After a brief review of the developments of metapsychology and the reason for the opposition to psychoanalysis being a blow to the narcissism of human beings, but rationalized
* Presidential address before the annual meeting of The American Psychoanalytic Association, held at Richmond, Va., May 12, 1925.
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as too great an insistence on sex, there is discussed the influence of psychoanalysis upon literature, particularly the use of the method of free associations on the structure of literary productions. The examples chosen were Butler's “Way of All Flesh,” Joyce's“Ulysses,” the novels of Marcel Proust, and T. S. Eliot's“The Waste Land.”
It is pointed out that in these literary productions the author possessed such an insight into his own unconscious that he was able to utilize the free association method to record his unconsciousthinking, a technical achievement deliberately taken over from the practice of psychoanalysis. Thus the modelling of many recent literary works has been based on the diffusion of psychoanalytic knowledge.
What Is a Cure in Psychoanalysis?—The author attempts in a short presentation to give a theoretic and practical summary of the phenomena concerned in psychoanalytic therapy.
The increased understanding of the rôle of the ego impulses in the genesis of a neurosis has aided in the application of this knowledge, slowly gained in the course of the development of theory and technique, in efforts to bring about a cure. The formation of a new ego-ideal is an important, if not the most important factor, in therapeutical results. By virtue of a change on the part of the newly formed ego-ideal to the libido strivings, these may be now taken care of in one or more of three ways, viz., rejection, as no longer useful; by acceptance as such; and lastly, by sublimation.
Again is stressed the importance of handling the resistances, in so far as they relate both to the unconscious of the patient and to the analytic situation. These resistances make themselves more massed during the“weaning” phase of the treatment; regression, en masse, is prevented, however, at this stage of the treatment, by the newly formed ego-ideal, developed during the positive phase of the treatment, for the“love” of the analyst. In the“weaning” stage ego growth must take place in denial of that“love.” The transference then becomes the“battle ground,” as Freud expresses it. The resolution of this new“transference neurosis,” a“new edition” of the old infantile neurosis, forms the crux of the treatment.
This situation, i.e., the new transference neurosis, brings the unconsciousmaterial connected with the pre-oedipus and the post-oedipus situations into activity up to the present, entailing upon the analyst the necessity of seeing that the patient goes through the analysis in denial of indulgence in reference to infantile (repressed) strivings, so that the patient may relive the past in the form of memory recall of the post-oedipus situations, and as interpretation of or reproduction in the analytic situation of the pre-oedipus situation. This latter pertains to material that could never be recovered in the form of memory recall.
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The rôle of a repetition compulsion (Wiederholungszwaung), especially as seen in connection with material related to the pre-oedipus situation, is discussed in its bearing upon therapy.
History of the Psychoanalytic Movement in America.—The author pointed out that the interest in psychoanalysis began to filter into this country through the group of psychiatrists of the Zurich school about 1906. The work of Professor Frederick Peterson with the psycho-galvanometer and with the association experiments of Jung initiated the interest in the new psychology in this country. Subsequently Professor Ernest Jones of the University of Toronto and Dr. A. A. Brill of New York City began to energetically present Freud's views to the medical practitioners—a feat which required considerable courage at that time (1907 to 1909). The visit of Freud to America at the invitation of the late Professor G. Stanley Hall, on the occasion of the twenty-fifth anniversary celebration of Clark University in 1909, proved a tremendous stimulus to psychoanalysis not only in America but also in Europe, for it marked the first academic recognition of Freud's labors.
Among others who early took an active rôle in the advancement of psychoanalysis may be mentioned the late Professor James J. Putnam of Harvard; Dr. Adolph Meyer, who early appreciated the significance of Freud's theories for interpretative psychiatry, and Drs. White and Jelliffe, through the publication of many translations and original articles on the subject. Two psychoanalytic societies, the New York, organized February, 1911, and the American, founded May, 1911, have been able to influence the scientific interest and activities of psychoanalysis in America to a considerable extent. Of recent years psychoanalysis has been over-popularized, and while the number of very competently trained medical men practicing it is constantly increasing, it has not been accorded the degree of recognition to which it is entitled, either from medical men or the more intelligent public, on account of misrepresentation at the hands of unqualified persons.
