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Ana-Maria Rizzuto, M.D.: Freud and the Spoken Word: Speech as a Key to the Unconscious
Jerome I Sashin, M.D. Lecture presented on April 9, 2016
We earn our living as psychoanalysts and psychotherapists by listening and talking to our patients. It seems natural to us that verbal exchanges will help to alleviate the psychic suffering of those who come to us seeking relief. We take for granted that our words in the therapeutic setting have the potential to reach obscure sources of psychic pathology and that by bringing them to the patient’s affective awareness they can modify their harmful consequences.
We need to ask, how did we come to learn about the therapeutic power of spoken words? Who discovered their healing power? How do they effect their psychic and somatic transformations?
These are the questions I asked myself when I became aware that the literature about the words exchanged in analysis is scant and that during my training as a psychiatrist and a psychoanalyst I had received no formal education about it.
I decided, after writing several papers about what my patients had taught me about their words, use of pronouns, and metaphors that it was time to go to the roots and explore how Freud, the creator of psychoanalysis, came to use words as a medical treatment, and what he had to say about words in the course of his long theoretical and clinical career.
In his 1926 essay The Question of Lay Analysis. Conversations with an Impartial Person, Freud explains to an imaginary interlocutor who wants to know what the analyst does to help a person other doctors of the time have not been able to: “Nothing takes place between them except that they talk to each other” (p. 187). My book explores the ‘except’ of that ‘nothing’ in Freud’s response.
The psychoanalytic literature about language is extensive and most valuable. Language is the cultural medium we use to talk to each other. However, talking is the personal event that takes place between two individuals who want to establish contact with each other by using the shared language of their culture.
BRIEF HISTORICAL REVIEW.
Freud (1925) describes in An Autobiographical Study how his colleague Dr. Josef Breuer told him about a case he had treated between 1880 and 1882 “in a peculiar manner” that “had allowed him to penetrate deeply into the causation and significance of hysterical symptoms” (p. 19). Breuer mentioned that the patient Fräulein Anna O. could be relieved of many symptoms “…if she was induced to express in words the affective fantasy by which she was at the moment dominated. Through this discovery, Breuer arrived at a new method of treatment” (p. 20, my italics). Freud asked himself whether such procedure could be generalized: “The state of things which he had discovered seemed to me to be of so fundamental a nature that I could not believe it could fail to be present in any case of hysteria if it had been proved to occur in a single one.” So deep was Freud’s conviction that he “worked at nothing else” (p. 21, my italics). The power of the spoken word had taken over Freud’s professional career.
What was so original in Breuer’s medical approach? Hysterics and mental patients were treated at the time with physical procedures, rest cures, medications, massages — and, following Charcot, Bernheim, Pierre Janet and others — hypnosis to remove their symptoms under the physician’s guidance. Breuer introduced three critical innovations: He listened attentively to Fräulein Anna O.’s communications, insisting that she tell him everything. He was truly interested in her private world and created with her assistance a continuous treatment to allow her to develop her convoluted stories. No one up to that moment had listened to a patient with such “immense care and patience” Freud said (1925b , p. 279). It was the beginning of a totally new mode of listening to spoken words and to the person who spoke them. The aim of such a method was completely new: to focus attention not on visible symptoms but to assist the patient to reveal her private pathogenic experiences in her own words. It took an astonishing act of courage to resort ‘only to words’ as a method of treatment in a medical and scientific environment committed exclusively to physical and chemical causes.
FREUD LEARNS TO TALK WITH FRAU EMMY VON N.
Freud saw Frau Emmy, a woman in her forties, for the first time on May 1, 1889. He described that her: “symptoms and personality interested me so greatly that I devoted a large part of my time to her … She was a hysteric ….This was my first attempt at handling that therapeutic method” (Breuer and Freud, p. 48).
She had a multitude of symptoms, including disturbances in her speech and numerous memories of frightening childhood events. Freud would hypnotize her and ask her to talk while still using customary medical techniques such as baths and massages.
He was still acting as the physician of the time by giving her hypnotic orders and posing many questions. He documented that during her massages she was able to talk on her own, to remember some events and “unburden herself without being asked to” (p. 56). Freud rejoiced: “It is as though she had adopted my procedure and was making use of our conversation, apparently unconstrained and guided by chance, as a supplement to her hypnosis” (p. 56, my italics). Yet Freud kept asking questions. One day Frau Emmy “Said in a definitely grumbling tone that I was not to keep on asking her where this and that came from, but to let her tell me what she had to say” (p. 63, my italics). “She then began of her own accord to talk about the things that had most affected her”(p. 64). Freud observed: “What she tells me before the hypnosis becomes more and more significant” (p. 64).
These citations suggest that Frau Emmy became Freud’s teacher as implied in the 1918 letter he wrote to her daughter: “It was precisely in connection with this case … that I … received the incentive to create psychoanalytical therapy” (Andersson, 1979. p. 14).
