CHAPTER XXI

PSYCHOANALYSIS

The foundations of this method and theory were laid by Sigmund Freud of Vienna, and set forth by him in his epoch-making book, the _Interpretation of Dreams_, published in 1900. Two schools of psychoanalysis exist at the present time: the Vienna school, which adheres strictly to the doctrines of Freud; and the Zurich school, which subscribes to a modification of these doctrines as taught by Dr. Jung.

While both schools agree upon general principles as to the anatomy of the mind, they differ in their teaching as to the _modus operandi_ of mental disease. Freud holds that functional nervous disorders are due to the retention by the subconscious mind of an infantile attitude towards life, and especially towards sex, and that this attitude, which should have been outgrown and left behind, sets up stresses and strains in the mind which lead to the manifestations of mental disease. He gives us the concept of the accumulation of emotion in this wound in the mind, just as pus accumulates in an abscess, giving rise to tenderness and pain. He conceives the function of the psychoanalyst to be to lance this abscess by bringing the subject of distress into consciousness, whereby the repressed emotion is realised and fully experienced, and thereby got rid of. This process is technically known as ABREACTION.

The psychologist who conducts the analysis is very likely to be the recipient of this repressed emotion because, at the moment of its arrival in consciousness, he is apt to be standing in the line of fire. This acceptance of the repressed emotion by the operator is conceived to be a most important phase of the cure, and is known as the TRANSFERENCE.

That this factor of the transference opens a door to most serious difficulties and dangers cannot be denied. The via media between undue influence and callous indifference is hard to find. It is maintained that more analysis will work off the emotion which much analysis has succeeded in lying bare, but in actual practice the process is not so simple and often leads to complications.

This transference of emotion to the analyst, together with the deleterious effects of continual and prolonged dwelling upon the unsavoury aspects of life which takes place in a psychoanalysis, constitute serious objections to this method of therapy.

Jung holds that mental disease is due to a failure of adaptation in the present, leading to regression to an infantile mode of thinking. It will thus be seen that the two theories, while based upon the same data, are fundamentally different, and must lead to differences in practical application.

Both schools explore the subconscious mind by means of dream analysis, and to this method the Zurich school also adds the method known as word reaction. The process of dream analysis is extremely complicated. Briefly, the patient is instructed to recount a dream, and this dream is then taken point by point, and the “free associations” traced out in the following manner. He is instructed to take an image in his dream as a starting-point, turn his mind loose, and watch where it goes, the theory being that it will retrace the association train of ideas by which the dream image was derived from the underlying wish. An elaborate technique exists for interpreting these dream images; so elaborate as to be beyond the scope of the present volume. How much of this technique is sound and how much is arbitrary is still a matter of opinion among psychologists; we have little data as yet as to the part played by unintentional suggestion on the part of the psychoanalyst, no doubt a considerable factor in some cases, and an exceedingly falsifying and misleading one.

The word association method of Jung is less open to objection on the ground of arbitrariness, and its operation is simpler. A list of anything from a dozen to a hundred or more words is made out. The first half-dozen words have usually no particular significance, but then follow a series of words believed to be specially associated with the different types of complex which may become split off from consciousness; lists of these have been worked out by different students of this school, but although one of these lists is usually used as a basis, the analyst generally inserts words which he believes will especially bear upon the patient’s particular problems. These words are called out to the patient, one at a time, and he is instructed to utter the first word that comes into his head in connection with each. The time he takes to do this is taken by a stop-watch usually working to one-fifth of a second. The first half-dozen of unimportant words will show the patient’s average reaction time, but if any words among the subsequent ones have special significance for him, there will be a perceptible lengthening of the time he takes to reply; moreover the replies may be curious, and either show special bearing upon his problems, or, by their irrelevancy, show that the original idea was discarded as unspeakable and a substitute hastily extemporised. If the list be read over again it will be found that, whereas those words which have no special significance are usually responded to by the same reaction word, those which bear upon the patient’s emotions produce a change in the reaction word. Free association is then resorted to, as in the case of dream symbols, to discover the underlying train of ideas and the factors in the subconscious from which they derive their emotion.

Many Freudians make use of this method also, and indeed the two methods of dream analysis and word association are generally regarded as supplementary. The chief value of the latter lies in the fact that it can be used in cases where the patient is either unable or reluctant to co-operate.

The difference in the view-point of the two schools of psychoanalysis leads to a difference in the method of handling the patient; the Freudian who believes that all nerve trouble is due to the retention of infantile habits of thinking, confines himself to analysis and nothing but analysis, offering the patient little or nothing in the way of explanation or instruction, but simply aiding him to lay bare the depths of his subconscious mind, believing that by so doing pent-up emotions will be worked off and split-off complexes reassociated to the personality. The disciple of Jung, on the other hand, believing that the trouble is due to a present failure of adaptation, though using the psychoanalytic method to reveal and bring into consciousness the dissociated complexes, uses a considerable amount of teaching and explanation in an endeavour to enable the patient to assimilate the fruits of experience and adapt himself to his environment. The Freudian complains that the follower of Jung beclouds the issue by unintentional suggestion, and the latter accuses the former of unnecessarily prolonging the process by leaving the patient to find his own way unaided by a wider experience.

The teaching and explanatory method, generally known as re-education, is chiefly associated with the name of du Bois, who was its original exponent, but as, in his day, the psychoanalytic method of investigating the causes of mental disease was unknown, he was often groping in the dark, and dealing with secondary symptoms and effects, so that his method fell into disrepute in the eyes of the new school; but that this method, wisely handled, can be of great benefit in expediting a cure and lessening the painfulness of the process is beyond gainsay.