Part 1

THE PROBLEM OF LAY-ANALYSES

[Illustration: [Logo]]

BY

SIGMUND FREUD

INTRODUCTION BY DR. S. FERENCZI

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NEW YORK MCMXXVII

BRENTANO’S ▾ PUBLISHER

COPYRIGHT, 1927, BY BRENTANO’S INC.

Manufactured in the United States of America

_The Problem of Lay-Analyses_ has been translated by A. Paul Maerker-Branden

and

_An Autobiographical Study_ has been translated by James Strachey.

CONTENTS

INTRODUCTION 11 THE PROBLEM OF LAY-ANALYSES 25 AN AUTOBIOGRAPHICAL STUDY 189

INTRODUCTION

An all-pervading feeling of profound responsibility to society in general, can be the only reason for a man, by far the most celebrated expert in his special field of endeavor, not to try to maintain a monopoly of his scientific findings, but make them accessible to the public. Such altruism is so much more remarkable if this man happens to be a member of the Æsculapian priesthood, a clan which, not unlike the Holy Roman Church, always assumed, and still assumes to a certain extent, an air of mysticism, for the purpose of barring the layman. For the very same reason—that of maintaining a monopoly—dead and obsolete languages are resorted to, for recording experiences in the form of technical terms, and even for the writing of prescriptions.

Of course, it must be admitted that the activities of insufficiently informed people, known as “quacks,” have done great damage to society. On the other hand, nobody will deny any more that the popularizing of modern hygiene, bacteriology, anatomy and pathology has proven a boon to humanity in general.

It is typical of the Father of Psychoanalysis, imbued with a deep sense of fairness towards mankind, that he has never indulged in a narrow-minded, professional point of view.

The mere accident that it remained for the science of medicine to discover the Psychology of the Unconscious and Psychoanalysis as such, was not enough reason for Sigmund Freud to treat his discovery as a strictly medical preserve.

Very helpful to Freud in this respect was the fact that he has a striking gift to make himself easily understood to the laity, in a manner usually not to be found in people specializing in the intricacies of science. Doubtless, Sigmund Freud’s astonishing gift to be his own best popularizer, unquestionably takes root in his ability to fathom the soul of others, to speak to each and everyone in their own language, as it were.

To my mind, Sigmund Freud’s treatise on _The Problem of Lay-Analyses_ gives much more than the title promises. This treatise is a complete outline, succinct and lucid at the same time, of psychoanalysis in its present state. If anybody would ask me today what book I could recommend to him for the easy understanding and grasping of the very essence of Psychoanalysis, I should not hesitate to recommend _The Problem of Lay-Analyses_. This book, to my best knowledge and belief, appears to me exemplary in its lucidity.

Freud unhesitatingly and strongly criticises “quacks,” who attempt to employ psychoanalysis without first being fully prepared for such work. To him it does not make the slightest difference whether these “quacks” are medically trained men—most of whom have up to now given only scant sympathy to his teachings—or, medically unprepared laymen. Freud is of the opinion that it is not the _medical_ training and the “M.D.” degree which makes a man a competent psychoanalyst, but rather inherent insight into the human soul—first of all, into the unconscious layers of his own soul—and _practical_ training. According to Freud, there are just as many medical as non-medical “quacks” exploiting psychoanalysis to the detriment of the general public and the new science as such. Moreover, at the present time, the relations of psychoanalysis to sciences in general are at least as close as they are to biology and medicine. It would, therefore, seem unfair to exclude non-medically trained men and women from the circle of psychoanalysts.

Of course, Freud does not close his eyes to the danger lurking behind the possibility of confounding strictly organic diseases with so-called functional or nervous ailments. Only after it is ascertained beyond doubt, by thorough medical examination, that a patient is a subject for psychoanalytical treatment, does Freud permit him to participate in the benefits of this therapy.

