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Emerson, L.E. (1915). Internationale Zeitschrift für ärztliche Psychoanalyse. Psychoanal. Rev., 2(3):346-353.
Psychoanalytic Electronic Publishing: Internationale Zeitschrift für ärztliche Psychoanalyse

(1915). Psychoanalytic Review, 2(3):346-353

Internationale Zeitschrift für ärztliche Psychoanalyse

L. E. Emerson, Ph.D.Author Information

(II. Jahrgang, 1914. Heft 1, January)

1.   On False Recollection (“déjà raconté”) during Psychoanalysis. Sigmund Freud.

2.   The Attitude of the Psychoanalytic Therapeutist to the Actual Conflicts. Prof. Ernest Jones, London.

3.   Some Clinical Observations on Paranoia and Paraphrenia. (A Contribution to the Psychology of “System-Formation.”) Dr. S. Ferenczi (Budapest).

4.   Prof. Dr. Ernst Dürr and his Relation to Psychoanalysis. DR. O. PFISTER, clergyman in Zurich.

1.   On False Recollection (“déjà raconté”) during Psychoanalysis.—Often, during an analysis, the patient remembers and tells something, and says, “but that I have already told you.” The doctor, however, may have no memory of it and if he says so the patient is

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vehement in his protestations of certainty. Both may be equally certain, but obviously there is no objective value to the feeling of certainty. The doctor may be as mistaken as the patient.

In a number of cases one may finally remember having heard the matter before, but in the majority of cases it is the patient who is mistaken. The explanation of this frequent fact seems to be that the patient had the intention of telling, and had even prepared the way and begun to tell, but was prevented by his resistance and finally misplaced the fact for the intention and remembered it as if accomplished. This material is of the greatest value for the analysis.

Grosset, in 1904, explained the phenomenon “déjà vu” as an unconscious perception later brought to consciousness by a similar impression. Freud, without knowing about Grosset's work, gave a similar explanation in the second edition of his “Psychopathology of Everyday Life,” published in 1907.

Freud gives the case of a patient who said in the course of association: “When I was about five years old playing in a garden with a knife I cut off my little finger,—oh, I only thought that it was cut off—but I have already told you that.” Freud denied ever hearing it, and finally the patient went on: “When I was five years old I was playing in the garden, near my nurse, and cut, with my pocket knife, the bark of a nut-tree, which also plays a rôle in my dreams. Suddenly I noticed with unspeakable fright that I had cut the little finger (right or left?) so nearly through that it only hung by the skin, I felt no pain, only a great anxiety. I did not trust myself to say anything to the nurse, who was only a few steps away, sat down on the nearest bank, and remained there unable to look at my finger. Finally, however, I became quiet, looked at my finger and saw that it was quite unharmed.”

The reason for the patient's resistance against telling this vision or hallucination was his desire to conceal his “castration complex,” which had resulted in an angst attack which he had suffered when fifteen.

Another form of “false recollection” often comes to the therapeutist at the end of a successful treatment. After all resistances have been overcome the patient says: “I have the feeling now that I always knew it.”

2.   The Attitude of the Psychoanalytic Therapeutist to the Actual Conflicts.—The attitude of the psychoanalyst to the question of the actual conflicts and difficulties in the life of the patient is not only one of the most important things to consider in the treatment, but is also one of the points in which the psychoanalytic method is distinguished most sharply from other psychotherapeutic methods.

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In each analysis one meets different difficulties which the patient must meet in actual life, such as disillusionments, worries, discontentment's, cares, problems, dilemmas, etc. These are grouped under the general name “actual conflicts.” These conflicts are usually among the first things met in an analysis, for they stand in direct relation to the complaints for which the patient seeks help. The correct solution of these conflicts is another thing, which often only relatively late in the analysis becomes clear.

There are two opposite attitudes which one may take to such conflicts, with all possible gradations in between. The one is, the doctor may concern himself directly with the problems by means of advice, suggestion, etc.; the other (which is psychoanalytic) consists in limiting his efforts to a discovering of the causes of the conflicts, in the conviction that if these are only found the best solution follows smoothly and spontaneously. This method may be called psychoanalytic in contrast to not-psychoanalytic methods of psychotherapy.

The advantage which the psychoanalytic attitude gives needs only slight explanation.

(1) Without an analysis one cannot know for sure just what the solution of the problem may be. Either the patient already knows what he ought to do, but does not know why he is not in a position to do it, or he hasn't any idea as to what attitude he best should take to the problem, i. e., what the best solution of the conflict might be. The doctor cannot tell, either, without an analysis, much less give advice. (2) Even if the doctor reaches the right solution of the conflict and tells it to the patient, it has a quite different effectiveness if the patient comes to that conclusion himself. A purpose imposed from without is fundamentally different from one that springs spontaneously in the soul. The ground for this is, even if the purpose is accurately psychologically symbolical of the deepest wishes of the person, it gets effectiveness only if the affect of these wishes can be transferred to the purpose, hence only if the path of the affect is rather free between the unconscious and the conscious. This is impossible if the purpose is merely imposed from without, as is done in not-psychoanalytic psychotherapy. … (3) If the doctor gives a definite solution of a conflict, and gives advice, he increases the dependence of the patient. The whole question can be considered as a part of the problem of the übertragung (transference).

