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Christopher D. Green
York University, Toronto, Ontario
ISSN 1492-3173
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By William H.R. Rivers (1920)
Posted May 2000
APPENDIX I
FREUD'S PSYCHOLOGY OF THE UNCONSCIOUS [1]
The usual course of scientific progress has been well exemplified, though perhaps in an exaggerated form, by the history of the theory of the unconscious put forward by Sigmund Freud, of Vienna. Few scientific theories escape the fate of being pushed by their advocates beyond the positions which they are fitted to hold, with the result that, failing to fulfil the expectations thus aroused, their merits are under-estimated or they are even thrust into the limbo reserved for dead hypotheses, only to be rescued therefrom by some later generation. If we are to trust the contemporary medical literature of Great Britain, this fate is now in store for Freud's theory of the unconscious. His views, or perhaps rather their applications, have stirred up such a hotbed of prejudice and misunderstanding that their undoubted merits are in serious danger of being obscured, or even wholly lost to view, in the conflict produced by the extravagance of Freud's adherents and the rancour of their opponents. This paper is an attempt to deal with the subject dispassionately from the point of view of one who has only temporarily been drawn by current events into the neighbourhood of the maelstrom of medical controversy.
The first point which may be noted is that Freud's theory of the unconscious is of far wider application than the perusal of recent medical literature would suggest. It is true that Freud is a physician and that he was led to his theory of the unconscious by the study of disease, but his theory is one which [p. 160] concerns a universal problem of psychology. If it is true, it must be taken into account, not only by the physician, but by the teacher, the politician, the moralist, the sociologist,[2] and every other worker who is concerned with the study of human conduct. Not only does the medical controversialist fail to recognise that he is dealing only with one corner of the subject, but too often he looks on the whole matter entirely from the so-called practical standpoint and judges a theory of universal interest by the consequences which follow the application of the theory in the hands of the more extravagant of its adherents. It is possible, even probable, that the practical application of Freud's theory of the unconscious in the domain of medicine may come to be held as one of its least important aspects, and that it is in other branches of human activity that its importance will in future be greatest. I may perhaps mention here that my own belief in the value of Freud's theory of the unconscious as a guide to the better understanding of human conduct is not so much based on my clinical experience as on general observation of human behaviour, on evidence provided by the experience of my friends, and most of all on the observation of my own mental activity, waking and sleeping.
In the mixture of invective and witticism which may pass for a serious contribution to the subject in the medical literature of this country, an objection frequently put forward is that in postulating unconscious mental states Freud is putting together incompatible and contradictory ideas. One possible course is that those who make this objection should see whether it is not possible to enlarge their conception of the mind, but to those who find this impossible a way out of the difficulty may be suggested. It would be an advantage if, instead of speaking of unconscious mental states, we were to speak of unconscious experience. Everyone would acknowledge that adult human beings have been the subjects of a vast body of experience of which they have no manifest memory, which does not enter into their manifest consciousness. Everyone would, I think, also be [p. 161] prepared to acknowledge that this body of unconscious experience influences our thoughts and actions, our feelings and sentiments. When we speak of such unconscious experience, we are keeping within the realm of obvious fact, although we are ignoring the problem concerned with the form in which the experience exists. Whether this unconscious experience is, or is not, to be included within the connotation of mind is largely verbal and depends on the definition of mind which we adopt. Since the science of psychology has until lately been almost exclusively concerned with problems of definition and description, it is natural that such a concept as that of Freud should meet with opposition, because it does not fit immediately into current systems of definition. The matter will perhaps become clearer if we consider the closely related body of experience which we term heredity. This term is only the name we have adopted for ancestral experience. When we discuss whether a given phenomenon, such as a morbid mental state, is due to heredity, what we are really discussing is how far the morbid state is the consequence of the experience of the ancestors of the patient. There have been those, such as Hering and Samuel Butler, who have extended the connotation of a psychological term so as to include this ancestral experience, and have regarded heredity as a species of memory. According to the more generally accepted usage this vast body of unconscious experience is not thought of as a whole in psychological terms. There are, however, certain elements in this ancestral experience which psychologists have singled out from the rest and; have termed instincts, and they are agreed in holding that instincts form part of the subject-matter of psychology. If such unconscious elements derived from ancestral experience are by universal assent included within the scope of the mind, it is difficult to understand how it is possible to exclude unconscious experience acquired in the lifetime of the individual. It would be humorous, if it were not pathetic, that many of those who object most strongly to Freud's views concerning the rôle of unconscious individual experience in the production of abnormal bodily and mental states should be loudest in the appreciation of the part [p 162] taken by that ancestral experience for which they use the term, too often the shibboleth, heredity.
