ORIGIN AND DEVELOPMENT 33

knowledge in this field is not yet very far advanced.
Breuer’s idea of the hypnoidal states has, moreover, been
shown to be superfluous and a hindrance to further inves-
tigation, and has been dropped from present conceptions
of psychoanalysis. Later I shall at least suggest what
other influences and processes have been disclosed besides
that of the hypnoidal states, to which Breuer limited the
causal moment.

You have probably also felt, and rightly, that Breuer’s
investigations gave you only a very incomplete theory and
insufficient explanation of the phenomena which we have
observed. But complete theories do not fall from Heaven,
and you would have had still greater reason to be dis-
trustful, had any one offered you at the beginning of his
servations a well-rounded theory, without any gaps; such
a theory could only be the child of his speculations and not
the fruit of an unprejudiced investigation of the facts.

Second Lecture

Ladies and Gentlemen: At about the same time that
Breuer was using the “talking-cure” with his patient, M.
Charcot began in Paris, with the hystericals of the Sal-
petriére, those researches which were to lead to a new
understanding of the disease. These results were, how-
ever, not yet known in Vienna. But when about ten years
later Breuer and J published our preliminary communica~
tion on the psychic mechanism of hysterical phenomena,
which grew out of the cathartic treatment of Breuer’s first
_ patient, we were both of us under the spell of Charcot’s
investigations. We made the pathogenic experiences of
our patients, whch acted as psychic traumata, equivalent
to those physical traumata whose influence on hysterical
paralyses Charcot had determined ; and Breuer’s hypothesis
of hypnoidal states is itself only an echo of the fact that
Charcot had artificially reproduced those traumatic paral.
yses in hypnosis. {

The great French observer, whose student I was during

34 AN OUTLINE OF PSYCHOANALYSIS

Ye

the years 1885-86, had no natural bent for creating psycho-
logical theories. His student, P. Janet, was the first to
attempt to penetrate more deeply into the psychic processes
of hysteria, and we followed his example, when we made
the mental splitting and the dissociation of personality the
central points of our theory. Janet propounds a theory of
hysteria which draws upon the principal theories of hered-
ity and degeneration which are current in France. Accord-
ing to his view hysteria is a form of degenerative alteration
of the nervous system, manifesting itself in a congenital
“weakness” of the function of psychic synthesis. The
hysterical patient is from the start incapable of correlating
and unifying the manifold of his mental processes, and so
there arises the tendency to mental dissociation. If you
will permit me to use a banal but clear illustration, Janet’s
hysterical reminds one of a weak woman who has been
shopping, and is now on her way home, laden with pack-
ages and bundles of every description. She cannot man-
age the whole lot with her two arms and her ten fingers,
and soon she drops one. When she stoops to pick this up,
another breaks loose, and so it goes on.

Now it does not agree very well with this assumed men-
tal weakness of hystericals, that there can be observed in
hysterical cases, besides the phenomena of lessened func-
tioning, examples of a partial increase of functional capac-
ity, as a sort of compensation. At the time when Breuer’s
patient had forgotten her mother-tongue and all other lan-
guages save English, her control of English attained such
a level that if a German book was put before her she could
give a fluent, perfect translation of its contents at sight.
When later I undertook to continue on my own account
the investigations begun by Breuer, I soon came to another
view of the origin of hysterical dissociation (or splitting
of consciousness). It was inevitable that my views should
diverge widely and radically, for my point of departure
was not, like that of Janet, laboratory researches, but
attempts at therapy. Above everything else, it was prac-

ORIGIN AND DEVELOPMENT | 35

tical needs that urged me on. The cathartic treatment, as
Breuer nad made use of it, presupposed that the patient
should be put in deep hypnosis, tor only in hypnosis was
available the knowledge of his pathogenic associations
which were unknown to him in his normal state. Now
hypnosis, as a fanciful, and so to speak, mystical, aid, ]
soon came to dislike; and when I discovered that, in spite
of all my efforts, I could not hypnotize by any means all
of my patients, I resolved to give up hypnotism and to
make the cathartic method independent of it.

