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Books, Part XXXIV
Wilheml Reich (1933)
Chapter III- On the Technique of Interpretation and of Resistance Analysis
I. Some Typical Errors in the Technique of Interpretation and their Results
In the analytic work, we must distinguish two parts: first, the cure of the patient, and second, his immunization, to the extent to which it can take place during the treatment. The cure itself consists of two parts, the introductory phase and the process of cure proper. True, this distinction is artificial; even the first resistance interpretation has a good deal to do with the cure. Nevertheless, even the preparations for a voyage to which Freud likened an analysis, have much to do with the voyage itself and may decide its success or failure. In analysis, at any rate, everything depends on how it is started. A case which has been started in a wrong or confused manner is usually lost. Most cases present the greatest difficulties in the introductory period, no matter whether they "go well" or not. It is precisely the cases which seemingly go smoothly in the beginning who later present the greatest difficulties, because the smooth course in the beginning makes difficult the early recognition and elimination of the difficulties. Errors made in the introduction of the analysis are all the more difficult to eliminate the longer the analysis proceeds without their correction.
Now, which are these special and typical difficulties of the introductory period?
The goal of the analysis in the introductory period is that of penetrating to the energy sources of the symptoms and of the neurotic character, in order to set the therapeutic process in mo
tion. This task is impeded by the resistances of the patient, among which the most stubborn are those arising out of transference conflicts. They have to be made conscious, interpreted and to be given up by the patient. Thus he progresses, ever more deeply, to the affectively important recollections from early infancy. The much-discussed question as to what is more important, affective re-living (acting out) or remembering, is of no significance to us. Clinical experience confirms Freud's demand that the patient who tends to repeat his experiences by acting out must, in order to really solve his conflicts, not only understand what he is acting out, but must also remember with affect.' I mention this only because I did not want to give the impression that we considered our work as consisting of nothing but resistance- and transference analysis, merely because in this section we discuss nothing but the principles of resistance analysis.
Now, what happens in ever so many cases instead of remembering with affect?
There are the cases which fail because the analyst, as a result of the many heterogeneous transferences, gets lost in the wealth of the material produced by the patient. We call this a "chaotic situation" and find that it is caused by certain mistakes in the technique of interpretation. Then there are the many cases in which the negative transference is overlooked because it. is hidden behind manifest positive attitudes. Finally, there are the many cases which show no progress in spite of deep-reaching recollection work, because no attention was paid to their affect-lameness or because it was not made the focal point of the analysis. In contrast to these cases which seem to run a normal course but end in a chaotic situation, we have those others which "do not go," that is, do not produce associations and oppose our efforts with passive resistance.
I am going to outline a few of my own bad failures and we shall soon see that they are due to typical errors. The similarity of most of these failures points to typical errors committed in the introductory period, errors which no longer can be counted among the gross beginner's sins. This is no reason for despair; as Ferenczi once said, every new experience costs us a case. All that matters is to see the error and to learn from it. It is no different in any other branch of medicine; only the hushing up of and the alibi-ing for the failures we shall leave to the others.
A patient suffering from inferiority feelings and self-consciousness acted out his impotence in the form of not having any associations ("I can't do anything"). Instead of recognizing the nature of this resistance and making conscious the tendencies to deprecation hidden behind it, I kept telling him that he did not want to work and did not want to get well. Although I was not altogether wrong in this, I made the mistake of not working on his "not wanting to" and of not trying to understand the reasons for his inability; instead, my own inability led me to make these senseless reproaches. Every patient has the tendency to remain ill, and I know that the phrase, "You don't want to get well," without any further explanation, is often used as a reproach by many analysts in unclear situations. It should be eliminated from the analyst's vocabulary and be replaced by self-scrutiny. For we must realize that every unresolved stoppage in an analysis is the fault of the analyst.
Another case, in the course of three years of analysis, had remembered the primal scene in all details. But not a single time had his affect-lameness subsided, not a single time had he made the analyst the reproaches which were-without affect, it is true--in his mind against his father. He was not cured. I had not known how to develop his repressed hatred. Ah, many will triumph: finally the admission that the recovery of the primal scene does no good therapeutically! They are wrong. Without analysis of early infantile experiences there is no real cure. What matters is that these recollections occur with the corresponding affects.
In another case it happened that the incest phantasy came up clearly in connection with a dream in the second week of the analysis and the patient himself realized its meaning. For a whole year, I heard nothing more about it; the result was correspondingly poor. I had learned that sometimes it is necessary to suppress material which comes up too soon, until such time as the patient is ready to assimilate it.
A case of erythrophobia resulted in failure because I painstakingly interpreted all material as it was presented without having first carefully eliminated the resistances. They came later, but then very intense and in chaotic disorder; I had shot my bolt, my explanations remained without effect, it was impossible to restore order. I may say that at that time, in the third or fourth year of my analytic practice, I was no longer such a beginner that I would have interpreted the unconscious unless it had shown itself in a clear and unequivocal manner and the patient had been near the solution himself, which is when Freud said interpretations should be given. Obviously, however, this precaution is insufficient, for this chaotic situation was of the very kind which one meets in seminars and control-analyses.
A case of classical hysteria with twilight states could have made an excellent recovery, to judge from later experiences in similar cases. But I failed to comprehend and treat in time the patient's reactions to the analysis of the positive transference, that is, her reactive hatred. I let myself be lured into a chaos by her recollections and found no way out. She kept having twilight states.
A number of bad experiences due to erroneous handling of the transference at the time of the disappointment reaction taught me to properly evaluate the danger to the analysis of the negative transference, be it the original negative transference or that originating from the disappointment of transference love. Not until a patient who had, in good positive transference, produced a wealth of recollections and yet had failed to get well, told me many months after breaking off the analysis that he had never trusted me, did I really know the danger of a negative transference which is allowed to remain latent. This made me, successfully, seek for the means of always getting the negative transference out of its hiding places.
In the Technical Seminar, also, we were mostly occupied with the problem of negative transference, particularly the latent. In other words, it was not a matter of an individual blind spot; the overlooking of the negative transference seems to be quite general. No doubt, this is due to our narcissism which makes us willing to listen to complimentary things but blind to negative attitudes unless they are expressed in more or less gross forms. It is striking that "transference" in the psychoanalytic literature always refers to positive attitudes; apart from the article on "Passive Technik" by Landauer, the problem of the negative transference is essentially neglected.
The overlooking of the negative transference is only one of the many mistakes which confuse the course of the analysis. We all experience what we have called the "chaotic situation," so I can
limit myself to some of the main points.
One situation is the following: Memories and actions are very numerous but fail to show any logical sequence; the patient brings much material from all strata of his unconscious, from all age periods; all this lies there in a big heap, as it were; nothing is worked through in the sense of the therapeutic goal; in spite of the wealth of material the patient has no feeling of its importance. The analyst has given many interpretations, but these have never deepened the analysis in one or the other direction. It seems clear that everything the patient has presented was in the service of a secret, unrecognized resistance. What makes such chaotic analyses dangerous is that the analyst continues to believe, for a long time, that they are running very well, simply because the patient "brings material." This goes on until the analyst-usually too late--recognizes that the patient has been going around in a circle and has kept presenting the same material, only in different aspects. In this manner, he could fill his analytic hours for years on end without ever undergoing any real change.
Here is a characteristic case which I took over from a colleague. He had been in analysis for eight months for a multiple perversion. During treatment, he had continually talked and produced material from the deepest layers. This was constantly interpreted. The more the material was interpreted, the more ample was the flow of associations. Finally, the analysis had to be interrupted for external reasons and the patient came to me. At that time I was already partly acquainted with the dangers of latent resistances. I was struck by the fact that the patient produced unconscious material uninterruptedly and was able, for instance, to present the finest details of the simple and double Oedipus complex. I asked the patient whether he really believed what he was saying and what he had heard. "But not in the least," he said, with all this, I cannot help smiling inside." When I asked him why he had not told this to the first analyst, he said he had not thought it necessary. There was nothing to be done, in spite of vigorous analysis of his smile, for he had already learned too much. The interpretations had all gone up in thin air, and my own interpretations bounced back from his attitude of smiling. After four months I gave him up, richer by another experience. It is possible, though, that a longer and more consistent analysis of his narcissistic defense might have brought a result after all. But at that time I had not had as yet the good results which one can achieve by consistent work on such attitudes.
