[111]

VI

“I THINK I know now what your inten-
tions are:–You wish to show me just
what knowledge is necessary for the practice
of psychoanalysis, so that I may be able to
judge whether physicians alone shall be per-
mitted to apply this method. Up to now, you
have mainly discussed psychology, and a little
biology or sex science, without a decided med-
ical slant. However, I may not have heard
everything yet.”

Certainly not. There are still a number of
gaps to be filled. But may I ask you a favor?
Will you be good enough to describe to me
how you imagine psychoanalytical treatment
is applied? Just pretend as if it were up to you
to analyse a patient.

“Well, I may make quite a mess of this! It
is surely not my intention to settle the argu-
ment between us, on the basis of such an ex-
periment. However, I shall do as you ask.

[112]

After all, the responsibility falls upon your
shoulders.

“Now then: I assume that the patient comes
to see me and embarks upon a recital of his
complaints. I promise him to cure, or at least
improve, his condition, provided that he will
follow my instructions. Then, I would ask him
to tell me, in all frankness, what he knows,
what ideas enter his mind. I should also re-
quest him to make a clean breast of everything,
even though there may be things which he
would hate to mention. Am I adhering to your
methods?”

You are! But, in addition you should have
the patient tell you all his thoughts, even if
they seem unimportant to him or lacking in
sense.

“Very well.–The patient, then, starts to re-
late his story and I listen. And what next? Oh,
yes, his information will make it possible for
me to conclude what impressions, experiences
and desires he may have repressed, because
he came face to face with them at a time when
his ‘I’ was still weak and too intimidated to
face the dilemma squarely.

[113]

The Problem of Lay-Analyses

“After I have told that to the patient, he
will reconstruct the old situations and correct
his reactions to them with my assistance. Thus,
the repressions, his ‘I’ had been forced to re-
sort to, will disappear and he is cured.—Is that
correct?”

Very good, indeed.—I already foresee that
more people are going to reproach me for hav-
ing trained a non-medical man to practise
psychoanalysis. I surely must admit that you
digested what I told you.

“I have only repeated what you told me,
like reciting something that has been com-
mitted to memory.

“But I do not feel able to clearly visualize
how I really would go about it. I cannot un-
derstand why such an analysis should require
an hour or more a day, for a period of months.
As a rule, the average human being has not
met with so many experiences. And as far as
repressions during childhood are concerned,
I assume that these are probably identical in
all cases.”

There are many new experiences to make in
the course of an analysis.

[114]

For example: You would find that it is not
so simple at all, from the information a patient
may volunteer, to draw conclusions as to those
of his experiences which he has forgotten, the
urges which he once repressed.

A patient may tell you something which, at
the moment, has just as little sense for you as
for him. You will have to make up your mind
that the material which the patient lays before
you, in accordance with the instruction you
gave him, must be interpreted in a special way.
Analogous, perhaps, to the treatment iron ore
receives for the purpose of extracting from it
valuable steel by some special process. In re-
taining this picture, for the purpose of com-
parison, you must know that tons and tons of
iron ore contain only very little of the valuable
steel for which you are looking. This is one
reason which would account for the fact that
psychoanalytical treatment is such a long
drawn-out process.

“But how is this ‘iron ore’ to be converted,
to apply your comparison once more?”

By assuming that the information and ideas
of a patient are nothing but distorted pictures

115

The Problem of Lay-Analyses

of those impressions and experiences you are
trying to unearth. Hints, as it were, from
which you would have to conclude what is
really behind them. To press it into a formula:
the information a patient yields, be it mem-
ories, ideas or dreams, will have to be inter-
preted first. This interpretation, of course,
must be guided by the expectations you
formed of the case on the basis of professional
knowledge, while listening to the patient’s re-
cital.

“‘Interpretation’! What a dreadful word!
I do not like to hear this term because, in ap-
plying it, you are depriving me of all confi-
dence. If everything depends on my inter-
pretation, who is going to assure me that my
interpretation is correct? Such a state of af-
fairs, according to my mind, simply means
that everything is left to fancies and whims.”