Since I could not alter the psychic state of most of my
patients at my wish, I directed my efforts to working with
them in their normal state. This seems at first sight to be
a particularly senseless and aimless undertaking. The
problem was this: to find out something from the patient
that the doctor did not know and the patient himself did
not know. How could one hope to make such a method
succeed? The memory of a very noteworthy and instruc-
tive proceeding came to my aid, which I had seen in Bern-
heim’s clinic at Nancy. Bernheim showed us that persons
put in a condition of hypnotic somnambulism, and sub-
jected to all sorts of experiences, had only apparently lost
the memory of those somnambulic experiences, and that
their memory of them could be awakened even in the nor-
mal state. If he asked them about their expcriences dur-
ing somnambulism, they said.at first that they did not re-
member, but if he persisted, urged, assured them that they
did know, then every time the forgotten memory came back.

Accordingly I did-this with my patients. When I had
reached in my procedure with them a point at which they
_ declared that they knew nothing more, I would assure
them that they did know, that they must just tell it out
and I would venture the assertion that the memory whick
would emerge at the moment that I laid my hand on the
patient’s forehead weuld be the right one. In this way I
succeeded, without hypnosis, in learning from the patient
all that was necessary for a enastruction of the connection

36 AN OUTLINE OF PSYCHOANALYSIS

between the forgotten pathogenic scenes and the symptoms
which they had left behind. This was a troublesome and
in its length an exhausting proceeding, and did not lend
itself to a finished technique. But I did not give it up
without drawing definite conclusions from the data which
I had gained. I had substantiated the fact that the for-
gotten memories were not lost They were in the posses-
sion of the patient, ready to emerge and form associations
with his other mental content, but hindered from becoming
conscious, and forced to remain in the unconscious by some
sort of a force. The existence of this force could be
assumed with certainty, for in attempting to drag up the
unconscious memories into the consciousness of the patient,
in opposition to this force, one got the sensation of his
own personal effort striving to overcome it. One could
get an idea of this force, which maintained the pathological
situation, from the resistance of the patient.

It is on this idea of resistance that I based my theory
of the psychic processes of hystericals. It had been found
that in order to cure the patient it was necessary that this
force should be overcome. Now with the mechanism of
the cure as a starting point, quite a definite theory could
be constructed. These same forces, which in the present
situation as resistances opposed the emergence of the for-
gotten ideas ito consciousness, must themselves have
caused the forgetting, and repressed from consciousness
the pathogenic experiences. I called this hypothetical
process “repression” (Verdrangung), and considered that
it was proved by the undeniable existence of resistance.

But now the question arose: what were those forces,
and what were the conditions of this repression, in which
we were now able to recognize the pathogenic mechanism
of hysteria? A comparative study of the pathogenic situa-
tions, which the’cathartic treatment has made possible,
allows us to answer this question. In all those experiences,
it had happened that a wish had been aroused, which was
fn sharp opposition to the other desires of the individual,

ORIGIN AND DEVELOPMENT 37

and was not capable of being reconciled with the ethical,
esthetic and personal pretensions of the patient’s per-
sonality. There had been a short conflict, and the end of
this inner struggle was the repression of the idea wliich
presented itself to consciousness as the bearer of this irre-
concilable wish. This was, then, repressed from conscious>
ness and forgotten. The incompatibility of the idea in
question with the “ego” of the patient was the motive of
the repression, the ethical and other pretensions of the
individual were the repressing forces. The presence of
the incompatible wish, or the duration of the conflict, had
given rise to a high degree of mental pain; this pain was
avoided by the repression. This latter process is evidently
in such a case a device for the protection of the personality.

