Freud - Complete Works (815 page)

   A ‘No’ from a person
in analysis is quite as ambiguous as a ‘Yes’, and is
indeed of even less value. In some rare cases it turns out to be
the expression of a legitimate dissent. Far more frequently it
expresses a resistance which may have been evoked by the
subject-matter of the construction that has been put forward but
which may just as easily have arisen from some other factor in the
complex analytic situation. Thus, a patient’s
‘No’ is no evidence of the correctness of a
construction, though it is perfectly compatible with it. Since
every such construction is an incomplete one, since it covers only
a small fragment of the forgotten events, we are free to suppose
that the patient is not in fact disputing what has been said to him
but is basing his contradiction upon the part that has not yet been
uncovered. As a rule he will not give his assent until he has
learnt the whole truth - which often covers a very great deal of
ground. So that the only safe interpretation of his
‘No’ is that it points to incompleteness; there can be
no doubt that the construction has not told him everything.

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   It appears, therefore, that the
direct utterances of the patient after he has been offered a
construction afford very little evidence upon the question whether
we have been right or wrong. It is of all the greater interest that
there are indirect forms of confirmation which are in every respect
trustworthy. One of these is a form of words that is used (as
though by general agreement) with very little variation by the most
different people: ‘I didn’t ever think’ (or
‘I shouldn’t ever have thought’)
‘that’ (or ‘of that’). This can be
translated without any hesitation into: ‘Yes, you’re
right this time - about my
unconscious
.’ Unfortunately
this formula, which is so welcome to the analyst, reaches his ears
more often after single interpretations than after he has produced
an extensive construction. An equally valuable confirmation is
implied (expressed this time positively) when the patient answers
with an association which contains something similar or analogous
to the content of the construction. Instead of taking an example of
this from an analysis (which would be easy to find but lengthy to
describe) I prefer to give an account of a small extra-analytical
experience which presents a similar situation so strikingly that it
produces an almost comic effect. It concerned one of my colleagues
who - it was long ago - had chosen me as a consultant in his
medical practice. One day, however, he brought his young wife to
see me, as she was causing him trouble. She refused on all sorts of
pretexts to have sexual relations with him, and what he expected of
me was evidently that I should lay before her the consequences of
her ill-advised behaviour. I went into the matter and explained to
her that her refusal would probably have unfortunate results for
her husband’s health or would lay him open to temptations
that might lead to a break-up of their marriage. At this point he
suddenly interrupted me with the remark: ‘The Englishman you
diagnosed as suffering from a cerebral tumour has died too.’
At first the remark seemed incomprehensible; the ‘too’
in his sentence was a mystery, for we had not been speaking of
anyone else who had died. But a short time afterwards I understood.
The man was evidently intending to confirm what I had been saying;
he was meaning to say: ‘Yes, you’re certainly quite
right. Your diagnosis was confirmed in the case of the other
patient too.’ It was an exact parallel to the indirect
confirmations that we obtain in analysis from associations. I will
not attempt to deny that there were other thoughts as well, put on
one side by my colleague, which had a share in determining his
remark.

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   Indirect confirmation from
associations that fit in with the content of a construction - that
give us a ‘too’ like the one in my story - provides a
valuable basis for judging whether the construction is likely to be
confirmed in the course of the analysis. It is particularly
striking when, by means of a parapraxis, a confirmation of this
kind insinuates itself into a direct denial. I once published
elsewhere a nice example of this. The name ‘Jauner’ (a
familiar one in Vienna) came up repeatedly in one of my
patient’s dreams without a sufficient explanation appearing
in his associations. I finally put forward the interpretation that
when he said ‘Jauner’ he probably meant
‘Gauner’, whereupon he promptly replied: ‘That
seems to me too "
jewagt
".’ Or there was the
other instance, in which, when I suggested to a patient that he
considered a particular fee too high, he meant to deny the
suggestion with the words ‘Ten dollars mean nothing to
me’ but instead of dollars put in a coin of lower value and
said ‘ten shillings’.

   If an analysis is dominated by
powerful factors that impose a negative therapeutic reaction, such
as a sense of guilt, a masochistic need for suffering or repugnance
to receiving help from the analyst, the patient’s behaviour
after he has been offered a construction often makes it very easy
for us to arrive at the decision that we are in search of. If the
construction is wrong, there is no change in the patient; but if it
is right or gives an approximation to the truth, he reacts to it
with an unmistakable aggravation of his symptoms and of his general
condition.

   We may sum the matter up by
asserting that there is no justification for the reproach that we
neglect or underestimate the importance of the attitude taken up by
those under analysis towards our constructions. We pay attention to
them and often derive valuable information from them. But these
reactions on the part of the patient are rarely unambiguous and
give no opportunity for a final judgement. Only the further course
of the analysis enables us to decide whether our constructions are
correct or unserviceable. We do not pretend that an individual
construction is anything more than a conjecture which awaits
examination, confirmation or rejection. We claim no authority for
it, we require no direct agreement from the patient, nor do we
argue with him if at first he denies it. In short, we conduct
ourselves on the model of a familiar figure in one of
Nestroy’s farces - the manservant who has a single answer on
his lips to every question or objection: ‘It will all become
clear in the course of future developments.’