In investigating the causes of such chaotic situations we soon find that the following errors in the technique of interpretation are to be blamed:
1. Too early interpretation of the meaning of the symptoms or of other manifestations of the deepest layers of the unconscious, particularly of symbols. The patient uses the analysis in the service of resistances which remain hidden and one finds out too late that, completely untouched by the analysis, the patient has been going around in a circle.
2. Interpretation of the material in 'the sequence in which it presents itself, without consideration of the structure of the neurosis and the stratification of the material. The error consists in interpreting for the sole reason that the material presents itself clearly (unsystematic interpretation of meaning).
3. The analysis becomes confused not only through interpretation of the material as it presents itself but also because the interpretations were given before work was done on the main resistances. That is, the interpretation of meaning preceded the interpretation of the resistance. The situation became further complicated by the fact that the resistances soon became linked with the relationship to the therapist, and thus the unsystematic resistance interpretation also complicated the transference situation. '
4. The interpretation of the transference resistances was not only unsystematic, but also inconsistent. That is, the fact was overlooked that the patient has the tendency of again hiding his resistances, of masking them by sterile productions or acute reaction formations. The latent transference resistances were mostly overlooked or the analyst was afraid to let them fully develop or to bring them into the open when they were hidden in one form or another.
These errors are probably based on a misconception of Freud's rule that the course of the analysis should be left to the patient. This rule can only mean that one should not disturb the work of the patient as long as it proceeds according to the patient's wish to get well and to our therapeutic intentions. But of course we must take action as soon as the patient's fear of meeting his conflicts and his tendency to stay ill disturb this course.
2. Systematic Interpretation and Resistance Analysis
The reader will ask now: What, then, is the correct technique? He will have gained sufficient insight into the difficulty of the subject to realize that I can give no more than very generalized conclusions from the errors described. There is another difficulty in the discussion of this subject: We are dealing with living, everchanging psychic life which inevitably becomes more or less rigid when we put it into words. What follows may give the impression of a rigid schema, and yet it is nothing but a rough sketch of a field which still has to be surveyed and thoroughly studied. It is only a matter of establishing a common language. Whatever in the following presentation appears schematic is no more than a means of orientation. The schema which automatically develops as soon as one separates one phenomenon from the other and views it separately, is nothing but a scientific makeshift. For the rest, we do not impute the schema, the rule, or the principle to the patient, but we view the patient without preconceived ideas and gain our orientation from his material, his behavior, from what he hides or misrepresents. Only then do we turn to the question, How do I best use what I have learned from this case in the technique of that case? It would be easier if, as Freud suggested at the Budapest Congress, we could formulate different resistance types; but even then we would have to find out in each case whether he shows this or that type of typical resistance. The latent negative transference is only one of these typical resistances, and we should not overlook others. The orientation can be gained only from the material of the individual patient.
We have seen that deep-reaching interpretations must be avoided as long as the first front of the cardinal resistances has not become clear and has not been eliminated, no matter how ample, clear and interpretable the material may be. The more memory material a patient presents without having produced the corresponding resistances the more one has to be on one's guard. At any rate, confronted with the choice of interpreting unconscious material or working on manifest resistances, one will decide in favor of the latter. Our principle is: No interpretation o f meaning when a resistance interpretation is needed. The reason for this is simple enough. If one interprets the meaning before eliminating the corresponding resistance, the patient either accepts the interpretation for reasons of the transference, or he completely depreciates it at the first appearance of a negative attitude, or the resistance comes afterwards. In either case, the interpretation has lost its therapeutic effectiveness and it is difficult if not impossible to correct the situation. The way to the deep unconscious which the interpretation has to take has been blocked.
It is important not to disturb the patient during the first few weeks in the development of his "analytic personality." The resistances, too, cannot be interpreted before they have fully developed and are essentially understood by the analyst. Of course, the time at which the interpretation of resistance is begun will largely depend on the experience, of the analyst; the experienced will need no more than slight signs, while the beginner, in the same case, will need more or less gross actions. It takes a good deal of experience to recognize the signs of a latent resistance. If one has grasped the meaning of such resistances, one will make them conscious through consistent interpretation; that is, one will show the patient first, that he has a resistance; then, which means it uses; and finally, against what the resistance is directed.
If the first transference resistance has not been preceded by sufficient production of memory material, its resolution meets with a difficulty which, it is true, becomes less with increasing experience of the analyst. This difficulty consists in the fact that, in order to resolve the resistance, one must know the unconscious material it contains, while, on the other hand, one cannot get at this material because the resistance blocks it. Just like a dream, every resistance has a historical meaning (an origin) and a present-day meaning. The difficulty can be overcome in the following manner: from the present situation--the development of which one has been watching--and from the form and the means of the resistance one finds the present meaning and purpose of the resistance. One then can influence it by interpretation sufficiently so that the infantile material makes its appearance; only with the help of this infantile material can the resistance be fully resolved. As far as the finding of the resistances and the divining of their present meaning is concerned, there can, of course, be no hard and fast rules; it is largely a matter of intuition; this is where the non-teachable analytic art begins. The subtler and the more secret the resistances are, the more the patient deceives, the more reliable will the intuitive acts of the analyst have to be. In other words, the analyst must be free of inhibitions and must have a special gift in addition.
What is a "latent resistance"? Attitudes of the patient which are not expressed directly and immediately as in the case of doubt, distrust, being late, silence, spite, lack of associations, etc., but indirectly in the mode of analytic production. Thus, extreme compliance or complete lack of manifest resistances always points to a latent and, for that reason, all the more dangerous passive resistance. I tackle such latent resistances as soon as I perceive them and do not hesitate to interrupt the patient's communications as soon as I have heard enough to understand the resistance. For experience shows that the therapeutic effect of the patient's communications is lost if they are made in the presence of unresolved resistances.
The onesided and consequently erroneous evaluation of the analytic material and the misinterpretation of Freud's thesis that one has to proceed from the surface often lead to dangerous misunderstandings and technical difficulties. To begin with, what does that mean, "analytic material'? The usual concept is: the patient's communications, dreams, associations, slips. True, there is often a theoretical realization of the fact that the total behavior of the patient also has analytic significance; but clear-cut experiences in the Seminar show that the behavior of the patient, his look, manner of speech, facial expression, dress, handclasp, etc., that all these things are not only underestimated in their analytic significance, but usually completely overlooked. At the Innsbruck Congress, Ferenczi and I, independently, stressed the significance of these formal elements for therapy; to me they have become, in the course of the years, the most important point of departure for the analysis of the character. The overestimation of the content of the material usually goes with an underestimation if not with a complete neglect of the manner in which the patient tells these things. If one, however, overlooks the mode of behavior of the patient or fails to consider it as at least as important as the content, one arrives, unawares, at a concept of the "psychic surface" which is therapeutically dangerous. If, for instance, a patient is very polite, while at the same time he brings ample material, say, about his relationship with his sister, one is confronted with two simultaneous contents of the "psychic surface": his love for his sister, and his behavior, his politeness. Both have unconscious roots. This view of the psychic surface puts a different face on the rule that "one should always proceed from the surface." Analytic experience shows that behind this politeness and niceness there is always hidden a more or less unconscious critical, distrustful or deprecatory attitude; that is, the stereotyped politeness of the patient is in itself a sign of negative criticism, of distrust or deprecation. This being the case, is it admissible to interpret the incestuous love for the sister when a corresponding dream or association appears? No. There are good reasons for choosing one part of the psychic surface to work on first, and not the other. Were one to wait until the patient himself begins to talk about his politeness and its reasons, one would make a serious mistake. Since such a character trait immediately becomes a resistance in the analysis, the same is true of it as of any resistance: the patient will never talk about it himself, it is up to the analyst to unmask it as a resistance. Here, an important objection might be made: that my contention that the politeness immediately turns into a resistance is incorrect, otherwise the patient would not produce material. But the point is just that, particularly in the beginning, the important thing is not the content, but the formal aspect of the material. To remain with the example of politeness: the neurotic, as a result of his repressions, has every reason to value highly his politeness and all social conventions and to use them as protection. True, it may be more pleasant to treat a polite patient than an impolite, very candid one, one who tells the analyst that he is too young or too old, that he has a shabby apartment or an ugly wife, that he looks stupid or too Jewish, that he behaves neurotically and better go for analysis himself, etc. Such things are not necessarily transference phenomena: in reality, the analyst never is a "blank screen"; the personal characteristics of the analyst are a fact which, to begin with, has nothing to do with transference. And our patients have an extraordinary ability to sense our weak points; more, in scenting them, many patients take revenge for the fundamental rule being forced upon them. There are some few patients, mostly sadistic characters, who derive their sadistic pleasure from the candor which is asked of them. Therapeutically this behavior is valuable although at times it becomes a resistance. But the overwhelming majority of our patients are much too inhibited and anxious, too much laden with guilt feelings, to develop such candor spontaneously. In disagreement with many of my colleagues, I must maintain my contention that every case, without exception, begins the analysis with a more or less explicit attitude of distrust and criticism which, as a rule, remains hidden. In order to convince oneself of this, it is necessary to make the patient discuss, first of all, all the matter-of-course factors making for distrust and criticism inherent in the situation (new kind of situation, unknown person, public opinion about analysis, etc.); only through this candor on the part of the analyst can the patient's confidence be gained. The technical question as to when these, not necessarily neurotic, attitudes of distrust and criticism should be discussed is not a difficult one; it is merely a matter of avoiding any deep-reaching interpretations of the unconscious as long as the wall of conventional politeness between patient and analyst continues to exist.