C. P. Oberndorf
Psychoanalytic Study of a Case of Organic Epilepsy.—A case of typical epileptic syndrome arising on a basis of definite structural cerebropathy, presumably syphilitic, although obviously not lending itself to systematic psychoanalytic investigation, is presented in the light of determining psychogenic factors as indicated by a combination of dreams, free associations, and clinical developments. It seems clear that the occurrence of convulsions was determined by the intolerable pressure of unconscious conflicts, set up by the attempts of a manifestly infantile girl to fit herself into an adult heretosexual relationship, and relieved by the emergence into consciousness of these conflicts with appropriate environmental adjustments. Her convulsions began in association with her
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engagement; they became aggravated by her marriage and most severe during her pregnancy; they decreased rapidly when she lived apart from her husband; were intensified by his revisits, and decreased markedly after her divorce, with a great improvement in her general health since.
Dreams and free associations indicated a persistent back-to-mother trend throughout, and the type of transference to the analyst was obviously of the mother-libido variety.
K. A. Menninger.
Regression.—In this paper, a review of the definitive statements as to the meaning of the term regression is made. The author finds no direct relationship between many of the notions which are to be discovered in the literature. Special consideration is given to the clinical investigations of Kempf and Ferenczi; the former on schizophrenic reactions correlated with behavioristic tendencies of rhesus monkeys; the latter on the paretic psychoses.
Certain aspects of the study of the schizophrenic dissociation in progress at the Sheppard and Enoch Pratt Hospital have been correlated with a view to the elucidation of regression, and illuminating features of several cases are mentioned.
The author concludes that the term regression is valuable, and that it represents a dynamic situation in which the organism makes a faulty adaptation to a situation, which adaptation is characterized by its inadequate reference to the present and the future, and that this situation is brought about by a peculiar“synthesis” of experience (anything lived, enjoyed, or the like) such that these data are divorced of“meaning,” and become to all intent and purpose—during the continuance of the regressive state—nonexistent so far as any evidence in thinking and behavior can be discovered. It has appeared in this work that the regressive process can, and actually does, retrace the ontogenetic pathway of the mental development, and that the use of the term should be restricted to precisely this dynamic situation; a reversive change in behavior and thinking, based upon a more or less smooth return to earlier condition, with“devitalization” of experience—either total, or the experience structuralized in one of the major systems of the personality—which has occurred subsequent to the period to which the regression has taken place.
H. S. Sullivan.
Psychoanalytic Improvisations and the Personal Equation.—In our evaluation of the causes and processes underlying mental disharmonies there has been omitted a very definite and significant factor—the factor, namely, of the personal equation that necessarily enters in unconsciously to bias the private interpretations of the psychiatrist and psychoanalyst.
Psychiatry has yet to employ in its evaluations the method of the laboratory. Its procedure has been throughout individualistic and accordingly
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its premises are as varied as the various individuals by whom they are severally sponsored. In the laboratory the materials at hand are its uncompromising guide. The laboratory has no concern outside of these materials. In its procedure it is bound to the processes of direct objective observation. No latitude is granted to the element of the personal equation.
Within the mental sphere, however, in which there should prevail no less the scientific processes of the laboratory, the personal equation constitutes a distinct barrier to observation. Sentimental indulgence, private interest, inhibiting memories, endless hidden compensatory images definitely enter in to bias the clear observation of what are presumably the psychoanalyst's objective materials of observation.
In the observation of physical phenomena the scientist's personal equation is entirely subordinated to the authority of exact data. But such a process of mental alignment with observable data presupposes a consensus of agreement among the observers. Such a consensus is the necessary sequence of a strict adherence to the materials observed. But in the mental sphere there has been no such consensual observation of consistent laboratory materials. This has been due to the barrier of our own personal equation. The result has been that the personal equation, the private interpretation, the unconscious improvisation have fairly honeycombed our psychoanalytic processes.
For illustrative material of this tendency to private improvisation we need seek no better clinic than our own psychoanalytic group. But we do not challenge these compensatory improvisations as they are represented among ourselves. The reason is that there is lacking our group or consensual observation of them.
In the absence of a social consensus of laboratory technique based upon a consensual agreement in terms, I am convinced that psychoanalysis and psychiatry can only be a purely arbitrary improvisation based upon the private prejudices of the particular observer and not a truly scientific observation based upon the accepted symbols of stabilized recognition.
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(1925). Psychoanalysis and Literature.*. Psychoanal. Rev., 12(4):460-464