The number of physicians is too limited and their duties in general too manifold to allow all of them to devote themselves to the study and the application of psychoanalysis, to an extent which would actually exhaust the healing qualities of this new science. A whole army of psychoanalysts alone would be necessary to treat all those so-called incorrigible children whose ailings and failings constitute a grave danger for the coming generation. Great numbers of trained psychoanalysts would also be necessary to attend to such “cases” as penal and insane institutions offer, for the purpose of gradually substituting sanitariums for penitentiaries.

“Criminal Therapy,” on a psychoanalytical basis, looms up to me as one of the biggest issues facing us, at the present time. Another issue, less urgent perhaps, is the psychological readjustment that thousands upon thousands need in their relations to family, profession and society in general. This opens a tremendous field for the analytically trained social workers.

Another field where applied psychoanalysis might become one of the indispensable necessities is the realm of education. All school teachers ought to have a thorough psychoanalytical training, so that we may entrust our children to them with more confidence. Finally—last but not least—all professional men whose work, in one way or another, has any bearing on the human soul, should be psychoanalytically trained. Anthropology, sociology, history, the psychology of art can no longer dispense with psychoanalysis.

It is in view of the extreme importance of psychoanalysis in all these fields of human endeavor that Freud asks whether the immeasurable advantages which the new science presents should be restricted, from sheer fear of a more or less studiously over-emphasized danger resulting from quackery. Dissemination of information seems to be the best agent for discouraging quackery and spreading dependable facts on the subject.

For the necessity of preparing an American edition of _The Problem of Lay-Analyses_ so soon after the publication of the German original, I myself may serve as a witness. It was my good fortune to accompany Dr. Freud on his now almost historical Argonauts’ trip to America in 1909, and admire the courageous readiness with which America’s outstanding leaders in the fields of psychology and neurology interested themselves in Freud’s theories. At that time, Freud and his teachings were still the bone of contention in the camps of European scientists.

The Nestor of America’s psychology, Dr. G. Stanley Hall, enthusiastically embraced Freud’s teachings. Dr. William James, the great philosopher and psychologist, listened to our gospel with great interest, though not as enthusiastic as Dr. Hall. Touching to the extreme was that youthful thirst of knowledge, with which Dr. James J. Putnam, that grand old man of Harvard University, hung on the lips of Dr. Freud. It is due to the untiring efforts of these men and the translation of Freud’s books by Dr. A. A. Brill, that psychoanalysis, in a comparatively short time and to a surprisingly great extent, gained ground in all strata of society in the United States. It is a matter of record that America became interested in Psychoanalysis much quicker than Europe.

Now, visiting America again after almost twenty years, I had occasion to observe how lasting and far-reaching an influence Dr. Freud’s teachings exert on all strata of American society. Of course, not only Freud and what he stands for, but also psychology in general, especially as it is applied to education. Time and again, I have noticed that it seems fairly impossible to listen to a conversation for any length of time, without hearing problems of psychoanalysis and the name Freud mentioned.

Not less stimulating and informative than the first, is the second part of the present volume, containing Freud’s own story of his life and his science. It is common knowledge today that Freud, in his inimitable objectivity, has always published facts and fancies which other scientists would have been only too careful to hide from the eyes of their contemporaries.

On the occasion of Freud’s seventieth birthday, I wrote in THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS (July/October 1926):

So far as his personality is concerned, he has completely taken the wind from the sails of modern methods of inquiry which attempts to gain fresh insight into the development of a scientist’s views, by studying the intimate details of his private life. In his “_Traumdeutung_” and “_Psychopathologie des Alltagslebens_”, Freud has undertaken this task himself in a way previously unknown, and has not only indicated new lines of research for this kind of inquiry, but given for all time an example of a candor quite ruthless towards himself. He has also revealed unhesitatingly the ‘secrets of the laboratory’, the inevitable vacillations and uncertainties that are usually so carefully kept hidden.