We cannot continue the discussion of the technique of interpretation without including the development and treatment of the transference neurosis. In a correctly carried-out analysis, it is not long, before the first strong transference resistance makes its appearance. We will have to understand first why it is that the first significant resistance against the continuation of the analysis becomes automatically, and in a manner which is determined by the structure of the individual case, connected with the analyst; what is the motive for what Ferenczi called "transference compulsion"? Our insistence on following the fundamental rule has begun to dislodge forbidden things. Sooner or later, the patient puts up an accentuated defense against their becoming conscious. At first, this defense is directed exclusively against the repressed material; but the patient knows neither that he has these forbidden things in himself nor that he is defending himself against them. As Freud has shown, the resistances themselves are unconscious. Yet, the resistance is an emotional process, and for this reason cannot remain hidden. Like everything else which has an irrational basis, this affect also seeks a rational causation, an anchoring in an actual situation. Thus the patient projects; he projects to the one who, by his insistence on the fundamental rule, has stirred up the whole conflict. The displacement of the defense from the unconscious to the therapist brings with it a displacement of the unconscious content also: the content also is displaced to the analyst. He becomes, for example, the strict father or the loving mother. It is clear that this defense can result at first only in a negative attitude. As the disturber of the neurotic equilibrium, the analyst automatically becomes the enemy, no matter whether the projected impulses are impulses of love or of hatred; for in either case there is, at the same time, defense against these impulses.
If it is hate impulses which are projected first, the transference resistance is unequivocally negative. If it is love impulses, the real transference resistance is preceded by a manifest but not conscious positive transference. This, however, turns regularly into reactive negative transference, partly because the disappointment is inevitable, resulting in the "disappointment reaction," partly because the patient defends himself against it as soon as, under the pressure of sensual impulses, it tends to become conscious; and every defense results in negative attitudes.
The technical problem of the latent negative transference is so important that it necessitates a separate presentation of its many forms and its treatment. Now, I shall only enumerate a few typical disease pictures in which we are most likely to meet a latent negative transference. They are:
1. The over-obedient, over-friendly, too trusting, that is, the "good patients"; those cases who are forever in positive transference and never show a disappointment reaction. Usually, they are passive-feminine characters or female hysterias with nymphomanic trends.
2. Those who are always conventional and correct. Usually, they are compulsive characters who have converted their hatred into "politeness at all cost."
3. The affect-lame patients. Like the "correct" patients, they are characterized by an intensive but blocked aggressivity. Usually, they are compulsive characters, but female hysterias also often show a superficial affect-lameness.
4. Patients complaining about a lack of genuineness in their feelings and their expressions, that is, who suffer from depersonalization. Among these are to be counted such patients who--consciously and at the same time compulsively--"play-act," that is, who somehow in the background of their mind know that they deceive the therapist. Usually, they belong to the group of narcissistic neuroses of the hypochondriac type. They regularly show an "inward smile" about everything and everybody, something which they themselves begin to feel as painful and which presents a very difficult therapeutic task.
The form and stratification of the first transference resistance are conditioned by the individual infantile love experiences. For this reason, we can achieve an orderly, not unnecessarily complicated analysis of the infantile conflicts only if in our interpretations we pay the strictest attention to this stratification. True, the contents of the transferences are not determined by our interpretations, but the sequence in which they become acute depends on our interpretation technique. It is important not only that the transference neurosis develops but that in developing it follows the same paths as its prototype, the original neurosis, and that it shows the same dynamic stratification. Freud has taught us that the original neurosis is only accessible through the transference neurosis. Clearly, the therapeutic task is all the easier the more completely and orderly the original neurosis unfolds in the transference neurosis. Of course, this takes place in the reverse order. It is easy to understand that a faulty analysis of the transference, such as the interpretation of an attitude from a deeper layer-no matter how clear the attitude and how correct the interpretation in itself--must blur the copy of the original neurosis and bring disorder into the transference neurosis. Experience teaches us that the transference neurosis develops spontaneously according to the structure of the individual neurosis if we avoid one mistake: that of giving too early, too deep-reaching and unsystematic interpretations.
To illustrate by a schematic example: If a patient first loved his mother, then hated his father, then, for fear, gave up his mother and converted his hatred of the father into passive-feminine love toward him, then his first transference, in a correctly carried-out resistance analysis, will be his passive-feminine attitude, the latest result of his libidinal development. A systematic resistance analysis will bring out the hatred of the father which hides behind it; only after this will a new cathexis of the mother occur, at first in the form of the love for the mother as transferred to the analyst. From there, it can be transferred to a woman in reality.
Remaining with this simplified example, we shall consider a possible less favorable outcome. Say, the patient shows manifest positive transference and produces dreams showing his passivefeminine attitude as well as dreams which show his attachment to his mother. Both are equally clear and interpretable. If the analyst recognizes the true layering of the positive transference; if he realizes that in the positive transference the reactive love of the father is the most superficial layer, the hatred of the father the second, and the transferred love of the mother the deepest layer, then, certainly, he will let the latter attitude alone, no matter how obvious it may be. If he did not, if, instead, he were to pick out first the transferred love of the mother, then there would be, between his interpretations of the incest love and the experience of the patient, the latent hatred of the father in the form of reactive transference love. This would present an impenetrable block of resistance. The interpretation which should have passed through the topically higher layer of distrust, unbelief and defense, would be seemingly accepted. But seemingly only; it would remain ineffective therapeutically and would have only one result: the patient, frightened by this interpretation and put on his guard, would even more industriously hide the hatred of the father and, because of intensified guilt feelings, would become still more "good." The analytic situation would be chaotic.
It is a matter, then, of picking, out of the material which flows from many psychic layers, that part which in the present or preceding transference resistance assumes a central position and which is not covered up by other attitudes. As theoretical as this may sound, it is possible of execution in any average case.
What, then, happens to all the rest of the material which at present is less important? Usually it is sufficient not to enter upon it; with that, it automatically recedes. However, it happens very
often that a patient puts an attitude or certain experiences into the foreground, in order to hide other things which are of more immediate importance. Clearly, such a resistance must be eliminated by constantly pointing to that which is being hidden while no attention is being paid to the "red herring." A typical example is the behavior of the patient in latent negative transference: he tries to hide his latent criticism and aversion by forcedly laudatory comments about the analyst and the analysis. If one analyzes this resistance, one easily arrives at the patient's motive, his fear of expressing criticism.
Only rarely is it necessary to suppress material which flows all too rapidly, as in the case when unconscious perverse or incestuous tendencies become conscious too early and too massively, at a time when the patient is as yet not ready to deal with them. If neglecting the material is not sufficient, one will have to divert the patient.
In this manner, the central content of the transference resistances remains in constant close contact with the memories, and the affects aroused by the transference become automatically associated with the memories. Thus one avoids the dangerous situation where memories appear without affects. The chaotic situation, on the other hand, is characterized by a latent resistance which remains unresolved for months and binds all affects, while at the same time the memories appear in wild disorder, concerning, say, today castration anxiety, then oral phantasies and then again incest phantasies.
By the proper selection of the material for interpretation we achieve a continuity in the analysis. We thus not only understand the present-day situation at any given time but can follow, like a red thread, the logical development of the transference. Our work is facilitated by the fact that the resistances which, after all, are nothing but individual bits of the neurosis, make their appearance in a logical sequence which is determined by the history and structure of the neurosis.
3. Consistency in Resistance Analysis
Thus far, we have dealt with the technique of interpretation of meaning and resistance; we saw that it must be ordered and systematic corresponding to the individual structure of the neurosis. In enumerating the errors in interpretation, we distinguished systematic from inconsistent interpretation. For we found that many cases become chaotic in spite of systematic interpretation because of a lack of consistency in the working through o f resistances which had already been interpreted.
