Chapter 24

FREUD and PSYCHOANALYSIS

While modern psychology was developing in academe, other important contributions were taking place in a quite different setting. Far removed from the psychological laboratory, Sigmund Freud was developing another approach to psychology through the study of personality disturbances revealed through clinical observation. He was learning that behind the conscious and rational person there was another phase of human nature, expressed through the dark, emotion-ridden unconscious motivations of his patients. He used the techniques of the clinical method rather than the controls of the experimental method. After a long period of isolation, he gained a few supporters. Two of these supporters went on to develop their own views, which are both important and significantly different from those of Freud. Consequently, after discussing psychoanalysis as expressed through the life, work, and theoretical system of Sigmund Freud in this chapter, attention will be devoted to Alfred Adler (1870 - 1937) and his Individual Psychology and to Carl Gustav Jung (1875 - 1961) and his Analytical Psychology in the next.

The Heritage of Freud

To understand some of the individuals and intellectual influences that affected Freud, it is necessary to start not in Austria but in France.

From the beginning of the nineteenth century, the French psychological tradition had centered on psychopathological problems. Pierre Janet, one of France's leading psychologists toward the end of the century, was to affirm that the development of "pathological" psychology was most characteristic of France.[1] The French were both utilitarian and idiographic in outlook in contrast to the Germans, who leaned toward purism and nomotheticsm. Even psychologists who had their degrees in philosophy or in one of the sciences were apt to be influenced by these traditions. There were two discriminable groups of psychologists in France at the time--the physician-psychologist, interested in abnormal mental phenomena and their treatment, and the academic-medical psychologist who paid some attention to the more conventional aspect of psychology, including its teaching, but who was also drawn into consideration of the same phenomena that interested his medical counterparts. Jean-Martin Charcot (1825 - 1893) and Hippolyte Bernheim (1840 - 1919) represent the former group; Théodule Ribot (1839 - 1916) and Pierre Janet (1859 - 1947), the latter. Binet, as befits the greatest French psychologist of his time, shared in this tradition but also created one of his own. He has already been treated in Chapter 00.

Pinel and the Treatment of the Insane

Near the beginning of the nineteenth century, France became the first country to begin developing adequate care for the insane and the feeble-minded. This may have stemmed in part from the development of French mechanistic philosophy that came to view human behavior as a product of brain action. It is only a short step to treating human misbehavior also as a product of brain action and thus beyond the will of the affected individual. The treatment of mental illness was thus a treatment of nervous diseases which is why most of the individuals who dealt with such issues in the 19th century were neurologists. If the mechanistic position was correct, then it was improper to keep the insane in the inhuman conditions then current. Their treatment as subhumans was based in part on the premise that they were willingly possessed by the devil or that they were throwbacks to an earlier, animalistic state.

Pinel was one who made such a moral argument for the humane treatment of the insane. Philippe Pinel (1745-1826) was one of France's leading physicians at the turn of the nineteenth century.[2] In 1792, he had been appointed superintendent of the asylum at Bicêtre. In the wake of the French revolution came his own particular application of the "Rights of Man" to the miserable patients in his charge, who heretofore had been kept in chains and treated as wild beasts, even to the point of being on exhibit to those who paid a small fee. After a personal plea before the Revolutionary Convention, Pinel was permitted to dispense with the chains. He treated his patients humanely and placed them under the care of reasonably competent physicians. His book on mental diseases was a powerful plea for more humane treatment of the insane.[3] Instead of accepting the view then current that the insane were wicked and in the grip of demoniacal possession, Pinel was convinced that brain dysfunction may be related to severe psychological disorders. He knew too little to advance very far, but the conviction was there. Pinel was succeeded in his work by Jean Etienne Esquirol (1771-1840), who worked assiduously at establishing properly run asylums. He also wrote a monumental work on mental diseases, one more rational and descriptive than the barren speculations of most of his predecessors.[4]

Jean Itard (1775-1838), a contemporary of Pinel and Esquirol, was the pioneer in the systematic study of mental deficiency.[5] A teacher of the deaf, he was consulted about the "wild boy of Aveyron" in 1798. The year before, in a woods in the Department of Aveyron, a so-called wild boy had been found by hunters. He was brought to Itard to see if he could be trained to live in civilization, a topic of more than usual interest because of the popularity of the then prevalent theories of the "noble savage." Itard worked long and arduously but could not in any way restore the child to normality. Through much effort, the boy learned a few habits more in keeping with his new environment, but was still unable to take care of himself. Finally it dawned on Itard that the boy was an idiot or an imbecile. He abandoned further work with the child as hopeless, since he shared in the common belief that idiots or imbeciles were but brutes incapable of any sort of training. But his assistant, Edouard Seguin (1812-1880), continued to work with the boy after Itard had given up because he appreciated that the gains made, slight though they were, caused the child to be both happier and better adjusted to society. Afterward, Sequin devoted his career to attempts to train feeble-minded children and eventually was put in charge of a school for the feeble-minded. This was the first institution of its kind; its establishment marks the beginning of training schools for the mentally retarded.

Hypnosis

Another source in France making for a medical psychology was an interest in hypnotic phenomena. The history of phenomena of what came to be called hypnotism is at least as old as temple medicine in ancient Greece. Its modern phase begins with the work of Franz Anton Mesmer (1734-1815).[6] After attracting considerable notoriety in Vienna through use of his so-called animal magnetism in treating all sorts of patients, he was ordered to leave the city. He settled in Paris during the 1780s, where his remarkable cures, especially of what we would now call hysterical patients, made him well known. He thought of animal magnetism as an invisible fluid whose magnetic power he communicated to his patients by making his hands pass over their bodies, after which he assured them that they were cured. Physicians called Mesmer an impostor, and the first of several commissions was appointed by the French government to investigate his powers. One of its members was Benjamin Franklin. The general conclusions of this and later commissions was that Mesmer effected many cures, but was mistaken in attributing to animal magnetism what was actually due to some as yet unknown physiological cause. Whatever else may have been taking place, magnetism as known in physics had nothing to do with these phenomena. The reports, generally unfavorable, were widely disseminated. As a consequence of this unfavorable publicity, Mesmer lost his practice and retired.

For some time after the French Revolution, Mesmerism, as it was by then called, led a checkered career, kept alive by a few who used it with little or no understanding of what they were doing. Meanwhile, it was derided as quackery by most physicians.

It was James Braid (c. 1795 - 1860) in England in 1843, who named the various phenomena "hypnotism."[7] He considered that in hypnotism some sort of change took place in the nervous system as the result of psychological instigation. Braid described hypnotism as induced sleep and considered hypnosis nothing more than a convenient and quick means of throwing the nervous system into a state useful for the treatment of certain disorders.[8] He showed that hypnotism could be produced by focusing the eyes on an inanimate object, a procedure which helped to remove it from the realm of the uncanny. His lack of exaggeration, his caution, and his modest admission of lack of understanding impressed other medical men. The fact that he first expressed his interest in the topic by publicly attacking the mesmerists probably served to provide him with a respectability that the earlier workers had lacked. His work became known in France in the middle of the nineteenth century through a Dr. Azam, a surgeon of Bordeaux. Azam saw its advantage in surgical operations and proceeded to use it in this way. He was followed by others. But hypnosis came into national prominence only with the work of Charcot.

Jean Charcot

Jean-Martin Charcot (1825-1893), a physician, was appointed professor of pathological anatomy at the University of Paris in 1860.[9] Two years later, he was appointed a senior physician to the Salpétrière, a hospital for mental disorders, where he established a neurological clinic. He is often referred to as the father of neurology because of his ability to relate clinical signs present in the functioning of his patients to the normal and morbid anatomy of the nervous system, a correlation that is precisely the basis of neurology today. He carried on important studies of such diseases as multiple sclerosis and spinal paralysis and worked with problems of the localization of lesions in the brain and spinal cord. He was also famous as a teacher, for he was skilled in communicating his knowledge of diagnosis and anatomy to his pupils through case conferences. His fame was international, and students came to him from all over Europe. In 1885-1886, Sigmund Freud worked under Charcot, learning enough from him to refer to him later as "my master."[10]

Charcot was already a well-established teacher and researcher when he acquired his interest in hypnosis. Charles Richet (1850-1935) in 1875 had judged the phenomenon of hypnosis to be undoubtedly genuine. Accepting this statement of a respected colleague, Charcot launched into a period of intense clinical investigation and made his case conferences famous by demonstrating the many phenomena that can be induced by hypnosis. He began to center his attention on patients showing symptoms of hysteria.

What are some of the symptoms of hysteria? Somnambulism (sleep walking), fugues (running away without awareness of doing so), multiple personalities, and convulsive attacks are all included whenever organic causes can be ruled out, as are contractures, paralyses, vomiting, deafness, blindness, loss of speech, and anaesthesia of parts of the body.[11] To add to the complexity, the symptoms change even from day to day, for one day a patient may complain of vomiting, and the next day of headache. Mesmer and the mesmerists must have treated a large number of individuals who later would have been in this category. Hysteria is the great simulator of other diseases, such as tumors, intestinal obstructions, lesions of the bones and muscles, as well as organically based blindness and deafness.

Charcot soon compared the phenomenon of hypnosis to artificial hysteria. The patients of Salpétrière, whom he found to be amenable to hypnosis and especially to very deep phases of hypnosis, were those already diagnosed as hysterics. he soon discovered that the symptoms of the hysteric patient could be modified by hypnosis, and hypnosis came to be the preferred method of treatment for this category of patients. He thus moved against established medical opinion, which still regarded hypnosis as somewhere between a theatrical stunt and sheer charlatanism.

At Salpétrière under Charcot's leadership it was believed that the hypnotic phenomenon arose from hysteria in that only a person with an hysterical make-up could be brought to hypnotic sleep. Based on studying various degrees of the depth of hypnosis, Charcot asserted the existence of three main progressive stages in the depth of hypnosis: lethargy (drowsiness), catalepsy (isolated suggestions can be accepted and acted upon, since there is no interference by other ideas), and somnambulism (ability to carry out complicated activities with no recollection afterward).[12]

Charcot's interest in producing deep hypnosis arose from his desire to be absolutely certain of being able to distinguish between true hysteria and simulation of these conditions. Hysteria and malingering are not easy to differentiate, and Charcot was satisfied only with placing his patients under deep hypnosis in order to be sure that faking was eliminated.

Meanwhile another approach to hypnosis was being developed in Nancy by Liebéault and Bernheim.

Liebéault and Bernheim

A country doctor, Ambroise-Auguste Liebéault (1823-1904)[13] had been using hypnosis in his practice without fee with all peasants who would agree to its use, whereas for other forms of treatment they had to pay. Knowing a bargain when they saw one, the peasants flocked to him. It was not until he happened to treat a former patient of the neurologist Hyppolyte Bernheim (1840-1919) that his work received the attention that would place it ultimately in the history of psychology and medicine. This patient, who suffered from sciatica, had not responded to Bernheim's treatment, but he did to Liebéault's hypnosis. The already well-known Bernheim was impressed and became a pupil of Liebéault in 1882 and a few years later wrote a text that made him the leader of the Nancy School.[14]

Together, Liebéault and Bernheim had founded the clinic at Nancy, which was presently to rival Paris as another center for work in hypnotism. These workers, seeing no essential difference between spontaneous and induced sleep,[15] used the suggestion of sleep as the basis for the production of hypnosis. Essentially, the method of treatment of the Nancy school was based upon suggestion. To them, suggestion meant that under hypnosis new attitudes and beliefs were accepted by the patient uncritically, and he would then behave in accordance with these new ideas. During hypnosis, these two doctors would tell their patients that they would feel well or that their symptoms would disappear. In a fair number of instances, the effect was not merely temporary, as might have been expected, but appeared to be permanent.

