Freud's view of hysteria in light of modern trauma research

Freud's earliest notion of the aetiology of hysterical symptoms was based on his hypothesis on the importance of trauma dissociation, upon which he began to construct his first theory of neurosis. Soon, his conception of trauma narrowed to apply only to sexual trauma, and later only to childhood experiences of sexual abuse by the father. He substituted these earliest variations on a theory of neurosis with the libido theory due to his discovery of infantile sexuality, the poor treatment results he had with hysteric patients, the frequency of hysteria symptoms, the difficulties he had in distinguishing between his patients' internal and external realities and the ambiguous nature of the reasons behind the patients' problems, presumably due to repression. Recent trauma research, however, has rediscovered trauma dissociation, which is separate from repression. This has led to a new theoretical understanding of trauma-originated dynamics and the development of corresponding treatment interventions. In this paper, the author analyzes the development of Freud's conceptions of hysteria in the social-clinical cultural context of his period, as well as the reasons which led Freud to abandon the notion that trauma dissociation was an underlying cause of hysteria symptoms.     

Freud’s Three Theories of Neurosis: Towards a Contemporary Theory of Trauma and Defense

This paper explores the development of Freud’s thinking on the aetiology of the neurosis. It is shown that Freud in the years 1893 to 1897 formulated three distinct and mutually incompatible theories of neurosis centred respectively on (a) psychic trauma and defence, (b) sexual trauma (seduction), and (c) repressed sexuality (libido). For Freud the decisive step was the shift from the first to the second theory, not from the second to the third. It is examined how Freud gave priority to the libido/fantasy theory until he returned in 1926 to a general trauma theory with his second theory of anxiety. The fate of Freud’s theory of neurosis in later psychoanalytic thinking is described as a process of dilution rather than an exploration of what is right and what is wrong in the theory. It is argued that the basic fault common to Freud’s second and third theories is the insistence on an exclusive sexual aetiology of the neurosis. On the other hand, it is argued that Freud’s first theory, centred on emotional trauma and defence, has turned out to be basically right and is therefore well suited to constitute a basis for a contemporary theory of neurosis (non-neurological mental disorders).     

Rorschach Correlates of Traumatic Neurosis of War

Only two cases out of a total population of 1500 military men evacuated from a war zone with psychiatric diagnoses were found to be suffering from traumatic neurosis. The Rorschach protocols of these two cases are presented and discussed within Kardiner's theoretical framework. Despite diverse social, educational, and occupational backgrounds these two Ss produced markedly similar protocols illustrating how in traumatic neurosis projective stimuli may serve as releasors for the abreactive repetition of the trauma as seen in highly charged responses which are affect-laden, violent, phobic and sometimes psychotic-like in nature.     

FREUD'S LETTERS TO FLIESS: FROM SEDUCTION TO SEXUAL BIOLOGY, FROM PSYCHOPATHOLOGY TO A CLINICAL ANTHROPOLOGY

The author describes the development of Freud's theory of neurosis from 1892 onwards, starting with his distinction between the actual neuroses and the psychoneuroses and his discovery of a specific, sexual aetiology for both, until which point it remained limited to pathology. The problem of the aetiology of perversion, however, confronted him with a paradox within the theory of seduction: how can an infantile sexual pleasure produce unpleasure when it is remembered at the time of puberty? This problem could not be solved within the framework of the seduction theory because the asexuality of childhood was essential to this theory. For an answer Freud had to turn to biology. He considered that the transformation of an infantile pleasure into unpleasure presupposed an organic repression of non‐genital sexual pleasure. This hypothesis of organic repression radically changed the anthropological claim of Freud's theory. As long as he was looking for a specific aetiology of neurosis and perversion, Freud's theory remained restricted to pathology. However, when he introduced infantile sexuality and its organic repression as universal organic processes, the strict distinction between normality and pathology could not be maintained. The author concludes that by turning to sexual biology, Freud transformed psychopathology into a clinical anthropology.     

Übertragung und Übertragungsneurose

The authors investigate Freud's concepts of transference, transference neurosis and their mutual relationship. They discuss the current criticism made on the concept of transference neurosis and raise the question, why patients accept the analyst's interpretations? They suggest understanding transference neurosis as conscious manifestations of transference referring to the analyst which are the outcome of successive interpretations of the type "just-like" followed, changed, and removed again by "just-like-it-was"-interpretations. They conclude that the patient does accept these interpretations not for reasons that are rational, but for reasons pertaining the transference situation.     

