The Story of Psychology

by Morton Hunt

  Freud called this inability to retrieve painful memories “resistance” and invented a way to break through it. He first used the technique in 1892 with a young woman who could not be hypnotized and who was unable to produce useful memories. He pressed her forehead with his hand, assuring her that this would infallibly produce such memories. And it did. What came to her mind that first time was the recollection of a night when she returned home from a party and stood beside her father’s sickbed. From that she went on, slowly and meanderingly, to related thoughts, and after a while to the recognition that she had felt guilty for enjoying herself while her father lay critically ill. At last, and with much effort, Freud got her to recognize that one of her symptoms, severe pain in her legs, was her way of fending off guilt-producing pleasures. She later made a complete recovery and married.17

  The essential aspect of the process, however, was not what Freud did with his hand but what the patient agreed to do. As he later explained:

  I assure [the patient] that, all the time the pressure lasts, he will see before him a recollection in the form of a picture or will have it in his thoughts in the form of an idea occurring to him; and I pledge him to communicate this picture or idea to me, whatever it may be. He is not to keep it to himself because he may happen to think it is not what is wanted, not the right thing, or because it would be too disagreeable for him to say it. There is to be no criticism of it, no reticence, either for emotional reasons or because it is judged unimportant. Only in this manner can we find what we are in search of, but in this manner we shall find it infallibly.18

  What came forth was very rarely a forgotten painful memory but usually a link in a chain of associations that, if pursued, slowly led to the pathogenic idea and to its hidden meaning. In Studies Freud called this process “analysis,” and the next year, 1896, began using the term “psychoanalysis.”

  Freud soon concluded that the pressure technique, which was only another form of suggestion, was inadvisable, because it was reminiscent of hypnosis and also made the doctor too vivid a presence at a time when the patient was trying to focus on memories. He abandoned it by 1900, relying thereafter on verbal suggestion.19

  Thus, by 1900 the basic elements of the method consisted of relaxation on the couch,* the therapist’s repeated suggestion that free association would yield useful ideas, the patient’s agreeing to say whatever came to mind without any holding back or self-censorship, and the unconscious associations this process revealed in the patient’s memories and ideas. The method proved applicable not only to hysteria but to other neuroses. Freud tinkered with the technique for decades, but its fundamentals, aimed at achieving curative insight by looking into the psychodynamic unconscious, had all been established within a dozen years of the time he first treated a patient without using hypnosis.

  There is, of course, a great deal more to psychoanalytic technique than this, much of it arcane and complex. Since we are concerned primarily with the development of psychological science and only to a limited extent with the treatment of mental disorders, we need not linger here over the details of psychoanalytic therapy or the variants devised by followers of Freud who came to disagree with his theories and therapeutic methods. But we must take note of two other elements of psychoanalytic therapy that Freud worked out, since they are central not only to his treatment of patients but to his use of psychoanalysis as the investigative method by which he made his major psychological discoveries.

  The first is the phenomenon of transference. Freud had mentioned this briefly and in a limited sense in Studies, but five years later, in 1900, a failed treatment led him to make much more of it. At that time he began treating an eighteen-year-old girl identified in his case report as Dora. He and she traced her hysterical symptoms back to a sexual approach made to her by Herr K., a neighbor, and to her conflicting feelings of repulsion and sexual attraction to him. But Dora broke off treatment after only three months, just as she was making good progress. Freud, stunned, pondered long and deeply about why she might have done so. Re-examining a dream of hers about leaving treatment—an analogue of her fleeing Herr K.’s house at the time of the sexual advance—he concluded that he himself, a heavy smoker whose breath smelled of tobacco smoke, had reminded Dora of Herr K., also a smoker, and that she may have begun to transfer the feelings she had for Herr K. to Freud. Not noticing this, he had failed to deal with it constructively. His conclusion:

  I ought to have listened to the warning myself. “Now,” I ought to have said to her, “it is from Herr K. that you have made a transference onto me. Have you noticed anything that leads you to suspect me of evil intentions similar (whether openly or in some sublimated form) to Herr K.’s? Or have you been struck by anything about me or got to know anything about me which has caught your fancy, as happened previously with Herr K.?”20

  This, he said, would have enabled Dora to clear up her feelings about Freud, remain in treatment, and look still deeper into herself for other memories.

  Transference, Freud concluded, cannot be avoided; dealing with it is by far the hardest part of the task but is an essential step in breaking through resistance and bringing the unconscious to light:

  It is only after the transference has been resolved that a patient arrives at a sense of conviction of the validity of the connections which have been established during the analysis… [In treatment] all the patient’s tendencies, including hostile ones, are aroused; they are then turned to account for the purposes of the analysis by being made conscious…Transference, which seems ordained to be the greatest obstacle to psychoanalysis, becomes its most powerful ally, if its presence can be detected each time and explained to the patient.21

  Seen from the viewpoint of therapy, the analysis of transference is a corrective experience that reveals and repairs the trauma. Had Freud acted in time, Dora would have seen that, unlike Herr K., he (and presumably many other men) could be trusted and that she did not have to fear their feelings about her or hers about them. Seen from the viewpoint of psychology, the analysis of transference is a way of investigating and verifying hypotheses about the unconscious motivations behind inexplicable behavior.

