler-Doctrine Concenwng Neurosis 173 
 
 has always longed to live. The young girl, who has 
 been put into an office and finds the montony of the 
 work there as loathsome as she finds the boldness of 
 the men, suddenly gets agoraphobia, there is noth- 
 ing to do but to allow her to stay at home and 
 escape her part towards helping in the home's com- 
 mon support. The teacher who has too much to do, 
 faints in the middle of a lecture, she is carried home, 
 gets a free day and thus defends herself against over- 
 tiredness. The further advanced neurotic who al- 
 ready spends life in bed and thinks it monotonous 
 to be alone, gets peculiar attacks in which, for 
 example, he rushes to the window and tries to throw 
 himself out; these attacks necessitate the continual 
 presence of a nurse, in spite of the fact that the 
 family can little afford the luxury. A poor woman 
 who suffers from her insignificant position in life, 
 when she moves to any new place, may attempt 
 suicide, so that everyone is frightened and she is 
 thus made a topic of general conversation, as if she 
 were some great celebrity; so for a time she is as- 
 sured against the pangs of obscurity. Examples 
 innumerable might be given. 
 
 It is evident that an understanding of this de- 
 fense-mechanism is of especial importance for every 
 practising physician. For it is very often with the 
 assistance of the doctor that neurotics are successful 
 in carrying through this stratagem. The patient 
 himself has no comprehension of the trouble to which
 
 174> History and Practice of Psychanalysis 
 
 he has suddenly fallen a victim. In spite of the 
 fact that in its very nature it is something illusory, 
 he accepts it as reality, and in this fact the neurosis 
 lies. The family is unable to explain the right con- 
 nection, although they often have a faint suspicion 
 of it. If then the physician comes and with his 
 authority supports the tendency to ill health, the 
 patient succeeds in putting it through in spite of 
 all opposition. Far from being nullified by prescrip- 
 tions which have no causal connection with the for- 
 mation process of the illness, these act only as a 
 means of working it more firmly into the nervous 
 system. The harm which has in this way been done 
 in the handling of neuroses through routine treat- 
 ment, isolating cures, and other blunders, can scarce- 
 ly be estimated. There is no possibility of coming to 
 a rational way of treating neuroses without a gen- 
 eral collegial understanding of this thing. We must 
 not forget that the over-coming of a defense mech- 
 anism demands work from within, and may often be 
 painful and take the energy of years. When the 
 patient finds out that he no longer is left in peace 
 but must take up the battle of life in order to be 
 well, then he runs to some other doctor. And this 
 one perhaps lets him once more sink back into his 
 protective measures, and by so doing cuts off the 
 road to health which had begun to be cleared out. 
 
 It may indeed be a difficult task to once more 
 take hold of life when a man has well established
 
 The Adler-Doctrine Concerning Neurosis 175 
 
 himself as a neurotic, under this defense-mechanism. 
 But on the other hand it not infrequently happens 
 that severe symptoms which have been built up in this 
 manner, disappear as if by magic, when the causal 
 associations are cleared up. It is as if the patient, 
 against his will had become enmeshed in a net of il- 
 lusions, it needs only that this be torn asunder in 
 order that he may become well and free. He has 
 fled from reality; but the neurosis has provided a 
 new experience; however dangerous reality itself 
 may be, there is one thing still more dangerous ; and 
 that is the effort to assure one's self against it in 
 any way whatever. 
 
 After these hints concerning Adler's meaning as it 
 has to do with neurotic defense mechanism, I shall 
 point out briefly what is involved in his other fun- 
 damental idea, viz, "the masculine protest." It may 
 be most suitable to start from a concrete case. 
 
 A robust man of about thirty years consulted 
 me once because of impotence. It came out at once 
 that the impotence applied only to his marriage ; dur- 
 ing the whole time of his youth he had been unusually 
 vigorous in the sexual respect. He had married sole- 
 ly for love and his wife was in no way opposed to 
 him. This seems peculiar, but the association is very 
 simple. I asked him some questions concerning his 
 father and he then broke out with the greatest bit- 
 terness. His father, he told me, had ruined his life. 
 All through his student days this father had dogged
 
 176 History and Practice of Psychanalysu 
 
 his steps in every possible way, he had made home 
 a perfect hell during his childhood, etc., etc. He 
 continued: "As far back as I can remember, I was 
 determined never to be the cause of bringing children 
 into the world, I Would not bring about such 
 damnation as I had known in my own life." Here 
 was the thing quite clear. The young man's waking 
 consciousness in childhood had been impressed with 
 a protest against the father, the flame being con- 
 tinually fed by new feelings of hatred which must be 
 suppressed. Out of this protest against the father 
 arose a protest against fatherhood. And it was this 
 which brought about all that failure of the sexual- 
 mechanism, when danger of fatherhood arose because 
 of his marriage. I asked him if he still held fast 
 to his decision not to wish to become a father. "No, 
 for God's sake!" he answered, "My wife would like 
 ten children if I could do my part." Consciously 
 then he had given up the protest. In such cases that 
 is always the first step toward health. Sometimes 
 the imprint which the protest puts upon the uncon- 
 scious mind is blotted out also: but if this is deep- 
 seated it may require tedious work to repair the con- 
 sequences of the past. 
 
 In this case it is easy to see the characteristics of 
 the neurotic attitude toward life. In the face of the 
 fact of an unhappy childhood, the sound, strong 
 man says to himself: "If I have children in the 
 future, it will be the effort of my life to see to it
 
 The Adler-Doctrine Concerning Neurotis 177 
 
 that they do not suffer as I have done." This is a 
 positive goal; it is something which at the same 
 time leaves the mind open for what is to come, and 
 which gives the mind a content. The neurotic on 
 the contrary, flees from difficulties ; the impotence is 
 an unconscious stratagem, by means of which this 
 patient had beforehand saved himself, without the 
 trouble of taking hold in earnest of the solution of a 
 risky problem. Neurosis is the negation of life. The 
 protest is the active side of this negation. The pas- 
 sive side is that of the defense. 
 
 This protest-mechanism opens up understanding 
 for very many neurotic disturbances. I just now re- 
 call a man who suffered from the same trouble as the 
 patient I have last mentioned; he had been left be- 
 hind by his competitors, and his feelings were en- 
 gulfed in protest against this unmerited treatment. 
 He was so taken up with thoughts concerning this 
 occurrence, that he never had time to devote himself 
 to his wife and his home. Another patient who came 
 to me for treatment for alcoholism, said to me: "I 
 notice that if anyone suspects me of being unable to 
 control myself, something within me arises in protest 
 and I go and get drunk. This protest is more dan- 
 gerous for me than anything else." 
 
 I said before, how the neurotic, unlike the degen- 
 erate can let himself be carried away by shadowy 
 fantasies; he must constantly keep hold of himself 
 in unavailing effort to alter the reality of which he
 
 178 History and Practice of Psychanalysls 
 
 is not master. The protest is this everlasting re- 
 bellion against life, which leads to nothing and after 
 which the neurotic once more sinks into his helpless- 
 ness, there is no one who exhausts his forces so un- 
 necessarily as the victim of a protest-mechanism. 
 The so-called neurasthenic "tiredness" is often 
 caused by simply this. 
 
 Adler gives the protest the epithet "masculine." 
 This means that all the struggling, the wish to be 
 first in competition with others, the strife for power, 
 which characterize the mind-current, has to do with 
 those qualities we are accustomed to call masculine. 
 But there is also another and more important rea- 
 son. We come upon the protest in the study of neu- 
 rosis to a great extent and in a special form, among 
 women, who inwardly rise up against their position 
 as women. Behind much neurotic suffering among 
 women Adler believes that he is able to see the hidden 
 desire to escape the position of woman. He gives 
 many examples of women who ever since the awaken- 
 ing of consciousness have been in open strife with 
 their sex, and who react with anxiety, insomnia and 
 other symptoms against everything which reminds 
 them of their part in life. This is not so strange as 
 it may appear. Woman since the earliest days of 
 civilization has been placed in a subordinate position ; 
 one might almost say that the feeling of inferiority 
 throughout centuries has worked into womanhood it- 
 self and now burdens the whole sex. A girl becomes
 
 The Adler-Doctrme Concerning Neurosis 179 
 
 aware of this disadvantage as soon as she experi- 
 ences the condescending airs and disdain with which 
 her brothers talk "of girls not being any good." Not 
 at all strange that such talk awakens a desire to 
 out-shine them. But in this very fact may a foun- 
 dation be laid in the girl for a conflict with her 
 own nature, which later on becomes fatal. The pro- 
 test, which should be directed against what is fal- 
 lacious in the opinion, instead directs itself against 
 the nature of womanhood itself. While on this sub- 
 ject it might be a temptation to see how Adler's 
 point of view holds good concerning the so-called 
 feminist movement. Undoubtedly he believes this 
 movement is just, as a means of rectifying the mis- 
 takes of the history of civilization. But he wonders 
 if it does not sometimes come in upon paths which 
 have relationship with those of illness, where occa- 
 sionally a woman goes astray, because, without un- 
 derstanding of the matter, she rises in arms and tries 
 to suppress that which is by far the finest and noblest 
 in her nature. In the strife after "equality with 
 man" alone, lies the seed for one such way of stray- 
 ing; in this one sees an inkling of the "masculine 
 protest," just as in every other place where the 
 woman puts forward man and masculinity as an 
 aim for her struggle. What it implies is not that 
 the woman shall be forced into the same plain as the 
 man and have opportunity to so develop her powers 
 that she shall set up an opposition against him ; what
 
 180 History and Practice of Pst/cfi analysis 
 
 it does mean is that she must be freed from the esti- 
 mation and standard of life which men have forced 
 upon her and thus have a fair chance to develop 
 freely and fully, her own nature. 
 
 Anything that makes an early straying aside upon 
 any one of these many wrong paths fatal, is the 
 fact that the individual at the same time puts before 
 him delusive aims and fashions his life-plan after 
 these. The neurotic, because of a feeling of infer- 
 iority, is thus separated from real life and is forced 
 into a life of fantasy. In place of working towards 
 tangible external goals, his aim is after something 
 which he constructs in his imagination. He thus de- 
 prives himself of the happiness that lies in the at- 
 tainment of something after which he has struggled. 
 He stands continually in front of the painful dis- 
 covery that his own fantasies are incongruous with 
 real life. "It has not turned out as I expected it to," 
 he says. "What is the use in striving for anything?" 
 and so his activity is paralyzed and he comes into 
 the state of relaxation of will-power so characteristic 
 of the neurasthenic. 
 
 The dangers attending the building up of these 
 fictitious ideas against which the neurotic strives, 
 are simply that the formation-process itself in es- 
 sential degree, finally is decided by those tendencies 
 with which he tries to compensate the feeling of 
 inferiority. In other words: the whole life-plan 
 comes to be decided either by the defense-mechanism
 
 The Adler-Doctrine Concerning Neurosis 181 
 
 or the protest. In order to leave his illusions 
 behind him it may often be necessary for the neurotic 
 to make over his whole life from the very foundation. 
 Generally the so-called regression, plays a great part 
 in every treatment. Through this something like a 
 stop is put to that development in which the indi- 
 vidual is being driven on by his inner forces. He is 
 compelled to go farther and farther back in order 
 to review every point in life's falsification, to which 
 he has become a victim. After this has been done 
 he comes again to his present life as if after an 
 inner voyage of exploration; he sees it in another 
 light and comprehends toward what genuine purpose 
 he should direct himself. 
 
 It is without doubt simply in the ruling of the 
 whole life-plan by wrong tendencies, that insurmount- 
 able hindrances often arise in the road to health. 
 
 I shall here give an example of what I mean. 
 
 I was consulted once by a man of about thirty 
 years, who was troubled by a disturbance in the 
 organ of speech. He did not stammer exactly, but 
 suddenly without the slightest warning the tongue 
 refused to do its service. It was a particularly un- 
 fortunate trouble for him because he had intended 
 to become a popular lecturer. He had put before 
 him as his aim in life the elevation of the people and 
 he meant to stand forth himself as a moral example. 
 Because he had been originally a poor peasant boy, 
 and gave me the impression of being orderly and dili-
 
 182 History and Practice of Psychanalysit 
 
 gent, but nevertheless exceedingly poorly gifted, I 
 suspected at once that there was a plain incongruity 
 between his qualifications and his ambition. I 
 thought that in all probability the trouble with the 
 speech had some dim association with this fact. In- 
 vestigation revealed that in childhood this patient 
 had indulged in the wildest imaginations connected 
 with war and plans for being a great victor; he 
 wanted to eclipse the great generals of his country 
 and make it once more a world power, etc. As soon 
 as he was grown up he had enlisted in the army. In 
 this act there was nothing peculiar. But he had by 
 no means taken this course with the thought of re- 
 maining a non-commissioned officer or any such in- 
 significant thing, he had done it with the undis- 
 turbed conviction that he shortly would become Chief 
 of the General Staff and in this position would be 
 able to work out his plans as soon as a war broke 
 out. Then came upon him the trouble with his 
 speech which forced him on to another path. He 
 had then gone to New Zealand. "Why New Zea- 
 land?" I asked him. He told me because he had 
 wanted to say that he had been farther away from 
 his native land than any one else, and so had chosen 
 the point on the globe which was precisely opposite 
 his own country. I shall not repeat all the queer cir- 
 cumstances with which this analysis swarmed. Terse- 
 ly, at each decision he allowed himself to be domi- 
 nated by his childhood's fiction of being foremost.
 
 The Adler-Doctrine Concerning Neurosis 188 
 
 His work as a lecturer was naturally nothing else 
 than the use of such subjects as temperance, the edu- 
 cation of the people and various other questions of 
 the day, in order to attract attention to himself, 
 just as indeed, many others use such means. The 
 disturbance of speech had arisen as a natural means 
 to try to force him to fit into reality, a thing I 
 must here pass by. In order to become well the man 
 had to give up his ideas of greatness and be resigned 
 to the fact that he was entirely an every-day unim- 
 portant workman, who must make an honorable 
 means of self-support his purpose in life; this 
 change was too much for him. 
 
 In referring to the origin of inferiority, I touched 
 upon one circumstance which puts great hindrances 
 in the way of making over of the fictitious life-plan, 
 viz: that the feeling of inferiority itself is woven in 
 with actual physical weaknesses and irregularities. 
 These thus constantly sustain the erroneous mind- 
 building processes. In this last case for example, 
 there existed a malformation of the gum which made 
 it hard for the patient to pronounce the letter "s." 
 
 There is still another circumstance which in this 
 respect is of even greater import and which for the 
 sake of simplicity I have hitherto passed by. I have 
 to presented the matter that it would seem as if 
 the feeling of inferiority arose in connection with 
 physical weakness and as if the defense- and protest- 
 mechanisms originated in connection with those dif-
 
 184 History and Practice of Psychanalysis 
 
 ficulties met with on account of it, in the fitting in 
 with reality. But all this has very often a deeper 
 association. Anomalies mean psychic educational 
 faults, and it is against these that compensation 
 must be established in different directions. In other 
 words the individual has something constitutional 
 within him from which he always tries to escape and 
 against which he continually revolts. Let us take as 
 an example a homosexual trait in a deeply moral man 
 of strong character. Under such circumstances a 
 compulsion-neurosis with a complicated ritual may 
 be erected, which forces the individual every second 
 of the day to be on his guard. He may, for in- 
 stance, be subjected to the compulsion of dressing 
 liimself in a certain way, of walking upon certain 
 stones in certain streets, of carrying out his work in 
 a certain way, he may, because of agorophobia, be 
 frightened away from all places where men solicit, 
 etc. I recall one man of splendid education, but 
 constitutionally homosexual, who joined the Salva- 
 tion Army and for whom religion played the part of 
 such a protecting defense-measure. Or the process 
 may also appear in the protest form. We might in 
 that case say that the protest is the tension between 
 abnormal tendencies, such as perverted animal in- 
 stincts, and the forces in use in the construction of 
 morals. The more one is reminded of the impulse 
 just so much the stronger arises the protest; this 
 is then discarded to other relativelv indifferent ob-
 
 The Adler-Doctrine Concerning Neurosis 185 
 
 jects and is projected into the surrounding world 
 and into work in accordance with well known mech- 
 anisms. So the reason which causes a woman's 
 shrewishness, through which she destroys her own 
 happiness as well as that of others, may lie in some 
 hidden perversity, from which she continually, by 
 this means, tries to turn her attention. 
 
 If neurotic conditions do not become amenable to 
 cure, the reason will often be found in such con- 
 stitutional anomalies, which make the fitting into real 
 life an impossibility. This does not, however, pre- 
 clude the possibility that the situation can be im- 
 proved, that is to say, that after analysis of the 
 associations the individual can replace the neurotic 
 defense-system with something better; for example 
 replace a compulsion-system that paralyzes the whole 
 working power, with a useful work which holds the 
 attention and engrosses the energy. 
 
 Such deep unchangeable abnormalities hold good 
 in the question of psychopathic conditions. For the 
 explanation of the psychology of these also, Adler's 
 lines of thought have value. This is understandable 
 if one keeps in mind the aim toward which both 
 fundamental tendencies point most surely; these 
 are realized in both the extreme psychic types, i. e. 
 in the dement and the protest-paranoiac. The for- 
 mer has withdrawn entirely from the outside world 
 and lives only in the fantasies which he, himself 
 produces. He has shielded himself by means of walls
 
 186 History and Practice of Psychanalysis 
 
 built up from the compulsion-system, symbols, atti- 
 tudes, automatisms, etc., in such a way that he no 
 longer is approachable. The latter, on the contrary, 
 instantly takes an "on guard" attitude toward every 
 one he meets. He is oversensitive in regard to the 
 outside world in such a way that he makes use of 
 each little thing as a welcome means of obtaining 
 outlet for the hate-saturated disharmony within him. 
 Of course in the construction of psychopathic con- 
 ditions, causes of quite another sort than those here 
 described also come into question ; with them medical 
 psychology has nothing to do. It is limited to 
 searching into psychological associations. 
 
 I said in the introduction of this paper that Adler 
 represented a revolt against the Freud system, which 
 sooner or later must have come. It may need no 
 more than the above hints concerning Adler*s teach- 
 ings to make clear to every one how widely they dif- 
 fer from everything that is connected with the name 
 of Freud. Obviously a presentation of everything, 
 which according to Adler is fundamentally important 
 for the construction of neurosis, may be given, with- 
 out once bringing the sexual life into question. In 
 his earnestness to point out other causes than those 
 emphasized by Freud, he has even gone so far as 
 wholly to deny that the sexual-life and its conflicts 
 are explanatory foundations for nervous suffering. 
 It may appear of only paradoxical interest. But 
 really that is the conclusion we must arrive at, if
 
 The Adler-Doctrine Concerning Neurosis 187 
 
 Adler's opinions are followed out to the goal toward 
 which they point. And Adler may be accused of 
 anything rather than of inconsistency. 
 
 The forces which Adler pointed out, and the action 
 of which he tried to follow in detail, play, accord- 
 ing to him, such a dominating role, that the sexual- 
 life itself, by the side of them, steps into the back- 
 ground. Where the feeling of inferiority has found 
 a way into a person's life everything must yield to 
 the effort to build up compensation in one way or 
 another, everything is subordinated to this, even 
 the longing to reach freedom of the senses. Before 
 the purpose of defending one's self against the dan- 
 gers of life, or the longing to overcome other dangers 
 by means of the masculine protest, the neurotic loses 
 sight of all other purposes. He not only loses love as 
 an aim in life, but he loses the faculty itself, to love. 
 He meets every rising tendency within himself, with 
 an anxious effort to flee from it. He dare not de- 
 vote himself to anything which may bring him in 
 contact with this dangerous reality, which is his con- 
 stant terror. Love would compel him to give up 
 those dreams which are dearer to him than life, and 
 drive him to the humiliating acknowledgment that he 
 has striven after an illusory goal ; so must he raise 
 himself up in protest against it. Because of this 
 everlasting seeking after fictitious aims, after un- 
 reality, the neurotic can never give himself up to the 
 risk of a real emotion, as he must do, if by means
 
 188 History and Practice of Psych analysis 
 
 of it he is to redeem himself. All that has to do with 
 the erotic, remains for him just as unreal as every- 
 thing else in his life, a fantasy, an arrangement, a 
 pose, a part to play. Because of this Adler believes 
 that it is preposterous to ascribe such a causal sig- 
 nificance to neurosis-formation, even where the pa- 
 tient himself shoves such significance into the fore- 
 ground and when at superficial consideration it seems 
 to play a chief part. The deciding factors are, in- 
 stead, all those things which drive the neurotic into 
 a life of unreality and impede his emancipation. 
 
 Even if Freud's sexual-doctrine may not be elim- 
 inated from scientific consciousness in so convenient 
 a way, Adler's point of view contains nevertheless 
 very much of value. It can not be denied that the 
 "libidinous satyr-play" is often an external phenome- 
 non, deep under which "the tragedy of the masculine 
 protest" works the destruction of the individual. 
 Strindberg, whose life and work are an inexhaustible 
 well-spring for the exemplification of Adler's view- 
 point is, in this regard, singularly instructive. One 
 of Adler's most faithful adherents, Freschl, has re- 
 cently devoted himself to a study of Strindberg's 
 book, "For Pay." This points out how, for the 
 author, everything was a question of power, an effort 
 to demonstrate his superiority. He feels his in- 
 feriority in regard to woman and marries three times 
 in the hope of finally becoming master over some one. 
 At the bottom of his inclination to endow woman at
 
 The Adler-Doctrme Concerning Neurosis 189 
 
 one and the same time with irresistible charm and 
 with the most horrible qualities, lies one of those 
 strange stratagems which are so often met with in 
 neurotics ; he does it to protect himself from the 
 humiliation which otherwise would mean his going 
 under in the battle against her, for no one need be 
 ashamed of being unable to withstand such mon- 
 sters of artifice and enchantment as he makes his 
 fictitious women appear to be. 
 
 Helen must conquer in order to show the danger- 
 ous power of which she is possessed and it is easy 
 to understand the need of the man to protect himself 
 against her, against women etc. Out of Strind- 
 berg's life and out of all his books it is easy to see 
 how aggression-tendencies originated from a neu- 
 rotic thought-scheme to which he must keep fast hold 
 in order to defend himself, since he plainly felt how 
 great was his insecurity against women. This feel- 
 ing of powerlessness in the struggle against her, was 
 however, only one expression standing out in the fore- 
 ground, for a general feeling of inferiority which he 
 had with him from the very beginning. 
 
 When Strindberg speaks of love between man 
 and woman, it does not mean anything like love, but 
 only the question which of the two shall get the 
 better of the other in the struggle for power. 
 
 This has interest in showing how Adler thus throws 
 new light upon a problem which Freud believed he 
 had made quite clear in the gleam from his dark-
 
 190 History and Practice of Psyclianalysis 
 
 lantern of sexual dogmatism. Through it there has 
 come about a re-valuation of all those facts which 
 Freud dragged forth and made subjects for dis- 
 cussion. The most important question is the manner 
 in which Adler manages the incest-doctrine. As I 
 pointed out in the foregoing paper, during the de- 
 velopment of psychanalysis this doctrine has become 
 such an absolute center in the whole structure of 
 the teaching, that it often seems as if an answer to 
 all the fundamentally essential questions seek de- 
 duction out of it. Adler's greatest import lies per- 
 haps simply in the fact that he constructed a dam 
 against the inclination of this incest-doctrine to over- 
 flow all the different spheres of human-nature. 
 
 The material for the incest-doctrine has been 
 chiefly gathered from dreams. It can neither enter 
 Adler's mind nor that of anyone else who is prac- 
 tically engaged with psychology, to deny that in the 
 dreams of neurotic patients incestuous fantasies are 
 to be met with about as Freud describes them, and 
 that through analysis one may find a trace of such 
 things in the unconscious life of everyone. The ques- 
 tion therefore is not so much this fact in and for 
 itself, but far more how it shall be explained. The 
 opposition which arose was chiefly against Freud's 
 manner of interpreting it as an expression of an 
 unconscious wish, which prevented free play of the 
 feelings and gave rise to insuperable resistance 
 against those forces which will out. What Adler
 
 The Adler-Doctrine Concerning Neurosis 191 
 
 above all objected to was the establishment of the 
 incest-motive as a reality in the life of the indi- 
 vidual. When he himself accepts the erotic conflict 
 in neurotics as an unreality, as a curtain, behind 
 which all these other forces are acting ; then it is but 
 a step for him also to accept the origin of those con- 
 flicts as an illusion, a self-deception. He also con- 
 sidered it only as a staging of the longing for pro- 
 tection and the struggle for power. When the man, 
 for instance, dreams that he is in intimate inter- 
 course with his mother, it means only that he runs 
 to her from the dangers of life in the same, way he 
 did as a child. And so it is always. The fact that 
 these sensuous situations appear in dreams so rela- 
 tively often, depends most closely upon a technical 
 circumstance in the formation of dreams. We pos- 
 sess in the unconscious mind, so to speak, a stratum 
 of memory pictures which superimposes an earlier 
 stadium in connection with the most primitive sensu- 
 ous sensations. Among these memories, pictures of 
 our nearest relations play the chief role, they being 
 then the only individuals who existed for us. Of the 
 psychic material furnished by this stratum, we make 
 use in dreams in order to express those tendencies by 
 which our conscious ego is ruled; we need this to 
 illustrate endeavors of quite another sort. 
 
 It seems to me that Adler is right in that the 
 incest-material must not be taken so seriously as 
 Freud took it. But on the other hand I do not be-
 
 192 History and Practice of Psi/ch analysis 
 
 lieve that the question can be solved according to 
 his psychological outlines ; it must be considered in 
 a broader connection, much broader than could here 
 even be sketched in. 
 
 But the strife which is now going on between 
 Freud and Adler means far more than scientific con- 
 troversies like those upon which I have touched; 
 it means even more than the ground work for medical 
 psychology. 
 
 I pointed out in the beginning that Freud tried 
 to interpret the psychic-life from its causal assump- 
 tions, just as every investigator of natural science 
 interprets phenomena which come within his field 
 of research. The basic idea in the sexual doctrine 
 is simply such an attempt to resolve all different 
 expressions of the mental life into more or less ac- 
 cidental forms, by the power which rules the whole 
 of the animal world. Freud's attempt aims, in other 
 words, to fit the teaching concerning the mental life 
 in, with all the rest of the system of natural science. 
 Adler's opposition is an expression of humanity's 
 everlasting protest against all under-valuation of 
 the specifically human forces; it is the claim of 
 the final view point on an equality with the causal. 
 
 It may thus be seen that Adler asserts finality with 
 that same ruthless one-sidedness, with which Freud
 
 The Adler-Doctrine Concerning Neurosis 193 
 
 emphasized causality, as the driving, creating, power 
 in human life. 
 
 According to Adler we understand nothing of that 
 which takes place within us unless we first and fore- 
 most direct attention to the ineffaceable struggle 
 after a purpose which rules all our undertakings. 
 The nature of neurosis is unveiled to us only when 
 we learn to distinguish between real and illusory 
 aims. If this struggle for a purpose comes from 
 within and carries with it the stamp of our deepest, 
 truest volition, if the purpose is in harmonious 
 proportion with our forces and if its attainment leads 
 to the emancipation of these forces, then we are on 
 the right road. But if the effort itself is distorted, 
 excited, and really an egotistical desire to demon- 
 strate our own superiority; if the purpose is some- 
 thing which in actuality we do not desire, some- 
 thing, which looked deeper into, is of no worth to 
 us, a will-o-the-wisp after which we reach only be- 
 cause it shines beautifully before our eyes, then 
 we are on the road to disease. 
 
 Behind this struggle toward a goal Adler catches 
 a gleam of the permanent life-plan. The idea for 
 him, carries with it almost a mystical purport, and 
 in reading his works one sometimes feels that this idea 
 is his name for the substance of life itself. To show 
 how deeply the life-plan is grown into the psyche, 
 he has investigated the earliest memories of child- 
 hood in a very large number of cases; he has found
 
 194? History and Practice of Psychanalysis 
 
 thereby that these always are a symbol of the life- 
 plan. As an instance, I questioned a young man 
 about his earliest recollections ; he had sat upon 
 somebody's knee and told tales of robbers and had 
 been overjoyed when some of the people near him 
 expressed delight. He was then three years old. 
 Now he is over twenty and wants to study to become 
 an artist ; his life is ruled by the longing to charm 
 in some such capacity, his contemporaries. The life- 
 plan is the indwelling, primitive, central point in the 
 human soul. Life consists of an effort to realize it. 
 In front of it everything else must give way, and to 
 it all other tendencies must be subordinated. 
 