The clinics of Nancy and Paris became ideological rivals. At Nancy it was taught that hypnosis, at least the mild form of it that was customarily used there, could be induced in nearly all subjects and that it was essentially a passive-receptive state brought about by suggestion. On the other hand, Charcot regarded hypnosis as a pathological state of the organism. At Nancy they challenged the identification of hypnosis with hysteria, arguing that the very stages that Charcot found were the result of specific suggestions. Later findings have tended to support Bernheim and Liebéault rather than Charcot.

Workers at Nancy and at Salpétrière, far apart as they might have thought themselves at the time, were both laboring with similar groups of patients--the neurotics. No longer was interest in abnormal mental phenomena to be confined to the severely disturbed on the wards of mental hospitals. These men had isolated the neuroses from other mental diseases and in doing so had discovered them.

Théodule Ribot

Théodule Ribot (1839-1916) had perhaps the greatest breadth of interests and certainly was the most well read of the French psychologists of his time. He served as the psychological educator of his countrymen. In 1870[16] and 1879[17] he published books that interpreted English associationism and German experimentalism to his colleagues. In general, French psychologists tended to be skeptical about the value of German experimental psychology and to make only sparing use of associationism. As a medical psychologist in the French tradition, Ribot also systematically explored what was known about the pathological aspects of affective life. He wrote books about diseases of the will, memory, and personality, regarding these abnormalities as products of faulty brain functioning. In discussions of diseases of personality and in his presentation of cases, Ribot stressed dissociation, the splitting of the bonds of consciousness. He also reintroduced evolutionary thinking into French psychology. In 1875 he founded and edited the Revue Philosophique, which was to publish a fair amount of psychological material.

Ribot was appointed Professor of Experimental Psychology in 1889 at the College of France. He was not, however, an experimental psychologist in the sense of having a laboratory. In his strategic position he was to have as students many of the next generation of academically oriented French psychologists.

Pierre Janet

Pierre Janet (1859-1947) studied philosophy and psychology in the Faculty of Letters and then went on to the Faculty of Medicine at the University of Paris.[18] Before completing his medical training, he accepted a teaching post in philosophy at a Lycee outside of Paris. At this time he was only twenty-two years old. Eager to advance his career, he became interested in a patient named Leonie, already known to the medical profession for exhibiting both hypnotic and clairvoyant phenomena. After making a careful study of this intriguing combination, he reported that it seemed she could be hypnotized from a distance. Through this case study Janet came into contact with Charcot.

Shortly afterward Janet returned to Paris to study again in both the Faculties of Letters and Medicine, and in 1889 he received his doctorate in letters with a thesis on the psychology of automatic activities.[19] The following year he was invited by Charcot to become director of the psychological laboratory of Salpétrière, where he tried to bring some order and system into the classification of hysteria and, in turn, to the conceptions of academic psychology. This study became the thesis for his doctorate in medicine, a degree he received in 1892.[20] After teaching at the Sorbonne from 1895 to 1902, Janet succeeded Ribot in the chair in the College of France, which he held until his retirement. He visited the United States in 1906 to lecture at Harvard University Medical School. The lectures were published in English as The Major Symptoms of Hysteria, the book for which he is best known in the United States.[21] During all these years, in addition to carrying out his academic duties, he was also a busy practicing physician, specializing in mental diseases. He died in 1947.

Janet himself clearly differentiated his work from that carried on at Salpétrière. The work under Charcot was primarily neurological, so that paralyses, contractures, and disturbances of the senses were emphasized. Janet, on the contrary, saw hysteria as a mental disease, which chiefly consisted of an exaggerated suggestibility; he therefore emphasized mental phenomena--particularly impairments of memory and the presence of fixed ideas. This appeal to fixed ideas was based on the fact that hysterical patients had somehow fastened onto the idea that they were paralyzed or had lost sensitivity. These symptoms were not readily resolved and, hence, were referred to as fixed ideas. Thus Janet was closer to Bernheim in his interpretation than to Charcot, for both Janet and Bernheim saw many of the phenomena of hypnosis and of hysteria as products of suggestion. This resemblance becomes evident when one stops to consider that the behavioral phenomena are similar; for the only difference seems to be that under hypnosis, we know how the behavioral phenomena were instilled, that is, we know their origin, whereas in hysteria we do not.

Psychic energy and its diminution or depletion was a guiding concept of Janet.[22] Feelings of pressure experienced by the patient and consequent feelings of effort served to individuate this diminution of functioning quite apart from behaviors considered as symptomatic of psychic energy. Janet held that we do not know the nature of the energy, but we can study its manifestations. Individuals differ in quantity of energy available to them from both hereditary and environmental origins.[23] Janet cited fatigue, malnutrition, disease, pernicious experience, and inadequate education as the environmental sources responsible for lessened energy. Neuroses are fundamentally due to conditions of low mental tension--an inability to mobilize enough energy to meet the exigencies of life. There was a weakness in these hysterical patients. Illustrative of how weakness came to be postulated is the frequent triviality of the precipitating situation. At age twenty a man found himself near a heavy object as it fell from a window, breaking glass with a sound as of a gun shot. The man became dumb for two months, and twenty-six years later the slightest unexpected noise would still strike him dumb for several months at a time.[24] An even more famous case was observed in Boston, where a young woman, upon being kissed unexpectedly, developed symptoms that kept Morton Prince, an American psychologist, busy for years.[25]

To Janet, personality was a matter of integration. Within the normal individual, this integration of tendencies and ideas is relatively stable; in the hysterical individual this unity is lacking, and in extreme cases a lack of integration may extend to the point of splitting the personality into alternating personalities, most often two, but sometimes more. In these extreme cases a failure of conscious control has taken place. There is, said Janet, a narrowing of the field of consciousness open to the individual. In the contraction of consciousness, the hysterical symptoms are carried on without the individual being consciously aware of them. A rhythmic movement of the arm evokes in the patient no sense that he is doing it; he looks at it as something alien. The arm is carrying out the movement without his volition. The paralyzed leg is an alien "stump," as some of his patients called it, attached to the body, but not part of the person. If double personalities develop, the primary personality may not be aware of the thoughts, feelings, and experiences of the secondary personality. When a fugue occurs, a person may travel, eat in restaurants, answer questions, and generally behave in a fashion that attracts no attention, yet he will, on "awakening," not know where he is, how he got there, or what he did in the interval of the weeks or months during which he lived in the fugue state.

Janet considered that the dissociative split of consciousness came about because of some mental or physical shock. Often he found that the patient's history showed either a long-maintained or a continued series of conflicts. Essentially, hysteria is a contraction of consciousness due to exhaustion of the higher functions.[26] Over all, the dynamic factor is conversion symbolism, the "driving back" of that which is unacceptable in consciousness. The patient tries to get rid of thoughts that are painful or in opposition to moral feelings; he struggles to drive them out of consciousness. When he succeeds in making these experiences unconscious, his symptoms develop with the contraction of consciousness. As a result of clinical investigation, Janet came close to a conception of unconsciousness as a dynamic process. He had spoken of automatic activities as early as 1889 in his doctoral thesis and had discussed the unconscious, but impartial critics see in this usage hardly more than a figure of speech.

As for treatment itself, Janet found that under hypnosis these forgotten experiences can often be recalled to the patient and that the symptoms, the origin of which was unknown, could be traced back to their source and, after hypnotic suggestions, would even disappear (although other symptoms might turn up to take their place).

As might be anticipated, these views created a strained relationship between Janet and Sigmund Freud, whose formulations were of a similar nature. Freud saw Janet as working in a similar area but at a superficial level. In turn, Janet claimed that psychoanalysis originated from his and Charcot's work.[27] As an eclectic in psychotherapy, Janet considered psychoanalysis one among many forms of treatment. Specifically, it served to bring about dissociation of traumatic memories.

The French psychopathologists saw their patients as people--sick individuals in need of care. They saw them as individuals and were interested in them as such as well as in what they could learn about them. An impersonal attitude, natural to study of the generalized human mind, was in the process of being supplemented by an interest in the welfare of the individual. Janet[28] made this explicit in a paper describing his way of investigating the individual's unique characteristics. The French psychologists of the nineteenth and early twentieth centuries advanced the understanding of the clinical method in psychology to a point where Freud and others could carry through the next stage. It seems clear that both utilitarian and idiographic prescriptions were being fostered. Moreover, hesitant steps were being made toward accepting the value of unconscious mentalism, irrationalism, developmentalism, dynamicism, i.e. factors making for change in the individual.

THE UNCONSCIOUS BEFORE FREUD

In an effort to glorify Freud, some enthusiastic disciples write as if his genius came into the world unaided by an intellectual-cultural heritage. They interpret psychology before Freud as concerned exclusively with conscious experience, while the world waited for Freud to discover the unconscious. Nothing could be further from the truth.[29]

The influence of unconscious psychological phenomena has been a theme throughout the ages, from Plato's sleeping beast through Augustine's limitless room of memory to Aquinas' inability to view the soul apart from awareness of its acts. One can leave aside Descartes, Spinoza, Leibniz, and the others who considered unconscious phenomena in some detail and move directly to the nineteenth century. Fechner was most influential on Freud with his iceberg analogy of the mind, that is, that the mind is mostly below the surface of awareness and is moved much by powerful hidden currents than by the winds of awareness. Fechner also introduced a topographical distinction between the sleeping and waking states. Sleep differs from the waking state, not only in intensity of mental function, but also in the activities of different stages. There were others immediately preceding Freud who seriously considered unconscious psychological phenomena, though, perhaps, without any direct influence upon him. Helmholtz utilized unconscious inference. Ebbinghaus wrote his dissertation on Hartmann's philosophy of the unconscious. Even Wundt had to have been aware of unconscious phenomena in order to deny them a place in psychology. Those who came before Freud attached significance in varying degrees to unconscious functioning. Some dismissed unconscious psychological phenomena as curiosities, to be mentioned but then ignored. Others attached a fair amount of meaning, or even importance, to manifestations of unconscious functioning. But none of them grasped the crucial importance of unconscious motivation or found a way to study it. Freud found a use for the unconscious, thought that its exploration might help to explain otherwise inexplicable phenomena, and saw that thoughts and feelings beyond awareness played a role in directing behavior. Moreover, he found a means of studying these unconscious processes.

OTHER INTELLECTUAL INFLUENCES ON FREUD

Among familiar aspects of the intellectual atmosphere that Freud absorbed in developing psychoanalysis were the Helmholtzian view of mechanistic determinism, the Darwinian ideas of development, the French psychopathological view of dissociation, and the Galtonian-Wundtian-Kraepelinian view of association. Factors outside the main psychological tradition were also influential, particularly the writing of Johann Wolfgang von Goethe (1749 - 1832), to which aspects of libido theory are traceable.[30] Freud acknowledged that Darwin's theories and Goethe's famous essay on nature influenced his choice of a medical profession.[31] Many strands of the past affected Freud's thinking. His genius lay in creating a dynamic interpretation of unconscious motivation.

The Development of Psychoanalysis Through the Life of Freud

The sheer wealth of material available about the life of Signumd Freud (1856 - 1939) makes it possible to relate rather closely his personal experiences to the development of his ideas.[32] This is especially pertinent to Freudian conceptions regarding sex, since it is easy to be skeptical of his views unless it can be shown that their sources were not his own biases and preconceptions, but experiences with his patients. Experience with some of his first patients suggested aspects of what emerged as the free association method and helped him in construction some of his major theoretical concepts.

Early Life

Sigmund Freud was born in 1856 in Freiburg, a town in what is now Czechoslovakia but was then a part of the Austro-Hungarian Empire. His father was a wool merchant, and the family background was lower middle class. When Sigmund was four years of age, his family moved to Vienna, where he was to live and work for nearly eighty years.