If one has happily gotten past the barrier of the first transference resistance, the memory work usually proceeds quickly and penetrates to childhood. But soon the patient will meet new layers of forbidden material which he now tries to ward off with a second front of transference resistances. The same process of resistance analysis starts again, with the difference that this time it has a somewhat different character. Then, it was a matter of the first difficulty; the new resistance has already an analytic past which has not remained without influence on it. One would expect that the patient, having learned from the first resistance analysis, would now cooperate in the elimination of the difficulty. But practical experience teaches us differently: in almost all cases, the patient reactivates, alongside the new resistance, the old one; sometimes he even relapses into the old resistance without showing the new one. The whole situation is complicated by this layering. The patient again takes recourse to the old resistance position which had apparently been eliminated. If, now, one tackles the new resistance first or exclusively, one neglects an interposed layer, namely, the reactivated old resistance and runs the risk of squandering one's interpretations. One can spare oneself disappointments and failures if one always goes back to the old resistance--no matter whether it is more or less manifest--and begins the work of resolving the resistance from there. In this way, one gradually penetrates to the new resistance and avoids the danger of gaining a new piece of territory while the enemy again settles down in that which was previously gained.
It is important to undermine the neurosis from the cardinal resistance, from a definite strong-point, as it were, instead of focusing one's attention on detail resistances, that is, attacking the neurosis at many different points which have no immediate connection. If one deploys the resistances and the analytic material consistently from the strong-point of the first transference resistance, one never loses sight of the total situation, past and present; this guarantees the indispensable continuity of the analysis and its thorough working through. Provided that one is dealing with already known typical disease pictures and provided that the resistance analysis was correctly carried out, it is even possible to foresee the sequence in which certain tendencies will appear as acute transference resistances.
No argument could convince us that haphazard interpretations of meaning or treatment of all patients according to the same schema could solve the enormous problems of psychotherapy. Those who attempt such things only show that they have not comprehended the real problems of psychotherapy and do not know what the "cutting of the Gordian knot" really means: the destruction of the possibilities of analytic cure. An analysis carried out in such fashion is beyond repair. Interpretation may be likened to a valuable drug which has to be used sparingly if it is not to lose its efficacy. Our experience shows that the laborious unraveling of the knot is still the shortest way to real success.
Then there are those who misinterpret the concept of analytic passivity and become past masters in waiting. They can give us ample case material to illustrate the chaotic situation. In resistance phases, it is up to the analyst to direct the course of the analysis; it is in the hands of the patient only in resistance-free periods. Nothing else can have been Freud's meaning. The danger of staying silent on principle or of letting the patient "float along" is no less than that of haphazard interpretations or interpretations according to a theoretical schema, for the patient as well as for the development of psychoanalytic therapy.
In certain forms of resistance, this kind of passivity is a very serious mistake. Say, a patient evades a resistance or the discussion of the corresponding material. He touches on quite a different subject, until there, too, he develops resistances, whereupon he switches to a third subject, etc. This "zigzag technique" may go on indefinitely, no matter whether one watches it "passively" or follows the patient step by step with interpretations. Since the patient is obviously in constant flight and since his efforts to satisfy the analyst with substitute productions remain sterile, the task of the analyst is that of again and again bringing him back to the first resistance position until he finds the courage to tackle it analytically.
Or the patient may take flight into the infantile, may give away what otherwise would be well-guarded secrets, only in order to hold the one position. These communications have, at best, no therapeutic value. Unless one prefers to interrupt, one may listen to them; the important thing is to work on the one position from which the patient escaped. The same is true in the case of the flight into actuality. The ideal is the development and analysis of the transference neurosis in a straight line, corresponding to the original neurosis; in this case, the patient unfolds his resistances systematically and in between produces memories with the corresponding affects.
The much-discussed question whether an "active" or a "passive" attitude in analysis is better, is, put that way, senseless. Generally speaking, one cannot act too early in analyzing resistances, and one cannot be too reserved in the interpretation of the unconscious, apart from resistances. The customary procedure is the reverse: one is too courageous in giving interpretations of meaning and becomes hesitant as soon as a resistance makes its appearance.
ON THE TECHNIQUE OF CHARACTER ANALYSIS
1. Introductory Review
Our therapeutic method is determined by the following basic theoretical concepts. The topical standpoint determines the technical principle that the unconscious has to be made conscious. The dynamic standpoint determines the rule that this has to take place not directly but by way of resistance analysis. The economic standpoint and the psychological structure determine the rule that the resistance analysis has to be carried out in a certain order according to the individual patient.
As long as the topical process, the making conscious of the unconscious, was considered the only task of analytic technique, the formula that the unconscious manifestations should be interpreted in the sequence in which they appeared was correct. The dynamics of the analysis, that is, whether or not the making conscious also released the corresponding affect, whether the analysis influenced the patient beyond a merely intellectual understanding, that was more or less left to chance. The inclusion of the dynamic element, that is, the demand that the patient should not only remember things but also experience them, already complicated the simple formula that one had to "make the unconscious conscious." However, the dynamics of the analytic affect do not depend on the contents but on the resistances which the patient puts up against them and on the emotional experience in overcoming them. This makes the analytic task a vastly different one. From the topical standpoint, it is sufficient to bring into the patient's consciousness, one after the other, the manifest elements of the unconscious; in other words, the guiding line is the content of the material. If one also considers the dynamic factor one has to relinquish this guiding line in favor of another which comprehends the content of the material as well as the affects: that of the successive resistances. In doing so we meet, in most patients, with a difficulty which we have not yet mentioned.
2. Character Armor and Character Resistance
a) The inability to follow the fundamental rule.
Rarely are our patients immediately accessible to analysis, capable of following the fundamental rule and of really opening up to the analyst. They cannot immediately have full confidence in a strange person; more importantly, years of illness, constant influencing by a neurotic milieu, bad experiences with physicians, in brief, the whole secondary warping of the personality have created a situation unfavorable to analysis. The elimination of this difficulty would not be so hard were it not supported by the character of the patient which is part and parcel of his neurosis. It is a difficulty which has been termed "narcissistic barrier." There are, in principle, two ways of meeting this difficulty, in especial, the rebellion against the fundamental rule.
One, which seems the usual one, is a direct education to analysis by information, reassurance, admonition, talking-to, etc. That is, one attempts to educate the patient to analytic candor by the establishment of some sort of positive transference. This corresponds to the technique proposed by Nunberg. Experience shows, however, that this pedagogical method is very uncertain; it lacks the basis of analytic clarity and is exposed to the constant variations in the transference situation.
The other way is more complicated and as yet not applicable in all patients, but far more certain. It is that of replacing the pedagogical measures by analytic interpretations. Instead of inducing the patient into analysis by advice, admonitions and transference manoeuvres, one focuses one's attention on the actual behavior of the patient and its meaning: why he doubts, or is late, or talks in a haughty or confused fashion, or communicates only every other or third thought, why he criticizes the analysis or produces exceptionally much material or material from exceptional depths. If, for example, a patient talks in a haughty manner, in technical terms, one may try to convince him that this is not good for the progress of the analysis, that he better give it up and behave less haughtily, for the sake of the analysis. Or, one may relinquish all attempts at persuasion and wait until one understands why the patient behaves in this and no other way. One may then find that his behavior is an attempt to compensate his feeling of inferiority toward the analyst and may influence him by consistent interpretation of the meaning of his behavior. This procedure, in contrast to the first-mentioned, is in full accord with the principle of analysis.
This attempt to replace pedagogical and similar active measures seemingly necessitated by the characteristic behavior of the patient, by purely analytic interpretations led unexpectedly to the analysis of the character.
Certain clinical experiences make it necessary to distinguish, among the various resistances we meet, a certain group as character resistances. They get their specific stamp not from their content but from the patient's specific way of acting and reacting. The compulsive character develops specifically different resistances than does the hysterical character; the latter different resistances from the impulsive or neurasthenic character. The form of the typical reactions which differ from character to character--though the contents may be the same--is determined by infantile experiences just like the content of the symptoms or phantasies.
b) Whence the character resistances?
