The other group of psychic processes which, as purely internal acts, can be contrasted to impressions and experiences – fantasies, relationary processes,6 emotional impulses, thought-connections7 – need to be considered separately as regards their relationship to forgetting and remembering. Something that occurs particularly frequently here is that something is ‘remembered’ that can never have been ‘forgotten’, since it was never at any point noticed, never conscious; moreover it appears to make no difference whatsoever to the psychic outcome whether such a ‘connection’ was a conscious one that was then forgotten, or whether it never reached the status of consciousness in the first place. The conviction that the patient arrives at in the course of analysis is entirely independent of this kind of memory.
Particularly in the case of the many forms of obsessional neurosis, forgetting is limited in the main to losing track of connections, misremembering the sequence of events, recalling memories in isolation.
A memory usually cannot be retrieved at all in the case of one particular group of extremely important experiences, namely those occurring at a very early stage of childhood that are experienced at the time without understanding, but are then subsequently understood and interpreted. We become aware of them via the patient's dreams, and are compelled to credit their existence by overwhelming evidence within the overall pattern of the neurosis; we are also persuaded by the fact that, once the patient has overcome his resistances, he does not see the absence of a memory or sensation of familiarity as grounds for not accepting that they took place. This topic needs to be approached with so much care, however, and introduces so much that is new and disturbing, that I shall deal with it quite separately with reference to appropriate material.8
Now the introduction of the new technique has meant that very little, and in many instances nothing whatever, has remained of this splendidly smooth progression of events. Here, too, there are cases that initially develop just as they would under the hypnotic technique, only to diverge at a later stage; other cases behave differently right from the outset. If for the purposes of defining the difference we stick to the latter type, then we may say that the patient does not remember anything at all of what he has forgotten and repressed, but rather acts it out. He reproduces it not as a memory, but as an action; he repeats it, without of course being aware of the fact that he is repeating it.
For example, instead of the patient recounting that he remembers having been defiant and refractory vis-à-vis his parents' authority, he behaves in just such a manner towards the physician. Instead of remembering that he became hopelessly stuck in his infantile sexual explorations, he presents a mass of confused dreams and associations, wails that he is no good at anything, and sees it as his fate never to bring any undertaking to a successful conclusion. Instead of remembering that he was intensely ashamed of certain sexual activities and fearful of discovery, he exhibits shame regarding the treatment that he has embarked upon, and tries to keep it secret from all and sundry – and so on.
More particularly, he begins the treatment with just such a repetition. Often when one has explained the basic rule of psychoanalysis to a patient with an eventful life story and a long history of illness, and asks him to say whatever comes into his mind, and then expects a stream of utterances to come bursting forth, the first thing one discovers is that he has no idea what to say. He remains silent, and maintains that nothing at all has come into his mind. This is of course nothing other than the repetition of a homosexual stance, which manifests itself as a resistance to remembrance of any kind. He remains in the grip of this compulsion to repeat for as long as he remains under treatment; and in the end we realize that this is his way of remembering.
What is chiefly going to interest us, of course, is the relationship that this repetitional compulsion bears to the transference and the resistance exhibited by the patient. We soon realize that the transference is itself merely an instance of repetition, and that this repetition involves transference of the forgotten past not only onto the physician, but onto all other areas of the patient's current situation. We must therefore expect that the patient will yield to the compulsion to repeat – which now takes the place of the impulse to remember – not only in his personal relationship to the physician, but in all other activities and relationships taking place in his life at the same time; for example, if during the course of the treatment he chooses a love-object, takes some task upon himself, involves himself in a project of any sort. The role played by resistance is also easy to recognize. The greater the resistance, the more thoroughly remembering will be replaced by acting out (repetition). After all, in hypnosis the ideal form of remembering corresponds to a condition in which resistance is completely pushed aside. If the treatment begins under the aegis of a mild and tacit regime of positive transference, this initially encourages submersion in the domain of memory (just as happens in hypnosis), during the course of which even the symptoms of the patient's illness are mute; however, if this transference subsequently becomes hostile or unduly intense, and therefore needs to be repressed, then remembering immediately gives way to acting out. From that point onwards it is the resistances that determine the sequence of what is repeated. The patient uses the arsenal of the past to arm himself with weapons to fight against the continuation of the treatment – weapons that we have to wrest from him one by one.
Now having seen that the patient repeats rather than remembers, and does so under conditions of resistance, we may now ask what it really is that he repeats or acts out. The answer is that he repeats everything deriving from the repressed element within himself9 that has already established itself in his manifest personality – his inhibitions and unproductive attitudes, his pathological characteristics. Indeed, he also repeats all his symptoms during the course of the treatment. And we can now see that in emphasizing the compulsion to repeat we have not discovered a new fact, but merely arrived at a more coherent view. It is now quite plain to us that the start of a patient's analysis does not mean the end of his illness, and that we need to treat the illness not as a matter belonging to the past, but as a force operating in the present. Piece by piece the entire illness is brought within the scope and ambit of the treatment, and while the patient experiences it as something intensely real and immediate, it is our job to do the therapeutic work, which consists to a very great extent in leading the patient back to the past.
