Nineteenth Lecture Resistance and Repression

We now need more data before we can advance further in our understanding of the neuroses; two observations lie to hand for us. Both are very remarkable and at first were very surprising. You are of course prepared for both of them by the work we did last year.

First: when we undertake to cure a patient of his symptoms he opposes against us a vigorous and tenacious resistance throughout the entire course of the treatment. This is such an extraordinary thing that we cannot expect much belief in it. It is best to say nothing about it to the patient’s relations, for they invariably regard it as a pretext set up by us to excuse the length or the failure of the treatment. The patient, too, exhibits all the manifestations of this resistance without recognizing it as such, and it is a great step forward when we have brought him to realize this fact and to reckon with it. To think that the patient, whose symptoms cause him and those about him such suffering, who is willing to make such sacrifices in time, money, effort, and self-conquest in order to be freed from them,—that he should, in the interests of his illness, resist the help offered him. How improbable this statement must sound! And yet it is so, and if the improbability is made a reproach against us we need only reply that it is not without its analogies; for a man who has rushed off to a dentist with a frightful toothache may very well fend him off when he takes his forceps to the decayed tooth.

The resistance shown by patients is highly varied and exceedingly subtle, often hard to recognize and protean in the manifold forms it takes; the analyst needs to be continually suspicious and on his guard against it. In psycho-analytic therapy we employ the technique which is already familiar to you through dream-interpretation: we require the patient to put himself into a condition of calm self-observation, without trying to think of anything, and then to communicate everything which he becomes inwardly aware of, feelings, thoughts, remembrances, in the order in which they arise in his mind. We expressly warn him against giving way to any kind of motive which would cause him to select from or to exclude any of the ideas (associations), whether because they are too “disagreeable,” or too “indiscreet” to be mentioned, or too “unimportant” or “irrelevant” or “nonsensical” to be worth saying. We impress upon him that he has only to attend to what is on the surface consciously in his mind, and to abandon all objections to whatever he finds, no matter what form they take; and we inform him that the success of the treatment, and, above all, its duration, will depend upon his conscientious adherence to this fundamental technical rule. We know from the technique of dream-interpretation that it is precisely those associations against which innumerable doubts and objections are raised that invariably contain the material leading to the discovery of the unconscious.

The first thing that happens as a result of instituting this technical rule is that it becomes the first point of attack for the resistance. The patient attempts to escape from it by every possible means. First he says nothing comes into his head, then that so much comes into his head that he can’t grasp any of it. Then we observe with displeasure and astonishment that he is giving in to his critical objections, first to this, then to that; he betrays it by the long pauses which occur in his talk. At last he admits that he really cannot say something, he is ashamed to, and he lets this feeling get the better of his promise. Or else, he has thought of something but it concerns someone else and not himself, and is therefore to be made an exception to the rule. Or else, what he has just thought of is really too unimportant, too stupid and too absurd, I could never have meant that he should take account of such thoughts. So it goes on, with untold variations, to which one continually replies that telling everything really means telling everything.

One hardly ever meets with a patient who does not attempt to make a reservation in some department of his thoughts, in order to guard them against intrusion by the analysis. One patient, who in the ordinary way was remarkably intelligent, concealed a most intimate love-affair from me for weeks in this way; when accused of this violation of the sacred rule he defended himself with the argument that he considered this particular story his private affair. Naturally analytic treatment cannot countenance a right of sanctuary like this; one might as well try to allow an exception to be made in certain parts of a town like Vienna, and forbid that any arrests should be made in the market-place or in the square by St. Stephen’s church, and then attempt to take up a “wanted” man. Of course he would never be found anywhere but in those safe places. Once I decided to permit a man to make an exception of such a point; for a great deal depended on his recovering his capacity for work and he was bound by his oath as a civil servant not to communicate certain matters to any other person. He was content with the result, it is true, but I was not: I made up my mind never again to repeat the attempt under such conditions.