I hope that the reader will agree with me that the part of this book which contains Freud’s “An Autobiographical Study” again displays candor and frankness to an astonishing degree. This part of the present volume, aside from other information, will also demonstrate to the student of psychology the tolerance Freud manifests in regard to former disciples of his who, apparently driven by an overpowering impatience, or because “they did not fancy to dwell in the Depths of the Unconscious” only too early, and with deplorable rashness, hastened to generalize their ideas, notwithstanding the insufficiency of their theories to explain complicated facts. As far as I am personally concerned, I cannot help considering Freud as one of the most progressive disciples of his own teachings, while the apostates of his doctrine appear to me as prematurely aged reactionaries.

Equipped with devious excuses and devices, these apostates deserted the paths of Freud’s teachings—paths that require the courage of the born pioneer—to return to the broad and beaten paths of orthodox psychology and biology.

May I not once more quote myself in this connection?

On December 28, 1926, speaking before the Mid-winter meeting of the American Psychoanalytical Association, I said:

It is a great mistake to gauge the age of a person by the number of years he has lived. To remain productive and to be capable of changing one’s opinions is to stay young. Both of these attributes are highly characteristic of Professor Freud, as his latest works attest. One finds nothing in them of stagnation in dogmatic assertions or of exhaustion of the fantasy. Against his own earlier theses he is perhaps often too unsparing, and the breadth of his perspective often exceeds everything which he has created in the past.

In conclusion, I wish to express the hope that this book will assist in dissipating an erroneous belief prevalent in certain circles. It appears that the general public have a decided tendency to confound Freud’s teachings and psychoanalysis, as such, with the subject of sex. “According to Freud there is only one _causa movens_, and that is sex!” is one of their mis-statements.

Of course, faithful students of Freud’s teachings will never arrive at such fallacious deductions. True, the attentive reader of this book will find that Freud, as far as sex is concerned, allots to this instinct more importance than the prudery and hypocrisy of present-day society is ready to grant it. But, ever and again, Freud emphasizes the mastering of urges—not by repression, to be sure, but by elimination of all that which appears logically, ethically, and æsthetically undesirable.

DR. S. FERENCZI. Budapest, Hungary.

New York, September 1927.

THE PROBLEM OF LAY-ANALYSES

I

It appears to me that the title of this treatise may require an explanation. Let me, therefore, state that the problem of Lay-Analyses expresses itself most succinctly in the question of whether medically untrained laymen should be permitted to practise psychoanalysis.

This problem, timely in general, is subject to national laws.

It is a timely question, in so far as, up to now, apparently nobody ever cared who was practising psychoanalysis. As a matter of fact, too little attention was paid to the question into whose hands the employment of this new science was entrusted, with unanimity prevailing only in reference to a more or less strong tendency to wish that nobody at all should practise psychoanalysis. There were different reasons for this well-nigh general aversion.

The demand, then, now put before the legislatures of certain countries, that only physicians be permitted to apply psychoanalysis proves that, after all, a new, and apparently more tolerant opinion is becoming prevalent, as regards the recognition of our science. This new trend of putting the stamp of official and scientific approval on psychoanalysis, by reserving the monopoly of its application to medically trained men, must, however, first successfully clear itself of any and all suspicion of being nothing other than just a modification of the resistance hitherto shown towards psychoanalysis. Today, at last, it is admitted that, under certain circumstances, psychoanalytical treatment is in order. However, if it is to be applied, certain countries stand ready to impose the restriction that licensed physicians only shall be permitted to administer this treatment.

The problem before us right now, then, is why only physicians should be permitted to practise psychoanalysis. This is a problem subject to national laws. In the United States and Germany, for example, this problem does not amount to more than just an academic discussion, because in these countries a patient may receive treatment from anybody he chooses. In these countries, anybody who feels the inclination may treat, as a “quack” to be sure, “cases,” provided he stands ready to assume full responsibility for the effect of his treatment. Not before the authorities are actually appealed to to retaliate for such tangible harm as a patient may have suffered from the hands of an unlicensed practitioner of psychoanalysis, does the law interfere in the United States, Germany and many other countries.

