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The epigraph on the title-page of this volume indicates the tradition to which I prefer to ally myself in my conception of the dream. I am proposing to show that dreams are capable of interpretation; and any contributions to the solution of the problems which have already been discussed will emerge only as possible by-products in the accomplishment of my special task. On the hypothesis that dreams are susceptible of interpretation, I at once find myself in disagreement with the prevailing doctrine of dreams- in fact, with all the theories of dreams, excepting only that of Scherner, for to interpret a dream is to specify its meaning, to replace it by something which takes its position in the concatenation of our psychic activities as a link of definite importance and value. But, as we have seen, the scientific theories of the dream leave no room for a problem of dream- interpretation; since, in the first place, according to these theories, dreaming is not a psychic activity at all, but a somatic process which makes itself known to the psychic apparatus by means of symbols. Lay opinion has always been opposed to these theories. It asserts its privilege of proceeding illogically, and although it admits that dreams are incomprehensible and absurd, it cannot summon up the courage to deny that dreams have any significance. Led by a dim intuition, it seems rather to assume that dreams have a meaning, albeit a hidden one; that they are intended as a substitute for some other thought-process, and that we have only to disclose this substitute correctly in order to discover the hidden meaning of the dream.
The unscientific world, therefore, has always endeavoured to interpret dreams, and by applying one or the other of two essentially different methods. The first of these methods envisages the dream-content as a whole, and seeks to replace it by another content, which is intelligible and in certain respects analogous. This is symbolic dream-interpretation; and of course it goes to pieces at the very outset in the case of those dreams which are not only unintelligible but confused. The construction which the biblical Joseph placed upon the dream of Pharaoh furnishes an example of this method. The seven fat kine, after which came seven lean ones that devoured the former, were a symbolic substitute for seven years of famine in the land of Egypt, which according to the prediction were to consume all the surplus that seven fruitful years had produced. Most of the artificial dreams contrived by the poets[1] are intended for some such symbolic interpretation, for they reproduce the thought conceived by the poet in a guise not unlike the disguise which we are wont to find in our dreams.
The idea that the dream concerns itself chiefly with the future, whose form it surmises in advance- a relic of the prophetic significance with which dreams were once invested- now becomes the motive for translating into the future the meaning of the dream which has been found by means of symbolic interpretation.
A demonstration of the manner in which one arrives at such a symbolic
interpretation cannot, of course, be given. Success remains a
matter of ingenious conjecture, of direct intuition, and for this
reason dream-interpretation has naturally been elevated into an
art which seems to depend upon extraordinary gifts.[2]
The second of the two popular methods of dream- interpretation
entirely abandons such claims. It might be described as the cipher
method, since it treats the dream as a kind of secret code in
which every sign is translated into another sign of known meaning,
according to an established key. For example, I have dreamt of
a letter, and also of a funeral or the like; I consult a "dream-book,"
and I find that "letter" is to be translated by "vexation"
and "funeral" by "engagement." It now remains
to establish a connection, which I am again to assume as pertaining
to the future, by means of the rigmarole which I have deciphered.
An interesting variant of this cipher procedure, a variant in
which its character of purely mechanical transference is to a
certain extent corrected, is presented in the work on dream-interpretation
by Artemidoros of Daldis.[3] Here not only the
dream-content, but also the personality and social position of
the dreamer are taken into consideration, so that the same dream-content
has a significance for the rich man, the married man, or the orator,
which is different from that which applies to the poor man, the
bachelor, or, let us say, the merchant. The essential point, then,
in this procedure is that the work of interpretation is not applied
to the entirety of the dream, but to each portion of the dream-content
severally, as though the dream were a conglomerate in which each
fragment calls for special treatment. Incoherent and confused
dreams are certainly those that have been responsible for the
invention of the cipher method.[4]
The worthlessness of both these popular methods of interpretation
does not admit of discussion. As regards the scientific treatment
of the subject, the symbolic method is limited in its application,
and is not susceptible of a general exposition. In the cipher
method everything depends upon whether the key, the dream-book,
is reliable, and for that all guarantees are lacking. So that
one might be tempted to grant the contention of the philosophers
and psychiatrists, and to dismiss the problem of dream-interpretation
as altogether fanciful.[5]
I have, however, come to think differently. I have been forced to perceive that here, once more, we have one of those not infrequent cases where an ancient and stubbornly retained popular belief seems to have come nearer to the truth of the matter than the opinion of modern science. I must insist that the dream actually does possess a meaning, and that a scientific method of dream-interpretation is possible. I arrived at my knowledge of this method in the following manner:
For years I have been occupied with the resolution of certain psycho-pathological structures- hysterical phobias, obsessional ideas, and the like- with therapeutic intentions. I have been so occupied, in fact, ever since I heard the significant statement of Joseph Breuer, to the effect that in these structures, regarded as morbid symptoms, solution and treatment go hand in hand.[6] Where it has been possible to trace a pathological idea back to those elements in the psychic life of the patient to which it owed its origin, this idea has crumbled away, and the patient has been relieved of it. In view of the failure of our other therapeutic efforts, and in the face of the mysterious character of these pathological conditions, it seemed to me tempting, in spite of all the difficulties, to follow the method initiated by Breuer until a complete elucidation of the subject had been achieved. I shall have occasion elsewhere to give a detailed account of the form which the technique of this procedure has finally assumed, and of the results of my efforts. In the course of these psycho-analytic studies, I happened upon the question of dream-interpretation. My patients, after I had pledged them to inform me of all the ideas and thoughts which occurred to them in connection with a given theme, related their dreams, and thus taught me that a dream may be interpolated in the psychic concatenation, which may be followed backwards from a pathological idea into the patient's memory. The next step was to treat the dream itself as a symptom, and to apply to it the method of interpretation which had been worked out for such symptoms.