Obsessional patients are exceedingly clever at making the technical rule almost useless by bringing their over-conscientiousness and doubt to bear upon it. Patients with anxiety-hysteria sometimes succeed in reducing it to absurdity by only producing associations which are so far removed from what is wanted that they yield nothing for analysis. However, I do not intend to introduce you to these technical difficulties of the treatment. It is enough to know that finally, with resolution and perseverance, we do succeed in extracting from the patient a certain amount of obedience for the rule of the technique; and then the resistance takes another line altogether. It appears as intellectual opposition, employs arguments as weapons, and turns to its own use all the difficulties and improbabilities which normal but uninstructed reasoning finds in analytical doctrines. We then have to hear from the mouth of the individual patient all the criticisms and objections which thunder about us in chorus in scientific literature. What the critics outside shout at us is nothing new, therefore. It is indeed a storm in a teacup. Still, the patient can be argued with; he is very glad to get us to instruct him, teach him, defeat him, point out the literature to him so that he can learn more; he is perfectly ready to become a supporter of psycho-analysis on the condition that analysis shall spare him personally. We recognize resistance in this desire for knowledge, however; it is a digression from the particular task in hand and we refuse to allow it. In the obsessional neurosis the resistance makes use of special tactics which we are prepared for. It permits the analysis to proceed uninterruptedly along its course, so that more and more light is thrown upon the problems of the case, until we begin to wonder at last why these explanations have no practical effect and entail no corresponding improvement in the symptoms. Then we discover that the resistance has fallen back upon the doubt characteristic of the obsessional neurosis and is holding us successfully at bay from this vantage-point. The patient has said to himself something of this kind: “This is all very pretty and very interesting. I should like to go on with it. I am sure it would do me a lot of good if it were true. But I don’t believe it in the least, and as long as I don’t believe it, it doesn’t affect my illness.” So it goes on for a long time, until at last this reservation itself is reached and then the decisive battle begins.

The intellectual resistances are not the worst; one can always get the better of them. But the patient knows how to set up resistances within the boundaries of analysis proper, and the defeat of these is one of the most difficult tasks of the technique. Instead of remembering certain of the feelings and states of mind of his previous life, he reproduces them, lives through again such of them as, by means of what is called the ‘transference,’ may be made effective in opposition against the physician and the treatment. If the patient is a man, he usually takes this material from his relationship with his father, in whose place he has now put the physician; and in so doing he erects resistances out of his struggles to attain to personal independence and independence of judgement, out of his ambition, the earliest aim of which was to equal or to excel the father, out of his disinclination to take the burden of gratitude upon himself for the second time in his life. There are periods in which one feels that the patient’s desire to put the analyst in the wrong, to make him feel his impotence, to triumph over him, has completely ousted the worthier desire to bring the illness to an end. Women have a genius for exploiting in the interests of resistance a tender erotically-tinged transference to the analyst; when this attraction reaches a certain intensity all interest in the actual situation of treatment fades away, together with every obligation incurred upon undertaking it. The inevitable jealousy and the embitterment consequent upon the unavoidable rejection, however considerately it is handled, is bound to injure the personal relationship with the physician, and so to put out of action one of the most powerful propelling forces in the analysis.

Resistances of this kind must not be narrowly condemned. They contain so much of the most important material from the patient’s past life and bring it back in so convincing a fashion that they come to be of the greatest assistance to the analysis, if a skilful technique is employed correctly to turn them to the best use. What is noteworthy is that this material always serves at first as a resistance and comes forward in a guise which is inimical to the treatment. Again it may be said that they are character-traits, individual attitudes of the Ego, which are thus mobilized to oppose the attempted alterations. One learns then how these character-traits have been developed in connection with the conditions of the neurosis and in reaction against its demands, and observes features in this character which would not otherwise have appeared, at least, not so clearly: that is, which may be designated latent. Also you must not carry away the impression that we look upon the appearance of these resistances as an unforeseen danger threatening our analytic influence. No, we know that these resistances are bound to appear; we are dissatisfied only if we cannot rouse them definitely enough and make the patient perceive them as such. Indeed, we understand at last that the overcoming of these resistances is the essential work of the analysis, that part of the work which alone assures us that we have achieved something for the patient.

