Selected papers on hysteria and other psychoneurosesFreud, Sigmund
Science
Selected papers on hysteria and other psychoneuroses
Freud, Sigmund
Hysteria; Neuroses; Psychoanalysis
1. The former value of the person should not be overlooked in the
disease, and you should refuse a patient who does not possess a certain
degree of education, and whose character is not in a measure reliable.
We must not forget that there are also healthy persons who are good for
nothing, and that if they only show a mere touch of the neurosis, one is
only too much inclined to blame the disease for incapacitating such
inferior persons. I maintain that the neurosis does not in any way stamp
its bearer as a dégéneré, but that frequently enough it is found in the
same individual associated with the manifestations of degeneration. The
analytic psychotherapy is therefore no procedure for the treatment of
neuropathic degeneration, on the contrary it is limited by it. It is
also not to be applied in persons who are not prompted by their own
suffering to seek the treatment, but subject themselves to it by order
of their relatives. The characteristic feature upon which the usefulness
of the psychoanalytic treatment depends, the educability, we will still
have to consider from another point of view.
2. If one wishes to take a safe course he should limit his selection to
persons of a normal state, for, in psychoanalytic procedures, it is from
the normal that we seize upon the morbid. Psychoses, confusional states,
and marked (I might say toxic) depressions, are unsuitable for analysis,
at least as it is practiced today. I do not think it at all impossible
that with the proper changes in the procedure it will be possible to
disregard this contraindication, and thus claim a psychotherapy for the
psychoses.
3. The age of the patient also plays a part in the selection for the
psychoanalytic treatment. Persons near or over the age of fifty lack, on
the one hand, the plasticity of the psychic processes upon which the
therapy depends—old people are no longer educable—and on the other hand,
the material which has to be elaborated, and the duration of the
treatment is immensely increased. The earliest age limit is to be
individually determined; youthful persons, even before puberty, are
excellent subjects for influence.
4. One should not attempt psychoanalysis when it is a question of
rapidly removing a threatening manifestation, as, for example, in the
case of an hysterical anorexia.
You have now gained the impression that the sphere of application of the
analytic psychotherapy is a very limited one, for you really heard me
enumerate nothing but contraindications. Nevertheless, there remain
sufficient cases and morbid states, such as all chronic forms of
hysteria with remnant manifestations, the extensive realms of compulsive
states, abulias, etc., on which this therapy can be tried.
It is pleasing that particularly the worthiest and highest developed
persons can thus be most helped. Where the analytic psychotherapy has
accomplished but little one can cheerfully assert that any other
treatment would have certainly resulted in nothing.
Public-domain text, read in full here on John Shaqi.
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