[30]

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 com-
pletely uninformed. It is regrettable that we
cannot arrange for them to attend an analyti-
cal 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 pa-
 

[31]

tient. 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 despond-
ency 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 under-
lying elements of his case, the patient may ob-
serve 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 em-
bark 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

32

cross a street, or board a train, unaccom-
panied.

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 annoy-
ing 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.

33

The Problem of Lay-Analyses

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 fe-
male patient, who is suffering in an entirely
different way, presenting entirely different
symptoms. We will assume that she is a pia-
niste, 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 be-
comes the victim of headaches or other pain-
ful 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

34

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 mus-
cular spasms, such attacks assume the aspect
of dreadful afflictions.

Still other patients become subject to dis-
turbances 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 physio-
logical 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 them-
selves. 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

[35]

The Problem of Lay-Analyses

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 na-
ture normally offers as a reward for such com-
placency.

Sooner or later, all such persons come to
consider themselves as sick and appeal to phy-
sicians, expecting to be cured of their nervous
manifestations, diagnosing them differently, ac-
cording 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 exam-
ined: 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 per-
haps the aid of mild stimulants, the patient’s
condition may, or may not, be temporarily
relieved.

36

The Problem of Lay-Analyses

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 pres-
ent, 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 be-
tween 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 proce-
dure is, of course, not of indispensable neces-
sity, quite frequently proving impossible to ar-
range. Usually the analyst simply makes an

37

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 indis-
pensable essentialities of magic is quickness,
sudden results. But psychoanalytical treatment
demands months, sometimes even years. Pro-
ceeding at such a snail’s pace, it loses the char-
acter of anything resembling magic.

As far as “words, words, words” are con-
cerned, they are surely not to be looked down
upon. Words, after all, are a powerful instru-
ment, the means by which we express our
feelings to each other, the agent through which
we influence one another. Words are able to
benefit us in the extreme, or liable to hurt us
to the quick. Doubtless, “in the beginning was

The Problem of Lay-Analyses

the Deed” and the Word came only later. Un-
der certain circumstances, the reduction of
the Deed to the mere Word may even prove a
cultural achievement. At any rate, the Word
was originally an implement of sorcery, a
magic manifestation which even today still re-
tains much of its old potency.

Mr. Referee now remarks: “Assuming
that the patient is not any better prepared for
the understanding of psychoanalytical treat-
ment, than I myself, how are you going to
induce him to believe in the Magic of the
Word, that is to deliver him from his suffer-
ings?”

Of course, some preparatory work is nec-
essary, but that is easily accomplished in a
simple manner. The patient is asked to be
absolutely frank with the psychoanalyst, not
to withhold intentionally anything that crowds
itself into his mind, and to overcome gradu-
ally all such influences as may exert themselves
to prevent certain of his thoughts or mem-
ories from being communicated to the psycho-
analyst.

There is not one of us but does not know

[38]

39

The Problem of Lay-Analyses

that there are certain things which we hate to
tell anybody else, or which we are utterly
unable to express at all. These are the so-called–
“most intimate” things. We also surmise–
and this proves the great progress that has
been made in the psychological understanding
of our Selves–that there are some other things
which we hate to admit to ourselves, which we
try to hide from ourselves and which, once
they are accidentally touched upon, we im-
mediately endeavor to crowd out of our
thoughts.

Doubtless, the root of a very remarkable
psychological problem manifests itself in the
fact that there are certain of our thoughts
which we try to hide from our very own Self!
That would seem to indicate that our very own
Self is not an indivisible unit, as we have al-
ways considered it! Rather, that there is a
certain something which may rise in opposi-
tion to our very own Self! Vaguely, then, we
surmise that our own Self and our soul life
may be two different things! If, now, the pa-
tient submits to the demand of psychoanaly-
sis to express everything in words that comes

40

to his mind, he comes to believe that an inter-
change of thoughts, under such extraordinary
conditions, is liable to lead to extraordinary
results.

“I understand you very well,” Mr. Referee
says. “You simply assume that everybody suf-
fering from a nervous disturbance is harbor-
ing something that depresses him, some dark
secret, perhaps, and by inducing him to impart
this secret to you, you relieve him of that de-
pression, thus alleviating his suffering. That,
after all, is the very principle of the Con-
fessional which the Catholic church has em-
ployed for centuries to wield her influence
over her communicants.”