Besides this, you must take into account that all accidental occurrences arising during the treatment are made use of by the patient to interfere with it, anything which could distract him or deter him from it, every hostile expression of opinion from anyone in his circle whom he can regard as an authority, any chance organic illness or one complicating the neurosis; indeed, he even converts every improvement in his condition into a motive for slackening his efforts. Then you will have obtained an approximate, though still incomplete, picture of the forms and the measures taken by the resistances which must be met and overcome in the course of every analysis. I have given such a detailed consideration to this point because I am about to inform you that our dynamic conception of the neuroses is founded upon this experience of ours of the resistances that neurotic patients set up against the cure of their symptoms. Breuer and I both originally practised psycho-therapy by the hypnotic method. Breuer’s first patient was treated throughout in a state of hypnotic suggestibility; at first I followed his example. I admit that at that time my work went forward more easily and agreeably and also took much less time: but the results were capricious and not permanent; therefore I finally gave up hypnotism. And then I understood that no comprehension of the dynamics of these affections was possible as long as hypnosis was employed. In this condition the very existence of resistances is concealed from the physician’s observation. Hypnosis drives back the resistances and frees a certain field for the work of the analysis, but dams them up at the boundaries of this field so that they are insurmountable; it is similar in effect to the doubt of the obsessional neurosis. Therefore I may say that true psycho-analysis only began when the help of hypnosis was discarded.

If it is a matter of such importance to establish these resistances then surely it would be wise to allow caution and doubt full play, in case we have been too ready with our assumption that they exist. Perhaps cases of neurosis may be found in which the associations really fail for other reasons, perhaps the arguments against our theories really deserve serious attention, and we may be wrong in so conveniently disposing of the patient’s intellectual objections by stigmatizing them as resistance. Well, I can only assure you that our judgement in this matter has not been formed hastily; we have had opportunity to observe these critical patients both before the resistance comes to the surface and after it disappears. In the course of the treatment the resistance varies in intensity continually; it always increases as a new topic is approached, it is at its height during the work upon it, and dies down again when this theme has been dealt with. Unless certain technical errors have been committed we never have to meet the full measure of resistance, of which any patient is capable, at once. Thus we could definitely ascertain that the same man would take up and then abandon his critical objections over and over again in the course of the analysis. Whenever we are on the point of bringing to his consciousness some piece of unconscious material which is particularly painful to him, then he is critical in the extreme; even though he may have previously understood and accepted a great deal, yet now all these gains seem to be obliterated; in his struggles to oppose at all costs he can behave just as though he were mentally deficient, a form of ‘emotional stupidity.’ If he can be successfully helped to overcome this new resistance he regains his insight and comprehension. His critical faculty is not functioning independently, and therefore is not to be respected as if it were; it is merely a maid-of-all-work for his affective attitudes and is directed by his resistance. When he dislikes anything he can defend himself against it most ingeniously; but when anything suits his book he can be credulous enough. We are perhaps all much the same; a person being analysed shows this dependence of the intellect upon the affective life so clearly because in the analysis he is so hard-pressed.

In what way can we now account for this fact observed, that the patient struggles so energetically against the relief of his symptoms and the restoration of his mental processes to normal functioning? We say that we have come upon the traces of powerful forces at work here opposing any change in the condition; they must be the same forces that originally induced the condition. In the formation of symptoms some process must have been gone through, which our experience in dispersing them makes us able to reconstruct. As we already know from Breuer’s observations, it follows from the existence of a symptom that some mental process has not been carried through to an end in a normal manner so that it could become conscious; the symptom is a substitute for that which has not come through. Now we know where to place the forces which we suspect to be at work. A vehement effort must have been exercised to prevent the mental process in question from penetrating into consciousness and as a result it has remained unconscious; being unconscious it had the power to construct a symptom. The same vehement effort is again at work during analytic treatment, opposing the attempt to bring the unconscious into consciousness. This we perceive in the form of resistances. The pathogenic process which is demonstrated by the resistances we call Repression.