His high intellectual capacity was recognized early, and it was soon known in the family that Sigmund was destined to be its scholar. Homely but revealing evidence of this is the fact that his study-bedroom was the only one equipped with an oil lamp; the rooms of others members of the household only had candles. A year earlier than usual he entered the gymnasium, from which he was graduated with distinction at the age of seventeen. Reading and studying seem to have filled the greater part of his life during these years. Then and later he read widely. He was interested in problems of social reform and, perhaps somewhat surprisingly, in military history. He had a considerable gift for languages and in maturity knew four or five quite thoroughly.

As for his choice of a career, the only professions open to a Viennese Jew in the 1870s were law and medicine. Freud turned to medicine, not because of any direct or compelling attraction to it, but because he felt that it might give him an opportunity to work on those problems of science that interested him. As was not too uncommon in his time, he took eight years, several more than necessary, to complete the medical curriculum. His penchant for sampling other fields not directly required for his training delayed his graduation until 1881.

This penchant for wide study led Freud to take several non-obligatory courses in philosophy with Franz Brentano. As a consequence, Freud was thoroughly familiar with Aristotle. The precise relation of this intellectual excursion to his later thinking is still an obscurity in Freud's intellectual development. Among his other teachers was the German physiologist Ernst Brücke (1819 - 1892), mentioned before in connection with the pact sworn against vitalism (p. 000). It was from Brücke that Freud learned to see man as a dynamic system following the laws of nature.

During these years, Freud had somewhat vaguely considered following a medical teaching career. But when he concluded that an academic career was not open to him, he turned to medical practice. Unfortunately, he had rather neglected the clinical phases of medical training. He realized that he would need more experience, so he worked in a variety of clinics and hospitals. He devoted considerably more time to neurology and speech psychopathology than was customary. He carried on research in a variety of problems. Then and later he was a prodigiously hard worker. It is worth noting that his very first research endeavor involved sex--in this case an attempt to determine the precise structure of the testes of a species of eel. The results were inconclusive; in this endeavor, the future discoverer of the castration complex was unsuccessful.

Freud did a considerable amount of microscopic work in Brücke's physiological institute. It was here that he discovered the analgesic power of cocaine, and he just missed becoming the first physician to apply it in eye operations, which turned out to be by far its most useful application in medicine. Freud also became a very competent neurologist and actually coined the term "agnosia," which is still used in neurological clinics. Indeed, he maintained a part-time practice in this specialty until almost the end of the nineteenth century.

He now had an even more compelling reason for going into practice: he had met and fallen in love with Martha Bernays. The courtship was a stormy one on his side; he exhibited violence, jealousy, and moodiness to a much greater degree than was characteristic of him before or afterwards.

With Freud's tremendously lengthy work hours, he saw relatively little of either his wife or his children. His wife did not accompany him on his vacations; he had discovered she could not keep up with his rapid traveling pace, and it seems never to have occurred to him to slow his pace down. To Freud, the place of women was in the home. His social recreations were card games with old cronies and visits to his mother, who lived to an advanced age.

Freud and Breuer

One friendship that developed during these years was to be very important both for Freud and for psychoanalysis. He became friends with Josef Breuer (1842 - 1925), a highly successful, sophisticated, and urbane practitioner whom Freud admired immensely. Breuer became for Freud what today we would call, using Freudian terminology, a father figure. Breuer also helped him in a material way, lending him money and offering him advice, both practical and medical. Naturally, this included discussion of the cases handled by Breuer. One case, that of "Anna O" which Freud first heard about in 1882, was of crucial significance.

In December l880, Breuer began to treat Fraulein Anna O. This girl of twenty-one had developed a whole host of symptoms. Hers seemed a classical case of hysteria-paralysis of the limbs, anesthesias, disturbances of sight and speech, nausea, and confusion. The illness had first appeared while she was caring for her severely ill father. She was compelled by her own illness to abandon nursing him. The events during her nursing made a deep impression upon her; but when she was first seen by Breuer, she could not remember them. Anna got into the habit of relating to Breuer the disagreeable events of the day. This provided a release for her pent-up emotions or, as it came to be called, a catharsis. She experienced relief and on occasion even the disappearance of a particular symptom but talking about her troubles. For example, during a period when she could not drink water, despite an intense thirst, she told Breuer that the same thing had occurred for a time when she was a girl. She now remembered that at that time she had seen the much-disliked dog of her governess drinking from a glass. She told Breuer this story in disgust and anger. Afterward, she found she could drink water again without trouble and there was no recurrence of this particular difficulty.

She referred to her sessions with Breuer as the "talking cure" and as "chimney sweeping". Breuer discovered that she was relieved of her symptoms if she was placed under hypnosis and induced to express her dominant feelings and emotions at the moment. It also turned out that what was unconscious to her, except under hypnosis, was some thought or impulse that she found repugnant. Symptoms replaced these thoughts or impulses. When she lived through the traumatic scenes again, without the inhibition of the associated feelings, Breuer found that the symptoms in question were reduced in severity or even disappeared. Her emotions up to this time could not be expressed in a normal way, so the emotions associated with these events had expressed themselves in symptoms. Breuer was so interested in her case that he began to devote more and more of his evenings to working with her. He apparently saw Anna for hours at a time every day for more than a year. He became so engrossed in working with her that his wife became bored at first and later jealous. Unknowingly, Breuer had developed what in later psychoanalytic perspective would be called a countertransference. When he finally realized what was happening, he stopped treating the girl. Anna herself had developed a positive transference: she had transferred to him, as she conceived him to be, the loves and hates that she had felt for her father. The evening that Breuer told Anna of his decision to stop seeing her, he was called to her home to find her excited and in the throes of hysterical childbirth, which he terminated by hypnosis.[33] This incident was too much for Breuer, who fled to Venice with his wife for a second honeymoon. Freud was very interested in this particular case, finding it exciting, unlike Breuer, not at all threatening.

Charcot and Hysteria

In l885, Freud was granted a small stipend to go to France to work under Charcot. Charcot's influence upon Freud as a result of this visit was expressed in theoretical and procedural influences. Heretofore he had held what might be called an organic point of view; after working under Charcot he became much more interested in the functional aspects of mental disorder.

A casual incident that occurred about this time is of importance. In the course of an informal conversation one evening, Charcot insisted that the origin of the difficulties of a particular patient, the wife of an impotent man, had a sexual basis.[34] The gist of this incident was repeated for Freud on several occasions with other physicians, but always it was mentioned casually and in passing. Freud began to wonder why this lead was not followed up in a more systematic and serious fashion in the medical literature. Remembering this incident, he was thereafter on the alert for any indication of sexual factors in the etiology of his patients. His knowledge of Anna O. must also have sensitized him to this particular lead.

Freud also learned Charcot's methods, particularly his use of hypnosis in the study of hysteria. Hysteria was a condition not at all well understood. At that time the very symptoms of hysteria made it faintly unrespectable. It was still interpreted by many physicians as a confusing mixture of stimulation, an overwrought imagination, and a wandering womb. Greek medicine had considered hysteria a condition due to womb movement, and in fact, the word comes from the same root as hysterectomy. With this etiology, it was popularly and professionally supposed that hysteria was a condition limited to women. But while working with Charcot, Freud observed instances of male hysteria. On his return to Vienna he insisted on lecturing on this topic. To put it mildly, his views, especially those on the reality of male hysteria, were not well received. He was actually publicly challenged to find a male with the symptoms Charcot claimed for hysteria. Without going into further details, it is easy to see why Freud thereafter disliked the members of organized medicine in Vienna and why they, in turn, regarded him as an unconventional medical practitioner.

Freud's Use of Hypnosis

In his practice, Freud had been using electrotherapy. This is not the same as electric shock therapy as used today; it consisted of the application of a painful electric shock directly to the afflicted organ, such as the arm. (It was later demonstrated that in those cases where it was successful, the result was due to suggestion rather than the shock).

Freud found the results of electrotherapy disappointing, and so turned to hypnosis, a technique that was still held in disrepute. Its use in his practice hardly added to his professional standing, but his interest was prompted by the power of hypnosis-concentration to bring the surface forgotten thoughts, and as Breuer and Charcot had demonstrated, this was important for the understanding of hysteria.

Freud modified hypnosis in the direction of Breuer's cathartic method of release of emotions. But gradually he eliminated the hypnotic trance until he arrived at the technique of merely having the patient lie on a couch, touching her forehead, and telling her to start talking. One of Freud's patients one day threw her arms around him. Unlike Breuer's panic over a display of affection, Freud saw this as a matter of considerable scientific interest. He began dimly at first, but with gradually increasing clarity, to realize that somehow effective work with the neurotic depended on a personal relationship between the physician and his patient.

The Method Of Free Association

During these years it was Freud's custom to question his patients rapidly and in considerable detail and to interject other comments freely as they occurred to him. One of his patients, Fraulein Elizabeth, sharply reproved him for interrupting her flowing thoughts. He saw the validity of her reproof and, gradually, the method of free association emerged. Basic to this concept is a thoroughgoing belief in causality--that all matters, dreams, and thoughts, no matter how trivial, incongruous, and inconsequential, actually had some cause. The value of allowing one's mind to wander had also been discussed by one of his favorite authors, Ludwig Borne. This author had written an essay with the striking title "The Art of Becoming an Original Writer in Three Days". As quoted by Ernest Jones, it concludes as follows:

Here follows the practical prescription I promised. Take a few sheets of paper and for three days in succession write down, without any falsification or hypocrisy, everything that comes into your head. Write what you think of yourself, of your women, of the Turkish War, of Goethe, of the Fonk criminal case, of the Last Judgement, of those senior to you in authority --and when the three days are over you will be amazed at what novel and startling thoughts have welled up in you. This is the art of becoming an original writer in three days.[35]

The method of free association that Freud used hereafter consisted essentially of instructing his patients that the basic rule they were to follow was to say whatever came to mind allowing no selection and no rearrangement whatsoever. This letting one's mind go, akin to day-dreaming aloud, sounds relatively easy to do; but his patients often found it unexpectedly difficult, since either there would be blanks, or violating the rule, they would struggle to rearrange the flow of their thoughts. Freud soon realized that these unexpected difficulties were significant as signs that material meaningful to the patient was close to the surface. He became alerted to the fact that when his patients experienced difficulties in associating, something of significant seemed to be occurring. From this finding arose his insistence that they must follow the basic rule, and the analysis progressed when they did so.

Other aspects of the psychoanalytic method developed during these years. Freud recognized his patients' remarkable unwillingness to disclose painful memories, a mechanism that he called resistance. Freud saw a connection between resistance and repression. Repression causes memory gaps or amnesias. The forces that produce repression also produce resistance.

The following example of free association illustrates a purposeful failure of memory, the Freudian significance of which is discussed a little later.[36] It is atypical only in that it occurred during a conversation, rather than in the course of the analysis of patient. An acquaintance, in conversation with Freud, stumbled over a Latin quotation and omitted the word aliquis. Knowing of Freud's contentions on this matter, this acquaintance challenged him to find the reason he had forgotten the word. Freud accepted the challenge. He gave the young man the usual instructions about free associations; the young man responded with what he himself considered to be the faintly ridiculous idea of dividing the word into two parts a liquis. The gist of the succession of free associations thereafter was as follows: "reliques-liquidation-liquidity-fluid-an article entitled, What St. Augustine Said Concerning Women,'-St. Januarius and his Blood Miracle." (Freud-"Didn't St. Januarius and St. Augustine have something to do with the calendar?") "Yes, and as for St. Januarius a phial of his blood liquified on the date of certain holiday, and if it doesn't take place the people get excited. A French general occupying the town once demanded the miracle take place forthwith." Young man hesitates. (Freud-"Why do you hesitate?") "Something too intimate to tell, comes to mind." What was too intimate to mention had to do with the menstrual cycle. As the acquaintance admitted, he was hoping for a miracle: an intimate female friend of his had missed her period.