Quite some time ago, Glover worked on the problem of differentiating character neuroses from symptom neuroses. Alexander also operated on the basis of this distinction. In my earlier writings, I also followed it. More exact comparison of the cases showed, however, that this distinction makes sense only insofar as there are neuroses with circumscribed symptoms and others without them; the former were called "symptom neuroses," the latter, "character neuroses." In the former, understandably, the symptoms are more obvious, in the latter the neurotic character traits. But, we must ask, are there symptoms without a neurotic reaction basis, in other words, without a neurotic character? The difference between the character neuroses and the symptom neuroses is only that in the latter the neurotic character also produced symptoms, that it became concentrated in them, as it were. If one recognizes the fact that the basis of a symptom neurosis is always a neurotic character, then it is clear that we shall have to deal with character-neurotic resistances in every analysis, that every analysis must be a character-analysis.
Another distinction which becomes immaterial from the standpoint of character-analysis is that between chronic neuroses, that is, neuroses which developed in childhood, and acute neuroses, which developed late. For the important thing is not whether the symptoms have made their appearance early or late. The important thing is that the neurotic character, the reaction basis for the symptom neurosis, was, in its essential traits, already formed at the period of the Oedipus phase. It is an old clinical experience that the boundary line which the patient draws between health and the outbreak of the disease becomes always obliterated during the analysis.
Since symptom formation does not serve as a distinguishing criterion we shall have to look for others. There is, first of all, insight into illness, and rationalization.
The lack of insight into illness is not an absolutely reliable but an essential sign of the character neurosis. The neurotic symptom is experienced as a foreign body and creates a feeling of being ill. The neurotic character trait, on the other hand, such as the exaggerated orderliness of the compulsive character or the anxious shyness of the hysterical character, are organically built into the personality. One may complain about being shy but does not feel ill for this reason. It is not until the characterological shyness turns into pathological blushing or the compulsion-neurotic orderliness into a compulsive ceremonial, that is, not until the neurotic character exacerbates symptomatically, that the person feels ill.
True enough, there are also symptoms for which there is no or only slight insight, things that are taken by the patient as bad habits or just peculiarities (chronic constipation, mild ejaculatio praecox, etc.). On the other hand, many character traits are often felt as illness, such as violent outbreaks of rage, tendency to lie, drink, waste money, etc. In spite of this, generally speaking, insight characterizes the neurotic symptom and its lack the neurotic character trait.
The second difference is that the symptom is never as thoroughly rationalized as the character. Neither a hysterical vomiting nor compulsive counting can be rationalized. The symptom appears meaningless, while the neurotic character is sufficiently rationalized not to appear meaningless or pathological. A reason is often given for neurotic character traits which would immediately be rejected as absurd if it were given for symptoms: "he just is that way." That implies that the individual was born that way, that this "happens to be" his character. Analysis shows this interpretation to be wrong; it shows that the character, for definite reasons, had to become that way and no different; that, in principle, it can be analyzed like the symptom and is alterable.
Occasionally, symptoms become part of the personality to such an extent that they resemble character traits. For example, a counting compulsion may appear only as part of general orderliness or a compulsive system only in terms of a compulsive work arrangement. Such modes of behavior are then considered as peculiarities rather than as signs of illness. So we can readily see that the concept of disease is an entirely fluid one, that there are all kinds of transitions from the symptom as an isolated foreign body over the neurotic character and the "bad habit" to rational action.
In comparison to the character trait, the symptom has a very simple construction with regard to its meaning and origin. True, the symptom also has a multiple determination; but the more deeply we penetrate into its determinations, the more we leave the realm of symptoms and the clearer becomes the characterological reaction basis. Thus one can arrive--theoretically--at the characterological reaction basis from any symptom. The symptom has its immediate determination in only a limited number of unconscious attitudes; hysterical vomiting, say, is based on a repressed fellatio phantasy or an oral wish for a child. Either expresses itself also characterologically, in a certain infantilism and maternal attitude. But the hysterical character which forms the basis of the symptom is determined by many--partly antagonistic--strivings and is expressed in a specific attitude or way of being. This is not as easy to dissect as the symptom; nevertheless, in principle it is, like the symptom, to be reduced to and understood from infantile strivings and experiences. While the symptom corresponds essentially to a single experience or striving, the character represents the specific way of being of an individual, an expression of his total past. For this reason, a symptom may develop suddenly while each individual character trait takes years to develop. In saying this we should not forget the fact that the symptom also could not have developed suddenly unless its characterological neurotic reaction basis had already been present.
The totality of the neurotic character traits makes itself felt in the analysis as a compact defense mechanism against our therapeutic endeavors. Analytic exploration of the development of this character "armor" shows that it also serves a definite economic purpose: on the one hand, it serves as a protection against the stimuli from the outer world, on the other hand against the inner libidinous strivings. The character armor can perform this task because libidinous and sadistic energies are consumed in the neurotic reaction formations, compensations and other neurotic attitudes. In the processes which form and maintain this armor, anxiety is constantly being bound up, in the same way as it is, according to Freud's description, in, say, compulsive symptoms. We shall have to say more later about the economy of character formation.
Since the neurotic character, in its economic function of a protecting armor, has established a certain equilibrium, albeit a neurotic one, the analysis presents a danger to this equilibrium. This is why the resistances which give the analysis of the individual case its specific imprint originate from this narcissistic protection mechanism. As we have seen, the mode of behavior is the result of the total development and as such can be analyzed and altered; thus it can also be the starting point for evolving the technique of character-analysis.
c) The technique of analyzing the character resistance.
Apart from the dreams, associations, slips and other communications of the patients, their attitude, that is, the manner in which they relate their dreams, commit slips, produce their associations and make their communications, deserves special attention. A patient who follows the fundamental rule from the beginning is a rare exception; it takes months of character-analytic work to make the patient halfway sufficiently honest in his communications. The mariner in which the patient talks, in which he greets the analyst or looks at him, the way he lies on the couch, the inflection of the voice, the degree of conventional politeness, all these things are valuable criteria for judging the latent resistances against the fundamental rule, and understanding them makes it possible to alter or eliminate them by interpretation. The how of saying things is as important "material" for interpretation as is what the patient says. One often hears analysts complain that the analysis does not go well, that the patient does not produce any "material." By that is usually meant the content of associations and communications. But the manner in which the patient, say, keeps quiet, or his sterile repetitions, are also "material" which can and must be put to use. There is hardly any situation in which the patient brings "no material"; it is our fault if we are unable to utilize the patient's behavior as "material."
That the behavior and the form of the communications have analytic significance is nothing new. What I am going to talk about is the fact that these things present an avenue of approach to the analysis of the character in a very definite and almost perfect manner. Past failures with many cases of neurotic characters have taught us that in these cases the form of the communications is, at least in the beginning, always more important than their content. One only has to remember the latent resistances of the affectlame, the "good," over-polite and ever-correct patients; those who
always present a deceptive positive transference or who violently and stereotypically ask for love; those who make a game of the analysis; those who are always "armored," who smile inwardly about everything and everyone. One could continue this enumeration indefinitely; it is easy to see that a great deal of painstaking work will have to be done to master the innumerable individual technical problems.
For the purpose of orientation and of sketching the essential differences between character-analysis and symptom-analysis, let us assume two pairs of patients for comparison. Let us assume we have under treatment at the same time two men suffering from premature ejaculation; one is a passive-feminine, the other a phallic-aggressive character. Also, two women with an eating disturbance; one is a compulsive character, the other a hysteric.
Let us assume further that the premature ejaculation of both men has the same unconscious meaning: the fear of the paternal penis in the woman's vagina. In the analysis, both patients, on the basis of their castration anxiety which is the basis of the symptom, produce a negative father transference. Both hate the analyst (the father) because they see in him the enemy who frustrates their pleasure; both have the unconscious wish to do away with him. In this situation, the phallic-sadistic character will ward off the danger of castration by insults, depreciation and threats, while the passive-feminine character, in the same case, will become steadily more passive, submissive and friendly. In both patients, the character has become a resistance: one fends off the danger aggressively, the other tries to avoid it by a deceptive submission. It goes without saying that the character resistance of the passive-feminine patient is more dangerous because he works with hidden means: he produces a wealth of material, he remembers all kinds of infantile experiences, in short, he seems to cooperate splendidly. Actually, however, he camouflages a secret spitefulness and hatred; as long as he maintains this attitude he does not have the courage to show his real self. If, now, one enters only upon what he produces, without paying attention to his way of behavior, then no analytic endeavor will change his condition. He may even remember the hatred of his father, but he will not experience it unless one interprets consistently the meaning of his deceptive attitude before beginning to interpret the deep meaning of his hatred of the father.