I will not multiply examples, but will give you the
history of a single one of my cases, in which the conditions
and the utility of the repression process stand out clearly
enough. Of course for my purpose I must abridge the
history of the case and omit many valuable theoretical
considerations. It is that of a young girl, who was deeply:
attached to her father, who had died a short time before,
and in whose care she had shared—a situation analogous
to that of Breuer’s patient. When her older sister mar-
ried, the girl grew to feel a peculiar sympathy for her new
brother-in-law, which easily passed with her for family
tenderness. This sister soon fell ill and died, while the
patient and her mother were away. The absent ones were
hastily recalled, without being told fully of the painful
situation. As the girl stood by the bedside of her dead
sister, for one short moment there surged up in her mind
an idea, which might be framed in these words: “Now he
is free and can marry me.” We may be sure that this
idea, which betrayed to her consciousness her intense love
for her brother-in-law, of which she had not been con-
‘scious, was the next moment consigned to repression by
her revolted feelings. The girl fell ill with severe hys-
terical symptoms, and, when I came to treat the case, it

38 AN OUTLINE OF PSYCHOANALYSIS

appeared that she had entirely forgotten that scene at her
sister’s bedside and the unnatural, egoistic desire which
had arisen in her. She remembered it during the treat-
ment, reproduced the pathogenic moment with every sign
of intense emotional excitement, and was cured by this
treatment.

Perhaps I can make the process of repression and its
necessary relation to the resistance of the patient, more
concrete by a rough illustration, which I will derive from
our present situation.

Suppose that here in this hall and in this audience, whose
exemplary stillness and attention I cannot sufficiently com-
mend, there is an individual who is creating a disturbance,
and, by his ill-bred laughing, talking, by scraping his feet,
distracts my attention from my task. I explain that I can-
not go on with my lecture under these conditions, and
thereupon several strong men among you get up, and, after
a short struggle, eject the disturber of the peace from the
hall. He is now “repressed,” and I can continue my lec-
ture. But in order that the disturbance may not be re-
peated, in case the man who has just been thrown out
attempts to force his way back into the room, the gentlemen
who have executed my suggestion take their chairs to tke
doer and establish themselves there as a “resistance,” 10
keep up the repression. Now, if you transfer both loca-
tions to the psyche, calling this “consciousness,’”” and the

#

outside the “unconscious,” you have a tolerably good illus- °

tration of the process of repression.

We can see now the difference between our theory and
that of Janet. We do not derive the psychic fission from
a congenital lack of capacity on the part of the mental
apparatus to synthesize its experiences, but we explain it
dynamically by the conflict of opposing mental forces, we
recognize in it the result of an active striving of each
mental complex against the other.

8 This case has been translated by Dr. Brill in Selected Papers
on Hysteria, etc., p. 3I—F 4.

°

ORIGIN AND DEVELOPMENT 3.

New questions at once arise in great number from out
theory. The situation of psychic conflict isa very frequent
one; an attempt of the ego to defend itself from painful
memories can be observed everywhere, and yet the result
is not a mental fission. We cannot avoid the assumption
that still other conditions are necessary, if the conflict is
to result in dissociation. I willingly concede that with the
assumption of “repression” we stand, not at the end, but
at the very beginning of a psychological theory. But we
can advance only one step at a time, and the completion
of our knowledge must await further and more thorough
work.

Now do not attempt to bring the case of Breuer’s
patient under the point of view of repression. This his-
tory cannot be subjected to such an attempt, for it was
gained with the help of hypnotic influence. Only when hyp-
nosis is excluded can you see the resistances and repres-
sions and get a correct ıdea of the pathogenic process. Hyp-
nosis conceals the resistances and so makes a certain part of
the mental field freely accessible. By this same process the
resistances on the borders of this field are heaped up into a
rampart, which makes all beyond inaccessible.