Although Freud altered his method of approach during these years, he did not vary the aims of his procedures. His principal endeavor was to bring to the surface of the patient's consciousness the traumatic event that was the presumed pathological starting point. Even when this point was achieved and the trauma revealed, Freud continued further back in time. The memories that these patients were able to produce inexorably went further and further into childhood, as if the patients were somehow attracted to this period of life. The importance that Freud attached to childhood will be brought out later in a more systematic discussion of the psychoanalytic theory.

Importance of Sexual Factors

Freud found that a remarkable number of his patients' repressed memories centered on sexual matters. This, of course, was long before the importance of sexual factors in psychoanalysis became a matter of common knowledge and could not be attributed to knowledge on the part of his patients that sexual disclosures were expected of them. After trying the method of direct inquiry into these sexual matters, Freud realized that this impeded treatment. He therefore resumed his passive position in treatment, but maintained vigilance to detect the appearance of sexual material.

In the late eighties and early nineties, Freud tried to interest Breuer in publishing material on his patient Anna O. and others treated by Freud. From Freud's point of view, Breuer was inexplicably reluctant. Eventually, however, they prepared and published in l895 the Studies on Hysteria, from which it has become customary to date the advent of psychoanalysis.[37] It included a joint paper, previously published, and five case histories, among them those of Anna O. and Elizabeth. Although Studies on Hysteria received a few reviews, mostly unfavorable, it created little stir. Only 626 copies were sold in the next thirteen years, for which each author received in royalty a sum equivalent to about $170. Between l895 and l897, bitterness developed between the Freud and Breuer, creating a breach that was never healed; thereafter they went their separate ways.

In 1896, Freud delivered before a psychiatric and neurological society in Vienna a paper on the etiology of hysteria. In it he referred specifically to his conviction that at the basis of every case of hysteria will be found a premature sexual experience early in childhood. He had become convinced that all his patients had experienced something resembling seduction when they were children; most often the adult seducer was an older relative, often the father. It was this trauma that produced the symptoms. One point that convinced him of the validity of his interpretation was the extreme reluctance of his patients to describe in detail that scene and the feeling of unreality that pervaded it. It was as if, unlike other forgotten material, they really did not remember the experience. This convinced him they were not malingering, because they seemed to protect that, although the reported incident was the truth, they felt somehow it could not have happened. A short time after he gave this paper, he came to the conclusion that in most, but not all, instances these childhood seduction had never actually occurred.

A lesser man might have hidden his mistake and tried to forget it. A less clinically acute individual might have "bravely" confessed his error and turned to other more profitable matters. Freud did neither. Instead, he went beyond his mistake and asked the question why their fantasies took the particular form they did. His patients were not lying; they believed their fantasies. Was not the very fact that their fantasies took sexual form evidence that there was a sexual tinge to their thinking, and was he not right to emphasize the sexual basis of their difficulty even though the situations they had described had actually never taken place? Despite the temporary setback, this mistake was later to be seen as an advance. Freud, armed with this new insight, was not ready to explore the whole range of sexuality. In recent years, there has been some question whether Freud was actually all that incorrect in his original judgment, however. The answer remains unclear.[38]

Self Analysis

For some time Freud had been developing the conviction that he needed to explore his own personality. It was immediately obvious that the method of free association would be impossible; he could not assume the attitude of the patient, give uncritically his flow of free association, and at the same time take on the role of the analyst alertly listening to the material. In earlier years some of his patients had spontaneously brought him their dreams for analysis, and he already done some work with dream interpretation. Consequently, dream interpretation suggested itself to him as a means of self-analysis.

This self-analysis was important to Freud. He needed it. Quite apart from some of the indications of neurotic difficulties already mentioned in passing, there were others; for example, a strong fear of railroad travel. Incidentally, in later psychoanalytic thinking this often symbolized leaving the security of the mother! His neurosis, with its frustrations, insecurities, intensities, impracticalities, uncertainties, and vulnerability to threat, gave way in the course of his self-analysis to that more integrated, assured, persevering person that his disciples were to know.

The Interpretation of Dreams

Freud's self-analysis and the writing of The Interpretation of Dreams, both completed in the summer of l899, went hand in hand.[39] This book is, by general consensus, Freud's most important single work. The procedure that he followed was to record his dream on waking and then free associate to the material of the dream. He found that his dreams contained material touched off by events of the day that had not been completely worked through to some satisfactory solution. In dreaming, the problem would be taken up again. Dreams represent a disguised effort to bring about a solution. This wishful aspect of the dream he referred to as wish-fulfillment. A person dreams of drinking before waking up thirsty. A medical student, wishing to continue sleeping after being called, dreams he is already at the hospital. Dreams have meaning, and deep seated desires can be investigated by dream analysis, though dream analysis is but an extension of free association not a substitute for it.

Freud drew a distinction between the manifest and the latent content of the dream. The manifest content is the dream taken at its face value; the latent content is the meaning behind this. The task of interpretation is to go from manifest to latent content. This is a complex task, and only some of Freud's dream symbols can be illustrated. Dreams of falling were seen by Freud as circumlocutions for giving way to erotic temptations; dreams of flying signified longing for sexual accomplishment. Certain images in dreams and for or symbolize objects and desires from the patient's world in a relatively constant fashion. The more common symbols in dreams tend to repeat themselves from patient to patient--money for feces; journey for death; a king for a father; a tree, a steeple, a sword or a snake for the penis; a box, a book, or a purse for the vagina; or a pair of sisters for the breasts. Common symbols, Freud warned, are not to be interpreted without knowledge of the particular patient's unconscious conflicts; the symbols have usual but not invariable meanings.

In spite of the fact that the book devoted to so-called symptomatic acts was not published until 1904, the subject was of concern to Freud during these earlier years. The theme of this book, The Psychopathology of Everyday Life, was the interference with conscious functioning by unconscious process.[40] The illustration already presented of the young man who could not remember a crucial word when he worried about the possible pregnancy of his sweetheart is an example of this. Freud supplied a wealth of illustration drawn from many areas to emphasize the unconscious significance of common errors: forgetting names; making mistakes in speech, reading, and writing (the famous Freudian slip); forgetting intentions; "chance" activities; "clumsy" actions; and the like. Such acts, he found, reveal unconscious desires.

The fact that "chance" acts, mannerisms, and slips of the tongue have unconscious motives opened another route to the understanding of the patient for Freud. Again he had evidence that no act is uncaused. Analysis of actions, along with dream analysis, became subsidiary to free association as a method of psychoanalysis. With these developments we come to the end of both a century and the formative and, in many ways, most important period of Freud's life.

Emergence From Isolation And Later Life

In the years l901 through l906, Freud began to emerge from the isolation that had surrounded him. As the period began, he was forty-five years of age, his practice was increasing, and in l902 a weekly discussion group was founded for those interested to learn his conception of "psychoanalysis," the term he applied to his approach. Not only were these men young, they were also relatively obscure and just at the beginning of their careers. Alfred Adler, to be discussed in the next chapter, worked with him during these years. Carl Gustav Jung, who first came to see him in l907, had already established himself as a promising and potentially important young psychiatrist in Zurich. Unlike most of the others who lived in Vienna, Jung visited Freud and then returned to his practice in Switzerland. For the next five years they were closely associated, and Freud began to feel that Jung was his spiritual son and the heir to psychoanalysis. It was during these years that Jung suggested to Freud that prospective psychoanalysts should themselves be analyzed, a procedure Freud adopted.[41] Otto Rank (1884 - 1939) also joined Freud in Vienna as a disciple at about the same time, while A. A. Brill (1874 - 1948), his American translator, and Ernest Jones (1879 - 1958), his biographer, were both in touch with him in l908.

During these years, Freud published prolifically, including the highly important volume Three Essays on the Theory of Sexuality.[42] Just as the interpretation of dreams had made him ridiculous in the eyes of many of his contemporaries, this new volume made him appear prurient as well, for he argued that all children are born with sexual drives. Despite the notoriety that his views were now receiving, other more perceptive individuals showed some appreciation of what he was attempting to do.

The first official recognition on an international scale of Freud's work came in l909 when, on the invitation from G. Stanley Hall, Freud was invited to lecture at a conference at Clark University in celebration of the twentieth anniversary of that university.[43] Although appreciative, Freud was not too attracted to Hall and spoke of him as having "a touch of king-maker about him," a rather perceptive remark.[44] Freud attended the meeting, however. Many other psychologists were in attendance. Freud met Titchener, Cattell, and James, just to name a few. Jung accompanied Freud and also gave lectures at the celebration. Troubled by a bladder infection and affected by the roughness of some aspects of American life, Freud did not consider the trip an unqualified success and thus maintained an uncomplimentary view of the United States. Although the papers Freud gave were subsequently published in the American Journal of Psychology and was covered in numerous newspapers and magazines in the United States, it probably was somewhat of a blow to him that he did not receive the public attention he had expected. Still, the visit was important for Freud, not only for his recognition in America but in Europe as well. Since the American Journal of Psychology was widely read in Europe, Freud's introduction to many European psychologists was through his articles published there.[45]

Two years later, in 1911, came the break with Alfred Adler, one of his earliest associates. Aside from differences of personality, the issue was whether or not Adler's ideas could be incorporated into psychoanalysis. Adler held that man has a tendency to compensate for a feeling of inferiority. In this and other respects, Adler was focusing upon aspects of behavior that demanded consideration of the social environment. At this time Freud could not see how it could be explained in terms of his theoretical position. Differences of opinion between Adler and Freud were aired through the discussion group that by now was called the Vienna Psychoanalytic Society. Both Freud and Adler eventually came to realize that their differences were irreconcilable, and Adler and some of the other members resigned from the Society. Acrimony seems to have existed on both sides, expressed by Adler by forming a separate group of his own. Freud himself was relieved, more than anything else, by this final break with Adler because, rightly or wrongly, he had come to consider him unreliable and recalcitrant.

This was not the case, however, with the break that came with Carl Jung. In Freud's view, very relevant to the issue over which they ultimately separated was the general religious and moral climate of Switzerland. Jung and other Swiss psychoanalysts had for some time shown a tendency to minimize the theoretical importance of the sexual basis of psychoanalytic theory. They had found when they did so that their relations with both their patients and the general public improved considerably. In May 1911 Jung told Freud that he regarded "libido" as a term expressing general, not sexual, tension. After a trip to New York Jung wrote Freud on how successful he had been in making psychoanalysis acceptable by leaving out matters of sex!

On Freud's part, this was not seen merely as a matter of disagreement about the theoretical importance of sex in psychoanalysis, important though this undoubtedly was; but to a great extend his distress arose from a conviction that Jung's reason for minimizing sex was an intellectually dishonest one. Freud believed that Jung was catering to popular opinion by omitting the sexual factor. Then and later, there was some suggestion that Jung believed Freud's Jewish background had something to do with his overemphasis of sex; this hurt Freud deeply.

In 1914, Jung formally severed his connection with Freudian psychoanalysis by resigning his position as president of the International Association of Psychoanalysis. As Freud put it, they took leave of one another without feeling a need for further meetings.[46] The break was difficult on both sides, but it was inevitable and final. The Jungian side of the story will be taken up in the next chapter.

The years of World War I interrupted Freud's work to some extent but brought no personal tragedy, unusual hardships, or limitations except in number of patients, food restrictions, and reduced income.

His own interests were moving into the more theoretical channels of "metapsychology," as he called it. Metapsychology was a term coined by analogy with Aristotelian metaphysics--going beyond psychology. He meant by it accounting for a mental process in terms of its dynamic significant, topographical features, and economic significance. He aimed to arrive at a general theoretical structure that would guide psychoanalysts in collecting and meaningfully organizing clinical data. These contributions will form a major part of the systematic account of psychoanalysis given later. During his remaining years Freud was occupied with a great variety of writings. He continued to make clinical contributions, but much of his time was taken up by metapsychology and the contributions of psychoanalysis to biology, anthropology, sociology, religion, art, and literature. The standard English edition of his works, from The Interpretation of Dreams[47] of 1900 through the posthumously published An Outline of Psychoanalysis,[48] fills twenty-four volumes.