The attempts of the patient to get advice on the actual conflicts, instead of seeking their fundamental causes are principally two sorts: either they are the expression of the well-known resistance to the investigation or they seek to find the physician and patient closer together.

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The tendencies of the physician are of a similar nature. Simple advice frees him from undertaking a difficult investigation, and gives him the satisfaction of expressing his omnipotent phantasies, as he takes the omniscient father-image attitude. The influence of the physician, which he must necessarily use in his relation to the patient, should be devoted wholly to overcoming the resistance, to having the unconscious made conscious, to the end that the patient gets the fullest self-knowledge possible.

The author disagrees with Jung in his recent development of psychoanalytic practice. He disagrees with Jung's emphasis of the importance of the “present conflict” and his minimizing the importance of the “wish-phantasies.”

In conclusion Jones maintains that in psychoanalysis the actual, as well as the past, conflicts, are to be solved only by an analysis of their unconscious causes, and not by any advice or explanation of life tasks. This, however, is an ideal hard to reach, especially if time does not allow a thoroughgoing analysis. Nevertheless, in this, as in other questions, psychoanalysis does not permit itself any mixture with other psychotherapeutic methods.

3.   Some Clinical Observations on Paranoia and Paraphrenia.—One day the sister of a young artist sought the author and told him that her brother, a very gifted young man, had been acting peculiarly for some time. He had read the treatise of a physician on serum treatment for tuberculosis and since then he had been occupied only with himself, having his urine and sputum analyzed for foreign matter, and although nothing was found, insisted on serum treatment by this physician. He soon showed that he had no simple hypochondriacal complaint. Not only the essay, but also the physician made an unusual impression on him. As he treated the young man somewhat harshly he buried himself in his note-book (which the sister gave me to read) in endless grubbing over the question how he could justify the physician. He interwove his hypochondriacal ideas in a greater philosophical system. For a long time he had been interested in Ostwald's philosophy, whose jealous follower he became. The idea of “energy” made an especially deep impression on him, and the strong emphasis of the principle of “economy” also. The proposition that we should use as little energy as possible in bringing anything about, he sought to apply to real life. This became most striking when combined with his hypochondriacal ideas. He noticed paresthesia in different organs, i. e., in his eyes, and remarked that it disappeared when he held his leg up high. Thus he could be undisturbed in his thinking, the most valuable activity he was capable of, he thought. Gradually he came to the conclusion that he ought to

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do nothing but think. He ordered the people about to give him absolute quiet for his mental labors. He would lie hours long in certain artificial attitudes. Ferenczi regarded these as a form of catatonia, conceived the pure psychical symptoms as fragments of hypochondriacal and morbid ambitions, diagnosed the case as paranoid paraphrenia (dementia præcox), and advised the family to send the young man temporarily to a sanitorium. The family refused to accept the diagnosis and advice.

Soon, however, the sister came again and told the following: the brother sought to have her sleep in his room. This she did. Several times a night he raised his legs high in the air. Then he began to talk to his sister about erotic desires and erections which disturbed him in his work. In the meanwhile he spoke of his father as having treated him too sternly, and for whom till now he had had no love. Now for the first time he revealed in himself, as in the father, their opposing feelings. Suddenly he said it would be against the economy of energy if he should satisfy his erotic needs for money with strange women. It would be more economical if his sister, in the interest of his psychical activities and as a true follower of the “energetic imperative,” give herself up to him. After this incident (which the sister kept secret) and after the patient had threatened suicide he was sent to a sanitorium.

The author gives a short history of another case.

A very intelligent young man who, besides the punctual fulfillment of his official duties, wrote rather remarkable poetry, and whose life had been followed by the author for more than fourteen years, was known to suffer from megalomania and delusions of persecution, not sufficiently developed, however, to prevent social relationships. Because of the author's interest in his poetry, the young man used to visit him about once a month, to tell his troubles as to a father-confessor, and go away somewhat relieved. He complained of his comrades and chief. He thought other literary men were banded together to prevent his recognition. In regard to sex he seemed to have no needs. He had once remarked that he had had unaccountable luck with women, that he liked them all without bothering himself much about any one, one had to be on guard against them, etc.

From remarks made from time to time the author got an insight into the deeper layers of his psychic life. He was in poor circumstances, early estranged from a father previously warmly loved. He transferred then (in his phantasy) the father rôle to an uncle, but must have seen soon that he had little to expect from this egotist and withdrew his love, and tried on the one hand, as we have seen, unsuccessfully to find again the lost father-image in his superiors,

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and on the other hand, his libido regressed to the narcissistic stage and he delighted in his own peculiar characteristics and accomplishments.

About the twelfth year of the author's acquaintance with the patient he had a breakdown. At about the same time he began to interest himself in psychoanalytic literature. He read the author's paper on the relation between paranoia and homosexuality, and asked him directly if he thought he was homosexual and a paranoiac. At first he made merry over the idea, but finally became convinced and came to the author and said he was deluded in the idea of persecution and that deeply he was homosexual. He remembered different occurrences which confirmed him in his opinion. Now he could explain a noteworthy sensation, half anxious, half libidinous, which he had in the presence of an old patron of his; also he understood why he wanted to get as near the author as possible so he could feel the exhalation of his breath. Now, too, he understood why he had accused his patron of homosexual purposes—it was simply his own thought which was father to the wish.