 Adler's undisturbed consistency comes out strong- 
 est by far in the way in which he puts another con- 
 struction on the Freud incest-doctrine. Even the 
 forces which penetrate most deeply into the assump- 
 tions of our earthly existence are not, according to 
 Adler, decisive for the form of it. By themselves 
 they are empty, illusory. Their real import is dis- 
 covered only when they are seen in connection with 
 the life-plan ; that is the substance which fills out 
 these forces with real content, which negotiates their 
 associations with reality in general. 
 
 It may seem as if an insurmountable wall separates 
 that which Freud, and Adler, represents, each in his 
 own way, and as if their most zealous disciples were 
 right in proclaiming that one must take sides in the
 
 The Adler-Doctrine Concerning Neurosis 195 
 
 question. As the attempt to couple the two views 
 together has been hitherto unsuccessful, it will in all 
 probability show itself to be useless later on. 
 
 But if a broader view of the matter is taken, the 
 situation changes and we find that both fundamental 
 opinions are only two different standpoints from 
 which the whole may be considered. 
 
 In choosing a point of outlook over all the grow- 
 ing phenomena of life, it is necessary to choose one 
 which under all circumstances remains undisturbed. 
 It is necessary to take fast hold of a fact, the surety 
 of which can never even be brought into discussion 
 and which at the same time has such radical impor- 
 tance that it always must be kept in mind. There 
 are in reality only two such facts as these. The 
 first is, that we all are born of woman and the 
 second, that all must some time die. 
 
 If Freud's incest-doctrine is stripped of all its 
 scientific adornment and disengaged from all its mis- 
 leading terminology, it is seen that the kernel of it 
 all is nothing but a presentation of this first fact. 
 The way itself, in which we come into life, is so in- 
 timately bound up with material forces, that these in 
 their entirety, must remain stamped by it. It im- 
 plies a bondage from which we are unable to make 
 ourselves free, we cannot even become wholly loosed 
 from that form in which the bondage primarily was 
 moulded. All experiences may be arranged under
 
 196 History and Practice of PsycJianalysis 
 
 this category as Freud has arranged them; and 
 thus one will arrive at his one-sided assertion of 
 causality. 
 
 On the other hand all the final tendencies of the 
 world's view point are woven into the fact that we 
 shall some time stand before the inevitable; finis. 
 Just as consciousness that the day comes to a close 
 within a certain period of time, forces us to ar- 
 range, so that we finish what we ought and wish to 
 do within that time, so the constant nearness of the 
 fact of death in our consciousness, forces us to con- 
 trive our lives after certain directing lines. We 
 must so establish ourselves that sometime we shall 
 with dignity, be able to leave our lives behind us, 
 a work completed. So strong is this need that we 
 cannot withdraw one single moment of our lives from 
 under its dominion ; we thus arrange all occurrences 
 in accordance with this fact. 
 
 As all in our lives, of which we have any knowl- 
 edge, falls as to time, between two points, birth and 
 death, so everything we think, desire, feel, bears the 
 imprint of both these fundamental facts ; all is a 
 struggle between forces whose origin predominates 
 in one or the other direction. Any genuine under- 
 standing of that which we experience and of our posi- 
 tion in life in its totality, we may arrive at just as 
 little on one as on the other, of these one-sided paths. 
 As warped and unreal as a fact appears when illu- 
 minated exclusively from the viewpoint of birth, just
 
 The Adler-Doctrme Concerning Neurosis 197 
 
 as warped and unreal does it appear when light shines 
 upon it only from the opposite direction. 
 
 However many valuable contributions to our 
 knowledge Adler's doctrine concerning neurosis has 
 given us, on the whole it seems to me as little able to 
 serve as a foundation for the needs of psychotherapy, 
 as the Freud system itself.
 
 THE NATURE OF HYPNOSIS 
 
 DURING the course of a practice which has 
 given me opportunity to observe the phenomena 
 of hypnosis about twenty thousand times, I have 
 more and more separated my own thought from that 
 of the general opinion concerning its nature. Above 
 all, I have lost sympathy with Bernheim's dictum: 
 "il n'y a pas d'hypnose, il n'y a que la suggestion." 
 That this phrase won such strong approbation, seems 
 to me to depend upon the fact, that it simplified 
 to an inexpressible degree a very difficult problem. 
 During the century that elapsed after the discovery 
 of the peculiar condition now called hypnosis, in- 
 numerable investigators endeavored to find an 
 explanation of it nature. When therefore, the fore- 
 most representative of this branch of research de- 
 clared emphatically that the objective point for his 
 research, generally speaking, did not exist, it came 
 as a kind of relief. After that no one need trouble 
 his brain to find further solution of the question ; the 
 whole theme could calmly be left where it was. 
 How obstructive this phrase of Bernheim's has been, 
 
 198
 
 The Nature of Hypnosis 199 
 
 not only to the development of the subject itself, 
 but also to the use of hypnosis on the practical side, 
 is easily to be seen if the literature is gone through. 
 It will probably be difficult to find anyone who went 
 farther in hypnotic research, without letting himself 
 be influenced by this stumbling block in the path than 
 Wetterstrand. For him hypnosis always remained a 
 unique psycho-physiological condition, that must 
 neither be confused with sleep nor with the waking 
 state, and which, irrespective of all suggestion, had a 
 high therapeutic value. Even if suggestion plays a 
 certain role in the production of this condition, it 
 can be called suggestion here just as little as in 
 sleep or in death. This idea was the foundation for 
 that method of treatment which Wetterstrand called 
 "The Prolonged Sleep" and with which he undoubt- 
 edly achieved amazing results. How far we have 
 come away from progress in this direction, is best 
 shown in the fact that Wetterstrand got no fol- 
 lowers in his own method. I shall not here refer to 
 the old controversy ; I have mentioned it thus briefly^ 
 merely to signify that I am myself most closely 
 joined to Wetterstrand's out-of-date standpoint on 
 this question. But for him also, as with the earlier 
 investigators, hypnotism was always veiled in a cer- 
 tain mystical vagueness. The purpose of this paper 
 is to point out with the greatest possible brevity, how 
 for me it has lost this mystical stamp. 
 
 In order to get a clear picture of hypnosis, I have
 
 200 History and Practice of Psychanalysis 
 
 at various times asked patients to give me a short 
 and accurate description of what they felt while in 
 the hypnotic condition. It seems to me better to take 
 up here, one such description rather than a general 
 collection of different experiences. The following 
 was written by a woman of forty, whom I had under 
 treatment for nervous vomiting and insomnia. She 
 was intelligent, had read much, but knew nothing 
 about hypnotic literature; what she wrote was de- 
 rived directly from her own experience. 
 
 The first sensation of the psychic action is one 
 of calm; every disturbing thought disappears and 
 instead comes an impression of quietness that seems 
 entirely physical. Every muscle relaxes and the eyes 
 close almost involuntarily. Little by little, all per- 
 ception of time disappears. That is the only thing 
 which, from the beginning, one almost entirely loses. 
 All sounds are heard as from a distance and a peace- 
 ful feeling of rest falls upon one mentally and phys- 
 ically. But this is of one's own free will, the feeling 
 that one has one's self in hand need not disappear for 
 an instant ; one can, if one wishes, think quite clearly, 
 open the eyes if one desires, hear what is said or what 
 takes place nearby (unexpected noises one always 
 hears), move as one desires, but one can also let all 
 thoughts go and lie quite motionless. It is a matter 
 of the will from the patient's side. Finally there 
 comes the most wonderful sensation, a feeling of con- 
 centration of one's self within one's body, as if one 
 were isolated within one's self. Everything disap- 
 pears, only the I consciousness is left. This con-
 
 The Nature of Hypnosis 201 
 
 centration is like the most absolute rest one can 
 imagine. When this condition is reached it must be 
 acknowledged that it requires a very great effort of 
 will in order to think, move, or even open the eyes; 
 it is possible to do it, but there is no desire. If a 
 trial is made to move or think, regret quickly fol- 
 lows and one makes haste to sink back again into 
 this Nirvana where one really loses neither conscious- 
 ness nor individuality, but finds the most delightful 
 rest than can be dreamed of. Then after the treat- 
 men ceases, in the first few moments, one feels sleepy 
 and unwilling to open the eyes, but after a very short 
 period this desire to sleep disappears and one feels 
 rested, alert, as if even the thought faculty had been 
 sharpened and both mental and physical forces 
 strengthened. 
 
 I have said that this patient was unacquainted 
 with hypnotic literature. I must add that at the time 
 of this written descripion, she had never been in- 
 fluenced by my suggestions. When I find hypnosis 
 induced, it is my practice to permit it to develop 
 as freely as possible; in advance I merely dispel 
 false ideas regarding it, especially the common belief 
 that it means a condition wherein consciousness is 
 lost. 
 
 In this description however, those characteristic 
 features appear, which are found in all descriptions 
 and which must start either from an earlier period 
 of time or from the animal magnetism period; ad- 
 mitting that these descriptions, especially those from
 
 202 History and Practice of Psychanaly&is 
 
 the former state, often are personally and even fan- 
 tastically colored, there are nevertheless always some 
 signs that are unmistakable. If it had to do only 
 with the product of imagination, this unity would be 
 hard to explain; it appears to me to show that it 
 indicates a condition sui generis, which different peo- 
 ple experience pretty much alike and of which in the 
 attempt at description each one takes hold in his own 
 way. 
 
 For the sake of simplicity I shall point out only 
 five characteristic points. 
 
 1. That which to the patient was most obvious, 
 was the fact that consciousness was retained, al- 
 though single objects disappeared out of it. The 
 psychologist is at once ready to object that this is 
 not possible. To all intents and purposes indeed, 
 consciousness disappears, according to all our or- 
 dinary experiences, at the moment we cease to occupy 
 ourselves with a specific thing. If during the night 
 we waken for a moment from sleep, we only realize 
 something of it because of the dream-pictures which 
 at the instant glided past us. And yet it cannot be 
 denied that a true observation lies at the bottom of 
 the patient's description. I have often from different 
 patients, heard the word Nirvana ; is not this meant 
 to signify a disappearance of all the world, with- 
 out the cessation of life because of that disappear- 
 ance ? Admitting that such a thing cannot be wholly 
 realized, in hypnosis there is however a tendency in
 
 The Nature of Hypnosis 203 
 
 that direction which never has been carried into 
 effect, to quite so great a degree, in any other 
 way. 
 
 2. The patient pointed out a peculiar feeling of 
 concentration within herself; a kind of flowing to- 
 gether of all that energy which generally is divided 
 between the common affairs of the world, the self, 
 the patient's own body i. e. the isolating of the 
 individual within himself. The phenomenon was 
 plain to Liebeault, when he founded the modern 
 theory of hypnosis. He laid stress upon the way in 
 which the attention draws itself back from those 
 things within the physical sphere, and thus becomes 
 accumulated in the brain ("!' accumulation de 1'at- 
 tention" ) : he explained the pathologic and thera- 
 peutic phenomena as a directing and concentrating 
 of the attention of the patient, who had thus been 
 made free. 
 
 3. If one takes as a point of procedure this specific 
 isolating within itself of the organism, the psychic 
 changes during hypnosis become easier to under- 
 stand. These have been looked upon as phenomena 
 of suggestion (by Hirschlaff and others), but this 
 idea does not fit in with my own experience. Even 
 if these changes could be intensified suggestively in 
 different directions, there is, nevertheless, in hypnosis 
 a kind of spontaneous preparation for them, to which 
 this intensification is added. The condition of hyp- 
 nosis means a partial cutting off of connection with 
 the outside world, which spontaneously carries with
 
 204) History and Practice of Psychanalysis 
 
 it a decline of the mental functions. Subjectively 
 this is bound up with a feeling which every one who 
 has experienced it, is reluctant to give up. It is de- 
 scribed generally as a sensation of heaviness, which 
 commonly starts in the feet and afterwards spreads 
 over the whole body, until the patient finally lies as if 
 paralyzed. A colleague whom I treated for mor- 
 phinism, characterized this sensation more as one of 
 pressure, which from every side, acted upon the 
 body. He found this sensation so typical, that he 
 had the impression that hypnosis could be induced 
 in this way; that is to say, by applying to various 
 parts of the body tightly pressing weights, so that 
 the fundamental idea of hypnosis might be sug- 
 gested into the consciousness and then hypnosis itself 
 would appear by means of associated reflexes. Ob- 
 jectively this sensation of weight or pressure cor- 
 responds to that of catalepsy. Characteristic to it 
 (as may be observed from the written description 
 cited), is rather a disinclination to move than an 
 inability to do so; in other words, the motionless 
 state is here natural and may be overcome only by a 
 disagreeable exertion of energy. 
 
 4. Further I must mention the automatism, al- 
 though this appears only indirectly in the description 
 cited. This has always been considered as a real 
 characteristic of the deep sleep. The disinclination to 
 move develops into an aversion towards all changes ; 
 a movement which has been started from without, is
 
 The Nature of Hypnosis 205 
 
 thus permitted to continue without effort to inter- 
 rupt it. But it is of greater importance that the 
 automatism of the physiological functions is rein- 
 forced during hypnosis. In ordinary circumstances 
 these are easily disturbed by innumerable things 
 which aggravate, in both a physical and psychic 
 way; when, during hypnosis, all these things fall 
 away, a regulating of the bodily functions sets in, 
 which for the understanding of the therapeutic value 
 of hypnosis is of the greatest importance. 
 
 5. In the description cited the patient time after 
 time reached this typical state of rest. And it is a 
 point upon which much stress is laid in all other 
 descriptions. Just as in this description, the impres- 
 sion is continually given, that it signifies a sensation 
 which only to a small degree can be characterized by 
 the word, rest; that it means something for which 
 speech has no word and this for the simple reason 
 that it has no existence in ordinary life. In practice 
 the word sleep must perforce, be made use of; but 
 this unfortunately always brings about a misunder- 
 standing. 
 
 The study of hypnosis is made much more difficult 
 because it very seldom appears in its pure form. In 
 general practice what, as a rule, is observed, is only 
 one or the other of the above mentioned features, sup- 
 plementing the waking condition. If the state of 
 hypnosis becomes deeper, sleep struggles to take 
 control, and the result is either one or another cross-
 
 206 History and Practice of Psychanalysis 
 
 ing with that. If hypnosis is to be seen in a purer 
 form it is necessary above all to strive after it. To 
 be convinced that this purer form does not exist and 
 to be influenced in one's work by this conviction is 
 sufficient reason for never observing it. So it is 
 possible to see very little of it if one, like Hirschlaff 
 for example, gives on an average of only ten minutes 
 for each seance; for in so short a time it is, as a 
 rule, impossible to produce the deeper state of hyp- 
 nosis. A much longer time must be counted upon if 
 one wishes to become convinced of its therapeutic ac- 
 tivity. I have very often had opportunities to ob- 
 serve how various pains, cramps and other neurotic 
 symptoms, which have not been influenced by an 
 hour's hypnotic treatment, disappear after two or 
 three hours. However it is not my intention to take 
 up here the therapeutic side of the question. That 
 demands particular work in the discussion of dif- 
 ferent cases, in order to separate the results of hyp- 
 nosis from those of suggestion. So far as I under- 
 stand it, the idea of suggestion must be stretched 
 out until it becomes all-inclusive, if a specific cura- 
 tive action in hypnosis alone is to be denied; but 
 with any such extension of an idea, science comes to 
 an end. 
 
 Before I set forth my opinion concerning the na- 
 ture of hypnosis I must make plain a few points 
 about the manner of inducing it, by the aid of which 
 I arrived at this conclusion.
 
 The Nature of Hypnosis 207 
 
 The first observation which led my thoughts in 
 this direction, I made more than eight years ago. 
 I had been called to a country estate, where a seven- 
 teen year old boy had for some years suffered from 
 headache, on account of which he had been obliged 
 to break off his studies. The pain was plainly of 
 psychic origin, and I explained this to him in all 
 its connections. I then wished to make a trial to 
 treat him hypnotically and told him to lie down upon 
 a couch. He looked at me then with much fear ex- 
 pressed in his face and asked: "Do you intend to 
 hypnotize me?" I replied in the affirmative and 
 quieted him. He then said with deep earnestness, 
 "I put myself into your hands with complete con- 
 fidence, doctor." He lay down and fell at once into a 
 deep sleep. When I awoke him some hours later, he 
 said: "It was so wonderful. When you laid your 
 hand on my forehead, I had exactly the same feeling 
 as when I was chloroformed last summer before an 
 operation for appendicitis, only with the difference 
 that this time I did not lose consciousness." After 
 this single treatment he remained definitely free from 
 headaches. 
 
 To a certain degree, hypnosis in this case, may be 
 looked upon as a reproduction of the insensibility of 
 chloroform ; that is to say, the fear in the beginning, 
 (natural before a dangerous operation), and the sud- 
 den entrance into a similar physiological condition. 
 Hypnosis would thus be the suggestive release of a
 
 208 History and Practice of Psyclianalysis 
 
 condition rehearsed in another way. But on the 
 other hand it can not be absolutely explained in 
 this way. It differed from the chloroform insensi- 
 bility, partly in that consciousness was retained, 
 partly in that there resulted an indubitable thera- 
 peutic action. I consider that the hypnosis thus be- 
 came a reflexive relapse into an earlier state of the 
 organism. This state cannot be identified with the 
 chloroform insensibility, but must be sought else- 
 where; the chloroform insensibility had simply the 
 importance of having acted as a preparation for this 
 relapse. 
 
 I have often observed something similar to this. 
 With experiences of this kind the importance of the 
 staging of the forms of sleep may be connected. 
 Especially instructive in this regard is the treatment 
 of alcoholists and morphinists. Generally these are 
 easily approached through hypnosis. In order to ex- 
 plain this fact the "dissociation of the nervous sys- 
 tem" is spoken of, but just what the meaning of this 
 phrase is, is not pointed out. It seems to me that 
 the matter ought rather to be understood as a reflex 
 reproduction of the intoxication, in the same way as 
 in the chloroform insensibility. Patients who have the 
 morphine-drowsiness fresh in mind, say almost as in 
 accord to some rule, after the first hypnotic treat- 
 ment: "It was exactly as if I had had morphine!" 
 One patient of mine, an alcoholist, looked delighted 
 and exclaimed: "That was just as good as a genu-
 
 The Nature of Hypnosis 209 
 
 ine spree!'* Here may also be found the cause for 
 the peculiar fact that desire for alcohol often dis- 
 appears after the very first hypnosis. The patient 
 no longer needs the external means for producing 
 intoxication; it comes through reflex action. The 
 further treatment is then based upon the fact that 
 the weaning from hypnosis is easier than is the wean- 
 ing from the alcohol habit. But as little as with the 
 chloroform insensibility, must hypnosis be identified 
 with the morphine- or alcohol-intoxication. The 
 woman who gave me the description of her sensations 
 while under hypnotic treatment, which I have made 
 use of in this paper, felt at first a similarity between 
 hypnosis and the morphinisms condition ; but no one 
 could possibly confound this description with a de- 
 scription of the morphine-intoxication. Considered 
 aside from this, hypnosis has a therapeutic action 
 of quite another sort than has morphine. We must 
 also in such cases allow for the fact that the poisons 
 have acted as a kind of preparation of the way. But 
 hypnosis succeeds just as well with people who have 
 never experienced such action from drugs ; that is to 
 say the return to some condition earlier experi- 
 enced, may occur without any such kind of prepara- 
 tion. 
 
 When it now becomes a question of finding out 
 when and how this condition, which during the state 
 of hypnosis takes the upper hand, is worked into the 
 organism, there is one fact which at once forces itself
 
 210 History and Practice of Psychanalysis 
 
 forward. It has been agreed upon by all investiga- 
 tors that the possibility of entering the hypnotic 
 state diminishes with years. That is to say, that 
 with each year the individual gets farther away from 
 this possibility. It is then necessary to take only 
 one step more to arrive at the following: hypnosis 
 is a temporary sinking back into that primary state 
 of rest which obtained during fetal life. 
 
 I also constitute the thing as follows : birth is a 
 violent revolution through which the hitherto har- 
 monious existence is rent asunder. The human be- 
 ing comes into touch with the external world, and 
 in connection therewith develops a new state of 
 the organism which we call the waking life. This 
 condition must be balanced by another also new 
 condition; so sleep comes. The two conditions are 
 contradictions which can be understood only in and 
 through each other. Looked at psychologically we 
 must suppose a fetal consciousness, even if this is 
 so far removed from us, that we do not see any 
 analogy at all through which we can comprehend 
 it. It is as impossible for us to imagine a life with- 
 out consciousness as to imagine an object which 
 occupies no place in space. Through the division 
 of existence at birth, a development of the conscious- 
 ness arises in two directions : the one has as its 
 goal oar wide-awake relation with the world, the 
 other our dream world. Physiologically the organ- 
 ism adjusts itself to these new demands. The ele-
 
 The Nature of Hypnosis 211 
 
 ment of destruction which the waking life carries 
 with it, makes it necessary that the organism even 
 more strongly than before, may be able to concen- 
 trate itself upon the inner reconstruction, as this 
 occurs during sleep. 
 
 But at the time of such splitting up of the primal 
 state of rest, a trace of it still is left in the organism. 
 We here find a circumstance that recurs with the 
 constructing of all new organs and functions. If 
 there is no effort toward supporting this trace, it is 
 soon covered up during the progress of life, and the 
 primal rest-state can no longer be brought into func- 
 tion. How it again is brought into the life through 
 hypnotic treatment, is connected with methods and 
 leads to questions which I cannot here discuss. 
 
 If, proceeding from this opinion concerning the 
 matter, the five characteristics of the hypnotic state 
 which I have pointed out are called to mind, it is 
 easy to understand the idea without further explana- 
 tion. 
 
 1. If we reckon only with consciousness after 
 birth, it is quite true that an existence is unrecog- 
 nized by the psychologist, where this state of primal- 
 rest is still preserved although detached things dis- 
 appear out of it. In order to understand the fact 
 that such a condition shows itself during hypnosis, 
 it is necessary to go back to the existence prior to 
 birth. No matter how little we may know con- 
 cerning consciousness as existing in that state, so
 
 History and Practice of Psychanalysis 
 
 much may be quite certain, that it is not occupied 
 with a single thing belonging to the outside world. 
 So considered it may not be too bold to presume that 
 all the Nirvana fantasies are added to this trace of 
 memory. 
 
 2. Concentration in itself takes the thought to a 
 time when that division, which the relation with the 
 world carries with it, had not yet arisen. The isola- 
 tion is a reproduction of that form in which we lived 
 when we were, as yet, unattached by any bond to 
 the external world. 
 
 3. To understand the physiological condition, it 
 must be pointed out, that the mental functions first 
 begin to act when the skin starts to play its part 
 in fixing boundaries against the outer world. What 
 is so characteristic in hypnosis, the withdrawal of 
 energy from the surface of the body, is thus noth- 
 ing but a regression to the state during an epoch 
 when this had, as yet, not been projected, when 
 the surface of the body as such did not yet exist. 
 Catalepsy is, in the same way, a regression to the 
 fetal form of muscular function. That which seems 
 to me to stand out most clearly about the cataleptic 
 state is not the fact that the extremities remain in 
 whatever uncomfortable position in which they may 
 be placed, but that this phenomenon occurs without 
 any feeling of weariness. It seems to be explainable 
 only as a regression to a state, in which the feeling 
 of weariness had not yet arisen, in which thus
 
 The Nature of Hypnosis 313 
 
 remaining in a very uncomfortable attitude was nat- 
 ural. The disappearance of pain and other phe- 
 nomena during hypnosis, becomes also in this way 
 understandable; they doubtless originate from 
 functions which may not have been in activity dur- 
 ing the fetal life. 
 
 The feeling of pressure is a re-experiencing of the 
 intra-uterine pressure. The question should be raised 
 as to whether no other traces of memory from fetal 
 life may be pointed out during hypnosis. A male 
 patient said to me after the first seance, that dur- 
 ing the whole time he had had a sensation as if 
 his body swayed back and forth as in a swing. A 
 young woman complained, after a prolonged sleep, 
 that the ground swayed under her. When I paid 
 closer attention to this, it appeared that she had 
 already had a feeling that the bed was swaying 
 under her in the same way, during the first treat- 
 ment I gave her. I reproved her for not telling me 
 this at once, so that I might have had an opportun- 
 ity to suggest the idea away. She answered that she 
 had believed this sensation to be necessarily con- 
 nected with hypnosis. That there is not more fre- 
 quent opportunity to observe such sensations, very 
 likely has its reason in the fact that the hypnotist 
 immediately tries to suppress all attempts in that 
 direction by means of counter suggestions. 
 
 4. The prominence of automatism in hypnosis 
 indicates the return to a form of life when the in-
 
 History and Practice of Psychanalyna 
 
 dividual was nothing but an automatically regulated 
 vegetative organ within the mother. 
 
 5. If this opinion is correct it is easily understood 
 how hypnosis is able to bring about a state of rest, 
 with which no other kind of rest can be compared. 
 Patients often say after an hour's hypnotic sleep, 
 that they feel more refreshed than after sleeping the 
 whole night. Only in one way is the detachment 
 from everything which keeps a tension upon us pos- 
 sible, namely through a sinking back into a condi- 
 tion when this tension had not yet begun to exist. 
 
 It ought now through experiment to be easy to 
 find confirmation of this opinion regarding the na- 
 ture of hypnosis. Unfortunately I have not had 
 opportunity to do this ; I have been obliged to satisfy 
 myself with whatever observations I could make in 
 my practice. 
 
 I should like however to give an idea of one way 
 of going about such experimentation. People who 
 have undergone psychanalysis, describe many differ- 
 ent dream situations which they carry back to the 
 fetal memory-trace. One should be able to investi- 
 gate how numerous such cases are; if hypnotism is 
 crossed with sleep and if dream-pictures present 
 themselves when the content of the waking conscious- 
 ness disappears. In actual practice it is always 
 necessary to direct the consciousness towards a de- 
 cided goal; consequently one has in practice no 
 opportunity to make such observations. But In this
 
 The Nature of Hypnosis 
 
 connection I wish to call to mind a circumstance 
 belonging to the time prior to the discovery of sug- 
 gestion, when the sleeping patient was left to him- 
 self with whatever fancies arose in his mind. It was 
 found then, that the world of imagination was gen- 
 erally ruled by one single theme, namely the internal 
 organs of the body. On account of this arose the 
 teaching concerning clairvoyance: people believed 
 that the medium was able to actually see the work- 
 ings of the various organs. It seems to me that the 
 matter ought to be explained thus : that during sleep 
 the deeply buried sensations from the fetal period, 
 again come to life and then with the assistance of 
 later acquired idea-material, construct out of them- 
 selves all those descriptions which fill the literature 
 of animal-magnetism. 
 
 Finally I want to point out the practical conclu- 
 sion of my opinion regarding the nature of hypnosis. 
 In the course of the years during which this opinion 
 was becoming constantly more clear to me, I ac- 
 quired a surer foundation for hypnotic-therapy. If 
 the opinion proves itself true it will also become 
 more clearly possible to judge than it hitherto has 
 been, in which cases treatment by hypnosis is in- 
 dicated; it will no longer be necessary as hereto- 
 fore, to fumble about in the maze of possibilities 
 and to experience disappointments in practice. 
 
 Even more important does it seem to me to be 
 that a sure way of producing hypnosis can be found
 
 216 History and Practice of Psychanalysis 
 
 in all those cases in which its use is desirable. For 
 all who are engaged in making use of hypnotism 
 as a method of treatment it may then be a certainty, 
 that the neurotic who is reachable through hypnosis, 
 has in it a powerful weapon against illness; we 
 have all probably had the bitter experience of finding 
 that our most earnest effort to produce hypnosis 
 has, sometimes, been unsuccessful and this may be 
 the chief reason why this mode of treatment does not 
 develop more rapidly. 
 
 Here then, the problem is changed. Instead of 
 asking how shall hypnosis be induced the question 
 is: how may the state of primal-rest be prevented 
 from disappearing so entirely, that it no longer can 
 be actualized? The practical answer to this ques- 
 tion is very simple. Almost without exception the 
 attempt to hypnotize a child succeeds, and if hyp- 
 notism has been practiced upon the child, it may in 
 the majority of cases be brought into activity during 
 riper years. 
 