Another patient, Frau Cäcilie M., demonstrated that she could feel verbal remarks as real events. She was cured of her facial neuralgia when she revived in analysis what she felt was “a bitter insult” by her husband: “She put her hand to her cheek, gave a loud cry of pain and said: ‘It was like a slap in the face’” (p. 178).
Freud was facing a great paradox: the ‘talking cure’ was the treatment of choice for those whose illness seemed caused by the inability to put some experiences into words, a psychical aphasia. Freud needed to explain how the ill effect of his patients’ silence became symptoms and how the power of words spoken to him cured them. How could he conceptualize the patient’s compelling need to complete their stories? Where did such a need come from, from what impulses or stimuli? I have suggested (Rizzuto, 1989) that one of Freud’s motives in writing his 1891 monograph On Aphasia came from his need to understand the speech phenomena he observed in Anna O., Emmy von N., and Frau Cäcilie.
Aphasia was a critical concern for the neurologists of the time who were creating their own models of the speech apparatus to explain neurological aphasias. However, the psychological aspect of the speech function found little or no room in those models. Freud received an invitation to write about aphasia from an encyclopedia of medicine that he said “led me to investigate the theory of aphasia … The fruit of this enquiry was a small critical and speculative book, Zur Auffassung der Aphasien”(1925, p. 18, my italics). Freud was already a prominent neurologist quite capable of challenging his seniors with his own ideas and the creation of his own speech apparatus. I contend that the monograph attends simultaneously to the pathology of neurally caused aphasias but also to the conditions for spontaneous speech and psychical functional aphasias (Rizzuto, 1993) . I believe that he wrote it at the mansion of Frau Emmy during the time he was briefly living there as her physician.
Freud considered the monograph “a really good thing,” and was bitterly disappointed about its limited reception. He said to his friend Fliess that he felt “pretty much alone … in the elucidation of the neuroses” (Freud, p. 74). Later on he refused to include it in the Standard Edition as a psychoanalytic contribution.
I disagree with Freud’s decision to exclude the monograph from his complete works. The central thesis of my book states that the monograph influenced most of Freud’s work and that his understanding of the structure and function of the speech apparatus and of the psychic word he presented in it colors his entire theoretical and technical contributions. I am not alone in this assessment.
Forrester (1980) concluded: “Freud’s work on aphasia … is the sine qua non of the birth of psychoanalytic theory as we can now distinguish it from other contemporary theories of neurosis: a theory of the power of words in the formation of symptoms” (p. 14, my italics) as well as of their resolution. Binswanger (1936), Bernfeld (1944), Stengel (1953), Kuhn (1983 ) and others consider it foundational for psychoanalysis. My paper A Proto-dictionary of Psycho-Analysis (1990) demonstrates that the basic vocabulary of psychoanalysis is already present in the monograph.
THE SPEECH APPARATUS AND ITS FUNCTIONING
The main function of the speech apparatus consists in creating the psychological word for talking and listening. Here is Freud’s diagram:
PSYCHOLOGICAL DIAGRAM OF A WORD- PRESENTATION
Object-associations
acoustic
tactile
visual
reading image
writing image
Word [presentations]
sound-image
motor image
The word presentation is shown as a closed complex of
presentations, whereas the object-presentation is shown as an
open one. The word-presentation is not linked to the object-
presentation by all its constituent elements, but only by its
sound-image. Among the object-associations, it is the visual
ones which stand for the object, in the same kind of way as the
sound-image stands for the word. The connections linking the
sound-image of the word with object associations other than
the visual ones are not indicated.
Freud, S. The Unconscious (1915) Appendix C, added by J. Strachey to the text. It is extracted from Freud’s diagram in On Aphasia.
Strachey’s translation.
In building his speech apparatus Freud followed rigorous neurological reasoning; in addition he included something rarely present in neurological papers: observations of everyday speech, self-observation, and introspection. He concluded that: 1) The speech apparatus is based on associations (Freud, 1891, 89; English, p. 87 ) and its pathology stems from anatomical lesions or functional factors that interrupt the links between associations. 2) The wish to speak and the stimuli for spontaneous speech originate in the object associations (1891, p. 92; English, p. 90). He clearly states that every “‘volitional’ excitation of the speech centres…involves the area of the auditory images [representations] and results in its stimulation by object associations” (1891, p. 86; English, p. 84). This means that the neurally registered object associations carry stimuli that activate the sound images of the word associations and ‘move’ the person to speak. 3) To perceive is to associate, because perception and association belong to one single process (1891, p. 58; English, p. 57). Freud, then, makes an astonishing assertion when he says that the paths of associations represent the perceiving body “in a manner suited to the function [of language]” (1891, p. 55, my translation; p. 53 in English, my italics) implying that the nervous system is organized to be able to use language. 4) Object representations originate in bodily sensory experiences; acoustic and motor representations contribute to the formation of word representations. As a result the speech apparatus is indebted to all the body sensory capabilities to form the elements it needs for the construction of its associations. 5) Finally, conscious representations of previously perceived objects emerge whenever the established path of object associations is stimulated: “…the psychical (das Psychische) emerges anew as a remembered image (Erinnerungsbild)” (1891, p. 58, my translation; English, p. 56) Otherwise the representations remain nonconscious.
