We may say that we have not sought out the simplest example as proof of a hidden wish-fulfillment. We would have to proceed in analogous manner with other distorted dreams. I cannot do that for you, and simply wish to express the conviction that it will be successful everywhere. But I wish to continue along this theoretical line. Experience has taught me that it is one of the most dangerous phases of the entire dream science, and that many contradictions and misunderstandings are connected therewith. Besides, you are perhaps still under the impression that I have retracted a part of my declaration, in that I said that the dream is a fulfilled wish or its opposite, an actualized anxiety or punishment, and you will think this is the opportunity to compel further reservations of me. I have also heard complaints that I am too abrupt about things which appear evident to me, and that for that reason I do not present the thing convincingly enough.
If a person has gone thus far with us in dream-interpretation, and accepted everything that has been offered, it is not unusual for him to call a halt at wish-fulfillment, and say, "Granted that in every instance the dream has a meaning, and that this meaning can be disclosed by psychoanalytic technique, why must this dream, despite all evidence to the contrary, always be forcedinto the formula of wish-fulfillment? Why might not the meaning of this nocturnal thought be as many-sided as thought is by day; why may not the dream in one case express a fulfilled wish, in another, as you yourself say, the opposite thereof, an actualized anxiety; or why may it not correspond to a resolution, a warning, a reflection with its pro's and con's, a reproach, a goad to conscience, an attempt to prepare oneself for a contemplated performance, etc? Why always nothing more than a wish, or at best, its opposite?"
One might maintain that a difference of opinion on these points is of no great importance, so long as we are at one otherwise. We might say that it is enough to have discovered the meaning of the dream, and the way to recognize it; that it is a matter of no importance, if we have too narrowly limited this meaning. But this is not so. A misunderstanding of this point strikes at the nature of our knowledge of the dream, and endangers its worth for the understanding of neuroses. Then, too, that method of approach which is esteemed in the business world as genteel is out of place in scientific endeavors, and harmful.
My first answer to the question why the dream may not be many-sided in its meaning is the usual one in such instances: I do not know why it should not be so. I would not be opposed to such a state of affairs. As far as I am concerned, it could well be true. Only one small matter prevents this broader and more comfortable explanation of the dream—namely, that as a matter of fact it isn't so. My second answer emphasizes the fact that the assumption that the dream corresponds to numerous forms of thought and intellectual operations is no stranger to me. In a story about a sick person I once reported a dream that occurred three nights running and then stopped, and I explained this suppression by saying that the dream corresponded to a resolution which had no reason to recur after having been carried out. More recently I published a dream which corresponded to a confession. How is it possible for me to contradict myself, and maintain that the dream is always only a fulfilled wish?
I do that, because I do not wish to admit a stupid misunderstanding which might cost us the fruits of all our labors with regard to the dream, a misunderstanding which confuses the dream with the latent dream-thought and affirms of the dreamsomething that applies specifically and solely to the latter. For it is entirely correct that the dream can represent, and be replaced by all those things we enumerated: a resolution, a warning, reflection, preparation, an attempt to solve a problem, etc. But if you look closely, you will recognize that all these things are true only of the latent dream thoughts, which have been changed about in the dream. You learn from the interpretation of the dreams that the person's unconscious thinking is occupied with such resolutions, preparations, reflections, etc., out of which the dream-work then builds the dream. If you are not at the time interested in the dream-work, but are very much interested in the unconscious thought-work of man, you eliminate the dream-work, and say of the dream, for all practical purposes quite correctly, that it corresponds to a warning, a resolution, etc. This often happens in psychoanalytic activity. People endeavor for the most part only to destroy the dream form, and to substitute in its place in the sequence the latent thoughts out of which the dream was made.
Thus we learn, from the appreciation of the latent dream-thoughts, that all the highly complicated psychic acts we have enumerated can go on unconsciously, a result as wonderful as it is confusing.
But to return, you are right only if you admit that you have made use of an abbreviated form of speech, and if you do not believe that you must connect the many-sidedness we have mentioned with the essence of the dream. When you speak of the dream you must mean either the manifest dream, i.e., the product of the dream-work, or at most the dream-work itself—that psychic occurrence which forms the manifest dream out of the latent dream thought. Any other use of the word is a confusion of concept that can only cause trouble. If your assertions refer to the latent thoughts back of the dream, say so, and do not cloud the problem of the dream by using such a faulty means of expression. The latent dream thoughts are the material which the dream-work remolds into the manifest dream. Why do you insist upon confusing the material with the work that makes use of it? Are you any better off than those who knew only the product of this work, and could explain neither where it came from nor how it was produced?
The only essential thing in the dream is the dream-work thathas had its influence upon the thought-material. We have no right to disregard it theoretically even if, in certain practical situations, we may fail to take it into account. Analytic observation, too, shows that the dream-work never limits itself to translating these thoughts in the archaic or regressive mode of expression known to you. Rather it regularly adds something which does not belong to the latent thoughts of waking, but which is the essential motive of dream-formation. This indispensable ingredient is at the same time the unconscious wish, for the fulfillment of which the dream content is rebuilt. The dream may be any conceivable thing, if you take into account only the thoughts represented by it, warning, resolution, preparation, etc.; it is also always the fulfillment of an unknown wish, and it is this only if you look upon it as the result of the dream-work. A dream is never itself a resolution, a warning, and no more—but always a resolution, etc., translated into an archaic form of expression with the help of the unconscious wish, and changed about for the purpose of fulfilling this wish. The one characteristic, wish-fulfillment, is constant; the other may vary; it may itself be a wish at times, so that the dream, with the aid of an unconscious wish, presents as fulfilled a latent wish out of waking hours.
I understand all this very well, but I do not know whether or not I shall be successful in making you understand it as well. I have difficulties, too, in proving it to you. This cannot be done without, on the one hand, careful analysis of many dreams, and on the other hand this most difficult and most important point of our conception of the dream cannot be set forth convincingly without reference to things to follow. Can you, in fact, believe that taking into consideration the intimate relationship of all things, one is able to penetrate deeply into the nature of one thing without having carefully considered other things of a very similar nature? Since we know nothing as yet about the closest relatives of the dream, neurotic symptoms, we must once again content ourselves with what has already been accomplished. I want to explain one more example to you, and propose a new viewpoint.
