1. Further Advice on the Technique of Psychoanalysis. III.1 Remarks on the Transference. sigmund freud.
2. Some Remarks on the Theory of Resistance. dr. theodor reik.
3. Psychogenic Anomalies of Voice Register. dr. S. ferenczi Buda-pest.
1.Further Advice on the Technique of Psychoanalysis. III. Remarks on the Transference. — While the beginner in psychoanalysis may tremble at the difficulties in front of him, by far the hardest situation to handle is the transference Übertragung. This is the situation where a female patient falls violently in love with the physician.
For the cultivated layman two issues are possible. One, less frequently possible, is for the love to lead to a legitimate union; the other, more likely result, is the ending of all relations. There is a third possibility thinkable, an illegitimate relation, but in reality this is impossible both for moral and professional reasons.
It is evident that the standpoint of the psychoanalyst must be different.
If we consider the second possibility, where patient and physician separate, obviously the treatment ceases. But the condition of the patient makes another analysis necessary. The patient falls in love with the second physician, then with a third, and so on. This fact, one of the foundations of the psychoanalytic theory, leads to two results, one for the analyst, the other for the patient.
For the physician it is a costly awakening, a good warning against the ever ready tendency to reciprocation of the transference Gegen-iibertragung. He must understand, too, that the love of the patient awakened through the analytic situation is not a true love aroused by his personality, that he has no ground for being proud of his “conquest.” For the patient, however, there is an alternative; either she must give up a psychoanalytic treatment, or she must regard falling in love with the analyst unavoidable.
Certain physicians who use the analytic method introduce the patient early to the phenomena of transference, even induce it for the benefit of the analysis. Such technique is a great mistake. One robs the phenomena of the character of spontaneity and also raises difficulties not easily surmounted.
1 See Vol. 1, pp. 1, 139, and 485.
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If one looks more closely at the situation he sees the influence of complicated motives. One has to do with the amorousness as such, the other with the resistance. The resistance acts as an “agent provocateur” increasing the amorousness, in order that a more vigorous resistance may be invoked, ostensibly to keep order.
There is a class of women with elementary passions, who will tolerate no substitution, whose psyche cannot become interested in anything else. Such are hopeless for psychoanalysis.
One should emphasize the resistance aspect of the so-called “love.”
A genuine love would make the patient amenable, willing and eager to solve the problem of her case, if for no other reason than to help the beloved man. Such a one would choose to go the way of a complete cure in order to honor the physician — prepare a place in reality in which her affectionate feelings might have their proper place. Instead of that the patient is obstinate and disobedient; throws away all interest in the treatment; shows no respect for the deeply founded convictions of the physician. Resistance thus shows itself in the form of “love.” When the physician refuses to play this sort of a game, the patient withdraws embittered, in a spirit of revenge.
But in the manifest “love” is there nothing real to be taken advantage of? For the analyst the ethical and professional motives are identical. He must remember that the patient is sick because of her fixation on her infantile form of love. His task is to help her to rise above the pleasure-pain principle of the unconscious and to live in reality.
The analyst has a three-fold battle to wage: i Against the power in himself tending to drag him down from the psychoanalytic level; 2 outside the analysis, against the opposition to the sexual significance of the symptoms and over-valuation of sex; 3 within the analysis, against the attempt of the patient to take him captive by her passionateness.
2.Some Remarks on the Theory of Resistance. — The resistance of the patient shows itself in all those obstructions which he puts forward as interfering with the recovery of his health, such as social and financial reasons, family conditions, etc.
Perhaps the most prominent resistance of the patient is his forget-fulness. We all know how the patient is told to tell everything and not to “censor” anything. Yet he does, and later says he forgot.
Patients in whom a quick and easy transference takes place often put up later a bitter and lengthy resistance the overcoming of which requires great effort. Patients who show a strong resistance in the beginning, however, have a much better prognosis.
There are more or less open expressions of the resistance in bursts of anger against the physician.
Resistance has many forms. Dr. Abraham tells of a patient whose resistance put on the mask of esthetic interest. He criticized the office, the things in it, and their arrangement. This criticism was broadened
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to take in the relatives and acquaintances of the physician. All this is well seen in primitive personal relations. Resistance is shown in the reverse form; high interest in physician, his belongings, relatives, etc. The physician is a substitute for the father and his wife becomes the mother. Sudden silence in an analysis sometimes means the concealing of unconscious evil wishes against the physician.
The author says that free treatment increases the resistance. The abstractor, however, takes issue with him here. Some of his most successful work has been done with free patients in a General Hospital.
Analogous to the “Gegenübertragung,” or return transference, is the “Gegcnwiderstand,” or return resistance. It is very easy to meet a great resistance with further resistance. This is a matter for self-analysis.
In conclusion, there are three fundamental components to resistance, 1 narcissistic tendencies, 2 hostile feelings due to homosexual repressions, and 3 anal eroticism.
Under the first component the author speaks of the “I-deal” and shows its relation to the father. Here the castration complex is important. The hostile attitude due to a repression of homosexual desires is very important, as the analyst has to be the object. In the anal-erotic situation the two fundamentals, greed and obstinacy, are most important.
The author has hardly said anything new, but has gathered together important elements under the concept resistance.
3.Psychogenic Anomalies of Voice Register. — Ferenczi gives an account of two cases: 1 A young man twenty-four accompanied by his mother came to be cured of impotence. He was seen to be a combination of neurosis and paranoia. He believed he had the magic power to make everybody, especially men, turn around and look at him whenever his gaze fell on them. His neurosis consisted in a feeling of anxiety on account of observing his magic power, especially when he observed inorganic things obeying his will. “For,” he said, “if the inorganic world obeys my will I could destroy the entire world.”
Analysis showed him to be in the narcissistic stage, mixed with homosexuality. The unconscious wish to please the whole world, especially men, repressed, showed itself on the one hand as a hysterical phobia, and on the other as a delusion of omnipotence.
The patient told of the homosexual role, as a maiden, he played in school. But he said “All these things I have long put aside.”
The patient has a very peculiar symptom. He had two voices — one high soprano, another normal baritone. There was absolutely nothing the matter with his larynx.
The analysis showed that he used his baritone voice when he was objective; when he tried to coquette or please Dr. Ferenczi, unconsciously, he used his soprano voice. This was not a true soprano but a falsetto. He could change these voices at will, but felt better using his falsetto.
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(2)The other patient was also a young man seventeen who came with his mother because he had an unmanageable voice.
Right before his mother he told of the uncertainty of his potency. He could only succeed in coitus after fellatio.
This patient also had two voices; a somewhat high falsetto and a very deep bass.
This patient was homoerotically fixed. While he is not insensible to women, when he has wish phantasies, including them, he also has hypo-chondriacal ideas, but his homoerotic wishes are less troubled, or freer.
Analysis showed an unconscious incestuous fixation on the mother.
The similarity of symptoms in these two cases leads the author to differentiate a homoerotic neurosis which he calls “Zwangshomoerotik.”
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Emerson, L.E. (1917). Internationale Zeitschrift für Ärztliche Psychoanalyse. Psychoanal. Rev., 4(4):451-454