Freud questioned the manner in which the body “is reproduced (abgebildet) in the cerebral cortex” (1891, p. 51; English, p. 50). Many neurologists postulated “exact representation of the body in the cerebral cortex” (1891, p. 49; English, p. 48). Freud’s associative theory suggests, on the contrary, that the sensory information is modified each time it reaches gray nuclei on the way up from the sense organs to the cortex. The gray nuclei add synaptic links in the form of new associations to the incoming sensory information and transform the representation they carry. I conclude that these synaptic processes convert the objects perceived and the words heard from others, into idiosyncratic personal objects and words with all their particular associative connotations. Freud did not make this extrapolation.
THE STRUCTURE OF THE APPARATUS
The speech apparatus involves the entire cerebral cortex. It has no anatomical structures proper to it. It shares the afferent pathways with the organs that bring all sensory information and has no afferent or efferent pathways of its own (1891, p 74, English, p. 72). The executive organs of the phonetic apparatus — the mouth, tongue, larynx, and all the muscles for speaking — are not part of the apparatus itself, but serve also other functions. In fact, the speech apparatus is a virtual apparatus for the meaningful organization of associations that come together to form the psychic word.
Freud entitled this illustration “Psychological Diagram of a Word-Presentation. Freud says that the words we learn from others acquire meaning by being linked to object-representations. The object representation is an intrapsychic organization of perceptual and associative processes of an individual that includes tactile, acoustic, visual and other sensory information organized as a sort of a unity. It is an open organization capable of adding new associations to itself. The word representation on the other hand is composed by the acoustic sound image and the motor image of the muscles used for the articulation of sounds, and later on in development by the writing and reading images. Freud conceives of the word representation as a “closed complex,” in the sense that words remain the same: we do not change the word ‘apple’ even though we are capable of adding personal associations to it. Then, he offers the key concept that would become the critical foundation of his theorizing and even his technique: “Among the object-associations, it is the visual ones which stand for the object, in the same kind of way as the sound-image stands for the word.” The connection between the visual component of the object representation and the sound-image of the word representation is the weakest point of the psychic word and its disruption brings about a neural or psychological aphasia.
Freud described three types of aphasia, 1) verbal and 2) agnostic that are caused by neural lesions in the cortex and 3) asymbolic aphasia that may be functional as in the case of fatigue or distraction. In asymbolic aphasia, the components of the psychological word– object and word representations– that are not neurologically damaged cannot be linked together. Most frequently than not this is not the result of a lesion but of a functional interference such as fatigue or psychopathology which do not allow the patient to form a meaningful word.
This connection between an internal object representation of an individual and a word representation form the psychological word that carries his/her personal meaning. Such words become the critical foundation for Freud’s understanding of pathology, free association, repression and a theory of cure. Theoretically Freud together with Breuer had already learned that the talking cure aims at finding meaningful psychic words to articulate the privately registered experiences of the patient. If the patient is unable to tolerate the affect elicited by the experience related to such integration he or she could not talk about it.
The main function of the speech apparatus consists in forming the psychic word the person needs and wants to speak. The apparatus is rich and theoretically and clinically very valuable but it has major shortcomings that would affect negatively the entire psychoanalytic theory and its technique. 1) It has no room for the speaking subject because it is a “self-sufficient system of representation” (Forrester, 1980, p. 29), i. e., an apparatus. 2) It limits object representations to single entities (Freud talked about substantives), and makes no room for scenic representations– that is episodic memory– or for the grammatical function of verbs and qualifiers present in ordinary speech. 3) It omits the interlocutor as indispensable for the articulation of spoken words: it is a one person model of speech. 4) Finally, it does not include any reference to the affective elements present in use of words and their phonetic components.
Together with Freud I conclude that without words we have no access to the inner world — the representational world — of another person. Words reveal the private reality that makes us unique as a species and individuals. Speaking always implies symbolizing in words the experiences of a sentient bodily mind. The talking cure opened the door, closed up to that moment, to the secret mental life of human beings, and revealed the only key to opening it: the patient’s words.
CLINICAL APPLICATIONS OF THE MODEL OF ON APHASIA
In Freud’s understanding, what makes the patient ill is the stimulation of those object associations that are not put into words. Freud’s great innovation consisted in attending to the intrapsychic function and meaning of words. The analyst aims at assisting the patient to find words for the unconscious representations that would otherwise remain unknown to him although they constitute the core of his intrapsychic life. In Freud’s description “[The analyst] gets him to talk, listens to him, talks to him in his turn and gets him to listen” (Freud, p. 187). This sums up the essence of an analysis. The words however, must be personally found living words capable of bringing back to psychic life the experienced moments and thoughts that are affectively unbearable and hence repressed.