Let us again take up that dream to which we have several times recurred, the dream of the three theatre tickets for 1 Fl. 50 Kr. I can assure you that I took this examplequite unpremeditatedly at first. You are acquainted with the latent dream thoughts: annoyance, upon hearing that her friend had just now become engaged, at the thought that she herself had hurried so to be married; contempt for her husband; the idea that she might have had a better one had she waited. We also know the wish, which made a dream out of these thoughts—it is "curiosity to see," being permitted to go to the theatre, very likely a derivation from the old curiosity finally to know just what happens when one is married. This curiosity, as is well known, regularly directs itself in the case of children to the sex-life of the parents. It is an impulse of childhood, and in so far as it persists later, an impulse whose roots reach back into the infantile. But that day's news played no part in awaking the curiosity, it awoke only annoyance and regret. This wish impulse did not have anything to do immediately with the latent dream thoughts, and we could fit the result of the dream interpretation into the analysis without considering the wish impulse at all. But then, the annoyance itself was not capable of producing the dream; a dream could not be derived from the thought: "It was stupid to marry so soon," except by reviving the old wish finally to see what happens when one is married. The wish then formed the dream content, in that it replaced marriage by going to the theatre, and gave it the form of an earlier wish-fulfillment: "so now I may go to the theatre and see all the forbidden things, and you may not. I am married and you must wait." In such a manner the present situation was transposed into its opposite, an old triumph put into the place of the recent defeat. Added thereto was a satisfied curiosity amalgamated with a satisfied egoistic sense of rivalry. This satisfaction determines the manifest dream content in which she really is sitting in the theatre, and her friend was unable to get tickets. Those bits of dream content are affixed to this satisfaction situation as unfitting and inexplicable modifications, behind which the latent dream thoughts still hide. Dream interpretation must take into consideration everything that serves toward the representation of the wish-fulfillment and must reconstruct from these suggestions the painful latent dream-thought.
The observation I now wish to make is for the purpose of drawing your attention to the latent, dream thoughts, nowpushed to the fore. I beg of you not to forget first, that the dreamer is unconscious of them, second, they are entirely logical and continuous, so that they may be understood as a comprehensible reaction to the dream occasion, third, that they may have the value of any desired psychic impulse or intellectual operation. I shall now designate these thoughts more forcibly than before as "day-remnants"; the dreamer may acknowledge them or not. I now separate day-remnants and latent dream thoughts in accordance with our previous usage of calling everything that we discover in interpreting the dream "latent dream thoughts," while the day-remnants are only a part of the latent dream thoughts. Then our conception goes to show that something additional has been added to the day-remnants, something which also belonged to the unconscious, a strong but suppressed wish impulse, and it is this alone that has made possible the dream fabrication. The influence of this wish impulse on the day-remnants creates the further participation of the latent dream thoughts, thoughts which no longer appear rational and understandable in relation to waking life.
In explaining the relationship of the day-remnants to the unconscious wish I have made use of a comparison which I can only repeat here. Every undertaking requires a capitalist, who defrays the expenses, and an entrepreneur, who has the idea and understands how to carry it out. The role of the capitalist in the dream fabrication is always played by the unconscious wish; it dispenses the psychic energy for dream-building. The actual worker is the day-remnant, which determines how the expenditure is to be made. Now the capitalist may himself have the idea and the particularized knowledge, or the entrepreneur may have the capital. This simplifies the practical situation, but makes its theoretical comprehension more difficult. In economics we always distinguish between the capitalist and the entrepreneur aspect in a single person, and thus we reconstruct the fundamental situation which was the point of departure for our comparison. In dream-fabrication the same variations occur. I shall leave their further development to you.
We can go no further here, for you have probably long been disturbed by a reflection which deserves to be heard. Are the day-remnants, you ask, really unconscious in the same sense as the unconscious wish which is essential to making them suitablefor the dream? You discern correctly. Here lies the salient point of the whole affair. They are not unconscious in the same sense. The dream wish belongs to a different unconsciousness, that which we have recognized as of infantile origin, fitted out with special mechanisms. It is entirely appropriate to separate these two types of unconsciousness and give them different designations. But let us rather wait until we have become acquainted with the field of neurotic symptoms. If people say one unconsciousness is fantastic, what will they say when we acknowledge that we arrived at our conclusions by using two kinds of unconsciousness?
Let us stop here. Once more you have heard something incomplete; but is there not hope in the thought that this science has a continuation which will be brought to light either by ourselves or by those to follow? And have not we ourselves discovered a sufficient number of new and surprising things?
Doubtful Points and Criticism
LET us not leave the subject of dreams before we have touched upon the most common doubts and uncertainties which have arisen in connection with the new ideas and conceptions we have discussed up to this point. The more attentive members of the audience probably have already accumulated some material bearing upon this.
1. You may have received the impression that the results of our work of interpretation of the dream have left so much that is uncertain, despite our close adherence to technique, that a true translation of the manifest dream into the latent dream thoughts is thereby rendered impossible. In support of this you will point out that in the first place, one never knows whether a specific element of the dream is to be taken literally or symbolically, since those elements which are used symbolically do not, because of that fact, cease to be themselves. But if one has no objective standard by which to decide this, the interpretation is, as to this point, left to the discretion of the dream interpreter. Moreover, because of the way in which the dream work combines opposites, it is always uncertain whether a specific dream element is to be taken in the positive or the negative sense, whether it is to be understood as itself or as its opposite. Hence this is another opportunity for the exercise of the interpreter's discretion. In the third place, in consequence of the frequency with which every sort of inversion is practised in the dream, the dream interpreter is at liberty to assume such an inversion at any point of the dream he pleases. And finally you will say, you have heard that one is seldom sure that the interpretation which is found is the only possible one. There is danger of overlooking a thoroughly admissible second interpretationof the same dream. Under these circumstances, you will conclude there is a scope left for the discretion of the interpreter, the breadth of which seems incompatible with the objective accuracy of the results. Or you may also conclude that the fault does not rest with the dream but that the inadequacies of our dream interpretation result from errors in our conceptions and hypotheses.
