Part 11
“Despite all these suspicious elements the patient insisted that the shot was an ‘accident.’ I was firmly convinced, however, that the neglect to find out whether the revolver was loaded before he began to play with it, as well as the self-inflicted injury, were psychically determined. He was still under the depressing effects of the unhappy love affair, and apparently wanted ‘to forget everything’ in the army. When this hope, too, was taken away from him he resorted to playing with the weapon--that is, to an unconscious attempt at suicide. The fact that he did not hold the revolver in the right but in the left hand speaks conclusively in favour of the fact that he was really only ‘playing’--that is, he did not wish consciously to commit suicide.”
Another analysis of an apparently accidental self-inflicted wound, detailed to me by an observer, recalls the saying, “He who digs a pit for others falls in himself.”[53]
“Mrs. X., belonging to a good middle-class family, is married and has three children. She is somewhat nervous, but never needed any strenuous treatment, as she could sufficiently adapt herself to life. One day she sustained a rather striking though transitory disfigurement of her face in the following manner: She stumbled in a street that was in process of repair and struck her face against the house wall. The whole face was bruised, the eyelids blue and œdematous, and as she feared that something might happen to her eyes she sent for the doctor. After she was calmed I asked her, ‘But why did you fall in such a manner?’ She answered that just before this accident she warned her husband, who had been suffering for some months from a joint affection, to be very careful in the street, and she often had the experience that in some remarkable way those things occurred to her against which she warned others.
“I was not satisfied with this as the determination of her accident, and asked her whether she had not something else to tell me. ‘Yes, just before the accident she noticed a nice picture in a shop on the other side of the street, which she suddenly desired as an ornament for her nursery, and wished to buy it at once. She thereupon walked across to the shop without looking at the street, stumbled over a heap of stones, and fell with her face against the wall without making the slightest effort to shield herself with her hands. The intention to buy the picture was immediately forgotten, and she walked home in haste.’
“‘But why were you not more careful?’ I asked.
“‘Oh!’ she answered, ‘perhaps it was only a punishment for that episode which I confided to you!’
“‘Has this episode still bothered you?’
“‘Yes, later I regretted it very much; I considered myself wicked, criminal, and immoral, but at the time I was almost crazy with nervousness.’
“She referred to an abortion which was started by a quack and had to be brought to completion by a gynecologist. This abortion was initiated with the consent of her husband, as both wished, on account of their pecuniary circumstances, to be spared from being additionally blessed with children.
“She said: ‘I had often reproached myself with the words, “You really had your child killed,” and I feared that such a crime could not remain unpunished. Now that you have assured me that there is nothing seriously wrong with my eyes I am quite assured I have already been sufficiently punished.’
“This accident, therefore, was, on the one hand, a retribution for her sin, but, on the other hand, it may have served as an escape from a more dire punishment which she had feared for many months. In the moment that she ran to the shop to buy the picture the memory of this whole history, with its fears (already quite active in her unconscious at the time she warned her husband), became overwhelming and could perhaps find expression in words like these: ‘But why do you want an ornament for the nursery?--you who had your child killed! You are a murderer! The great punishment is surely approaching!’
“This thought did not become conscious, but instead of it she made use of the situation--I might say of the psychologic moment--to utilize in a commonplace manner the heap of stones to inflict upon herself this punishment. It was for this reason that she did not even attempt to put out her arms while falling and was not much frightened. The second, and probably lesser, determinant of her accident was obviously the self-punishment for her unconscious wish to be rid of her husband, who was an accessory to the crime in this affair. This was betrayed by her absolutely superfluous warning to be very careful in the street on account of the stones. For, just because her husband had a weak leg, he was very careful in walking.”
If such a rage against one’s own integrity and one’s own life can be hidden behind apparently accidental awkwardness and motor insufficiency, then it is not a big step forward to grasp the possibility of transferring the same conception to mistakes which seriously endanger the life and health of others. What I can put forward as evidence for the validity of this conception was taken from my experience with neurotics, and hence does not fully meet the demands of this situation. I will report a case in which it was not an erroneously carried-out action, but what may be more aptly termed a symbolic or chance action that gave me the clue which later made possible the solution of the patient’s conflict.