In his work with Frau Emmy, before the writing of the monograph, Freud had not yet grasped the connection between representations and words. It was in working with her that he learned that they must be connected. As a hypnotist he was always trying to wipe away the traumatic scenes, memories and pictures she brought up. Slowly he learned that “the only way of relieving her was to give her an opportunity of talking off under hypnosis that particular reminiscence which was tormenting her at the moment, together with all its accompanying load of feelings and their physical expression” (Breuer and Freud, p. 70). Soon he learned that Frau Emmy could also talk meaningfully without being hypnotized. Technically, he concluded: “Only those symptoms of which I carried out a psychical analysis were really permanently removed” (ibid. p. 101). Freud was learning under Frau Emmy’s guidance about the connections between representations and spoken words and thinking deeply about it. I claim that such learning from her and other women patients led him to create in the context of his knowledge of neurology his own model of the speech apparatus.
Subsequently, Freud applied without mentioning On Aphasia the concept of asymbolic aphasia to the treatment of hysteria. He based his therapeutic model on three pillars: his pre-existing model of the speech apparatus, clinical data from the psychical processes he observed in his patients, and new concepts he was creating to help connect the first two. Through hypnosis and later on by directly inviting the patient to look internally he insisted that his female patients put into words what they were seeing in their minds. He was applying the assertion he had made in On Aphasia: “All stimulations to speak spontaneously come from the region of the object associations’ (E. p. 78; G. p.81). He expected that his request to look inside would activate the path of associations so that “…the psychical (das Psychische) [would]emerge[s] anew as a remembered image (Erinnerungsbild)” Freud, E. p. 56, G. 58, my translation). In this manner through the visual activation the need to speak about what emerged in the mind would progressively undo the asymbolic aphasia that caused somatic and psychical symptoms. Activating visual components in the representational reality of the patient had the potential to call forth useful words for the patient to articulate what mattered to her. In the absence of words to describe the mind’s content the stimulus of the representation had become pathogenic and led to the formation of symptoms. Freud realized that psychic pathology stems from experiences the patient was unable to tolerate.
Freud describes the intrapsychic process of symptom formation in the case of Miss Lucy, whom he treated from December of 1892 to February of 1893, a year and one half after the publication of the monograph, and presented it as his second case in Studies on Hysteria. Miss Lucy did not respond well to hypnosis but was capable of bringing up significant events in a normal state of consciousness. Freud would press on her forehead and say: “You will see something in front of you or something will come into your head. Catch hold of it. It will be what we are looking for” (ibid, p. 110). Then he theorized about the pathogenic moment:
The actual traumatic moment, then, is the one at which the incompatibility [Wiederspruch, contradiction] forces itself upon the ego [sich dem Ich aufdrängt] and at which the latter decides on the repudiation [Verweisung] of the incompatible idea [Vorstellung]. That idea is not annihilated by a repudiation of this kind, but merely repressed into the unconscious [ins Unbewußte gedrängt]. … The splitting [Spaltung ] of consciousness in these cases of acquired hysteria is accordingly a deliberate and intentional one [eine gewollte, absichtliche]… the actual outcome is something different from what the subject intended. What he wanted was to do away with an idea [Vorstellung], as though it had never appeared, but all he succeeds in doing is to isolate it psychically. (Breuer and Freud, 1893-1895, p. 123).
The treatment of hysteria therefore calls for a technique capable of reestablishing the missing connection between representations and words, i.e., undoing an asymbolic aphasia. It is that connection that makes the representation conscious and gives meaning to the spoken words. Freud believed that these words had the power to revive the original traumatic moment and its affect and bring it to conscious awareness. The goal was to integrate the patient’s experience in her conscious ego [Ich], thus increasing her understanding and acceptance of herself.
He did the same in working with Fräulein Elisabeth von R. whom he began to see in the autumn of 1892. When he was unable to hypnotize her, Freud resorted to pressing her forehead and instructed her to report to him “faithfully whatever appeared before her inner eye or passed through her memory at the moment of the pressure” (p. 145, my italics). In the chapter on “Psychotherapy of Hysteria” Freud explains that: “The procedure by pressure is no more than a trick for temporarily taking unawares an ego which is eager for defence” (p. 278). His intention was to create a state of divided attention — an expression he had used in On Aphasia– to distract the patient’s ego so that the painful scenes could emerge. When things went well with Fräulein Elisabeth he reported that “it was surprising with what promptitude the different scenes relating to a given theme emerged in a strictly chronological order. It was as though she were reading a lengthy book of pictures, whose pages were being turned over before her eyes” (ibid, my italics). Freud’s satisfaction was obvious: “I derived from this analysis a literally unqualified reliance on my technique” (p. 154). At other times she would not get close to her troubles, and Freud in the hope of eliciting meaningful imagery even asked her to visit the grave of her sister since he suspected it was related to his patient’s psychic crime. But Fräulein Elisabeth showed him what psychical resistance can be and do. The term resistance originated in the patient’s efforts not to remember, to visualize, to feel, and to communicate the representations that troubled her. Freud described what intense effort it cost him to overcome the patient’s resistance and concluded: “It is the psychotherapist’s business to put these together once more into the organization which he presumes to have existed” (p. 291), i.e, to restore the integrity of the psychical representation and the words that make them conscious. Freud’s technical proposal was unavoidable: “Words are the essential tool of mental treatment.” Their task of making conscious what had been rejected restored the patient’s psychical integrity.