Far more important than the largely verbal question, whether the unconscious influences which mould our conduct are or are not to be regarded as constituents of: the mind, is the question concerning that which distinguishes Freud's theory of the unconscious from other theories which deal with this subject. A favourite statement concerning Freud's theory is that its fundamental idea is mental conflict. Standing out prominently in the system of Freud is the idea of conflict between the mental tendencies of the individual and the traditional code of conduct prescribed by the society to which the individual belongs. This conflict, however, was fully recognised by psychologists long before Freud. if this idea were the chief characteristic of his theory, no great claim for novelty or originality could be advanced. If a writer were to point to conflict as characteristic of human society, few would regard the proposition as either profound or especially illuminating, and the idea of mental conflict is in much the same case. The feature which makes Freud's theory noteworthy is his scheme of the nature of the opponents in the conflict, and of the mechanism by which the conflict is conducted.
Another concept characteristic of Freud's psychology is that of dissociation, but here again the idea is older than Freud, and forms part of systems of psychology very different from his. The special merit of Freud's theory in this respect is that it provides a psychological theory of dissociation, of the factors upon which it depends, acid of the processes by which its effects can be overcome.
There is much to be said for a view which would regard as a distinctive feature of Freud's system his theory of forgetting. According to the views long current in psychology, forgetting is a passive process which stands in no special need of explanation. According to these older views, experience is remembered in so far as it is frequently repeated and according as it is interesting and arouses emotion, pleasant or unpleasant. It has been frequently recognised, however, that it is forgetting rather than [p. 163] remembering which needs explanation. It is, perhaps, the greatest merit of Freud's theory that it provides us with such an explanation. According to Freud, forgetting -- and especially the forgetting of unpleasant experience -- is not a passive but an active process, one in which such experience is thrust out of consciousness and kept under control by a mechanism which by a metaphorical simile Freud has termed the censorship. This censorship is Supposed to act as a constant guard, only allowing the suppressed experience to reach consciousness in sleep, hypnotism, and automatic or other states in which the normal control of the censorship is removed or weakened. Even when the censorship thus permits the suppressed experience to become manifest, the experience is often only allowed to show itself in an indirect and often symbolic manner. It is this belief in a process of active suppression of unpleasant experience which is the special characteristic of Freud's theory of the unconscious, and it is his doctrine of the part taken by such suppressed experience in the production of bodily and mental disorder which is the leading feature of his theory in its relation to medicine. According to Freud many morbid mental states and many bodily states dependent on mental disturbance are due to a conflict between bodies of suppressed experience, now usually called "complexes" and the general personality of the sufferer.
Still more important than nomenclature m theoretical basis as a cause of prejudice and misunderstanding has been the stress which Freud and his followers have laid upon sexual experience as the material of morbid complexes. In his theory Freud uses the term "sexual" with a far wider connotation than is customary, using it to comprise anything which is either directly or indirectly connected with the process of reproduction. His followers, however, and to a large extent Freud himself, have become so engrossed with the cruder side of sexual life that their works might often be taken for contributions to pornography rather than to medicine. In some of Freud's followers this absorption in the sexual has gone to such lengths that perverse tendencies and prurient ideas are scented in every thought, waking or sleeping, of the patients who came under their care. [p. 164] To a certain extent this excess is a reaction from the timidity and prudery of the great mass of the medical profession in relation to sexual matters, and is a protest against the ignorance of this side of life which so often exists. The mistake which is now being made by many is to regard this excess as a necessary part of the Freudian scheme instead of an unfortunate excrescence, probably due in large measure to the social environment in which the theory had its origin. There are even those who are so obsessed by the sexual aspect of Freud's pyschology[sic] that they regard sexuality as its basic principle and have fallen into a state of mind which wholly blinds them to its merits.
