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That this is indeed the way in which the subject comes to be fixated on the repression, and to hold to a danger situation that no longer exists, is clearly borne out by the sheer fact of psychoanalytic therapy, which, though modest enough in itself, is enormously significant in theoretical terms. When in the course of psychoanalysis we give the ego the requisite help that enables it to lift its repressions, it recovers its power over the repressed id, and can get the drive-impulses to pursue their course as if the old danger situations no longer existed. Our achievements in this regard are fully in accord with the limited scope of our powers in medicine generally. In our therapeutic practice, after all, we must be content as a rule to achieve the same benign outcome that would have materialized anyway given the right circumstances – but to do so more rapidly, more reliably, and with less fuss.

Our deliberations thus far have shown us that it is the
quantitative
ratios of the various factors involved – ratios that cannot be directly
demonstrated but only indirectly inferred – which determine whether old danger situations are perpetuated, whether repressions effected by the ego are maintained, whether childhood neuroses are continued in later life. Among the factors that are involved in the causation of neuroses – having created the conditions in which the various psychic forces do battle with each other – three in particular seem to us to stand out: a biological one, a phylogenetic one, and a purely psychological one.

The biological factor is the very lengthy period during which the young of the human species remain in a state of helplessness and dependence. The intra-uterine existence of human beings appears somewhat abbreviated by comparison with that of most animals, and they come into the world less able to cope. As a result, the objective external world exerts a more powerful influence on them, and the ego is encouraged to differentiate from the id at a very early stage; furthermore, the dangers posed by the external world become more significant, and the importance of the object – the only thing that can protect them from these dangers and make up for the loss of their intra-uterine existence – is vastly increased. This biological factor thus produces the first danger situations in each child's life, and generates the need to be loved – a need that stays with him throughout his life.

The second, phylogenetic, factor is merely a supposition on our part – but one forced upon us by a very curious aspect of libido development. We find that the sexual life of man does not develop along a steady path from birth to maturity, as does that of most animals closely related to him, but abruptly breaks off after an initial flourish lasting until the fifth year of life, then starts again at puberty, picking up where it left off in its infantile beginnings. We rather think that at some point during the shaping of mankind's destiny some momentous event must have occurred that left its mark in the form of this break in human sexual development.
63
The pathogenic significance of this factor is clearly demonstrated by the fact that most of the demands asserted by the drives in infantile sexuality are treated by the ego as dangers and duly warded off, with the result that the later sexual impulses of puberty, which ought to be
ego-accordant,
64
are at risk of succumbing to the attraction of the paradigmatic impulses of infancy, and following them into repression. Here we find ourselves face to face with the most direct cause of neurosis. It is striking that the human being's early contact with the demands of sexuality affects the ego in much the same way as does his over-early contact with the external world.

The third, psychological, factor is to be found in a certain imperfectness of our psychic apparatus that has to do precisely with its differentiation into an ego and an id, and is thus ultimately also due to the influence of the external world. By dint of paying due attention to the dangers posed by objective reality, the ego is compelled to take defensive action against certain drive-impulses in the id, and to treat them as dangers. But the ego cannot protect itself against the dangers posed by its own inner drives as effectively as it can against a threat posed by external reality. Being itself intimately bound up with the id, it can fight off the danger posed by a drive only by restricting its own organization and accepting symptom-formation as the price it has to pay for obstructing the drive. If the rejected drive subsequently renews its assault, then the ego finds itself beset by all those difficulties that constitute the affliction familiar to us as ‘neurosis’.

And that, I rather think, is about as far as we have managed to get for the time being in our quest to understand the nature and causation of neurosis.

XI
Addenda

In the course of this discussion various topics have been raised which then had to be all too quickly abandoned. These topics are now brought together here so that they can receive the full measure of attention that they deserve.