THEORETICAL ELABORATIONS OF THE MODEL OF ON APHASIA
It is impossible to summarize in the twenty pages allowed for a lecture the extremely rich elaborations and new theorizing that Freud added to his early conception of the function of words and the participation of their components in the formation of symptoms, dreams, repression, the unconscious, jokes, the pathology of everyday life and the dynamics of psychic life. For those who really want to know I have only one recommendation: read the book!
Today I would limit myself to explore Freud’s conceptions of the role of words in the interpretation of dreams, repression, and technique.
The Interpretation of Dreams
Freud considered that “the interpretation of dreams is like a window through which we can get a glimpse of the interior of that [mental] apparatus” (p. 219). It is worth remembering that in The interpretation of Dreams Freud also conceived the mind as a mental apparatus of which the speech apparatus was the antecedent.
Freud’s use of the word ‘glimpse’ is apt because most of what is to be uncovered pertains to imagery, scenes, and memories of events in the individual’s life. Dream interpretation reveals another variety of asymbolic aphasia: thoughts, scenes, and feelings that belong together have been kept apart by censorship. When the disguises employed in dream formation are removed these elements are put together again and verbalized. We notice in the Interpretation of Dreams a shift in Freud’s vocabulary. He does not use the expression ‘object-representation’ as the element that must be linked to words to achieve meaning. Without any explanation he replaces it with ‘thoughts’ and ‘scenes’ as they appear in the dream and in the associations to it. He did not use the expression ‘object-representation’ again until 1915, in The Unconscious, where he refers to it for the last time as a theoretical term. For this reason, Strachey added the corresponding portion of On Aphasia, as Appendix C to The Unconscious, as shown in the graphic here. Freud’s complex model for reaching the personal meaning of a dream, when simplified to its essential elements, has the same structure as the asymbolic aphasia model.
Freud insists that in waking and in dreaming states, psychic life is guided by purposes. The essence of dream interpretation consists in making unrecognized hidden wishful purposes accessible and meaningful to conscious awareness. However, the ever-present tension between the purposive psychic life of the individual and Freud’s conception in the Interpretation of Dreams of a self-sufficient mental apparatus carries the problem created by its predecessor, the speech apparatus: a purpose requires a subject but the mental apparatus has no subject. The patient’s purpose in the dream escapes his conscious awareness. Psychoanalysis aims at making that purpose available to the dreamer by articulating it in words so that it can be integrated into his understanding of himself.
Unconscious processes transform memories, somatic stimuli, the day’s residues, dream thoughts, and dream wishes to give them an internal perceptual form in the manifest dream’s imagery that is acceptable to the dreamer’s censorship. This transformative process creates visual and sensory representations to disguise unacceptable wishes. They present illusory imagery for the purpose of creating a defensive and distracting decoy.
The manifest content is what the dreamer knows consciously about his experience during sleep upon awakening. The more or less vivid imagery can be described in words to oneself or to another as the internal perceptions and feelings the dreamer recalls. The prevalent form of these images is visual, but the dream may also include verbal and auditory experiences as well as sensations of touch, smell, taste, bodily movements and visceral feelings. The vividness and dramatization of events in the manifest content are decoys to distract the dreamer from his true purposes and concerns.
There is here a difference with the conception of On Aphasia. In the monograph, the word did link to the visual representation of a mental object, whose psychic value and reality were not challenged. An apple is an apple. An apple in a dream is and is not an apple: it functions as a decoy in the form of an apple, a distortion effected by the displacement and condensation that the dream formation has imposed on the actual thought processes of the dreamer.
In the process of dreaming a thought that may be a wish, is objectified and “is represented as a scene, or, as it seems to us, is experienced” (1900, 534). Reconstituting the original repressed thoughts that motivated the person’s dream and undoing their disguise is the goal of the interpretation of dreams. Those thoughts once verbalized would elicit affect, an affect that was already hinted at in the dream. Freud says explicitly that the affect experienced during dreaming is a real, undisguised affect. He concludes that in dreams the affect is the constituent “which alone can give us a pointer as to how we should fill in the missing thoughts,” meaning the correct completion of the representational complex after undoing the censorship. (Freud, 1900, 461). The completion of the “complex” [an expression from On Aphasia] means, I believe, reaching the original repressed thoughts that motivated the person’s dream thoughts by the mediation of the associative words in analysis. As a result, the feelings and thoughts originally experienced join together to undo the defensive asymbolic aphasia, and the patient becomes able to talked about what she had repressed in dreaming.