It will now be necessary to make our conception of this process of repression more precise. It is the essential preliminary condition for the development of symptoms, but it is also something else, a thing to which we have no parallel. Let us take as a model an impulse, a mental process seeking to convert itself into action: we know that it can suffer rejection, by virtue of what we call “repudiation” or “condemnation”; whereupon the energy at its disposal is withdrawn, it becomes powerless, but it can continue to exist as a memory. The whole process of decision on the point takes place with the full cognizance of the Ego. It is very different when we imagine the same impulse subject to repression: it would then retain its energy and no memory of it would be left behind; the process of repression, too, would be accomplished without the cognizance of the Ego. This comparison therefore brings us no nearer to the nature of repression.

I will expound to you those theoretical conceptions which alone have proved useful in giving greater definiteness to the term repression. For this purpose it is first necessary that we should proceed from the purely descriptive meaning of the word “unconscious” to its systematic meaning; that is, we resolve to think of the consciousness or unconsciousness of a mental process as merely one of its qualities and not necessarily definitive. Suppose that a process of this kind has remained unconscious, its being withheld from consciousness may be merely a sign of the fate it has undergone, not necessarily the fate itself. Let us suppose, in order to gain a more concrete notion of this fate, that every mental process—there is one exception, which I will go into later—first exists in an unconscious state or phase, and only develops out of this into a conscious phase, much as a photograph is first a negative and then becomes a picture through the printing of the positive. But not every negative is made into a positive, and it is just as little necessary that every unconscious mental process should convert itself into a conscious one. It may be best expressed as follows: Each single process belongs in the first place to the unconscious psychical system; from this system it can under certain conditions proceed further into the conscious system.

The crudest conception of these systems is the one we shall find most convenient, a spatial one. The unconscious system may therefore be compared to a large ante-room, in which the various mental excitations are crowding upon one another, like individual beings. Adjoining this is a second, smaller apartment, a sort of reception-room, in which, too, consciousness resides. But on the threshold between the two there stands a personage with the office of door-keeper, who examines the various mental excitations, censors them, and denies them admittance to the reception-room when he disapproves of them. You will see at once that it does not make much difference whether the door-keeper turns any one impulse back at the threshold, or drives it out again once it has entered the reception-room; that is merely a matter of the degree of his vigilance and promptness in recognition. Now this metaphor may be employed to widen our terminology. The excitations in the unconscious, in the antechamber, are not visible to consciousness, which is of course in the other room, so to begin with they remain unconscious. When they have pressed forward to the threshold and been turned back by the door-keeper, they are ‘incapable of becoming conscious’; we call them then repressed. But even those excitations which are allowed over the threshold do not necessarily become conscious; they can only become so if they succeed in attracting the eye of consciousness. This second chamber therefore may be suitably called the preconscious system. In this way the process of becoming conscious retains its purely descriptive sense. Being repressed, when applied to any single impulse, means being unable to pass out of the unconscious system because of the door-keeper’s refusal of admittance into the preconscious. The door-keeper is what we have learnt to know as resistance in our attempts in analytic treatment to loosen the repressions.

Now I know very well that you will say that these conceptions are as crude as they are fantastic and not at all permissible in a scientific presentation. I know they are crude; further indeed, we even know that they are incorrect, and unless I am mistaken, we have something better ready as a substitute for them; whether you will then continue to think them so fantastic, I do not know. At the moment they are useful aids to understanding, like Ampère’s manikin swimming in the electric current, and, in so far as they do assist comprehension, are not to be despised. Still, I should like to assure you that these crude hypotheses, the two chambers, the door-keeper on the threshold between the two, and consciousness as a spectator at the end of the second room, must indicate an extensive approximation to the actual reality. I should also like to hear you admit that our designations, unconscious, preconscious, and conscious, are less prejudicial and more easily defensible than some others which have been suggested or have come into use, e.g. sub-conscious, inter-conscious, co-conscious, etc.

If so, I should think it more significant if you then went on to point out that any such constitution of the mental apparatus as I have assumed in order to account for neurotic symptoms can only be of universal validity and must throw light on normal functioning. In this, of course, you are perfectly right. We cannot follow up this conclusion at the moment; but our interest in the psychology of symptom-development would certainly be enormously increased if we could see any prospect of obtaining, by the study of pathological conditions, an insight into normal mental functioning, hitherto such a mystery.