For this a certain psychic preparation on the part of the patient is necessary. A twofold effort is made, to stimulate his attentiveness in respect of his psychic perceptions, and to eliminate the critical spirit in which he is ordinarily in the habit of viewing such thoughts as come to the surface. For the purpose of self-observation with concentrated attention it is advantageous that the patient should take up a restful position and close his eyes; he must be explicitly instructed to renounce all criticism of the thought-formations which he may perceive. He must also be told that the success of the psycho-analysis depends upon his noting and communicating everything that passes through his mind, and that he must not allow himself to suppress one idea because it seems to him unimportant or irrelevant to the subject, or another because it seems nonsensical. He must preserve an absolute impartiality in respect to his ideas; for if he is unsuccessful in finding the desired solution of the dream, the obsessional idea, or the like, it will be because he permits himself to be critical of them.
I have noticed in the course of my psycho-analytical work that the psychological state of a man in an attitude of reflection is entirely different from that of a man who is observing his psychic processes. In reflection there is a greater play of psychic activity than in the most attentive self-observation; this is shown even by the tense attitude and the wrinkled brow of the man in a state of reflection, as opposed to the mimic tranquillity of the man observing himself. In both cases there must be concentrated attention, but the reflective man makes use of his critical faculties, with the result that he rejects some of the thoughts which rise into consciousness after he has become aware of them, and abruptly interrupts others, so that he does not follow the lines of thought which they would otherwise open up for him; while in respect of yet other thoughts he is able to behave in such a manner that they do not become conscious at all- that is to say, they are suppressed before they are perceived. In self-observation, on the other hand, he has but one task- that of suppressing criticism; if he succeeds in doing this, an unlimited number of thoughts enter his consciousness which would otherwise have eluded his grasp. With the aid of the material thus obtained- material which is new to the self-observer- it is possible to achieve the interpretation of pathological ideas, and also that of dream-formations. As will be seen, the point is to induce a psychic state which is in some degree analogous, as regards the distribution of psychic energy (mobile attention), to the state of the mind before falling asleep- and also, of course, to the hypnotic state. On falling asleep the undesired ideas emerge, owing to the slackening of a certain arbitrary (and, of course, also critical) action, which is allowed to influence the trend of our ideas; we are accustomed to speak of fatigue as the reason of this slackening; the emerging undesired ideas are changed into visual and auditory images. In the condition which it utilized for the analysis of dreams and pathological ideas, this activity is purposely and deliberately renounced, and the psychic energy thus saved (or some part of it) is employed in attentively tracking the undesired thoughts which now come to the surface- thoughts which retain their identity as ideas (in which the condition differs from the state of falling asleep). Undesired ideas are thus changed into desired ones.
There are many people who do not seem to find it easy to adopt the required attitude toward the apparently "freely rising" ideas, and to renounce the criticism which is otherwise applied to them. The "undesired ideas" habitually evoke the most violent resistance, which seeks to prevent them from coming to the surface. But if we may credit our great poet-philosopher Friedrich Schiller, the essential condition of poetical creation includes a very similar attitude. In a certain passage in his correspondence with Korner (for the tracing of which we are indebted to Otto Rank), Schiller replies in the following words to a friend who complains of his lack of creative power: "The reason for your complaint lies, it seems to me, in the constraint which your intellect imposes upon your imagination. Here I will make an observation, and illustrate it by an allegory. Apparently it is not good- and indeed it hinders the creative work of the mind- if the intellect examines too closely the ideas already pouring in, as it were, at the gates. Regarded in isolation, an idea may be quite insignificant, and venturesome in the extreme, but it may acquire importance from an idea which follows it; perhaps, in a certain collocation with other ideas, which may seem equally absurd, it may be capable of furnishing a very serviceable link. The intellect cannot judge all these ideas unless it can retain them until it has considered them in connection with these other ideas. In the case of a creative mind, it seems to me, the intellect has withdrawn its watchers from the gates, and the ideas rush in pell-mell, and only then does it review and inspect the multitude. You worthy critics, or whatever you may call yourselves, are ashamed or afraid of the momentary and passing madness which is found in all real creators, the longer or shorter duration of which distinguishes the thinking artist from the dreamer. Hence your complaints of unfruitfulness, for you reject too soon and discriminate too severely" (letter of December 1, 1788).