Just a moment, now! Things are not as bad
as all that. Why exclude processes of your own
soul from the same rule which you are ready
to admit to that of others?

Provided you have acquired a certain self-
discipline and are in the possession of suffi-
 

116

cient information, your interpretations will
not be influenced by personal peculiarities, and
are bound to prove correct.

Do not draw the conclusion from this that
it is my opinion that the personality of the
analyst does not make any difference, for this
phase of the analysis. A certain sensitiveness
for that which was unconsciously repressed, is
necessary; also an aptness with which every-
body is not equally endowed. Most of all, it
is here where the absolute necessity for a
thorough and searching self-analysis of the
analyst is proved, for the purpose of preclud-
ing any prejudice that may drag a distorted
element into the interpretation.

One thing, of course, still remains: Personal
Equation, which, as an element of individual-
ity, is destined to play a much more important
part in psychoanalysis than anywhere else.
Although an abnormal man may develop into
an expert physicist, an analyst will always be
handicapped by his own anomalies, when it
comes to conceive pictures of soul life, free
from distortions.

Inasmuch as it is impossible to prove to

117

The Problem of Lay-Analyses

anybody his anomalies, general unanimity in
the matter of Psychology of the Depths will
prove especially difficult to achieve. There are
even a handful of psychologists who claim it
to be practically impossible ever to achieve
such unanimity, and who also insist that every
fool is entitled to proclaim his special brand
of foolishness as wisdom.

I admit I am more optimistically inclined.
After all, our experiences prove that, even
in psychology, harmony of opinion may be
achieved to a tolerably satisfactory degree. No
doubt, each individual realm of science pre-
sents its own individual difficulties which have
to be eliminated. Moreover, there are some as-
pects of the art of interpretation, as applied
in analysis which, like some other knowledge,
may be acquired by study. For example, those
aspects pertaining to the peculiarly indirect
representation by symbols.

“To be frank with you: I have lost all am-
bition, even to dabble theoretically with the
application of psychoanalysis. Heaven knows
what further surprises are still in store for
me!”

118

You are perfectly correct to abandon such
an intention.

You have already convinced yourself how
much training and practice is necessary. And
once you have found the correct interpreta-
tions, a new problem presents itself. It is then
up to you to lay in wait and virtually pounce
upon the correct, the psychological moment,
if you wish to acquaint your patient of your
interpretations with the idea of benefiting
him.

“How to tell what is the psychological mo-
ment?”

That is a matter of extreme tact which, by
the way, may be greatly improved through ex-
perience. You would commit a very grave er-
ror if you would fling your interpretation, as
soon as it had been ascertained, at the patient.
This would only lead to resistance, refusal, in-
dignation, but never result in his “I” getting a
firm hold of whatever it was that caused his
repressions. It is an iron clad rule to permit
your patient to approach this elusive cause of
repression close enough, to make it possible
for him to obtain an immediate and strong

119

grip on it, under the correctly timed guidance
of the interpretation you may suggest.

“I am very much afraid that I would never
master this art. But suppose that I observe this
rule strictly, then what?”

Then it will be your lot to make a discovery
which you did not expect to make.

“What kind of a discovery?”

That you had an entirely wrong opinion
about your patient. That there is no reason in
the world for you to depend on his coöpera-
tion or complacency. That, as a matter of fact,
your patient is resolved to raise as many ob-
stacles as possible against your combined ex-
ertions. With one word: that he does not alto-
gether want to get well!

“Well, that is about the most ludicrous
statement you have made so far! I simply don’t
believe it! The patient, suffering so intensely,
complaining so heartrendingly, sacrificing so
much to be cured, actually does not want to
get well! Is it possible you really mean what
you say?”

I mean every word of it! What I have just
stated is the truth. Not the whole truth, but a

[120]

The Problem of Lay-Analyses

good deal of it. The patient wants, yet does
not want, to get well. Because his “I” has lost
its unity of purpose, it is preventing him from
summing up undivided will power. Were the
state of affairs a different one, our patient
would not be a neurotic!

