Introductory lectures on psycho-analysis : $b a course of twenty-eight lectures delivered at the University of ViennaFreud, Sigmund
Science
Introductory lectures on psycho-analysis : $b a course of twenty-eight lectures delivered at the University of Vienna
Freud, Sigmund
Psychoanalysis
Anyone of you who makes the necessary effort to look up this question
will certainly be strongly impressed by the wealth of evidential
material. But he will also meet with a difficulty. The meaning of a
symptom lies, as we have seen, in its connection with the life of the
patient. The more individually the symptom has been formed, the more
clearly may we expect to establish this connection. Then the task
resolves itself specifically into a discovery, for every nonsensical
idea and every useless action, of the past situation in which the idea
was justified and the action served a useful purpose. The obsessive act
of the patient who ran to the table and rang for the maid is a perfect
model of this kind of symptom. But symptoms of quite a different type
are very frequently seen. They are what we call _typical_ symptoms of a
disease, in each case they are practically identical, the individual
differences in them vanish or at least fade away, so that it is
difficult to connect them with the patient’s life or to relate them to
special situations in his past. Let us consider the obsessional neurosis
again. The second patient’s ceremonies preparatory to sleep are in many
ways quite typical, although showing enough individual features as well
to make an “historical” interpretation, so to speak, possible. But all
obsessional patients are given to repetitions, to isolating certain of
their actions and to rhythmic performances. Most of them wash too much.
Those patients who suffer from agoraphobia (topophobia, fear of space),
no longer reckoned as an obsessional neurosis but now classified as
anxiety-hysteria, reproduce the same features of the pathological
picture often with fatiguing monotony. They fear enclosed spaces, wide,
open squares, long stretches of road, and avenues; they feel protected
if accompanied, or if a vehicle drives behind them, and so on.
Nevertheless, on this groundwork of similarity the various patients
construct individual conditions of their own, moods, one might call
them, which directly contrast with other cases. One fears narrow streets
only, another wide streets only, one can walk only when few people are
about, others only when surrounded with people. Similarly in hysteria,
beside the wealth of individual features there are always plenty of
common typical symptoms which appear to resist an easy interpretation on
historical lines. Do not let us forget that it is these typical symptoms
which enable us to take our bearings in forming a diagnosis. Supposing
we do trace back a typical symptom in a case of hysteria to an
experience or to a chain of similar experiences (for instance, an
hysterical vomiting to a series of impressions of a disgusting nature),
it will be confusing to discover in another case of vomiting an entirely
dissimilar series of apparently causative experiences. It almost looks
as though hysterical patients must vomit, for some unknown reason, and
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