Reading ‘Further Remarks on the Neuro-Psychoses of Defence’
Further Remarks on the Neuro-Psychoses of Defence
Standard Edition Volume III
The central thesis of the 1894 paper The Neuro-Psychoses of Defence restated: that it is possible to distinguish mechanisms in hysteria, obsession and hallucinatory psychosis which are not conscious but which serve to defend against an idea that is incompatible with the ego. The terms ‘repression’ is used here interchangeably with ‘defence’, and Freud is also bold enough now to describe these mechanisms as ‘unconscious’. The processes at work in hysteria, obsession and paranoia are described here in greater detail.
Freud and Breuer’s view is that hysteria can be traced back to traumatic experiences of an invariably sexual nature. But what makes such an experience traumatic, and what constitutes a sexual experience? Freud suggests that there must be a first, early sexual experience in which the patient is the passive participant. By ‘sexual’ he means genital, and by ‘early’ he means before the patient is aware of the sexual significance of this seduction. It is thus not the traumatic sexual encounter in the here-and-now that constitutes the necessary precondition for hysteria – it is the fact that this reactivates the memory of a primary sexual experience, which is retroactively understood as being sexual. As Freud puts it, “It is not the [primary] experiences themselves which act traumatically but their revival as a memory after the subject has entered on sexual maturity” (p.164). It is this retroactive revival of an earlier trauma at the point of encounter with a later one (a “posthumous operation” (p.166), as Freud calls it) that constitutes the precondition for hysteria in adult life, and which makes the trauma encountered at that moment traumatic. “All the experiences and excitations which, in the period after puberty, prepare the way for, or precipitate, the outbreak of hysteria, demonstrably have their effect only because they arouse the memory-trace of these traumas in childhood” (p.166).
Are we therefore to regard these secondary traumatic encounters as specifically sexual themselves? It would appear so. Whilst Freud says that they are “not subject to the strict conditions which govern the traumas in childhood” (p.166), and that they “vary in their intensity and nature” (p.166), he only lists sexual acts as examples.
But what could it be about sexual ideas that makes it necessary for them to be repressed? Sexual ideas produce somatic excitation, and this excitation is then “transposed into the psychical sphere” (p.167, footnote). But Freud’s argument is that if you don’t know that the experience was a sexual one, it is not the experience itself but the memory of the experience, revived in maturity (which Freud situates not at puberty but between the ages of 8 and 10) that has the excitatory effect. Whereas usually the experience itself would produce excitation (and the memory of it less so), if the experience is not understood as sexual it will be the other way round: the memory will carry, this “excitatory effect” (p.167, footnote). This reversal itself is what is necessary for repression: “An inverted relation of this sort between real experience and memory seems to contain the psychological precondition for the occurrence of a repression” (p.167, footnote). So, what makes it necessary for the sexual idea to be repressed is this very fact that it is not understoodas at the time of the experience. All of this assumes a primary sexual experience (the ‘seduction theory’), the hypothesis of which Freud later abandons, but it is important to understand that it is not the character or nature of the sexual experience that Freud believes is pathogenic (the violence of the sexual assault, the barbarity of the depravity, etc), but the very fact that it is sexual, (although not understood as such until later). What this means is that when Freud abandons the seduction theory, he is not necessarily abandoning the theory on which it, in turn, rests. It would seem that it does not matter that Freud is talking about sexual trauma– the idea of deferred action still holds because it this is a mechanism which Freud identifies as specific to sexuality: “Sexual life affords – through the retardation of pubertal maturity as compared with the psychical functions – the only possibility that occurs for this inversion of relative effectiveness” (p.167) [my italics].
Nevertheless, Freud is clear that these earlier, “childhood traumas” (p.164), constitute what we would nowadays label sexual abuse. And Freud leaves us in no doubt as to the severity of the kind of sexual abuse he is describing, severe cases of which “had all to be classed as grave sexual injuries; some of them were positively revolting” (p.164). The perpetrators of such abuse are wide-ranging: Freud lists nurses, servants, teachers, governesses and other children, but much later, in the 1925 edition of Studies in Hysteria admits that the father himself was in many cases the agent of abuse (footnote, p.164). The fact that Freud did not mention this fact in the published edition at the time provides ammunition for Jeffrey Masson’s thesis of Freud’s theoretical cowardice in Assault on Truth. (It is worth noting here that Freud excludes masturbation as exerting a pathogenic effect in hysteria).