And yet, such a withdrawal of the watchers from the gates of the intellect, as Schiller puts it, such a translation into the condition of uncritical self-observation, is by no means difficult.
Most of my patients accomplish it after my first instructions. I myself can do so very completely, if I assist the process by writing down the ideas that flash through my mind. The quantum of psychic energy by which the critical activity is thus reduced, and by which the intensity of self-observation may be increased, varies considerably according to the subject-matter upon which the attention is to be fixed.
The first step in the application of this procedure teaches us that one cannot make the dream as a whole the object of one's attention, but only the individual components of its content. If I ask a patient who is as yet unpractised: "What occurs to you in connection with this dream?" he is unable, as a rule, to fix upon anything in his psychic field of vision. I must first dissect the dream for him; then, in connection with each fragment, he gives me a number of ideas which may be described as the thoughts behind this part of the dream. In this first and important condition, then, the method of dream-interpretation which I employ diverges from the popular, historical and legendary method of interpretation by symbolism and approaches more nearly to the second or cipher method. Like this, it is an interpretation in detail, not en masse; like this, it conceives the dream, from the outset, as something built up, as a conglomerate of psychic formations.
In the course of my psycho-analysis of neurotics I have already subjected perhaps more than a thousand dreams to interpretation, but I do not wish to use this material now as an introduction to the theory and technique of dream-interpretation. For quite apart from the fact that I should lay myself open to the objection that these are the dreams of neuropaths, so that the conclusions drawn from them would not apply to the dreams of healthy persons, there is another reason that impels me to reject them. The theme to which these dreams point is, of course, always the history of the malady that is responsible for the neurosis. Hence every dream would require a very long introduction, and an investigation of the nature and aetiological conditions of the psychoneuroses, matters which are in themselves novel and exceedingly strange, and which would therefore distract attention from the dream- problem proper. My purpose is rather to prepare the way, by the solution of the dream-problem, for the solution of the more difficult problems of the psychology of the neuroses. But if I eliminate the dreams of neurotics, which constitute my principal material, I cannot be too fastidious in my treatment of the rest. Only those dreams are left which have been incidentally related to me by healthy persons of my acquaintance, or which I find given as examples in the literature of dream-life. Unfortunately, in all these dreams I am deprived of the analysis without which I cannot find the meaning of the dream. My mode of procedure is, of course, less easy than that of the popular cipher method, which translates the given dream-content by reference to an established key; I, on the contrary, hold that the same dream-content may conceal a different meaning in the case of different persons, or in different connections. I must, therefore, resort to my own dreams as a source of abundant and convenient material, furnished by a person who is more or less normal, and containing references to many incidents of everyday life. I shall certainly be confronted with doubts as to the trustworthiness of these self- analyses and it will be said that arbitrariness is by no means excluded in such analyses. In my own judgment, conditions are more likely to be favourable in self-observation than in the observation of others; in any case, it is permissible to investigate how much can be accomplished in the matter of dream- interpretation by means of self-analysis. There are other difficulties which must be overcome in my own inner self. One has a comprehensible aversion to exposing so many intimate details of one's own psychic life, and one does not feel secure against the misinterpretations of strangers. But one must be able to transcend such considerations. "Tout psychologiste," writes Delboeuf, "est oblige de faire l'aveu meme de ses faiblesses s'il croit par la jeter du jour sur quelque probleme obscur."[7] And I may assume for the reader that his initial interest in the indiscretions which I must commit will very soon give way to an exclusive engrossment in the psychological problems elucidated by them.'[8]
I shall therefore select one of my own dreams for the purpose of elucidating my method of interpretation. Every such dream necessitates a preliminary statement; so that I must now beg the reader to make my interests his own for a time, and to become absorbed, with me, in the most trifling details of my life; for an interest in the hidden significance of dreams imperatively demands just such a transference.