All your material is irreproachable, but I do not believe that it justifies your conclusions in two directions, namely, that dream interpretation as we practice it is sacrificed to arbitrariness and that the deficiency of our results makes the justification of our method doubtful. If you will substitute for the arbitrariness of the interpreter, his skill, his experience, his comprehension, I agree with you. We shall surely not be able to dispense with some such personal factor, particularly not in difficult tasks of dream interpretation. But this same state of affairs exists also in other scientific occupations. There is no way in which to make sure that one man will not wield a technique less well, or utilize it more fully, than another. What might, for example, impress you as arbitrariness in the interpretation of symbols, is compensated for by the fact that as a rule the connection of the dream thoughts among themselves, the connection of the dream with the life of the dreamer, and the whole psychic situation in which the dream occurs, chooses just one of the possible interpretations advanced and rejects the others as useless for its purposes. The conclusion drawn from the inadequacies of dream interpretation, that our hypotheses are wrong, is weakened by an observation which shows that the ambiguity and indefiniteness of the dream is rather characteristic and necessarily to be expected.
Recollect that we said that the dream work translates the dream thoughts into primitive expressions analogous to picture writing. All these primitive systems of expression are, however, subject to such indefiniteness and ambiguities, but it does not follow that we are justified in doubting their usefulness. You know that the fusion of opposites by the dream-work is analogous to the so-called "antithetical meaning of primitive words," in the oldest languages. The philologist, R. Abel (1884), whom we have to thank for this point of view, admonishes us not to believe that the meaning of the communication which one personmade to another when using such ambiguous words was necessarily unclear. Tone and gesture used in connection with the words would have left no room for doubt as to which of the two opposites the speaker intended to communicate. In writing, where gesture is lacking, it was replaced by a supplementary picture sign not intended to be spoken, as for example by the picture of a little man squatting lazily or standing erect, according to whether the ambiguous hieroglyphic was to mean "weak" or "strong." It was in this way that one avoided any misunderstanding despite the ambiguity of the sounds and signs.
We recognize in the ancient systems of expression, e.g., the writings of those oldest languages, a number of uncertainties which we would not tolerate in our present-day writings. Thus in many Semitic writings only the consonants of words are indicated. The reader had to supply the omitted vowels according to his knowledge and the context. Hieroglyphic writing does not proceed in exactly this way, but quite similarly, and that is why the pronunciation of old Egyptian has remained unknown to us. The holy writings of the Egyptians contain still other uncertainties. For example, it is left to the discretion of the writer whether or not he shall arrange the pictures from right to left or from left to right. To be able to read we have to follow the rule that we must depend upon the faces of the figures, birds, and the like. The writer, however, could also arrange the picture signs in vertical rows, and in inscriptions on small objects he was guided by considerations of beauty and proportion further to change the order of the signs. Probably the most confusing feature of hieroglyphic writing is to be found in the fact that there is no space between words. The pictures stretch over the page at uniform distances from one another, and generally one does not know whether a sign belongs to what has gone before or is the beginning of a new word. Persian cuneiform writing, on the other hand, makes use of an oblique wedge sign to separate the words.
The Chinese tongue and script is exceedingly old, but still used by four hundred million people. Please do not think I understand anything about it. I have only informed myself concerning it because I hoped to find analogies to the indefinite aspects of the dream. Nor was I disappointed. The Chineselanguage is filled with so many vagaries that it strikes terror into our hearts. It consists, as is well known, of a number of syllable sounds which are spoken singly or are combined in twos. One of the chief dialects has about four hundred such sounds. Now since the vocabulary of this dialect is estimated at about four thousand words, it follows that every sound has on an average of ten different meanings, some less but others, consequently, more. Hence there are a great number of ways of avoiding a multiplicity of meaning, since one cannot guess from the context alone which of the ten meanings of the syllable sound the speaker intended to convey to the hearer. Among them are the combining of two sounds into a compounded word and the use of four different "tones" with which to utter these syllables. For our purposes of comparison, it is still more interesting to note that this language has practically no grammar. It is impossible to say of a one-syllable word whether it is a noun, a verb, or an adjective, and we find none of those changes in the forms of the words by means of which we might recognize sex, number, ending, tense or mood. The language, therefore, might be said to consist of raw material, much in the same manner as our thought language is broken up by the dream work into its raw materials when the expressions of relationship are left out. In the Chinese, in all cases of vagueness the decision is left to the understanding of the hearer, who is guided by the context. I have secured an example of a Chinese saying which, literally translated, reads: "Little to be seen, much to wonder at." That is not difficult to understand. It may mean, "The less a man has seen, the more he finds to wonder at," or, "There is much to admire for the man who has seen little." Naturally, there is no need to choose between these two translations, which differ only in grammar. Despite these uncertainties, we are assured, the Chinese language is an extraordinarily excellent medium for the expression of thought. Vagueness does not, therefore, necessarily lead to ambiguity.
Now we must certainly admit that the condition of affairs is far less favorable in the expression-system of the dream than in these ancient languages and writings. For, after all, these latter are really designed for communication, that is to say, they were always intended to be understood, no matter in what way and with what aids. But it is just this characteristic whichthe dream lacks. The dream does not want to tell anyone anything, it is no vehicle of communication, it is, on the contrary, constructed so as not to be understood. For that reason we must not be surprised or misled if we should discover that a number of the ambiguities and vagaries of the dream do not permit of determination. As the one specific gain of our comparison, we have only the realization that such uncertainties as people tried to make use of in objecting to the validity of our dream interpretation, are rather the invariable characteristic of all primitive systems of expression.
How far the dream can really be understood can be determined only by practice and experience. My opinion is, that that is very far indeed, and the comparison of results which correctly trained analysts have gathered confirms my view. The lay public, even that part of the lay public which is interested in science, likes, in the face of the difficulties and uncertainties of a scientific task, to make what I consider an unjust show of its superior scepticism. Perhaps not all of you are acquainted with the fact that a similar situation arose in the history of the deciphering of the Babylonian-Assyrian inscriptions. There was a period then when public opinion went far in declaring the decipherors of cuneiform writing to be visionaries and the whole research a "fraud." But in the year 1857 the Royal Asiatic Society made a decisive test. It challenged the four most distinguished decipherors of cuneiform writing, Rawlinson, Hincks, Fox Talbot and Oppert, each to send to it in a sealed envelope his independent translation of a newly discovered inscription, and the Society was then able to testify, after having made a comparison of the four readings, that their agreement was sufficiently marked to justify confidence in what already had been accomplished, and faith in further progress. At this the mockery of the learned lay world gradually came to an end and the confidence in the reading of cuneiform documents has grown appreciably since then.