However, for the actual neuroses (neurasthenia and anxiety neurosis) the case is different. If the precipitating sexual causes for the latter occur in the here-and-now, and do not undergo any psychical elaboration, they would not depend on this gap between a sexual experience and the understanding of it as such that constitutes ‘deferred action’ and is the precondition for repression. This is the argument Freud makes in his paper On the Grounds…. But in this paper he writes that “The current causes which produce neurasthenia and anxiety neurosis often at the same time play the part of exciting causes of the neuroses of defence; on the other hand, the specific causes of a defence-neurosis – the traumas of childhood- can at the same time lay the foundations for a later development of neurasthenia” (p.169). This seems to contradict the theory he has just outlined. Whilst in a footnote added in 1924 Freud accepts that “I attributed to the aetiological factor of seduction a significance and universality which it does not possess” (p.168, footnote), if we accept that what makes a trauma traumatic is gap of deferred action involved in sexuality itself, it still appears contradictory.
In contrast to hysteria, the aetiology of obsessional neurosis is to be found not in a passive sexual experience in infancy, but one in which the subject is actively participant. Freud is quite clear that ‘active’ participation here means that the act was one of aggression. However, Freud claims that in all cases of obsession that he has come across he has been able to find a “substratum of hysterical symptoms” (p.168), (in the sense of a sexual experience in which the infant was passive) which further complicates the distinctions between the neuroses commented on in the last paragraph. He suggests that it might be the factor of age that could allow a more rigorous distinction between obsession from hysteria.
He expresses his view on obsessional aetiology in a neat formula: “Obsessional ideas are invariably transformed self-reproaches which have re-emerged from repression and which always relate to some sexual act that was performed with pleasure in childhood” (p.169). The sequence goes as follows: there is a primary sexual act in which the subject takes a passive position (this “will later on make repression possible” (p.169)); this is then followed by an act of sexual aggression, the memory of which becomes attached to a self-reproach when the child reaches maturity, and it is defended against by being repressed, leaving behind what he calls a “primary symptom defence” (p.169) that takes the form of conscientiousness, shame, etc. The neurosis comes about when the defence fails and the repressed returns (Freud is not specific about what might cause this), the obsessional symptom created thereby bearing the hallmark of a compromise the repression and the repressed. Whilst Freud admits he will need to know more about the nature of the unconscious to explain this in greater detail he does offer some further remarks.
He isolates two forms of obsessional neurosis: one in which only the “mnemic content of the act involving self-reproach” becomes conscious, and one in which “the self-reproachful affect connection with the act does so as well” (p.170). In the first, we can see a clear connection between the form the obsession takes and what has been repressed, despite the fact that, Freud says, the obsession itself substitutes something from the here-and-now for something in the past, and something non-sexual for what was sexual. Such an obsession has its origin in a splitting of two separate trains of thought, only one of which has “passed by way of the repressed memory” (p.171). Freud is not very clear on this point, but he seems to be suggesting that if these two trains of thought are contradictory, rather than being resolved, the compromise between the repression and the repressed gives the obsession the character of an absurdity. However, he says that even if they are not contradictory, they will still look like an obsessional idea. In the second case, it is the self-reproach rather than the mnemic content of the act that becomes conscious, and the affect attached to it is manifested as shame, hypochondria, social anxiety, religious anxiety, etc. Because of the fact that the “mnemic content of the act involving self-reproach” (p.171) is not necessarily represented in consciousness, Freud notes how difficult this makes the task of diagnosis. Whilst this passage appears convoluted, it nevertheless contains rather radical idea nowadays, when diagnosis in psychotherapy is so often taken to be simply a matter of identifying symptoms and matching them with disorders. This is indeed what the diagnostic manuals the DSM and ICD allow practitioners to do. However, Freud’s approach is different. If he constitutes obsession by the mechanisms he describes, even when a patient exhibits symptoms like those described immediately above Freud will still be able to make the diagnosis of obsession. It is not the symptoms, but the structure or mechanism that is the basis for a diagnosis.