In the summer of 1895 I had treated psycho-analytically a young lady who was an intimate friend of mine and of my family. It will be understood that such complicated relations may excite manifold feelings in the physician, and especially the psychotherapist. The personal interest of the physician is greater, but his authority less. If he fails, his friendship with the patient's relatives is in danger of being undermined. In this case, however, the treatment ended in partial success; the patient was cured of her hysterical anxiety, but not of all her somatic symptoms. At that time I was not yet quite sure of the criteria which denote the final cure of an hysterical case, and I expected her to accept a solution which did not seem acceptable to her. In the midst of this disagreement, we discontinued the treatment for the summer holidays. One day a younger colleague, one of my most intimate friends, who had visited the patient- Irma- and her family in their country residence, called upon me. I asked him how Irma was, and received the reply: "She is better, but not quite well." I realize that these words of my friend Otto's, or the tone of voice in which they were spoken, annoyed me. I thought I heard a reproach in the words, perhaps to the effect that I had promised the patient too much, and- rightly or wrongly- I attributed Otto's apparent taking sides against me to the influence of the patient's relatives, who, I assumed, had never approved of my treatment. This disagreeable impression, however, did not become clear to me, nor did I speak of it. That same evening I wrote the clinical history of Irma's case, in order to give it, as though to justify myself, to Dr. M, a mutual friend, who was at that time the leading personality in our circle. During the night (or rather in the early morning) I had the following dream, which I recorded immediately after waking.[9]
A great hall- a number of guests, whom we are receiving- among them Irma, whom I immediately take aside, as though to answer her letter, and to reproach her for not yet accepting the "solution." I say to her: "If you still have pains, it is really only your own fault."- She answers: "If you only knew what pains I have now in the throat, stomach, and abdomen- I am choked by them." I am startled, and look at her. She looks pale and puffy. I think that after all I must be overlooking some organic affection. I take her to the window and look into her throat. She offers some resistance to this, like a woman who has a set of false teeth. I think, surely, she doesn't need them.- The mouth then opens wide, and I find a large white spot on the right, and elsewhere I see extensive grayish-white scabs adhering to curiously curled formations, which are evidently shaped like the turbinal bones of the nose.- I quickly call Dr. M, who repeats the examination and confirms it.... Dr. M looks quite unlike his usual self; he is very pale, he limps, and his chin is clean-shaven.... Now my friend Otto, too, is standing beside her, and my friend Leopold percusses her covered chest, and says "She has a dullness below, on the left," and also calls attention to an infiltrated portion of skin on the left shoulder (which I can feel, in spite of the dress).... M says: "There's no doubt that it's an infection, but it doesn't matter; dysentery will follow and the poison will be eliminated." ... We know, too, precisely how the infection originated. My friend Otto, not long ago, gave her, when she was feeling unwell, an injection of a preparation of propyl... propyls... propionic acid... trimethylamin (the formula of which I see before me, printed in heavy type).... One doesn't give such injections so rashly.... Probably, too, the syringe was not clean.
This dream has an advantage over many others. It is at once obvious to what events of the preceding day it is related, and of what subject it treats. The preliminary statement explains these matters. The news of Irma's health which I had received from Otto, and the clinical history, which I was writing late into the night, had occupied my psychic activities even during sleep. Nevertheless, no one who had read the preliminary report, and had knowledge of the content of the dream, could guess what the dream signified. Nor do I myself know. I am puzzled by the morbid symptoms of which Irma complains in the dream, for they are not the symptoms for which I treated her. I smile at the nonsensical idea of an injection of propionic acid, and at Dr. M's attempt at consolation. Towards the end the dream seems more obscure and quicker in tempo than at the beginning. In order to learn the significance of all these details I resolve to undertake an exhaustive analysis.
The hall- a number of guests, whom we are receiving. We were living that summer at Bellevue, an isolated house on one of the hills adjoining the Kahlenberg. This house was originally built as a place of entertainment, and therefore has unusually lofty, hall-like rooms. The dream was dreamed in Bellevue, a few days before my wife's birthday. During the day my wife had mentioned that she expected several friends, and among them Irma, to come to us as guests for her birthday. My dream, then, anticipates this situation: It is my wife's birthday, and we are receiving a number of people, among them Irma, as guests in the large hall of Bellevue.
I reproach Irma for not having accepted the "solution." I say, "If you still have pains, it is really your own fault." I might even have said this while awake; I may have actually said it. At that time I was of the opinion (recognized later to be incorrect) that my task was limited to informing patients of the hidden meaning of their symptoms. Whether they then accepted or did not accept the solution upon which success depended- for that I was not responsible. I am grateful to this error, which, fortunately, has now been overcome, since it made life easier for me at a time when, with all my unavoidable ignorance, I was expected to effect successful cures. But I note that, in the speech which I make to Irma in the dream, I am above all anxious that I shall not be blamed for the pains which she still suffers. If it is Irma's own fault, it cannot be mine. Should the purpose of the dream be looked for in this quarter?
Irma's complaints- pains in the neck, abdomen, and stomach; she is choked by them. Pains in the stomach belonged to the symptom- complex of my patient, but they were not very prominent; she complained rather of qualms and a feeling of nausea. Pains in the neck and abdomen and constriction of the throat played hardly any part in her case. I wonder why I have decided upon this choice of symptoms in the dream; for the moment I cannot discover the reason.
She looks pale and puffy. My patient had always a rosy complexion. I suspect that here another person is being substituted for her.
I am startled at the idea that I may have overlooked some organic affection. This, as the reader will readily believe, is a constant fear with the specialist who sees neurotics almost exclusively, and who is accustomed to ascribe to hysteria so many manifestations which other physicians treat as organic. On the other hand, I am haunted by a faint doubt- I do not know whence it comes- whether my alarm is altogether honest. If Irma's pains are indeed of organic origin, it is not my duty to cure them. My treatment, of course, removes only hysterical pains. It seems to me, in fact, that I wish to find an error in the diagnosis; for then I could not be reproached with failure to effect a cure.