Yes and no, is our answer to this. The Con-
fessional, to a certain extent, may be consid-
ered as belonging into the realm of psycho-
analysis; leading up to it, as it were. However,
the Confessional as such is far removed from
coinciding with the very being of psychoanal-
ysis, and it is unable to explain the results of
psychoanalytical treatment. In the Confes-
sional, the sinner tells what he knows, but in
the Analysis, the neurotic is expected to reveal

41

much more. Besides, there are no known cases
where the Confessional proved effective
enough to remedy direct symptoms of ail-
ments.

“Then I don’t understand you after all,”
Mr. Referee interjects. “What do you mean
by stating that the neurotic is ‘expected to re-
veal more’ in the course of psychoanalytical
treatment? Of course, I can very well imagine
that you, as a psychoanalyst, may wield a
greater influence over your patient than the
Father Confessor over a penitent, for the sim-
ple reason that you become better acquainted
with him, employing your growing influence
to talk unhealthy thoughts out of your patient,
as it were, disseminating his apprehensions,
and so forth. Frankly, it appears most remark-
able to me that by such a procedure, it should
be possible to alleviate purely physical man-
ifestations, such as nausea, diarrhœa, and
cramps. I know that such results are possible
by taking recourse to hypnosis. Most probably,
through prolonged association with your pa-
tient, you gradually succeed in establishing
hypnotic relations between you and him. By

[42]

this I mean that you inadvertently come to ex-
ert upon him a suggestive influence. Thus, the
miracle wrought by your therapy is nothing
other than the result of hypnotic suggestion.
However, as far as I know, results by hypnotic
therapy are procured much quicker than by
psychoanalysis which you yourself admit takes
months, and sometimes even years.”

After all, Mr. Referee does not seem to be
so utterly uninformed and helplessly at sea as
we had considered him in the beginning.
Doubtless, he is eagerly bent upon grasping
the essence of psychoanalysis, on the basis of
certain knowledge which he has acquired. He
endeavors to connect psychoanalysis with
something he already knows.

Thus, he forces upon us the difficult task of
explaining to him that he will never succeed
in comprehending psychoanalysis in this way,
because psychoanalysis is a process sui generis,
something new and peculiar, understandable
only with the assistance of new conceptions,
or presumptions.

However, we still owe our inquisitive friend
a reply to a point raised by him.

[43]

The Problem of Lay-Analyses

What you, Mr. Referee, mentioned before
about the personal influence exerted by the
psychoanalyst on his patient, should not go
without comment. Such an influence actually
prevails in the analysis, playing an important
rôle. However, this influence is utterly unlike
the influence induced by hypnosis.

I shall have to prove to you that the situa-
tions in these two cases decidedly differ from
each other. However, for the time being, the
statement may suffice that this personal in-
fluence–this “suggestive element” if you wish
–is not drawn upon for the purpose of sup-
pressing symptoms of nervous afflictions anal-
ogous to treatment by hypnotic suggestions.
Besides, it is absolutely wrong to assume that
this “suggestive element” is the agent and
promoter of analytical treatment. It may be
that such is the case right at the beginning of
the treatment. Later, however, this very same
“suggestive element” proves itself an oppos-
ing factor, forcing us to resort to extensive
counter-measures.

Just let me explain to you how thoroughly
opposed the technique of analysis is to any-
 

44

thing and everything resembling the hypnotic
technique of diverting or dissipating a pa-
tient’s apprehensions.

Assumed that our patient is obsessed with
an intense feeling of being guilty of, say, some
horrible crime, we do not advise him to stifle
the qualms of his conscience simply on the
strength of the fact that there is no doubt as
to his innocence. He himself has already pro-
ceeded along this trend of reasoning, but to
no avail. On the contrary, we try to impress
him with the possibility that there may be
something tangible at the bottom of so pro-
found a feeling of guilt, and that it may be
possible to detect this disturbing something.

“I should be greatly astonished,” Mr. Ref-
eree interrupts, “if you could really assuage
your patient’s feeling of guilt by agreeing
that there may be some tangible reason for
his apprehension. But what is the mode of
procedure which is applied in your analysis,
and to what treatment do you subject your
patient?”