To make matters more complicated, an obsession can be formed that is actually a “secondary defence” (p.172) that guards against anything that comes into associative connection with the “initially repressed memory” (p.172). Here an obsessional action results from the defence becoming “transferred to the protective measures themselves” (p.172). Unlike those described above, they do not exhibit a clear link with the ideas they are defending against – we notice no aggressivity in them, they are merely a kind of second order defence. Secondary defence entails “a forcible diversion onto other thoughts with a content as contrary as possible” (p.173) and, to return to the problem of diagnostics, they may take any form – superstitiousness, conscientiousness – but very often appear as phobias.
Paranoia too, for Freud,involves a defence – it is a “psychosis of defence” (p.174). But, in a remark that will tickle the ears of those familiar with Lacan’s view on psychosis he says that “Paranoia must, however, have a special method or mechanism of repression which is peculiar to it, in the same way as hysteria effects repression by the method of conversion into somatic innervation, and obsessional neurosis by the method of substitution” (p.175). Nonetheless, he proceeds to describe and analyse the case of a certain ‘Frau P’ whose paranoia he attributes to early sexual experiences involving her brother in order to justify placing it within the category of the neuro-psychoses of defence. He explains that the treatment he employed in this case was the same as that used in the treatment of hysteria (Breuer’s cathartic method with the ‘pressure technique’).
Freud notes a number of symptoms in his description of the case (which we will not examine in detail here): suspicion of her relatives; feeling of being watched and that people could read her thoughts; complaints of strange sensations in her lower abdomen and genitals connected with visual hallucinations, followed shortly after by auditory hallucinations; and refusal of nourishment. Despite this array, Freud is confident of a diagnosis of “a quite frequent form of chronic paranoia” (p.177), because rather than being interested in the symptomatology involved his focus is on “the aetiology of the case and the mechanism” (p.177).
A number of interpretations that Freud makes have hallmarks of both hysteria and obsession: to obsession he links the affect of shame and self-reproach at being naked, which Freud links to the childhood memory (presumably actively enjoyed) of showing herself to her brother before going to bed; however Freud also says that this kind of thing is “so often found in the aetiology of hysteria” (p.179). Similarly, the fact that the strange sensations in her abdomen are exacerbated by the analytic work (what Freud refers to beautifully as symptoms “joining in the conversion” (p.180)) are, he says, “regularly observed to happen in the analysis of hysterical mnemic residues” (p.180). Also, Freud takes the auditory hallucinations she complains of to be “consequences of a compromise between the resistance of the ego and the power of the returning repressed” (p.183), the fact of their indefiniteness and distortion being evidence of this compromise, which would seem to correspond to the mechanism of obsession as described by Freud earlier.
In the final part of this paper Freud concerns himself with a comparison between the mechanisms of paranoia and obsession, based on what he has learned from this case. We find in both the mechanism of repression, enacted upon the memory of an infantile sexual experience, followed by the return of the repressed in symptoms. Delusions of persecution are to be understood as transformed self-reproaches, which cannot be acknowledged by the subject. In obsession we find this self-reproach transformed (as a primary defence) into self-distrust; in paranoia “the self-reproach is repressed in a manner which may be described as projection” (p.184), which is manifested as distrust of others. Other symptoms can be understood as compromise formations like those we find in obsession, and the content of mnemic hallucinations exhibit the distortion by substitution Freud refers to earlier regarding obsession. However symptoms of secondary defence are absent in paranoia.
Delusional ideas, whilst being the result of a compromise (a feature Freud puts on the side of obsession) impose themselves on the ego in such a way that the ego has to adapt to them. This Freud calls “interpretative delusions which end in an alteration of the ego” (p.185), a specification that does not seem a million miles away from the Lacanian view that psychotic delusions are attempts to pin down or localise meaning where the Name of the Father is absent.
By Owen Hewitson, LacanOnline.com
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