The author was much pleased at this insight on the part of the patient, especially as he hoped this would have a good therapeutic effect and thus would prove that the possibility of therapy in paranoia was not so bad as had been thought.

A few days later the patient came again. He was still excited, but not so euphoric. He had great anxiety. Unbearable homosexual phantasies kept coming to him. He saw gross phallic symbols which nauseated him. He fancied himself in pederastic situations (also with the author). He was quieted, however, and sent away.

Then nothing was heard of the patient for some days till a member of his family came to the author and told him that the patient had been for some time inaccessible, hallucinated, talked to himself, and the day before had forced himself first into his uncle's house and then into the palace of a wealthy man and created a scandal. Then he went home, lay in his bed and would not speak a word.

The author sought the patient and found him in a deep catatonic stupor (rigid, negativistic, inaccessible, hallucinated). At first he seemed to recognize him, reached out his hand, and then lapsed back into stupor. He remained weeks in this state and then got better. But he had not a complete insight into his illness—he objectified in part his feelings. He denied that he had had a psychosis and believed no more in the relation between his psychical experiences and homosexuality.

The first patient became sick while he was taking over “whole” a fertile philosophical system (Ostwald's). Philosophical systems

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which seek to make the whole world rational without any place for individuality are comparable to the delusional formations of paranoiacs. These systems express the need of such patients to rationalize their own irrational conflicting tendencies.

The second case shows how the patient projected his ethically incompatible wishes on his official surroundings. In his desire for a system he happened on the psychoanalytic literature which gave him a true insight into his condition, but it was unbearable and so he took flight into dementia. He came out of his attack in so far as he was able to put away his insight and reconstruct his delusional system of persecution.

In the matter of therapy this corroborates Freud's pessimistic view as to the value of psychoanalytic therapy in paranoia.

The peculiar catatonic attitude of the first patient is explained by the patient himself in his incestuous longings for his sister. If we remember the long known symbolical identification of leg with penis, leg-stretching with erection, we may see in every catatonic stiffening a repressed tendency to an erection.

The author quotes another case, of a patient, who said he got erotic pleasure in his catatonic attitudes and movements. The extreme bending of his body, which he kept up for minutes, served, he said, “to break the erection of his bowels.”

4.   Prof. Dr. Ernst Dürr and his Relation to Psychoanalysis.—In the death of Dr. Dürr psychoanalysis has lost a champion. He had already done great work in philosophy, psychology, and pedagogy, when he overcame an initial resistance and turned to psychoanalysis. The application of psychoanalysis to pedagogy had much to hope for from him: a hope that now must remain unfulfilled.

Like almost everybody else, in the beginning, he was repelled by psychoanalysis. He wrote, “It is to be hoped that the dogmatic declarations of the Freudian School, especially their highly improbable hypotheses as to the sexual life, will be taken most critically.”

A friendly reference by Professor Dürr to me of Pfister's studies led to an acquaintance. Then Dürr desired a psychoanalysis made on himself. Only one hour was possible, but it sufficed to prove to him the importance of the analysis, and to Pfister it proved Dürr's high character.

From now on there was a regular correspondence. In the spring of 1913 Pfister undertook some analytical experiments on Dürr. At this time he deplored that he had had to write his principal psychological work without knowing Freud's. As to Freud's theoretical constructions he had no corrections to offer. He said they all flowed from his principal presuppositions. Whether he regarded these as

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established Pfister does not know, but he says he is sure that Dürr has deepened and clarified the theory to an extent few psychoanalysts have done. Pfister quotes him as saying: “I am convinced that psychology will undergo a thorough transformation through psychoanalysis.”

Like all who busy themselves with analysis he turned to more and more concrete life problems, such as the love of the child for its parents, and its love disturbances, the “Edipus complex,” the damming of anger through the commandment, “Honour thy father and mother”; the over-compensation of hate against the father by doubled tenderness; the later rebellion against all authority in church and state, art and science, as in daily life.

Although he speaks with high praise of what psychoanalysis can do to heal the sick soul, he issues a timely warning in saying that “education is different from healing.”

Dürr was much indebted to his wife, who translated James' Psychology, and who was a true companion in his scientific progress.

If we follow Dürr's development in psychoanalysis, we find that it takes the course of the probable evolution of psychology. First, absolute denial of psychoanalysis as an improbable hypothesis, founded dogmatically, and contradicting in many points results won by psychology; then a consideration of particular psychoanalytic achievements, with much head-shaking, but still with reflection; then renewed examination, starting from traditional conceptions; and finally, analytical investigations themselves are undertaken, best if the investigator tries to analyze himself.

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Article Citation [Who Cited This?]

Emerson, L.E. (1915). Internationale Zeitschrift für ärztliche Psychoanalyse. Psychoanal. Rev., 2(3):346-353

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