Selected papers on hysteria and other psychoneurosesFreud, Sigmund
Science
Selected papers on hysteria and other psychoneuroses
Freud, Sigmund
Hysteria; Neuroses; Psychoanalysis
I shall now mention those difficulties and inconveniences of our
therapeutic method which are not evident from the preceding histories,
or from the following remarks concerning the technique of the method.—I
will rather enumerate and indicate than carry them out. The process is
toilsome and wearisome for the physician, it presupposes a profound
interest for psychological incidents, as well as a personal sympathy for
the patient. I could not conceive myself entering deeply into the
psychic mechanism of a hysteria in a person who appeared to me common
and disagreeable, and who would not, on closer acquaintanceship, be able
to awaken in me human sympathy; whereas I can well treat a tabetic or a
rheumatic patient regardless of such personal liking. Not less are the
requisites on the patient’s side. The process is especially inapplicable
below a certain niveau of intelligence. It is rendered extremely
difficult wherever there is any tinge of weakmindedness. It requires the
full consent and the attention of the patients, but, above all, their
confidence, for the analysis regularly leads to the inmost and most
secretly guarded psychic processes. A large proportion of the patients
suitable for such treatment withdraw from the physician as soon as they
become cognizant whither his investigations tend; to them the physician
remains a stranger. In others who have determined to give themselves up
to the physician and bestow their confidence upon him, something usually
voluntarily given but never demanded, in all those, I say, it is hardly
avoidable that the personal relation to the physician should not become
unduly prominent, at least for some time. Indeed, it seems as if such an
influence exerted by the physician is a condition under which alone a
solution of the problem is made possible. I do not believe that it makes
any essential difference in this condition whether we make use of
hypnosis or have to avoid or substitute it. Yet fairness demands that we
emphasize the fact that although these inconveniences are inseparable
from our method, they, nevertheless, cannot be charged to it. It is much
more evident that they are formed in the preliminary states of the
neurosis to be cured, and that they then attach themselves to every
medical activity which intensively concerns itself with the patient, and
produce in him a psychic change. I could see no harm or danger in the
application of hypnosis even in those cases where it was used
excessively. The causes for the harm produced lay elsewhere and deeper.
When I review the therapeutic efforts of those years since the
communications of my honored teacher and friend, J. Breuer, gave me the
cathartic method, I believe that I have more often produced good than
harm, and brought about some things which could not have been produced
by any other therapeutic means. On the whole it was, as expressed in the
“Preliminary Communication,” “a distinct therapeutic gain.”
Public-domain text, read in full here on John Shaqi.
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