2. A second series of objections is firmly grounded in the impression from which you too probably are not free, that a number of the solutions of dream interpretations which we find it necessary to make seem forced, artificial, far-fetched, in other words, violent or even comical or jocose. These comments are so frequent that I shall choose at random the latest examplewhich has come to my attention. Recently, in free Switzerland, the director of a boarding-school was relieved of his position on account of his active interest in psychoanalysis. He raised objections and a Berne newspaper made public the judgment of the school authorities. I quote from that article some sentences which apply to psychoanalysis: "Moreover, we are surprised at the many far-fetched and artificial examples as found in the aforementioned book of Dr. Pfister of Zurich.... Thus, it certainly is a cause of surprise when the director of a boarding-school so uncritically accepts all these assertions and apparent proofs." These observations are offered as the decisions of "one who judges calmly." I rather think this calm is "artificial." Let us examine these remarks more closely in the hope that a little reflection and knowledge of the subject can be no detriment to calm judgment.
It is positively refreshing to see how quickly and unerringly some individuals can judge a delicate question of abstruse psychology by first impressions. The interpretations seem to them far-fetched and forced, they do not please them, so the interpretations are wrong and the whole business of interpretation amounts to nothing. No fleeting thought ever brushes the other possibility, that these interpretations must appear as they are for good reasons, which would give rise to the further question of what these good reasons might be.
The content thus judged generally relates to the results of displacement, with which you have become acquainted as the strongest device of the dream censor. It is with the help of displacements that the dream censor creates substitute-formations which we have designated as allusions. But they are allusions which are not easily recognized as such, and from which it is not easy to find one's way back to the original and which are connected with this original by means of the strangest, most unusual, most superficial associations. In all of these cases, however, it is a question of matters which are to be hidden, which were intended for concealment; this is what the dream censor aims to do. We must not expect to find a thing that has been concealed in its accustomed place in the spot where it belongs. In this respect the Commissions for the Surveillance of Frontiers now in office are more cunning than the Swiss school authorities. In their search for documents and maps theyare not content to search through portfolios and letter cases but they also take into account the possibility that spies and smugglers might carry such severely proscribed articles in the most concealed parts of their clothing, where they certainly do not belong, as for example between the double soles of their boots. If the concealed objects are found in such a place, they certainly are very far-fetched, but nevertheless they have been "fetched."
If we recognize that the most remote, the most extraordinary associations between the latent dream element and its manifest substitute are possible, associations appearing ofttimes comical, ofttimes witty, we follow in so doing a wealth of experience derived from examples whose solutions we have, as a rule, not found ourselves. Often it is not possible to give such interpretations from our own examples. No sane person could guess the requisite association. The dreamer either gives us the translation with one stroke by means of his immediate association—he can do this, for this substitute formation was created by his mind—or he provides us with so much material that the solution no longer demands any special astuteness but forces itself upon us as inevitable. If the dreamer does not help us in either of these two ways, then indeed the manifest element in question remains forever incomprehensible to us. Allow me to give you one more such example of recent occurrence. One of my patients lost her father during the time that she was undergoing treatment. Since then she has made use of every opportunity to bring him back to life in her dreams. In one of her dreams her father appears in a certain connection, of no further importance here, and says, "It is a quarter past eleven, it is half past eleven, it is quarter of twelve." All she can think of in connection with this curious incident is the recollection that her father liked to see his grown-up children appear punctually at the general meal hour. That very thing probably had some connection with the dream element, but permitted of no conclusion as to its source. Judging from the situation of the treatment at that time, there was a justified suspicion that a carefully suppressed critical rebellion against her loved and respected father played its part in this dream. Continuing her associations, and apparently far afield from topics relevant to the dream, the dreamer relates that yesterday many things of a psychologicalnature had been discussed in her presence, and that a relative made the remark: "The cave man (Urmensch) continues to live in all of us." Now we think we understand. That gave her an excellent opportunity of picturing her father as continuing to live. So in the dream she made of him a clockman (Uhrmensch) by having him announce the quarter-hours at noon time.
You may not be able to disregard the similarity which this examples bears to a pun, and it really has happened frequently that the dreamer's pun is attributed to the interpreter. There are still other examples in which it is not at all easy to decide whether one is dealing with a joke or a dream. But you will recall that the same doubt confronted us when we were dealing with slips of the tongue. A man tells us a dream of his, that his uncle, while they were sitting in the latter'sautomobile, gave him a kiss. He very quickly supplies the interpretation himself. It means "auto-eroticism," (a term taken from the study of the libido, or love impulse, and designating satisfaction of that impulse without an external object). Did this man permit himself to make fun of us and give out as a dream a pun that occurred to him? I do not believe so; he really dreamed it. Whence comes the astounding similarity? This question at one time led me quite a ways from my path, by making it necessary for me to make a thorough investigation of the problem of humor itself. By so doing I came to the conclusion that the origin of wit lies in a foreconscious train of thought which is left for a moment to unconscious manipulation, from which it then emerges as a joke. Under the influence of the unconscious it experiences the workings of the mechanisms there in force, namely, of condensation and displacement, that is, of the same processes which we found active in the dream work, and it is to this agreement that we are to ascribe the similarity between wit and the dream, wherever it occurs. The unintentional "dream joke" has, however, none of the pleasure-giving quality of the ordinary joke. Why that is so, greater penetration into the study of wit may teach you. The "dream joke" seems a poor joke to us, it does not make us laugh, it leaves us cold.
Here we are also following in the footsteps of ancient dream interpretation, which has left us, in addition to much that is useless, many a good example of dream interpretationwe ourselves cannot surpass. I am now going to tell you a dream of historical importance which Plutarch and Artemidorus of Daldis both tell concerning Alexander the Great, with certain variations. When the King was engaged in besieging the city of Tyre (322 B.C.), which was being stubbornly defended, he once dreamed that he saw a dancing satyr. Aristandros, his dream interpreter, who accompanied the army, interpreted this dream for him by making of the wordSatyros,σἁ Τὑρος, "Thine is Tyre," and thus promising him a triumph over the city. Alexander allowed himself to be influenced by this interpretation to continue the siege, and finally captured Tyre. The interpretation, which seems artificial enough, was without doubt the correct one.