I once undertook to improve the marriage relations of a very intelligent man, whose differences with his tenderly attached young wife could surely be traced to real causes, but as he himself admitted could not be altogether explained through them. He continually occupied himself with the thought of a separation, which he repeatedly rejected because he dearly loved his two small children. In spite of this he always returned to that resolution and sought no means to make the situation bearable to himself. Such an unsettlement of a conflict served to prove to me that there were unconscious and repressed motives which enforced the conflicting conscious thoughts, and in such cases I always undertake to end the conflict by psychic analysis. One day the man related to me a slight occurrence which had extremely frightened him. He was sporting with the older child, by far his favourite. He tossed it high in the air and repeated this tossing till finally he thrust it so high that its head almost struck the massive gas chandelier. Almost, but not quite, or say “just about!” Nothing happened to the child except that it became dizzy from fright. The father stood transfixed with the child in his arms, while the mother merged into an hysterical attack. The particular facility of this careless movement, with the violent reaction in the parents, suggested to me to look upon this accident as a symbolic action which gave expression to an evil intention toward the beloved child.
I could remove the contradiction of the actual tenderness of this father for his child by referring the impulse to injure it to the time when it was the only one, and so small that as yet the father had no occasion for tender interest in it. Then it was easy to assume that this man, so little pleased with his wife at that time, might have thought: “If this small being for whom I have no regard whatever should die, I would be free and could separate from my wife.” The wish for the death of this much loved being must therefore have continued unconsciously. From here it was easy to find the way to the unconscious fixation of this wish.
There was indeed a powerful determinant in a memory from the patient’s childhood: it referred to the death of a little brother, which the mother laid to his father’s negligence, and which led to serious quarrels with threats of separation between the parents. The continued course of my patient’s life, as well as the therapeutic success confirmed my analysis.
IX
SYMPTOMATIC AND CHANCE ACTIONS
The actions described so far, in which we recognize the execution of an unconscious intention, appeared as disturbances of other unintended actions, and hid themselves under the pretext of awkwardness. Chance actions, which we shall now discuss, differ from erroneously carried out actions only in that they disdain the support of a conscious intention and really need no pretext. They appear independently and are accepted because one does not credit them with any aim or purpose. We execute them “without thinking anything of them,” “by mere chance,” “just to keep the hands busy,” and we feel confident that such information will be quite sufficient should one inquire as to their significance. In order to enjoy the advantage of this exceptional position these actions which no longer claim awkwardness as an excuse must fulfil certain conditions: they must not be striking, and their effects must be insignificant.
I have collected a large number of such “chance actions” from myself and others, and after thoroughly investigating the individual examples, I believe that the name “symptomatic actions” is more suitable. They give expression to something which the actor himself does not suspect in them, and which as a rule he has no intention of imparting to others, but aims to keep to himself. Like the other phenomena considered so far, they thus play the part of symptoms.
The richest output of such chance or symptomatic actions is above all obtained in the psychoanalytic treatment of neurotics. I cannot deny myself the pleasure of showing by two examples of this nature how far and how delicately the determination of these plain occurrences are swayed by unconscious thoughts. The line of demarcation between the symptomatic actions and the erroneously carried out actions is so indefinite that I could have disposed of these examples in the preceding chapter.
(_a_) During the analysis a young woman reproduced this idea which suddenly occurred to her. Yesterday while cutting her nails “she had cut into the flesh while engaged in trimming the cuticle.” This is of so little interest that we ask in astonishment why it is at all remembered and mentioned, and therefore come to the conclusion that we deal with a symptomatic action. It was really the finger upon which the wedding-ring is worn which was injured through this slight awkwardness. It happened, moreover, on her wedding-day, which thus gives to the injury of the delicate skin a very definite and easily guessed meaning. At the same time she also related a dream which alluded to the awkwardness of her husband and her anesthesia as a woman. But why did she injure the ring finger of her left hand when the wedding-ring is worn on the right? Her husband is a jurist, a “Doctor of Laws” (_Doktor der Rechte_, literally a Doctor of Rights), and her secret affection as a girl belonged to a physician who was jokingly called _Doktor der Linke_ (literally Doctor of Left). Incidentally a left-handed marriage has a definite meaning.
(_b_) A single young woman relates: “Yesterday, quite unintentionally, I tore a hundred-dollar note in two pieces and gave half to a woman who was visiting me. Is that, too, a symptomatic action?” After closer investigation the matter of the hundred-dollar note elicited the following associations: She dedicated a part of her time and her fortune to charitable work. Together with another woman she was taking care of the rearing of an orphan. The hundred dollars was the contribution sent her by that woman, which she enclosed in an envelope and provisionally deposited on her writing-desk.