The most valuable things that we have learned from
Breuer’s observations were his conclusions as to the con-
nection of the symptoms with the pathogenic experiences or
psychic traumata, and we must not neglect to evaluate this
result properly from the standpoint of the repression-the-
ory. It is not at first evident how we can get from the re-
pression to the creation of the symptoms. Instead of giving
a complicated theoretical derivation, I will return at this
point to the illustration which I used to typify repression.

Remember that with the ejection of the rowdy and the
establishment of the watchers before the door, the affair
is not necessarily ended. It may very well happen that

the ejected man, now embittered and quite careless of con-
sequences, gives us more to do. He is no longer among
us, we are free from his presence, his scornful laugh, his

40 AN OUTLINE OF PSYCHOANALYSIS

half-audible remarks, but in a certain sense the repression
has miscarried, for he makes a terrible uproar outside, and
by his outcries and by hammering on the door with his
fists interferes with my lecture more than before. Under
these circumstances it would be hailed with delight if pos-_
sibly our honored president, Dr. Stanley Hall, should take
upon himself the role of peacemaker and mediator. He
would speak with the rowdy on the outside, and then turn
to us with the recommendation that we let him in again,
provided he would guarantee to behave himself better. On
Dr. Hall’s authority we decide to stop the repression, and
now quiet and peace reign again. This is in fact a fairly
good presentation of the task devolving upon the physician
in the psychoanalytic therapy of neuroses. To say the
same thing more directly: we come to the conclusion, from
working with hysterical patients and other neurotics, that
they have not fully succeeded in repressing the idea to
which the incompatible wish is attached. They have, in-
deed, driven it out of consciousness and out of memory,
and apparently saved themselves a great amount of psychic
pain, but in the unconscious the suppressed wish still exists,
“only waiting for its chance to become active, and finally
succeeds 1n sending into consciousness, instead of the re-
pressed idea, a disguised and unrecognizable surrogate-
creation (Ersatsbildung), to which the same painful sen-
sations associate themselves that the patient thought he
was rid of through his repression. This surrogate of the
suppressed idea—the symptom—is secure against further
attacks from the defenses of the ego, and instead of a
short conflict there originates now a permanent suffering.
We can observe in the symptom, besides the tokens of its
disguise, a remnant of traceable similarity with the orig-
inally repressed idea; the way in which the surrogate is
built up can be discovered during the psychoanalytic treat-
ment of the patient, and for his cure the symptom must be
traced back over the same route to the repressed idea. It
this repressed material is once more made part of the con-

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- ORIGIN AND DEVELOPMENT = 1441

scious mental functions—a process which supposes the
overcoming of considerable resistance—the psychic con-
flict which then arises the same which the patient wished
to avoid, is made capable of a happier termination, under
the guidance of the physician, than is offered by repression,
There are several possible suitable decisions which can
bring conflict and neurosis to a happy end; in particular
cases the attempt may be made to combine several of these.
Either the personality of the patient may be convinced
that he has been wrong in rejecting the pathogenic wish,
and he may be made to accept it either wholly or in part;
or this wish may itself be directed to a higher goal which
is free from objection, by what is called sublimation
(Sublimierung); or the rejection may be recognized as
rightly motivated, and the automatic and therefore insuffi-
cient mechanism of repression be reinforced by the higher,
more characteristically human mental faculties: one suc-
ceeds in mastering his wishes by conscious thought.

Forgive me if I have not been able to present more
clearly these main points of the treatment which is today
known as “psychoanalysis.” The difficulties do not lie
merely in the newness of the subject.

Regarding the nature of the unacceptable wishes, which
succeed in making their influence felt out of the uncon-
scious, in spite of repression; and regarding the question
of what subjective and constitutional factors must be
present for such a failure of repression and such a surro-
gate or symptom creation to take place, we will speak in
later remarks.

Third Lecture

Ladies and Gentlemen: It is not always easy to tell
the truth, especially when one must be brief, and so today
I must correct an incorrect statement that I made in my

last lecture.

I told you how when J gave up using hypnosis IJ pressed!

my patients to tell me what came into their minds that had

#