In the case of the second pair, let us assume that an acute positive transference has developed. The central content of this positive transference is, in either patient, the same as that of the symptom, namely, an oral fellatio phantasy. But although the positive transference has the same content in either case, the form of the transference resistance will be quite different: the hysterical patient will, say, show an anxious silence and a shy behavior; the compulsive character a spiteful silence or a cold , haughty behavior. In one case the positive transference is warded off by aggression, in the other by anxiety. And the form of this defense will always be the same in the same patient: the hysterical patient will always defend herself anxiously, the compulsive patient aggressively, no matter what unconscious content is on the point of breaking through. That is, in one and the same patient, the character resistance remains always the same and only disappears with the very roots o f the neurosis.
In the character armor, the narcissistic defense finds its concrete chronic expression. In addition to the known resistances which are mobilized against every new piece of unconscious material, we have to recognize a constant factor of a formal nature which originates from the patient's character. Because of this origin, we call the constant formal resistance factor "character resistance."
In summary, the most important aspects of the character resistance are the following:
The character resistance expresses itself not in the content of the material, but in the formal aspects of the general behavior, the manner of talking, of the gait, facial expression and typical attitudes such as smiling, deriding, haughtiness, over-correctness, the manner of the politeness or of the aggression, etc.
What is specific of the character resistance is not what the patient says or does, but how he talks and acts, not what he gives away in a dream but how he censors, distorts, etc.
The character resistance remains the same in one and the same patient no matter what the material is against which it is directed. Different characters present the same material in a different manner. For example, a hysteric patient will ward off the positive father transference in an anxious manner, the compulsive woman in an aggressive manner.
The character resistance, which expresses itself formally, can be understood as to its content and can be reduced to infantile experiences and instinctual drives just like the neurotic symptom?
During analysis, the character of a patient soon becomes a resistance. That is, in ordinary life, the character plays the same role as in analysis: that of a psychic protection mechanism. The individual is "characterologically armored" against the outer world and against his unconscious drives.
Study of character formation reveals the fact that the character armor was formed in infancy for the same reasons and purposes which the character resistance serves in the analytic situation. The appearance in the analysis of the character as resistance reflects its infantile genesis. The situations which make the character resistance appear in the analysis are exact duplicates of those situations in infancy which set character formation into motion. For this reason, we find in the character resistance both a defensive function and a transference of infantile relationships with the outer world.
Economically speaking, the character in ordinary life and the character resistance in the analysis serve the same function, that of avoiding unpleasure, of establishing and maintaining a psychic equilibrium--neurotic though it may be--and finally, that of absorbing repressed energies. One of its cardinal functions is that of binding "free-floating" anxiety, or, in other words, that of absorbing dammed-up energy. Just as the historical, infantile element is present and active in the neurotic symptoms, so it is in the character. This is why a consistent dissolving of character resistances provides an infallible and immediate avenue of approach to the central infantile conflict.
What, then, follows from these facts for the technique of character-analysis? Are there essential differences between characteranalysis and ordinary resistance analysis? There are. They are related to:
a) the selection of the sequence in which the material is interpreted;
b) the technique of resistance interpretation itself.
As to a) : If we speak of "selection of material," we have to expect an important objection: some will say that any selection is at variance with basic psychoanalytic principles, that one should let oneself be guided by the patient, that with any kind of selection one runs the danger of following one's personal inclinations. To this we have to say that in this kind of selection it is not a matter of neglecting analytic material; it is merely a matter of safeguarding a logical sequence of interpretation which corresponds to the structure of the individual neurosis. All the material is finally interpreted; only, in any given situation this or that detail is more important than another. Incidentally, the analyst always makes selections anyhow, for he has already made a selection when he does not interpret a dream in the sequence in which it is presented but selects this or that detail for interpretation. One also has made a selection if one pays attention only to the content of the communications but not to their form. In other words, the very fact that the patient presents material of the most diverse kinds forces one to make a selection; what matters is only that one select correctly with regard to the given analytic situation.
In patients who, for character reasons, consistently fail to follow the fundamental rule, and generally where one deals with a character resistance, one will be forced constantly to lift the character resistance out o f the total material and to dissolve it by the interpretation of its meaning. That does not mean, of course, that one neglects the rest of the material; on the contrary, every bit of material is valuable which gives us information about the meaning and origin of the disturbing character trait; one merely postpones the interpretation of what material does not have an immediate connection with the transference resistance until such time as the character resistance is understood and overcome at least in itsessential. features. I have already tried to show (cf. Chapter III ) what are the dangers of giving deep-reaching interpretations in the presence of undissolved character resistances.
As to b) : We shall now turn to some special problems of character-analytic technique. First of all, we must point out a possible misunderstanding. We said that character-analysis begins with the emphasis on and the consistent analysis of the character resistance. It should be well understood that this does not mean that one asks the patient, say, not to be aggressive, not to deceive, not to talk in a confused manner, etc. Such procedure would be not only un-analytic but altogether sterile. The fact has to be emphasized again and again that what is described here as characteranalysis has nothing to do with education, admonition, trying to make the patient behave differently, etc. In character-analysis, we ask ourself why the patient deceives, talks in a confused manner, why he is affect-blocked, etc.; we try to arouse the patient's interest in his character traits in order to be able, with his help, to explore analytically their origin and meaning. All we do is to lift the character trait which presents the cardinal resistance out of the level of the personality and to show the patient, if possible, the superficial connections between character and symptoms; it is left to him whether or not he will utilize his knowledge for an alteration of his character. In principle, the procedure is not different from the analysis of a symptom. What is added in characteranalysis is merely that we isolate the character trait and confront the patient with it repeatedly until he begins to look at it objectively and to experience it like a painful symptom; thus, the character trait begins to be experienced as a foreign body which the patient wants to get rid of.
Surprisingly, this process brings about a change--although only a temporary one--in the personality. With progressing characteranalysis, that impulse or trait automatically comes to the fore which had given rise to the character resistance in the transference. To go back to the illustration of the passive-feminine character: the more the patient achieves an objective attitude toward his tendency to passive submission, the more aggressive does he become. This is so because his passive-feminine attitude was essentially a reaction to repressed aggressive impulses. But with the aggression we also have a return of the infantile castration anxiety which in infancy had caused the change from aggressive to passive-feminine behavior. In this way the analysis of the character resistance leads directly to the center of the neurosis, the Oedipus complex.
One should not have any illusions, however. The isolation of such a character resistance and its analytic working-through usually takes many months of sustained effort and patient persistence. Once the breakthrough has succeeded, though, the analysis usually proceeds rapidly, with emotionally charged analytical experiences. If, on the other hand, one neglects such character resistances and instead simply follows the line of the material, interpreting everything in it, such resistances form a ballast which it is difficult if not impossible to remove. In that case, one gains more and more the impression that every interpretation of meaning was wasted, that the patient continues to doubt everything or only pretends to accept things, or that he meets everything with an inward smile. If the elimination of these resistances was not begun right in the beginning, they confront one with an insuperable obstacle in the later stages of the analysis, at a time when the most important interpretations of the Oedipus complex have already been given.
I have already tried to refute the objection that it is impossible to tackle resistances before one knows their infantile determination. The essential thing is first to see through the present-day meaning of the character resistance; this is usually possible without the infantile material. The latter is needed for the dissolution of the resistance. If at first one does no more than to show the patient the resistance and to interpret its present-day meaning, then the corresponding infantile material with the aid of which we can eliminate the resistance soon makes its appearance.
If we put so much emphasis on the analysis of the mode of behavior, this does not imply a neglect of the contents. We only add something that hitherto has been neglected. Experience shows that the analysis of character resistances has to assume first rank. This does not mean, of course, that one would only analyze character resistances up to a certain date and then begin with the interpretation of contents. The two phases--resistance analysis and analysis of early infantile experiences--overlap essentially; only in the beginning, we have a preponderance of character-analysis, that is, "education to analysis by analysis," while in the later stages the emphasis is on the contents and the infantile. This is, of course, no rigid rule but depends on the attitudes of the individual patient. In one patient, the interpretation of the infantile material will be begun earlier, in another later. It is a basic rule, however, not to give any deep-reaching interpretations--no matter how clear-cut the material--as long as the patient is not ready to assimilate them. Again, this is nothing new, but it seems that differences in analytic technique are largely determined by what one or the other analyst means by "ready for analytic interpretation." We also have to distinguish those contents which are part and parcel of the character resistance and others which belong to other spheres of experiencing. As a rule, the patient is in the beginning ready to take cognizance of the former, but not of the latter. Generally speaking, our character-analytic endeavors are nothing but an attempt to achieve the greatest possible security in the introduction of the analysis and in the interpretation of the. infantile material. This leads us to the important task of studying and systematically describing the various forms of characterological transference resistances. If we understand them, the technique derives automatically from their structure.
d) Derivation o f the situational technique from the structure o f the character resistance (interpretation technique of the defense).