During the period from 1919 until his death in 1939 Freud Was at the pinnacle of his fame. In the years immediately following the war, of course, Europe was in chaos. The International Association of Psychoanalysis and the newly organized publishing house founded in Vienna in 1919 were both in a precarious state.

One of his most faithful and hard-working assistants in these administrative ventures was Otto Rank, who had been a protegé of Freud. Under Freud's urging he had taken a nonmedical university degree preparatory to further theoretical work in psychoanalysis. He had a special flair for the interpretation of myths, legends, and dreams. Rank's book, The Trauma of Birth, appeared in 1923.[49] Birth trauma as a source of anxiety was the theme. At first, Rank saw this conception as falling within the framework of conventional psychoanalysis, but his reinterpretation of other Freudian contentions in terms of this theme--weaning as anxiety-provoking because it was a separation from the mother, and the male sexual urge as a desire to return into the mother's body--was not accepted by other psychoanalysts. Many heated arguments began. Because of his fondness for Rank, Freud tried to reconcile his views with Rank's as well as with those of Rank's opponents. The attempt was doomed to failure since Rank saw this as rejection by Freud. Rank had meanwhile developed an increasingly severe emotional disturbance. After several trips to the United States, he finally settled here. His break with Freud was final and complete.

In 1923 the first symptom of cancer of the jaw, from which Freud eventually died, had developed. A series of operations was necessary and he had to wear a prosthesis which interfered with his voice to such an extent that he could hardly be understood. In all, he had thirty-three operations. During these years his daughter Anna was his nurse. He had to reduce the number of patients he saw and take longer summer vacations. He had many financial worries during this period, created by the publishing house as well as the public's ambivalent attitude toward him. Abuse from the medical profession continued. On the other hand, he became a world figure, becoming acquainted with and, in some instances, close friends with prominent individuals, such as Thomas Mann and H. G. Wells. Meanwhile the International Association was going through a certain amount of controversy. One of the most important sources of contention was the question of the practice of psychoanalysis by individuals without medical training. The American Psychoanalytic Association, which had been formed under medical leadership, was vehemently opposed to so-called lay analysis. Associations in other countries were divided in opinion but generally favorable to the practice of psychoanalysis by individuals who had the requisite training but no medical degree. Freud wrote a book entitled The Question of Lay Analysis in 1926._ In it he unequivocally supported the position that a medical degree was not necessary in order to practice psychoanalysis, a position from which he thereafter never wavered._

In the 1930s Adolf Hitler came into power in Germany. As early as May 1933, the Nazis made a bonfire of Freud's books in Berlin. By 1934 all Jewish psychoanalysts in Germany who could escape had done so. Freud's friends had been urging him to leave Vienna, but he insisted stubbornly that he would remain. In March 1938 the Nazis invaded Austria. The Nazis had actually taken over Vienna, and storm troopers had broken into his home before he could be persuaded to leave. The Nazis held him in Vienna until his stock of unsold books could be brought back from Switzerland for public burning. The Nazis were persuaded to release Freud partly through the intervention of W. C. Bullitt, then United States Ambassador to France. Freud's arrival in London created a sensation that was given considerable space in the press. During this time his physical health was failing rapidly, but he was still very alert mentally. He continued, in fact, to work almost up until the end. He finished his book Moses and Monotheism in 1938,[50] and died on September 23, 1939.

Theory of Personality

From the work of Freud came a method of investigation, an approach to psychotherapy, and a theory of personality that were major aspects of his metapsychology.[51] His clinical method of investigation has already been discussed. Incidentally, it should be added that for verification of findings, he depended at first mainly on the same relationships occurring repeatedly among his patients. Later those trained in psychoanalysis added to this store of clinically verified findings. It might not unjustly be called validation by consensus of "informed" opinion. The difficulty that this creates, however, is a strong tendency to disregard findings of others not trained in psychoanalysis. Freud's approaches to psychotherapy, particularly his method of free association and dream analysis, have already been presented in some detail.

Any summary of Freud's metapsychology is apt to give the impression that it was static--a fixed system, frozen into the form in which it is encountered. This is misleading because, to Freud, it was a loosely integrated group of theories which evolved through the years with momentarily important points discarded by the wayside. With Freud, as with others, theoretical formulations outlived their usefulness. They are vehicles to be used in part of one's journey but eventually to be given up when no longer cogent. This same evolution continued after Freud. What follows is an attempt to give a classic picture of psychoanalysis as Freud saw it. By the same token, it cannot be a complete view of contemporary psychoanalysis. An effort is made to present only the orthodox Freudian position, differentiated from the steadily increasing number of neo-Freudians who would assimilate Freud into a larger--typically a social--framework of non-Freudian origin.

The Dynamics of Structure of Personality

To Freud, personality was essentially a dynamic concept in which mental life was an interplay of reciprocally urging and checking forces.[52] Consequently, it is necessary to examine the nature of these forces and the structures through which their interplay takes place. This is tantamount to saying that there needs to be concern with the dynamics and the structures, of personality. One form of specification of dynamics can be seen through an examination of Freud's theory of instincts.

Theory of Instincts

In accordance with the deterministic and positivistic philosophy of his era, Freud employed the theory of finite energy as the power behind this reciprocal interplay of forces. He maintained that the physiological energy of the human organism, by virtue of Helmholtz's principle of the conservation of energy, may be transformed into energy for psychological activity. Psychic energy and its psychological manifestation, instinct, together emerge as the basic unit in the dynamics of personality structure. It is a quantum of psychic energy, which functions on transformed physiological energy, linking a body's need to a psychological wish. There are a number of separate bodily needs, each of which gives rise to erotic wishes. These may be identified by referring to the erogenous zones of mouth, anus, and sex organs as centers for different wishes. Taken together, these instincts are the sum total of psychic energy. An instinct has four functional characteristics: (1) impetus, the motor element in the amount of force that it represents; (2) aim, the satisfaction obtained by abolishing the condition of stimulation; (3) object, that through which the aim can be achieved; and (4) source, the somatic process in a body part which eventuates a stimulus.[53]

Freud appealed to the concepts of instinct and energy to give his views on sex a scientific footing and provide a means of describing their interrelationships meaningfully. This formulation occurred shortly after the turn of the century.

About two decades later, Freud faced another problem. The war years forced him to direct his attention to aggressive behavior and the subsidiary problem of understanding it in relation to sex. The theory of the death instinct was the consequence. At this point he held that in representing bodily demands, the instincts follow two aims, the life instinct (Eros) and the death instinct (Thanatos).[54] Under these two headings, Freud assumed a multitude of instincts, although he never identified all of them specifically nor derived their total number. The life instinct operates for human survival and racial propagation, and includes such categories as hunger, sex, and thirst. The form of energy for the manifestations of the life instinct is called libido. The death instinct of Freudian theory, impelling one toward death, is analogous to the catabolic, the breaking-down, processes of the body and is therefore opposed to the anabolic, or building, processes of the life instinct. The death instinct, which has the aim of reducing living things to inorganic matter,[55] is systematically less important and, following Fenichel,[56] will be dispensed with in the account to follow. But aggression is utilized within the framework of libido theory. Aggression is an innate, independent, instinctual disposition.[57]

The Id, Ego, and Superego

Originally Freud conceived of the personality structure in terms of the unconscious, the conscious, and the preconscious (that which is capable of consciousness without special effort). This original focus on conscious and unconscious phenomena was brought about by Freud's concern with hysteria and hypnosis. In hypnosis, for example, there is a clear distinction between what the subject is aware of in the waking state and what he can report in the hypnotic state. The distinction between consciousness and unconsciousness was sufficient at this point to account for the phenomena theoretically. Later, however, he preferred to use the unconscious descriptively as a quality of experience.[58] In the psychoanalytic hour, with the shifting panorama of free association, terms like conscious and unconscious are too bald to be used for behavior that is the result of interacting, supporting, or canceling forces. Identification is difficult when only these results are open to observation. Consequently, in the interest of a greater dynamic emphasis, Freud modified his conceptual scheme.

The structural components of the personality are the inherent system of the id and its derivatives, the ego and the superego.[59] The ego and the superego derive their energy from libido, the primary psychic energy reservoir of the id. The libido, consequently, is not only the basic force for personality dynamics but also the source of organization of the personality structure. Each of these structures must now be examined in detail, and attention must be paid to their interrelationship in the fully developed personality. The course of development of the three structures is reserved for presentation in terms of psychosexual stages.

The id is unconscious[60] and is the oldest of the personality structures.[61] It contains everything that is inherited, present at birth, or fixed in the constitution.[62] This includes the source of the instinctual energy, the libido, which demands discharge.[63]

The libido is expressed in the id through the principle of tension-reduction--the pleasure principle--by which the id operates. A physiological tension occurs in an area of bodily need and is then translated into a psychological wish, the aim of which is to reduce tension. The id obeys the pleasure principle[64] in the seeking of pleasure and avoidance of pain without any other consideration to modify or direct it.[65] The goal of the id is the satisfaction of needs, irrespective of considerations of danger or preservation of life.[66] In the words of the musical comedy song of some years ago, "It wants what it wants when it wants it." There is no consideration of decorum, morals, or modesty.[67]

The id has no direct relation with the external world.[68] Everything we know about the id relates to the ego.[69] Since it is unconscious, it can be known only through the ego, which is conscious. Consequently, while still considering the id, it is necessary to deal briefly with this ego function. The id is known through its intrusions into the consciousness of the ego. Dreams, for example, are an externalization of this internal process in which the id tendencies are partially released during the relaxation of the ego in sleep.[70] Examination of dreams is one way of gaining some dim and frightening knowledge of id sources.[71] According to Freud, the dreams of even the most straight-laced person contain amoral elements, illustrative of the functioning of the id.

The ego includes the conscious portion of the personality structure. The processes of the ego alone are conscious.[72] More strictly, the ego includes the preconscious as well, i.e., that which is capable of becoming conscious voluntarily.[73] The ego is formed by the individual's experience.[74]

In contradistinction to the id, which is guided by the pleasure principle, the ego follows the reality principle.[75] In guiding activities, the ego takes into account the external world and its realities. The ego is the organization interpolated between sensory and perceptual processes and motor activity, of which the individual is aware as his "I."[76]

The instincts of the id press for satisfaction; the ego modifies and channels these drives.[77] Since all libido was originally id, the ego arises from a modification of id.[78] Once it does so, the ego serves as an intermediary between the id and the external world. Here its constructive function is to interpose intellectual activity, which calculates ways and considers alternatives, before allowing the demands of instinct to be accomplished.[79] As an approximation, the ego represents reason, while the id represents the untamed passions; of course, when the latter are represented in consciousness, it is also through the ego.[80] If one were to draw upon the previous history of psychology for an illustration, Plato's fable of the charioteer would come to mind. The ego is in control of voluntary movement and is aware of external events.[81] It stores up experiences in memory; it adapts, it leans, it avoids. Thus it has relation to both the id and the external world.

In summary, ego refers to both awareness of self and the carrying on of executive functions. In following the reality principle, the ego mediates between the imperative pressures from the id, the structures of the superego (described in a moment), and the demands of external reality.