On the early history of male hysteria and psychic trauma

This paper discusses the influence of Jean-Martin Charcot's views on Sigmund Freud's early theory of hysteria and the notion of psychical trauma. We consider the early history of both psychical trauma and male hysteria, for in Charcot's view traumatic hysteria and male hysteria are identical. Freud's two 1886 lectures on male hysteria, delivered after his return from Paris, are crucial to the subject because they present Freud's first impressions of Charcot and his teaching. Some of the ideas presented in the two lectures foreshadow Freud's later generalization of the etiological role of trauma and his theory of the role of psychical trauma in the genesis of hysteria; that is, each hysterical symptom is due to a psychical trauma reviving an earlier traumatic event—the so-called principle of deferred action (Nachtraglichkeit). Several arguments substantiate the thesis that Freud's notion of psychical (sexual) trauma was developed in reference to Charcot's notion of traumatic hysteria, and that the early psychoanalytic theory of psychical trauma is clearly indebted to Freud's encounter with Charcot's male traumatic hysterical patients. The discussed Freudian development points out the major role of (physical) traumata in eliciting psychopathological pictures and in this way is of definite historical relevance for the present-day discussion on the traumatic nature of the so-called multiple personality syndrome and other dissociative disorders, and post-traumatic stress disorders.     

Ferenczi's “Confusion of Tongues” Theory and the Analysis of the Incest Trauma

Abstract

The tender-mother transference of Ferenczi's humanistic analytic orientation was as important an advance in pioneering times as was Kohut's selfobject transference in contemporary psychoanalysis. Ferenczi's clinical theory and method began a focus on pre-oedipal experiences, which eventually became an alternate to the oedipal theory. Freud was critical of Ferenczi's formulation, leading a successful attempt to suppress his work and remove it from mainstream psychoanalysis because he believed it was “regressive.” In actuality, Ferenczi's “Confusion of Tongues” theory and “Relaxation Therapy” were prophetic and pioneering attempts to understand and treat the incest trauma (ironically the clinical data upon which Freud founded psychoanalysis 100 years ago). In the case of Miss T., Ferenczi's ideas are applied to the contemporary analysis of the incest trauma.     

抑郁性神经症患者精神创伤的临床调查与分析

通过调查与分析。希望进一步了解导致抑郁性神经症的精神创伤的性质和易感人群的年龄、教育程度和性别等方面的特点。为此类疾病的病因分析及其防治提供客观的依据。结果表明：1．不同的年龄、教育程度和性别均有各自敏感的生活事件,部分生活事件在任何年龄阶段、教育程度、性别的人群中都可构成精神创伤;2．家庭矛盾、个人发展、疾病、失去亲人等生活事件容易构成精神创伤,其中家庭矛盾尤为突出;3．不可控的生活事件是构成抑郁性神经症近、远期精神创伤的重要基础。可见,抑郁性神经症的发病与精神创伤关系密切;不同教育程度、年龄、性别对生活事件的体验及其导致精神创伤的程度不同。     

Childhood and Trauma

In this paper, I follow the evolution of the concept of trauma within psychoanalytic theory, and some of the effects of this evolution. Starting out from the point where Freud gives up the theory of trauma as the cause of neurosis in 1897, and the alleged reasons for such a change, I analyze the theoretical and clinical consequences of this change within psychoanalysis. I proceed to develop Ferenczi's ideas on trauma, their relevance to present-day psychoanalytic theorizing and practice, as well as for the understanding of the psychic processes in children, tracing the development of some of these ideas in contemporary psychoanalytic thinking.     

Schilder and Pavlov’s theory of higher nervous activity

In the late 1920s, the Viennese psychoanalyst Paul Schilder, after performing a conditioning experiment with human subjects, criticized I. P. Pavlov’s concept of “experimental neurosis.” Schilder maintained that subjective reports by conditioned human subjects were more informative than the objectively observed behavior of conditioned dogs. In 1932, Pavlov published a rejoinder to Schilder’s critique in theJournal of the American Medical Association. Pavlov maintained that Schilder misunderstood the value and implications of the scientific, objective method in the study of experimental neurosis. In 1934, Schilder subjected Pavlov’s theory of higher nervous activity to an incisive critique in a 1935 article inImago. Schilder objected to Pavlov’s narrow, reductionist conceptualization of the conditional reflex. Schilder reiterated his view that the psychological, subjective explanation of the conditional reflex is preferable to the physiological, objective explanation, and that the inference of cortical phenomena from experimental findings might be improper. Neither Pavlov nor any of his disciples replied to Schilder. The author provides an apology for the Pavlovian position, suggesting that Schilder was unfamiliar with early and late writings of Pavlov.     

Psychoanalysis is a two‐way street

The paper discusses psychoanalysis as a mutual exchange between the analyst and analysand. A number of questions are raised: What was Ferenczi's and the early psychoanalysts' contribution to the interpersonal relational dynamics of psychoanalytic treatment? Why did countertransference become an indispensable tool in relationship‐based psychoanalysis? Why is the transference‐countertransference dynamic seen as a special dialogue between the analyst and analysand? What was Ferenczi's paradigm shift in the trauma theory? How did he combine the object relation approach with Freud's original trauma theory? The paper illustrates through some case study vignettes the intersubjective and intrapsychic dynamic in the process of traumatization. We can look at countertransference as an indicator of the patient's basic interpersonal experiences and traumas. Finally the paper discusses countertransference in the light of attachment theory, connecting the early initiatives of inter‐relational approaches in psychoanalysis with recent research.     