A
Modification of Previously Expressed Views

a) Resistance and counter-cathexis

It is an important element of the theory of repression that it does not consist in an isolated, one-off process, but requires the continuous application of effort. If this effort were to cease, then the repressed drive, which is constantly replenished by its original well-springs, would make a further advance along the same path from which it had previously been ousted: the repression would either fail, or have to be repeated over and over again. It is thus the continuous nature of the drive that makes it necessary for the ego to devote itself unceasingly to its defence campaign in order to ensure its success. It is this sustained activity aimed at safeguarding the repression that we encounter in our therapeutic ministrations as
resistance
. Resistance presupposes the phenomenon that I have termed
counter-cathexis
.
65
Such a phenomenon is palpably present in obsessional neurosis, where it takes the form of an ego-alteration, that is, a
reaction-formation
within the ego, due to an intensification of whatever stance is antithetical to the thrust of the drive that is being repressed (e.g. compassion, conscientiousness, cleanliness). These
reaction-formations in obsessional neurosis are all simply an exaggerated form of normal character traits that develop during the latency period. It is far more difficult to produce evidence of counter-cathexis in the case of hysteria, where in theoretical terms we would expect it to be just as indispensable. Here, too, there is unmistakable evidence of a certain degree of ego-alteration as a result of reaction-formation; indeed this is so marked in some circumstances that it forces itself on our attention as the principal symptom of the condition. It is in this way that the ambivalence conflict in hysteria is resolved, for instance: feelings of hatred towards a loved person are suppressed by dint of exaggerated affection and anxious concern for them. However, it needs to be emphasized that, in contradistinction to obsessional neurosis, such reaction-formations do not exhibit the generalized nature typical of character traits, but are confined to quite specific interactions. For instance, if a hysterical woman displays excessive affection towards her own children, while in truth hating them, this does not mean that she will
in general
be any more loving than other women, or indeed any more affectionate towards other children. In hysteria, reaction-formation sticks doggedly to a particular object, and does not turn into a general tendency on the part of the ego – whereas it is precisely such a generalizing process, a freeing-up of object relationships, an increase in the scope for displacement with regard to object-choice, that characterizes obsessional neurosis.

There is another form of counter-cathexis that does seem rather more appropriate to the particular nature of hysteria. The repressed drive-impulse can be activated (re-cathected) from two different directions: firstly from within, due to an intensification of the drive brought about by its own internal sources of excitation, and secondly from without, due to perception of an object that the drive finds desirable. Hysterical counter-cathexis, however, is largely directed
outwards
, and against any perception that might pose a danger. It takes the form of a special vigilance which, by means of restrictions of the ego, avoids situations in which such a perception might occur, or, if it occurs anyway, succeeds in preventing the subject from paying any attention to it. Certain French writers (notably Laforgue)
have recently highlighted this feature of hysteria by giving it the special name ‘scotomization’.
66
This particular technique of counter-cathexis is even more marked in the phobias, where the subject's whole focus of interest is to remove himself ever further from any situation that might involve the perception he so dreads. Although it is not an absolute one, the complete contrast in the direction of the counter-cathexis in hysteria and phobias on the one hand, and in obsessional neurosis on the other, appears to be significant. It invites us to suppose that there is a rather more intimate connection between repression and external counter-cathexis, as also between regression and internal counter-cathexis (ego-alteration due to reaction-formation). The task of warding off a dangerous perception is incidentally common to all neuroses. In obsessional neurosis, sundry ‘dos’ and ‘don'ts’ are intended to serve this same purpose.

We established on an earlier occasion that the resistance that we have to overcome in psychoanalysis is produced by the ego, which doggedly persists in its counter-cathexes.
67
The ego finds it hard to turn its attention to perceptions and notions which it has hitherto made it a rule to avoid, or to acknowledge as its own certain impulses blatantly antithetical to those it is wont to think its own. It is just such a view of this resistance that forms the basis of our attempts to overcome it in analysis. Where, on account of its affinity with the repressed drive-impulse, the resistance is unconscious – as is frequently the case – we make it conscious; once it has become conscious, we put up logical arguments against it; we promise the ego rewards and advantages if it abandons its resistance. There is thus no call to doubt or modify the notion of ‘resistance’ by the ego. None the less, the question arises whether it is sufficient on its own to account for the actual facts of the matter as presented to us in psychoanalysis. We find that the ego still has difficulty in undoing the repressions, even after it has resolved to relinquish its resistances, and we have used the term ‘working through’ to describe the phase of strenuous endeavour that follows this laudable resolve. We now need to recognize the dynamic factor that makes this working-through process both necessary and understandable. It must surely be the case that, even when the resistance of the ego has been
removed, there is still something else to be overcome – namely the powerful compulsion to repeat, the attraction of the unconscious paradigms acting upon the suppressed drive process; and there could be no objection to our terming this factor the
resistance of the unconscious
.