The visitor was a prominent woman with whom she was associated in another act of charity. This woman wished to note the names of a number of persons to whom she could apply for charitable aid. There was no paper, so my patient grasped the envelope from her desk, and without thinking of its contents tore it in two pieces, one of which she kept, in order to have a duplicate list of names, and gave the other to her visitor.
Note the harmlessness of this aimless occurrence. It is known that a hundred-dollar note suffers no loss in value when it is torn, provided all the pieces are produced. That the woman would not throw away the piece of paper was assumed by the importance of the names on it, and there was just as little doubt that she would return the valuable content as soon as she noticed it.
But to what unconscious thought should this chance action, which was made possible through forgetfulness, give expression? The visitor in this case had a very definite relation to my patient and myself. It was she who at one time had recommended me as physician to the suffering girl, and if I am not mistaken my patient considered herself indebted for this advice. Should this halved hundred-dollar note perhaps represent a fee for her mediation? That still remained enigmatic.
But other material was added to this beginning. Several days before a woman mediator of a different sort had inquired of a relative whether the gracious young lady wished to make the acquaintance of a certain gentleman, and that morning, some hours before the woman’s visit, the wooing letter of the suitor arrived, giving occasion for much mirth. When therefore the visitor opened the conversation with inquiries regarding the health of my patient, the latter could well have thought: “You certainly found me the right doctor, but if you could assist me in obtaining the right husband (and a child) I should be still more grateful.”
Both mediators became fused into one in this repressed thought, and she handed the visitor the fee which her fantasy was ready to give the other. This resolution became perfectly convincing when I add that I had told her of such chance or symptomatic actions only the previous evening. She then took advantage of the next occasion to produce an analogous action.
We can undertake a grouping of these extremely frequent chance and symptomatic actions according to their occurrence as habitual, regular under certain circumstances, and as isolated ones. The first group (such as playing with the watch-chain, fingering one’s beard, and so on), which can almost serve as a characteristic of the person concerned, is related to the numerous tic movements, and certainly deserves to be dealt with in connection with the latter. In the second group I place the playing with one’s cane, the scribbling with one’s pencil, the jingling of coins in one’s pocket, kneading dough and other plastic materials, all sorts of handling of one’s clothing, and many other actions of the same order.
These playful occupations during psychic treatment regularly conceal sense and meaning to which other expression is denied. Generally the person in question knows nothing about it; he is unaware whether he is doing the same thing or whether he has imitated certain modifications in his customary playing, and he also fails to see or hear the effects of these actions. For example, he does not hear the noise which is produced by the jingling of coins, and he is astonished and incredulous when his attention is called to it. Of equal significance to the physician, and worthy of his observation, is everything that one does with his clothing often without noticing it. Every change in the customary attire, every little negligence, such as an unfastened button, every trace of exposure means to express something that the wearer of the apparel does not wish to say directly, usually he is entirely unconscious of it.
The interpretation of these trifling chance actions, as well as the proof for their interpretation, can be demonstrated every time with sufficient certainty from the surrounding circumstances during the treatment, from the themes under discussion, and from the ideas that come to the surface when attention is directed to the seeming accident. Because of this connection I will refrain from supporting my assertions by reporting examples with their analyses; but I mention these matters because I believe that they have the same meaning in normal persons as in my patients.
I cannot, however, refrain from showing by at least one example how closely an habitually accomplished symbolic action may be connected with the most intimate and important part of the life of a normal individual.[54]
“As Professor Freud has taught us, the symbolism in the infantile life of the normal plays a greater rôle than was expected from earlier psychoanalytic experiences. In view of this the following brief analysis may be of general interest, especially on account of its medical aspects.
“A doctor on rearranging his furniture in a new house came across a straight, wooden stethoscope, and, after pausing to decide where he should put it, was impelled to place it on the side of his writing-desk in such a position that it stood exactly between his chair and the one reserved for his patients. The act in itself was certainly odd, for in the first place the straight stethoscope served no purpose, as he invariably used a binaural one; and in the second place all his medical apparatus and instruments were always kept in drawers, with the sole exception of this one. However, he gave no thought to the matter until one day it was brought to his notice by a patient who had never seen a wooden stethoscope, asking him what it was. On being told, she asked why he kept it there. He answered in an offhand way that that place was as good as any other. This, however, started him thinking, and he wondered whether there had been an unconscious motive in his action. Being interested in the psychoanalytic method, he asked me to investigate the matter.