 Neurosis is, as psychanalysis undoubtedly shows, 
 no single limited happening in the life of the adult ; 
 it is rather to be considered as a colored thread 
 which starting in childhood runs on through life and 
 twines itself around life's varied experiences in every 
 direction, trying to bring existence into a state of 
 confusion. In consequence one ought, through close 
 observation, to be able to make the diagnosis dur-
 
 The Nature of Hypnosis 217 
 
 ing childhood. If the first symptoms then can not 
 be overcome, at least the child should be given the 
 weapon which hypnosis provides, to help towards 
 overcoming the threatening enemy.
 
 VI 
 
 THE CONSCIOUS VERSUS THE UNCONSCIOUS 
 
 I WAS once spending a few days in a foreign 
 town, when a woman called upon me to get my 
 opinion regarding her case. In appearance she was 
 delicately built, and impressed me as one who had 
 suffered much. She gave me the following history : 
 At the age of twenty-four she had made a love- 
 match. She was now in her early forties. Her hus- 
 band was a professor and had always entertained 
 the warmest affection for her. She was able to say 
 that, up to the time of her present illness, her mar- 
 ried life had been an unusually happy one. She 
 had had four children who were all in good health 
 and well developed. Her way of life was frugal but 
 it was without financial worries. Her last child had 
 been born ten years prior to the time of her con- 
 sultation with me, and it was from that occurrence 
 she dated the beginning of her present condition. 
 The delivery of this child had been a very severe 
 ordeal and had been followed by puerperal fever. 
 She had been confined for many weeks to her bed, 
 lingering between life and death, and her vitality 
 
 218
 
 The Conscious Venus the Unconscious 19 
 
 had been very greatly depleted. She had since al- 
 ways imagined that this exhaustion had been the 
 cause of the condition which followed. The con- 
 nection between cause and effect had, however, re- 
 mained a secret over which she had, during all these 
 years, daily brooded. 
 
 During the attack of puerperal fever she had 
 been treated most skillfully by an elderly physician. 
 Some times he had made his call in the evening, 
 staying for a time in the twilight, merely sitting 
 quietly beside her bed. She noticed how after a 
 time, he gradually occupied more and more of her 
 thoughts, so that she began to long for his visits and 
 found the time he spent with her, the only time of 
 the whole day when she really felt any pleasure in 
 life. She guarded every word he spoke to her and 
 began finally to talk with him in her thoughts. 
 
 The feeling she entertained regarding the matter 
 became something almost sacred to her, something 
 for which she certainly, at that time, had no fear. 
 She believed that it arose only from her illness and 
 because of the fact that the doctor had a quieting 
 influence upon her. She was sure that in her inner 
 life she would return to her usual condition, as soon 
 as the illness no longer separated her from the nor- 
 mal external state of affairs. But after her re- 
 covery it quickly became clear to her that the doctor 
 had made so deep an impression upon her mind, that 
 she was unable to make herself free from him. As
 
 220 History and Practice of Psychanalysis 
 
 soon as she awoke in the morning, she saw him, 
 mentally, before her; wondered if she would, pos- 
 sibly, meet him during the day; what he might then 
 be doing; if he was thinking about her, etc. If she 
 went out she thought she saw him in every other 
 man she met. If the telephone rang, she thought, 
 "That must be he!" If she read something, in her 
 thoughts she talked it over with him. If she sat 
 alone, letting her thoughts wander where they would, 
 one fantasy after another obtruded itself upon her 
 and everything was connected with him. Shortly, in 
 every minute of the day, in everything she attempted 
 to do, he was not only present, but was even the 
 central point about which all else revolved. 
 
 These experiences were very strange to her and 
 all her pleasure in life little by little was destroyed 
 by this hopeless brooding. She was obliged over and 
 over again to ask herself, if she did in truth be- 
 long to this man and what would happen if he 
 should say to her: "Come to me." Sometimes she 
 felt herself so entirely a paitt of him that she 
 thought she would be able to give up everything else 
 for his sake. But at the same time she could not 
 believe that all her married life had been built upon 
 a lie. She belonged to her husband and her children 
 and under all circumstances would she remain in her 
 home. She talked the whole thing over with her 
 husband, but he was not able to advise her. In her 
 need she went to the doctor, with whom she now no
 
 The Conscious Versus the Unconscious 
 
 longer met, and frankly related the entire story 
 to him, hoping that this might bring relief. But it 
 did not help matters as he was quite as much at a 
 loss as her husband had been. She perceived that 
 if she did not wish to become wholly a wreck, she 
 would have to put aside all these ruinous thoughts. 
 With all the strength that was inherent in the purity 
 of her character, she struggled against the doctor 
 as against an enemy. Every hour of the day she 
 filled with useful work and in the evening went, ex- 
 hausted, to bed. Only after some years of this was 
 she successful in feeling a sense of freedom for per- 
 haps half an hour or a little more during the day. 
 In this way she had lived for ten whole years. 
 
 The history of course turned my thoughts into a 
 definite direction. I asked her some questions about 
 her childhood and more about her married life. 
 
 She had been brought up under happy circum- 
 stances. Her father was a teacher. Both parents 
 were still living. She had one brother and the 
 parents were accustomed to say that he was his 
 mother's boy while she belonged to her father. As 
 a little child she has been often ill and at such times 
 she had been treated by her father with the greatest 
 tenderness. She could still recall the nights of fever 
 when he had sat beside her bed. She had loved him 
 with all the fanciful adoration of a child. One detail 
 directed my attention to the great influence he had 
 had upon the development of her life. At her con-
 
 222 History and Practice of Pgychanalysis 
 
 firmation, he had given her a book in which he had 
 written some lines. These words had burned them- 
 selves into her mind and had become the guiding 
 motive of her whole life. 
 
 As to her married life, the fact that her husband 
 was delicate at the time of their marriage, played 
 a certain role. The feeling of love for him had come 
 upon her gradually. A friend had been accustomed 
 to say to her: "That man should be your husband. 
 You could make something of him and help him 
 recover his health." Undoubtedly the mother-feeling 
 for the man was one of the chief ingredients in the 
 emotional-complex of her love and it continued so to 
 be in the time that followed. But she had had noth- 
 ing to regret. With great satisfaction she had real- 
 ized how her husband became happier and healthier. 
 She had herself always been dearly loved by him 
 and in the beginning had been as much satisfied as a 
 wife, generally speaking perhaps, can be. Neverthe- 
 less, there was in her life a kind of emptiness from 
 which she was unable to escape and which, as the 
 years went by, increased. On the one hand she 
 sometimes felt a passing erotic emotion towards men 
 whom she occasionally met and whom she did not at 
 all wish to approach. This troubled her very much. 
 In her secret thoughts always she wished to remain 
 true to her husband. She brooded over the question 
 as to whether there was some defect in him, or if 
 she herself were really a bad woman, or if perhaps,
 
 The Conscious Versus the Unconscious 223 
 
 every woman had something of this feeling. On the 
 other hand she was sometimes tortured by an un- 
 comfortable, undefined longing. It was hard for her 
 to describe in words, just in what this consisted. 
 She could express it best perhaps by saying that she 
 wished that she might for once be loved, not as a 
 mother, not as a wife, but exclusively for her own 
 sake, quite independently of the question as to 
 whether she were useful to her husband or not. 
 Some depths in her innate womanly nature revolted 
 against the married life. She was ashamed of it but 
 she could not deny it. 
 
 Here apparently was an example of Freud's dis- 
 covery of the transference of the father-complex to 
 the doctor. 
 
 The explanation of this idea made a deep impres- 
 sion upon the patient. On the one hand she at once 
 got hold of a vague idea that this was the secret 
 of her trouble; on the other hand she understood 
 that she would never have been able to discover it 
 for herself, even if she had pondered over it the 
 whole of her life through. 
 
 When she returned to me the following day, she 
 was able to relate many details which, in the inter- 
 val, had come into her mind and which confirmed 
 my theory. Among those compulsion-fantasies 
 which had the doctor as their central point, the fol- 
 lowing riddle for example, came back again and 
 again: she seemed to be sitting on a little footstool
 
 History and Practice of Psyclianalysis 
 
 in the corner of a room. The doctor was walking 
 up and down reading a book. She sat quite still, 
 listening to his footsteps and feeling the greatest 
 contentment. She recognized here the newly-con- 
 structed impression of a recollection from childhood. 
 Just like this she had been accustomed to sit upon 
 a footstool in a corner of her father's study and he 
 had had the habit of walking in this way, up and 
 down as he read. She had often, too, pondered over 
 the following detail : When in imagination she again 
 lived through the visit of the doctor, she recalled 
 how he never rang as other visitors did; he opened 
 the door for himself and she heard his steps at once 
 outside in the entrance hall. Just in this way had 
 she always heard her father when he came home. 
 Shortly one problem after another found its natural 
 solution. 
 
 There is nothing novel in this history. I have se- 
 lected it because of its unusual simplicity and 
 because to me it seems rather well adapted for throw- 
 ing light upon a question which in my opinion in- 
 volves the cardinal point in psychanalytical-therapy. 
 In this case we confront a division of the personality 
 into two parts between which the patient wavers, 
 unable to find rest in either direction. One part con- 
 sists of the past life, the childhood, condensed in the
 
 The Conscious Versus the Unconscious 225 
 
 figure of the father; the other consists of the pres- 
 ent which has its center in the married life and in 
 everything connected with that. It may also be said 
 that one part consists of the repressed portion of the 
 life, that is to say, of the unconscious; the other of 
 the conscious. The neurosis arose because the or- 
 ganization of these two worlds which had been built 
 up in the course of the patient's life, was broken up 
 so that in her actual life two opposing complexes, 
 which under normal circumstances must have ex- 
 cluded each other, began to struggle against each 
 other. It resulted in the situation: the conscious 
 versus the unconscious. Something akin to this is to 
 be found in every form of neurosis. What is to be 
 said concerning this case may therefore easily be 
 applicable to every case. 
 
 At the point in the description of the case where 
 I broke off, the unconscious confusion lay broadly 
 before me. But by means of such an explanation 
 the patient is not helped. Notwithstanding the fact 
 that the intellect can grasp the condition of com- 
 pulsion, the patient remains as unhappy as before. 
 The question must present itself : "What shall I now 
 do? In what way can this new knowledge aid me?" 
 And subsequently the analyst must ask himself: 
 "How shall I proceed with this treatment?" 
 
 The question has become a very real ottie in 
 psychanalysis. It is, e. g., to be found in the last 
 number (1913, No. IV) "Die Zietschrift fur
 
 226 History and Practice of Psychanalyria 
 
 artzliche Psychoanalyse," in Ferenczi's article on 
 Jung's "Wandlungen und Symbole der Libido." He 
 
 He (Jung) considers the most important factor 
 in the treatment of nervous patients to be the guiding 
 back to the road of reality, from which they have 
 been turned aside. But we still maintain that the 
 closest and most important realities for the patient 
 are the symptoms of his illness, and that because of 
 this we should be concerned only with these. When 
 one directs the attention of the patient upon his life- 
 work it results only in making him suffer the more, 
 because of his inability to perform that work. The 
 life-plan of the patient ought not to be taken into 
 consideration in making the analysis ; if it is carried 
 deeply enough the patient finds a way out of his 
 difficulty for himself, without assistance. The prop- 
 er analytical technique must try to make the patient 
 so independent of the analyst that he will no longer 
 care for his advice. 
 
 According to Ferenczi therefore the matter should 
 be treated in the following manner: one should be- 
 gin in the usual way and through free associations 
 bring still more material out of the unconscious. 
 This should be done without any tendency on the 
 part of the analyst; that is to say, the analyst 
 should work in the same manner as a chemist who 
 decomposes some substance into its elements. Prac- 
 tically, in the case under consideration the method 
 would be as follows: we should here break up the
 
 The Conscious Versus the Unconscious 227 
 
 whole related history into its separate parts as a 
 dream is broken up, with its separate dream-pic- 
 tures, and investigate each and every one of these 
 parts to discover what is hidden therein. We 
 should examine every passing erotic-inclination and 
 bring every possible thing to light in all that has 
 connection with it. Every memory from childhood, 
 every experience of the married-life should be treated 
 in the same way and after this the patient should 
 be dismissed. 
 
 The first question which now arises is this: 
 Can analysis ever be made so entirely free from the 
 assumption of something, as it should be, if a prin- 
 ciple like this is followed? 
 
 Opponents of psychanalysis often assert that the 
 analyst always knows just what the end of the 
 analysis will be as soon as the beginning of it is 
 known. I will not say if there is any truth in that 
 opinion or not. But I believe that it is not pos- 
 sible to remain entirely free from assumptions. Un- 
 less the analyst makes the case clear for himself and 
 if during the treatment he is not led by a general 
 opinion of the individual situation, there is danger 
 always of being guided by an assumed theory. No 
 one can assert any injustice towards psychanalysts 
 on my behalf, if I say that I believe that there are 
 those who in the case cited, would eventually have 
 arrived at the incest-complex. They would have so 
 tonducted the analysis that, through free associa-
 
 228 History and Practice of Psyclianalysis 
 
 tions, they might bring into light the idea that all 
 the erotic inclinations were substitutes for the father 
 and that the experiences of the married-life were car- 
 ried over from childhood memories. The prevailing 
 theory is so firmly fixed in many heads, that it over- 
 rules all other directing motives. We must all agree 
 that life cannot be compressed into any one theory, 
 even if this has its origin in the highest genius and 
 appears to be all-embracing. 
 
 In working out the analysis of a life in its vary- 
 ing fluctuations, one ought never to begin from a 
 point external to the individual; the point from 
 which the analysis is begun, must be sought for with- 
 in the individual. In reading reports of the ordinary 
 analyses it is difficult not to wonder if the resistance 
 of the patient is not a resistance against the theory 
 of the analyst rather than against the truth. If an 
 individual opposes himself against truth it is un- 
 natural and must be overcome, but if he opposes 
 himself against the fixing of his mind into a strange 
 theory, then it is the result of the instinctive feeling 
 of self-preservation, and this should be respected. 
 
 But if I take the position that analysis can be 
 carried out without theoretical assumptions, the 
 question arises, what is the therapeutic value of per- 
 mitting the unconscious material of life to inundate 
 the consciousness in this way. 
 
 It is possible to argue the question after which 
 principle the unconscious material of life is ar-
 
 The Conscious Versus the Unconscious 229 
 
 ranged, that is to say if it is entirely subordinated 
 to the lust-principle or not. One thing may be sure, 
 viz : it is not arranged after any principle that means 
 an absolute adaptation to life. I mean, when it is 
 made apparent to the consciousness, it does not 
 automatically arrange itself so that the patient im- 
 mediately finds his way back to life. To believe 
 something like that, would be to make of the uncon- 
 scious a god. In comparison with the consciousness, 
 the unconscious contains something of chaos. Now 
 the neurosis consists in the fact that the patient 
 has not been able to discover a way out of that part 
 of life which he, hitherto, has known. How then 
 would he find his way out of the new chaos? Imagine 
 for instance the patient in the case here cited. 
 Hitherto she had lived in a kind of hell because she 
 did not know whether her life was bound up with 
 that of the doctor or with that of her husband. Now 
 in addition, she must ponder the question whether 
 she may not in the same way be bound up with any 
 of those other men for whom she had had a fleeting 
 erotic inclination. So would she become entangled in 
 a thousand new problems. 
 
 What Ferenczi says concerning the purpose of 
 making the patient independent of the analyst is 
 quite justifiable. But the patient never becomes so 
 before he has acquired a genuine connection with life. 
 The leaving of a patient in a condition wherein he 
 finds his life becoming only a much more difficult
 
 230 History and Practice of Psychanalysis 
 
 problem to solve, means that he must either remain 
 a neurotic or else seek help in some other direc- 
 tion. 
 
 To me it seems that this fundamental principle of 
 psychanalysis is the remnant of its first epoch. At 
 that time there was belief in a solution by way of 
 intellectuality; if repressed wishes only could come 
 into the consciousness, everything would regulate 
 itself. That opinion has of course been changed. 
 But analysis is nevertheless made use of in a way 
 that makes it appear that the opinion is still ten- 
 able. 
 
 This epoch brought us much new information con- 
 cerning the unconscious life, and there can be no 
 doubt that further work along these lines will show 
 still richer results. But that is a scientific matter 
 which only indirectly has a therapeutic value. I 
 believe that a clearer standpoint upon these ques- 
 tions can only be reached when we separate science 
 more decidedly than is generally done, from the art 
 of healing. Here we have something analogous to 
 that which occurred in the first days of the hypnotic 
 era. Nobody is likely to try to refute the great 
 scientific value of Charcot's explanation of hysteria. 
 That the experiments he made had any therapeutic 
 worth he did not himself pretend. To me, it seems 
 that the violent attacks against psychanalysis some- 
 times have root in the fact that something is claimed 
 for therapeutics, which really has only scientific
 
 The Conscious Versus the Unconscious 281 
 
 value. Therapeutics is more decidedly an art in it- 
 self and must not be subordinated to science. 
 
 I am therefore unable to agree with Ferenczi con- 
 cerning the matter of the continuation of the treat- 
 ment in the case cited. I rather here, ally myself to 
 Jung's opinion : the task of the physician is to show 
 the patient the way to reality ; and in order to avoid 
 misconceptions I should like to point out what I 
 mean by the word "reality." In introducing into 
 empirical research an idea which has been mishandled 
 by metaphysical philosophy, there is easily danger of 
 introducing something of speculation which is out 
 of place there. In looking at anything from the 
 empirical point of view we are living in a world of 
 relative conditions; an absolute reality never comes 
 into question. It is only an adaptation of one's self 
 to the external part of existing relative conditions 
 and that adaptation must be looked upon as the 
 best possible one, which, in the highest degree de- 
 velops pleasure, the making free of forces, power 
 over one's life, in short everything that for us 
 means the affirmation of life itself. Instead of seek- 
 ing after absolute reality, that which has the highest 
 reality value should be sought. 
 
 According to Jung it is not enough that the ma- 
 terial of the unconscious life be brought to light. 
 It is necessary that the patient be taught to attain 
 power over it, to apprehend the difference between 
 actuality and illusion. An understanding must be
 
 232 History and Practice of Psydianalysis 
 
 accorded him, as to where the different ways be- 
 tween which he has to choose, will lead, etc. Psych- 
 analysis here ceases to be something for itself alone 
 and becomes subordinated to a principle which may 
 be considered the chief principle of psychotherapy. 
 Here is a bridge which joins psychanalysis to other 
 psychotherapeutic endeavors. The analysis must 
 be gone through with because the road to reality is 
 blocked by unconscious complexes, because the pa- 
 tient is driven away from that road by unconscious 
 forces, not because the analysis in itself has any 
 healing value. 
 
 But in replying to the question as to the continua- 
 tion of the treatment in this way, the answer is by 
 no means made clear. We have arrived only at 
 that place where we stand before the real cardinal 
 point of psychanalytical-therapy. This may be for- 
 mulated as follows : ought the highest reality value 
 to be placed upon the unconscious or upon the con- 
 scious life? I said before that that point should 
 be sought within the patient, from which life shall 
 be made clear to him ; in this search then, ought the 
 central point of the conscious or that of the uncon- 
 scious mind be chosen? 
 
 This question must have a decided answer, if, as 
 in the case cited in this paper, the unconscious mind 
 is in such a struggle with the conscious, that no 
 accommodation is possible, that either the one or 
 the other must become subordinated. Briefly, the
 
 The Conscious Versus the Unconscious 233 
 
 question must be decided as to whether the father- 
 complex or the later years are to be declared the 
 factor which played the part of reality in the pa- 
 tient's life; upon this decision hangs the following 
 interpretation of the case. 
 
 If the first possibility is chosen, the patient would 
 be addressed something like this : "You have idolized 
 your father and he has dominated the whole de- 
 velopment of your life. Have you really ever be- 
 come free from him? I can scarcely believe so. 
 What was it that held you back at the time when 
 first you met the man who afterwards became your 
 husband? It was that bond which attached you to 
 your father. To sacrifice him would have meant to 
 sacrifice so much of yourself that never again could 
 you have found happiness in life. The feeling you 
 have for your father you call love, and doubtless 
 you have regarded it as something ideal. If you 
 examine it more clearly you will discover that this 
 feeling was not entirely free from sensuality. It was 
 a sensual pleasure to you when he cared for you. If 
 you recall the sensations with which you were filled 
 when he touched you, caressed you, dressed you, 
 put you to bed, you will find that the body played 
 a great part in all this. That you have never been 
 free in your sexual-life is evident from the passing 
 erotic inclinations you have described. You have 
 always longed in vain for something. This inability 
 to become free has its root in the fact that your
 
 234 History and Practice of Psychanalysis 
 
 sexual impulses have been bound up in your father. 
 Neither in the ideal love nor in the sensual love 
 have you succeeded in breaking loose from him. All 
 that which you have lived in the past has been a sub- 
 stitute for him. Especially has the love for your 
 husband been such a substitute. For a certain num- 
 ber of years you succeeded in maintaining the illu- 
 sion of freedom in the married life. But nature can- 
 not be driven away. When you became ill and so 
 no longer had the power to keep nature from you 
 by means of self-suggestions of happiness, the father 
 once more laid claim to that which already was his. 
 This time he came to you embodied in the doctor. 
 Upon this doctor you were able to transfer in high- 
 est degree, the love for your father; in speaking 
 of love in connection with your life, it would mean 
 this feeling to which we must refer. Your father 
 is the substituted picture. Had you been able to 
 follow this feeling you could also have experienced 
 a much stronger sexual freedom when in the married 
 life," etc. 
 
 It must, however, be made clear that if the patient 
 had been shown this way to reality, in the further 
 analysis one would expect to find more testimony for 
 the supposition that this way was the right one. 
 The unconscious mechanism is thus fixed upon as 
 the reality and everything that is brought to light 
 appears as a ratification of it. If this way is false 
 it may never be amenable to correction ; the patient
 
 The Conscious Venus the Unconscious 235 
 
 will be driven still farther on the already chosen 
 path. Resistances which try to block the path will 
 be regarded as resistances which must be overcome. 
 The patient struggles against a change of the values 
 in life, which seem doubtful to him. This struggle 
 is really just as definite as the struggle which a fixed 
 theory involves. 
 
 I do not know if any analyst would use analysis 
 just in this way. In the literature concerning it 
 there is sometimes a tendency in this direction. The 
 reason for this is that sexuality is looked upon as a 
 fixed system of forces which can be repressed, but 
 not made free. Now since incest is the nucleus of 
 this system of forces it would be the final conse- 
 quence of the whole idea to declare that one must 
 adapt one's self to incest if one would arrive at actual 
 sexual freedom at all. It is a fact that Freud has 
 already reached this conclusion. To me it is hard 
 to make anything else out of the following lines: 
 "It sounds unpleasant and it is still more para- 
 doxical, but it must nevertheless be said, that, who- 
 ever would be really free and therefore happy in the 
 love-life must give up respect for women and adapt 
 himself to the idea of incest with mother and sis- 
 ter." * It would have been very considerate to say 
 the least, if Freud had given an example from his own 
 
 * Freud. Beitrage zur Psychology des Liebeslebens. Jahr- 
 buch fur psychoanalytische und psychopathologische For- 
 schung. Band IV. Heft 1.
 
 236 History and Practice of Psychanalysis 
 
 knowledge wherein any contemporary human-being 
 had arrived at happiness and inner freedom by way 
 of incestuous practices. If a theory leads to con- 
 sequences which evidently are contrary to the most 
 simple facts, there must be some falsity in its fun- 
 damental principles. 
 
 Jung's libido-opinion upon this point must be ac- 
 knowledged as an invaluable step ahead. He re- 
 moves from the idea that rigidity which not only is 
 strange to the libido but to all that concerns life 
 itself. Instead he puts into the idea the faculty for 
 transformation which is everywhere to be observed. 
 As I agree with Jung in my opinion as to the pur- 
 pose of the treatment of the case under considera- 
 tion, I must also agree with him on this point. 
 
 Every tendency which proclaims the unconscious 
 mind to be the reality and leads the patient to adapt 
 himself to its mechanism, I regard as false. If a 
 choice must necessarily be made between the un- 
 conscious and the conscious it seems to me evident 
 that the highest reality belongs to the conscious life. 
 If I should give my reasons for this belief, it would 
 lead to a discussion of the nature of the unconscious 
 mind which would go beyond the limits of this paper. 
 I must therefore confine myself to a relation of the 
 leading thoughts in my actual talk with the pa- 
 tient. 
 
 I said to her something like the following: "The 
 nucleus of your illness lies in the fact that uncon-
 
 The Conscious Versus the Unconscious 237 
 
 sciously you have confounded the personality of 
 your father with that of the doctor. What you must 
 now do is to get a right comprehension of this mis- 
 take and then you will also understand how to make 
 yourself free from the consequences of it. 
 
 "Life is a process of creation, through which every 
 day, every minute, we endeavor to produce a value 
 out of the material of the time that has passed. 
 During the puerperal fever you became separated 
 from the incessant progressive production of the 
 real being. Instead of making use of the present, 
 instead of advancing towards the future, you sank 
 back into a time gone by. Present reality disap- 
 peared, as far as you were concerned, and that part 
 of your life through which you already had passed 
 became your actual state of existence. Because of 
 the illness you again became a little, helpless child; 
 the nights of fever in your childhood and the mem- 
 ories bound up in these, once more filled your con- 
 sciousness. You again felt a yearning for the bliss 
 you had experienced when your father cared for you 
 in your helplessness. Too exhausted to bring about 
 that correction which belongs to the normal process 
 of life, every longing fancy was changed into a fact. 
 When you felt the doctor near you, his personality 
 was so interwoven with the memory of your father 
 that you were unable to separate one thread from 
 another. As you returned after your convales- 
 cence, to reality, you brought with you this fragment
 
 38 History and Practice of Psych analysis 
 
 of illusion into your daily life. That you have 
 clung to it with such tenacity, has a special rea- 
 son. You have told me about a feeling of emptiness 
 in your life, about an incomprehensible, haunting 
 longing. On the one hand your married life has not 
 become what you desired; on the other, you have 
 revolted against filling up this emptiness with an 
 intrigue with any of those for whom you have had 
 a passing erotic feeling. Notwithstanding your con- 
 sideration for husband and children, you have felt 
 instinctively that you were not upon the right road. 
 During your exhaustion you glided out of real life 
 and then a new way of filling the emptiness arose, 
 namely that of fantasy or illusion. Then out of 
 the past you dug up that situation which most close- 
 ly corresponded to that for which you yearned. You 
 wanted to be loved for your own sake alone, setting 
 aside the question as to whether or not you were 
 useful to your husband. Such a love as this, in its 
 deepest sense, exists only in the heart of the parent 
 for the child. Among grown people, a kind of 
 reciprocity always plays a part in love. So you 
 saved yourself from being undeceived concerning 
 what life had in store for you, by going back to the 
 early days of your childhood; then you were torn 
 between two worlds, between that of the child and 
 that of the adult. But now you must go farther in 
 the creating of your real existence. Your illness 
 should mean nothing to you excepting that you have
 
 The Conscious Versus the Unconscious 289 
 
 gone back for the purpose of fetching a lost value, 
 which you wanted to maintain in your life. You 
 can be happy in the fact that your love-life became 
 so well fixed as it did in your childhood years, in 
 your connection with your father; but that should 
 be a fact in itself, which ought not to be mixed up 
 with your life as a married woman. Nothing would 
 have been more fatal than if you had been able to 
 give way to your feeling for the doctor ; that would 
 have meant the running after an illusion ; so your 
 life would probably have come into hopeless confu- 
 sion. You may be sure that your married life is 
 built up upon a safe foundation. If, however, it 
 has not brought you entire gratification, it is not 
 impossible that it will do so in the future. This will 
 come to pass the more, just as you the more find in 
 it an outlet for all the dammed-up feeling in your 
 heart. Apparently much depends upon your hus- 
 band. If he brings to you real understanding for 
 what you suffer, he will be able to fill the emptiness 
 which has hitherto been a factor in your life. In 
 any case you must make use of all your forces to 
 free yourself from this unreal part of your life and 
 to develop your married life to the highest possible 
 degree of perfection." 
 
 If psychanalysis is used in this way as a means by 
 which the patient is helped to come back to reality
 
 240 History and Practice of Psychanalysis 
 
 and if it is regarded as the desired conscious adap- 
 tation to life, the treatment will not be carried on so 
 irrelevantly. 
 