In Austria, however, where I am writing this treatise, bearing in mind the special conditions which prevail there, in regard to the administration of psychoanalytical treatment, the authorities employ the law of the country as a preventive. In my country, without considering ultimate results, the law, in sweeping restrictions, enjoins all and sundry laymen from treating ailing people.

In the Republic of Austria, therefore, there is a very practical aspect to the question of whether laymen should be permitted to treat ailing people with psychoanalysis. As a matter of fact, under present conditions, this question seems to be settled since it is already answered by the wording of the law, now appearing on the statutes of my country: Nervous people are unquestionably sick people; laymen are doubtlessly no licensed physicians; psychoanalysis is a remedy for the healing, or improvement, of nervous disorders. As in the eyes of the law, the latter are considered diseases and the treatment of all such ailments reserved for licensed physicians exclusively, laymen are liable to severe punishment when employing psychoanalysis for the treatment of nervous people.

In view of this plain state of affairs, one scarcely dares to approach the question of permitting the laity to practise psychoanalysis in Austria. However, in spite of the obviousness of the situation as a whole, there are some additional aspects to the question which, albeit the law does not take cognisance of them, should nevertheless be considered.

It may develop that in connection with psychoanalysis, people in need of treatment are not sick people, in the broad meaning of this term; laymen not always to be considered laymen, nor physicians what physicians are generally supposed to be—the very premise upon which these physicians base their claims. If such a state of affairs becomes apparent, it would be justifiable to insist upon a modification of the law, prohibiting the unlicensed practise of medicine, as far as the application of psychoanalytic treatment is concerned.

II

Whether this modification shall be enacted as a law will depend mostly on people who may not be expected to know the peculiarities of analytical treatment. It will be our task, therefore, to instruct these impartial referees, these typical laymen whom we will assume, for the time being, are completely uninformed. It is regrettable that we cannot arrange for them to attend an analytical treatment in the rôle of an observer. It is one of the peculiarities of the “analytical situation” that it will not suffer the presence of a third party.

Moreover, individual sessions are liable to be very unequal, as regards the information they may yield. Mr. Referee happening in at an analytical session, would probably not profit to any great extent. As a matter of fact, he might altogether misinterpret that which is discussed between the analyst and the patient. He may even become downright bored with the proceedings. Therefore Mr. Referee must needs be satisfied with the information we shall presently impart to him, endeavoring to set it forth as lucidly as possible.

Let us assume that the patient is suffering from attacks of moodiness, which he is unable to control, or else is the victim of a despondency so depressing as to paralyse his energy, causing him to lose all confidence in himself, manifesting extreme self-consciousness when among strangers. Without grasping the underlying elements of his case, the patient may observe that not only the discharge of his daily duties becomes more and more arduous for him, but also that he experiences difficulties when called upon to make a decision or embark upon some enterprise.

One day—utterly ignorant of the exact cause—he succumbs to an attack of fear. From then on, he is unable to cross a street alone, or board a train, without fighting off a certain inarticulate fear. This condition, as a matter of fact, may even become so pronounced as to render it absolutely impossible for him to cross a street, or board a train, unaccompanied.

Or—what appears very peculiar to him—his thoughts “wander”; they are no longer subject to his will. They attach themselves to problems which, in reality, do not interest him at all but which he is, nevertheless, unable to dismiss from his mind. He imposes perfectly ludicrous tasks upon himself, such as counting the windows along the street. When attending to simple functions, such as mailing a letter or turning off the gas, doubts harass him a few moments later, as to whether he has really dropped the letter into the mail box and whether he actually turned off the gas.

Perhaps such a condition is merely annoying at first, but it becomes intolerable when, in advanced stages, it proves impossible to shake off such preposterous ideas as having flung a child under the wheels of a car, or thrown somebody from a bridge into the river, or being haunted by the terrifying doubt of whether he is not in reality the murderer the police are trying to apprehend for the latest spectacular crime.