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III

   How this occurs in the process of
the analysis - the way in which a conjecture of ours is transformed
into the patient’s conviction - this is hardly worth
describing. All of it is familiar to every analyst from his daily
experience and is intelligible without difficulty. Only one point
requires investigation and explanation. The path that starts from
the analyst’s construction ought to end in the
patient’s recollection; but it does not always lead so far.
Quite often we do not succeed in bringing the patient to recollect
what has been repressed. Instead of that, if the analysis is
carried out correctly, we produce in him an assured conviction of
the truth of the construction which achieves the same therapeutic
result as a recaptured memory. The problem of what the
circumstances are in which this occurs and of how it is possible
that what appears to be an incomplete substitute should
nevertheless produce a complete result - all of this is matter for
a later enquiry.

   I shall conclude this brief paper
with a few remarks which open up a wider perspective. I have been
struck by the manner in which, in certain analyses, the
communication of an obviously apt construction has evoked in the
patients a surprising and at first incomprehensible phenomenon.
They have had lively recollections called up in them - which they
themselves have described as ‘ultra-clear’ - but what
they have recollected has not been the event that was the subject
of the construction but details relating to that subject. For
instance, they have recollected with abnormal sharpness the faces
of the people involved in the construction or the rooms in which
something of the sort might have happened, or, a step further away,
the furniture in such rooms - on the subject of which the
construction had naturally no possibility of any knowledge. This
has occurred both in dreams immediately after the construction had
been put forward and in waking states resembling phantasies. These
recollections have themselves led to nothing further and it has
seemed plausible to regard them as the product of a compromise. The
‘upward drive’ of the repressed, stirred into activity
by the putting forward of the construction, has striven to carry
the important memory-traces into consciousness; but a resistance
has succeeded, not, it is true, in
stopping
that movement,
but in
displacing
it on to adjacent objects of minor
significance.

Constructions In Analysis

5058

   These recollections might have
been described as hallucinations if a belief in their actual
presence had been added to their clearness. The importance of this
analogy seemed greater when I noticed that true hallucinations
occasionally occurred in the case of other patients who were
certainly not psychotic. My line of thought proceeded as follows.
Perhaps it may be a general characteristic of hallucinations to
which sufficient attention has not hitherto been paid that in them
something that has been experienced in infancy and then forgotten
returns - something that the child has seen or heard at a time when
he could still hardly speak and that now forces its way into
consciousness, probably distorted and displaced owing to the
operation of forces that are opposed to this return. And, in view
of the close relation between hallucinations and particular forms
of psychosis, our line of thought may be carried still further. It
may be that the delusions into which these hallucinations are so
constantly incorporated may themselves be less independent of the
upward drive of the unconscious and the return of the repressed
than we usually assume. In the mechanism of a delusion we stress as
a rule only two factors: the turning away from the real world and
its motive forces on the one hand, and the influence exercised by
wish-fulfilment on the content of the delusion on the other. But
may it not be that the dynamic process is rather that the turning
away from reality is exploited by the upward drive of the repressed
in order to force its content into consciousness, while the
resistances stirred up by this process and the trend to
wish-fulfilment share the responsibility for the distortion and
displacement of what is recollected? This is after all the familiar
mechanism of dreams, which intuition has equated with madness from
time immemorial.

   This view of delusions is not, I
think, entirely new, but it nevertheless emphasizes a point of view
which is not usually brought into the foreground. The essence of it
is that there is not only
method
in madness, as the poet has
already perceived, but also a fragment of
historical truth
;
and it is plausible to suppose that the compulsive belief attaching
to delusions derives its strength precisely from infantile sources
of this kind. All that I can produce to-day in support of this
theory are reminiscences, not fresh impressions. It would probably
be worth while to make an attempt to study cases of the disorder in
question on the basis of the hypotheses that have been here put
forward and also to carry out their treatment on those same lines.
The vain effort would be abandoned of convincing the patient of the
error of his delusion and of its contradiction of reality; and, on
the contrary, the recognition of its kernel of truth would afford
common ground upon which the therapeutic work could develop. That
work would consist in liberating the fragment of historical truth
from its distortions and its attachments to the actual present day
and in leading it back to the point in the past to which it
belongs. The transposing of material from a forgotten past on to
the present or on to an expectation of the future is indeed a
habitual occurrence in neurotics no less than in psychotics. Often
enough, when a neurotic is led by an anxiety-state to expect the
occurrence of some terrible event, he is in fact merely under the
influence of a repressed memory (which is seeking to enter
consciousness but cannot become conscious) that something which was
at that time terrifying did really happen. I believe that we should
gain a great deal of valuable knowledge from work of this kind upon
psychotics even if it led to no therapeutic success.

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   I am aware that it is of small
service to handle so important a subject in the cursory fashion
that I have here employed. But none the less I have not been able
to resist the seduction of an analogy. The delusions of patients
appear to me to be the equivalents of the constructions which we
build up in the course of an analytic treatment - attempts at
explanation and cure, though it is true that these, under the
conditions of a psychosis, can do no more than replace the fragment
of reality that is being disavowed in the present by another
fragment that had already been disavowed in the remote past. It
will be the task of each individual investigation to reveal the
intimate connections between the material of the present disavowal
and that of the original repression. Just as our construction is
only effective because it recovers a fragment of lost experience,
so the delusion owes its convincing power to the element of
historical truth which it inserts in the place of the rejected
reality. In this way a proposition which I originally asserted only
of hysteria would apply also to delusions - namely, that those who
are subject to them are suffering from their own reminiscences. I
never intended by this short formula to dispute the complexity of
the causation of the illness or to exclude the operation of many
other factors.