 For example as regards the length of time needed. 
 The contention is often made that psychanalysis is 
 a very tedious method. But what makes this tedi- 
 ousness necessary is the accumulation of material 
 from the unconscious mind. In confining one's self to 
 the exposition of the unconscious connections in 
 broad lines, the position will be different. As an 
 example I can once more use the case cited. As I 
 shall quickly show, this treatment reached as satis- 
 factory a result as could be wished for; and for this 
 only three hours were necessary. I make no claim 
 that such great curtailment may as a rule, be looked 
 for, I will only emphasize that under fortunate cir- 
 cumstances it is possible. What made it possible in 
 this case was the fact that the disturbance had not 
 advanced to the state when nervous symptoms were 
 produced. The conflict was yet in a sort of pro- 
 longed nascent state. If compulsion- or conversion- 
 symptoms had developed the treatment must have 
 been of much longer duration. Under such circum- 
 stances much material is necessary for the purpose 
 of convincing the patient of the real connections ; 
 the facts which show that the interpretation is the 
 correct one must be brought up over and over again. 
 And this may take years. 
 
 But there is still another thing which may make
 
 The Conscious Versus the Unconscious 
 
 the treatment tedious and that is the fact that 
 psychic changes come about slowly. . Opposing such 
 curtailment as was reached in this case, it may be 
 asserted that in the course of days or weeks no 
 result can be observed. The neurosis is not a lim- 
 ited episode in the life of the patient. The neurosis 
 is a thread that starts at birth and ends with death. 
 The treatment brings about a change; the value of 
 this change really can be appreciated only when a 
 view over the whole life is obtained. The greatest 
 change is a change from a negative to a positive 
 state of existence. The purpose is reached when the 
 neurotic condition has been transformed, so that it 
 serves in life as do other forces. But this as a 
 general thing, comes about only through develop- 
 ment after the treatment. Only examination of what 
 goes on in the inner life of the patient after a con- 
 siderable lapse of time subsequent to the end of the 
 treatment, can give an insight into its importance. 
 In order to more closely explain this point I will 
 come back to the case. 
 
 In spite of the purely practical advantages of the 
 manner in which the treatment of this case could 
 be curtailed, it seems to be significant in another 
 way, viz: in regard to the matter of the transfer- 
 ence. 
 
 The transference of the father-complex to the per- 
 sonality of the doctor is a scientific fact; but I do 
 not ascribe to this process the therapeutic value
 
 242 History and Practice of Psychanalysis 
 
 which is generally accorded it. No case can more 
 plainly show than can this case, what transference 
 fundamentally means to the patient. In this par- 
 ticular case an illusion was brought into the pa- 
 tient's life which became the nucleus for compulsion- 
 neurosis ; if circumstances are seldom so evident as 
 in this case, I nevertheless believe that transference 
 generally means something of a similar nature, that 
 is to say, a confusion in the creation of the real 
 existence. Life is composed of genuine connections, 
 not of imago-connections. The claim is made that 
 the transference is broken up during the course of 
 the treatment. But is the patient not overrated on 
 this point? If an individual, in the course of some 
 years, has confided all his secrets to another and 
 permitted this other to look into all his thoughts, all 
 his feelings, a psychological connection becomes 
 established which neither by command nor by analy- 
 sis can be broken off. Fundamentally there are only 
 two 'possibilities : either the patient must arrange 
 a connection with the analyst similar to that which 
 the Romanist occupies in connection with his confes- 
 sor, or else the connection must suddenly be broken 
 off, which alternative for the patient means as a rule 
 a severe catastrophy. The first alternative is more 
 agreeable for the patient, the second for the doctor, 
 but both are so difficult that a third possibility seems 
 to be necessary. Such a one arises in the way in 
 which the connection with the doctor is reduced, and
 
 The Conscious Versus the Unconscious 243 
 
 also as much as possible, the transference upon him ; 
 no real arrangement ever takes place at all, but the 
 doctor disappears as soon as his role as intermediary 
 between the patient and reality is played out. 
 
 Against this way of making use of psychanalysis, 
 some objections may be made. In the first place it 
 may be asserted that this is not psychanalysis, and 
 it is not if the word is confined within the limits 
 used by Freud. But it must be so regarded, never- 
 theless, because analysis of the psychic confusion 
 was absolutely necessary for the recovery of the pa- 
 tient. Without clear comprehension of the transfer- 
 ence and regression no one would have been able to 
 help in this case. 
 
 In the second place it may be said : psychanaly- 
 sis endeavors to give the patient power over the un- 
 conscious ; the extension of consciousness never can 
 be injurious. It must therefore be regarded as a 
 fault of principle to confine analysis to narrow 
 boundaries, etc. 
 
 Regarding the first point it must be maintained 
 that psychotherapy in general tries to increase the 
 power over life. But power over life and power over 
 the unconscious ought not to be considered as iden- 
 tical. Making a patient live over again hundreds 
 of analerotic memories from childhood does not mean 
 necessarily the giving to him of higher power over 
 his present life. It may mean so, if this complex 
 has acted as an obstructive force in his life; unless
 
 244 History and Practice of Psychanalysis 
 
 this is the case, such analysis has just the contrary 
 effect to that after which it strives. It, in such a 
 case, directs the attention and through this, the phys- 
 ical energy, to past unessentials, instead of turning 
 the energy towards things of the future which are 
 essential; and by so doing the power over life is 
 diminished. 
 
 The discussion of this subject as well as of sim- 
 ilar objections has but slight interest. The question 
 in hand is a practical one and everything hangs upon 
 the answer given by the immediate practical results. 
 Had I not obtained good results in the case I have 
 here set forth, I should have kept to a more dog- 
 matic way of using psychanalysis. Some further ex- 
 planation of the case seems to me to be suitable 
 for throwing light upon the question and for refuting 
 possible objections. 
 
 I have not seen the patient since the treatment as 
 herein described, was concluded. But a year and a 
 half later I received a letter from which I may quote 
 some lines; not only because I look upon them as 
 confirmation of the correctness of my opinion, but 
 chiefly because they give a more intimate glimpse 
 than any description at second hand can give, of 
 that which took place within her mind after that 
 time. If anyone should perhaps scoff at the some- 
 what fantastic style in which this letter is written, I 
 will add that the patient belonged to a family from 
 which sprang a great poet, and that she herself had
 
 The Conscious Versus the Unconscious 245 
 
 been brought up in an atmosphere of poetry. But 
 if anyone draws the conclusion from this rather 
 gushing letter, that the patient after treatment, was 
 just as hysterical as before, I shall reply, that an 
 analyst or physician, has nothing to do with the 
 personality of the patient; his task only is to help 
 the patient to come into that right connection with 
 life in which he originally was created, into inti- 
 mate touch again with what life itself means and al- 
 ways must mean. 
 
 The letter was as follows: 
 
 Saved absolutely and forever I send you 
 greeting, in greatest surety and most thankful 
 memory. There is no power which cannot be used 
 to a higher value. In this fact is found the entire 
 unity between me and my husband, which has strug- 
 gled through to victory. 
 
 That night after taking leave of you, something 
 happened to the child-wife, whose path crossed yours 
 in X. For this I want to try to find an understand- 
 able expression. That which in my mind had been 
 divided into two observers, each always making a 
 different judgment; into two wills separated en- 
 tirely in one moment, the one from the other, and 
 my thought took the direction which you had pointed 
 out. On the one hand there was I, myself, alive, con- 
 scious, undivided, on the other hand was the dead 
 illusory part of me, the morbid excrescence, the 
 parasite. Reality and unreality were torn apart. 
 What an experience ! What an intoxicating feeling 
 of freedom! Was this health? Could life be so
 
 246 History and Practice of Psychanalygis 
 
 wonderful? Do well people know what it is they 
 have? What injustice against those who fight a 
 double fight! Make free a bird from its cage and 
 ask if it thanks you! 
 
 Still on the side of reality something was left 
 which threatened me with a struggle. The power 
 which was hidden in it must be turned into another 
 direction. Its very roots must be forked out. Dear- 
 er than the dearest at this moment seemed to me to 
 be the object for this struggle. To give it up was 
 the same as to give up my own existence or to say 
 the least, all further unfoldment of that existence. 
 But out of the unexplored depths a voice cried to me, 
 with the power of the Eternal: "Look not there! 
 Look here! Dare to take the leap! It means more 
 than your life." . . . The act is the growth of the 
 decision; if he (my husband) would but give me 
 the chance to speak ! Driven by an irresistible neces- 
 sity the wife seized the opportunity; she laid bare 
 the facts, she implored forgiveness as only one does 
 who looks death in the face. And she met with sim- 
 ple honesty, love of truth and respect! ... It 
 seemed to me finally as if all my weal and woe hung 
 upon the first syllable he uttered. He might kill 
 me, anything but silence. That I could not have 
 borne. He answered: "Forgive me; the fault was 
 mine." Then welled forth the stream which like a 
 cleansing bath flowed over our souls, over our des- 
 tinies, over the years gone by, over days and nights, 
 hours, minutes, seconds . . . the stream which made 
 everything pure, which renewed and strengthened. 
 And which, united with the freest of bonds, thus 
 bound us together. . . . And yet there was some- 
 thing, this woman would have: to meet with some
 
 The Conscious Versus the Unconscious 247 
 
 one like herself who could rightly estimate the thing 
 which was crystallizing in her mind; with some one 
 who could understand that which had been discovered 
 and appreciated by a stranger. Still remained then 
 an expression of the desire "to be loved for her own 
 sake alone." And was this very thing not looming in 
 the distance, did she not begin to be sensible of that 
 for which she so passionately had longed? . . . Since 
 then everything has been like a Te Deum. . . . 
 Everything, from the smallest to the greatest, has 
 become inestimably full of meaning. Everything, in 
 the great whole, has found its place. With folded 
 hands the child-wife has gone her way, as if she 
 were looking beyond herself as if the reins had 
 been taken in hand by the conscious will, while she 
 heard a decided command: Not there no, here 
 must you go ! Greater depths must you penetrate ! 
 Self-sacrifice , , ,
 
 VII 
 
 EXTRACT FROM A CASE-HISTORY 
 
 THE following is the essential history of a case, 
 in the treatment of which I was successful in 
 dissolving analytically, a strongly constituted sys- 
 tem of persecution of ten years standing, and in giv- 
 ing the patient, an unmarried woman of fifty-three 
 years of age, complete comprehension of her illness. 
 Since the end of the treatment in April, 1910, this 
 patient has exhibited no trace of mental disease or of 
 mental weakness. It will be my effort here not only 
 to give a description of the patient before and after 
 the treatment she received from me, but also and 
 chiefly, to try to make plain how the change in her 
 mentality came about. I shall thus endeavor to 
 trace out the forces which had been in action during 
 the formation of the illness and also those through 
 which it was broken up. 
 
 The patient came to see me for the first time on 
 December 10th, 1909. She brought with her a let- 
 ter from Miss K., a woman who is famous in the so- 
 called feminist movement. This letter the patient 
 
 248
 
 Extract from a Case-History 249 
 
 asked me to read. I found that it was partly an 
 assurance that neither the head of the firm in which 
 the patient was employed, nor, so far as the writer 
 knew, anyone else, had ever entertained a deroga- 
 tory opinion of the patient; partly the letter was 
 written to earnestly advise the patient to consult 
 me for the purpose of a chance of being made free 
 from her wrong way of thinking. 
 
 The patient at once assured me that she had not 
 come to me to talk over what might be revolving 
 in her mind. She said that for many years she had 
 suffered from struma, and that because of this she 
 was exceedingly nervous. She hoped that I might 
 possibly be able to help her by means of hypnotic 
 treatment. She had been told that such treatment 
 had sometimes been successful in causing goitre to 
 disappear. If the nervousness which was caused by 
 this trouble could be lessened, she felt that she might 
 perhaps be able to better resist the people who per- 
 secuted her. It had come to the point where she must 
 get some help, for now there was no limit to the 
 insolence of these people. The situation in which she 
 found herself was simply unbearable. 
 
 I asked her some questions about the letter. 
 
 She told me that she had had the temerity to write 
 to Miss K., knowing that she was a friend of the 
 manager of the office in which she, the patient, was 
 employed, and feeling that matters had reached a 
 point where this manager must take some action
 
 250 History and Practice of Psyclianalysis 
 
 regarding the daily misconduct, there directed 
 against herself. All complaints of her own had ac- 
 complished nothing. She had also formerly believed 
 that Miss K. was herself a central point in the con- 
 spiracy against her, particularly as she was sure 
 that Miss K. had sown many of the seeds of this con- 
 spiracy during her travels on the continent. The 
 contents of the letter, however, had caused the 
 patient much astonishment. Nevertheless if it were 
 actually a fact that Miss K. knew nothing about 
 this persecution of which she was the victim, it would 
 not in the least alter things. 
 
 Other evidences were innumerable, pouring in upon 
 her daily from every direction. She plainly consid- 
 ered it superfluous to tell me anything about this, 
 as naturally I must already know her history and 
 the details of that persecution to which she was 
 subjected. 
 
 Upon my denial of all such knowledge, the pa- 
 tient again seemed much surprised and at first dis- 
 inclined to credit me. However she permitted herself 
 to be persuaded that I actually was in ignorance of 
 the matter. Gradually I drew her into a conversa- 
 tion concerning this persecution, which I may here 
 condense as follows: 
 
 She noticed the persecution through various kinds 
 of signs, as for instance, people scraping with their 
 feet, making peculiar movements with the legs and 
 arms, showing her pencils, scissors and similar ol>-
 
 Extract from a Case-History 251 
 
 jects for the express purpose of insulting her; but 
 the worst thing was that people stuck out their 
 tongues at her in a manner that was quite unmis- 
 takable. In the morning as soon as she made her 
 appearance in the street, this thing began. So it was 
 everywhere. She could not go into a shop where she 
 was known. If she was obliged to make a purchase 
 she must seek some distant shop where she could hope 
 that she was still unrecognized. Sometimes this ruse 
 succeeded once. But upon her second visit she al- 
 ways noticed that these shop-keepers too, had be- 
 come involved in the conspiracy. With the conduc- 
 tors on the street-cars it was just as bad. After a 
 great strike which had taken place five years before, 
 when all the conductors who before that time had an- 
 noyed her, had been dismissed, she had hoped at first 
 that those newly taken on, might assume no part in 
 such misconduct. But within a few days they too 
 began. The worst place of all was the office in which 
 she was employed. The cashier there was a real 
 devil ; he egged on the others and was the ring-leader 
 of the whole thing. Each time he passed the door 
 he made a sign outside. The assurance given by 
 Miss K. in her letter that the manager had no part 
 in all this, was of no value at all. He also had stuck 
 out his tongue at her; she had seen it many times. 
 In the restaurant where she was accustomed to dine, 
 the thing had become insupportable ; as soon as she 
 entered the place, all the people there began. Even
 
 252 History and Practice of Psychanalysis 
 
 her nearest friend, Miss D., in whom she had long 
 hoped to find protection, had become, some months 
 prior to her visit to me, her open enemy. None 
 of the other diners in the restaurant any longer gave 
 her greeting when she entered. She had many proofs 
 that all had gone over to the enemy. At this time 
 she would now be going without her dinner altogether 
 had not a niece asked her to come to her. In that 
 house she felt herself fairly secure, although she had 
 seen signs of the persecution in the two-year-old 
 daughter of the house ; an impudent maid had en- 
 ticed the child into it. The patient lived with her 
 mother where, fortunately, the persecutors gener- 
 ally left her in peace. 
 
 In order that I should not believe she was exag- 
 gerating she would tell me at once, (this was at her 
 second visit) ; that her persecution had a real cause. 
 There are so many people who at any cost, try to 
 prevent a woman from doing as she pleases with her 
 life. She had had an intrigue with a man. This 
 was fully within her right and she did not in the 
 least regret it. She had wanted to live like a real 
 woman and she had done so. But such a thing people 
 could not endure. This was the foundation of the 
 entire history; she had been forced out of society; 
 she might as well say that she had been condemned 
 to death. Her persecutors constantly brought her 
 punishment to bear upon her. She asked me if I were 
 acquainted with the history of Miss X. This poor
 
 Extract from a Case-History 253 
 
 girl's persecutors had succeeded in getting out of 
 her doctor the secret that she was pregnant; when 
 knowledge of this betrayal came to the girl, she had 
 committed suicide.* The patient believed that it was 
 the intention of her persecutors also to drive her to 
 suicide. She believed that they would sooner or later 
 succeed. Using all her strength she felt herself now 
 powerless to resist. During these ten years the con- 
 spiracy had become more and more extensive. She 
 knew very well one of its most active centers. This 
 was The Woman's League Society. She assured me 
 that it was a fact that this society was a veritable 
 inquisition. It was situated close to the school-house 
 and was an agency for shop-people, hospital em- 
 ployees, etc. It had influence everywhere and so was 
 able to lead the persecution against her in all direc- 
 tions. The members of the League spied with a dili- 
 gence hardly credible. Thus, as soon as she visited 
 a new shop, the employees received orders to insult 
 her. Formerly for many years she had been a 
 teacher. She had been offered a position as princi- 
 pal in one of the largest of the schools for girls. 
 The schools also belonged to the worst class of her 
 persecutors. She knew exactly which scoundrels 
 were organizing the persecution there. She also had 
 been a journalist, and she assured me that beyond 
 doubt, the persecution from which she suffered had 
 at first been spread through the press. Everybody 
 * This history I know to be true.
 
 254 History and Practice of Psychanalysis 
 
 knew her there. Of especially great importance had 
 been a caricature of her which had appeared in the 
 Christmas number of "Puck," 1899, and an article 
 in "Hvad Nytt" in February, 1900, wherein she had 
 been sharply attacked. At that time she had been 
 unable to open a newspaper without discovering at- 
 tacks and insinuations against herself which of 
 course everybody understood. This still was a com- 
 mon occurrence. A conference at the Journalist's 
 Club at which her case had been discussed had had 
 great effect. From an anonymous letter in which 
 she had been accused of the most atrocious things, 
 she had seen quite clearly that she had been con- 
 demned. The letter she had immediately burned, 
 hoping thus to forget it ; but she had not succeeded. 
 There had been times when the persecution had been 
 less intense. But these times had been when her 
 enemies were gathering new strength, so that after- 
 wards it had become more bitter than ever. In the 
 year 1903 there had seemed to begin a change for 
 the better, but since 1906 the conspiracy had spread 
 wider and wider. Particularly had it grown worse 
 since an operation she had been obliged to undergo 
 in June, 1908. 
 
 I asked the patient if she ever had been able to 
 assure herself that other people noticed the signs 
 of which she spoke. 
 
 She replied that the signs all belonged to a sign- 
 language which is wide-spread. Her family had
 
 Extract from a Case-History 255 
 
 made attempts to persuade her that the whole thing 
 was imagination. But the proof she had for her 
 knowledge was so overwhelming that she could not 
 for one moment doubt the reality of it. Once she 
 had requested her niece to follow her to the post- 
 office and to carefully watch the post-mistress so 
 that she might be convinced for herself. The woman 
 had stuck her tongue out at her from ear to ear! 
 Afterwards the niece had said that she had not ob- 
 served this, but that could not possibly be true. 
 
 I asked the patient if in her earlier life she had 
 been subjected to such persecution. 
 
 She answered no, not at all. She always had 
 been upon most friendly terms with her fellow-men. 
 
 Upon further questioning concerning the begin- 
 ning of her trouble, she told me she had noticed as 
 far back as the spring of the year 1899, that she 
 was looked at in a peculiar way; sometimes also 
 people had offered her insults. The signs she had 
 first begun to notice some months later in X-Burg, 
 whither she had followed the man with whom she had 
 been in love. She had returned home hoping these 
 signs were unknown there ; but she very soon discov- 
 ered that her hope had been in vain. In the month of 
 February, 1900, these signs had broken upon her so 
 from all sides that she could not at all protect her- 
 self. . . . Some years prior to this time she had 
 passed through an experience which had destroyed 
 her courage, and at the time mentioned she was
 
 256 History and Practice of PsycTianalysis 
 
 still suffering from this experience. But her general 
 mental condition had not been one of depression. 
 Formerly she had been of a very cheerful disposi- 
 tion nor had she been unusually vacillating in tem- 
 perament. 
 
 Regarding heredity, the patient had much to re- 
 late, whereof I shall note only the most significant 
 points. Her father had been the result of a passing 
 intrigue with a farm-girl. He was a clever and tal- 
 ented, but very peculiar man. He had given up an 
 excellent business as a watch-maker, in order to start 
 several newspapers, of which at least one became 
 of importance. Always he had innumerable schemes 
 in his head, of which very few amounted to anything. 
 He had, for example, erected a "hygienic bakery" 
 and for several years he had worked at a plan for a 
 carriage which was to run on rails automatically 
 laid out for itself ; he had taken out innumerable pat- 
 ents on different inventions. Most of them were 
 quite impossible. For instance he had devised an 
 apparatus for refreshing soldiers during the march. 
 This apparatus consisted of a rubber bulb fitted be- 
 tween the foot and the sole of the shoe, to which was 
 attached a tube, which ran up to the top of the 
 head; from this tube, at every step, a current of air 
 was blown into the face of the wearer. His latest 
 patent had been a device for drawing the blankets 
 up over the head at night. He was a man who 
 quarreled with everybody and who was almost always
 
 Extract from a Case-Hutory 257 
 
 involved in processes of law. He now was somewhat 
 more careful about such matters, as once he had 
 come very near to committing perjury. All the half- 
 sisters and brothers of this man were most peculiar. 
 One of the brothers, while very intelligent, was hos- 
 tile to other people, adventurous, a pathological liar 
 and often mixed up in quarrels. Another, who is 
 still alive, is a notorious litigant. A sister who be- 
 came famous as a writer, had been unable as a child 
 to separate reality from fantasy; she used to come 
 home and relate things about herself which she had 
 made up, but in which she entirely believed. Still 
 another had suffered from an inability to resist go- 
 ing round and round in street-cars; finally she had 
 thrown herself from a train and been killed. An- 
 other had been quite insane and had died in an 
 asylum. On the mother's side there had been nothing 
 abnormal. The mother was still living and at eighty 
 years of age was in the best of physical and mental 
 health. 
 
 Of the twelve brothers and sisters of the patient, 
 five had died young. All those living were more or 
 less nervous. One brother had for years suffered 
 from aphony; he also imagined that he was perse- 
 cuted. One sister had phobia for different things. 
 Two other sisters had undergone deep changes in 
 their personalities. One, in her youth, had been of 
 a cold, careless nature, but had married happily 
 and now apparently, was a saint, who already existed
 
 258 History and Practice of Psychanalysis 
 
 in the other world. She was a theosophist, vege- 
 tarian, etc. Among the children of the relatives 
 also nervous diseases and peculiarities were common. 
 One youthful neurasthenic was determined to kill his 
 mother because she had brought children into the 
 world, although she knew that she belonged to a 
 most degenerate family. Law-suits had been with- 
 out number between the different members of the 
 family. 
 
 . . . The thing most noticeable at first about the 
 patient was a restless, strained expression ; this domi- 
 nated her behavior, her features and especially her 
 eyes. Her intellectual capacity was excellent. In 
 speaking, thoughts came in strong logical order. 
 Undoubtedly she was a very talented woman and 
 her ideas regarding things having no connection with 
 her insane imagery, were excellent. As to the 
 question of megalomania it was noticeable that both 
 as teacher and as journalist, she had been very highly 
 appreciated ; but her feeling for herself had exceeded 
 natural limits. 
 
 In the original description of this case * I have 
 explained my opinion, that it must be regarded as a 
 
 * "Zur Radikalbehandlung der Chronischen Paranoia," 
 Bjerre. Sonderabdruck aus dem Jahrbuch fur Psychoanaly- 
 tische und Psychopathologische Forschungen, 111 Band, 2. 
 Halfte.
 
 Extract from a Case-History 259 
 
 case of true paranoia; but here I shall confine my- 
 self to a curtailed description of the treatment. 
 
 This treatment began with the first visit of the 
 patient to my office. The formation of a rapport 
 between doctor and patient is perhaps, the most 
 difficult thing to achieve, in a case wherein the pa- 
 tient feels hatred towards the whole world and sees 
 in every human being a new enemy. That from 
 the very start, this patient felt herself calm in my 
 consulting-room and was able to speak easily to me, 
 is a fact. The reason for this, I am unable with cer- 
 tainty, to explain. The letter of recommendation 
 from Miss K. possibly had had some suggestive in- 
 fluence. But I believe that the effort I made to put 
 myself as fully as possible, in her place, was the 
 most important factor. I did not allow myself to 
 show the slightest doubt as to the reality of the per- 
 secution of which she felt herself the victim, but spoke 
 with her about these things as about any other facts. 
 I so completely was able to play this part that she 
 felt that at last she had found someone who under- 
 stood her situation and did not approach her with 
 the usual weakminded objections. I thus gained a 
 peculiar position, which showed itself partly in the 
 fact that she really listened to what I had to say, 
 partly in the fact that I was not added to the flock 
 of her pursuers. It is true that she explained to me 
 how on one of her first visits she also had noticed 
 in me signs of persecution and how she had come
 
 260 History and Practice of Psychanalysi* 
 
 very near considering me too in the light of an 
 enemy; but fortunately I had succeeded in nipping 
 this suspicion in the bud and in persuading her that 
 she had nothing to fear from me. Nevertheless I 
 had been by no means sure that she would return to 
 me again, after that time. The fact of her doing 
 so was probably due to no other reason than that 
 it amused her to talk with me. At first it gave her 
 a sense of freedom to find herself understood; then 
 gradually I drew her into general conversation. I 
 showed a lively interest in her family history, in 
 her childhood, etc. Imperceptibly I began to inter- 
 pret what she told me, in words in which she sus- 
 pected no intention. That everything I said to her 
 however, was suggested after a certain plan, is self- 
 evident. After a little I began to make some ex- 
 planations in which she was greatly interested. As 
 she told me facts concerning her parents, I referred 
 to the question of heredity, explaining how a child 
 may be born with some defect, which can have a deep 
 influence upon its after life without its being con- 
 scious of it. I gave her examples of this which 
 stimulated her after- thoughts. We spoke much 
 about her childhood. During that time the patient 
 had resided in a small provincial town. Her recol- 
 lections of this home were pleasant, but only because 
 of her mother, who made everything about her home- 
 like and happy. At that time the position of the 
 father in the family was that of a stranger. Against
 
 Extract from a Case-History 861 
 
 his schemes the patient had been just as much op- 
 posed as were all the other members of the family. 
 "We acquired," she said, "a habit of looking upon 
 him as a wrong-doer who needlessly interfered with 
 the business and, with his unfortunate ideas, de- 
 stroyed our financial status." And yet the patient 
 had entertained a certain admiration for her father's 
 cleverness, imagination and energy. She admitted 
 to me that in many ways she was like him particu- 
 larly in her love of change. He also had awakened 
 her literary interest. For her mother the patient had 
 always had the warmest attachment. ... I told her 
 some of the remarkable facts concerning the uncon- 
 scious influence of parents upon their children and 
 how such influence may often be much stronger than 
 anyone suspects ; how a child may imitate the traits, 
 or even almost the whole destiny of a parent, without 
 in the least understanding it ; how for instance such 
 a tendency as quarrelsomeness may, little by little, 
 find its way into the child's mind and constantly 
 acquire a stronger hold there. 
 
 Among the first impulses of her life the patient 
 recollected a very lively fancy. In her play she lived 
 so thoroughly in fictitious places and situations, that 
 it was often difficult for her to return to connection 
 with the real. One thing she used to imagine was 
 that pins were horse-men and that the pin-cushion 
 was a forest through which they galloped in the 
 night. When she had grown older she had lived in
 
 262 History and Practice of Psychanalysis 
 
 day-dreams. Then she had been the princess in the 
 sleeping castle, waiting for the prince to come who 
 should awaken her with a kiss ; always he came from 
 some unknown, distant land and had taken her with 
 him far from the things of every-day life. Such 
 tales gave me the opportunity to speak with her 
 about imagination and reality and about the urgent 
 need of keeping sharply defined the subjective and 
 objective worlds. She admitted that, like her aunt, 
 she had had difficulty in doing this ; but she insisted 
 that this had played no part in her life. 
 
 Relations between herself and her brothers and 
 sisters had been very pleasant. Especially had the 
 patient been devoted to one sister, two years her 
 senior. In this sister's companionship she had found 
 the protection she had so needed in her younger days. 
 At that time she had been very bashful and uncertain 
 of herself. In company she had been wont to hide 
 herself behind this sister and let her do the talking 
 for both; she had nicknamed this sister her "trum- 
 pet." Both had early made up their minds never 
 to marry; they would instead "marry each other." 
 