Despite what was just said about ego and consciousness, a portion of the ego is unconsciousness.[82] This unconscious portion results from repression. Materials once conscious, but unacceptable to the ego, are pushed back into the unconscious.[83] Because of its origin, we call this portion of the ego the repressed. Repression, in eliminating unwelcome impulses from consciousness,[84] is a flight mechanism.[85] That which is repressed has an "upward driving force," that is, an impulsion or drive to break through into consciousness again.[86] The ego, under the influence of external reality, controls its entrance into consciousness, and an interplay of reciprocally checking and urging forces develops in which libido must be expended. Repression requires a continuous expenditure of effort.[87]

Anxiety, by definition, is something "felt."[88] As an affective state it is experienced by the ego and serves it as a danger signal. The id cannot be afraid; it cannot estimate danger, for it knows nothing of the external world. There are three kinds of anxiety.[89] Reality anxiety occurs in the face of the dangers from the external world which are too great to cope with; normal or moral anxiety (guilt) in the face of superego restrictions; and neurotic anxiety in the face of the demands of the id. Anxiety, no matter what its particular form, serves as a signal of danger.[90]

The ego, operating through the reality principle, is capable of investigating energy in either an inanimate object, some "favorite" possession, or another person. This energy attachment Freud called cathexis, the sum of psychic energy with which an object is invested.[91] This attachment of energy is analogous to an electric charge.[92] When libido of the ego is invested in an object (including persons) it becomes object-libido.[93] This process of investment transforms ego-libido into object-libido.[94] The reverse also takes place: object-libido can return to ego-libido. Moreover, libido is mobile[95] and can pass from one object to another.

A form of cathexis is operating within the structure per se in the process of ego-id interaction.[96] In checking the id, the ego must automatically expend a great amount of energy. This checking force is anticathexis and is the principle that maintains repression.[97]

The so-called ego defense mechanisms need elucidation.[98] Each ego makes use of various characteristic ways of defending itself against anxiety. Since there are a large number of defense mechanisms, the fact that each individual has a characteristic pattern of them, with some stronger than others, allows for a considerable variety in personality structures. Repression, just described, is one of the major ego defense mechanisms. Not only repression but also fixation, projection, introjection, and others serve the same function. Just as repression, they demand the expenditure of libido to keep anxiety from appearing. They maintain "peace and quiet," but in a manner analogous to a garrison keeping an otherwise unruly population in check. At best they maintain a stalemate; at worst they express themselves in the eruptions of neurotic or psychotic symptoms.

An important ego function that does not require this continual expenditure of energy is sublimation. This is the most successful of the various mechanisms in that it allows the discharge of energy to bring about a cessation of impulses without the continued defensive function of the other mechanisms. Sublimations are the socially approved ways of discharging libido without anxiety; they express libido with aims other than sexual gratification. Illustrations may be drawn from the various stages of psychosexual development. A child's oral pleasures may be sublimated by pleasures in speaking, and he may go on to a career as a politician or professor. Interest in anal matters may be sublimated by work in the arts; phallic interests may be sublimated by nature study. Many forms of sublimation, however, would not show the obvious relations just sketched. Sublimation, in fact, takes on protean forms with law, order, social progress, interaction, and achievement as areas of manifestation.

The superego is the third of the personality structures. It serves as the vehicle for the conscience.[99] It develops out of the ego, arising as an aftermath of the Oedipus Complex, a facet of development discussed later. It is organized in much the same manner as the ego and deals with the ego as a strict father would toward his child.[100] The tension this engenders is guilt,[101] which was defined earlier as moral anxiety. The superego serves the special function within the ego of demanding restriction and rejection,[102] and it therefore follows that repression is the work of the superego.[103] Although in conflict in many situations, the superego and ego may function harmoniously; in fact, only when there is a conflict can we distinguish between them.[104] When this happens, the superego serves as a pressure on the ego. It makes the child feel guilty, just as his parents had made him feel guilty. In a more general fashion, the superego expresses the child's moral imperatives, ideals, and the like. It serves to control those sexual and aggressive impulses that would otherwise endanger social stability.

Such are the dynamics and structures of personality as Freud and his followers viewed them.

Stages of Psychosexual Development

Psychoanalytic personality development is conceptualized by Freud[105] as a progression through a series of psychosexual stages. These stages are determined by changes in areas of libidinal localization expressed in changing modes of pleasure findings. They are characterized by differences in object relations, the structural organization of personality, and the appearance of various behavior mechanism, that is, the ego defense mechanism. Freud's original notion about psychosexual stages was developed to explain the appearance of sexuality in infancy and childhood and the underlying structure of sexual perversions. One of Freud's senior collaborators, Karl Abraham (1877 - 1925),[106] contributed a great deal to the elaboration of the theory of psychosexual stages, especially to its extension to explain character structure in the adult on the basis of the child's experiences in the various stages. Freud subsequently accepted this work, so in this sense it is orthodoxly Freudian.

In the progression from birth to adolescence, there are the oral, anal, phallic, and genital psychosexual stages (with the later two stages separated by the so-called latency period). Although the stages overlap and characteristics of an earlier stage are not entirely absent before the appearance of later stages, erotic pleasures tend to be localized successively in the particular erogenous zones corresponding to the stages.

The Oral Stage. The oral stage extends from birth to sometime in the second year. I the early oral phase, the mode of pleasure-finding is most concretely expressed in sucking and swallowing or, more figuratively, incorporating, i.e., symbolically making objects part of oneself. Sensations of the lips, mouth, tongue, and cheeks are exciting in and by themselves. Freud points to the prevalence of thumbsucking without the reward of food as an illustration of pleasure of and for itself.[107] Sucking is pleasurable and is thus a manifestation of libido. The infant's general mouth-centeredness is also illustrative. "He puts everything in his mouth," says the mother.

At birth the infant makes no distinction between world and ego. Libidinal energy is entirely narcissistic; it is directed toward himself but without awareness that there is a separation of self and world. For example, the mother's breast and body are not distinguished from his own body. The distinction between the infant's self and the environment comes with the diversion of libido from id to ego functions. This distinction comes about, according to Anna Freud, because his needs are not met immediately. If he could always summon up the breast immediately, there would be no occasion to develop any awareness of "self" and there would be no occasion to develop any awareness of "self" and "other" from this experience. But his needs are met only after a delay; the mother, by the very nature of things, fails to respond instantaneously. The inevitable delays in ministering to his wants force a recognition on his part that there is a world "out there" that is not part of "him," from which he is separate. Self and social awareness develop hand in hand, when the world and ego begin to be distinguished from each other.[108]

The mother is the first object of the infant's libido, i.e., ego-libido becomes object-libido as invested in the mother. In non-psychoanalytic terminology, the child is bonding, beginning to form a positive attachment; he is learning in an infantile way to "love" his mother. Some id has been transformed, while the remainder is unchanged.[109] Out of the id, present from birth, the ego begins with awareness of the world.

In attempting to control id impulses, the ego supplements the pleasure principle, previously the only regulating principle, with the reality principle, which requires the individual to take into consideration conditions imposed by the outer world.[110] The first signs of the reality principle operating in infants may be nondramatic and hardly noticeable, but they exist. For example, there are the barest beginnings of tolerating delays in having his needs met when the infant does not cry continually because of hunger pangs. After a signal cry, he may be quiet for a few seconds. As the mother describes it, "Johnny isn't as impatient as he used to be." This toleration is the beginning of conforming to the reality principle.

If the mother is gentle and adroit, the infant's little world is pleasant; if the mother is rough and clumsy, the world is bad, not in any clear-cut, thought-out way, but in a nonverbal "feeling." This last observation goes a long way toward accounting for the fact that difficulties of adjustment can occur in homes that look ideal to an adult. The world of the infant is very small and does not take into account the income of the family, the amount of land surrounding the house, the number of servants, or any other indices so obvious to adult eyes. His world is his interaction with his mother.

Incorporation is important in this oral phase. From incorporation or non-incorporation comes the development of two important personality mechanisms, that is, characteristic ways in which the infant (and later the adult) operates. These mechanism are introjection and projection. [111]

The late-oral or oral-sadistic phase begins at about the age when the eruption of teeth occurs. The modes of pleasure-finding shift. Biting dominates, while devouring and destroying are more figurative expressions. The situation is intensified by the process of weaning, which usually occurs at this time. The child is in pain and is frustrated, and ambivalence makes its appearance. No longer is there unalloyed positive attachment to the mother. The object relation with the mother, heretofore only loving, is complicated by the appearance of feelings of hatred, so both positive and negative feelings are concurrently present. How these problems of weaning affect the infant depends in considerable measure on whether or not weaning is either too abrupt or too early. In either case, trouble of adjustment is to be expected. Anxiety will appear inevitably, but it will be intensified if this source of frustration is not introduced slowly and gradually. Each child fixates, i.e., invests some libido in oral matters; but the amount is determined by the extend of oral gratification.[112] Undue frustration or too much gratification can produce too great a fixation, possibly resulting in less than optimal adjustment later.

The oral stage ends sometime in the second year of life, but oral activities continue to be sources of satisfaction though in varying degrees from individual to individual.[113] Too great or too little gratification may result in an oral character, with oral preoccupations forming a disproportionate part of day-to-day interests--excessive eating, drinking, kissing, and smoking. There will be not only these excessive mouth habits, but also more symbolic manifestations of orality in attitudes of dependence or assurance. An infant over-gratified in the oral stage may in adulthood be sanguinely optimistic that everything will turn out all right, while lack of gratification may contribute to the formation of a pessimistic individual, who is passively dependent on others for his feelings of esteem. Frustrations in the late oral stage can result in a host of ambivalent adult attitudes, friendly-hostile, aggressive-submissive, and so on, along with a tendency to exaggerate and swing from one extreme of these attitudes to the other. A tendency toward "biting" remarks is also characteristic.

The Anal Stage. The area of libidinal localization is shifted to the anal region sometime during the second year of life, giving rise to the anal stage. Before examining the phenomena, look for a moment at the situation as the infant might. There is nothing about the odor, texture, or appearance of the feces that is inherently unpleasant. The infant has no innate repulsion. He has created it, and the mother seems to prize it, since she is pleased when he as a movement and concerned when he does not. According to Freudian thinking, defecation is "perceived" by the infant as the giving of a gift. What happens to his gift? The mother flushes it down the toilet! Often he acts out his puzzlement about his strange behavior by toilet play, throwing toys in the toilet, only to retrieve them again.

There are two phases to the anal stage--the expelling and the retaining phases. In other words, pleasure is obtained first from the sheer act of expelling and later from the feeling of retaining a full lower intestine. The more figurative or symbolic pleasures of the first phase are expressed in rejecting or destroying, while pleasures of the later phase are expressed in controlling or possessing. Extending over both phases is a sadistic overlay. Anal behavior used to hurt someone else may be manifest in the more symbolic pleasures associated with both phases. The infant may take pleasure in using expulsiveness as a means of defying the parents, or he may withhold excretion as a means of defiance. Parents may not necessarily agree with the Freudian interpretation, but they will certainly agree that the toilet training period is typically one of struggle and the infant seems to be doing just what has been described!

The child's ego, equipped with self-awareness by the oral stage, extends its prowess in the anal stage away from passive functions toward actively directing his own behavior according to his changing environment. In short, the ego begins to take on executive functions; it is becoming the doer. The infant no longer must induce others to do for him, but begins to do for himself. He learns to keep clean, to walk, and to talk. With these accomplishments, he can begin to manipulate his environment. In learning to talk, he can let his wants be known more efficiently. Speech is also important in ego development; through it he learns to handle himself as well as communicate with others. He now self-communicates. In fact, language is such a wonderful tool that in psychoanalytic thinking it assumes a magical and symbolic significance to the child. An illustration from children somewhat older than the age under consideration is particularly apt. "Sticks and stones may break my bones, but names may never hurt me!" This chant is learned by children for its reassurance value. They have to be reassured that names will, in fact, not hurt them. Parents will attest to the fact that on occasion they do have to tell their children at this age that being called a "garbage pail" does not make them one!

Not only is mastery of motility taking place, but judgment on the part of the ego is beginning to develop as well. Partly dependent upon the growth of speech, judgment is shown through reality testing. The infant tries out everything, in the process of which his behavior would make most mothers modify the old saying to read--"Fools (and little children) rush in where angels fear to tread." However immature his judgment may be, the child certainly is exercising it.

