The Collected Works of Sigmund Freud. Sigmund Freud

readily what psychic impulses in his several patients have remained unconscious. Accordingly it would seem easy for him to cure the patient by imparting this knowledge to him and freeing him of his ignorance. At least the part played by the unconscious meaning of the symptoms could easily be discovered in this manner, and it would only be in dealing with the relationship of the symptoms to the experiences of the patient that the physician would be handicapped. In the face of these experiences, of course, he is the ignorant one of the two, for he did not go through these experiences, and must wait until the patient remembers them and tells them to him. But in many cases this difficulty could be readily overcome. One can question the relatives of the patient concerning these experiences, and they will often be in a position to point out those that carry any traumatic significance; they may even be able to inform the analyst of experiences of which the patient knows nothing because they occurred in the very early years of his life. By a combination of such means it would seem that the pathogenic ignorance of the patient could be cleared up in a short time and without much trouble.

If only that were all! We have made discoveries for which we were at first unprepared. Knowing and knowing is not always the same thing; there are various kinds of knowing that are psychologically by no means comparable. “Il y a fagots et fagots,”³⁹ as Molière says. The knowledge of the physician is not the same as that of the patient and cannot bring about the same results. The physician can gain no results by transferring his knowledge to the patient in so many words. This is perhaps putting it incorrectly, for though the transference does not result in dissolving the symptoms, it does set the analysis in motion, and calls out an energetic denial, the first sign usually that this has taken place. The patient has learned something that he did not know up to that time, the meaning of his symptoms, and yet he knows it as little as before. So we discover there is more than one kind of ignorance. It will require a deepening of our psychological insight to make clear to us wherein the difference lies. But our assertion nevertheless remains true that the symptoms disappear with the knowledge of their meaning. For there is only one limiting condition; the knowledge must be founded on an inner change in the patient which can be attained only through psychic labors directed toward a definite end. We have here been confronted by problems which will soon lead us to the elaboration of a dynamics of symptom formation.

      I must stop to ask you whether this is not all too vague and too complicated? Do I not confuse you by so often retracting my words and restricting them, spinning out trains of thought and then rejecting them? I should be sorry if this were the case. However, I strongly dislike simplification at the expense of truth, and am not averse to having you receive the full impression of how many-sided and complicated the subject is. I also think that there is no harm done if I say more on every point than you can at the moment make use of. I know that every hearer and reader arranges what is offered him in his own thoughts, shortens it, simplifies it and extracts what he wishes to retain. Within a given measure it is true that the more we begin with the more we have left. Let me hope that, despite all the by-play, you have clearly grasped the essential parts of my remarks, those about the meaning of symptoms, about the unconscious, and the relation between the two. You probably have also understood that our further efforts are to take two directions: first, the clinical problem — to discover how persons become sick, how they later on accomplish a neurotic adaptation toward life; secondly, a problem of psychic dynamics, the evolution of the neurotic symptoms themselves from the prerequisites of the neuroses. We will undoubtedly somewhere come on a point of contact for these two problems.

      I do not wish to go any further today, but since our time is not yet up I intend to call your attention to another characteristic of our two analyses, namely, the memory gaps or amnesias, whose full appreciation will be possible later. You have heard that it is possible to express the object of psychoanalytic treatment in a formula: all pathogenic unconscious experience must be transposed into consciousness. You will perhaps be surprised to learn that this formula can be replaced by another: all the memory gaps of the patient must be filled out, his amnesias must be abolished. Practically this amounts to the same thing. Therefore an important role in the development of his symptoms must be accredited to the amnesias of the neurotic. The analysis of our first case, however, will hardly justify this valuation of the amnesia. The patient has not forgotten the scene from which the compulsion act derives — on the contrary, she remembers it vividly, nor is there any other forgotten factor which comes into play in the development of these symptoms. Less clear, but entirely analogous, is the situation in the case of our second patient, the girl with the compulsive ritual. She, too, has not really forgotten the behavior of her early years, the fact that she insisted that the door between her bedroom and that of her parents be kept open, and that she banished her mother out of her place in her parents’ bed. She recalls all this very clearly, although hesitatingly and unwillingly. Only one factor stands out strikingly in our first case, that though the patient carries out her compulsive act innumerable times, she is not once reminded of its similarity with the experience after the bridal-night; nor was this memory even suggested when by direct questions she was asked to search for its motivation. The same is true of the girl, for in her case not only her ritual, but the situation which provoked it, is repeated identically night after night. In neither case is there any actual amnesia, no lapse of memory, but an association is broken off which should have called out a reproduction, a revival in the memory. Such a disturbance is enough to bring on a compulsion neurosis. Hysteria, however, shows a different picture, for it is usually characterized by most grandiose amnesias. As a rule, in the analysis of each hysterical symptom, one is led back to a whole chain of impressions which, upon their recovery, are expressly designated as forgotten up to the moment. On the one hand this chain extends back to the earliest years of life, so that the hysterical amnesias may be regarded as the direct continuation of the infantile amnesias, which hides the beginnings of our psychic life from those of us who are normal. On the other hand, we discover with surprise that the most recent experiences of the patient are blurred by these losses of memory — that especially the provocations which favored or brought on the illness are, if not entirely wiped out by the amnesia, at least partially obliterated. Without fail important details have disappeared from the general picture of such a recent memory, or are placed by false memories. Indeed it happens almost regularly that just before the completion of an analysis, certain memories of recent experiences suddenly come to light. They had been held back all this time, and had left noticeable gaps in the context.

      We have pointed out that such a crippling of the ability to recall is characteristic of hysteria. In hysteria symptomatic conditions also arise (hysterical attacks) which need leave no trace in the memory. If these things do not occur in compulsion-neuroses, you are justified in concluding that these amnesias exhibit psychological characteristics of the hysterical change, and not a general trait of the neuroses. The significance of this difference will be more closely limited by the following observations. We have combined two things as the meaning of a symptom, its “whence,” on the one hand, and its “whither” or “why,” on the other. By these we mean to indicate the impressions and experiences whence the symptom arises, and the purpose the symptom serves. The “whence” of a symptom is traced back to impressions which have come from without, which have therefore necessarily been conscious at some time, but which may have sunk into the unconscious — that is, have been forgotten. The “why” of the symptom, its tendency, is in every case an endopsychic process, developed from within, which may or may not have become conscious at first, but could just as readily never have entered consciousness at all and have been unconscious from its inception. It is, after all, not so very significant that, as happens in the hysterias, amnesia has covered over the “whence” of the symptom, the experience upon which it is based; for it is the “why,” the tendency of the symptom, which establishes its dependence on the unconscious, and indeed no less so in the compulsion neuroses than in hysteria. In both cases the “why” may have been unconscious from the very first.

      By thus bringing into prominence the unconscious in psychic life, we have raised the most evil spirits of criticism against psychoanalysis. Do not be surprised at this, and do not believe that the opposition is directed only against the difficulties offered by the conception of the unconscious or against the relative inaccessibility of the experiences which represent it. I believe it comes from another source. Humanity, in the course of time, has had to endure