We now turn to the problem of how the situational technique of character-analysis can be derived from the structure of the character resistance in a patient who develops his resistances right in the beginning, the structure of which is, however, completely unintelligible at first. In the following case the character resistance had a very complicated structure; there were a great many coexistent and overlapping determinations. We shall try to describe the reasons which prompted me to begin the interpretation work with one aspect of the resistance and not with any other. Here also we will see that a consistent and logical interpretation of the defenses and of the mechanisms of the "armor" leads directly into the central infantile conflicts.
A CASE OF MANIFEST INFERIORITY FEELINGS
A man 30 years of age came to analysis because he "didn't get any fun out of life." He did not really think he was sick but, he said, he had heard about psychoanalysis and perhaps it would make things clearer to him. When asked about symptoms, he stated he did not have any. Later it was found that his potency was quite defective. He did not quite dare approach women, had sexual intercourse very infrequently, and then he suffered from premature ejaculation and intercourse left him unsatisfied. He had very little insight into his impotence. He had become reconciled to it; after all, he said, there were a lot of men who "didn't need that sort of thing."
His behavior immediately betrayed a severely inhibited individual. He spoke without looking at one, in a low voice, haltingly, and embarrassedly clearing his throat. At the same time, there was an obvious attempt to suppress his embarrassment and to appear courageous. Nevertheless, his whole appearance gave the impression of severe feelings of inferiority.
Having been informed of the fundamental rule, the patient began to talk hesitatingly and in a low voice. Among the first communications was the recollection of two "terrible" experiences. Once he had run over a woman with an automobile and she had died of her injuries. Another time, as a medical orderly during the war, he had had to do a tracheotomy. The bare recollection of these two experiences filled him with horror. In the course of the first few sessions he then talked, in the same monotonous, low and suppressed manner about his youth. Being next to the youngest of a number of children, he was relegated to an inferior place. His oldest brother, some twenty years his senior, was the parents' favorite; this brother had traveled a good deal, "knew the world," prided himself on his experiences and when he came home from one of his travels "the whole house pivoted around him." Although the content of his story made the envy of this brother and the hatred of him obvious enough, the patient, in response to a cautious query, denied ever having felt anything like that toward his brother. Then he talked about his mother, how good she had been to him and how she had died when he was 7 years of age. At this, he began to cry softly; he became ashamed of this and did not say anything for some time. It seemed clear that his mother had been the only person who had given him some love and attention and that her loss had been a severe shock to him. After her death, he had spent 5 years in the house of this brother. It was not the content but the tone of his story which revealed his enormous bitterness about the unfriendly, cold and domineering behavior of his brother. Then he related in a few brief sentences that now he had a friend who loved and admired him very much. After this, a continuous silence set in. A few days later he related a dream : He saw himself in a foreign city with his friend; only, the face of his friend was different. The fact that the patient had left his own city for the purpose of the analysis suggested that the man in the dream represented the analyst. This identification of the analyst with the friend might have been interpreted as a beginning positive transference. In view of the total situation, however, this would have been unwise. He himself recognized the analyst in the friend, but had nothing to add to this. Since he either kept silent or else expressed his doubts that he would be able to carry out the analysis, I told him that he had something against me but did not have the courage to come out with it. He denied this categorically, whereupon I told him that he also never had had the courage to express his inimical impulses toward his brother, not even to think them consciously; and that apparently he had established some kind of connection between his older brother and myself. This was true in itself, but I made the mistake of interpreting his resistance at too deep a level. Nor did the interpretation have any success; on the contrary, the inhibition became intensified. So I waited a few days until I should be able to understand, from his behavior, the more important present-day meaning of his resistance. What was clear at this time was that there was a transference not only of the hatred of the brother but also a strong defense against a feminine attitude (cf. the dream about the friend). But an interpretation in this direction would have been inadvisable at this time. So I continued to point out that for some reason he defended himself against me and the analysis, that his whole being pointed to his being blocked against the analysis. To this he agreed by saying that, yes, that was the way he was generally in life, rigid, inaccessible and on the defensive. While I demonstrated to him his defense in every session, on every possible occasion, I was struck by the monotonous expression with which he uttered his complaints. Every session began with the same sentences: "I don't feel anything, the analysis doesn't have any influence on me, I don't see how I'll ever achieve it, nothing comes to my mind, the analysis doesn't have any influence on me, etc. I did not understand what he wanted to express with these complaints, and yet it was clear that here was the key to an understanding of his resistance.
Here we have a good opportunity for studying the difference between the character-analytic and the active-suggestive education to analysis. I might have admonished him in a kindly way to tell me more about this and that; I might have been able thus to establish an artificial positive transference; but experience with other cases had shown me that one does not get far with such procedures. Since his whole behavior did not leave any room for doubt that he refuted the analysis in general and me in particular, I could simply stick to this interpretation and wait for further reactions. When, on one occasion, the talk reverted to the dream, he said the best proof for his not refuting me was that he identified me with his friend. I suggested to him that possibly he had expected me to love and admire him as much as his friend did; that he then was disappointed and very much resented my reserve. He had to admit that he had had such thoughts but that he had not dared to tell them to me. He then related how he always only demanded love and especially recognition, and that he had a very defensive attitude toward men with a particularly masculine appearance. He said he did not feel equal to such men, and in the relationship with his friend he had played the feminine part. Again there was material for interpreting his feminine transference but his total behavior warned against it. The situation was difficult, for the elements of his resistance which I already understood, the transference of hatred from his brother, and the narcissistic-feminine attitude toward his superiors, were strongly warded off; consequently, I had to be very careful or I might have provoked him into breaking off the analysis. In addition, he continued to complain in every session, in the same way, that the analysis did not touch him, etc.; this was something which I still did not understand after about four weeks of analysis, and yet, I felt that it was an essential and acutely active character resistance.
I fell ill and had to interrupt the analysis for two weeks. The patient sent me a bottle of brandy as a tonic. When I resumed the analysis he seemed to be glad. At the same time, he continued his old complaints and related that he was very much bothered by thoughts about death, that he constantly was afraid that something had happened to some member of his family; and that during my illness he had always been thinking that I might die. It was when this thought bothered him particularly badly one day that he had sent me the brandy. At this point, the temptation was great to interpret his repressed death wishes. The material for doing so was ample, but I felt that such an interpretation would be fruitless because it would bounce back from the wall of his complaints that "nothing touches me, the analysis has no influence on me." In the meantime, the secret double meaning of his complaint, "nothing touches me" ("nichts dringt in mich ein") had become clear; it was an expression of his most deeply repressed transference wish for anal intercourse. But would it have been justifiable to point out to him his homosexual love impulse--which, it is true, manifested itself clearly enough--while he, with his whole being, continued to protest against the analysis? First it had to become clear what was the meaning of his complaints about the uselessness of the analysis. True, I could have shown him that he was wrong in his complaints: he dreamed without interruption, the thoughts about death became more intense, and many other things went on in him. But I knew from experience that that would not have helped the situation. Furthermore, I felt distinctly the armor which stood between the unconscious material and the analysis, and had to assume that the existing resistance would not let any interpretation penetrate to the unconscious. For these reasons, I did no more than consistently to show him his attitude, interpreting it as the expression of a violent defense, and telling him that we had to wait until we understood this behavior. He understood already that the death thoughts on the occasion of my illness had not necessarily been the expression of a loving solicitude.
In the course of the next few weeks it became increasingly clear that his inferiority feeling connected with his feminine transference played a considerable role in his behavior and his complaints. Yet, the situation still did not seem ripe for interpretation; the meaning of his behavior was not sufficiently clear. To summarize the essential aspects of the solution as it was found later:
a) He desired recognition and love from me as from all men who appeared masculine to him. That he wanted love and had been disappointed by me had already been interpreted repeatedly, without success.
b) He had a definite attitude of envy and hatred toward me, transferred from his brother. This could, at this time, not be interpreted because the interpretation would have been wasted.
c) He defended himself against his feminine transference. This defense could not be interpreted without touching upon the warded-off femininity.
d) He felt inferior before me, because of his femininity. His eternal complaints could only be the expression of this feeling of inferiority.