We must not let ourselves get upset about such emendations: they are distinctly desirable if they bring us new knowledge, and by no means shameful if, rather than discrediting our old knowledge, they serve to refine it, perhaps by narrowing down a generalization that is somewhat broad, or broadening an interpretation that is rather too narrow. However, we cannot assume that by making this particular emendation we have attained to a comprehensive overview of all the different types of resistance confronting us in psychoanalysis. On the contrary, we find on closer examination that we have altogether five kinds of resistance to contend with, arising from three distinct directions, that is, from the ego, the id and the super-ego. The ego turns out to be the source of three of them, each having a different dynamic. The first of these three resistances on the part of the ego is the one we have just dealt with, namely
repression
resistance, and there is very little that we can add here. Although similar in nature,
transference
resistance none the less belongs in a separate category: it manifests itself differently and much more distinctly in analysis, since it contrives to establish a relationship with the analytic situation or with the person of the analyst, and thereby to rekindle a repression that was meant to be merely recollected. A further form of ego resistance, but one of a very different nature, is that predicated on
illness-gain
, which essentially involves assimilating the symptom into the ego. It corresponds to a fervent unwillingness to refrain from any gratification or other relief. As for the fourth type of resistance, namely that of the
id
, we have just seen how it is this that makes the ‘working-through’ process necessary. The fifth kind of resistance, that of the
super-ego
the last to be recognized and the most obscure, though not always the least powerful – appears to stem from the subject's sense of guilt or need for punishment; it puts obstacles in the way of any form of success – including, of course, the subject's own recovery through psychoanalysis.
68

b) Fear arising from transformation of libido

The interpretation of fear put forward in this essay diverges to some extent from the one that I previously thought correct. I used to regard fear as a general reaction on the part of the ego in circumstances of unpleasure; I always sought to account for its appearance in economic terms, and on the basis of my investigations into the ‘actual’ neuroses I assumed that any libido (sexual excitation) rejected or not utilized by the ego finds direct release in the form of fear. There is no overlooking the fact that these various findings do not accord well with each other, or at the very least do not follow logically from one another. Furthermore, they foster the impression of a particularly intimate link between fear and libido, something that once again does not accord with the general nature of fear as a reaction denoting unpleasure.

The objection to this previous interpretation stemmed from my argument making the ego the sole locus of fear, and was thus one of the results of my attempt in
The Ego and the Id
at a taxonomy of the psychic apparatus. The earlier interpretation tended to regard the libido of the repressed drive-impulse as the source of the fear; according to the later one, however, this fear was the ego's responsibility. ‘Ego-fear’ or ‘drive-(id-) fear’ – that is the question. Given the fact that the ego operates with desexualized energy, the new version also posits a much less intimate connection between fear and libido. I hope I have at least succeeded in making the contradiction clear, and in precisely delineating the area of uncertainty.

Rank's insistence that the affect of fear is indeed – as I myself initially maintained – a consequence of the birth process, and a repetition of the situation then experienced, obliged me to take a fresh look at the fear problem. I was unable to get anywhere with Rank's own interpretation, according to which birth is a trauma, the state of fear is the reaction to that trauma giving the requisite release, and each new affect of fear is an attempt to ‘abreact’ the trauma ever more completely. It became necessary to go back a stage and look at the
danger situation
underlying the fear reaction. The introduction of this factor enabled us to view things in a new
perspective. We now saw birth as the paradigm for all the danger situations that subsequently arise in the new circumstances created by changes in the subject's form of existence and by the progressive development of his psyche; but we also saw its own significance as being restricted to this paradigmatic role with regard to danger. The fear experienced at birth now became in this perspective the paradigm of a state of affect that necessarily shared the destiny of other affects. On the one hand the affect of fear, having been purposive in the original danger situation, automatically reproduces itself as a
counter
-purposive form of reaction in situations analogous to those in which it first arose; on the other hand, the
ego
reproduces it, having managed to gain power over it, and uses it as a warning of the impending danger and as a means of jolting the pleasure/ unpleasure mechanism into action. The biological importance of the affect of fear received its due, in that fear was recognized as being the universal reaction to a danger situation; the role of the ego as the locus of fear was confirmed, in that it was acknowledged as being a function of the ego to produce the affect of fear in accordance with its own particular needs. The fear that manifests itself in all the later phases of life was thus seen as originating in two distinct ways: one – invariably justifiable in economic terms – that occurs involuntarily and automatically whenever a danger situation arises that is analogous to that of birth; another that is specifically produced by the ego as a preventative measure whenever there is simply the
threat
of such a situation arising. In this latter case, the ego was seen as subjecting itself to fear as if to a vaccine, so to speak, thus accepting a mild dose of illness in order to avoid a full-blown attack. It is as if the ego deliberately summons up a vivid picture of the danger situation – with the unmistakable purpose of restricting this painful experience to a mere hint or signal. We have already shown in considerable detail how in the process the various danger situations develop separately, one after another, yet remain genetically linked. We shall perhaps manage to penetrate a little further in our understanding of fear once we tackle the problem of the relationship between neurotic fear and objective fear.