3. I can imagine that it will make a special impression on you to hear that objections to our conception of the dream have been raised also by persons who, as psychoanalysts, have themselves been interested in the interpretation of dreams. It would have been too extraordinary if so pregnant an opportunity for new errors had remained unutilized, and thus, owing to comprehensible confusions and unjustified generalizations, there have been assertions made which, in point of incorrectness are not far behind the medical conception of dreams. One of these you already know. It is the declaration that the dream is occupied with the dreamer's attempts at adaptation to his present environment, and attempts to solve future problems, in other words, that the dream follows a "prospective tendency" (A. Maeder). We have already shown that this assertion is based upon a confusion of the dream with the latent thoughts of the dream, that as a premise it overlooks the existence of the dream-work. In characterizing that psychic activity which is unconscious and to which the latent thoughts of the dream belong, the above assertion is no novelty, nor is it exhaustive, for this unconscious psychic activity occupies itself with many other things besides preparation for the future. A much worse confusion seems to underlie the assurance that back of every dream one finds the "death-clause," or death-wish. I am not quite certain what this formula is meant to indicate, but I suppose that back of it is a confusion of the dream with the whole personality of the dreamer.
An unjustified generalization, based on few good examples, is the pronouncement that every dream permits of two interpretations,one such as we have explained, the so-called psychoanalytic, and another, the so-called anagogical or mystical, which ignores the instinctive impulses and aims at a representation of the higher psychic functions (V. Silberer). There are such dreams, but you will try in vain to extend this conception to even a majority of the dreams. But after everything you have heard, the statement will seem very incomprehensible that all dreams can be interpreted bisexually, that is, as the concurrence of two tendencies which may be designated as male and female (A. Adler). To be sure, there are a few such dreams, and you may learn later that these are built up in the manner of certain hysterical symptoms. I mention all these newly discovered general characteristics of the dream in order to warn you against them or at least in order not to leave you in doubt as to how I judge them.
4. At one time the objective value of dream research was called into question by the observation that patients undergoing analysis accommodate the content of their dreams to the favorite theories of their physicians, so that some dream predominantly of sexual impulses, others of the desire for power and still others even of rebirth (W. Stekel). The weight of this observation is diminished by the consideration that people dreamed before there was such a thing as a psychoanalytic treatment to influence their dreams, and that those who are now undergoing treatment were also in the habit of dreaming before the treatment was commenced. The meaning of this novel discovery can soon be recognized as a matter of course and as of no consequence for the theory of the dream. Those day-remnants which give rise to the dream are the overflow from the strong interest of the waking life. If the remarks of the physician and the stimuli which he gives have become significant to the patient under analysis, then they become a part of the day's remnants, can serve as psychic stimuli for the formation of a dream along with other, emotionally-charged, unsolved interests of the day, and operate much as do the somatic stimuli which act upon the sleeper during his sleep. Just like these other incitors of the dream, the sequence of ideas which the physician sets in motion may appear in the manifest content, or may be traced in the latent content of the dream. Indeed, we know that one can produce dreams experimentally, or to speak more accurately,one can insert into the dream a part of the dream material. Thus the analyst in influencing his patients, merely plays the role of an experimenter in the manner of Mourly Vold, who places the limbs of his subjects in certain positions.
One can often influence the dreamer as to thesubject-matterof his dream, but one can never influencewhat he will dreamabout it. The mechanism of the dream-work and the unconscious wish that is hidden in the dream are beyond the reach of all foreign influences. We already realized, when we evaluated the dreams caused by bodily stimuli, that the peculiarity and self-sufficiency of the dream life shows itself in the reaction with which the dream retorts to the bodily or physical stimuli which are presented. The statement here discussed, which aims to throw doubt upon the objectivity of dream research, is again based on a confusion—this time of the whole dream with the dream material.
This much, ladies and gentlemen, I wanted to tell you concerning the problems of the dream. You will suspect that I have omitted a great deal, and have yourselves discovered that I had to be inconclusive on almost all points. But that is due to the relation which the phenomena of the dream have to those of the neuroses. We studied the dream by way of introduction to the study of the neuroses, and that was surely more correct than the reverse would have been. But just as the dream prepares us for the understanding of the neuroses, so in turn the correct evaluation of the dream can only be gained after a knowledge of neurotic phenomena has been won.
I do not know what you will think about this, but I must assure you that I do not regret having taken so much of your interest and of your available time for the problems of the dream. There is no other field in which one can so quickly become convinced of the correctness of the assertions by which psychoanalysis stands or falls. It will take the strenuous labor of many months, even years, to show that the symptoms in a case of neurotic break-down have their meaning, serve a purpose, and result from the fortunes of the patient. On the other hand, the efforts of a few hours suffice in proving the same content in a dream product which at first seems incomprehensibly confused, and thereby to confirm all the hypotheses of psychoanalysis, the unconsciousness of psychic processes, the special mechanism whichthey follow, and the motive forces which manifest themselves in them. And if we associate the thorough analogy in the construction of the dream and the neurotic symptom with the rapidity of transformation which makes of the dreamer an alert and reasonable individual, we gain the certainty that the neurosis also is based only on a change in the balance of the forces of psychic life.
Psychoanalysis and Psychiatry
IAM very glad to welcome you back to continue our discussions. I last lectured to you on the psychoanalytic treatment of errors and of the dream. To-day I should like to introduce you to an understanding of neurotic phenomena, which, as you soon will discover, have much in common with both of those topics. But I shall tell you in advance that I cannot leave you to take the same attitude toward me that you had before. At that time I was anxious to take no step without complete reference to your judgment. I discussed much with you, I listened to your objections, in short, I deferred to you and to your "normal common sense." That is no longer possible, and for a very simple reason. As phenomena, the dream and errors were not strange to you. One might say that you had as much experience as I, or that you could easily acquire as much. But neuroses are foreign to you; since you are not doctors yourselves you have had access to them only through what I have told you. Of what use is the best judgment if it is not supported by familiarity with the material in question?
Do not, however, understand this as an announcement of dogmatic lectures which demand your unconditional belief. That would be a gross misunderstanding. I do not wish to convince you. I am out to stimulate your interest and shake your prejudices. If, in consequence of not knowing the facts, you are not in a position to judge, neither should you believe nor condemn. Listen and allow yourselves to be influenced by what I tell you. One cannot be so easily convinced; at least if he comes by convictions without effort, they soon prove to be valueless and unable to hold their own. He only has a right to conviction who has handled the same material for many years and who in so doing has gone through the same new and surprising experiences again and again. Why, in matters of intellect theselightning conversions, these momentary repulsions? Do you not feel that acoup de foudre, that love at first sight, originates in quite a different field, namely, in that of the emotions? We do not even demand that our patients should become convinced of and predisposed to psychoanalysis. When they do, they seem suspicious to us. The attitude we prefer in them is one of benevolent scepticism. Will you not also try to let the psychoanalytic conception develop in your mind beside the popular or "psychiatric"? They will influence each other, mutually measure their strength, and some day work themselves into a decision on your part.