I take her to the window in order to look into her throat. She resists a little, like a woman who has false teeth. I think to myself, she does not need them. I had never had occasion to inspect Irma's oral cavity. The incident in the dream reminds me of an examination, made some time before, of a governess who at first produced an impression of youthful beauty, but who, upon opening her mouth, took certain measures to conceal her denture. Other memories of medical examinations, and of petty secrets revealed by them, to the embarrassment of both physician and patient, associate themselves with this case.- "She surely does not need them," is perhaps in the first place a compliment to Irma; but I suspect yet another meaning. In a careful analysis one is able to feel whether or not the arriere-pensees which are to be expected have all been exhausted. The way in which Irma stands at the window suddenly reminds me of another experience. Irma has an intimate woman friend of whom I think very highly. One evening, on paying her a visit, I found her at the window in the position reproduced in the dream, and her physician, the same Dr. M, declared that she had a diphtheritic membrane. The person of Dr. M and the membrane return, indeed, in the course of the dream. Now it occurs to me that during the past few months I have had every reason to suppose that this lady too is hysterical. Yes, Irma herself betrayed the fact to me. But what do I know of her condition? Only the one thing, that like Irma in the dream she suffers from hysterical choking. Thus, in the dream I have replaced my patient by her friend. Now I remember that I have often played with the supposition that this lady, too, might ask me to relieve her of her symptoms. But even at the time I thought it improbable, since she is extremely reserved. She resists, as the dream shows. Another explanation might be that she does not need it; in fact, until now she has shown herself strong enough to master her condition without outside help. Now only a few features remain, which I can assign neither to Irma nor to her friend; pale, puffy, false teeth. The false teeth led me to the governess; I now feel inclined to be satisfied with bad teeth. Here another person, to whom these features may allude, occurs to me. She is not my patient, and I do not wish her to be my patient, for I have noticed that she is not at her ease with me, and I do not consider her a docile patient. She is generally pale, and once, when she had not felt particularly well, she was puffy.[10] I have thus compared my patient Irma with two others, who would likewise resist treatment. What is the meaning of the fact that I have exchanged her for her friend in the dream? Perhaps that I wish to exchange her; either her friend arouses in me stronger sympathies, or I have a higher regard for her intelligence. For I consider Irma foolish because she does not accept my solution. The other woman would be more sensible, and would thus be more likely to yield. The mouth then opens readily; she would tell more than Irma.[11]
What I see in the throat: a white spot and scabby turbinal bones. The white spot recalls diphtheria, and thus Irma's friend, but it also recalls the grave illness of my eldest daughter two years earlier, and all the anxiety of that unhappy time. The scab on the turbinal bones reminds me of my anxiety concerning my own health. At that time I frequently used cocaine in order to suppress distressing swellings in the nose, and I had heard a few days previously that a lady patient who did likewise had contracted an extensive necrosis of the nasal mucous membrane. In 1885 it was I who had recommended the use of cocaine, and I had been gravely reproached in consequence. A dear friend, who had died before the date of this dream, had hastened his end by the misuse of this remedy.
I quickly call Dr. M, who repeats the examination. This would simply correspond to the position which M occupied among us. But the word quickly is striking enough to demand a special examination. It reminds me of a sad medical experience. By continually prescribing a drug (sulphonal), which at that time was still considered harmless, I was once responsible for a condition of acute poisoning in the case of a woman patient, and hastily turned for assistance to my older and more experienced colleague. The fact that I really had this case in mind is confirmed by a subsidiary circumstance. The patient, who succumbed to the toxic effects of the drug, bore the same name as my eldest daughter. I had never thought of this until now; but now it seems to me almost like a retribution of fate- as though the substitution of persons had to be continued in another sense: this Matilda for that Matilda; an eye for an eye, a tooth for a tooth. It is as though I were seeking every opportunity to reproach myself for a lack of medical conscientiousness.
Dr. M is pale; his chin is shaven, and he limps. Of this so much is correct, that his unhealthy appearance often arouses the concern of his friends. The other two characteristics must belong to another person. An elder brother living abroad occurs to me, for he, too, shaves his chin, and if I remember him rightly, the M of the dream bears on the whole a certain resemblance to him. And some days previously the news arrived that he was limping on account of an arthritic affection of the hip. There must be some reason why I fuse the two persons into one in my dream. I remember that, in fact, I was on bad terms with both of them for similar reasons. Both had rejected a certain proposal which I had recently made them.