“The first memory that occurred to him was the fact that when a medical student he had been struck by the habit his hospital interne had of always carrying in his hand a wooden stethoscope on his ward visits, although he never used it. He greatly admired this interne, and was much attached to him. Later on, when he himself became an interne he contracted the same habit, and would feel very uncomfortable if by mistake he left the room without having the instrument to swing in his hand. The aimlessness of the habit was shown, not only by the fact that the only stethoscope he ever used was a binaural one, which he carried in his pocket, but also in that it was continued when he was a surgical interne and never needed any stethoscope at all.
“From this it was evident that the idea of the instrument in question had in some way or other become invested with a greater psychic significance than normally belongs to it--in other words, that to the subject it stood for more than it does for other people. The idea must have got unconsciously associated with some other one, which it symbolized, and from which it derived its additional fulness of meaning. I will forestall the rest of the analysis by saying what this secondary idea was--namely, a phallic one; the way in which this curious association had been formed will presently be related. The discomfort he experienced in hospital on missing the instrument, and the relief and assurance the presence of it gave him, was related to what is known as a ‘castration-complex’--namely, a childhood fear, often continued in a disguised form into adult life, lest a private part of his body should be taken away from him, just as playthings so often were. The fear was due to paternal threats that it would be cut off if he were not a good boy, particularly in a certain direction. This is a very common complex, and accounts for a great deal of general nervousness and lack of confidence in later years.
“Then came a number of childhood memories relating to his family doctor. He had been strongly attached to this doctor as a child, and during the analysis long-buried memories were recovered of a double phantasy he had in his fourth year concerning the birth of a younger sister--namely, that she was the child (1) of himself and his mother, the father being relegated to the background, and (2) of the doctor and himself; in this he thus played both a masculine and feminine part.[55] At the time, when his curiosity was being aroused by the event, he could not help noticing the prominent share taken by the doctor in the proceedings, and the subordinate position occupied by the father: the significance of this for his later life will presently be pointed out.
“The stethoscope association was formed through many connections. In the first place, the physical appearance of the instrument--a straight, rigid, hollow tube, having a small bulbous summit at one extremity and a broad base at the other--and the fact of its being the essential part of the medical paraphernalia, the instrument with which the doctor performed his magical and interesting feats, were matters that attracted his boyish attention. He had had his chest repeatedly examined by the doctor at the age of six, and distinctly recollected the voluptuous sensation of feeling the latter’s head near him pressing the wooden stethoscope into his chest, and of the rhythmic to-and-fro respiratory movement. He had been struck by the doctor’s habit of carrying his stethoscope inside his hat; he found it interesting that the doctor should carry his chief instrument concealed about his person, always handy when he went to see patients, and that he only had to take off his hat (_i.e_., a part of his clothing) and ‘pull it out.’ At the age of eight he was impressed by being told by an older boy that it was the doctor’s custom to get into bed with his women patients. It is certain that the doctor, who was young and handsome, was extremely popular among the women of the neighbourhood, including the subject’s own mother. The doctor and his ‘instrument’ were therefore the objects of great interest throughout his boyhood.
“It is probable that, as in many other cases, unconscious identification with the family doctor had been a main motive in determining the subject’s choice of profession. It was here doubly conditioned (1) by the superiority of the doctor on certain interesting occasions to the father, of whom the subject was very jealous, and (2) by the doctor’s knowledge of forbidden topics[56] and his opportunity for illicit indulgence. The subject admitted that he had on several occasions experienced erotic temptations in regard to his women patients; he had twice fallen in love with one, and finally had married one.
“The next memory was of a dream, plainly of a homosexual-masochistic nature; in it a man, who proved to be a replacement figure of the family doctor, attacked the subject with a ‘sword.’ The idea of a sword, as is so frequently the case in dreams, represented the same idea that was mentioned above to be associated with that of a wooden stethoscope. The thought of a sword reminded the subject of the passage in the _Nibelung Saga_, where Sigurd sleeps with his naked sword (_Gram_) between him and Brunhilda, an incident that had always greatly struck his imagination.