On the other hand, you must not think for a moment that what I present to you as the psychoanalytic conception is a purely speculative system. Indeed, it is a sum total of experiences and observations, either their direct expression or their elaboration. Whether this elaboration is done adequately and whether the method is justifiable will be tested in the further progress of the science. After two and a half decades, now that I am fairly advanced in years, I may say that it was particularly difficult, intensive and all-absorbing work which yielded these observations. I have often had the impression that our opponents were unwilling to take into consideration this objective origin of our statements, as if they thought it were only a question of subjective ideas arising haphazard, ideas to which another may oppose his every passing whim. This antagonistic behavior is not entirely comprehensible to me. Perhaps the physician's habit of steering clear of his neurotic patients and listening so very casually to what they have to say allows him to lose sight of the possibility of deriving anything valuable from his patients' communications, and therefore, of making penetrating observations on them. I take this opportunity of promising you that I shall carry on little controversy in the course of my lectures, least of all with individual controversialists. I have never been able to convince myself of the truth of the saying that controversy is the father of all things. I believe that it comes down to us from the Greek sophist philosophy and errs as does the latter through the overvaluation of dialectics. To me, on the contrary, it seems as if the so-called scientific criticism were on the whole unfruitful, quite apart from the fact that it is almost always carried on in a most personalspirit. For my part, up to a few years ago, I could even boast that I had entered into a regular scientific dispute with only one scholar (Lowenfeld, of Munich). The end of this was that we became friends and have remained friends to this day. But I did not repeat this attempt for a long time, because I was not certain that the outcome would be the same.
Now you will surely judge that so to reject the discussion of literature must evidence stubborness, a very special obtuseness against objections, or, as the kindly colloquialisms of science have it, "a complete personal bias." In answer, I would say that should you attain to a conviction by such hard labor, you would thereby derive a certain right to sustain it with some tenacity. Furthermore, I should like to emphasize the fact that I have modified my views on certain important points in the course of my researches, changed them and replaced them by new ones, and that I naturally made a public statement of that fact each time. What has been the result of this frankness? Some paid no attention at all to my self-corrections and even to-day criticize me for assertions which have long since ceased to have the same meaning for me. Others reproach me for just this deviation, and on account of it declare me unreliable. For is anyone who has changed his opinions several times still trustworthy; is not his latest assertion, as well, open to error? At the same time he who holds unswervingly to what he has once said, or cannot be made to give it up quickly enough, is called stubborn and biased. In the face of these contradictory criticisms, what else can one do but be himself and act according to his own dictates? That is what I have decided to do, and I will not allow myself to be restrained from modifying and adapting my theories as the progress of my experience demands. In the basic ideas I have hitherto found nothing to change, and I hope that such will continue to be the case.
Now I shall present to you the psychoanalytic conception of neurotic manifestations. The natural thing for me to do is to connect them to the phenomena we have previously treated, for the sake of their analogy as well as their contrast. I will select as symptomatic an act of frequent occurrence in my office hour. Of course, the analyst cannot do much for those who seek him in his medical capacity, and lay the woes of a lifetime before him in fifteen minutes. His deeper knowledge makes it difficult forhim to deliver a snap decision as do other physicians—"There is nothing wrong with you"—and to give the advice, "Go to a watering-place for a while." One of our colleagues, in answer to the question as to what he did with his office patients, said, shrugging his shoulders, that he simply "fines them so many kronen for their mischief-making." So it will not surprise you to hear that even in the case of very busy analysts, the hours for consultation are not very crowded. I have had the ordinary door between my waiting room and my office doubled and strengthened by a covering of felt. The purpose of this little arrangement cannot be doubted. Now it happens over and over again that people who are admitted from my waiting room omit to close the door behind them; in fact, they almost always leave both doors open. As soon as I have noticed this I insist rather gruffly that he or she go back in order to rectify the omission, even though it be an elegant gentleman or a lady in all her finery. This gives an impression of misapplied pedantry. I have, in fact, occasionally discredited myself by such a demand, since the individual concerned was one of those who cannot touch even a door knob, and prefer as well to have their attendants spared this contact. But most frequently I was right, for he who conducts himself in this way, and leaves the door from the waiting room into the physician's consultation room open, belongs to the rabble and deserves to be received inhospitably. Do not, I beg you, defend him until you have heard what follows. For the fact is that this negligence of the patient's only occurs when he has been alone in the waiting room and so leaves an empty room behind him, never when others, strangers, have been waiting with him. If that latter is the case, he knows very well that it is in his interest not to be listened to while he is talking to the physician, and never omits to close both the doors with care.
This omission of the patient's is so predetermined that it becomes neither accidental nor meaningless, indeed, not even unimportant, for, as we shall see, it throws light upon the relation of this patient to the physician. He is one of the great number of those who seek authority, who want to be dazzled, intimidated. Perhaps he had inquired by telephone as to what time he had best call, he had prepared himself to come on a crowd of suppliants somewhat like those infront of a branch milk station. He now enters an empty waiting room which is, moreover, most modestly furnished, and he is disappointed. He must demand reparation from the physician for the wasted respect that he had tendered him, and so he omits to close the door between the reception room and the office. By this, he means to say to the physician: "Oh, well, there is no one here anyway, and probably no one will come as long as I am here." He would also be quite unmannerly and supercilious during the consultation if his presumption were not at once restrained by a sharp reminder.
You will find nothing in the analysis of this little symptomatic act which was not previously known to you. That is to say, it asserts that this act is not accidental, but has a motive, a meaning, a purpose, that it has its assignable connections psychologically, and that it serves as a small indication of a more important psychological process. But above all it implies that the process thus intimated is not known to the consciousness of the individual in whom it takes place, for none of the patients who left the two doors open would have admitted that they meant by this omission to show me their contempt. Some could probably recall a slight sense of disappointment at entering an empty waiting room, but the connection between this impression and the symptomatic act which followed—of these, his consciousness was surely not aware.
Now let us place, side by side with this small analysis of a symptomatic act, an observation on a pathological case. I choose one which is fresh in my mind and which can also be described with relative brevity. A certain measure of minuteness of detail is unavoidable in any such account.
