Introductory lectures on psycho-analysis · Sigmund Freud
SEVENTEENTH LECTURE THE MEANING OF SYMPTOMS
If the bolster was a woman, then the shaking of the eiderdown till all the feathers were at the bottom, making a protuberance there, also had a meaning. It meant impregnating a woman; she did not neglect, though, to obliterate the pregnancy again, for she had for years been terrified that intercourse between her parents might result in another child and present her with a rival. On the other hand, if the large bolster meant the mother then the small pillow could only represent the daughter. Why had this pillow to be placed diamond-wise upon the bolster and her head be laid exactly in its middle lengthways? She was easily reminded that a diamond is repeatedly used in drawings on walls to signify the open female genitals. The part of the man (the father) she thus played herself and replaced the male organ by her own head. (Cf. Symbolism of beheading for castration.) Horrible thoughts, you will say, to run in the mind of a virgin girl. I admit that; but do not forget that I have not invented these ideas, only exposed them. A ritual of this kind before sleep is also peculiar enough, and you cannot deny the correspondence, revealed by the interpretation, between the ceremonies and the phantasies. It is more important to me, however, that you should notice that the ritual was the outcome, not of one single phantasy, but of several together which of course must have had a nodal point somewhere. Note, too, that the details of the ritual reflect the sexual wishes both positively and negatively, and serve in part as expressions of them, in part as defences against them.
It would be possible to obtain much more out of the analysis of this ritual by bringing it into its place in connection with the patient’s other symptoms. But that is not our purpose at the moment. You must be content with a reference to an erotic attachment to the father, originating very early in childhood, which had enslaved this girl. It was perhaps for this reason that she was so unfriendly towards her mother. Also we cannot overlook the fact that the analysis of this symptom has again led to the patient’s sexual life. The more insight we gain into the meaning and purpose of neurotic symptoms, the less surprising will this seem. From two selected examples I have now shown you that neurotic symptoms have meaning, like errors and like dreams, and that they are closely connected with the events of the patient’s life. Can I expect you to believe this exceptionally significant statement on the strength of two examples? No. But can you expect me to go on quoting examples to you until you declare yourselves convinced? Again, no; for in view of the explicit treatment given to each individual case I should have to devote five hours a week for a whole term to the consideration of this one point in the theory of the neuroses. I will content myself therefore with the samples given, as evidence of my statement; and will refer you for more to the literature on the subject, to the classical interpretation of symptoms in Breuer’s first case (hysteria), to the striking elucidations of very obscure symptoms in dementia præcox, so-called, made by C. G. Jung at a time when this investigator was a mere psycho-analyst and did not yet aspire to be a prophet, and to all the subsequent contributions with which our periodicals have been filled since then. Precisely this type of investigation is plentiful. Analysis, interpretation, and translation of neurotic symptoms has proved so attractive to psycho-analysts that in comparison they have temporarily neglected the other problems of the neuroses.
Anyone of you who makes the necessary effort to look up this question will certainly be strongly impressed by the wealth of evidential material. But he will also meet with a difficulty. The meaning of a symptom lies, as we have seen, in its connection with the life of the patient. The more individually the symptom has been formed, the more clearly may we expect to establish this connection. Then the task resolves itself specifically into a discovery, for every nonsensical idea and every useless action, of the past situation in which the idea was justified and the action served a useful purpose. The obsessive act of the patient who ran to the table and rang for the maid is a perfect model of this kind of symptom. But symptoms of quite a different type are very frequently seen. They are what we call _typical_ symptoms of a disease, in each case they are practically identical, the individual differences in them vanish or at least fade away, so that it is difficult to connect them with the patient’s life or to relate them to special situations in his past. Let us consider the obsessional neurosis again.
The second patient’s ceremonies preparatory to sleep are in many ways quite typical, although showing enough individual features as well to make an “historical” interpretation, so to speak, possible. But all obsessional patients are given to repetitions, to isolating certain of their actions and to rhythmic performances. Most of them wash too much. Those patients who suffer from agoraphobia (topophobia, fear of space), no longer reckoned as an obsessional neurosis but now classified as anxiety-hysteria, reproduce the same features of the pathological picture often with fatiguing monotony. They fear enclosed spaces, wide, open squares, long stretches of road, and avenues; they feel protected if accompanied, or if a vehicle drives behind them, and so on. Nevertheless, on this groundwork of similarity the various patients construct individual conditions of their own, moods, one might call them, which directly contrast with other cases. One fears narrow streets only, another wide streets only, one can walk only when few people are about, others only when surrounded with people. Similarly in hysteria, beside the wealth of individual features there are always plenty of common typical symptoms which appear to resist an easy interpretation on historical lines. Do not let us forget that it is these typical symptoms which enable us to take our bearings in forming a diagnosis. Supposing we do trace back a typical symptom in a case of hysteria to an experience or to a chain of similar experiences (for instance, an hysterical vomiting to a series of impressions of a disgusting nature), it will be confusing to discover in another case of vomiting an entirely dissimilar series of apparently causative experiences. It almost looks as though hysterical patients must vomit, for some unknown reason, and as though the historical factors revealed by analysis were but pretexts, seized upon by an inner necessity, when opportunity offered, to serve its purpose.
This brings us to the discouraging conclusion that although individual forms of neurotic symptoms can certainly be satisfactorily explained by their relation to the patient’s experiences, yet our science fails us for the far more frequent typical symptoms in the same cases. In addition to this, I have not nearly explained to you all the difficulties that arise during a resolute pursuit of the historical meaning of a symptom. Nor shall I do so; for although my intention is to conceal nothing from you and to gloss over nothing, I do not need to confuse you and stupefy you at the outset of our studies together. It is true that our understanding of symptom-interpretation has only just begun, but we will hold fast to the knowledge gained and proceed to overcome step by step the difficulties of the unknown. I will try to cheer you with the thought that it is hardly possible to presume a fundamental difference between the one kind of symptom and the other. If the individual form of symptom is so unmistakably connected with the patient’s experiences, it is possible that the typical symptom relates to an experience which is itself typical and common to all humanity. Other regularly recurring features of a neurosis, such as the repetition and doubt of the obsessional neurosis, may be universal reactions which the patient is compelled to exaggerate by the nature of the morbid change. In short, there is no reason to give up hastily in despair; let us see what more we can find out.
There is a very similar difficulty met with in the theory of dreams, one which I could not deal with in the course of our previous discussions of dreams. The manifest content of dreams is multifarious and highly differentiated individually, and we have shown exhaustively what can be obtained by analysis from this content. But there are also dreams which may in the same way be called _typical_ and occur in everybody, dreams with an identical content, which present the same difficulties to analysis. These are the dreams of falling, flying, floating, swimming, of being hindered, of being naked, and certain other anxiety-dreams; which yield first this, then that, interpretation, according to the person concerned, without any explanation of their monotonous and typical recurrence. But we notice that in these dreams also the common groundwork is embroidered with additions of an individually varying character. Most probably they too will prove to fit in with other knowledge about the dream-life, gained from a study of other kinds of dreams—not by any forcible twist, but by a gradual widening of our comprehension of these things.
Ideas discussed in this chapter
Text from Project Gutenberg, public domain in the United States.