The results of his repression have simply in-
vaded his “I,” firmly holding their ground
there, so to speak. The “I” is wielding just as
little influence over these effects as over the re-
pression itself. Usually, the “I” is not at all
aware of the prevailing state of affairs. These
patients are of a peculiar type, putting diffi-
culties in our way which we do not expect to
encounter. All our social institutions are or-
ganized to fit individuals with a unified, nor-
mal “I,” which may be clasified as either good
or bad. This “I” either functions properly, or
is impeded by some overwhelming influence.
Thus, the forensic alternative: mentally re-
sponsible or not responsible.

But all these standard terms do not fit the
neurotic!

Doubtless, it is difficult to adapt the de-
mands of social life to their psychological con-
 

[121]

dition. During the War, this was proved to a
great extent.

Were those neurotics who shirked from
military duty, pretending illness, simulants or
not?

They were both!

As soon as such patients were treated as
simulants, by making it uncomfortable for
them to indulge in sickness, they recuperated;
and as soon as allegedly cured patients had
been returned to the rank and file, they once
more became ill. There was simply no way to
deal effectively with them.

Analogous to this is the case of the neurotic
in everyday life.

They complain about their sickness, at the
same time exploiting it to the limit. As a mat-
ter of fact, if an attempt is made to cure them
of their ailment, they will protect this most
cherished possession of theirs with the self-
same fervor with which a lioness defends her
offspring. But there would be no sense in
blaming neurotics for the contradictory be-
havior they display.

“Would it not be best, then, not to treat such

[122]

difficult people at all? Simply leave them to
themselves? It seems to me that it cannot pos-
sibly be worthwhile to spend as much effort on
them as appears necessary, according to what
you say.”

I do not agree with you on this point.

Doubtless, it seems wiser to simply submit
to the complications which life presents,
rather than to fight them. Not each and every
one of the neurotics we treat may be worth the
exertions of an analysis, but there are surely
enough worthwhile individuals among them.
It must be our goal to decrease the number of
persons who are forced to face the exaspera-
tions of civilized life with a soul insufficiently
prepared. To this end, we must collect ex-
perience upon experience, and come to fully
grasp many problems. Every analysis is bound
to prove instructive, yielding new knowledge,
aside from the personal benefit it may confer
upon an individual patient.

“Supposing that the ‘I’ of a patient devel-
oped such tendencies which would make him
wish to retain the sickness of which he com-
plains, would not these tendencies be justified,

123

on the basis of certain reasons and motives? It
is impossible for me to understand why some-
body should want to be sick. What satisfaction
could he derive from that?”

Just remember the war neurotics who were
exempt from duty, because they were con-
sidered sick. In everyday life, sickness may
be successfully employed as a screen, behind
which to hide professional insufficiencies, or–
in the circle of family life–as a means to in-
duce relatives to make sacrifices, demonstra-
tions of affection, or to foist one’s will upon
them, generally. All this is quite obvious and
comes under the term “sickness profit” (analo-
gous to war profit). It is remarkable, however,
that the neurotic, or rather his “I,” proves un-
able to grasp the connection of such motives
with their logical consequences.

The influence of such tendencies to gain
“sickness profit” is combated, by forcing the
“I” to become aware of them. But there are
still other, more obscure motives, for holding
on to sickness, which cannot be disposed so
easily. As a matter of fact, these reasons can-
not be understood, without venturing once

[124]

more into the sphere of psychological theories.
“Oh, go right ahead! A little theory, more
or less–what does it matter?”

When I explained to you the relations be-
tween the “I” and the “It,” I withheld from
you an important part of the soul apparatus.
You see, within the “I” itself, there persists
a particular faction which we call the “Super-
Ego.”

This “Super-Ego” enjoys a privileged po-
sition between the “I” and the “It.” It belongs
to the “I,” sharing with it its intricate psycho-
logical make-up. On the other hand, it enter-
tains very close relations with the “It.” The
“Super-Ego” is in reality the record of first
impressions as conceived by the “It”; it is the
heir of the dissolved Œdipus Complex.