My friend Otto is now standing next to the patient, and my friend Leopold examines her and calls attention to a dulness low down on the left side. My friend Leopold also is a physician, and a relative of Otto's. Since the two practice the same specialty, fate has made them competitors, so that they are constantly being compared with one another. Both of them assisted me for years, while I was still directing a public clinic for neurotic children. There, scenes like that reproduced in my dream had often taken place. While I would be discussing the diagnosis of a case with Otto, Leopold would examine the child anew and make an unexpected contribution towards our decision. There was a difference of character between the two men like that between Inspector Brasig and his friend Karl. Otto was remarkably prompt and alert; Leopold was slow and thoughtful, but thorough. If I contrast Otto and the cautious Leopold in the dream I do so, apparently, in order to extol Leopold. The comparison is like that made above between the disobedient patient Irma and her friend, who was believed to be more sensible. I now become aware of one of the tracks along which the association of ideas in the dream proceeds: from the sick child to the children's clinic. Concerning the dulness low on the left side, I have the impression that it corresponds with a certain case of which all the details were similar, a case in which Leopold impressed me by his thoroughness. I thought vaguely, too, of something like a metastatic affection, but it might also be a reference to the patient whom I should have liked to have in Irma's place. For this lady, as far as I can gather, exhibited symptoms which imitated tuberculosis.
An infiltrated portion of skin on the left shoulder. I know at once that this is my own rheumatism of the shoulder, which I always feel if I lie awake long at night. The very phrasing of the dream sounds ambiguous: Something which I can feel, as he does, in spite of the dress. "Feel on my own body" is intended. Further, it occurs to me how unusual the phrase infiltrated portion of skin sounds. We are accustomed to the phrase: "an infiltration of the upper posterior left"; this would refer to the lungs, and thus, once more, to tuberculosis.
In spite of the dress. This, to be sure, is only an interpolation. At the clinic the children were, of course, examined undressed; here we have some contrast to the manner in which adult female patients have to be examined. The story used to be told of an eminent physician that he always examined his patients through their clothes. The rest is obscure to me; I have, frankly, no inclination to follow the matter further.
Dr. M says: "It's an infection, but it doesn't matter; dysentery will follow, and the poison will be eliminated." This, at first, seems to me ridiculous; nevertheless, like everything else, it must be carefully analysed; more closely observed it seems after all to have a sort of meaning. What I had found in the patient was a local diphtheritis. I remember the discussion about diphtheritis and diphtheria at the time of my daughter's illness. Diphtheria is the general infection which proceeds from local diphtheritis. Leopold demonstrates the existence of such a general infection by the dulness, which also suggests a metastatic focus. I believe, however, that just this kind of metastasis does not occur in the case of diphtheria. It reminds me rather of pyaemia.
It doesn't matter is a consolation. I believe it fits in as follows: The last part of the dream has yielded a content to the effect that the patient's sufferings are the result of a serious organic affection. I begin to suspect that by this I am only trying to shift the blame from myself. Psychic treatment cannot be held responsible for the continued presence of a diphtheritic affection. Now, indeed, I am distressed by the thought of having invented such a serious illness for Irma, for the sole purpose of exculpating myself. It seems so cruel. Accordingly, I need the assurance that the outcome will be benign, and it seems to me that I made a good choice when I put the words that consoled me into the mouth of Dr. M. But here I am placing myself in a position of superiority to the dream; a fact which needs explanation.
But why is this consolation so nonsensical?
Dysentery. Some sort of far-fetched theoretical notion that the toxins of disease might be eliminated through the intestines. Am I thereby trying to make fun of Dr. M's remarkable store of far- fetched explanations, his habit of conceiving curious pathological relations? Dysentery suggests something else. A few months ago I had in my care a young man who was suffering from remarkable intestinal troubles; a case which had been treated by other colleagues as one of "anaemia with malnutrition." I realized that it was a case of hysteria; I was unwilling to use my psycho-therapy on him, and sent him off on a sea-voyage. Now a few days previously I had received a despairing letter from him; he wrote from Egypt, saying that he had had a fresh attack, which the doctor had declared to be dysentery. I suspect that the diagnosis is merely an error on the part of an ignorant colleague, who is allowing himself to be fooled by the hysteria; yet I cannot help reproaching myself for putting the invalid in a position where he might contract some organic affection of the bowels in addition to his hysteria. Furthermore, dysentery sounds not unlike diphtheria, a word which does not occur in the dream.
Yes, it must be the case that with the consoling prognosis, Dysentery will develop, etc., I am making fun of Dr. M, for I recollect that years ago he once jestingly told a very similar story of a colleague. He had been called in to consult with him in the case of a woman who was very seriously ill, and he felt obliged to confront his colleague, who seemed very hopeful, with the fact that he found albumen in the patient's urine. His colleague, however, did not allow this to worry him, but answered calmly: "That does not matter, my dear sir; the albumen will soon be excreted!" Thus I can no longer doubt that this part of the dream expresses derision for those of my colleagues who are ignorant of hysteria. And, as though in confirmation, the thought enters my mind: "Does Dr. M know that the appearances in Irma's friend, his patient, which gave him reason to fear tuberculosis, are likewise due to hysteria? Has he recognized this hysteria, or has he allowed himself to be fooled?"
But what can be my motive in treating this friend so badly? That is simple enough: Dr. M agrees with my solution as little as does Irma herself. Thus, in this dream I have already revenged myself on two persons: on Irma in the words, If you still have pains, it is your own fault, and on Dr. M in the wording of the nonsensical consolation which has been put into his mouth.