 At the time when they came to S to live, the 
 
 patient having been then thirteen years of age, 
 they had hunted out a house in which they were 
 agreed upon the intention to live as "old maids." 
 Young men afterwards frequented the house in an en- 
 tirely unaffected way; flirtations came about but 
 were soon forgotten.
 
 Extract from a Case-History 263 
 
 When the patient was eighteen the great experi- 
 ence of her life came. Soon before this she had, in 
 co-operation with her sister begun to make up little 
 "newspapers" which were circulated among their 
 immediate circle of friends and acquaintances. This 
 of course had been done anonymously, and they had 
 had much amusement out of it. As a joke they fin- 
 ally had inserted a marriage notice in a public 
 newspaper. One of the replies to this had been the 
 beginning of a correspondence which had lasted 
 without interruption for twenty years, during all 
 of which time the patient had never personally en- 
 countered her correspondent, although he lived in 
 the same city. Her connection with this unknown 
 had been a source of great happiness to her. She 
 had anticipated his letters with all the eagerness and 
 delight incident to love. Not only had she been at- 
 tached to his man with her whole soul; he also had 
 been connected in some peculiar manner with her 
 erotic life. With him she had felt that she would 
 be able to marry; to him she could give herself. 
 He was the fairy prince of whom she had always 
 dreamed. During her twenties, she had made the 
 acquaintance of another man with whom she felt 
 herself in sympathy and who loved her. She also 
 had had a feeling of love for him, but after seven 
 years of doubt and inner strife, she had broken 
 with him. Evidently she had felt that she never 
 could quite free herself from the writer of the letters
 
 History and Practice of Psychanalysis 
 
 with whom she was forever connected by a kind of 
 mystic bond. The patient was unable, even at the 
 time I saw her, to speak of this correspondence with- 
 out tears coming into her eyes and she insisted that 
 in spite of everything, it had been the thing of 
 greatest import in her whole life. The destruction 
 of this connection had been her most painful experi- 
 ence. It had occupied some years and many things 
 had played a part in it. But one only had been de- 
 cisive. When at last in her thirty-eighth year she 
 had met the man personally at a party, she at once 
 understood that she had completely deceived herself. 
 The ideal she had so long believed to have had exist- 
 ence behind the letters, was not there at all. Instead 
 she saw an entirely common-place man, who at the 
 same time was in the midst of a liaison with her own 
 youngest sister. This had been too hard a blow for 
 her. She wished never to see him again. Then she 
 had begun to hate him and to grow bitter against 
 the whole world. 
 
 I dwelt long upon this very significant part of her 
 life. I showed her how deeply this unusual experi- 
 ence had buried itself in her nature and suggested 
 to her that this might produce morbid displacement 
 between fantasy and reality. This she could take 
 no credence in ; with the exception of the goitre, she 
 assured me that she always had been in excellent 
 health. 
 
 Her external life, during all these years she had
 
 Extract from a Case-History 265 
 
 filled in the following manner : After the termina- 
 tion of her schooling she had assisted her father for 
 some years in the editing of his papers. At the age 
 of twenty-three she had gone for a period of three 
 years, to a seminary, after which she worked for 
 thirteen years as a teacher sometimes in private 
 families, sometimes in the higher schools for girls. 
 She had suffered much from the constraint of the 
 seminary, nor was the work of a teacher suited to 
 her temperament. Nevertheless, as I have said be- 
 fore she had everywhere been liked. A position 
 which had been offered to her as principal of a school 
 she had refused, because she had been unable to 
 resign herself to remaining always a teacher. 
 
 After she had freed herself from the writer of 
 the letters, she had felt herself sufficiently strong to 
 take a decisive step. She had given up forever her 
 position as a teacher and taken a place on the 
 staff of a weekly paper. Here she had worked for 
 two years and during that time had acquired a posi- 
 tion of importance. Without any definite reason she 
 had resigned this also in October, 1898 ; she had not 
 wished to feel bound down to anything. Until the 
 following April, she then had had occasional work 
 on different newspapers, in insurance offices, etc. 
 During all these years she had come into closer 
 touch with many people; partly her friends were 
 families of high social position whose children she 
 had taught, partly they were in the circle of teach-
 
 266 History and Practice of Psychanalysis 
 
 ers, but chiefly were they colleagues of the press. 
 For the purpose of study she had visited Germany, 
 England and France. Everywhere she had made 
 acquaintances without difficulty. She had a lively 
 interest in many subjects, hislory, politics, litera- 
 ture, etc. More than all had she become interested 
 in the so-called feminist movement and at every op- 
 portunity she had defended the rights of women. 
 
 I pointed out to her the importance of the fact 
 that during all this period of her richest develop- 
 ment, she had been connected with a kind of work 
 which really had been unsuited to her. Her dissatis- 
 faction during all this period probably had its 
 strongest root in her sexual restraint. Had she been 
 able to concentrate her forces upon some work which 
 would have been in accord with her desires and her 
 talent, this dissatisfaction to a certain degree would 
 have been effaced. And what would have been even 
 more important, she would have lived her life in 
 closer connection with the external world. For some 
 sort of activity, which at the same time makes an in- 
 dividual free and of use to others, is, next to the 
 sexual-life, the strongest bridge between individual 
 existence and the world. As far as the sexual-life 
 went she had already been driven from reality to 
 fantasy and afterwards the same thing had occurred 
 where social activity was concerned. If the daily 
 work does not satisfy, everyone is apt to fill that 
 life with day-dreams. The lack of ability in the
 
 Extract from a Case-History 267 
 
 patient, which had really existed from the beginning, 
 to apprehend objectively, had become in the course 
 of years, still more effaced. Her childish habit of 
 living in a world of dreams, she plainly had never 
 become free from. She was unable to deny that 
 all this was true, but that it could have any deeper 
 significance she could not at all believe. 
 
 In the winter of 1898-1899 she had begun the 
 liaison with Mr. C. who had come to town for busi- 
 ness reasons. She had been obliged to visit him at 
 his hotel, in order to execute a business commission. 
 As early as her second visit he had made advances 
 to her which she had not resisted; not at all be- 
 cause she felt any love for the man that she had 
 not imagined for a moment. But she wanted to 
 really live the real life of a woman and she had so 
 made use of the opportunity which here came in her 
 way. In the place of that happiness which she had 
 lost, she would at least enjoy experience and knowl- 
 edge. This was her right and she had never re- 
 gretted having taken it. In April, 1899, she had 
 followed Mr. C. to X-Burg, a town on the con- 
 tinent, for the avowed purpose of taking a position 
 in his office. There she had remained until Novem- 
 ber when the liaison came to an end and she had re- 
 turned home. In her home town she had already 
 remarked that people spied upon her. Once when she 
 was about to leave a hotel she had noticed that a 
 waiter made a grimace. He had without doubt, been
 
 268 History and Practice of Psychanalysis 
 
 listening at the door and from this beginning her 
 persecution had spread among the waiters one of 
 its worst breeding-places. 
 
 When I now began more closely to question her 
 concerning these first signs of the persecution, one 
 thing which I had already noticed in my former 
 talks with the patient, became more clear to me: 
 she tried always to keep away from the treatment of 
 details ; as a rule she was unable to look at one thing 
 by itself and to keep that one thing fixed in her 
 thought, until we had thoroughly done with it. When 
 she arrived at a certain point in her narrative, the 
 threads of thought became tangled and the whole 
 thing was wiped out. I tried to prevent this and 
 many times called her attention to the fact by say- 
 ing, "No, don't tell me anything more. Let us keep 
 to this until we are ready to go on !" This irritated 
 her very much and that I had come upon a weak 
 spot here was plainly evident; she was many times 
 angry, but I did not give in. Finally she said, "I 
 cannot think with exactness; I have never really 
 thought with my intellect, only with my feelings. 
 If we are going to get any farther, you must let me 
 think in my own way." 
 
 I explained to her the absolute necessity of using 
 the intellect for the purpose of thinking. I told her 
 that if she had never been able to do this, it was 
 high time for her to try; and I added a long lec- 
 ture on thinking with the feelings, so that her ideas
 
 Extract from a Case-History 269 
 
 upon the subject might be made clear. I described 
 to her how the mind must impair in case one never 
 makes an effort to cleanse the thoughts of tempo- 
 rary moods and sensations, and the dangers con- 
 nected with such a course. Finally she permitted 
 me to linger long enough on every detail until I was 
 thoroughly convinced that the thing was fully worked 
 out in her mind. In short, I had to teach her how 
 to think. It was a tiresome piece of re-education, 
 from which she many times would have liked to run 
 away. When we went on with her narrative I com- 
 pelled her to re-live every experience not as she her- 
 self recalled it, but as she would have lived through it 
 if at the time, she had been able to see clearly and 
 distinctly. 
 
 In regard to the first time she had noticed the 
 signs of persecution, she now told me the follow- 
 ing: She had had to attend a horse-race in 
 X-Burg in order to report it for her paper. On 
 the reporters' stand, she had been spoken to by an 
 elegantly dressed woman who happened to sit next 
 her. She presently noticed that this woman was the 
 object of peculiar attention from the men. She ob- 
 served how one man after the other made strange 
 signs to her, especially with the tongue. At first 
 she had been at a loss to understand it, but it pres- 
 ently became clear to her that these signs must have 
 a hidden sexual meaning. She had moved away from 
 the woman without learning her name, and she did
 
 870 History and Practice of Psychanalysis 
 
 not meet her again. During the next few days 
 she noticed with horror that people in the streets 
 began to make similar signs to herself. 
 
 In the course of this talk I gave her, with great 
 caution, an explanation somewhat as follows: 
 "Naturally these events may have taken place exact- 
 ly as you believe. That I will not at all deny. But 
 it seems also possible to me that you have been the 
 victim of a very curious mistake. Something similar 
 to such a mistake we occasionally experience in a 
 lesser degree but, as a rule, it does not attract our 
 attention. Life is very full of illusions and many 
 people remain forever entangled in their mistakes. 
 When the experiences of today superimpose upon 
 those of yesterday, we sometimes lose our conscious 
 view, and with it, control over our own lives, we 
 became, that is to say, play-things of unconscious 
 motives. The more experiences accumulate, the more 
 overwhelming they are, just so much the more dif- 
 ficult it is to connect them at once with the "I." 
 Take for instance, a case like this : you may have suf- 
 fered some great loss. You travel in order to forget 
 that is, you try to bury your trouble under a mass 
 of new experiences. You become carried away by 
 these you forget yourself. Presently this new 
 stock of experiences melts in with the old. Even 
 more clearly still can you see this, if you meet with 
 someone who makes a deep impression upon % you. 
 What one of us has not in youth, been so influenced
 
 Extract from a Case-History 871 
 
 by some great personality that he has lost his own 
 "I" in this other seeing with the other's eyes, writ- 
 ing with the other's pen? It may be years before 
 the "I" assimilates the accumulated material if it 
 ever succeeds in so doing. Here is a way open for 
 trouble, for stunting development, and these things 
 are very common occurrences in a lesser degree. How 
 many people, for instance, escape traits of alien 
 personalities, which remain forever to steer life into 
 wrong directions, without their being conscious of 
 such a thing? How many people have in their in- 
 most thoughts, identified themselves with Hamlet and 
 because of that have been restrained in every act of 
 life? In the healthy person there are psychic ten- 
 dencies to assure against such misfortunes; such a 
 one examines the inner life and discovers wherein 
 lies the wrong. But in order to accomplish that, 
 one must have a clear vision and be able to think 
 with keenness. So if, as you have done, one has 
 thought only with the feelings and has worked no 
 clear way out through the mass of befogging ex- 
 periences, he becomes fertile soil for the seed of all 
 kinds of mistakes. And such dangers are, like all 
 other dangers, so much the greater, the less one is 
 prepared to cope with them. The worst kinds of 
 troubles arise simply because a stock of experiences 
 creep into the consciousness without being noticed. 
 If anyone has exerted a strong influence upon you, 
 without your having remarked this influence, then,
 
 872 History and Practice of Psychanalysis 
 
 not only the thoughts of this person, but also his 
 personality and even more, his destiny, can be so 
 mixed in the depths of the unconscious mind with 
 your own "I" that you cannot separate one thread 
 from another. Unconsciously you identify yourself 
 with that other. In such a way, for instance, one 
 often assumes the pains of another. In order to 
 fully understand this it is necessary to take one 
 very important fact concerning the unconscious 
 mind into consideration. The unconscious mind is 
 not so centralized as is the conscious ; in it the con- 
 glomeration of earlier experiences are not bound to- 
 gether into one "I." Under peculiar circumstances 
 such a conglomeration, which is called a complex, 
 may attain a certain independence, may grow and 
 acquire an insidious influence upon the conscious "I." 
 Just as under normal circumstances, this "I" takes 
 sustenance from the external world and assimilates 
 everything that agrees with it, so an unconscious 
 complex can attract to itself everything that is in 
 accord with it, without our noticing it in the least 
 degree. So we may come under the power of the un- 
 conscious mind." 
 
 I was successful in making these ideas clear to the 
 patient only after long explanation and by means of 
 many examples taken from everyday life, as well as 
 from pathological psychology. She was greatly in- 
 terested in all this ; but that it should have any spe- 
 cial application to herself she could not at all be-
 
 Extract from a Case-History 273 
 
 lieve. But by the suggestion of these facts, lines of 
 thought were drawn through her mind, along which 
 her further thought could work out to a deeper 
 comprehension of the pathological processes in her 
 life. 
 
 I continued my conversation with her as follows : 
 "You will now perhaps better be able to under- 
 stand your peculiar experience in X-Burg. You 
 had lived there for some months in a liaison which 
 dominated your whole thought. In this liaison you 
 had endeavored to find a substitute for the happiness 
 which you had lost, and by means of it you desired 
 above all to demonstrate for yourself the right of a 
 woman to live her sexual-life. But this intrigue of 
 yours had to be kept secret ; had it become known it 
 would have ruined you forever. You were unable at 
 the time to deny to yourself that you were in a 
 state of anxiety. (The patient had admitted to me 
 that she had fear concerning the result of her manner 
 of life) ; you had surely pictured to yourself what 
 the consequences might be. Above all you feared 
 that this intrigue might further degrade you; that 
 sexuality once brought into action might drive you 
 farther and farther. Your demonstration of the 
 rights of women told you that you were within your 
 full legitimate field ; but the woman in you also told 
 you that you were running into grave danger. In 
 the conscious mind there arises in every such case, 
 a complex, which strikes a strong note of fear and
 
 274 History and Practice of Psychanalysis 
 
 anxious watching. In this state of mind you were, 
 when you came across that unknown woman on the 
 reporters' stand. From her dress and general ap- 
 pearance you unconsciously concluded that there 
 might reasonably be some doubt as to her respect- 
 ability. Your conscious personality was not at- 
 tracted toward her; intentionally you failed to seek 
 her acquaintance. 'By accident' you got a seat 
 beside her on the stand. But that is as much as to 
 say that the complex in your mind felt itself at- 
 tracted toward her; such accidents do not exist. 
 The complex suggested to you, like Mephistopheles : 
 'such another you too will become ; seek the com- 
 pany in which you belong!' As a flirt, this woman 
 must attract peculiar notice ; that you unconsciously 
 concluded, and upon this point you strongly concen- 
 trated your attention. You perceived at once that 
 you were right. Perhaps it was so in reality. But 
 if it had not been it would have seemed so to you. 
 We always see what we wish to see. But even more 
 do we see everything which a complex forces upon 
 our attention; hallucinations easily arise in this 
 manner. Possibly some one, or even many, had 
 laughed at this woman, in such a way that the tongue 
 could be seen. No matter how it came to pass you 
 have observed peculiar movements of the tongue and 
 this has made a deep impression upon you. To sum 
 up: an unconscious complex unnoticed by you, 
 drew this woman into your mind and associated her
 
 Extract from a Case-History 275 
 
 so strongly with itself, that unconsciously you iden- 
 tified yourself with her. In the days that followed 
 this identification tried to weave itself into your own 
 personality. Tfoe consequence was that you too 
 longer saw with your own eyes, but with hers ; and so 
 people in the streets made the same movements with 
 the tongue to you that they had made to her." 
 
 The patient received this explanation with a con- 
 temptuous smile. She meant by this to intimate that 
 very possibly something of this sort might take 
 place, but that she, herself, never could have made 
 such a mistake ; she could believe the evidence of her 
 own eyes, etc., etc. I made no attempt to convince 
 her; on the contrary I assured her that it was very 
 probable that she was right ; that I did not at all say 
 that things must be as I had suggested, but that it 
 was a possibility with which one must reckon. In 
 order to make full investigation of anything, all 
 possibilities must be put to proof, not merely the 
 ones most probable. 
 
 I took up the matter of the tongue and ques- 
 tioned her as to any unpleasant experiences in which 
 that member had played a part in her life. She re- 
 called among other things, that once in the street, 
 she had met a man who suddenly had become mad 
 and who screamed and stuck his tongue out of a 
 horrible looking mouth. This picture had burned 
 itself with painful clearness into her memory. 
 
 I explained how such an emotional picture always
 
 $76 History and Practice of Psychanalysis 
 
 with great ease becomes reconstructed and how it 
 has a tendency to associate everything with itself 
 which is in any way similar to it. "Probably," I 
 went on, "you never would have noticed these slight 
 movements of the tongue if in your mind there had 
 not already existed an over-determined picture of an 
 outstretched tongue." But this also was too much 
 for her to believe. 
 
 I now talked with her about the unintentional 
 symptom acts common to everyday life. How peo- 
 ple continually make little unconscious movements, 
 which are not especially noticed by others. To these 
 belong the habit of moistening the lips with the 
 tongue. This phenomenon is like the blind spot on 
 the retina: it remains unnoticed unless attention 
 is directly called to it. By means of an over-de- 
 termined picture of an out-stretched tongue, I ex- 
 plained to the patient that her attention had been 
 too strongly attracted to every small movement of 
 the tongue attracted to the very smallest, with the 
 same surety that a piece of iron is attracted to a 
 magnet ; and that whereas she had thought the phe- 
 nomenon an objective one, it was in reality subjec- 
 tive. She laughed heartily at an idea so absurd. 
 
 Continuing, I explained to her how naturally one 
 accompanies a forceful thought with some gesture. 
 If one thinks intensely about the tongue it is hard 
 to keep it entirely still. To this is added another 
 fact; all such movements are very contagious. If,
 
 Extract from a Case-History 277 
 
 for instance, anyone in a company, begins to yawn, 
 soon one after the other does the same thing. The 
 connection thus might be formulated as follows: 
 because she the patient, had fixed her attention on 
 the outstretched tongue, she had herself stretched 
 out her own tongue unusually often. And this she 
 had done just at those times when she feared that 
 someone else might do it. The movements of her 
 own tongue thus had been contagious to others. So 
 that which she had observed, had, in reality, come 
 from herself. 
 
 The patient looked upon this idea as inexpressibly 
 funny. She would not even believe that I meant it 
 in earnest. Every effort I made to analyse the com- 
 plication from this side, met with insurmountable 
 resistance. The gestures she had seen, were, and 
 would remain, signs of a sexual persecution, for 
 this her proof was abundant and unequivocal. She 
 had even read in many books by modern writers, that 
 such signs are known generally, and therefore the 
 whole thing became still more clear. S., for example, 
 tells of a man who made signs like these to a woman, 
 as he drank her health at dinner. Unfortunately 
 such things have a foundation in fact, and could not 
 be explained away. The other gestures were equally 
 proofs in themselves. 
 
 I will here let the patient go on with her own 
 story : 
 
 When she had left X-Burg she had hoped that
 
 278 History and Practice of Psychanalysis 
 
 her love-affair was known only in that town and 
 that she would not be exposed to further persecu- 
 tion in other places. But she had quickly discov- 
 ered that the sign-language was also known in her 
 native land and was there to be used against her. 
 She soon learned that her love-affair was a matter 
 of common gossip at home, as well. This was made 
 manifest to her in many ways. Wherever she went, 
 people talked about her and if she turned her back, 
 they laughed. An article which she had written for 
 one of the weekly papers was not accepted, a 
 thing which never before had happened. In the 
 editorial rooms she was strangely treated, the 
 editor even had left the room when she entered it. 
 Former acquaintances showed her the cold shoulder, 
 sometimes not even greeting her in the street. It 
 had been all the harder to bear when she had dis- 
 covered that she could not trust even her oldest 
 friends. In the beginning she had conjectured that 
 the rumor concerning her had been privately spread 
 about. She had recommended as her successor in the 
 office at X-Burg, a country-woman of her own and 
 she believed that this woman had also since been 
 seduced and that she had then tried in this manner 
 to avenge herself for having been sent to the place. 
 
 At last had come a fatal day in February, 1910, 
 when she finally understood clearly that all she had 
 hitherto observed had been merely the harbinger of 
 a general persecution. As she already had related,
 
 Extract from a Case-History 879 
 
 the thing had rushed in upon her from all sides. 
 Everywhere she went she saw the signs and every- 
 where people talked about her and avoided her. She 
 was positive that her persecutors had made use of 
 public agencies. Her love-affair had become known 
 to the whole town and she had been utterly con- 
 demned by society, utterly ostracised. It was her 
 fate to be hunted to death. All because she had done 
 something which it was her perfect right to do. She 
 had then made up her mind to turn against every- 
 body and to shut herself up within herself. So the 
 thing had gone on from year to year until at last 
 she and her mother had come to live entirely alone. 
 Meanwhile the conspiracy against her had spread all 
 over Europe; she even had certain proof that in 
 America also, centers of this persecution existed. 
 She complained bitterly that society should so treat 
 an innocent woman. 
 
 I now broke the ground for exact examination and 
 test of every single proof of the persecution. I 
 asked her to describe in detail every occurrence as 
 completely as she was able to recall it. I began with 
 the public proofs and then went on to those of a 
 more private nature. As it would be superfluous to 
 explain all this material, I shall give only a few 
 examples.
 
 280 History and Practice of Psychanalysw 
 
 To begin with she had told me that a caricature 
 in the Christmas number of "Puck" (1899) and 
 an article in "Hvad Nytt" in February, 1900, had 
 been of great significance in her case. 
 
 I telephoned to the office of "Puck" to get a copy 
 of the number in question. I found that this periodi- 
 cal had not yet come into existence in the year 
 1899. I tried vainly to find the caricature else- 
 where. I then told the patient of my failure and 
 begged her to help me without fear, in my search. 
 She succeeded in finding it in another humorous 
 paper published in 1902 ; but she now made the dis- 
 covery that the text had been aimed at another 
 journalist instead of at herself. She also found the 
 article in "Hvad Nytt" for me. It had to do with 
 a lecture on the subject of morality and contained 
 no personal insinuations of any kind whatsoever. 
 The patient was compelled to admit that she had 
 made here two indubitable mistakes in memory. She 
 was surprised, but otherwise it made no impression 
 upon her. The fact of the persecution remained 
 absolutely unchanged. It had simply come about 
 through other means than those she had credited. 
 Perhaps it was the outcome of the February meeting 
 of the Society of Journalists, where her case had 
 been discussed, or possibly exclusively through ar- 
 ticles in the newspapers, to which at the time, she 
 had attached little importance. 
 
 As an instance of the persecution emanating from
 
 Extract from a Case-History 281 
 
 her own friends (as she saw matters) I relate the 
 following : 
 
 A family, all the members of which had been her 
 friends, who lived in a provincial city, came to town 
 and stopped at a hotel there. When she called upon 
 them she had been received with customary hospi- 
 tality. There had been the usual little pleasantries 
 and the best of good feeling between them. Sud- 
 denly a waiter had appeared and summoned the hus- 
 band out of the room. When, after some time, he 
 returned, he had appeared quite changed. He had 
 been cold and disagreeable and had so influenced 
 the wife and daughter, by means of secret signs, that 
 they also had altered their attitude toward her. 
 The conversation had languished and she had felt 
 constrained to take her leave. So her association 
 with this family had come to an end. When they 
 had come to town again later on, she had not even 
 been informed of the fact. In her opinion the 
 waiter had called the husband out of the room to 
 inform him about herself. Waiters, as I have before 
 pointed out, were always, in the mind of the patient, 
 centers from which information concerning her 
 spread. 
 
 As an explanation of this incident, I suggested to 
 her, the following : the husband, no doubt, had been 
 called to the telephone by the waiter a thing which 
 occurs at least once every fifteen minutes to most 
 business or professional people. Or possibly some-
 
 282 History and Practice of Psyclianalysis 
 
 one was looking for him personally. Just like every- 
 thing else, this occurrence had at once awakened her 
 distrust. A suspicion something like this had then 
 taken possession of her: "Now someone is going to 
 tell him about me and our friendly intercourse will 
 end." Her attention had concentrated itself upon 
 this thought, her distrust had been ready to grasp 
 any detail and, by misconstruing it, to find in it a 
 proof. When the husband returned his thoughts 
 had been busy with some news he had received. 
 The wife and daughter had noticed this and had 
 been curious to hear what was the matter. Per- 
 haps even, they had been expecting news of impor- 
 tance. The members of the family might well have 
 grown silent because of other reasons than the ones 
 she had imputed to them. But because of this si- 
 lence she had assumed absolute evidence of the fact 
 that these people too had joined her persecutors. 
 And she had herself, acted accordingly. She had 
 grown bitter and repellant, she had taken her leave 
 in a cold, offended manner, in fact she had made it 
 plain that she wished to have no more to do with 
 them. The family could scarcely do anything but 
 acquiesce and be silent about the whole matter. 
 These and similar explanations the patient refused 
 to accept, because, in her own mind, she knew bet- 
 ter. It was impossible that she could be so mistaken, 
 etc. 
 
 However I went on quietly and without interrup-
 
 Extract from a Case-History 283 
 
 tion. The conditions she had observed in her of- 
 fice, I insisted upon with particular care. 
 
 She had told me that the cashier there was a 
 woman-hater; he wanted to throw all women out 
 of the office. Mrs. L., who died of tuberculosis 
 in 1909 had really been driven to her death, she 
 asserted, by this man. The patient had already 
 assured me that she was not the only one convinced 
 of this fact. The man hated her too. After the 
 death of Mrs. L. things had become even worse 
 than before. After finishing Mrs. L. his hatred had 
 settled upon herself. Every time he passed her 
 door he scraped with his feet. I explained to her 
 how many disputes naturally arise through the daily 
 friction brought about where many people work in 
 the same building. It might have been that the 
 cashier was a rival of Mrs. L. for the good-will of 
 the manager. But I doubted if this could have had 
 connection with her illness. "Even admitting that 
 Mrs. L. was exposed to such persecution," I said to 
 the patient, "it would not necessarily follow that 
 after her death, the cashier should have begun to 
 persecute you. You may have been deceived in that 
 idea. You recall how we have spoken of your in- 
 clination to put yourself in the place of someone else 
 quite unconsciously, it is true and you recall 
 that I explained also how one person may for in- 
 stance, feel the pains of another. I have at this time 
 under treatment, an old man, who will serve as a good
 
 284 History and Practice of Psychanalysis 
 
 example of this very fact. He suffers from pain in 
 the stomach and vomiting; these are in reality the 
 symptoms of the illness of his dead wife, who had 
 cancer of the stomach. Did you not after Mrs. 
 L.'s death take upon yourself the persecution which 
 in her case may have been a fact ?" 
 
 After this manner the treatment went on. I saw 
 the patient every other day until the middle of Feb- 
 ruary, (with an interruption of two weeks after 
 Christmas), or for a period of about seven weeks. 
 The result seemed then to be null. Many of the 
 new experiences and points of view I gave her had, 
 it is true, awakened her astonishment and had mo- 
 mentarily shaken her position; but at each subse- 
 quent interview these successes had been overthrown 
 by her own system and she could then explain every- 
 thing in her own way. No change for the better 
 had come about in her intercourse with those with 
 whom she daily had to do, rather if anything, 
 the contrary. On New Year's Day she had asked for 
 a private interview with her manager, having deter- 
 mined to tell him in detail all about the persecu- 
 tion and of her desire that the punishment of the 
 cashier and others might be enforced. The patient's 
 niece, whom I have before had occasion to mention, 
 succeeding in preventing this catastrophe. Other- 
 wise the patient would have lost her position and, 
 as she was without means, this must have resulted in 
 her being sent to an institution.
 