Getting the patient to remember, as practised in hypnosis, inevitably had the air of a laboratory experiment. Getting the patient to repeat, as practised under the more modern technique of analysis, means summoning up a chunk of real life, and cannot therefore always be harmless and free of risk. The whole problem arises here of ‘deterioration during treatment’, a phenomenon that often proves unavoidable.
Most importantly, the very inception of the treatment itself necessarily induces a change in the patient's conscious attitude to his illness. As a rule he has been content up to then to bemoan his illness, to despise it as so much nonsense and to underestimate its significance, whilst for the rest applying the same repressive behaviour, the same head-in-the-sand strategy, to the manifestations of his illness that he applied to its origins. Thus it can happen that he does not properly appreciate the conditions under which his phobia functions, does not listen carefully enough to what his obsessional ideas are saying to him, or does not grasp the real intention of his obsessional impulse. This of course is the last thing his treatment needs. He has to find the courage to focus his attention on the manifestations of his illness. He must no longer regard the illness as something contemptible, but rather as a worthy opponent, a part of his very being that exists for good reasons, and from which he must extract something of real value for his subsequent life. The way is thus prepared from the outset for him to be reconciled with the repressed element within himself, which expresses itself in his symptoms, whilst at the same time allowing for a certain tolerance towards his illness. And if as a result of this new relationship to his illness
the patient's conflicts are exacerbated, or if symptoms are forced into the open that had previously remained in the shadows, then one can easily reassure him on this score by pointing out that these merely constitute a necessary but transitory deterioration in his condition, and that one cannot destroy an enemy if he is absent or out of range. However, the resistance can exploit the situation for its own ends and seek to abuse the licence to be ill. It then seems to exclaim: ‘Look what happens when I really do let myself become involved in these things! Wasn't I quite right to consign them all to repression?’ Juvenile and child patients are particularly prone to use the focus on their illness necessitated by their treatment as an excuse to wallow in their symptoms.
Further dangers arise as treatment progresses, in that new, more deep-seated drive-impulses – still nascent rather than fully established – can emerge as repetition. Lastly, the patient's actions outside the transference process can cause temporary harm in his everyday life, indeed can be so chosen as to permanently undermine that very condition of health that the treatment is meant to achieve.
The tactic that the physician has to adopt in this situation is easily justified. The goal that he holds fast to, even though he knows it to be unattainable under the new technique, remains the old form of remembering, that is, reproducing things within the psychic domain. He prepares himself for a constant battle with the patient, in order to keep within the psychic domain all those impulses that the patient would prefer to divert into the motor domain, and regards it as a therapeutic triumph when he successfully uses the remembering process to resolve an issue that the patient would rather get rid of in the form of an action. If the bond formed through transference is at all effective, then the treatment will successfully prevent any really significant acts of remembering on the part of the patient, and will use the nascent stage of any attempts at such acts as material contributing to the therapeutic process. One can best protect the patient from being damaged through giving rein to his impulses if one puts him under an explicit obligation not to make any decisions during the course of his treatment that vitally affect his life, such as choosing a career or a definitive love-object, but instead to wait until he is fully recovered.
In doing this, however, it is sensible to give scope to such aspects of the patient's personal freedom as are consistent with these precautions, and not to stop him from carrying out intentions which, though foolish, are without consequence, whilst also bearing in mind that people can really only achieve insight through their own hurt and their own experience. There are indeed also cases in which the patient cannot be prevented from entering upon some wholly inappropriate undertaking, and which only later become ripe for psychoanalytical treatment, and responsive to it. Occasionally there are also bound to be cases where one does not have the time to put the bridle of transference on a patient's rampant drives, or where the patient in the course of an act of repetition destroys the bond that ties him to the treatment. As an extreme example of this I might mention the case of an elderly lady who, when afflicted by twilight states,10 had repeatedly left home and husband and fled somewhere or other without ever becoming conscious of the force impelling her to ‘run away’ in this manner. On starting her treatment with me she displayed a well-developed form of affectionate transference, this intensified with uncanny rapidity over the first few days, and by the end of the week she had ‘run away’ from me too, without my having had the time to say anything to her that might have prevented this repetition.