  The second element of analytic technique that became a principal method of psychological investigation for Freud is dream interpretation. Despite his failure to recognize Dora’s dream as a signal of her transference to him, he had been fruitfully using patients’ dreams for five years to get at unconscious material; he later called dream interpretation “the royal road to the knowledge of the unconscious in mental life.”22

  Freud was far from the first psychologist to be interested in dreams; in The Interpretation of Dreams (1900), he cited 115 references to earlier discussions of the subject. But most psychologists had viewed dreams as degraded, absurd, and meaningless thoughts that originated not in any psychic process but in some bodily process that was disturbing sleep. Freud, conceiving of the unconscious as not merely ideas and memories outside of awareness but as the repository of painful feelings and events that have been forcibly forgotten, saw dreams as significant hidden material breaking into view while the protective conscious self is off duty.

  He hypothesized that dreams fulfill wishes that would otherwise wake us and that their basic purpose is to enable us to continue sleeping. Some dreams fulfill simple bodily needs. In Interpretation Freud said that whenever he had eaten salty food, he became thirsty during the night and dreamed of drinking in great gulps. He also cited the dream of a young medical colleague who liked to sleep late and whose landlady called through the door one morning, “Wake up, Herr Pepi! It’s time to go to the hospital!” That morning Pepi particularly wanted to stay in bed, and dreamed that he was a patient in bed in the hospital, at which point he said to himself, “As I’m already in the hospital, there’s no need for me to go there,” and went on sleeping.23

  But the wish fulfillment of many dreams is far subtler and more recondite. Often, wishes that have been hidden in the unconscious threaten to break through int
o consciousness during the relaxed condition of sleep; if they did, they would produce distress sufficient to awaken the sleeper. To protect sleep, Freud supposed, the unconscious mind disguises disturbing elements, transforming them into relatively innocuous ones; the dream is mysterious precisely because what it seems to be about is not what it is really about. But by free-associating to what we remember of dreams, we may be able to recognize the real content behind the disguise and so peer into our unconscious mind.

  Freud arrived at this view after he first analyzed a dream of his own. In July 1895, he dreamed about “Irma,” a young woman he was then treating. The dream is complicated and Freud’s analysis of it very long (over eleven pages). In brief, he meets Irma in a large hall where guests are arriving and learns from her that she has been having choking pains in her throat, stomach, and abdomen; fears that he has incompetently overlooked some organic trouble; and after many other details, discovers that his friend Otto, a physician, had given Irma an injection with an unclean syringe and that this was the source of her trouble.

  Pursuing the real meanings of the many components of the dream through free association, Freud recalled that the previous day he had met his friend Oscar Rie, a pediatrician who knew Irma, and who had said to him, “She’s better, but not quite well.” Freud had felt annoyed; he had taken this to be veiled criticism, meaning that he had been treating Irma with only partial success. In the dream, he disguised the truth by turning Oscar Rie into Otto, changing Irma’s remaining neurotic symptoms into physical ones, and making Otto responsible for her condition—unlike himself, who was always scrupulous about the cleanliness of needles he used. Freud’s conclusions:

  Otto had in fact annoyed me by his remarks about Irma’s incomplete cure, and the dream gave me my revenge by throwing the reproach back on to him. The dream acquitted me of responsibility for Irma’s condition by showing that it was due to other factors… The dream represented a particular state of affairs as I should have wished it to be. Thus its content was the fulfillment of a wish and its motive was a wish. 24

  Through ruthless self-examination of his own less than creditable motives in the dream, Freud had discovered a technique of incomparable value. Within the next five years he analyzed over a thousand dreams of his patients and reported in Interpretation that the method was one of the most useful tools of psychoanalytic treatment and of research on the workings of the unconscious mind.

  The use of psychoanalytic procedures for research purposes has been much criticized as methodologically unsound. Free association leads the patient and analyst to an interpretation of a dream, but how can one prove that the interpretation is correct? In a few cases there may be historical evidence that a trauma, reconstructed from a dream symbol, did in fact occur, but in most cases, as in Freud’s Irma dream, there is no way to prove objectively that the interpretation has revealed the real dream content.

  Yet as anyone knows who has ever interpreted his or her dreams in therapy, there comes a moment in the effort when one feels a shock of recognition, an epiphany, a sense of having stumbled on emotional truth. In the end, dream analysis is authenticated by the analysand’s own response—“Yes! This must be the true meaning of it because it feels true”—and because that response enables him or her to begin grappling with the problem that generated the dream.

  In Freud’s case, free association and dream analysis led him to just such experiences of illumination and rescued him from a serious scientific error. Very early in his practice of psychotherapy, he suspected that sexual difficulties were at the basis of many or most neurotic disorders. He might have got that idea from the Zeitgeist. Although Viennese society was still thoroughly prudish and hypocritical about sexuality, in medical and scientific circles it had become a matter of much interest. Dr. Richard von Krafft-Ebing had published a lengthy account of sexual deviations, and anthropologists were reporting the sexual customs of peoples around the world.