 Extract from a Case-History 385 
 
 Nevertheless I believe that in the depths of her 
 unconscious mind, a change had already begun. 
 Her appearance no longer was so tense and strained ; 
 her voice no longer had the tone of absolute cer- 
 tainty when she spoke of the persecution and her 
 laughter had lost some of its superciliousness. I 
 felt that there was a possibility that doubt, sug- 
 gested to her in a hundred different ways, had taken 
 root and was quietly growing. Her heart no longer 
 was in what she said. I resolved to venture upon 
 a decisive step. I boldly told her that I myself had 
 begun to doubt that she ever really had been exposed 
 to persecution. Many situations seemed so peculiar 
 to me, that this doubt had begun to worry me. I 
 wanted to see clearly into the matter. I therefore 
 asked her permission to put myself in communica- 
 tion with some one who must be cognizant of the 
 persecution if such a state of things really existed. 
 I proposed a colleague whom I had known for many 
 years and who was the friend as well as the physician, 
 in her own family. She had mentioned him to me 
 several times, imputing to him a certain part in the 
 spreading of her troubles. She now made no objec- 
 tion to my proposition. 
 
 It is unnecessary to add that this step would 
 have been useless, unless the suggestibility of the 
 patient had grown enormously during the course of 
 her treatment. Undertaken prematurely the result 
 >f such a step, like so many of a similar nature
 
 286 History and Practice of Psychanalysis 
 
 before, would have been entirely negative. Now 
 however, the soil was so well prepared that it seemed 
 possible to me that such a suggestion might overcome 
 the strongest resistance. In view of this coming 
 examination I increased the tension of the patient's 
 mind regarding it, by putting it off from day to day. 
 Then I consulted with my colleague alone; he knew 
 that the patient suffered from paranoia and he was 
 able to provide me with some interesting details re- 
 garding her earlier life. 
 
 On the 28th of February I told the patient that 
 my colleague had heard not the slightest thing either 
 of her love-affair or of the persecution and that 
 he was absolutely convinced that no one ever had 
 either thought or spoken evil about her. It took me 
 quite half an hour to impress this fact upon her. 
 She was so amazed that she could hardly speak. 
 When she left me it was quite clear that my state- 
 ment had produced an effect; and at our next con- 
 versation I found that this effect had been greater 
 than I had dared to hope. The struggle between 
 the complexes and the suggestions no longer ap- 
 peared to be beyond our range of vision. Doubt 
 concerning the system of persecution was plainly 
 coming to the surface. This ignorance of such an old 
 friend of the family was the first shock toward 
 emancipation. All that which during the course of 
 the treatment had been sown with such precaution 
 and had since been germinating in the depths of her
 
 Extract from a Case-History 287 
 
 unconscious mind, now began to stretch up toward 
 the light, while the ground beneath "the system" 
 began to shake. Nevertheless the patient by no 
 means abandoned her point of view at once and with 
 no further effort to sustain it. She came back with 
 the old objections. Still I had won ground and be- 
 cause of her uncertainty I ventured upon more ener- 
 getic suggestions. I said no longer, "This or that 
 may have been so ;** I asserted : "This or that came 
 about in this way. Without the shadow of a doubt 
 you were entirely mistaken." I went over all the 
 motives which had been discussed before and showed 
 her with compelling logic, that my interpretation was 
 the only one possible. I now gave her little oppor- 
 tunity to speak, but went on uninterruptedly with 
 my new arguments. Instead of contemptuous laugh- 
 ter, she listened to me amazed. She began to get 
 some inkling of the possibility of deliverance, yet she 
 dared not believe in it. But with every subsequent 
 talk with me this hope grew and I assured her that 
 she was about to experience a complete inner en- 
 lightenment. If however she must still wait a little 
 for this she must not become impatient. 
 
 "You must take into consideration what an un- 
 precedented development all this implies," I said to 
 her. "How long it took people to understand 
 that the earth revolves around the sun instead of the 
 other way about ! In your case there is in question 
 a still deeper re-valuation of ideas. The persecution
 
 288 History and Practice of Psychanalysis 
 
 grew into an external fact for you. Now you will 
 come to see that it had its roots in your own mind. 
 It has been exclusively an inner fact. It has come 
 into existence because of morbid displacement in 
 your unconscious mind." 
 
 During this part of the treatment, the inner 
 change in the patient became more and more evident 
 and what was more, there came about with it a 
 change in her attitude toward the external world. 
 The powerful inner tension gave way and the symp- 
 toms grew less pronounced. 
 
 She told me that she still saw the signs, but that 
 they seemed more remote and that they did not op- 
 press her as they formerly had done, that she had 
 begun to bother herself no longer about them. She 
 was now able with no great uneasiness to visit shops, 
 even the same shops wherein she had been formerly so 
 tormented. At the office too things were going bet- 
 ter. She had found flowers on her desk on her birth- 
 day. They had been placed there by the daughter of 
 Mrs. L., a woman whom she always had feared as a 
 secret enemy. I made her see how formerly she would 
 have been certain to have seen signs of the persecu- 
 tion in these very flowers. Even the cashier evi- 
 dently had grown more courteous. At my special 
 request she called upon some former acquaintances 
 and was astonished to find among them no ill will 
 against herself. At every point I made clear to her
 
 Extract from a Case-History 289 
 
 of course, the connection between these apparent 
 outer changes and her own actual inner change. 
 
 On the llth of March came the most decisive step 
 in the whole treatment. 
 
 She began immediately upon her visit to my of- 
 fice, to relate to me how during the past few days, 
 two recollections had taken hold of her, although 
 she did not know why they had come. For years 
 she had not even given a thought to the occurrences 
 in question, and now with no apparent reason, they 
 stood pre-eminent, fully clear before her conscious 
 mind. 
 
 When she was 17 years of age she had had a 
 friend a few years her senior. This friend was much 
 in love at the time, but her father had opposed her 
 marriage with the man. It had been reported to my 
 patient that this friend had moved to a provincial 
 city; after some time, however, she received a letter 
 telling her that her friend was still living in town, 
 secretly, in one of the suburbs and was awaiting 
 the birth of a child. After this event had taken 
 place, she went one evening to see her friend, in com- 
 pany with her own sister. This also had been done 
 secretly. While there she had met the young father 
 and had been quite enchanted by the blissful atmos- 
 phere which filled the house. The whole circum- 
 stance had made a deep impression upon her and 
 had excited her lively imagination.
 
 290 History and Practice of Psyclianalysit 
 
 As she spoke to me about this matter I was im- 
 pressed with the idea that all her girlish dreams had 
 once more come to life. At the same time she laid 
 so much stress upon her indignation over the lies and 
 deceptions with which these people had been obliged 
 to surround themselves in order to escape persecu- 
 tion from their neighbors, that I was forced to the 
 conclusion that the social side of this story had been 
 at the time, of main interest to her. 
 
 The second recollection was of something which 
 had entered still deeper into her life. 
 
 Among the girls with whom she had been confirmed 
 there had been one who was her especially intimate 
 friend. This girl, later on, had moved away from 
 town and correspondence between the two had grad- 
 ually come to an end, so that at last my patient very 
 seldom had news of her. In the year 1899 the pa- 
 tient heard accidentally that this friend was ill, 
 but she had thought nothing further about the mat- 
 ter. Some months later still, when the patient was 
 living in a boarding-house in England, she had read 
 in a newspaper that this friend had been arrested 
 on charge of infanticide ; the body of the dead child 
 had been found hidden in a doll's house. The patient 
 had a strong feeling that her friend was innocent and 
 was highly indignant at such infamy. The news- 
 papers made a great sensation out of the story and 
 her friend's name was mercilessly dragged through 
 the press. The case was talked about everywhere*
 
 Extract from a Case-History 291 
 
 An autopsy, however, was made upon the child and 
 it was thus proved, without the shadow of a doubt, 
 that it had been born dead. The whole scandal had 
 been the work of an official, a man who was an 
 enemy of the family. But because of the scorn and 
 persecution to which she had been subjected the poor 
 woman was completely broken. She would no longer 
 remain in her native land, but went to hide herself 
 somewhere in America. There she had encountered 
 many hardships. 
 
 The patient used the strongest words in trying to 
 explain to me how this story had shocked her. But 
 it had not been only because of compassion for her 
 friend; more than all had her sense of justice been 
 affronted. She had felt that the matter was an in- 
 sult directed against her sex. She even had desired, 
 at the time, to make public interference in order to 
 expose a code of morals, that will condone such 
 treatment of a woman who elects to decide the cir- 
 cumstances of her own life. 
 
 After this narration I asked the patient if she 
 could not herself guess the reason why such recol- 
 lections had now come to her, out of her uncon- 
 scious mind. Hesitatingly she then brought them 
 into connection with all I previously had explained 
 to her in regard to morbid identification, etc. She 
 called to mind the incident at the horse-races in 
 X-Burg and admitted that her thoughts, since she 
 had been made to see clearly through them, had
 
 292 History and Practice of Psychanaly&is 
 
 slowly worked out analogous experiences. Without 
 a clear understanding of that incident* she never 
 would have been able to understand that she had, 
 unconsciously, confounded her own fate with that 
 of her friend. 
 
 I spared no words in making fully clear to her, 
 until she herself was finally convinced of the truth, 
 that we now, on the spot, had discovered the nucleus 
 of her imaginary persecution. What she had expe- 
 rienced during the past ten years had been no per- 
 secution directed against herself; of such a thing 
 not a trace existed. It had been the persecution 
 against her friend. This, wrongly brought into con- 
 nection with her own "I," had amalgamated in the 
 depths of her unconscious mind and had been brought 
 to light by the incident in X-Burg. There she had 
 herself been in a position similar in certain aspects 
 to that of her friend. She had feared becoming 
 gravid and unconsciously had come to the conclusion 
 that such a misfortune would bring about like con- 
 sequences to herself. Then in her unconscious mind 
 had taken fire, the great struggle with the opponents 
 of the rights of women and she had prepared herself 
 to be persecuted and hunted down. Gradually this 
 persecution-complex had broken its way through to 
 the conscious mind. Making use of paths already 
 staked out for it, it had usurped more and more au- 
 thority over her personality, and so contracted the 
 limits of her life within narrower and narrower boun-
 
 Extract from a Case-History 
 
 daries. In this way she had become the victim of the 
 hallucinations. 
 
 After she accepted this explanation, the feeling 
 that she had had her long-fettered feet made free, 
 seemed to take more and more hold upon her and she 
 found herself coming more and more continually 
 into contact with the outside world. Nevertheless 
 the struggle between the complex and reality was not 
 yet over. It was an almost insurmountable difficulty 
 to carry through a revaluation of experiences which 
 had lasted for ten years. I constantly had to sup- 
 port the inner working of her mind with energetic 
 suggestions. In spite of everything, her doubts were 
 always ready to be awakened and the unbelievable 
 strength of her illusions was ready to spring into 
 light. It seemed to her impossible to think that all 
 the thousands of evidences of the persecution, could 
 actually be false ; yet on the other hand deliverance 
 from all this misery was so great a happiness, that 
 she could scarcely credit the reality of its coming 
 to pass. 
 
 I finally felt obliged to make a proposition to her 
 that she should speak to one of her imaginary per- 
 secutors. I selected for this purpose Miss D. who 
 had been the last person with whom the patient had 
 held any communication. 
 
 The patient wanted to think this idea over. On 
 the 24th of March I received a note, containing the 
 following lines : "I have determined to take no half-
 
 294 History and Practice of Psychanalyris 
 
 measures. I must appeal to Miss D. Her opinion 
 now seems necessary to me, if I am to get a clear 
 idea of my own mental condition and of my position 
 toward the world. Will you please write to her 
 about it?" 
 
 On the first of April when I told the patient that 
 I had talked about her with Miss D. and that the 
 latter had not the slightest suspicion of any perse- 
 cution, she answered me simply: "Then my last 
 doubt is gone." 
 
 From that date the patient may be considered re- 
 covered. A week later when she called upon me she 
 felt herself entirely free. She had made a call upon 
 Miss D. and the old friendship was just as strong as 
 ever between them. Furthermore she had again 
 started taking dinners at a restaurant and her 
 friends there had made a little feast to welcome her 
 back. 
 
 She continued to visit me once every week until I 
 left town in June. During this time she renewed old 
 connections more and more freely. It had become a 
 delight to her to walk through the streets, to visit 
 shops, etc., without the slightest feeling of uneasi- 
 ness. She was overjoyed to stand once more in nat- 
 ural rapport with life. Of her past illness she spoke 
 with entire objectivity. Once, for example, she 
 asked my opinion as to whether she had had hallu- 
 cinations or not. She believed that the movements of 
 the tongue sometimes were hallucinations because
 
 Extract from a Case-History 295 
 
 they had been made with such lightning speed. Genu- 
 ine movements scarcely could be made so rapidly. 
 Very likely the scraping with the feet too had been 
 hallucinatory. I told her that in my opinion she 
 had reached the right conclusion in this matter. 
 
 When the summer was over the patient again came 
 to see me. She had spent her vacation with a friend 
 at the seaside, and had had great pleasure out of 
 it. She had there made many pleasant acquaint- 
 ances with whom she had daily association. The 
 old thoughts had never returned. She said very 
 calmly : ". . . It was an illness. Now it is over." 
 
 During the past year the patient has visited me 
 perhaps a dozen times. We have talked together 
 about literature and the various events of the day. 
 Occasionally I have made use of my opportunity to 
 inquire into details concerning her past life. I never 
 have been able to discover the slightest trace of either 
 relapse or mental weakness. She has worked with 
 full forces and she has lost no opportunity to enjoy 
 whatever pleasure came in her way. 
 
 Several times she has expressed a wish that I 
 make her case-history public. "Perhaps," she has 
 said, "it might help someone else and then I should 
 not have gone through my fearful suffering to no 
 purpose." When I determined to do this I told her 
 and she was greatly gratified. 
 
 I had, after the treatment came to a conclusion, 
 made the acquaintance of the patient's niece of whom
 
 296 History and Practice of Psychanalytis 
 
 I have already had occasion to speak, a very intel- 
 ligent and highly educated woman. She knew with 
 certainty that the love-affair of the patient in 
 X-Burg was no imaginary experience but something 
 which she really had lived through. She (the niece) 
 had known the man concerned. Through this niece 
 I was able to verify statements of the patient con- 
 cerning her family, etc. During the whole course 
 of the treatment the niece had met daily with the 
 patient and discussed the new points of view with 
 her. There is no doubt, that in this niece I had a 
 valuable ally. 
 
 We still have the question to consider as to 
 whether other circumstances than those solely con- 
 nected with my treatment, had influence upon the 
 patient. The one change in her external life dur- 
 ing this time, was the death of her father. To all 
 appearances this event had passed with her as any 
 indifferent occurrence might have done. She came 
 the same day, as usual, to me for her treatment, nor 
 should I have suspected that anything had happened 
 if she had not been dressed in mourning. The man 
 was very old and ill and, like the rest of the family, 
 the patient looked upon his death as a kind of relief. 
 I am convinced that this occurrence had not even 
 an unconscious effect upon the state of her mind. 
 I am furthermore convinced that no conditions un- 
 known to me had had influence upon her. The niece, 
 who was conversant with all details in the life of the
 
 Extract from a Case-History 297 
 
 patient, surely would not have remained in ignorance 
 if any such conditions had existed, nor in her sym- 
 pathetic assistance with my work in the case, would 
 she have failed to report any contingent circum- 
 stances to me.
 
 vni 
 
 POINTS OF VIEW AND OUTLOOKS 
 
 IT is difficult to obtain a clear outlook over the 
 possibilities of psychotherapy through a fragmen- 
 tary presentation of some of its issues and lines of 
 thought. Even if we should go through in detail 
 everything which, during the past century can pos- 
 sibly be looked upon as falling within this sphere, 
 and if we should pause at each one who has had any- 
 thing to do with it, we should not even then be able 
 fully to comprehend what it now means. And still 
 less should we be able to construct for ourselves a 
 clear idea of the present status of psychotherapy 
 and of the purpose toward which it most deeply aims. 
 It is necessary to see it all in wider historical connec- 
 tions. 
 
 In its earliest state the healing art was inextric- 
 ably mixed up with religion. The priest was also the 
 medicine man. Zarathustra's holy books contain 
 very many rules concerning ablutions, etc. ; things 
 which in these days would come under the head of 
 hygiene. In the Greek temple of Asclepius, the 
 gods enlightened those who slept within, as to how 
 
 298
 
 Points of View and Outlooks 299 
 
 they might free themselves from disease. Thus in 
 the earliest state of culture there arose a struggle 
 within mankind to guard itself against unseen ene- 
 mies by whom it felt itself to be surrounded ; to these 
 enemies disease belonged, it was as dim and intan- 
 gible as the rest. This struggle was an aimless one, 
 a grasping after anything at all in which there 
 seemed to be, even for the moment, an atom of help. 
 Out of this guarded primitive-culture the art of heal- 
 ing was differentiated as a decided, limited factor in 
 human life. This came about through observation, 
 the fixing of cause and effect and the contrivance 
 of means, the value of which could with surety be 
 verified. It became the task of this new function to 
 conquer, on the sure road of experience, one field 
 after another. The history of medicine simply 
 shows how research, century after century, has taken 
 hold of the phenomena of disease, which at an earlier 
 period had been thought to originate from the inter- 
 ference of unknown gods. Primitive culture has con- 
 stantly tried to keep this development down. Even 
 now the disentanglement of medicine from religion 
 meets with opposition. How tenacious this is, is 
 shown for instance, in the annals of Lourdes. And 
 how deeply rooted the association is in the human 
 consciousness, may be understood from the enor- 
 mous following which such a movement as Christian 
 Science can win, even among those who believe them- 
 selves educated.
 
 300 History and Practice of Psychanalysis 
 
 The psychic-life is generally the sphere wherein 
 the application of causal laws meets with greatest 
 difficulties. When the thought first came up that 
 each observable phenomenon in the external world 
 is a decided consequence of a decided act, it met with 
 unprecedented opposition. Gradually we became 
 used to this way of representation. The idea that 
 the same thing holds good in the observable phe- 
 nomena of the psychic life, continues to be strange 
 to many. And this more especially in questions of 
 morbid conditions. Anxiety comes upon a person 
 without knowledge as to whence it came and the vic- 
 tim calms himself with the thought that lies nearest 
 at hand, viz: "This lias no special cause." If we 
 discover something in the world about us that we 
 do not understand we presume at once that after 
 closer examination we may be able to deduce a reason 
 for it out of given laws. But if we discover in a 
 similar way something unfamiliar within ourselves, 
 we much too easily accept the feeling that we are 
 the prey of forces which are not to be reached. It 
 is hard to see the connection between cause and effect 
 in the sphere of the unsound mental life ; but it must 
 be allowed that we are victims to gross illusion when, 
 powerless before this difficulty, we decide that no 
 connection exists, or that in every case, it is incap- 
 able of being unraveled. 
 
 All this means that the disentanglement of psycho
 
 Points of View and Outlooks 301 
 
 therapy from primitive culture has not kept abreast 
 of the rest of medicine. In this field people still 
 surrender themselves to chance, time, contingencies, 
 whatever they call that which they believe they 
 are unable to grasp, just as a thousand years ago 
 they resigned themselves to the devastation of epi- 
 demics. Or else they seek help in every conceivable 
 direction, whether it has connection with the genuine 
 cause of suffering or not, simply because "something 
 must be done." It would be an interesting task to 
 show how primitive man's way of apprehending the 
 world, still lives in this sphere of consciousness, 
 stretched out to an extent concerning which no one 
 may be able to obtain a clear idea. Who, for in- 
 stance, reckons, in the critical examination of his 
 feelings, with the periodicity of the psychic-life, in 
 precisely the same way we reckon with that perio- 
 dicity in the external world, which reveals itself in the 
 change between day and night, summer and winter; 
 and yet the former is no less obvious than the lat- 
 ter. In an old romance of the north country it is 
 related how the people, when the sun in the autumn 
 showed itself each day less and less, were seized with 
 terrible fear lest it should never again return, and 
 how this fear continued during the whole of the dark 
 period. We have acquired an undisturbed trust in 
 the conformity to law of external forces; but how 
 very far we really are from similar confidence in that
 
 302 History and Practice of Psychanalysis 
 
 which takes place within ourselves. And when shall 
 we come so far that we not only shall understand, 
 but also be able to subordinate the forces of the inner 
 life, in a way similar to that in which we now work 
 to make the utmost use of nature's forces in our 
 service ? I have several times in the foregoing studies 
 called attention to the fact that the chief aim of 
 psychotherapy is often the re-valuing, through which 
 something which formerly was destructive becomes a 
 means for advancement. But this goal seems very 
 distant when not even the slightest presumption that 
 we shall be able to aspire to it, the feeling of all 
 things being established by law, is common property. 
 One ought to be able to show in every single re- 
 spect how psychotherapy's disentanglement as an in- 
 dependent factor in human life, is hindered by primi- 
 tive conceptions and by the preservation of these 
 conceptions by institutions which long since have 
 outlived their usefulness. Much which rightfully 
 falls within the field of a purposeful psychotherapy 
 and ought to have been relegated to that field, is still 
 associated in the most perplexing and indefinite way, 
 with religious ideas. Possibly it may yet require cen- 
 turies to dissolve every bit of this residue of the past. 
 It is not necessary to examine the question here ; but 
 if one wishes to understand psychotherapy's struggle 
 for freedom out of bondage, one must look at it in 
 connection with the difficulties which medicine in
 
 Points of View and Outlooks 303 
 
 general has had to overcome, in order to arrive at its 
 present status. 
 
 If psychotherapy is to succeed in constituting 
 itself as a necessary part of the life-culture it means 
 first of all that all efforts which revolve about it be 
 gathered together, humanized, and developed. The 
 inner process of education is more important than 
 the fight against external conditions, no matter how 
 old may be the prejudices upon which this fight may 
 be founded. 
 
 Instead of tearing the movement to shreds in dis- 
 cussion of theoretical details, its representatives 
 must above all have great unity of purpose in view, 
 before which all incidental differences of meaning be- 
 come relatively unimportant. A great work must be 
 attacked from different sides; every personal 
 thought-force represents one such side. When the 
 same necessity lies at the bottom of all attacks, the 
 work by itself, during its growth reaches a certain 
 unification. 
 
 I have tried to show how psychotherapy has taken 
 on peculiar differences in the hands of different 
 teachers. Now one, now another foundation for it 
 lias been tried, and adjustment of the treatment 
 toward one or another purpose has been striven after.
 
 304 History and Practice of Psychanalysis 
 
 In spite of this there is no difficulty in demonstrat- 
 ing the unity which is behind all this apparent dis- 
 sension. Ideas emanating from different sources 
 are like different threads upon which the growth is 
 spun out to greater lengths; and all threads run 
 together to a warp where the fabric finally appears 
 in bold relief, picturing life itself with all its depths 
 and all its variations between light and shade. The 
 warp is in danger as soon as some one endeavors to 
 make one thread or the other the only one essen- 
 tial ; and this the more if at the same time one tries 
 to cut the other threads in hope of being able to dem- 
 onstrate their superfluity. Sadly enough one can 
 not exonerate any single one among the leaders in 
 this line of thought from having made an effort in 
 this direction. But happily on the other hand, one 
 begins to see the unsuitability of all such attempts. 
 Especially from one direction there is at work an 
 earnest effort to free the movement from all one- 
 sided tendencies and to lift it up in its entirety, to a 
 higher plane. 
 
 One of these threads of development, I have tried 
 in the foregoing pages to deduce from Feuchters- 
 leben. For him the chief characteristic was the em- 
 phasizing of the importance of common-sense for 
 the preservation of health. His dream was of some
 
 Points of View and Outlooks 305 
 
 doctrine of wisdom which would be so wholly in har- 
 mony with nature's own arrangements that he who 
 let himself be led by her would be able to take care 
 of his inner equilibrium, no matter how strong were 
 the storms of life which might try to shake it. That 
 this dream could not be realized is chiefly because 
 most of that which threatens the harmony of the 
 psychic-life, does not lie as a rule within the sphere 
 of consciousness, and therefore is not accessible to 
 the working out of the laws of common-sense. But 
 despite all limitations, this rationalistic trend will 
 always keep its value. Today in its most pro- 
 nounced form it is supported by Dubois and is a 
 somewhat milder way by Dejerine. 
 
 A great mass of suffering has its root in misap- 
 prehensions, exaggerated suspicions, stirred-up de- 
 mands which can not be satisfied. Many people sus- 
 pect an incurable trouble in every pain, or judge 
 themselves in the severest way for each thought that 
 arises in opposition to their longing for purity. It 
 falls within the activity of the doctor to bring such 
 confusion to rights by throwing light upon it; he 
 does not bear the name doctor, teacher, for noth- 
 ing. It may often happen that a valetudinarian feels 
 himself freed, after a single investigation into his 
 inner life, from some burden he has carried on his 
 back for years. But oftener it happens that the pa- 
 tient has tangled himself into such confusion, and 
 that erroneous ideas have become so fixed into his
 
 806 History and Practice of Psychanalysis 
 
 mind, that deliverance from them can be attained 
 only after exhaustive analysis. Under such circum- 
 stances it is by no means enough to say "Such and 
 such is so." One must be able by means of numerous 
 analogies to demonstrate that it is so; one must be 
 able to convince the patient of the right of these 
 causal-connections, which at first glance appear to 
 be unfounded. In order to do this, not only the knowl- 
 edge of the neurologist concerning nervous disturb- 
 ances is necessary,but also the insight of the psychol- 
 ogist, as to those ways in which the patient has 
 come to accept something unreal in the place of 
 reality. Without a deepened power for acute ob- 
 servation of all that which in co-operation, has built 
 up the psychic turmoil, the rationalistic movement 
 dissolves into empty dialectic. It is greatly to be 
 deplored that Dubois instead of appropriating 
 psychanalysis and using it, has tried to support "his 
 method's" superiority against it. 
 
 And it is much to be regretted that Feuchtersleben 
 has no disciples in these days who would seek to ap- 
 ply modern human wisdom to psychotherapy. The 
 one who perhaps comes nearest to this, Marcinowski, 
 follows far too one-sidedly in Nietzsche's foot-steps. 
 It is not sufficient to gather wisdom from the painful 
 experiences of one or another thinker; one must try 
 to harken to it directly from all the lamentations un- 
 der which the times are groaning. 
 
 Everyone has certain directing lines for his way
 
 Pomts of View and Outlooks 307 
 
 of thinking and acting. If one wishes by way of 
 rational persuasion to bring about a favorable 
 change where nervous disturbances are concerned, 
 one must also let himself be led by certain principles. 
 Whence shall we then produce them? From those 
 most generally applied? It will not be denied that 
 there are truths which constantly hold a certain 
 value; but there is nothing which under all circum- 
 stances has an equal value. By far the plainest of 
 these truths seems to be that the same thing which 
 under certain conditions may lead one person to sick- 
 ness, under different conditions may lead another to 
 health. There is nothing more risky than to hold 
 fast to any decided principle according to which an 
 effort is made to influence all. The psychotherapist 
 in front of each individual case must be willing to 
 give up himself as well as anything else which he 
 highly values ; he must with entire plasticity, seek to 
 adapt himself to the special exigencies of the case. 
 The line of direction for his persuasion he must fetch 
 out of the patient's own psychic-life in the given sit- 
 uation; it means to abstract from the condition, 
 those truths which have the highest value just for 
 him in just that moment. I have already called at- 
 tention to this in another connection; but too much 
 stress cannot be laid upon this point. Nothing can 
 be more against the spirit of psychotherapy than an 
 effort to force the mind into a ready-made thought- 
 system, which may have either religious or scientific
 
 308 History and Practice of Psychanalysis 
 
 imprint. For all such attempts counteract the true 
 fundamental conditions for real psychic health 
 namely individual liberation and the preservation of 
 inner plasticity. If one is fettered by mass-instincts, 
 petrified in thoughts that do not arise from one's 
 own inner life, even if apparently one seems to con- 
 tinue mentally sound, it is by no means sure that 
 one's state is such that it ought to be preferred to a 
 turbulent struggle with reality. 
 
 From the psychanalytical view-point all manner of 
 objections are made against treatment by persua- 
 sion. One reasons about it after this manner: life is 
 as a rule not built up in a logical way it is our feel- 
 ings and impulses that determine all things the 
 thoughts are only a superficial temporary remodel- 
 ing of those forces, a secondary "rationalization" of 
 their content. All the opinions of a person are con- 
 structed in this manner in roundabout ways, out of 
 the most profound earthly forces; against these, 
 logical persuasion carries no weight. As a matter 
 of fact, no one lets himself be talked over to any- 
 thing and every attempt to aid a sufferer in this way 
 is vain. More plainly than this, spiritual loneliness 
 cannot be pointed out. It will be hard to find a line 
 of thought which excels the Freud dogmatism in 
 making life isolated. 
 