We know precisely how the infection originated. This precise knowledge in the dream is remarkable. Only a moment before this we did not yet know of the infection, since it was first demonstrated by Leopold.
My friend Otto gave her an injection not long ago, when she was feeling unwell. Otto had actually related during his short visit to Irma's family that he had been called in to a neighbouring hotel in order to give an injection to someone who had been suddenly taken ill. Injections remind me once more of the unfortunate friend who poisoned himself with cocaine. I had recommended the remedy for internal use only during the withdrawal of morphia; but he immediately gave himself injections of cocaine.
With a preparation of propyl... propyls... propionic acid. How on earth did this occur to me? On the evening of the day after I had written the clinical history and dreamed about the case, my wife opened a bottle of liqueur labelled "Ananas,"[12] which was a present from our friend Otto. He had, as a matter of fact, a habit of making presents on every possible occasion; I hope he will some day be cured of this by a wife.[13] This liqueur smelt so strongly of fusel oil that I refused to drink it. My wife suggested: "We will give the bottle to the servants," and I, more prudent, objected, with the philanthropic remark: "They shan't be poisoned either." The smell of fusel oil (amyl...) has now apparently awakened my memory of the whole series: propyl, methyl, etc., which furnished the preparation of propyl mentioned in the dream. Here, indeed, I have effected a substitution: I dreamt of propyl after smelling amyl; but substitutions of this kind are perhaps permissible, especially in organic chemistry. -
Trimethylamin. In the dream I see the chemical formula of this substance- which at all events is evidence of a great effort on the part of my memory- and the formula is even printed in heavy type, as though to distinguish it from the context as something of particular importance. And where does trimethylamin, thus forced on my attention, lead me? To a conversation with another friend, who for years has been familiar with all my germinating ideas, and I with his. At that time he had just informed me of certain ideas concerning a sexual chemistry, and had mentioned, among others, that he thought he had found in trimethylamin one of the products of sexual metabolism. This substance thus leads me to sexuality, the factor to which I attribute the greatest significance in respect of the origin of these nervous affections which I am trying to cure. My patient Irma is a young widow; if I am required to excuse my failure to cure her, I shall perhaps do best to refer to this condition, which her admirers would be glad to terminate. But in what a singular fashion such a dream is fitted together! The friend who in my dream becomes my patient in Irma's place is likewise a young widow.
I surmise why it is that the formula of trimethylamin is so insistent in the dream. So many important things are centered about this one word: trimethylamin is an allusion, not merely to the all-important factor of sexuality, but also to a friend whose sympathy I remember with satisfaction whenever I feel isolated in my opinions. And this friend, who plays such a large part in my life: will he not appear yet again in the concatenation of ideas peculiar to this dream? Of course; he has a special knowledge of the results of affections of the nose and the sinuses, and has revealed to science several highly remarkable relations between the turbinal bones and the female sexual organs. (The three curly formations in Irma's throat.) I got him to examine Irma, in order to determine whether her gastric pains were of nasal origin. But he himself suffers from suppurative rhinitis, which gives me concern, and to this perhaps there is an allusion in pyaemia, which hovers before me in the metastasis of the dream.
One doesn't give such injections so rashly. Here the reproach of rashness is hurled directly at my friend Otto. I believe I had some such thought in the afternoon, when he seemed to indicate, by word and look, that he had taken sides against me. It was, perhaps: "How easily he is influenced; how irresponsibly he pronounces judgment." Further, the above sentence points once more to my deceased friend, who so irresponsibly resorted to cocaine injections. As I have said, I had not intended that injections of the drug should be taken. I note that in reproaching Otto I once more touch upon the story of the unfortunate Matilda, which was the pretext for the same reproach against me. Here, obviously, I am collecting examples of my conscientiousness, and also of the reverse.
Probably too the syringe was not clean. Another reproach directed at Otto, but originating elsewhere. On the previous day I happened to meet the son of an old lady of eighty-two, to whom I am obliged to give two injections of morphia daily. At present she is in the country, and I have heard that she is suffering from phlebitis. I immediately thought that this might be a case of infiltration caused by a dirty syringe. It is my pride that in two years I have not given her a single infiltration; I am always careful, of course, to see that the syringe is perfectly clean. For I am conscientious. From the phlebitis I return to my wife, who once suffered from thrombosis during a period of pregnancy, and now three related situations come to the surface in my memory, involving my wife, Irma, and the dead Matilda, whose identity has apparently justified my putting these three persons in one another's places.