However, the chief means for controlling the patient's compulsion to repeat, and turning it into a means of activating memory,11 lies in the way that the transference is handled. We render the compulsion harmless, indeed beneficial, by allowing it some sovereignty, by giving it its head within a specific domain. We offer it transference as a playground in which it has licence to express itself with almost total freedom, coupled with an obligation to reveal to us everything in the way of pathogenic drives that have hidden themselves away in the patient's psyche. The patient's co-operation need extend only as far as respect for the conditions of existence of the analysis, and, provided this is the case, we can routinely succeed in giving all the symptoms of his illness a new meaning in terms of transference; in replacing his ordinary neurosis with a transference neurosis, of which he can be cured through the therapeutic process. Transference thus creates an intermediate realm between sickness and a healthy life by means of which the transition from one to the other is accomplished. The new condition has assumed all the characteristics of the illness, but it constitutes an artificial illness that is in all respects amenable to treatment. At the same time it is a real, lived experience, but one made possible by particularly favourable conditions, and purely temporary in nature. The repetition reactions exhibited in transference then lead along familiar paths to the reawakening of memories, which surface without any apparent difficulty once the patient's resistances have been overcome.
I could close here if it were not for the fact that the title of this essay obliges me to demonstrate one further element of psychoanalytical technique. As is well known, what opens the way to the overcoming of resistances is that the physician identifies the resistance that the patient himself had never recognized, and reveals it to him. Now it seems that beginners in the practice of analysis are inclined to think that this purely preliminary phase constitutes the entire task. I have often been asked for advice in cases where the physician complained that he had shown the patient his resistance, yet nothing had changed, indeed the resistance had merely intensified and the entire situation had become even more impenetrable than before. The treatment seemed to be going nowhere. But this gloomy assessment invariably proved to be wrong. In most cases the treatment could not have been going better, the physician had simply forgotten that identifying the resistance can never result in its immediate cessation. One has to give the patient time to familiarize himself with the resistance now that he is aware of it, to work his way through it, to overcome it by defying it and carrying on with the therapy in accordance with the basic rule of analysis. Only when the resistance is at its most intense can one manage in co-operation with the patient to detect the repressed drive-impulses that sustain the resistance; and it is only by directly experiencing it in this way that the patient becomes truly convinced of its existence and power. The physician need do nothing other than wait, and allow things to take their course – a process that cannot be prevented, and cannot always be accelerated. If he bears this steadfastly in mind, he will often save himself from the delusion that he has failed, when in fact he is conducting the treatment along entirely the right lines.
This process of working through the resistances may in practice become an arduous task for the patient and a considerable test of the physician's patience. But it is the phase of treatment that effects the biggest change in the patient, and which distinguishes psychoanalytical treatment from any form of suggestion-based therapy. Theoretically speaking, one can equate it to the ‘abreacting’12 of the emotional quanta pent up through repression that hypnotic treatment entirely depended on for its success.
(1914)
Beyond the Pleasure Principle
I
In psychoanalytic theory we assume without further ado that the evolution of psychic processes is automatically regulated by the pleasure principle; that is to say, we believe that these processes are invariably triggered by an unpleasurable tension, and then follow a path such that their ultimate outcome represents a diminution of this tension, and hence a propensity to avoid unpleasure or to generate pleasure. When, in our study of psychic processes, we look at them with specific reference to this manner in which they evolve, we introduce the ‘economic’ perspective into our work. An account that pays due attention to this economic factor, as well as to the topical and dynamic aspects, seems to us to be the most complete kind that is presently conceivable, and to merit special distinction by use of the term metapsychological.1
It is of no interest to us in any o
f this to investigate the extent to which, in postulating the pleasure principle, we have echoed or embraced any particular, historically established philosophical system. We have arrived at such speculative assumptions simply as a result of our efforts to give a description and account of the facts that we observe on a daily basis in our field of study. Being original or getting there first do not figure among the aims laid down for psychoanalytic inquiry, and the impressions on which the postulation of this principle is based are so obvious that it is scarcely possible to overlook them. On the other hand, we would gladly acknowledge our gratitude to any philosophical or psychological theory capable of revealing to us the meaning of these sensations of pleasure and unpleasure that are so imperative for us. In this respect, unfortunately, nothing of any use is available to us. This is the darkest and most impenetrable area of the psyche, and whilst we cannot possibly avoid touching upon it, it seems to me that we do best to offer only the most tentative of suppositions on the subject. After much consideration we are minded to posit a connection between pleasure/ unpleasure and the quantity of excitation present – yet not annexed2 in any way – within the psyche; a connection whereby unpleasure corresponds to an increase in that quantity, and pleasure to a decrease. We are not thinking here in terms of a simple relationship between the strength of the sensations and the quantitative changes that we are linking them to; least of all – in view of everything that psycho-physiology has taught us - are we thinking in terms of a directly proportional relationship. The key determining factor so far as the sensation is concerned is probably the intensity of the decrease or increase over a particular period of time. Experimentation may well have a part to play here: we analysts would certainly be well advised not to venture any more deeply into these problems until such time as we can be guided by very specific observations.