 Nevertheless in the persuasion method there is a 
 certain degree of truth. 
 
 It is true that nothing can be lastingly inserted
 
 Pomtg of View and Outlooks 309 
 
 into a mind by means of persuasion, which is strange 
 to that mind. But persuasion may be a forceful 
 aid in actualizing something vital which has sunk 
 down out of sight and withered away. It is perhaps 
 true that life and the activity to which we are des- 
 tined, far from carrying on our inner accretion of 
 power, often or most often is of the greatest 
 danger to it. Social demands trample unscrupu- 
 lously upon that to which we aspire in our longing 
 toward freedom; they seek to bring the very desires 
 of our hearts to silence. When this goes on year 
 after year our natures draw back into themselves 
 distracted; more and more the feeling of what one 
 is and what one wishes, is lost. It is the psych- 
 analyst's duty to call forth these voices of the deep, 
 which have so continually been silenced that the 
 patient no longer hears them himself. If he is suc- 
 cessful in doing this and if he gets the proper grip 
 on the personality of the patient, then he may often 
 need the whole logical strength of persuasion to con- 
 vince that patient that he is what he is. The real self 
 has disappeared so entirely in this leveling struggle, 
 that at first the patient does not recognize it when 
 it again stands before his eyes; the analyst must 
 point out now one, now the other feature in order 
 to convince him that it really belongs to that self. 
 It is true that every person is a being in himself and 
 that each of us in his inmost nature is alone. But 
 one of the greatest values of life lies in this fact,
 
 310 History and Practice of Psychanalysia 
 
 for if it were not true we should never be able to 
 discover each other. And in the joy of this dis- 
 covery the oppression of loneliness disappears. 
 
 I said the foremost representative of the rational- 
 istic method of treatment, Dubois, turned against the 
 modern trend of thought which is summed up under 
 the name, psychanalysis. This, however, has not 
 prevented its development. It more nearly signified 
 that he and his followers turned against treatment 
 by suggestion. In childish self-vindication he has 
 set up his "persuasion" idea in opposition to the old 
 idea of suggestion. This has produced, in connec- 
 tion therewith, treatises by the hundred, where, in 
 scholastic dialectic, attempts have been made to draw 
 boundaries between these two ideas in order to then 
 give either one or the other the preference ; the re- 
 sult has been confusion. 
 
 In the foregoing pages I defined suggestion as an 
 idea which is carried into effect in the organism in 
 a unique way ; it implies transition from imagination 
 to reality. As I have just said, by means of per- 
 suasion something which has lost its reality value 
 may once more regain it. There is thus a kind of 
 inner affinity between the two processes. This never- 
 theless, does not prevent one from theoretically sepa- 
 rating them; the homogeneous changes may come 
 about in different ways. However, this separation 
 has very little of interest. For in practice the bound- 
 ary lines run together. In practice there is no ques-
 
 Points of View and Outlooks 311 
 
 tion of a theoretical preference over the one or the 
 other; there one makes use of that which is most 
 suitable to the occasion. 
 
 A little episode occurs to me which made the na- 
 ture of suggestion suddenly stand out clear before 
 me. 
 
 Once many years ago, I was out on a tramp in 
 the mountains and started early one morning to 
 ascend a peak. I had been up before and knew the 
 ascent was not dangerous. I had a guide with whom 
 I had had long acquaintance and upon whom I could 
 rely implicitly. But somehow when I neared the top 
 I became frightened. The chasms below yawned ter- 
 rifyingly and the ice-slopes above were steep; I 
 stopped and gazed down at the sharp rocks among 
 which I should land in case I lost my footing. I 
 grew dizzy and the distance between me and my guide 
 seemed to grow. At last I shouted to him that he 
 must chop better steps in the ice. He turned around, 
 he must have noticed something unsteady in my 
 voice ; for he answered at once : "No need of that ! 
 There isn't a trace of danger." And so he went 
 on. I can still recall how all apprehension dis- 
 appeared at once as if by magic. I laughed at the 
 feeling I had had. I looked down and up with the 
 same composure I would have felt in walking the 
 levelest and most familiar road. The words of the 
 guide had meant something quite other than the ex- 
 pression of a fact, the communication of an idea;
 
 812 History and Practice of Psychanalysis 
 
 they had meant an inner change of the most obvious 
 sort. 
 
 The first and most momentous reason for the pos- 
 sibility of this occurrence lies in the fact that I had 
 become confused and that the words brought me 
 back to reality. They actualized, to put it in an- 
 other way, something that was within me, but which 
 for the moment was obscured by delusive feelings and 
 erroneous representations. Had a real danger exist- 
 ed, the words would have meant nothing to me. The 
 other reason lay in my confidence in the guide. I 
 knew him well enough to be positive that he never 
 would say anything that he himself was not sure of. 
 This may seem like credulity. But I knew that if it 
 had been necessary, he would, by means of examples 
 of similar cases by pointing out the angles of the 
 ice-slopes, the softness of the ice, etc., have been 
 able to demonstrate the truthfulness of his assertion. 
 Back of this is really hidden all the logical apparatus 
 of persuasion. 
 
 Something like it continually happens in the rela- 
 tion between doctor and patient. What else is the 
 invalid but a poor seeking wanderer in the desolate 
 places of life. Things swim before his eyes, every- 
 thing looks terrible and hard to climb he is unable 
 to calmly pilot himself between the yawning abysses 
 of his conflicts. If the physician says: "Here is 
 your way!" he must also be able to prove that it 
 is so. And if he can do that then the use of many
 
 Points of View and Outlooks 313 
 
 words would be superfluous. It is not necessary to 
 enter upon the question of the mystery of silence in 
 order to show how a single hearty grasp of the hand 
 may sometimes hold more meaning than the most 
 eloquent explanation. And suggestion is simply that 
 spiritual grasp of the hand that directly carries 
 things once more to their right place. 
 
 Understanding of this is important because it is 
 with this setting aside of obscure complications in 
 the feeling- and thought-life, that one especially has 
 to do. The prevailing idea of treatment by sugges- 
 tion has been that it simply means the implanting 
 of health-bringing thoughts ; it much of tener im- 
 plies the breaking down and dissolving of auto-sug- 
 gestions which stand in the way of recovery. We 
 become ill chiefly because of experiences filled with 
 fear, around which there assemble hopeless thoughts 
 and fantasies, that outline the whole of existence as 
 a single horror, until they become a barrier which 
 the current of life does not succeed in breaking 
 through when it tries to reach us. In such spheres 
 are built up those false syntheses which hold us 
 bound and which decide what takes place in our inner 
 lives. 
 
 It seems to me far beyond all doubt that treat- 
 ment by suggestion is constructed upon such a true 
 foundation, that it deserves a broader place in thera- 
 peutics than it now holds. But it must most assured- 
 ly not be carelessly handled nor allowed to sink into
 
 314 History and Practice of Psychanalysis 
 
 mere routine mold. It can and must be made of 
 deeper import. 
 
 I said that it is unnecessary to ponder over the 
 mystery of silence in order to understand sugges- 
 tion; but the same thing can scarcely be said re- 
 garding treatment by hypnosis. In the latter case 
 the effort is made to arrive at an inner quietude in 
 which not only the use of many words becomes super- 
 fluous, but which at the same time, means immediate 
 disentanglement from everything that tears every- 
 day life to pieces. What hinders self-healing of the 
 wound is often simply lack of stillness, lack of 
 ability to silence the voices within us. Just as by 
 means of suggestion one tries to actualize the essen- 
 tial qualities in a person and give to these qualities 
 power to carry the burden, so in hypnosis one tries 
 to bring the patient into a condition where every- 
 thing that interferes with silence is eliminated. Both 
 therapeutic factors in the literature concerning them, 
 have customarily been considered together, even to 
 such an extent that the two terms have been used 
 as synonymous. They have an inner connection, but 
 scarcely of the kind generally imagined. Hypnotism 
 is at the same time both simpler and more full of 
 mystery. We all know how we are more susceptible 
 to that which reaches us from without, the more
 
 Points of View and Outlooks 315 
 
 indeed, as we let the thoughts have free rein and 
 abandon ourselves to them. We do not catch the 
 deeper import of what some one says, if we brace 
 ourselves to meet it with our own counter arguments ; 
 we do not feel all the sentiment which rests over na- 
 ture if our attention remains bound up in some 
 problem which occupied us before we went out of 
 doors. The added susceptibility the suggestibility 
 in hypnosis is nothing but a consequence of the 
 intentional unfastening of the trend of thought. 
 And it thus has far-reaching association with the 
 commonest every day circumstances. But when this 
 simple process reaches a certain point it is as if 
 the whole tension into which the daily life has knit 
 itself together, and in which we are compulsorily fet- 
 tered, relaxed. It is as if the soul-life at the same 
 time gained additional, more graduated plasticity, a 
 freedom, due to which things may be carried into ef- 
 fect in our inner lives, which under ordinary cir- 
 cumstances would remain objects to be wished for in 
 vain. It is after an expression for this, that one 
 seeks when one talks about suggestibility in its 
 deeper meaning ; here one touches something that has 
 to do with the mystery of life itself. And that 
 one stands sometimes in the practical demonstration 
 of this circumstance, before phenomena which work 
 wonders, can scarcely be a subject for denial. Those 
 quick cures of which we read in the literature of the 
 decade from 1880-1890, were not products of the
 
 316 History and Practice of Psychanalysis 
 
 mind, but realities. I have myself many times seen 
 such curative action, which unless I had seen it, I 
 should have had hard work to credit. But unfortu- 
 nately such things are not to be counted on. The 
 modern physician holds decided opposition to every- 
 thing he cannot bring into full and tangible connec- 
 tion with the rest of knowledge. He prefers to let 
 one factor lie untouched until its claim for clear 
 explanation is satisfied, rather than to reckon with 
 it in any wavering uncertain form. Hitherto there 
 has been insuperable difficulty in amalgamating hyp- 
 nosis with the rest of science; how an effort I have 
 made in this direction will come out is still uncer- 
 tain. For myself, however, it means a solution of 
 the problem. 
 
 In cures in the hypnotic condition many different 
 factors undoubtedly play a part. That these fac- 
 tors may be separated and demonstrated each one 
 by itself, seems to me probable; it should in other 
 words signify a deliberate development ef hypnotic 
 therapy along different lines. 
 
 As an example of what I mean I may here men- 
 tion Frank's way of getting at hypnosis. It is allied 
 most closely to the first stadium of psychanalyses. 
 It was applied then to the effort to "abreact" those 
 affects which had been pushed aside into the uncon-
 
 Points of View and Outlooks 317 
 
 scious mind. In this way one made an endeavor to 
 bring them again to life, to reproduce them in the 
 consciousness. As I showed when speaking of this 
 before, we have come, because of reasons which, 
 viewed on a large scale must be considered valid, 
 away from this road. Psychanalysts satisfy them- 
 selves now in general, with the working out of the re- 
 pressed idea-material itself and with the explanation 
 of this material; it is on this last point that the 
 chief importance now lies. 
 
 But the original standpoint hides a kernel of truth 
 which entitles it to preservation. 
 
 The continuity in the chain of different experi- 
 ences is first brought about through the inner con- 
 nection of the feelings. There was a deep folk- 
 hygienic wisdom in the old rule which compelled every 
 one to go to mass each morning. There people were 
 calmed into the same mood from day to day, from 
 month to month, from year to year; it was like 
 a continuous living stream of feeling that bore them, 
 one might almost say, from the cradle to the grave. 
 If there came then inner storms of the most lacerat- 
 ing kind, this foundation-current of the feelings nev- 
 ertheless always represented a certain connection. 
 The modern man stripped of all such assistance finds 
 himself in a situation which leaves possibilities open 
 for inharmonious disorganization reaching to the 
 very bottom of his nature. Every time a person is 
 carried away by a new emotion, the same thing as a
 
 318 History and Practice of Psychanalysis 
 
 new "I" is built up in his mind. And if this discon- 
 tinuity is once well constructed, it is hard to over- 
 come. Life continually goes on driven by the hope 
 that at last one feeling shall force all others into the 
 background and dissolve all that has gone before into 
 undisturbed harmony. But just in that lack of col- 
 lectedness which the emotion implies, lies the great- 
 est obstacle for hope thai this ever will be accom- 
 plished. For the qualification itself for a great and 
 all-devouring feeling is simply a certain inner cen- 
 tralization of the emotions a possibility for all the 
 separate currents to flow together. 
 
 It is right to try to make use of that inner still- 
 ness which is the essence of hypnosis, toward a gath- 
 ering together of the shattered emotions. One shuts 
 out thereby every new thing which might further dis- 
 turb these emotions ; this means the isolation of the 
 individual within himself. It means further that con- 
 centration inward, which is so characteristic of hyp- 
 nosis. If we wish te bring out into our conscious- 
 ness something which has been repressed and lies 
 hidden behind strong opposition, then we direct the 
 attention toward that end; by so doing first comes 
 out the memory-picture itself, stripped of all the sen- 
 timents and affects with which it originally was 
 bound up, and which in it had its symbol. Only lit- 
 tle by little does all come to life again the,picture 
 itself fading away before the deeper reality. When 
 in such a way one again lives through those feelings
 
 Points of View and Outlooks 319 
 
 which have been most vital in life as ineffaceable real- 
 ities in a single connection, then is the disharmony 
 made loose from its foundation. I am inclined to 
 believe that the strong effect Wetterstrand obtained 
 by means of the prolonged sleep, in a great measure 
 was due to the fact that during it there set in spon- 
 taneously some such centralizing of the emotions. 
 At least I have found it so at various times when 
 I myself have made use of the same method. 
 
 In the face of the effort of psychanalysis to 
 monopolize psychotherapy, not even the most val- 
 uable of the earlier suggestions has been able to hold 
 ground. Not only because all the new view- 
 points it gives us, draw attention away from what al- 
 ready was proven; but more because it turns itself 
 against everything old and tries to trample it under 
 foot. In the eyes of his pupils, Freud not only has 
 definitely solved the riddle of the Theban Sphinx but 
 he has also torn away the veil from the sphinx that 
 stands staring over modern life, and that has its ever- 
 lasting representative in Hamlet. And under the 
 lines of direction Freud gives out for methods of 
 treatment all other efforts must be subordinated. 
 
 I said before that the so-called rational therapy, 
 the logical persuasion, is dismissed as worthless by 
 Freud and his school. In an earlier connection I
 
 S20 History and Practice of Psychanalysis 
 
 pointed out how they maintain the emptiness of 
 treatment by suggestion, through talk of the trans- 
 ference of the father-complex upon the doctor. The 
 latter question is, however, more complicated than 
 they considered it. To silence all talk about sug- 
 gestion playing any part in psychanalysis, Freud 
 has banished the world itself from all the literature 
 inspired by him. For all those psychological condi- 
 tions which are brought to light by means of the 
 study of suggestion, he uses his own designations. 
 His fundamental idea is this: suggestion is at first 
 hand an affective phenomenon signifying such things 
 as confidence, collusion, sympathy, etc. If these 
 are not there, transferred representations cannot be 
 carried over in the characteristic way. It thus means 
 really a transference of feelings with a definite con- 
 tent of ideas. The suggestion is consequently noth- 
 ing but a special case of transference in general. 
 Therewith Freud solves the whole thing in one of his 
 principles. Because the transference proceeds from 
 our earliest emotional associations, i. e. those with 
 mother and father, it finally means the transference 
 of corresponding complexes. It is unnecessary to 
 add that these, like everything else in the world- 
 progress has the sexual key-note ; suggestion is thus 
 a sexual phenomenon. 
 
 By means of such desperate forcing of everything 
 into an inelastic theoretical impasse there is ef- 
 fected, however, something quite different from that
 
 Points of View and Outlooks 321 
 
 which was intended. Truths are not altered because 
 they are given a stamp which makes them apparently 
 unreal or absurd. If they have not in themselves 
 such strong holding-power that they survive this 
 procedure, they soon of themselves disappear out of 
 the reckoning, t This way of treating the truth-values 
 of the past, shows better than anything else the limi- 
 tations of a view-point. All criticisms coming from 
 without and all inner scientific differences, do not so 
 much harm what Freud brought forth, as does his 
 infelicitious tendency to drive one-sidedness to ab- 
 surdity. It is depressing to see such a movement 
 work upon its own annihilation. For it can never 
 be denied that it was first through the ideas which 
 came from this direction, that psychotherapy was 
 able to lift itself up to importance and become a gen- 
 eral life-factor. Freud with one stroke has given the 
 study of the soul-life such breadth and such surety, 
 that we have obtained a foundation upon which to 
 build for all time. One may be never so bitter against 
 him for the blunders he has made yet no one can 
 carry out a single simple treatment without making 
 use of some thing he discovered. It devolves upon 
 those who will take the scientific inheritance after 
 him to see to it that all his daring ingenious ideas are 
 followed out with every conceivable freedom from 
 prejudice. Only then can everything which now is 
 in a state of fermentation, be worked out. 
 
 And yet not so much skill is needed to unite psych-
 
 322 History and Practice of Psychanalyns 
 
 analysis to what already obtained when Freud took 
 hold of the subject. 
 
 Concerning the psychology of suggestion for in- 
 stance, the analogy between post-hypnotic sugges- 
 tion and childhood-trauma has many times been 
 pointed out. And this with right. In post-hypnotic 
 suggestion an idea, which one induces into the me- 
 dium, is released into action after a definite time, 
 or becomes apparent by means of a transitory nerv- 
 ous disturbance, as loss of sensation, paralysis or 
 something of the sort. Childhood trauma is in a 
 similar way a sphere of representations which life 
 works into the consciousness in an earlier stadium, 
 and which after decades, breaks out in neuroses, giv- 
 ing definite forms to their symptoms. Supposing 
 that suggestion always does contain an affective mo- 
 ment everything is far from said that may be said 
 concerning this process. If one applies in this man- 
 ner what one has learned to know about suggestion 
 from the psychanalytical store of knowledge, much 
 clearness of vision is won. 
 
 But of yet greater import than that these new 
 ideas have, without restraint, added themselves to 
 that which already was astir within the realm of psy- 
 chotherapeutics, is that they incorporate, reorgan- 
 ize, cleanse and go deeply into, the psychic means, 
 through which people long before this time had tried 
 to find a road to health. We find again here on a
 
 Points of View and Outlooks 323 
 
 new plane, suited to modern demands, many factors 
 which played a great part in intellectual culture. 
 
 There is a deep-seated necessity in mankind for 
 confiding in someone. We exist as a rule, not as 
 isolated beings, but only in and through each other 
 and with a bond that holds us all together. There 
 are circumstances under which this necessity cannot 
 be looked after in the ordinary way, by means of 
 conversation between friend and friend. There are 
 secret places so deeply hidden, that we cannot bear 
 to see again one to whom we have disclosed them ; 
 there are things that are so holy, that never under 
 conditions common to daily life, can we find an hour 
 quiet enough to give us courage to touch upon them. 
 ... It is out of such postulations that the confes- 
 sional sprang forth as a necessary life-factor. How- 
 ever paradoxical it may seem, there are divers 
 circumstances that make it easier to talk with an out- 
 sider about things most intimate, than with one who 
 belongs to us. The latter can not avoid taking part 
 in those painful emotions by which we are tormented, 
 in quite another way than does the former and this 
 resonance may easily increase the pain; instead of 
 then becoming free ourselves, we have on the con- 
 trary, dragged another down into our own misery. 
 It requires something which under every condition 
 can maintain its objectivity for what we covet is 
 simply to get a part of this objectivity and so make 
 free our pain from ourselves as an object by itself.
 
 824? Histori/ and Practice of Psychanalysis 
 
 And furthermore: if we rely no matter how little 
 upon someone dear to us, it can then never be said 
 that we are relying upon our own discretion as fully 
 as necessary. This discretion must needs be kept 
 going because of something other than a personal 
 promise, something like a public institution which 
 under no circumstances can be disturbed; this must 
 be the priest's or the physician's official duty. And 
 first and last; it is by no means enough that the 
 person to whom we speak should listen as one person 
 ordinarily listens to another; he must so listen 
 that our confusion clears itself away and our uncer- 
 tainty is dispersed. 
 
 When we have this point in view, we better under- 
 stand what I referred to by way of introduction 
 the difficulty psychotherapy has had to make itself 
 free from primitive ideas. The confessional from 
 olden time belonged to the priest, and it still does so 
 in many countries. And this although it is really as 
 absurd to beg the priest to listen to the agony of 
 the mind as it would be to ask him to listen to the 
 heart in order to determine if its valves are sound. 
 The priest lacks the scientific education necessary to 
 be able to decide if an affliction is determined phys- 
 ically or psychically and this scientific education 
 must always remain the starting point of each in- 
 vestigation. Far from signifying a work toward 
 individual liberation, the confessor's study is turned 
 toward forcing existence into a system of thought
 
 Points of View and Outlooks 825 
 
 which has little value in the life of our times. And 
 his activity is bound up with a vow to preserve this 
 thought system. Face to face with the individual 
 human being's pain, the question with him never be- 
 comes one of how, through liberation of the cramped 
 forces, he may be able to reach out toward healthful 
 life-work and harmony; it means only a dragging 
 forth of old doctrinal phrases, in the hope that they 
 may be able to bring some comfort. That which 
 gives courage and strength is a feeling of personal 
 value, which the psychotherapist strives to present 
 when he clears up causal-connection complications 
 and shows that the sufferer has been a victim of con- 
 flicts and misconceptions; on the other hand there 
 is nothing so humiliating for such a sufferer, as to 
 hear his inner struggle for freedom summarily dis- 
 missed with a few moral phrases. 
 
 This circumstance becomes even plainer if we con- 
 sider the question of redemption. 
 
 This is the confessional's final goal. And it is 
 arrived at through the idea that the priest, by means 
 of some mystic power, confers remission of sins. It 
 does not need to be pointed out that the priest there- 
 by betrays his descent from the magic wizard, and 
 that this point in the religious-system is a remnant 
 of the oldest, most primitive of ideas. Inner redemp- 
 tion is a psychologic process, which in the same de- 
 gree as other processes is open to research. We can 
 investigate the roads upon which those who have
 
 826 History and Practice of Psychanalysis 
 
 attained most in spiritual redemption, searched 
 toward their goal we can find certain genera], fea- 
 tures which can be applied to others and help less 
 happily circumstanced individuals on. I have al- 
 ready shown how this instruction in the art of inner 
 redemption is an important component part in 
 psychotherapy. In that way we attempt to make the 
 happiest hours which the strong experience, gen- 
 eral property; we proceed from the undisturbed 
 fact that the strong in this succeed in casting away 
 the burden of suffering under the weight of which 
 others have gone to pieces. We ask how? And we 
 seek the answer through analytical research. We 
 say "There is the road !" And if it turns out im- 
 passible, in any case we do not tire of pointing out 
 the fact that it nevertheless is there. 
 
 But it serves little advantage to talk of this thing. 
 Already for centuries mankind on its onward path, 
 has seen into that which is absurd and demoralizing 
 in the confessional. That the confessional has been 
 able in so widespread a degree to prevail, is alto- 
 gether dependent upon the tenacity with which the 
 folk-consciousness clings to a thing which is well 
 worked into it and nothing can alter this. But 
 what these people have not understood, is how to 
 estimate the necessity that ultimately lies at the 
 foundation of the confessional; had they done that, 
 they would have understood also that this too must 
 in some way be looked after. The fact is that the
 
 Points of View and Outlooks 327 
 
 confessional has more and more been put over upon 
 the physician. With or against his will the family 
 doctor often is dragged into all the conflicts and sor- 
 rows that ultimately lie at the bottom of those dis- 
 turbances for which he has been consulted. In this 
 very fact is already a step ahead. Unfortunately 
 the doctor, because of the strong material features 
 incident to his whole education, has difficulty in esti- 
 mating psychic factors at their full value; besides 
 how is he to give himself time to hear everything a 
 patient has to tell? His time is already over- 
 full of things which more directly fall into his sphere 
 of action. Intimate conversation is to him always 
 something incidental. It is, however, to this actual 
 transference of the confessional from priest to doc- 
 tor, from religion to science, that psychotherapy is 
 connected. Its development consists only in that it 
 changes into something of especial import what to 
 the doctor in general has been a minor thing, a trifle, 
 and that it puts forward especial training toward 
 this end as a deliberate intention. And it is psych- 
 analysis which at this point has been the lever of 
 the development ; for it has brought to light the ab- 
 solute necessity of mutual discourse for the bringing 
 about of psychic health. 
 
 However psychanalysis is something more than the 
 drawing forth of everything that has disturbed a life
 
 328 History and Practice of Psychanalysis 
 
 in its making and that has led unfoldment of this 
 life astray. It does not limit itself to the throwing 
 of light upon what is dragged out of dark nooks 
 and corners, whither an effort has been made to force 
 it back; it strives before all after what its name 
 implies, viz : the breaking up of that which is brought 
 to light. 
 
 Even in this regard psychanalysis is connected 
 directly with a primitive life-factor. As far back as 
 it is possible to trace culture, one may also plainly 
 trace a certain tendency among its first representa- 
 tives toward introspection, a tendency to ponder over 
 what happened in the inner life. It has not merely 
 been a question of becoming lost in that inner life 
 a longing after an intensified perception of all its 
 workings; it has been an attempt to take hold of 
 these workings intellectually and to break them up 
 into their elementary factors. This destructive inner 
 activity has grown into the consciousness as some- 
 thing so self-evident, that we do not even reflect upon 
 the fact that in reality it is something unnatural. 
 The one thing natural, the one thing which spontane- 
 ously awakens happiness and makes life richer, is the 
 free expression of those forces which come from our 
 inner life they may seek their outlet in the form 
 of contemplation, of impulses, of activity. To thus 
 turn ourselves against life's forces as against enemies, 
 to try to grind them to pieces . . . like everything 
 unnatural this produces aversion for life. And still
 
 Points of View and Outlooks 329 
 
 this analytical feature, which is found among the 
 upholders of culture in all times must have authoriza- 
 tion. We come clearly upon it when we examine the 
 individual thinkers ; we find how they carry on some- 
 thing in the unconscious mind that leaves them no 
 peace thoughts perpetually circle around this thing 
 it is a problem they must have solved. What is the 
 single individual but a symbol of the whole? In 
 each muser is mirrored the suffering that burdens 
 all, the same riddle over which mankind as a whole 
 has brooded, generation after generation, comes back 
 to each and every one of them. 
 
 This compulsion toward self-analysis increases 
 during all phases of unfoldment which, more than 
 others, form boundary lines between something that 
 has been and something that is to be. It may be hard 
 to find a time when this fact has been more evident 
 than in the present. Ever since Rousseau dissected 
 and laid bare his morbid impulses and his most inti- 
 mate feelings, numberless writers have freed their in- 
 ner lives with similar unmercifulness. And this has 
 won response; those who have gone the farthest 
 have been the most highly esteemed. One does 
 not need to mention other names than Ibsen, 
 Nietzsche, Strindberg, Dostojewski. It is as if the 
 need of clear inner vision forced itself out with such 
 strength, that all other considerations must retire 
 into the background. 
 
 To this feature also psychanalysis joins itself
 
 S80 History and Practice of Psychanalysis 
 
 That it has attained such rapid and surprising re- 
 sponse, is largely because it has been prepared for 
 in this way, in the general consciousness. But it is 
 still more because of something else; it breaks open 
 a new road for analysis. Instead of being handled as 
 hitherto, by individual thinkers and writers, it now 
 becomes an object for joint research. It no longer 
 is the thought property of single individuals it is a 
 question of co-operative work on the broadest basis. 
 Just as every one in the dream becomes spontane- 
 ously a poet, who conjures out symbols and meta- 
 phors which in depth and clearness often eclipse the 
 best that acknowledged writers have succeeded in 
 bringing forth, so each one, through dream-analysis, 
 may become a thinker who assists in spreading light 
 over the unknown. When everything that in this 
 way becomes manifest, is gathered together and ar- 
 ranged, there arises hope that the analytical ten- 
 dency in this new system of co-operation may suc- 
 ceed in reaching out toward a goal, which hitherto 
 has constantly disappeared as an illusion. Thus 
 far psychanalysis has indeed already shown itself to 
 be something other than empty illusion, since every- 
 one, who with comprehension, has followed Freud's 
 researches may get gratifying answers to many hith- 
 erto obscure life problems. 
 
 I shall not again touch upon any of the details 
 of psychanalysis. Only at one point I must pause. 
 