Difficulties of adjustment experienced during the anal stage may also leave their mark on the adult personality in the form of the so-called anal character. According to Freud[114] the triad of characteristics that are associated with the anal character is orderliness, parsimoniousness, and obstinacy. In this context, orderliness refers to scrupulousness in keeping everything just so--socks placed away by color, the desk blotter in its precise place--and finickiness about cleanliness. Parsimoniousness refers to "tightness" with money and other things such as speech. Obstinacy refers to immobility even to the point of defiance and irritability. Scrooge, the character in Dickens, and his present-day comic strip descendants exemplify the anal character. These characteristics are generalized extensions of earlier compliance with the parents' wishes regarding excretion. "Cleanliness," "tightness," and "immovability" suffice to show the rationale of this extension.

The Phallic Stage. Libidinal interests are shifted to the genital zone at about the end of the third or beginning of the fourth year. Genital interests have been present before this age--erections have occurred and masturbation is not unknown--but the interests are now intensified. Part of this intensification is maturational in character, because physical changes are taking place. This is referred to as the phallic stage. Interests center on the sex organs themselves with touching, looking at, and exhibiting genitals, rather than heterosexual behavior which is characteristic of the genital stage yet to come. Sexual fantasies appear, and, in general, a high value is placed on the sex organs as such. An important consequence of the phallic stage is that boys become more masculine and girls more feminine. As a result, it will no longer be possible to use "he" generically for both boys and girls. The sexes must now be distinguished, psychoanalytically speaking.

An event of tremendous importance takes place during the years of the phallic stage--the formation and, under normal circumstances, dissolution of the Oedipus Complex. Hence, it is both logical and convenient to discuss it at this point. However, unless attention is directed to it, an historical inaccuracy would be perpetrated. The theory of the Oedipus Complex was one of Freud's own unique contributions, dating from the period around the turn of the century, not the later years when the theory of psychosexual stages was formulated.

The high valuation of the sex organs characteristic of the phallic stage is significant in the emergence of the Oedipus Complex, which, as might be expected, takes a different course for boys and girls. Its operation in boys will be considered first.

The legend of Oedipus is best known for Sophocles' trilogy of plays. The essentials of the plot revolve around Oedipus killing his father and marrying his mother. Freud turned to this legend for the name, Oedipus Complex, to describe the symbolic playing out of this same drama in the life of every boy. By the very nature of things, the boy will fall in love with his mother and direct death wishes toward his father.

With the coming of phallic interests, the boy develops feelings and behavior directed toward the mother that, commensurate with his age and physical state, are sexual in nature. In fumbling childish ways he shows his sexual feelings. These advances his mother rebuffs.[115] The father is also seen as having privileges with the mother from which the boy is barred. For example, when the father is away, the boy may have the privilege of sleeping in the mother's bed, but when the father returns, this is not permitted. He becomes jealous, and strong hostile feelings toward the father develop. But mother-son incest is prohibited in almost all cultures, bringing into play a powerful taboo reinforced by the father's authority over the boy. The boy is a rival to an all-powerful father, and he also has feelings against which all society sets its face. Small wonder that he develops anxiety and fears the loss of both his parents' love. Massive anxiety, therefore, makes its appearance. As if this were not enough, he has a more specific anxiety about his sex organ, on which, it will be remembered, he places a high value. This is castration anxiety, a fear from implied or actual threat to the organ that some parents employ. When the boy learns of the anatomical lack in girls, this may reinforce his belief in the reality of castration. The cumulative pressures of these anxieties are so great that he represses his desires for the mother, replacing them with tender affection, while his feelings of hostility toward the father are replaced by identification. The Oedipus Complex is "smashed," but its effects are still there. It has not disappeared, but is under the control, sometimes shaky, of maintained repression.

In the girl the Oedipus Complex takes a different course, because she, unlike the boy, must give up her original pre-Oedipal object choice of the mother and redirect libido toward the father.[116] Moreover, the castration anxiety of the boy is impossible for her since the lack that this implies is already a fact. This lack she notices, and "penis envy" develops. She has fantasies that this castration has happened as a punishment, and she wishes to regain it through the father. This drives her into the Oedipus situation in which the loss may be repaired again in fantasy by having a child through the father. She "loves" the father and therefore "hates" the mother, her rival, whom she also blames for her castration. As a means of solving this problem, the girl learns to identify with the mother. The already existing ambivalence toward the mother aids in this displacement of love to the father. In this way the girl is prepared for the Oedipus shift, events driving her into it, rather than destroying it, as was the case with the boy. Because of the way it was formed, there is less drive for the girl to overcome it as abruptly as does the boy, and, in fact, the Oedipal situation remains in effect with the girl for a longer period and is continued more or less indefinitely.

If one asks, not unnaturally, why this stirring drama which takes place in both boys and girls is not so clearly remembered that it becomes common knowledge of our individual past, the answer, psychoanalytically speaking, is simple. We have repressed our knowledge, and, although it is still operative unconsciously, we cannot consciously recall it.[117]

For both the boy and the girl the aftermath of the Oedipal situation is the formation of the superego.[118] The superego is the heir of the Oedipus Complex in that it arises after the complex has been repressed.[119] Parental influence is again paramount.[120] The child identifies with parental views on manners and morals, or rather with their idealized and purified views. He makes both their approving and disapproving attitudes his own. These demands are often exacting, beyond his childish capacities of accomplishment. Consequently, he is plagued with feelings of guilt; he has measured himself with this idealized view and falls short.

In adult life, an individual showing disproportionate effects of the phallic stage would have continuing castration anxiety or penis envy. The male phallic character gives the impression of being a devil-may-care, masculine, assured person.[121] Intense vanity, exhibitionism, sensitiveness, and a tendency to maintain the offensive are characteristic. At least fitting the stereotype of the phallic character would be the motorcycle fan, the professional wrestler, and the like. A girl driven by her envy would use her physical charms or other capabilities to overcome the male in any way she could. Actually, both male and female phallic characters are dependent, narcissistic, and unable to have mature heterosexual relations. Sexual conquests are precisely that, not means of relating to other individuals.

With the formation of the superego, the last major constituent of the topographical organization of personality has come into being. The interrelationships among id, ego, superego, and environment are taking on their final form. Earlier in this account, consideration was given to the dynamics and structure of personality. If a strictly developmental sequence of presentation had seemed desirable, that discussion could have been interpolated at this point with relatively little modification.

The Latency Period. The latency period extends over the years five to ten with no new area of libidinal localization making an appearance. It was originally considered a period of sexual quiescence. However, sexual interests are still very much present, but sublimation and other mechanisms are operative, producing a relatively quiet period. Social feelings are extended to individuals outside the family circle at this age. The opinion of their peers looms very large to children in this period.

The Genital Stage. At about the age of ten, the genital stage is introduced by the pre-pubertal phase preparatory to physical maturity. During the next two or three years or so, there is a sharp increase in the sheer amount of libido available. As sketched by Anna Freud, regression occurs; libido is redirected to infantile love objects; Oedipal fantasies reappear; aggressive impulses are intensified; habits of cleanliness may be lost; immodestly and cruelty may be apparent.[122] There are no new elements, but rather a revival of tendencies from infancy. A general disruption of id, ego, and superego relationships occurs. When the id is in the ascendancy, means of pre-genital gratification predominate; when the ego is the stronger, anxiety results. Criminal attacks that make the headlines of our newspapers, although more often involving a youngster a year or two older, frequently involve what is essentially a failure to hold id impulses in check.

With the arrival of bodily sexual maturity or puberty, there tends to be a dropping away of the sloppy and violent behavior characteristic of the earlier phase and greater refinement and even fussiness may appear. Sexual interests again extend beyond family figures. The boy or girl may behave as if a stranger in his own family, with uneasiness over displays of affection. "Crushes" on persons who are parent substitutes may be of high intensity but short duration, and are quickly forgotten. In general, the disruption of the earlier genital phase gives way to the beginnings of some approximation of the genital character of adulthood.

The normal, genital character if adulthood is one of non-neurotic sexual adjustment with extensive use of sublimation as a constructive means of ego adjustment.[123] Nevertheless, all adults show some effects of the other previous psychosexual stages. Oral, anal, and phallic characters, despite their deviation, are within the normal range if adjustment. In fact, the dividing line between them and the genital character is a matter of degree. In a sense the genital character is an ideal imperfectly achieved by most adults.

It should be obvious that the psychoanalytic theory of psychosexual development places considerable stress on the formative decisiveness of the early years of life. More space has been devoted to the first five or six years of life than to the rest of the first fourteen years through adolescence, and adulthood has received hardly more than a footnote. This proportion of space is in keeping with psychoanalytic emphasis.[124] Adulthood is an elaboration of the events in infancy and childhood.

Overview

A unique pattern of prescriptive emphases is found in psychoanalysis. Idiographicism predominates over nomotheticism. Unconscious mentalism, dynamicism, developmentalism, and irrationalism are intertwined salient factors. Shared with some of the other views of psychology discussed in previous chapters are centralism, contentual subjectivism, and determinism. It is not surprising that psychoanalysis is not completely integrated with the rest of psychology even to this day, despite today's broader acceptance and utilization of the very prescriptions considered central to psychoanalysis. But this greater rapprochement was a development to come in the generations after Freud.

Summary

In considerable measure, psychoanalysis has been seen to emerge from Freud's experience with patients. His was a clinical method of both investigation and verification. Through free associations, actions and dream analyses he found individual interpretive clues that he then related to other presumably congruent findings from the same sources, either from the same or other patients. Consistency of the data, either within a case or from one case to later cases, led to increased confidence and ultimately to certainty about them. Conspicuous by its absence was the control that would have been given by experiment or some other method of studying exceptions to his generalizations. His emphasis on sex--extended sex as it were, with ramifications into all areas of human behavior and experience--is at the same time indicative of the emphasis he placed on the instinctual character of man's drives to action. He attached crucial importance to childhood development. The decisive imprint of childhood upon our adult behavior was not only expressed through a psychogenetic emphasis, but was also to be played out in a manner that followed a remorseless, biologically genetic pattern. Similarly, he placed emphasis upon the dark, primordial forces of the id, which had the ego at its mercy.

All of these foci were to be questioned, modified, or amplified in varying degrees by followers and critics. The use of methods other than the clinical, emphasis on forms of motivation other than the sexual, greater emphasis upon experience after childhood, increased emphasis upon the social at the expense of the instinctual factors, and recognition of a greater autonomy of conscious control by the ego all were to come in the period after his death. Psychoanalysis, as a means of investigation, as a method of treatment, and as a theory of personality continued after Freud. To these themes the book will return in the next chapter.
REFERENCES

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[1]P. Janet, The Major Symptoms of Hysteria, 2nd ed. (New York: Macmillan, 1920).

[2]W. Riese, The Legacy of Phillipe Pinel: An Inquiry into Thought on Mental Alienation (New York: Springer, 1969).

[3]P. Pinel, Traité médico-philosophique sur l'aliénation mentale (Paris: Richard, Caille and Revier, 1801).

[4]J. E. Esquirol, Des maladies mentales (Paris: Baillière, 1838).

[5]R. Pintner, Intelligence Testing: Methods and Results (New York: Holt, 1923).

[6]H. F. Ellenberger, The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (New York: Basic Books, 1970).

[7]Ibid., p. 112.

[8]J. Braid, Neurypnology; or, The Rationale of Nervous Sleep; Considered in Relation with Animal Magnetism (London: Churchill, 1843) (Reprinted, 1899).

[9]G. Guillain, J. M. Charcot 1825-1893: His Life-His Work, trans. P. Bailey (New York: Hoeber, 1960).

[10]S. Freud, "The History of the Psychoanalytic Movement," A. A. Brill, ed., The Basic Writings of Sigmund Freud (New York: Random House, 1938), p. 943 (1912).

[11]Janet, Major Symptoms.

[12]J. M. Charcot, Clinical Lectures on Diseases of the Nervous System, trans. T. Savill (London: New Sydenham Society, 1889), III.