Our earlier hypothesis of a direct transformation of libido into
fear is now of less interest to us – but if we take stock of it all the same, then we need to distinguish between several different sets of circumstances. It is certainly not applicable where fear serves as a signal to alert the ego, and it is thus also not applicable to any of those danger situations that prompt the ego to initiate a repression. As is most plainly evident in the conversion hysterias, the libidinal cathexis of the repressed drive-impulse finds uses other than being transformed into fear, or released as fear. In our further discussion of danger situations, however, we shall come upon a particular form of fear-generation that probably needs to be viewed rather differently.

c) Repression and defence

In the context of these discussions on the problem of fear I have reverted to a concept – or to put it more modestly, a term – that I used exclusively at the start of my work thirty years ago, and then subsequently abandoned. I mean the term ‘defence process’.
69
In due course I replaced it with the term ‘repression’, but the relationship between the two remained imprecise. I now think that it is distinctly advantageous to hark back to the old concept of ‘defence’, provided it is clearly established that it is intended to serve as the general designation for
all
the techniques used by the ego in its various conflicts, any of which may lead to neurosis, while ‘repression’ remains the name of one particular such mechanism that we have first become more familiar with because of the direction our investigations happen to have taken.

Even a purely terminological innovation requires to be justified; it needs to reflect a new perspective or a new insight. And indeed, the resumption of the concept of ‘defence’, and the narrowing of the concept of ‘repression’, gives due recognition to a fact that has long been known but has acquired extra significance thanks to various more recent discoveries. We first learned about repression and symptom-formation in the context of hysteria. We saw that the perceptions attaching to excitatory experiences and the notions attaching to pathogenic trains of thought are forgotten and thus
excluded from reproduction within the subject's memory, and we therefore concluded that keeping certain things from consciousness is one of the chief characteristics of hysterical repression. We later studied obsessional neurosis and found that in this particular disorder the pathogenic events are
not
forgotten. They remain conscious, but are ‘isolated’ in some way not yet comprehensible to us, so that much the same outcome is achieved as in the case of hysterical amnesia. None the less, the difference is large enough to justify our view that the process whereby demands on the part of drives are rebuffed in obsessional neurosis cannot be the same as that in hysteria. Further investigations have taught us that in obsessional neurosis the vigorous resistance of the ego causes the drive-impulses to regress to an earlier libidinal phase, and while this does not render a repression superfluous, it is clearly similar to repression in its effect. In addition, we have seen that counter-cathexis – a process we can also assume to be operative in hysteria – plays a particularly important role in protecting the ego in obsessional neurosis by means of reactive ego-alteration; we have become aware of an ‘isolation’ process albeit without yet being able to explain how it works that finds direct expression at the symptomatic level; and we have also become aware of the 'obliteration of past events’, a procedure we can only call magical, which unquestionably has a defensive function, but bears no further resemblance to the process of ‘repression’. These findings are reason enough to reintroduce the old concept of
defence
– which can readily embrace all these processes with their common purpose of protecting the ego against challenges on the part of drives – and to subsume repression under it as a special sub-category. The importance of using nomenclature of this sort becomes even greater if we take into account the possibility that in digging ever deeper in our researches we may well find that there is an intimate connection between particular forms of defence and specific disorders, for instance between repression and hysteria. Furthermore, we expect that there is a real possibility of our discovering another, equally significant pattern of dependence: it may well be that
prior
to the sharp differentiation of the ego and the id and the formation of the super-ego, the psychic apparatus
uses different methods of defence from those it uses
after
attaining these stages of organization.

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