 What first is most striking in a cursory glance
 
 Points of View and Outlooks 331 
 
 over Freud's work, is his emphasizing of the power 
 of the past over us. The man of action, who lives 
 in the general whirl and never takes thought of any- 
 thing other than how he may get along from day to 
 day, does not notice this power. The neurasthenic, 
 on the contrary, who incessantly works up his experi- 
 ences in order to fret over now one, now another of 
 them, is over-sensitive to this fact. Be the case one 
 way or the other, the past always binds us and rises 
 like a wall in the way of that to which we wish to 
 attain. Even where activity continues free, the past 
 influences it, in all details. One intelligent man, of 
 great energy, said to me when, during analysis, he 
 became aware of this fact: "But then surely every 
 one ought to undergo psychanalysis once a year, in 
 order to discover the real motive for his actions." 
 It is certain that consistent searching through of all 
 the obscurity which drives and hunts us on, should 
 relieve our daily life of much confusion. 
 
 "That which is bound on earth shall be bound in 
 heaven." This sentence may here be repeated only 
 with the difference that in the place of earth and 
 heaven, we use the words childhood and the life that 
 succeeds it. It is simply out of all that which is 
 built up during the first years, that opposition to life 
 is chiefly derived. What is disastrous is that this 
 constructive work is not led by the same rationality 
 that later is to be the deciding factor ; it is led by 
 a consciousness that has not learned to separate fact
 
 332 History and Practice of Psychanalysis 
 
 from fantasy, reality from unreality. In all neuroses 
 this fragment of the childhood-life plays a certain 
 part; in all the peculiar ideas of neurotics it re- 
 mains and blocks the path for the free building up of 
 the "I." It represents an opposition against which 
 the forces in vain are broken in their struggle toward 
 an ideal which has developed during the years of 
 growth. Often enough one may see how disharmony 
 has its root in this strife between the child in man 
 its world of illusion and manner of feeling toward 
 life on the one hand and on the other the reality 
 in which the grown person tries to arrive at harmony. 
 On earth in heaven ; who knows if it is not simply 
 this bondage to what one thought and felt before 
 one yet was an independent being who could feel 
 and think for himself, that more than anything else 
 prevents the world from becoming a dwelling place 
 of harmony? 
 
 I have said before what Freud's incest-doctrine 
 seems to me to imply, if one strips it of its extraor- 
 dinary terminology. It places the inscrutability of 
 the impulse before one's eyes and shows us how sat- 
 urated with fate is the early anchorage of the feel- 
 ings. There is something fearful in all this. Freud 
 has laid bare chasms and exhibited tragic depths be- 
 fore which we ask: "How shall any one be able to 
 escape this thing?" There is nothing farther from 
 Freud than a therapeutic enthusiasm which works 
 every success in practice up to a new illusion. Thus
 
 Points of View and Outlooks 333 
 
 psychotherapy is made ridiculous if any one imputes 
 to its ability to "cure" all or even half of the suffer- 
 ing that falls within its sphere. Whoever takes up 
 this work must surely soon enough obtain insight into 
 the cruelty of life and the perishableness of hope. 
 But, and this is perhaps the greatest thing in Freud's 
 work, it is only through the unyielding truth, that 
 a way is opened to freedom ; it is only after one lays 
 life bare in its most horrid nakedness that one may 
 hope to come to rights with it. Every system of 
 philosophy built on lies is bad philosophy. On a 
 foundation of lies one may, possibly drag himself 
 along from the jugglery of one day to that of the 
 next; but to so reach a state of existence worthy a 
 human being never. 
 
 It is interesting to note how psychanalysis even 
 at this point, takes up and drives to its extremity a 
 movement, that already occupies a widespread space 
 in cultural life ; I refer to the attempt to find out the 
 real life of the child and to help it on to early indi- 
 vidual freedom, instead of holding it back in the 
 thought- and feeling-life of childhood. "I have al- 
 ready shown how the application of psychanalysis 
 to pedagogics is one of its most important sides. 
 Just as Rousseau when he became conscious of the 
 misery of his own life, turned his interest toward the 
 training of children, so the enlightenment received 
 from psychanalysis must be directed toward the same 
 end. For the individual alone it may seem as if there
 
 334 History and Practice of Psychanalysis 
 
 were little comfort in this his own fate remains in- 
 deed, just the same. And among all those things 
 which rest heavily upon and oppress us, this feeling 
 is perhaps the crudest of all; so it is and so it will 
 always be. If we can look with a brighter eye toward 
 the generation to come, something at least of the 
 agony of life is dissipated and we may breathe more 
 easily. 
 
 However this bondage and opposition to life's 
 current originates not only in childhood. In neu- 
 rotics there remains like a block in the conscious- 
 ness, not simply an unmelted piece of this. Freud's 
 latest researches go to show that even a bit of primi- 
 tive man's world is left in neurotics and holds them 
 down. He has presented numerous analogies be- 
 tween savage conceptions, feelings and circum- 
 stances, which appear in compulsion-conditions and 
 other nervous symptoms. Something holds good 
 here, similar to the experiences of childhood; fan- 
 tasies, imaginations, impulses, symbols, work them- 
 selves together and construct a whole system, which 
 remains established long after the different units have 
 lost their real significance. As one individual may 
 be burdened by that which he built up and grew into 
 during childhood, so we may all be burdened con- 
 tinually by the dead remains of the childhood of 
 humanity.
 
 Points of View and Outlooks 335 
 
 It does not need pointing out that psychanalysis 
 also in its attempt to investigate, dissolve and an- 
 nihilate all this, adds to the prevailing cultural life. 
 It makes a tendency conscious which acted uninter- 
 ruptedly during many centuries, and it shows its 
 deep importance. 
 
 In the face of the enormous efforts investigators 
 have made to work out and reconstruct in minutest 
 detail the past folk-life, many soundly skeptical peo- 
 ple have asked : To what end is all this ? We surely 
 do not live to dig out ruins which cannot in the 
 slightest degree produce new results ; how much more 
 important is it that we should devote our forces 
 toward the formation of something which can give 
 us safety and happiness. Does not the man who 
 busies himself with such things resemble the neu- 
 rotic who constantly digs into his own morbid inner- 
 life instead of turning himself outwards and enjoying 
 the sun's warmth and all that grows therein? In a 
 certain degree, yes. But as the neurotic must arrive 
 at a clear understanding of something in order to 
 become free from it, so must humanity bring to light 
 the hidden foundation of its life so that it may cast 
 off that which, stretching itself up out of the past, 
 holds it in bondage. In order to see this connec"- 
 tion, one need think only of the old religious dogmas. 
 All attacks against them amounted to little before 
 higher criticism of the Bible came and broke them 
 up. Then disappeared into thin air and became only
 
 336 History and Practice of Psychanalysis 
 
 legends and fantasies much, which hitherto had lived 
 in the consciousness as tangible reality. 
 
 While psychanalysis makes us more conscious of 
 the deep import of research work it drives its eman- 
 cipating tendencies to the extreme limit; it carries 
 it all the way down into those psychic elements, the 
 syntheses of which construct the foundation for our 
 ideas. 
 
 But psychanalysis means still something more than 
 this dragging forth of psychic material and its dis- 
 solution into simpler factors; it means also an in- 
 terpretation of these forces of the depths. And in 
 most cases this means a re-interpretation, a re-valua- 
 tion. 
 
 It was chiefly through the necessity of drawing 
 the dream-life into analysis that we were forced to 
 put interpretation procedure into the foreground. 
 In this field we may see also more plainly what it 
 means. Dreams come into the consciousness as a 
 meaningless jumble of unconnected pictures; by 
 means of interpretation the real content is brought 
 to light, and through interpretation the connection 
 and meaning becomes apparent. Thus we find that 
 the apparently unimportant pictures are something 
 else than visions whirled about by chance; they are 
 symbols. And behind these symbols are hidden some- 
 thing most deeply essential.
 
 Points of View and Outlooks 337 
 
 It is an especially important thing that research 
 turned so directly toward the interpretation of sym- 
 bols. To me it seems to have come upon the nucleus 
 of the matter there. 
 
 While speaking of this in the foregoing pages, I 
 pointed out the connection between earlier ways of 
 representation and our dream symbols. This had 
 before been suspected, but no one had been able to 
 explain it as comparative analytical research has 
 done. Nietzsche, for example, dared give out that 
 bold saying of his that the world in which we live 
 during dreams was the only world known to primi- 
 tive people i. e. that we fall back during sleep tem- 
 porarily to their form of life, we make use of their 
 form of expression. This principle ought to broaden 
 our view for what is accidental in the world we be- 
 lieve we experience as final reality. No educated 
 person is likely in these days to take the external 
 world for exactly that reality it seems to us to be; 
 it is the appearance of something unknown it is 
 finally a symbol which we cannot interpret. The 
 great transformation human consciousness under- 
 went, from the time the world-ideas were formed ac- 
 cording to the present laws of the dream-life and to 
 the era of philosophical thinking, thus essentially 
 consists in the creating of new symbols. In place of 
 those fleeting symbols mainly consisting of simple 
 sensuous perceptions, more lasting ones have been 
 constructed, those stamped by the intellectual life
 
 838 History and Practice of Psychanalysis 
 
 predominating; affect symbolism has been compen- 
 sated for with science, which opens out into the 
 material world. 
 
 Simultaneously with this change an effort has also 
 gone on to interpret the different symbols. People 
 are not content with experiencing existence in one or 
 another form ; they will have established also the con- 
 nection and meaning in what they experience. Just 
 as psychanalysis everywhere unites to primitive life- 
 factors and intentionally broadens and in a certain 
 degree completes them, so it also does here. It takes 
 up this more indefinite effort to interpret the world 
 experience and makes thereof a methodical, fully con- 
 scious symbol-research. Whither our co-operation 
 towards the attainment of the goal will lead, no one 
 can now prophecy ; but if it serves any good purpose 
 it must be carried far beyond the boundaries Freud 
 has staked out. 
 
 The greatest fault with Freud is that he has 
 squeezed even the interpretation of symbols into his 
 sexual doctrine. 
 
 In the solitary dream-symbol, all of that life which 
 in the waking state, we spread out over space and 
 time, seems pressed together into a single picture. 
 This picture gives a synopsis of the situation in 
 which for the moment, we find ourselves; in inter- 
 pretating the picture we must take into consideration 
 all those factors which play a part in it. The new- 
 est branch in psychanalysis, that which has its cen-
 
 Points of View and Outlooks 339 
 
 ter in Zurich, and is represented by Jung, Maeder, 
 Riklin and others are striving after just this. It is 
 to the merit of Adler that we have left behind Freud's 
 sexual doctrine; it is the effort of this branch to 
 overcome Adler's one-sidedness also. 
 
 I have said in connection with the "rational" 
 method of treatment that every persuasion must al- 
 ways be brought out of the patient's own psyche. 
 The same thing holds good where it is a question of 
 finding the true clue for interpertation. And it is 
 in this case even more momentous, inasmuch as it has 
 to do with deeper things. Psychanalysis aims not 
 only at the interpretation of single dream-symbols or 
 single neurotic symptoms; it endeavors as its final 
 aim, to set forth the right interpretation of all those 
 forces which wrestle within the patient to show him 
 what, in his inmost heart, he most ardently yearns 
 for. It tries in this way to reunite him with reality 
 and it appears thereby not only as the central point 
 in psychotherapeutics ; it reveals its indissolvable 
 connection with the most essential aim of all cultural 
 progress. 
 
 It seems to me that the future of psychotherapy 
 mainly depends upon certain inner qualifications. It 
 means a self-perfection that is realized in the degree 
 one finds what is most essential in the various cur-
 
 840 History and Practice of Psychanalysis 
 
 rents and leads these to flow harmoniously together. 
 All trifling arguments must be overcome. Only such 
 an inner development can give the movement enough 
 strength to break the external opposition. 
 
 This can be found, and this must be found. 
 
 The medical corps itself as a rule, still meets the 
 effort to construct a new branch of therapeutics with 
 a blending of the indifference with which the very 
 earliest attempts in the same direction were met and 
 the attempt towards annihilation with which Freud 
 is constantly beset. This does not at all imply that 
 there are not many members of that corps who suffer 
 because of the powerlessness of physical therapeutic 
 measures against neurosis, and who with interest 
 grasp each new possibility, including those coming 
 from this direction. But strangely enough this in- 
 terest is met with least among those who ought to 
 be most interested, that is to say, among neurolo- 
 gists and alienists. The official position which these 
 adopt towards psychanalysis is everywhere evident, 
 and this is partly because they are as strongly en- 
 trenched in material phenomena as their colleagues, 
 partly because they especially have to do with such 
 forms of mental and nervous disease that treatment 
 of any sort is unavailing. 
 
 While the attitude of the profession towards 
 psychotherapy is of great importance, nevertheless 
 everything does not hinge upon it. We must not for- 
 get that many different elements enter into this sub-
 
 Points of View and Outlooks 341 
 
 ject, which as a matter of fact lie outside the bound- 
 ary lines of traditional medicine. Psychotherapy 
 tries in its sphere of activity to gather together and 
 perfect life-factors which hitherto have belonged else- 
 where. It is more important therefore what stand 
 people in general take regarding it than what view 
 a limited professional circle adopts. 
 
 In raising one's self in opposition to psycho- 
 therapy one overlooks all too easily that its funda- 
 mental factors suggestion, analysis, symbol-inter- 
 pretation, etc., already exist as actual forces in the 
 consciousness. And not only do they so exist but 
 they push a way out with demand for realization, 
 which in course of time cannot be repressed. Modern 
 life with its rude objectivity, has of necessity dragged 
 with it not only a belittling of the inner intimate ex- 
 istence, but also a brutalizing of all that care of 
 the soul-life which in former times went before every- 
 thing else. Psychotherapy is trying in new ways and 
 under new forms to recommend cures for the evils of 
 the times and in this way to fulfill one of its most 
 grave demands. Present-day people who feel their 
 souls stifled in this world, which more and more is 
 stamped by mechanical technique, yearn for what 
 really lives and moves, feeling but one thing neces- 
 sary, namely: the care of that which has awakened 
 and wishes to grow in the unfathomable depths of 
 the mind. 
 
 It is to the call for the cure of souls in
 
 342 History and Practice of Psychanalysi* 
 
 the highest sense, that the psychotherapist seeks to 
 find an answer. Even if th search towards it thus 
 far has its great defects that is no reason why the 
 work should not be carried on. Those who toil in 
 this direction should take into consideration that at 
 the same time they try to destroy the longing which 
 the answer means. 
 
 But it must be conceded psychotherapy among 
 the general public meets with no such violent opposi- 
 tion as a new movement does meet with customarily. 
 This is chiefly because it is, in the whole of its na- 
 ture, so little aggressive. As it has to do with the 
 improvement of the single individual, so also in a 
 broad view it has to do with a positive purpose ; the 
 creating of something that is not, instead of the de- 
 molishing of something already extant. 
 
 There is perhaps really only one thing, that psy- 
 chotherapy must turn itself against. And that is 
 against every tendency to preserve worn-out forms 
 of the religious life. 
 
 The analysis of consciousness has beyond meas- 
 ure made clear the apodictic power of the past. 
 Each effort to preserve something which no longer 
 has living force which does not harmonize with all 
 our ways of thinking and feeling which does not 
 move our hearts and bear us on towards clearer un- 
 derstanding; every such effort is a power that 
 fetters the mind and drives the mind so fettered, down 
 towards destruction.
 
 Pomts of View and Outlooks 343 
 
 I come again here to the same idea with which I 
 began. 
 
 Psychotherapy must not only endeavor to make 
 free the soul-life and to guard it from all primitive 
 conceptions that still live in modern layers of the old 
 religious systems; it must try to drive this effort, 
 which has been going on for centuries, towards a defi- 
 nite goal. It is unnecessary to point out that while 
 this implies a freeing of the deepest, noblest forces 
 in human nature, it also implies a liberating of all 
 that for which humanity has yearned when it sought 
 the divine. 
 
 The struggle against spiritual death, the strife 
 after purity, clearness of vision, freedom, these will 
 always remain psychotherapy's alpha and omega, let 
 it assume what temporary forms it may, in different 
 times and in various hands.
 
 INDEX 
 
 Abraham, 87 
 
 Albreaction, 93, 98, 137, 138 
 
 ABLER DOCTRINE CON- 
 CERNING NEUROSIS, 
 152-197 
 
 Adler's conception of the life 
 plan, 193, 194, 226 
 separation from Freud, 88, 
 152, 158 
 
 Agorophobia, 173 
 
 Alcoholists, '209 
 
 Anal-erotism, 128 
 
 Application of psychanalysis 
 to pedagogics, 143, 144, 333 
 
 Auto-erotism, 128, 130, 133 
 
 Automatism, 213 
 
 B 
 
 Beaunis, 60 
 
 Bernheim, 59, 60, 79, 198 
 Bernheim's books, 86 
 Bethesda, The new, 52 
 Bjornstrom, 71 
 Braid, 56, 57, 58, 67, 80 
 Bramwell, 58, 69 
 Breuer, 85, 86 
 Breuer's case, 85, 92 
 use of hypnotism, 85 
 
 Cardinal point of psychana- 
 lytical therapy, 232 
 
 CASE HISTORY, EX- 
 TRACT FROM A, 248-297 
 
 Catalepsy, 212 
 
 Cathartic method, 103, 104 
 
 Causal view-point, 156, 192, 
 
 196 
 Censoring in dreams, 87, 108, 
 
 110 
 Charcot, 60, 69, 78, 86, 156, 
 
 230 
 
 Childhood trauma and post- 
 hypnotic suggestion, 322 
 Christian Science, 22, 23, 299, 
 
 300 
 Cicero, Kant's use of the 
 
 word, 19, 23 
 Clairvoyance, 215 
 Complex, 93, 95, 98, 132, 134, 
 
 225, 233 
 
 Compensation, 159, 160, 167 
 Compulsion fantasies, 223, 
 
 225, 
 
 system, 185 
 
 Concentration, 203, 212 
 Condensation, 108, 112 
 Confessional, 323, 324, 325, 
 
 326 
 CONSCIOUS VERSUS THE 
 
 UNCONSCIOUS, 218-247 
 Conscious life, 150, 151, 153, 
 
 236 
 
 Consciousness, 202, 207, 243 
 Conversion, 95, 96, 98 
 Copernicus, 21 
 Curtailment of treatment, 
 
 240, 241 
 
 .D 
 
 Dangers of treatment by 
 psychanalysis, 146, 147, 148 
 
 345
 
 346 
 
 Index 
 
 Defense-mechanism, 172, 173, 
 
 174, 175, 183, 184, 187 
 Degeneration, 161, 167, 175 
 Dejerine, 305 
 
 Displacement, 108, 109, 167 
 Dramatization, 108, 109 
 Dostojewski, 329 
 Dreams, 105, 106, 107, 108, 
 
 109, 110, 111, 112, 113, 114, 
 
 150, 154, 336 
 Dreams and insanity, 112 
 
 construction of, 108 
 
 interpretation of, 105, 106, 
 107 
 
 psychological processes in, 
 108 
 
 use of symbols in, 110, 336 
 
 wish-motive in, 114, 154 
 Dubois, 305, 306, 310 
 
 E 
 
 "Electro-biologists," 57 
 Ellis, Havelock, 128 
 Epilepsy question, 78, 79 
 
 Fantasy, 165, 166, 167, 168, 
 
 169, 180, 185 
 Father-complex, 223, 233, 234, 
 
 241 
 Feeling of inferiority, 164, 
 
 165, 166, 167, 169, 179, 182, 
 
 183, 187, 188, 189 
 Feminist movement, Adler's 
 
 idea of, 178, 179, 180 
 Ferenczi, 151, 226, 229 
 Fetal memory trace, 215 
 Feuchtersleben, Ernst von, 
 
 20, 27, 28, 29, 31, 33, 35, 
 
 36, 37, 304, 306 
 Finality, 192, 196 
 Forel, 69 
 Folk-consciousness, 50 
 
 Folk-lore, 111 
 
 "For Pay," 188, 189 
 
 Foville, 64 
 
 Frank, 316 
 
 Freschl, 188 
 
 Freud, 69, 83, 86, 87, 88, 89, 
 90, 91, 92, 93, 94, 95, 97, 
 99, 101, 103, 105, 106, 107, 
 108, 110, 111, 112, 114, 118, 
 120, 121, 125, 126, 127, 128, 
 132, 133, 134, 136, 140, 142, 
 143, 149, 150, 151, 153, 156, 
 157, 188, 190, 192, 235, 243, 
 319, 331, 332, 333, 338 
 
 Freud's catagorical sentence, 
 121 
 
 cathartic method, 103 
 incest doctrine, 190, 191, 
 
 195, 235, 236, 332 
 ingenuity, 112 
 one-sidedness, 150, 157, 321 
 periodicals, 89 
 scientific honesty, 130 
 symptomatology of neuro- 
 sis, 133 
 
 Freudian wish, 114, 154 
 
 Fundamental types, 30, 31 
 
 Future of psychotherapy, 339, 
 340, 341, 342, 343 
 
 Genius, 161, 167, 175 
 Gorki's "Night Refuge," 168 
 Gout, Kant's, 17, 18, 19 
 
 H 
 
 H allucination, 113 
 Hevisi, 54, 55 
 Hirschloff, 69, 203, 206 
 Hitschmann, 91 
 Hoche, 84, 90 
 Homo-sexuality, 118, 184 
 Hufelend, 18, 27
 
 Index 
 
 347 
 
 Hypnosis, 79, 80, 101, 198, 
 
 199, 201, 202, 203, 204, 205, 
 
 206, 20T, 208, 210, 314, 315, 
 
 316, 318 
 Hypnotic condition, 199, 316 
 
 suggestion, 66 
 
 treatment, 69 
 Hypnotism, 57, 72, 79, 83, 87, 
 
 314 
 
 and suggestion, 314, 315 
 
 Freud's reason for aban- 
 doning use of, 101, 102 
 
 Wetterstrand's independent 
 
 idea concerning, 79, 81 
 Hypochondriac, 33 
 Hysteria, characteristics for, 
 
 133 
 
 Ibsen, 329 
 
 Ibsen's "Ghosts," 124 
 
 Illusion, the world of, 165, 
 167 
 
 Imago-connections, 242 
 
 Impotence, cases of, 175, 177 
 
 Indications for treatment, 
 145, 146 
 
 Infantile trauma and neuro- 
 sis, 121, 125 
 
 Introspection, 100 
 
 Isolation, 203 
 
 Isserlin, 91 
 
 Jones-Hamlet interpretation, 
 
 106 
 Jung, 87, 89, 111, 226, 231, 
 
 236, 339 
 
 K 
 
 Kant, 17, 18, 19, 20, 21, 22, 
 
 23, 24, 25, 26, 39 
 KANT AND FEUCHTERS- 
 
 LEBEN, 17-42 
 Kant's influence on the de- 
 
 velopment of psychother- 
 apy, 19, 20, 39, 40 
 
 Kant's psychological dietetic 
 prescription, 23 
 
 Kb'nigsberg, 24 
 
 Krafft-Ebing, 69 
 
 Latent dream material, 107, 
 108 
 
 Legend of paradise, 165 
 
 "Lehrbuch der artzliche See- 
 ienkunde*" Feuchtersleben, 
 27 
 
 Li^beault, 23, 49, 51, 58, 59, 
 61, 62, 63, 64, 65, 66, 67, 203 
 
 Lidbeault's definition of sug- 
 gestion, 166 
 
 Li?beault's psychology of the 
 attention, 64, 65 
 
 Ligoise, 60 
 
 Luthur, 127 
 
 M 
 
 Madonna hallucinations, 143 
 
 Magnatizers, 56 
 
 Maeder, 339 
 
 Manifest dream pictures, 107, 
 
 108 
 
 Marcinowski, 306 
 Masculine protest, 171, 175, 
 
 176, 177, 178, 179, 181, 187, 
 
 188 
 
 Memory traces, 213 
 Moll, 69 
 Morphinists, 208 
 Muthmann, 101 
 
 N 
 
 Nancy-School, 24, 43, 58, 59, 
 
 60, 67, 69, 80, 86 
 Narcissism, 130 
 NATURE OF HYPNOSIS, 
 
 THE, 198-217
 
 348 
 
 Index 
 
 "Neurhypnology," 57 
 Neurosis, 161, 167, 171, 174, 
 
 216, 225, 229, 241 
 Neurotic, 170, 173, 175 
 
 attitude, 176 
 
 conditions, 185, 241 
 Nietzsche, 306, 329, 337 
 Nirvana, 201, 202, 212 
 
 (Edipus-Complex, 134, 136, 
 
 141 
 Organic defect, 161, 162 
 
 Reality, 165, 167, 168, 175, 
 
 226, 231, 232, 234, 236, 239, 
 
 261, 262 
 
 Regression, 181, 242 
 Religion and therapeutics, 70, 
 
 268, 269, 298, 299, 302, 342 
 Repression, 93, 94, 97, 98, 119, 
 
 120, 131, 140 
 Repressed wishes, 230 
 Resistance, 228 
 Results reached, 145, 146 
 Re-valuation, 302, 336 
 Riklin, 339 
 Rousseau, 329, 333 
 
 Persecution-complex, 292, 293 
 Persuasion method, 308, 309, 
 
 310, 312 
 
 Phenomena of suggestion, 63 
 Poet's faculty, 42 
 POINTS OF VIEW AND 
 
 OUTLOOKS, 298-343 
 Polymorphic perversity, 118 
 Primal state of rest, 210, 211 
 Prolonged sleep, 80, 199, 319 
 Prophylactic hope, 142 
 PSYCHANALYSIS AS A 
 
 SCIENCE AND METH- 
 OD OF TREATMENT, 
 
 83-151 
 Psychanalytical periodicals, 
 
 88, 89 
 Psychic epidemic, 53, 84 
 
 types, 185 
 Psychology of the attention, 
 
 Liebeault, 64, 65, 66 
 
 of Freud, 157 
 Psycho-therapy, the future of, 
 
 339, 340, 34l 
 Puberty, 130 
 
 R 
 
 Raimann, 84 
 Rank, 89 
 
 Sachs, 89 
 
 Sadger, 87 
 
 Schisms in the movement, 89 
 
 Schmidkunz, 62 
 
 Schrenk-Notzing, 69 
 
 Science and therapeutics, 230 
 
 Scientific demands, 72 
 
 Self-analysis, 100, 101 
 
 Self honesty, 101 
 
 Sexual doctrine, Freud's, 94, 
 
 126, 127, 128, 129, 130, 131, 
 
 132, 133, 138, 157, 188, 192, 
 
 320 
 
 development, 130 
 
 dogmatism, 190 
 
 unfoldment, 130. 131, 132, 
 133, 140 
 
 wish, 114 
 Sixtus, 71 
 Skin, 63, 212 
 Slang, 111 
 Somnambulism, 83 
 Speech, disturbance in, 181, 
 
 182, 183 
 Stekel, 87-89 
 
 Strindberg, 170, 188, 189, 329 
 Sublimation, 94, 132, 140, 144 
 Suggestion, 61, 62, 63, 64, 66, 
 
 67, 68, 70, 80, 148, 311, 320, 
 
 322
 
 Index 
 
 349 
 
 Suggestive therapeutics, 70, 
 
 79 
 
 Suicide, 147, 173 
 Symbols, 108, 111 
 Symbols in dreams, 111, 336, 
 
 337, 338 
 
 "Talking-cure," 85 
 Technical means, 103, 104 
 Therapeutic points of view, 
 
 137 
 
 Therapeutics and science, 230 
 Transference, 132, 140, 242, 
 
 243, 320 
 
 of father-complex, 223, 233, 
 
 234, 241 
 
 Traumatic neurosis, 120 
 "Traumdeutung," 106 
 
 U 
 
 Unconscious material, 228, 
 239 
 
 mechanism, 234 
 mind, 98, 191, 225, 226, 227 
 wish, 114, 190 
 
 "Use of Hypnotism in Prac- 
 tical Medicine," 71, 78 
 
 Van Eeden, 69 
 Van Helmont, 64 
 Van Reutergehm, 69 
 "Verdrangen," 93 
 
 W 
 
 Waking life, 102 
 WETTERSTRAND AND 
 
 THE NANCY-SCHOOL, 
 
 43-83 
 
 anecdotes of, 73, 76, 77 
 Wetterstrand's case histories, 
 
 72 
 
 energy, 81 
 
 letters, 43, 44, 47, 48 
 Wild analysing, 138 
 Wish motive in dreams, 114 S 
 
 154 
 Witticisms, 111 
 
 Zeihen, 101 
 
 Zurich School, 87, 88, 339
 
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