It is a wonderful turn of late that just as Freud's theory of the unconscious and the method of psycho-analysis founded upon it should be so hotly discussed, there should have occurred events which have produced oil an enormous scale just those conditions of paralysis and contracture, phobia and obsession, which the theory was especially designed to explain. Fate would seem to have presented us at the present time with an unexampled opportunity to test the truth of Freud's theory of the unconscious, at any rate in so far as it is concerned with the part taken by sexual factors in the production of mental and functional nervous disorder. In my own experience, cases arising out of the war which illustrate the Freudian theory of sexuality directly and obviously have been few and far between. Since the army at the present time would seem to be fairly representative of the whole male population of the country, this failure to discover to any great extent the cases with which the literature of the Freudian school abounds might well be regarded as significant. If my experience is a trustworthy sample, it would seem as if the problem was already well on the way towards settlement.
There me, however, certain features of the situation which must be taken into account before we should accept this conclusion. First, it must be noted that, while the proportion of the population from which cases of war-strain are now being drawn is very large, it is not wholly representative, but has been selected, though in a very rough manner, by the medical [p. 165] examination preliminary to enlistment. There is some reason to think that many persons who would be likely to support the Freudian point of view, have for one reason or another escaped inclusion in the army, or if they have joined are given work which does not expose them to the more severe shocks and strains of warfare. Another and more important reservation depends on the fact that warfare tends to produce states of anxiety and apprehension so deep-seated and far-reaching that they obscure causes of a different kind. Cases arising out of the war do not for this reason furnish satisfactory material whereby to test the truth of the Freudian position. Persons who break down under the strains of ordinary life, in whom other states are not hidden by the overpowering emotional conditions arising out of modern warfare, provide material which shows far more readily the influence of unconscious factors of the kind which are held to be so important by Freud and his school. Even when these reservations are taken into account, however, there remains little to support the Freudian position in the form in which it is usually presented to us by its advocates. We now have abundant evidence that those forms of paralysis and contracture, phobia and obsession, which regarded by Freud and his disciples as pre-eminently the result of suppressed sexual tendencies, occur freely in persons whose sexual life seems to be wholly normal and commonplace, who seem to have been unusually free from those sexual repressions which are so frequent in modern civilisation, especially among the more leisured classes of the community. It is, of course, obvious that the evidence in this direction, being negative, cannot be conclusive. The point is that while we have over and over again abundant evidence that pathological nervous and mental states are due, it would seem directly, to the strains and shocks of warfare, there is, in my experience, singularly little evidence to show that, even indirectly and as a subsidiary factor, any part has been taken in the process of causation by conflicts arising out of the activity of suppressed sexual complexes. Certainly, if results are any guide, the morbid states disappear without any such complexes having [p. 166] been brought to the surface, while in other cases the morbid states persist in spite of the discovery of definite complexes, sexual or otherwise, going back to times long before the war.
The denial of the validity of Freud's theory of the unconscious in the farm currently held by its adherents, as the means of explaining nervous and mental disorders, is, however, something very different from the denial of the validity of this theory altogether. While in my experience instances of the kind which abound in the Freudian literature sue rarely met with among the cases arising out of the war, there is hardly a case which this theory does not help us the better to understand -- not a day of clinical experience in which Freud's theory may not be of direct practical use in diagnosis and treatment. The terrifying dreams, the sudden gusts of depression or restlessness, the cases of altered personality amounting often to definite fugues, which are among the most characteristic results of the present war, receive by far their most natural explanation as the result of war experience, which by some pathological process, often assisted later by conscious activity on the part of the patient, has been either suppressed or is in process of undergoing changes which will lead sooner or later to this result. While the results of warfare provide little evidence in favour of the production of functional nervous disorders by the activity of suppressed sexual complexes, T believe that they will be found to provide abundant evidence in favour of the validity of Freud's theory of forgetting, which in the earlier part of this paper I have regarded as the most striking and characteristic feature of his psychology.
I do not attempt to deal generally with the practical consequences which must follow, if we accept the view that many of the symptoms which follow the: strains and shocks of warfare depend an the suppression of painful experience. I am content now to point out one consequence if we accept the position that certain symptoms of war-strain depend on the activity of suppressed experiences arising-directly out of the war. I believe that I am: stating the orthodox view of the medical profession, I am certainly expressing that of the man in the street, if I say [p. 167] that the forgetting of unpleasant experience is held to be the obvious and natural line of procedure. The advice given takes such forms as: "Put it out of pour mind," "Try not to think of it." Moreover, if the advice is not successful and the solitude of the night allows the painful thoughts to force themselves on the attention of the patient, hypnotic drugs, hypnoidal suggestion, or perhaps even definite hypnotism, are employed to assist the process of driving the painful thoughts below the threshold of consciousness. When hypnotism or hypnoidal suggestion is employed, there is definite danger of producing just those states of dissociation which it should be our most vital duty to avoid, while it is a moot question whether the employment of hypnotic drugs does not tend to produce the same effect though in a different and more gradual way.