What is the role of words in the dream process? The dream-work has transformed meaningful dream thoughts into the nonsensical pictographic dream content. “In this process thoughts are transformed into images, mainly of a visual sort; that is to say, word-presentations are taken back to thing-presentations which correspond to them” (Freud, 1917, p. 228). It has to do with the dream process’s need for visual representation. Freud says that the dream formation “does not shrink from the effort of recasting unadaptable thoughts into a new verbal form … provided that that process facilitates representation” (p. 344, my italics), in other words the dreaming process seeks words capable of eliciting visual imagery. The task of analysis is to uncover the original dream thoughts by following the associations to the decoy imagery in the dream until they lead to the censored original thoughts. “It is from these dream-thoughts and not from a dream’s manifest content that we disentangle its meaning” (Freud, 1900, p. 277).
Freud comments: “It is very noteworthy how little the dream-work keeps to the word-presentations; it is always ready to exchange one word for another till it finds the expression which is most handy for plastic representation” [plastic means visual or sensory] (p. 228). … Freud clarifies that “for a dream all operations with words are no more than a preparation for a regression to things” (221, of this). He presents the example of his dream in using the same sounding word ‘Kosten’ [cost], a name, and ‘kosten’ [to taste], a verb, to cover up in a dream his wish to get things at low cost (Kosten) by dreaming about eating spinach, the taste of which he disliked as a child.
The model of the psychic word sustains the conceptualization of the dream formation in the mind. The ‘progressive’ sequence in On Aphasia established that the object association produced stimuli. The visual component associated with that object is linked to the sound component of the word, which activates the motor execution of the spoken word. In The Interpretation of Dreams the direction is reversed. There is no motor act; instead the sound component of the word in the mind of the dreamer (kosten/Kosten) acts as the stimulus to activate the visual imagery. In dreams “the excitation moves in a backward direction. Instead of being transmitted towards the motor end of the apparatus it moves towards the sensory end and finally reaches the perceptual system” (1900, 542) [point to graphic here], i.e., the direction is reversed. Most of the imagery in the remembered dream represents a decoy to conceal the actual scenes present in the thoughts the person has had as a repressed wish. The interpretation of the dream links those mental scenes to conscious words to assist the patient to accept the wish as her own. In the dream Three theater tickets, the imagery of being in a hurry to buy the tickets is linked to the woman’s earlier hurry to marry her present husband and the ensuing retroactive wish that she could have gotten a much better husband if she had not been in a hurry.
CONSCIOUSNESS AND REPRESSION AS GAPS IN CONSCIOUSNESS
“The theory of repression is the corner-stone on which the whole structure of psycho-analysis rests” ( Freud, 1914, p. 16).
In this second part of my lecture I will present a broad overview of Freud’s conceptions about the function of words in psychic life. I will make explicit several premises present from the beginning in his work but not clearly presented except in a few places. My purpose is to organize and simplify his very complex ideas about the intrapsychic function of words.
In his posthumously published Some Elementary Lessons in Psycho-Analysis, (Freud, 1940) Freud repeats that : “The psychical … is in itself unconscious” (p. 283), while “consciousness is only a quality …. of what is psychical, and moreover an inconstant one” (p. 285-286). Yet, it “remains the one light which illuminates our path and leads us through the darkness of mental life. In consequence … our scientific work … will consist in translating unconscious processes into conscious ones, and thus filling in the gaps in conscious perception.…” (p. 286, my italics). The gaps in consciousness result from potentially conscious internal perceptions that have been repressed and made unconscious under the aegis of the pleasure principle so as to avoid psychic pain.
This rich sentence condenses the essence of Freud’s psychoanalytic work and the theories that support it. Conscious perception is always a transient phenomenon. However, perception of external and internal phenomena is the origin and foundation of psychic life. As Freud described in On Aphasia the senses’ perceptions get continuously enriched on the way to the cerebral cortex by gathering new associations as they pass through several gray nuclei. Modern scientists’s lingo affirms that there is no immaculate perception. In Freud’s view the perceptive process leaves behind what he called facilitations in relation to the sequence of neuronal excitatory processes involved in it. Thought formation “must make no essential changes in the facilitations created by the primary process; otherwise , indeed, it would falsify the traces of reality” (Freud, 1950- 1985, p. 335) . These unchangeable neuro-psychical registrations are the foundation of psychic determinism, i.e. the organism’s use of pre-established facilitating paths of perception and thought in its functioning.