Do you not recognize, moreover, what it is that supports these conceptions of the two systems and the relationship between them and consciousness? The door-keeper between the unconscious and the preconscious is nothing else than the censorship to which we found the form of the manifest dream subjected. The residue of the day’s experiences, which we found to be the stimuli exciting the dream, was preconscious material which at night during sleep had been influenced by unconscious and repressed wishes and excitations; and had thus by association with them been able to form the latent dream, by means of their energy. Under the dominion of the unconscious system this material had been elaborated (worked over)—by condensation and displacement—in a way which in normal mental life, i.e. in the preconscious system, is unknown or admissible very rarely. This difference in their manner of functioning is what distinguishes the two systems for us; the relationship to consciousness, which is a permanent feature of the preconscious, indicates to which of the two systems any given process belongs. Neither is dreaming a pathological phenomenon; every healthy person may dream while asleep. Every inference concerning the constitution of the mental apparatus which comprises an understanding of both dreams and neurotic symptoms has an irrefutable claim to be regarded as applying also to normal mental life.

This is as much as we will say about repression for the present. Moreover, it is but a necessary preliminary condition, a prerequisite, of symptom-formation. We know that the symptom is a substitute for some other process which was held back by repression; but even given repression we have still a long way to go before we can obtain comprehension of this substitute-formation. There are other sides to the problem of repression itself which present questions to be answered: What kind of mental excitations suffer repression? What forces effect it? and from what motives? On one point only, so far, have we gained any knowledge relevant to these questions. While investigating the problem of resistance we learned that the forces behind it proceed from the Ego, from character-traits, recognizable or latent: it is these forces therefore which have also effected the repression, or at least they have taken a part in it. We know nothing more than this at present.

The second observation for which I prepared you will help us now. By means of analysis we can always discover the purpose behind the neurotic symptom. This is of course nothing new to you: I have already pointed it out in two cases of neurosis. But, to be sure, what do two cases signify? You have a right to demand two hundred cases, innumerable cases, in demonstration of it. But then, I cannot comply with that. So you must fall back on personal experience, or upon belief, which in this matter can rely upon the unanimous testimony of all psycho-analysts.

You will remember that in the two cases in which we submitted the symptoms to detailed investigation analysis led to the innermost secrets of the patient’s sexual life. In the first case, moreover, the purpose or tendency of the symptom under examination was particularly evident; in the second case, it was perhaps to some extent veiled by another factor to be mentioned later. Well now, what we found in these two examples we should find in every case we submitted to analysis. Every time we should be led by analysis to the sexual experiences and desires of the patient, and every time we should have to affirm that the symptom served the same purpose. This purpose shows itself to be the gratification of sexual wishes; the symptoms serve the purpose of sexual gratification for the patient; they are a substitute for satisfactions which he does not obtain in reality.

Think of the obsessive act of our first patient. This woman has to do without the husband she loved so intensely; on account of his deficiencies and short-comings she could not share his life. She had to be faithful to him; she could not put anyone else in his place. Her obsessional symptom gives her what she so much desires; it exalts her husband, denies and corrects his deficiencies, above all, his impotence. This symptom is fundamentally a wish-fulfilment, in that respect exactly like a dream; it is, moreover, what a dream is not always, an erotic wish-fulfilment. In the case of the second patient you could see that her ritual aims at preventing intercourse between the parents or at hindering the procreation of another child; you have probably also divined that fundamentally it seeks to set her in her mother’s place. It again therefore constitutes a removal of hindrances to sexual satisfaction and the fulfilment of the subject’s own sexual wishes. Of the complications referred to in the second case I shall speak shortly.