This “Super-Ego,” as a matter of fact, is
able to oppose the “I,” act towards it as if it
were something inferior and, in general, treat
it almost with contempt. For the “I” it is just
as important to remain in agreement with the
“Super-Ego” as with the “It.” Disagreement
between the “Super-Ego” and the “I” is of
far-reaching consequences for the soul life.

[125]

Doubtless, you have already surmised that the
“Super-Ego” is the agent of that phenome-
non which we call our conscience.

For the maintenance of healthy soul life, it
is very important that the “Super-Ego” de-
velop normally, that is, becomes sufficiently
impersonal. It is just this development which
is insufficient in the neurotic, because his Œdi-
pus Complex was not properly transformed.
His “Super-Ego,” in regard to the “I,” still
assumes the rôle of the strict father to the
child, with the morality of the “I” manifesting
itself in a primitive manner by meekly submit-
ting to punishment, meted out by the “Super-
Ego.” Sickness is resorted to, as the means of
this “self-punishment.” The neurotic, behav-
ing as if under a burden of guilt accepts sick-
ness as a punishment to assuage this feeling of
delinquency.

“That sounds very mysterious. But the most
remarkable thing seems to be that the patient
remains unconscious of the power of his con-
science.”

Well, we are only now beginning to appre-
ciate the importance of all these vital condi-
 

126

tions. That is the reason why my explanations
were so puzzling to you. But now, I believe I
can continue.

All those agents which oppose the recupera-
tion of a patient, we term the “resistance” of
the patient. While “sickness profit” is the
source of such resistance, the “unconscious
feeling of guilt” represents the resistance of
the “Super-Ego” of which, as the strongest
factor, we are very much in fear.

But there are other manifestations of resist-
ance which become evident in the process of
treatment.

If the “I,” at an early period, was induced
through fear, to take recourse to a repression,
this fear still persists, manifesting itself now as
a resistance, as soon as the “I” approaches
that which was repressed. It is easy enough to
realize that difficulties may be encountered, if
a certain tendency, which for decades has pro-
ceeded along a specific course, is suddenly ex-
pected to swing into a new path opened to it.

Such a condition may be termed the resist-
ance of the “It.”

The battle against all these resistances is our

127

main work during the analytical treatment, in
comparison with which the task of interpreta-
tion almost fades into insignificance. But by
this battle and the ensuing defeat of resist-
ances, the “I” of the patient is so transformed
and strengthened that his future behavior,
after the termination of the treatment, may be
regarded with complete equanimity.

On the other hand, you will understand now
why our treatment is so protracted. Expanse
and multifariousness of the material are not
as decisive factors as the question of whether
the way is clear. Remember that the same
course, which in times of peace, may be trav-
eled in a few hours by railroad, may take an
army, during wartime, weeks and weeks, be-
cause the resistance of the enemy must first be
overcome. Battles to overcome resistance re-
quire time in soul life also. I am sorry to say
that, up to now, all exertions to shorten the
duration of analytical treatments to any ap-
preciable degree, have proved unavailing. It
seems that the best way to shorten the length of
the treatment, is simply to apply it as correctly
as possible.

128

The Problem of Lay-Analyses

“If I ever felt the temptation to dabble with
your science and to attempt to analyze a pa-
tient, your information in reference to those
resistances, that may be encountered, cured
me thoroughly of any such ambition.

“But, tell me about the element of personal
influence which you have admitted is present
in the analysis. Is this not a valuable factor in
the battle against resistance?”

I am glad that you bring this question up.
This personal influence is our strongest dy-
namic weapon; it is the agent which we intro-
duce as something new, into the analytical
situation, thus lending it impetus.

This could never be accomplished by the
intellectual substance of our interpretation
alone because the patient, sharing all the prej-
udices of his environment, need not have
more faith in us than our scientific critics. The
neurotic coöperates with the analyst simply
because he believes in him, and he believes in
him because he gradually develops a certain
sentimental trend toward the analyst. A child,
also, believes only persons to whom it is at-
tached.