All these delusions are utter nonsense, as he himself very well knows. He has never done any harm to anybody, but if he really were a fugitive from justice, this obsession, this feeling of contrition could not be stronger.

To take another case:—this time of a female patient, who is suffering in an entirely different way, presenting entirely different symptoms. We will assume that she is a pianiste, who suddenly experiences cramps in her fingers and discovers herself unable to play. As soon as she thinks of attending a social affair, she immediately feels the necessity of obeying a recurrent natural need, making it impossible for her to leave her own house. Thus, she has been forced to give up mingling with her friends, or attend dances, the theatre, or concerts.

At the most inopportune moments, she becomes the victim of headaches or other painful sensations. Eventually, after meals, she feels impelled to yield to nausea, a condition which, if prolonged, may become dangerous. Finally, she becomes absolutely unable to stand any of those little excitements which cannot be eliminated from daily life. Upon such occasions, she readily faints. As these spells are frequently complicated with muscular spasms, such attacks assume the aspect of dreadful afflictions.

Still other patients become subject to disturbances in a sphere where bodily functions coördinate with manifestations of sentiment. If men, they find themselves unable to give physiological expression to those tender urges that induce them to gravitate towards the other sex. On the other hand, all these physiological reactions may be at their command when not aimed at the person they cherish most. Then, there are still other cases, when bonds of sensuality will tie them to persons whom they actually despise and of whom they have the most earnest desire to free themselves. Or their sensuality imposes urges upon them whose fulfillment causes them to shudder.

If they be women, such patients, on account of fear or disgust, or from some other restraint of unknown origin, become unable to perform those functions which their sex imposes upon them. In cases where they have yielded to the prompting of passion, they discover that that gratification is withheld from them which nature normally offers as a reward for such complacency.

Sooner or later, all such persons come to consider themselves as sick and appeal to physicians, expecting to be cured of their nervous ailments. Physicians have classified these manifestations, diagnosing them differently, according to their own personal point of view. These ailments are listed under such terms as neurasthenia, psychasthenia, phobias and neuroses of different kinds, and with that sweeping term hysterics. The parts of the body inducing such disturbances are examined: the heart, the stomach, the intestines, the sex organs, and all are found to be in the best of condition. The physician then advises the patient to change his mode of living, to take a vacation, to exercise. Thus, with perhaps the aid of mild stimulants, the patient’s condition may, or may not, be temporarily relieved.

Eventually, the patient is informed that there are certain practitioners who specialize in the treatment of just such ailments, and thus they come to be psychoanalysed.

Mr. Referee, whom we will assume is present, has impatiently listened, while we have given an account of the nervous disturbances with which one may be afflicted. Mr. Referee suddenly becomes attentive, expressing his growing interest in these words: “Well, now at last we shall see what the psychoanalyst will do with the patient, whom physicians could not help.”

To all appearances, nothing takes place between patient and psychoanalyst except that they talk with each other. The psychoanalyst does not take recourse to any instruments, while examining the patient, nor does he write out prescriptions. If it can be arranged, he will not even take the patient out of his usual surroundings, or upset his daily routine in any way, while treating him. Such a procedure is, of course, not of indispensable necessity, quite frequently proving impossible to arrange. Usually the analyst simply makes an appointment with his patient, then lets him talk, listens to him, lets him talk again and listens once more.

Mr. Referee now clearly manifests relief but, at the same time, his face also assumes a disdainful expression. Apparently, he thinks: “Is that all? ‘Words, words, words,’ as Prince Hamlet says. Is psychoanalysis perhaps some sort of magic rite, employing mere words with which to chase away a patient’s ailment?”

Quite right! It surely would be magic if it would only work faster. One of the indispensable essentialities of magic is quickness, sudden results. But psychoanalytical treatment demands months, sometimes even years. Proceeding at such a snail’s pace, it loses the character of anything resembling magic.