A young officer, home on a short leave of absence, asked me to see his mother-in-law who, in spite of the happiest circumstances, was embittering her own and her people's existence by a senseless idea. I am introduced to a well preserved lady of fifty-three with pleasant, simple manners, who gives the following account without any hesitation: She is most happily married and lives in the country with her husband, who operates a large factory. She cannot say enough for the kind thoughtfulness of her husband. They had married for love thirty years ago, and since then there had never been a shadow, a quarrel or cause for jealousy. Now, even though her two children are well married,the husband and father does not yet want to retire, from a feeling of duty. A year ago there happened the incredible thing, incomprehensible to herself as well. She gave complete credence to an anonymous letter which accused her excellent husband of having an affair with a young girl—and since then her happiness is destroyed. The more detailed circumstances were somewhat as follows: She had a chambermaid with whom she had perhaps too often discussed intimate matters. This girl pursued another young woman with positively malicious enmity because the latter had progressed so much further in life, despite the fact that she was of no better origin. Instead of going into domestic service, the girl had obtained a business training, had entered the factory and in consequence of the short-handedness due to the drafting of the clerks into the army had advanced to a good position. She now lives in the factory itself, meets all the gentlemen socially, and is even addressed as "Miss." The girl who had remained behind in life was of course ready to speak all possible evil of her one-time schoolmate. One day our patient and her chambermaid were talking of an old gentleman who had been visiting at the house, and of whom it was known that he did not live with his wife, but kept another woman as his mistress. She does not know how it happened that she suddenly remarked, "That would be the most awful thing that could happen to me, if I should ever hear that my good husband also had a mistress." The next day she received an anonymous letter through the mail which, in a disguised handwriting, carried this very communication which she had conjured up. She concluded—it seems justifiably—that the letter was the handiwork of her malignant chambermaid, for the letter named as the husband's mistress the self-same woman whom the maid persecuted with her hatred. Our patient, in spite of the fact that she immediately saw through the intrigue and had seen enough in her town to know how little credence such cowardly denunciations deserve, was nevertheless at once prostrated by the letter. She became dreadfully excited and promptly sent for her husband in order to heap the bitterest reproaches upon him. Her husband laughingly denied the accusation and did the best that could be done. He called in the family physician, who was as well the doctor in attendance at the factory, and the latter added his efforts to quiet theunhappy woman. Their further procedure was also entirely reasonable. The chambermaid was dismissed, but the pretended rival was not. Since then, the patient claims she has repeatedly so far calmed herself as no longer to believe the contents of the anonymous letter, but this relief was neither thoroughgoing nor lasting. It was enough to hear the name of the young lady spoken or to meet her on the street in order to precipitate a new attack of suspicion, pain and reproach.
This, now, is the case history of this good woman. It does not need much psychiatric experience to understand that her portrayal of her own case was, if anything, rather too mild in contrast to other nervous patients. The picture, we say, was dissimulated; in reality she had never overcome her belief in the accusation of the anonymous letter.
Now what position does a psychiatrist take toward such a case? We already know what he would do in the case of the symptomatic act of the patient who does not close the doors to the waiting room. He declares it an accident without psychological interest, with which he need not concern himself. But this attitude cannot be maintained toward the pathological case of the jealous woman. The symptomatic act seems no great matter, but the symptom itself claims attention by reason of its gravity. It is bound up with intense subjective suffering while objectively it threatens to break up a home; therefore its claim to psychiatric interest cannot be put aside. The first endeavor of the psychiatrist is to characterize the symptom by some distinctive feature. The idea with which this woman torments herself cannot in itself be called nonsensical, for it does happen that elderly married men have affairs with young girls. But there is something else about it that is nonsensical and incredible. The patient has no reason beyond the declaration in the anonymous letter to believe that her tender and faithful husband belongs to this sort of married men, otherwise not uncommon. She knows that this letter in itself carries no proof; she can satisfactorily explain its origin; therefore she ought to be able to persuade herself that she has no reason to be jealous. Indeed she does this, but in spite of it she suffers every bit as much as she would if she acknowledged this jealousy as fully justified. We are agreed to call ideas of this sort, which are inaccessible to arguments based on logic or on facts,"obsessions." Thus the good lady suffers from an "obsession of jealousy" that is surely a distinctive characterization for this pathological case.
Having reached this first certainty, our psychiatric interest will have become aroused. If we cannot do away with a delusion by taking reality into account, it can hardly have arisen from reality. But the delusion, what is its origin? There are delusions of the most widely varied content. Why is it that in our case the content should be jealousy? In what types of persons are obsessions liable to occur, and, in particular, obsessions of jealousy? We would like to turn to the psychiatrist with such questions, but here he leaves us in the lurch. There is only one of our queries which he heeds. He will examine the family history of this woman andperhapswill give us the answer: "The people who develop obsessions are those in whose families similar and other psychic disturbances have repeatedly occurred." In other words, if this lady develops an obsession she does so because she was predisposed to it by reason of her heredity. That is certainly something, but is it all that we want to know? Is it all that was effective in causing this breakdown? Shall we be content to assume that it is immaterial, accidental and inexplicable why the obsession of jealousy develops rather than any other? And may we also accept this sentence about the dominance of the influence of heredity in its negative meaning, that is, that no matter what experiences came to this human being she was predestined to develop some kind of obsession? You will want to know why scientific psychiatry will give no further explanation. And I reply, "He is a rascal who gives more than he owns." The psychiatrist does not know of any path that leads him further in the explanation of such a case. He must content himself with the diagnosis and a prognosis which, despite a wealth of experience, is uncertain.