[129]

The Problem of Lay-Analyses

I have already told you how we employ this
especially great “suggestive” influence. Not to
suppress the symptoms—it is here where the
analytical method is utterly unlike any other
psycho-therapeutical method!—but as a driv-
ing power to induce the “I” of the patient to
defeat his resistances.

“And suppose you succeed? Would that in-
sure easy sailing from then on?”

Such ought to be the case. But an unex-
pected complication arises.

It was perhaps the greatest surprise for the
analyst to observe that the sentimental rela-
tions which the patient endeavors to establish,
are of a very particular nature. Already the
first physician who attempted analysis—it was
not I—discovered this phenomenon, which
served to bewilder him intensely. These senti-
mental relations are, to express it bluntly, of
an amorous nature. Remarkable, isn’t it, if you
take into consideration the fact that the ana-
lyst does nothing to invite such emotions, but
rather endeavors to maintain distance, senti-
mentally speaking, between the patient and
himself.

[130]

All this is so much more remarkable, as
these odd sentimental relations utterly disre-
gard all such obstacles, as difference in age,
sex, and social strata. This amorousness ap-
pears fated. Not that it constitutes a character-
istic otherwise alien to spontaneous love. You
are well aware that the contrary of this may be
only too frequently observed. Although it is
the rule in the analytical situation, the latter,
as such, cannot serve as a rational explanation
for this development. To all appearances,
nothing else should result from the relation
between the patient and the analyst, than just
a certain measure of respect, confidence, grati-
tude and humane sympathy. However, what
really results from it is this condition of at-
tachment, which in itself gives the impression
of being some disorder.

“Well, I should say that such a development
would tend to favor analytical purposes. If
one is enamoured, one is complacent and ready
to do almost anything for love’s sweet sake.”

Of course, in the beginning, this condition
favors the analysis, but later on, when these
sentimental relations gradually become inten-

131

sified, displaying their inherent nature, diffi-
culties crop up which do not promote the aim
of the analysis. You see, an enamoured patient
is not satisfied merely to obey the analyst. The
patient becomes presumptuous, demanding
tenderness and sensual gratification. Even-
tually, jealousy develops and the lovelorn pa-
tient gradually arrives at a stage where more
and more clearly, a preparedness for enmity
and revenge is shown. Simultaneously, analo-
gous to any other form of love, all other im-
pulses of the soul are repressed, submerging
the interest in treatment and recuperation.
There is no doubt that love has assumed the
place of the neurosis, and that our labors have
simply resulted in substituting one disturbance
for another.

“That sounds hopeless. What can be done?
Perhaps analysis in such a case should be dis-
carded. But since you say that every case yields
this result, then analysis in general would have
to be discarded.”

First, let us take stock of the situation in or-
der to learn from it. Whatever is thus gained
may assist us in mastering the situation. After

[132]

all, is it not quite remarkable that we should
succeed in transforming a neurotic condition
into a state of unwholesome attachment?

Our conviction that neurotic conditions
arise partly from abnormally directed senti-
mental tendencies, gains unquestionable cor-
roboration by our findings. Ascertaining these
facts, we feel more assured and dare to make
this enamoured condition the object of analy-
sis.

We also make another observation. This
condition of amorousness, as part of the analy-
sis, is not always so apparent in all cases, as I
have tried to picture it to you.

And why isn’t that the case? We shall soon
see.

In the same measure as the sensual and hos-
tile aspects of a patient’s attachment endeavor
to manifest themselves, the inherent opposi-
tion of the patient against such tendencies as-
serts itself. He combats them and attempts to
repress them, before our very eyes. Thus we
come to comprehend the whole development:

–The patient merely repeats, in the form of
being enamoured with the analyst, experiences

133

of his soul life of days gone by. Certain tend-
encies of his soul, ready to burst forth, and
closely connected with the inception of his
neurosis, have simply been transferred by him
to the analyst. He also repeats before our eyes
all those gestures of opposition, gone through
before, and would like nothing so much as to
repeat in his relations with the analyst, all the
phases of that forgotten period of his life.