Reflections on Freud's Dora Case After 48 Years

I revisit Freud's case of Dora from the vantage point of current literary and psychoanalytic perspectives. Mahony (this issue) argues that Freud's understanding of Dora is unconvincing to the modern reader because Dora is a victim of trauma rather than sexual repression. I extend Mahony's ideas in terms of the development of psychoanalytic ideas, place Freud's view in the context of my psychoanalytic education in the mid-20th century, and suggest that modern contributions to trauma theory and memory further support the thesis that Dora was a victim of trauma rather than of conflicted libidinal desires.     

论霍妮神经症理论的人本主义倾向

霍妮神经症理论是对真实自我异化成长模式的探索,真实自我是霍妮神经症理论的逻辑起点。霍妮通过对真实自我是潜能状态的规定及自我实现的理论探索,自发地展现了其浓厚的人本主义倾向。     

Back to a crossroad: Nietzsche,Freud, and the east

Nietzsche's work reveals a gradual reversal of his initial antipathy to Buddhism, coming to view the latter no longer as an anaesthetising religious neurosis, but as a methodology for negation that inspires a conquest over ressentiment, a healing of internalized division, and a celebrative existence. This trend was influenced by his relationship to Schopenhauer and Deussen, and his own personal maturation. Both the source of this philosophy and the reasons for Nietzsche's failure to realise it in his own life are traced to conflictual intrapsychic oppositions in his own parental internalizations. Freud's central concepts (the unconscious, instinctual repression, neurosis, internalized good and bad parental objects, and the discontents of civilization) were modeled on Nietzsche's thinking. Yet Freud rejected oriental mysticism and its somatic focus as regressive. His failure to take up Nietzsche's eventual insight into Buddhism, and his consequent pessimism, are attributable to his personal and theoretical resistance to the issue of the early symbiotic union of mother and infant.     

The problem of real trauma and the future of psychoanalysis

Abstract

Contemporary psychoanalysis emphasizes the role of “real” trauma, as it is well shown by recent sociological and theoretical developments (such as Kohut's Self psychology, object relation theory, renewed interest in Ferenczi's and Sullivan's contributions, etc.). To understand more clearly these developments, the author traces again the steps laid down by Freud in building the psychoanalytic edifice. The renewed interest in the environment, in real traumas, and in the vicissitudes of object relations could be a “paradigm change” in psychoanalysis: a return to Freud's original seduction theory. This development is seen as related to the difficulties of Freud's drive theory.     

Navigating Trauma in Joseph Conrad's Victory: A Voyage From Sigmund Freud to Philip M. Bromberg

In Victory, Joseph Conrad (1915/1924) revises his earlier treatment of trauma as a singular cataclysmic event in the life of a potentially heroic adult, usually male (as depicted in Heart of Darkness [1898], Lord Jim [1900], and Under Western Eyes [1911]), to a conception of trauma as the corrosive effect of a child's repeated exposures to emotionally invalidating caregivers. Abandoning a view of trauma that would accord with Freud's account of a single shocking incident, in Beyond the Pleasure Principle, Conrad adopts instead a view that parallels Philip Bromberg's account of trauma as a series of toxic childhood occurrences. Thus Conrad's novel Victory presciently anticipates the corrective vision of contemporary relational psychoanalytic theory, which has largely supplanted Freud's more dramatic narratives with a subtle and nuanced understanding of trauma as a long-term lack of validation in childhood that forecloses adult possibilities. In Victory's portraits of two characters whose lives are constricted by pathological dissociation, Conrad presents literary examples that confirm and illumine Bromberg's clinical and theoretical explications of this pervasive psychological phenomenon.     

Freud's philosophy of the uncanny

This paper is an attempt to uncover and bring to a coherent interpretation Freud's thoughts on the phenomenon of uncanniness. Starting out with the essay “The uncanny” the author wants to show that uncanniness plays an important rôle in the turn that Freud's thinking goes through at this time, and that the concept can serve as a springboard for a critical, phenomeno- logical reading of Freud's thoughts on the development of the ego. The analysis of the phenomenon of uncanniness itself tends to disrupt the coherence of Freud's earlier views and pushes him towards his later thinking. “Unheimlich” in German has the double meaning of uncanny and unhome-like, and what is not at home in itself in an uncanny sense, according to Freud, is precisely the human ego. Freud in “The uncanny” links the interpretation of uncanniness to compulsive repetition and thus makes the connection to trauma and birth anxiety discussed in later works such as “Beyond the pleasure principle” and “Inhibitions, symptoms and anxiety”. The origin of our general sensitivity to the uncanny is thus, according to Freud, the loss of the mother suffered by the child as a kind of a priori traumatic experience, which is also the very event that makes the child into an ego. The understanding of traumatic neurosis and other forms of mental illness is consequently linked to an analysis of this primal uncanniness of life.     

霍妮神经症理论述评

依照神经症演进的心理历程为线索,从神经症的起因、人际策略、心理内防御策略、最终表现和治疗五个方面系统论述了霍妮的神经症理论,并在此基础上指出,霍妮的神经症理论是对弗洛依德思想的批判继承,其理论影响力、应用性正受到应有的关注。