All the percepts of a given individual remain registered in the descriptive unconscious as her/his psychic reality. This vast unconscious allows for a limited consciousness. Freud insists that nothing is conscious that has not been previously unconscious (Freud, 1900, 613). Nonconscious thought processes may recombine aspects of these perceptions but they have no way of accessing consciousness. There is only one key, one tool to make unconscious thought available to its owner: speech serves the intrapsychic function of making thought and memory of registered intrapsychic processes perceptible and available to conscious awareness. To put it briefly, speech creates a perceptible internal reality and permits access to the thought reality of the person, i.e. not the reality of perception but of our own thoughts and conceptions in the interior of the mind (Freud’s Project, p. 373). Freud made it very clear that psychic life takes place in the realm of such thought reality, which through its associative processes transforms any perception of actual reality and private thoughts into the idiosyncratic psychic reality of the perceiver. Without words such unconscious psychic reality remains unknown to the person who has perceptions and thoughts. In describing a psychical reality that differs from perceptual reality Freud set the stage for the field of psychoanalytic exploration based on the use of spoken words to bring unconscious psychic reality to conscious awareness.
Furthermore these processes “share this character of indestructibility with all other mental acts which are truly unconscious …. These are paths which have been laid down once and for all, which never fall into disuse and which, whenever an unconscious excitation re-cathects them, are always ready to conduct the excitatory process to discharge” (Freud, 1900, p. 553). Here we have the so called facilitations he described in On Aphasia. The excitatory process is the direct heir– in my opinion — of the latent stimulation Freud described in On Aphasia as present in the object-representations that would stimulate speech. The dynamic potential for some level of expression is always present in our unknown unconscious.
Psychic life becomes truly complicated when the pleasure unpleasure principle is applied. The nervous system and its mental processes do not tolerate unpleasure. Psychic defenses, in particular repression, intervene to block the emergence of any process that brings unpleasure to conscious awareness. Freud insists that this “is the key to the whole theory of repression: the second system [secondary thought processes and words] can only cathect an idea if it also inhibits any development of unpleasure that may proceed from it. Anything that excites unpleasure would be inaccessible to the second system as well as to the first. These elements would promptly be dropped in obedience to the unpleasure principle” (Freud, 1900, p. 601). Repression has entered the dialectic between conscious and unconscious processes and has created a gap in the conscious memory and mental processes of the person. The stimulation of the unconscious representation “seeking” verbal expression has been interrupted and placed under repression. However, if the significance of the unconscious object is strong it will continue to seek some expression, more frequently than not in a symptom. Freud knew from working with hysterics that only a complete narrative of a repressed thought or experience could remove the symptoms and bring pathogenic memories and the mind to rest.
In brief, the pleasure principle would interfere with conscious awareness of painful memories of events or of private thoughts and fantasies and their verbalization. There is a gap in the consciousness of the individual even if s/he is not aware of it, except in the form of symptoms, obscure distress, incomprehensible behaviors, or repeated enactments in everyday life. The person has become a mystery to him/herself in this realm of his life. Pathology represents a transformed manifestation of those aspects of his psychic reality that are affectively painful and cannot be integrated into her consciousness due to the unrelenting work of repression.
Role of words in technique
Freud was proud of his discovery of repression as a mechanism of defense. It was an extraordinary scientific innovation and the key that opened the door to the newly discovered unconscious. He took care that the credit would go to him: “The theory of repression quite certainly came to me independently of any other source” (Freud, 1914, p. 15). The discovery emerged from his observations of resistance in his patients. They were unable to follow their associations. They interrupted themselves or found circuitous ways of avoiding what was emerging in their minds. But Freud remained certain that there was only one way out of this pathological dilemma: to translate those unpleasurable representations into adequate words while assisting the patient to tolerate the pain and distress that emerged with them. He presented the moving example of Fräulein Elisabeth when he put it to her that what she could not accept and had caused her problems with walking was that she was in love with her brother-in-law. She experienced a terrible pain but once she was able to accept that she had been in love with him her symptoms disappeared.
Freud used his technique of free association to facilitate the verbalization of unconsciously repudiated material by making use of two notions implicitly present in On Aphasia: the first, he invited the patient to remove as much as possible any incipient censorship and to allow herself to accept whatever came to mind, a literal translation of the German, what fell into the mind (Einfall), and to the best oh her ability to perceive it as it appeared, usually in the form of images connected to memories, thoughts, and fantasies. This part of the technique aimed at the revival of derivatives of repressed past perceptions. The second part of the process consisted of asking the patient to tell him in words what she had perceived internally. This double maneuver was an application of the concept of divided attention, a way of tricking the patient’s ego into allowing derivatives of the repressed to emerge in words. He had described the phenomenon of divided attention in On Aphasia. The process facilitated getting closer to the repressed until it could be articulated and the affect could be progressively tamed until the patient was able to tolerate it in his conscious awareness.
In my reading of it, Freud’s technique of free association and its use in the therapeutic process is based on the psychic word of On Aphasia, in which a representation finds the adequate word that expresses what the patient had previously repressed.