What the patient is showing us now is ac-
cordingly the very nucleus of the most inti-
mate story of his life. He is reproducing this
nucleus in a tangible form, as if actual, in-
stead of just remembering this incipient stage
of his condition. Thus, the riddle of trans-
ferred love has been solved and the analysis,
with the assistance of this new discovery
which, for a time, almost seemed to wreck it,
may be continued.

“That is surely complicated. Does the pa-
tient believe so easily that he is not in love,
and merely feels forced to revive an old epi-
sode, as it were?”

Everything now depends upon the greatest
dexterity in handling this “transference,” to

[134]

achieve our objective. You will easily see that
the demands of the analytical technique at
this point are very exacting. It is here where
the most serious mistakes may be committed,
or the most splendid results achieved. Any at-
tempt to evade these difficulties, by suppress-
ing or neglecting the transference, would be
senseless. Such evasion would not be deserving
of the term of analysis. To send a patient
home, as soon as the discomfort of a transfer-
ence neurosis manifests itself, would also be
senseless and would amount to cowardice. It
would be approximately analogous to calling
forth spirits and then running away, as soon as
they put in their appearance.

Of course, there is no other way out some-
times. There are cases in which it is impossible
to master an unshackled transference, and the
analysis must then be terminated. But at least
one should wrestle with these evil spirits to
the best of one’s ability.

To give in to the demands of a transference
–the desires of a patient for tenderness or
sensual gratification–is impossible, not only
for moral reasons but also as it would prove

[135]

impractical, if resorted to as a means to
achieve a successful analysis. A neurotic can-
not be healed, by being permitted to indulge in
uncorrected repetitions of situations which he
unconsciously prepared. When making a com-
promise with a neurotic, by meeting him half-
way, it is necessary to take care not to be
manœuvred into the ludicrous position of the
clergyman, who tried to convert the insurance
agent with the result that the insurance agent
did not join the church, but the clergyman
took out a policy.

The only way out of the dilemma of trans-
ference is to delve into the past of the patient
and reconstruct events as they were actually
lived through by the patient, or else only pic-
tured, with the assistance of his urge-
stimulated imagination. For all this, the ana-
lyst requires much dexterity, patience, calm-
ness and self-effacement.

“And where, do you think, did the neurotic
meet the original of this transference love?”

In his childhood, and, as a rule, in one of
his parents. You will readily remember how
much importance we had to attach to these

136

The Problem of Lay-Analyses

earliest of all sentimental relations. Here, the
circle is completed.

“You have finished, then? To be frank with
you, I am quite bewildered by all you have
told me. But, now pray tell me, where to study
all that is necessary to practise analysis?”

Two institutes serve this purpose by giving
instruction in psychoanalysis. The first is in
Berlin, in charge of Dr. Max Eitigon of the
local organization. The second is maintained
by the Vienna Psychoanalytical Society, with
great sacrifice. The authorities, up to now,
have thrown many obstacles in the path of the
young institute. A third institute will be
opened in London, by the local organization
there and will be under the direction of Dr.
E. Jones.

In all these institutes, the disciples them-
selves are analysed, and are then given theoret-
ical instruction in all subjects important for
them. When permitted to analyse their first,
simple cases, they have the advantage of being
under the supervision of more experienced
analysts. The course usually requires about
two years, but even after this period, a disciple

137

is still a beginner, and not by far to be con-
sidered a master. What else the young analyst
needs, he acquires thorough practice, and by
intercourse with older colleagues.

The preparatory work for the analytical
training is not at all simple: the work is hard,
the responsibility tremendous.

Whoever attended such a course, has been
analysed himself, has grasped the Psychol-
ogy of the Unconscious, as far as it can be
taught today, is sufficiently versed in the
science of sex, and has acquired the difficult
technique of psychoanalysis, including the art
of interpretation, the method of combating
resistances and the manner in which to handle
transferences, can no longer be considered a
layman, in the field of psychoanalysis. He is
able to treat neurotic disturbances and will, in
time, be in a position to achieve all that may
be expected of this therapy.