[13]G. Zilboorg and G. W. Henry, A History of Medical Psychology (New York: Norton, 1941), pp. 357-378.

[14]H. Bernheim, Hypnosis and Suggestion in Psychotherapy: A Treatise on the Nature and Uses of Hypnosis, 2nd ed., trans. C. A. Herter (New Hyde Park, N.Y.: University Books, 1964) (1884-1886).

[15]A. A. Liebéault, Du sommeil et des états analogues, considérés sur tout au point de vue de l'action de la morale sur le physique (Paris: Masson, 1866).

[16]T. A. Ribot, English Psychology (London: King, 1873), (1870).

[17]T. A. Ribot, German Psychology of To-day (New York: Scribner's, 1886) (1879).

[18]P. Janet, "Pierre Janet," C. Murchison, ed., History of Psychology in Autobiography (Worcester: Clark University Press, 1930) Vol. I, pp. 123-133; W. S. Taylor, "Pierre Janet, 1859-1947," American Journal of Psychology, LX (1947): 637-645.

[19]P. Janet, L'automatisme psychologique (Paris: Alcan, 1889).

[20]P. Janet, L'état mental des hystériques (Paris: Rueff, 1892).

[21]P. Janet, The Major Symptoms of Hysteria (New York: Macmillan, 1907).

[22]P. Janet, L'analyse psychologique (Psychology analysis), in English, C. Murchison, ed., Psychologies of 1930 (Worchester: Clark University press, 1930), pp. 369-373.

[23]Taylor, "Pierre Janet."

[24]Janet, Major Symptoms.

[25]M. Prince, The Dissociation of a Personality (New York: Longmans, Green, 1905).

[26]Janet, L'analyse psychologique.

[27]P. Janet, Psychological Healing: A Historical and Clinical Study, 2 vols., trans. E. and C. Paul (London: Allen and Unwin, 1925).

[28]Janet, L'analyse psychologique.

[29]For discussion of this problem and, indeed, practically all aspects of Freudian thinking, see Ellenberger, The Discovery of the Unconscious.

[30]S. Rosenzweig, "The Cultural Matrix of the Unconscious," American Psychologist, XI (1956): 561-562.

[31]S. Freud, "An Autobiographical Study" in J. Strachey, ed., The Standard Edition of the Complete Psychological Works of Sigmund Freud (London: Hogarth, 1959), Vol. XX, pp. 7-70 (1925). Frank Sulloway's interesting treatment of Freud is appropriately titled Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (New York: Basic Books, 1979).

[32]Albrecht, The New Psychology in America. There is no lack of biographical work on Freud. Sulloway has been mentioned already. Another excellent recent biography is Ronald W. Clark, Freud: The Man and the Cause (New York: Random House, 1980). The classic treatment of Freud is Ernest Jones, The Life and Work of Sigmumd Freud (New York: Basic Books, 1953) 3 vols. A much smaller, more personal work is Hanns Sachs, Freud: Master and Friend (Cambridge, Mass.: Harvard University Press, 1944). The most recent treatment by Peter Gay ( ) was not been read in time to be used in this chapter. This does not begin to list the totality of the literature, however.

[33]Anna O.'s real name was Bertha Pappenheim. She never married, was very devout, and went on to a career in social work. She became so distinguished in her field that Germany issued a postal stamp in her honor in 1954. What has been reported in the text is the "received opinion" as given by Breuer, Jones, and Freud. H. F. Ellenberger, however, has unearthed new evidence reported in "The Story of 'Anna O': A Critical Review with New Data," Journal of the History of the Behavioral Sciences VIII (1972): 267-279, which casts considerable doubt that there was either catharsis or a cure.

[34]S. Freud, "The History of the Psychoanalytic Movement," in A. A. Brill, ed., The Basic Writings of Sigmund Freud (New York: Random House, 1938), pp. 933-977 (1914).

[35]Jones, The Life and Works of Sigmund Freud, Vol. I, p. 246.

[36]S. Freud, "Psychopathology of Everyday Life," in Brill, ed., The Basic Writings of Sigmund Freud, pp. 35-178 (1904).

[37]J. Breuer and S. Freud, Studies on Hysteria (London: Hogarth, 1955) (1895).

[38]Jeffrey M. Masson, The Assault on Truth: Freud's Suppression of the Seduction Theory (New York: Farrar, Straus, & Giroux, 1984); A revision of the revisionist view is found in Frank Cioffi's review, "The Cradle of Neurosis," Times Literary Supplement, July 6, 1984, pp. 743-744.

[39]S. Freud, The Interpretation of Dreams (London: Hogarth, 1953) (1900).

[40]Freud, Psychopathology of Everyday Life.

[41]M. Fordham, The Objective Psyche (New York: Humanities Press, 1960).

[42]S. Freud, Three Essays on the Theory of Sexuality (London: Hogarth, 1953) (1905).

[43]Rand B. Evans and William A. Koelsch, "Psychoanalysis Arrives in America: The 1909 Psychology Conference at Clark University," American Psychologist, 40 (1985), 942-948.

[44]Freud, "Autobiographical Study," p. 51.

[45]Freud, "The Origin and Development of Psychoanalysis," American Journal of Psychology 21 (1910) 181-218.

[46]Freud, "The History of the Psychoanalytic Movement."

[47]Freud, The Interpretation of Dreams.

[48]S. Freud, An Outline of Psychoanalysis (New York: W. W. Norton and Company, 1949) (1939).

[49]O. Rank, The Trauma of Birth (New York: Harcourt, Brace and Company, 1929) (1923).

[50]S. Freud, The Question of Lay Analysis (New York: W. W. Norton and Company, 1950) (1926).

[50]For an interesting parallel between Freud's attitude toward lay analysis and those of the phrenologist, Gall, see Karl M. Dallenbach, "Phrenology versus Psychoanalysis," American Journal of Psychology, 69 (1956): 511-525.

[50]S. Freud, Moses and Monotheism (New York: Alfred A. Knopf, 1939).

[51]N. Fodor and F. Gaynor, Freud: Dictionary of Psychoanalysis (New York: Philosophical Library, 1950). This reference is a convenient source to find citations of the definitions of some of the crucial characteristics of psychoanalysis.

[52]S. Freud, "Psychogenic Visual Disturbances According to Psychoanalytic Conceptions," Collected Papers (London: Hogarth, 1924), Vol. II, pp. 105-112. (1910).

[53]S. Freud, "Instincts and Their Vicissitudes," Collected Papers, Vol. IV, pp. 60-83 (1915); S. Freud, The Ego and the Id (London: Hogarth, 1947) (1923).

[54]S. Freud, Beyond the Pleasure Principle (New York: Boni and Liveright, 1922) (1920).

[55]Freud, An Outline of Psychoanalysis, Chap. 2.

[56]O. Fenichel, The Psychoanalytic Theory of Neuroses (New York: W. W. Norton and Company, 1945).

[57]S. Freud, Civilization and Its Discontents (London: Liveright, 1930), Chap. 6 (1929).

[58]Freud, An Outline of Psychoanalysis.

[59]Ibid.

[60]Freud, The Question of Lay Analysis, Chap. 2.

[61] Freud, An Outline of Psychoanalysis, Chap. 2.

[62]Ibid.

[63]S. Freud, New Introductory Lectures on Psychoanalysis (New York: W. W. Norton and Company, 1935), Chap. 3 (1932).

[64]Freud, An Outline of Psychoanalysis, Chap. 8.

[65]Freud, Beyond the Pleasure Principle, Chap. 1.

[66]Freud, An Outline of Psychoanalysis.

[67]Freud, New Introductory Lectures on Psychoanalysis, Lec. 2.

[68]Freud, An Outline of Psychoanalysis, Chap. 8.

[69]Ibid., Chap. 2.

[70]S. Freud, "Metaphysical Supplement to the Theory of Dreams," Collected Papers, Vol. IV, pp. 137-151.

[71]Freud, An Outline of Psychoanalysis, Chap. 2.

[72]Freud, The Question of Lay Analysis, Chap. 2.

[73]Freud, Moses and Monotheism, Part III, Sec. 1.

[74]Freud, An Outline of Psychoanalysis, Chap. 1.

[75]Freud, The Question of Lay Analysis, Chap. 3.

[76]Ibid., Chap. 2.

[77]Ibid., Chap. 3.

[78]Freud, An Outline of Psychoanalysis, Chap. 1.

[79]Ibid., Chap. 8.

[80]Freud, New Introductory Lectures on Psychoanalysis, Lec. 3.

[81]Freud, An Outline of Psychoanalysis, Chap. 1.

[82]Freud, New Introductory Lectures on Psychoanalysis, Lec. 1.

[83]Freud, An Outline of Psychoanalysis, Chap. 4.

[84]S. Freud, "Repression," Collected Papers, Vol. IV, pp. 84-97 (1915).

[85]S. Freud, The Problem of Anxiety (New York: W. W. Norton and Company, (1936), Chap. 10 (1926).

[86]Freud, New Introductory Lectures on Psychoanalysis, Lec. 3.

[87]Freud, The Problem of Anxiety, Chap. 10.

[88]Ibid., Chap. 8.

[89]Freud, New Introductory Lectures on Psychoanalysis, Lec. 3.

[90]Freud, An Outline of Psychoanalysis, Chap. 1.

[91]S. Freud, Wit and Its Relation to the Unconscious (New York: Moffat, 1916), Chap. 5 (1905).

[92]Freud, An Outline of Psychoanalysis, Chap. 2.

[93]Freud, Three Essays on the Theory of Sexuality.

[94]Freud, New Introductory Lectures on Psychoanalysis, Lec. 4.

[95]Freud, An Outline of Psychoanalysis, Chap. 2.

[96]Ibid., Chap. 6.

[97]S. Freud, "The Unconscious," Collected Papers, Vol. IV, pp. 98-136 (1915).

[98]A. Freud, The Ego and the Mechanisms of Defense (London: Hogarth, 1937).

[99]Freud, An Outline of Psychoanalysis, Chap. 5.

[100]Ibid.

[101]Freud, New Introductory Lectures on Psychoanalysis, Lec. 3.

[102]Ibid.

[103]Ibid.

[104]Freud, The Problem of Anxiety, Chap. 3.

[105]The general outline of what follows is dependent upon Freud, An Outline of Psychoanalysis, but some of the details are derived from other sources. For example, Freud originally describe only one oral phase, but this and other stages were elaborated and, as Freud accepted them, these elaborations are presented.

[106]K. Abraham, Selected Papers on Psychoanalysis (London: Hogarth, 1927).

[107]Freud, Three Essays on the Theory of Sexuality.

[108]A. Freud, "Some Remarks on Infant Observation," in Ruth S. Eissler et al., eds., Psychoanalytic Studies of the Child (New York: International, 1947), Vol. II, pp. 11-30.

[109]Freud, An Outline of Psychoanalysis, Chap. 4.

[110]Freud, The Question of Lay Analysis, Chap. 3.

[111]G. S. Blum, Psychoanalytic Theories of Personality (New York: McGraw-Hill Book Company, 1953), pp. 46-47 (Reprinted by permission).

[112]Fenichel, The Psychoanalytic Theory of Neuroses.

[113]Ibid.

[114]Freud, New Introductory Lectures on Psychoanalysis, Lec. 6.

[115]R. L. Munroe, Schools of Psychoanalytic Thought (New York: Dryden Press, 1955).

[116]Ibid.

[117]Freud, New Introductory Lectures on Psychoanalysis, Lec. 3.

[118]Ibid.

[119]Freud, An Outline of Psychoanalysis, Chap. 8.

[120]Ibid., Chap. 1.

[121]Fenichel, The Psychoanalytic Theory of Neuroses.

[122]Freud, Ego and Mechanisms of Defense.

[123]Fenichel, The Psychoanalytic Theory of Neuroses.

[124]Freud, Moses and Monotheism, Part III, Sec. II.