I have now completed the interpretation of the dream.[14] In the course of this interpretation I have taken great pains to avoid all those notions which must have been suggested by a comparison of the dream-content with the dream-thoughts hidden behind this content. Meanwhile the meaning of the dream has dawned upon me. I have noted an intention which is realized through the dream, and which must have been my motive in dreaming. The dream fulfills several wishes, which were awakened within me by the events of the previous evening (Otto's news, and the writing of the clinical history). For the result of the dream is that it is not I who am to blame for the pain which Irma is still suffering, but that Otto is to blame for it. Now Otto has annoyed me by his remark about Irma's imperfect cure; the dream avenges me upon him, in that it turns the reproach upon himself. The dream acquits me of responsibility for Irma's condition, as it refers this condition to other causes (which do, indeed, furnish quite a number of explanations). The dream represents a certain state of affairs, such as I might wish to exist; the content of the dream is thus the fulfilment of a wish; its motive is a wish.
This much is apparent at first sight. But many other details of the dream become intelligible when regarded from the standpoint of wish-fulfilment. I take my revenge on Otto, not merely for too readily taking sides against me. in that I accuse him of careless medical treatment (the injection), but I revenge myself also for the bad liqueur which smells of fusel oil, and I find an expression in the dream which unites both these reproaches: the injection of a preparation of propyl. Still I am not satisfied, but continue to avenge myself by comparing him with his more reliable colleague. Thereby I seem to say: "I like him better than you." But Otto is not the only person who must be made to feel the weight of my anger. I take my revenge on the disobedient patient, by exchanging her for a more sensible and more docile one. Nor do I pass over Dr. M's contradiction; for I express, in an obvious allusion, my opinion of him: namely, that his attitude in this case is that of an ignoramus (Dysentery will develop, etc.). Indeed, it seems as though I were appealing from him to someone better informed (my friend, who told me about trimethylamin), just as I have turned from Irma to her friend, and from Otto to Leopold. It is as though I were to say: Rid me of these three persons, replace them by three others of my own choice, and I shall be rid of the reproaches which I am not willing to admit that I deserve! In my dream the unreasonableness of these reproaches is demonstrated for me in the most elaborate manner. Irma's pains are not attributable to me, since she herself is to blame for them, in that she refuses to accept my solution. They do not concern me, for being as they are of an organic nature, they cannot possibly be cured by psychic treatment. Irma's sufferings are satisfactorily explained by her widowhood (trimethylamin!); a state which I cannot alter. Irma's illness has been caused by an incautious injection administered by Otto, an injection of an unsuitable drug, such as I should never have administered. Irma's complaint is the result of an injection made with an unclean syringe, like the phlebitis of my old lady patient, whereas my injections have never caused any ill effects. I am aware that these explanations of Irma's illness, which unite in acquitting me, do not agree with one another; that they even exclude one another. The whole plea- for this dream is nothing else- recalls vividly the defence offered by a man who was accused by his neighbour of having returned a kettle in a damaged condition. In the first place, he had returned the kettle undamaged; in the second place it already had holes in it when he borrowed it; and in the third place, he had never borrowed it at all. A complicated defence, but so much the better; if only one of these three lines of defence is recognized as valid, the man must be acquitted.
Still other themes play a part in the dream, and their relation to my non-responsibility for Irma's illness is not so apparent: my daughter's illness, and that of a patient with the same name; the harmfulness of cocaine; the affection of my patient, who was traveling in Egypt; concern about the health of my wife; my brother, and Dr. M; my own physical troubles, and anxiety concerning my absent friend, who is suffering from suppurative rhinitis. But if I keep all these things in view, they combine into a single train of thought, which might be labelled: Concern for the health of myself and others; professional conscientiousness. I recall a vaguely disagreeable feeling when Otto gave me the news of Irma's condition. Lastly, I am inclined, after the event, to find an expression of this fleeting sensation in the train of thoughts which forms part of the dream. It is as though Otto had said to me: "You do not take your medical duties seriously enough; you are not conscientious; you do not perform what you promise." Thereupon this train of thought placed itself at my service, in order that I might give proof of my extreme conscientiousness, of my intimate concern about the health of my relatives, friends and patients. Curiously enough, there are also some painful memories in this material, which confirm the blame attached to Otto rather than my own exculpation. The material is apparently impartial, but the connection between this broader material, on which the dream is based, and the more limited theme from which emerges the wish to be innocent of Irma's illness, is, nevertheless, unmistakable.
I do not wish to assert that I have entirely revealed the meaning of the dream, or that my interpretation is flawless.
I could still spend much time upon it; I could draw further explanations
from it, and discuss further problems which it seems to propound.
I can even perceive the points from which further mental associations
might be traced; but such considerations as are always involved
in every dream of one's own prevent me from interpreting it farther.
Those who are overready to condemn such reserve should make the
experiment of trying to be more straightforward. For the present
I am content with the one fresh discovery which has just been
made: If the method of dream- interpretation here indicated is
followed, it will be found that dreams do really possess a meaning,
and are by no means the expression of a disintegrated cerebral
activity, as the writers on the subject would have us believe.
When the work of interpretation has been completed the dream can
be recognized as a wish fulfilment.
[6] Studien uber Hysterie, 1895. [Compare page 26 above.]
[9] This is the first dream which I subjected to an exhaustive interpretation.
[12] "Ananas," moreover, has a remarkable assonance with the family name of my patient Irma.