  But these works dealt with adult sexuality; children were thought to be innocent, pure, and untouched by sexual desires or experiences. Freud, however, had repeatedly heard patients recall, after much effort, that they had had sexual feelings in childhood and, astonishingly, that they had been sexually molested by adults, their experiences having ranged from being fondled to being raped. Hysteria was one outcome; obsessional neuroses, phobias, and paranoia were others. The guilty adults were nursemaids, governesses, domestic servants, teachers, older brothers—and, most shockingly, in the case of female patients, fathers.25

  Freud was amazed, and thought he had made a major discovery. By 1896, after half a dozen years of hypnotherapeutic and analytic experience, he announced his so-called seduction theory in a published paper and in a lecture before the local Society for Psychiatry and Neurology presided over by the great Krafft-Ebing.26 The lecture was received icily, and Krafft-Ebing told him, “It sounds like a scientific fairy tale.”27 In the weeks and months after the lecture Freud felt shunned by the medical community and totally isolated, and referrals of patients fell off alarmingly. But although he clung to his belief in his discovery for a while, eventually he too reluctantly began to doubt its validity.

  For one thing, he was having only partial success treating patients who had unearthed recollections of molestation; some, in fact, who he thought were doing best, broke off treatment before being cured. For another, he was finding it ever harder to believe that perverse acts by fathers against their daughters were so widespread. Since there was no unarguable indication of reality in the unconscious, these recollections of seduction might actually be fictitious.28 This was a depressing thought; what he had considered a major discovery and “the solution of a thousands-[of-]years-old problem” might be an error.

  Although he had recently been able to move his growing family to a spacious apartment at Berggasse 19 and was doing well enough to indulge in his keenest pleasure, an annual trip to Italy, he had many other reasons for being depressed and anxious. His father’s death, in October 1896, had affected Freud far more deeply than he had anticipated (he felt “torn up by the roots”); his long friendship with Breuer, who had been so helpful to him but who would not accept his increasingly radical ideas about neurosis and therapy, was disintegrating; and although he had held the unpaid but prestigious position of Privatdozent (lecturer) in neuropathology at the university for nearly a dozen years, he still had not been appointed a professor, a far more prestigious status that would have aided his career. For all these reasons, Freud’s neurotic symptoms became exacerbated, particularly his worries about money, fears of heart disease, obsession with thoughts of death, and a travel phobia that made it impossible for him to visit Rome, which he desperately wanted to do but the thought of which filled him with inexplicable fear.

  In the summer of 1897 the forty-one-year-old Freud began to psychoanalyze himself in an effort to understand and combat his own neurosis.29 To a degree, he had already been doing this by analyzing some of his dreams, but now he subjected himself daily to his own scrutiny in a rigorous, systematic fashion. Descartes, Kant, and James—even, perhaps, Socrates—had examined their conscious minds, but only Freud sought to unlock the secrets of his unconscious mind.

  Self-analysis may seem a contradiction in terms. How can one be guide and guided, analyst and analysand, at the same time? How can one be the patient and also the therapist onto whom the patient transfers feelings that he then analyzes? But no one else was trained or able to serve as Freud’s analyst, and he had to do it himself. To some extent, however, he made Wilhelm Fliess, to whom he was developing a powerful attachment, a surrogate analyst. Fliess, although an ear, nose, and throat specialist, had many interests, including psychology, about which he formulated a number of theories, some brilliant and others mystical and absurd. Freud wrote regularly and often to Fliess, telling him what was happening in his research and self-analysis, and met him from time to time for what Freud called “congresses”—two or three days of intense discussion about his and Fliess’s work
and theories. Fliess’s letters in response to Freud’s do not exist nor is there any record of what he said in their congresses, but it is generally believed that he helped in the self-analysis or at least that Freud clarified his own thinking in the course of telling the results of self-analysis to a trusted confidant.

  Every day, for several years, Freud used free association and the examination of each night’s dreams to seek hidden memories, early experiences, and the concealed motives behind his daily wishes, emotions, slips of the tongue, and little memory lapses; he sought to understand himself and, through himself, psychological phenomena common to humankind. “This analysis is harder than any other,” he wrote to Fliess early in the process. “But I believe it has got to be done and is a necessary stage in my work.”30 Time and again he thought he was finished, only to discover otherwise; time and again he came to a standstill, fought to make progress—and made it, as a later letter tells:

  I am now experiencing in myself all the things that as a third party I have witnessed going on in my patients—days when I slink about depressed because I have understood nothing of the day’s dreams, fantasies, or mood, and other days when a flash of lightning brings coherence into the picture, and what has gone before is revealed as preparation for the present.31

  No wonder it was hard work. He was unearthing from his “dung heap,” as he called it, memories that had been deeply hidden because they were repellent and guilt-producing, such as his childish jealousy of a younger brother (who died in infancy, leaving a permanent residue of guilt in Freud), his conflicting feelings of love and hate for his father, and particularly a time when, at two and a half, he saw his mother nude and was sexually aroused.32