It is important to clarify that the notion of “representation” is too limited. Freud did not use it in his clinical writings. Instead he spoke of thoughts, events, and scenes. Representation is a theoretical term and scenes and events is what we actually perceive in life: lived moments, imagery, thoughts of our past and present life and the memories of them. The problem that arises when we try to translate such internal phenomena into spoken words is that the words cannot encompass the entire richness of the imagery. This is one of the reasons that prompted Freud to ask his patients to look again to see what else could be put into words. It is the same thing that causes us today to go over and over a situation during the therapeutic process until a more complete meaning is found that the patient is able to accept along with the affects he is able to tolerate. Usually these “representations” become a meaningful narrative of a repressed experience. The gap in consciousness has now been closed.
Freud’s great contribution in relation to speech consists in having unveiled the intrapsychic function of words, their capacity to carry the most private experiences of our personal lives, even those we are unable or unwilling to know. Freud showed us beyond doubt that the true referent of a word is not external reality but the intrapsychic processes that represent the idiosyncratic reality of our private mind. For this reason the psychoanalytic dialogue is like no other and differs significantly from that of everyday life. Freud said: “The talk of which psycho-analytic treatment consists brooks no listener; it cannot be demonstrated” (p. 17) and “you cannot be present as an audience at a psycho-analytic treatment. You can only be told about it … at second hand, as it were” (Freud, 1915-16, p. 18).
Freud wrote the Ego and the Id in 1923. In it he returns and amplifies his conceptions about the function of words in psychic life and connects each agency to words in the therapeutic process of undoing repression. He says: “It is done by supplying Pcs. intermediate links through the work of analysis” (p. 21). He goes on to elaborate in detail the different connections between the three levels of consciousness in relation to the use of words. I leave that out now because I want to focus on the “dialogues” he describes between the agencies in relation to identification and love.
Freud describes that “When it happens that a person has to give up a sexual object, there quite often ensues an alteration of his ego which can only be described as a setting up of the object inside the ego” (p. 29), i. e., a representational process. There is an identification with the object that leads Freud to “suppose that the character of the ego is a precipitate of abandoned object-cathexes and that it contains the history of those object-choices” (p. 29). This identification also affects the id because it is “a method by which the ego can obtain control over the id and deepen its relations with it—at the cost, it is true, of acquiescing to a large extent in the id’s experiences” (p. 30, my italics). At this point Freud introduces a fascinating ‘dialogue’ between the ego and the id: “When the ego assumes the features of the object, it is forcing itself, so to speak, upon the id as a love-object and is trying to make good the id’s loss by saying: ‘Look, you can love me too—I am so like the object.’”(p. 30, my italics).
This metaphoric statement has a profound truth. What I find especially interesting is that the ego ‘talks’ to the id to ‘seduce’ it into loving the ego with the same love it had for the object. The “you can love me too” of the sentence indicates the intention to use visual similarity to get the id’s love. It implies that in the internal life of the individual the visual representation of the object and of the ego identified with it are so much alike that the id would be able to love it. In my reading of it, the sentence implies more than a single instance of identification. Such an internal dialogue between aspects of ourselves is an everyday event that colors not only our relationship with ourselves, but also with all the objects that pertain to our psychic reality. In my appraisal, as in the sentence addressed by the ego to the id, words do not stand alone: visual imagery also enters the conversation as when the ego insists on being loved because of its resemblance to the object. The imperative request for love is not enough: the id has to ‘see’ that the ego resembles the object. Once more the visual representation of the object is the means by which the ego demands the id’s love. Even the agencies of the mind communicate through psychic words effect their aim.
There is much more to be said. However I have no time left. I hope to have demonstrated beyond reasonable doubt the lasting influence of the model of the spoken word in On Aphasia upon Freud’s theories and technique. I hope to have shown that our psychic life is conditioned by our need to speak to others and ourselves. I hope to have convinced you that our “talking cure” is the only procedure that opens up the closed doors of our vast unconscious mind.
Finally, in closing I want to mention the negative impact of the model of the speech and mental apparatuses on psychoanalytic theory and technique. 1) They have left out the speaking and sentient subject as agent. Apparatuses neither act nor feel: there are the machinery of the mind. 2) Freud retained the notion of affect as discharge while ignoring at the theoretical level that affect represents the experience of a sentient subject. 3) Finally, Freud never considered the role of the addressee during speech even though he did not fail to notice transference and countertransference. These limitations cut deep into our classic psychoanalytic theory. Many of the new theories that have emerged in the last five decades attempt to address one of these theoretical failures by offering new proposals. This is not the place to address them.
Instead it is my hope and my suggestion that we take very seriously the way we speak with our patients in all its staggering complexity and progressively elaborate in as systematic way as the subject matter permits our conception of psychoanalytic speech. It is an enormous task but it opens up our curiosity and brings with it much excitement.
Psychic life becomes truly complicated when the pleasure unpleasure principle is applied. The