If the view I have put forward has any validity the proper line of conduct should be the direct opposite of that which, is usually taken. Instead of advising repression and assisting it by drugs, suggestion, or hypnotism, we should lead the patient resolutely to face the situation provided by his painful experience. We should point out to him that such experience that of which he has been the subject can never be thrust wholly out of his life, though it may be possible to put it out of sight and cover it up so that it may seem to have been abolished. His experience should be talked over in all its bearings. Its good side should be emphasised, for it is characteristic of the painful experience of warfare that it usually has a good or even a noble side, which in his condition of misery the patient does not see at all, or greatly under-estimates. By such conversation an emotional experience, which is perhaps tending to become dissociated, may be intellectualised and brought into harmony with the rest of the mental life., or in more technical language, integrated with the normal personality of the sufferer. As a matter of practical experience the relief afforded to a patient by the process of talking over his painful experience, and by the discussion how he can readjust his life to the new conditions, usually gives immediate relief and may be followed by great improvement or even rapid disappearance of his chief [p. 168] symptoms. It is in grave cases in which the painful experience of warfare has come to persons of somewhat neuropathic tendency, liable to the occurrence of dissociation, that this line of treatment is especially useful, but in slighter cases and more normal subjects there is much to be said for encouraging the patient to become familiar with his painful experience instead of treating it by the process of taboo, surrounding it, and assisting the tendency of the patient to surround it, with a halo of mystery. What is rather needed is the encouragement of that kind of familiarity which breeds indifference, if not contempt.
I have only dealt superficially with some of the misunderstanding in which Freud's theory of the unconscious has been enveloped, especially in this country, while briefly considering the place which this theory seems destined to take in relation to the vast mass of clinical experience which modern warfare is providing. I must conclude by considering in the most general manner what I hold to be the value of Freud's theory to medicine. Freud's theory of the unconscious should appeal to the physician in that it provides him with a definite working scheme of influences, which he has long known to be active in the causation of mental disorders and of the bodily disorders which are traceable to mental factors. The modern conception of such disorders is that they are not merely the result of some shock or strain, but are the outcome of the whole life-history of those who suffer, that they are the result of the totality of the individual experience of the patient as well as of that ancestral experience which we call heredity. Of this ancestral experience, and to a large extent of the individual experience, everyone will acknowledge that it is not accessible to the manifest consciousness of the patient and cannot be learnt from him by the ordinary methods of obtaining the history of the patient and his illness. The great merit of Freud is that he has provided us with a theory of the mechanism by which this experience, not readily and directly accessible to consciousness, produces its effects, while he and his followers have devised clinical methods by which these hidden factors in the causation of disease may be [p. 169] brought to light. For the physician who is not content to walk in the old ruts when in the presence of the greatest afflictions which can befall mankind, Freud has provided a working scheme of diagnosis and therapeutics to aid him in his attempts to discover the causes of mental disorder and to find means by which it may be remedied. My own standpoint is that Freud's psychology of the unconscious provides a consistent working hypothesis to aid us in our attempts to discover the rôle of unconscious experience in the production of disease. To me it is only such an hypothesis designed, like all hypotheses, to stimulate inquiry and help us in our practice, while we are groping our way towards the truth concerning the nature of mental disorder. We can be confident that the scheme as it stands before us now is only the partial truth and will suffer many modifications with further research, but that it takes us some way in the direction of the truth seems to me certain. If this value of Freud's theory were only a probability, or even only a possibility, are we justified in ignoring it as an instrument for the better understanding of disorders of which at present we know so little? Are we to reject a helping hand with contumely because it sometimes leads us to discover unpleasant aspects of human nature and because it comes from Vienna?
Footnotes
[1] A paper read at a meeting. of the Edinburgh Pathological Club, March 7, 1917; published in the Lancet, June 16, 1917.
[2] Cf. Sociological Review (1916), ix. 11.