I wish to avoid making reservations later on about the universal applicability of these statements, and therefore I will ask you to notice that all I have just been saying about repression, symptom-formation and symptom-interpretation has been obtained from the study of three types of neurosis, and for the present is only applicable to these three types—namely, anxiety-hysteria, conversion-hysteria, and the obsessional neurosis. These three disorders, which we are accustomed to combine together in a group as the TRANSFERENCE NEUROSES, constitute the field open to psycho-analytic therapy. The other neuroses have been far less closely studied psycho-analytically; in one group of them the impossibility of therapeutic influence has no doubt been one reason for this neglect. You must not forget that psycho-analysis is still a very young science, that much time and trouble are required for the study of it, and that not so very long ago there was only one man practising it: yet we are approaching from all directions to a nearer comprehension of these other conditions which are not transference neuroses. I hope I shall still be able to tell you of the developments that our hypotheses and conclusions have undergone in the course of adaptation to this new material, and to show you that these further studies have not yielded contradictions but have led to a higher degree of unification in our knowledge. Everything that has been said, then, applies only to the three transference neuroses and I will now add another piece of information which throws further light upon the significance of the symptoms. A comparative examination of the situations out of which the disease arose yields the following result, which may be reduced to a formula—namely, that these persons have fallen ill owing to some kind of PRIVATION which they suffer when reality withholds from them gratification of their sexual wishes. You will perceive how beautifully these two conclusions supplement one another. The symptoms are now explicable as substitute-gratifications for desires which are unsatisfied in life.

It is certainly possible to make all kinds of objections to the proposition that neurotic symptoms are substitutes for sexual gratifications. I will discuss two of them to-day. If any one of you has himself undertaken the analysis of a large number of neurotics, he will perhaps shake his head and say: “In certain cases this is not at all applicable, in them the symptoms seem rather to contain the opposite purpose, of excluding or of discontinuing sexual gratification.” I shall not dispute your interpretation. In psycho-analysis things are often a good deal more complicated than we could wish: if they had been simpler psycho-analysis would perhaps not have been required to bring them to light. Certain features of the ritual of our second patient are distinctly recognizable as being of this ascetic character, inimical to sexual satisfaction; e.g., her removing the clocks for the magic purpose of preventing erections at night, or her trying to prevent the falling and breaking of vessels, which amounts to a protection of her virginity. In other cases of ceremonials on going to bed which I have analysed this negative character was far more marked; the whole ritual could consist of defensive regulations against sexual recollections and temptations. But we have long ago learnt from psycho-analysis that opposites do not constitute a contradiction. We might extend our proposition and say that the purpose of the symptom is either a sexual gratification or a defence against it; in hysteria the positive, wish-fulfilling character predominates on the whole, and in the obsessional neurosis the negative ascetic character. The symptoms can serve the purpose both of sexual gratification and of its opposite so well because this double-sidedness, or polarity, has a most suitable foundation in one element of their mechanism which we have not yet had an opportunity to mention. They are in fact, as we shall see, the effects of compromises between two opposed tendencies, acting on one another; they represent both that which is repressed, and also that which has effected the repression and has co-operated in bringing them about. The representation of either one or another of these two factors may predominate in the symptom, but it happens very rarely that one of them is absent altogether. In hysteria a collaboration of the two tendencies in one symptom is usually achieved. In the obsessional neurosis the two parts are often distinct: the symptom is then a double one and consists of two successive actions which cancel each other.

It will not be so easy to dispose of a second difficulty. When you consider a whole series of symptom-interpretations your first opinion would probably be that the conception of a sexual substitute-gratification has to be stretched to its widest limits in order to include them. You will not neglect to point out that these symptoms offer nothing real in the way of gratification, that often enough they are confined to re-animating a sensation, or to enacting a phantasy arising from some sexual complex. Further, that the ostensible sexual gratification is very often of an infantile and unworthy character, perhaps approximating to a masturbatory act, or is reminiscent of dirty habits which long ago in childhood had been forbidden and abandoned. And further still, you will express your astonishment that anyone should reckon among sexual gratifications those which can only be described as gratifications of cruel or horrible appetites, or which may be termed unnatural. Indeed, we shall come to no agreement on these latter points until we have submitted human sexuality to a thorough investigation and have thus established what we are justified in calling sexual.