Yet, can psychoanalysis do more at this point? Indeed yes! I hope to show you that even in so inaccessible a case as this it can discover something which makes the further understanding possible. May I ask you first to note the apparently insignificant fact that the patient actually provoked the anonymous letter which now supports her delusion. The day before, she announces to the intriguing chambermaid that if her husband were to have an affair with a young girl it would be the worstmisfortune that could befall her. By so doing she really gave the maid the idea of sending her the anonymous letter. The obsession thus attains a certain independence from the letter; it existed in the patient beforehand—perhaps as a dread; or was it a wish? Consider, moreover, these additional details yielded by an analysis of only two hours. The patient was indeed most helpful when, after telling her story, she was urged to communicate her further thoughts, ideas and recollections. She declared that nothing came to her mind, that she had already told everything. After two hours the undertaking had really to be given up because she announced that she already felt cured and was sure that the morbid idea would not return. Of course, she said this because of this resistance and her fear of continuing the analysis. In these two hours, however, she had let fall certain remarks which made possible definite interpretation, indeed made it incontestable; and this interpretation throws a clear light on the origin of her obsession of jealousy. Namely, she herself was very much infatuated with a certain young man, the very same son-in-law upon whose urging she had come to consult me professionally. She knew nothing of this infatuation, or at least only a very little. Because of the existing relationship, it was very easy for this infatuation to masquerade under the guise of harmless tenderness. With all our further experience it is not difficult to feel our way toward an understanding of the psychic life of this honest woman and good mother. Such an infatuation, a monstrous, impossible thing, could not be allowed to become conscious. But it continued to exist and unconsciously exerted a heavy pressure. Something had to happen, some sort of relief had to be found and the mechanism of displacement which so constantly takes part in the origin of obsessional jealousy offered the most immediate mitigation. If not only she, old woman that she was, was in love with a young man but if also her old husband had an affair with a young girl, then she would be freed from the voice of her conscience which accused her of infidelity. The phantasy of her husband's infidelity was thus like a cooling salve on her burning wound. Of her own love she never became conscious, but the reflection of it, which would bring her such advantages, now became compulsive, obsessional and conscious. Naturally all arguments directed against the obsession were of no avail since they weredirected only to the reflection, and not to the original force to which it owed its strength and which, unimpeachable, lay buried in the unconscious.
Let us now piece together these fragments to see what a short and impeded psychoanalysis can nevertheless contribute to the understanding of this case. It is assumed of course that our inquiries were carefully conducted, a point which I cannot at this place submit to your judgment. In the first place, the obsession becomes no longer nonsensical nor incomprehensible, it is full of meaning, well motivated and an integral part of the patient's emotional experience. Secondly, it is a necessary reaction toward an unconscious psychological process, revealed in other ways, and it is to this very circumstance that it owes its obsessional nature, that is, its resistance to arguments based on logic or fact. In itself the obsession is something wished for, a kind of consolation. Finally, the experiences underlying the condition are such as unmistakably determine an obsession of jealousy and no other. You will also recognize the part played by the two important analogies in the analysis of the symptomatic act with reference to its meaning and intent and also to its relation to an unconscious factor in the situation.
Naturally, we have not yet answered all the questions which may be put on the basis of this case. Rather the case bristles with further problems of a kind which we have not yet been able to solve in any way, and of others which could not be solved because of the disadvantage of the circumstances under which we were working. For example: why is this happily married woman open to an infatuation for her son-in-law, and why does the relief which could have been obtained in other ways come to her by way of this mirror-image, this projection of her own condition upon her husband? I trust you will not think that it is idle and wanton to open such problems. Already we have much material at our disposal for their possible solution. This woman is in that critical age when her sexual needs undergo a sudden and unwelcome exaggeration. This might in itself be sufficient. In addition, her good and faithful mate may for many years have been lacking in that sufficient sexual capacity which the well-preserved woman needs for her satisfaction. We have learned by experience to know that those very men whose faithfulness is thus placed beyond a doubt are most gentle intheir treatment of their wives and unusually forbearing toward their nervous complaints. Furthermore, the fact that it was just the young husband of a daughter who became the object of her abnormal infatuation is by no means insignificant. A strong erotic attachment to the daughter, which in the last analysis leads back to the mother's sexual constitution, will often find a way to live on under such a disguise. May I perhaps remind you in this connection that the relationship between mother and son-in-law has seemed particularly delicate since all time and is one which among primitive peoples gave rise to very powerful taboos and avoidances.[37]It often transgresses our cultural standards positively as well as negatively. I cannot tell you of course which of these three factors were at work in our case; whether two of them only, or whether all of them coöperated, for as you know I did not have the opportunity to continue the analysis beyond two hours.
I realize at this point, ladies and gentlemen, that I have been speaking entirely of things for which your understanding was not prepared. I did this in order to carry through the comparison of psychiatry and psychoanalysis. May I now ask one thing of you? Have you noticed any contradiction between them? Psychiatry does not apply the technical methods of psychoanalysis, and neglects to look for any significance in the content of the obsession. Instead of first seeking out more specific and immediate causes, psychiatry refers us to the very general and remote source—heredity. But does this imply a contradiction, a conflict between them? Do they not rather supplement one another? For does the hereditary factor deny the significance of the experience, is it not rather true that both operate together in the most effective way? You must admit that there is nothing in the nature of psychiatric work which must repudiate psychoanalytic research. Therefore, it is the psychiatrists who oppose psychoanalysis, not psychiatry itself. Psychoanalysis stands in about the same relation to psychiatry as does histology to anatomy. The one studies the outer forms of organs, the other the closer structure of tissues and cells. A contradiction between two types of study, where one simplifies the other, is not easily conceivable. You know that anatomy to-day forms the basis of scientific medicine, but there was a time when thedissection of human corpses to learn the inner structure of the body was as much frowned upon as the practice of psychoanalysis, which seeks to ascertain the inner workings of the human soul, seems proscribed to-day. And presumably a not too distant time will bring us to the realization that a psychiatry which aspires to scientific depth is not possible without a real knowledge of the deeper unconscious processes in the psychic life.
Perhaps this much-attacked psychoanalysis has now found some friends among you who are anxious to see it justify itself as well from another aspect, namely, the therapeutic side. You know that the therapy of psychiatry has hitherto not been able to influence obsessions. Can psychoanalysis perhaps do so, thanks to its insight into the mechanism of these symptoms? No, ladies and gentlemen, it cannot; for the present at least it is just as powerless in the face of these maladies as every other therapy. We can understand what it was that happened within the patient, but we have no means of making the patient himself understand this. In fact, I told you that I could not extend the analysis of the obsession beyond the first steps. Would you therefore assert that analysis is objectionable in such cases because it remains without result? I think not. We have the right, indeed we have the duty to pursue scientific research without regard to an immediate practical effect. Some day, though we do not know when or where, every little scrap of knowledge will have been translated into skill, even into therapeutic skill. If psychoanalysis were as unsuccessful in all other forms of nervous and psychological disease as it is in the case of the obsession, it would nevertheless remain fully justified as an irreplaceable method of scientific research. It is true that we would then not be in a position to practice it, for the human subjects from which we must learn, live and will in their own right; they must have motives of their own in order to assist in the work, but they would deny themselves to us. Therefore let me conclude this session by telling you that there are comprehensive groups of nervous diseases concerning which our better understanding has actually been translated into therapeutic power; moreover, that in disturbances which are most difficult to reach we can under certain conditions secure results which are second to none in the field of internal therapeutics.