Now I interpreted his inferiority feeling toward me. At first, this led nowhere, but after I had consistently held up his behavior to him for several days, he did bring some communications concerning his boundless envy, not of me, but other men of whom he also felt inferior. Now it suddenly occurred to me that his constant complaining could have only one meaning: "The analysis has no influence on me," that is, "It is no good," that is, "the analyst is inferior, is impotent, cannot achieve anything with me." The complaints were in part a triumph over the analyst, in part a reproach to him. I told him what I thought of his complaints. The result was astounding. Immediately he brought forth a wealth of examples which showed that he always acted this way when anybody tried to influence him. He could not tolerate the superiority of anybody and always tried to tear them down. He had always done the exact opposite of what any superior had asked him to do. There appeared a wealth of recollections of his spiteful and deprecatory behavior toward teachers.
Here, then, was his suppressed aggression, the most extreme manifestation of which thus far had been his death wishes. But soon the resistance reappeared in the same old form, there were the same complaints, the same reserve, the same silence. But now I knew that my discovery had greatly impressed him, which had increased his feminine attitude; this, of course, resulted in an intensified defense against the femininity. In analyzing the resistance, I started again from the inferiority feeling toward me; but now I deepened the interpretation by the statement that he did not only feel inferior but that, because of his inferiority, he felt himself in a female role toward me, which hurt his masculine pride.
Although previously the patient had, presented ample material with regard to his feminine attitude toward masculine men and had had full insight for this fact, now he denied it all. This was a new problem. Why should he now refuse to admit what he had previously described himself? I told him that he felt so inferior toward me that he did not want to accept any explanation from me even if that implied his going back on himself. He realized this to be true and now talked about the relationship with his friend in some detail. He had actually played the feminine role and there often had been sexual intercourse between the legs. Now I was able to show him that his defensive attitude in the analysis was nothing but the struggle against the surrender to the analysis which, to his unconscious, was apparently linked up with the idea of surrendering to the analyst in a female fashion. This hurt his pride, and this was the reason for his stubborn resistance against the influence of the analysis. To this he reacted with a confirmatory dream: he lies on a sofa with the analyst, who kisses him. This clear dream provoked a new phase of resistance in the old form of complaints that the analysis did not touch him, that he was cold, etc. Again I interpreted the complaints as a depreciation of the analysis and a defense against surrendering to it. But at the same time I began to explain to him the economic meaning of this defense. I told him that from what he had told thus far about his infancy and adolescence it was obvious that he had closed himself up against all disappointments by the outer world and against the rough and cold treatment by his father, brother and teachers; that this seemed to have been his only salvation even if it demanded great sacrifices in happiness.
This interpretation seemed highly plausible to him and he soon produced memories of his attitude toward his teachers. He always felt they were cold and distant--a clear projection of his own attitude--and although he was aroused when they beat or scolded him he remained indifferent. In this connection he said that he often had wished I had been more severe. This wish did not seem to fit the situation at that time; only much later it became clear that he wished to put me and my prototypes, the teachers, in a bad light with his spite. For a few days the analysis proceeded smoothly, without any resistances; he now remembered that there had been a period in his childhood when he had been very wild and aggressive. At the same time he produced dreams with a strong feminine attitude toward me. I could only assume that the recollection of his aggression had mobilized the guilt feeling which now was expressed in the passive-feminine dreams. I avoided an analysis of these dreams not only because they had no immediate connection with the actual transference situation, but also because it seemed to me that he was not ready to understand the connection between his aggression and the dreams which expressed a guilt feeling. Many analysts will consider this an arbitrary selection of material. Experience shows, however, that the best therapeutic effect is to be expected when an immediate connection is already established between the transference situation and the infantile material. I only ventured the assumption that, to judge from his recollections of his aggressive infantile behavior, he had at one time been quite different, the exact opposite of what he was today, and that the analysis would have to find out at what time and under what circumstances this change in his character had taken place. I told him that his present femininity probably was an avoidance of his aggressive masculinity. To this the patient did not react except by falling back into his old resistance of complaining that he could not achieve it, that the analysis did not touch him, etc.
I interpreted again his inferiority feeling and his recurrent attempt to prove the analysis, or the analyst, to be impotent; but now I also tried to work on the transference from the brother, pointing out that he had said that his brother always played the dominant role. Upon this he entered only with much hesitation, apparently because we were dealing with the central conflict of his infancy; he talked again about how much attention his mother had paid to his brother, without, however, mentioning any subjective attitude toward this. As was shown by a cautious approach to the question, the envy of his brother was completely repressed. Apparently, this envy was so closely associated with intense hatred that not even the envy was allowed to become conscious. The approach to this problem provoked a particularly violent resistance which continued for days in the form of his stereotyped complaints about his inability. Since the resistance did not budge it had to be assumed that here was a particularly acute rejection of the person of the analyst. I asked him again to talk quite freely and without fear about the analysis and, in particular, about the analyst, and to tell me what impression I had made on him on the occasion of the first meeting. After much hesitation he said the analyst had appeared to him so masculine and brutal, like a man who is absolutely ruthless with women. So I asked him about his attitude toward men who gave an impression of being potent.
This was at the end of the fourth month of the analysis. Now for the first time that repressed attitude toward the brother broke through which had the closest connection with his most disturbing transference attitude, the envy of potency. With much affect he now remembered that he had always condemned his brother for always being after women, seducing them and bragging about it afterwards. He said I had immediately reminded him of his brother. I explained to him that obviously he saw in me his potent brother and that he could not open up to me because he condemned me and resented my assumed superiority just as he used to resent that of his brother; furthermore, it was plain now that the basis of his inferiority feeling was a feeling of impotence.
Then occurred what one always sees in a correctly and consistently carried-out analysis: the central element of the character resistance rose to the surface. All of a sudden he remembered that he had repeatedly compared his small penis with the big one of his brother and how he had envied his brother.
As might have been expected, a new wave of resistance occurred; again the complaint, "I can't do anything." Now I could go somewhat further in the interpretation and show him that he was acting out his impotence. His reaction to this was wholly unexpected. In connection with my interpretation of his distrust he said for the first time that he had never believed anyone, that he did not believe anything, and probably also not in the analysis. This was, of course, an important step ahead, but the connection of this statement with the analytic situation was not altogether clear. For two hours he talked about all the many disappointments which he had experienced and believed that they were a rational explanation of his distrust. Again the old resistance reappeared; as it was not clear what had precipitated it this time, I kept waiting. The old behavior continued for several days. I only interpreted again those elements of the resistance with which I was already well acquainted. Then, suddenly, a new element of the resistance appeared: he said he was afraid of the analysis because it might rob him of his ideals. Now the situation was clear again. He had transferred his castration anxiety from his brother to me. He was afraid of me. Of course, I did not touch upon his castration anxiety but proceeded again from his inferiority feeling and his impotence and asked him whether his high ideals did not make him feel superior and better than everybody else. He admitted this openly; more than that, he said that he was really better than all those who kept running after women and lived sexually like animals. He added, however, that this feeling was all too often disturbed by his feeling of impotence, and that apparently he had not become quite reconciled to his sexual weakness after all. Now I could show him the neurotic manner in which he tried to overcome his feeling of impotence: he was trying to recover a feeling of potency in the realm of ideals. I showed him the mechanism of compensation and pointed out again the resistances against the analysis which originated from his secret feeling of superiority. I told him that not only did he think himself secretly better and cleverer than others; it was for this very reason that he resisted the analysis. For if it succeeded, he would have taken recourse to the aid of somebody else and it would have vanquished his neurosis, the secret pleasure gain of which had just been unearthed. From the standpoint of the neurosis this would be a defeat which, furthermore, to his unconscious, would mean becoming a woman. In this way, by progressing from the ego and its defense mechanisms, I prepared the soil for an interpretation of the castration complex and of the feminine fixation.
The character-analysis had succeeded, then, in penetrating from his mode of behavior directly to the center of his neurosis, his castration anxiety, the envy of his brother because of his mother's favoritism, and the disappointment in his mother. What is important here is not that these unconscious elements rose to the surface; that often occurs spontaneously. What is important is the logical sequence and the close contact with the ego-defense and the transference in which they came up; further, that this took place without any urging, purely as the result of analytic interpretation of the behavior; further, that it took place with the corresponding affects. This is what constitutes a consistent character-analysis; it is a thorough working through of the conflicts assimilated by the ego.
In contrast, let us consider what probably would have happened without a consistent emphasis on the defenses. Right at the beginning, there was the possibility of interpreting the passivehomosexual attitude toward the brother, and the death wishes. Undoubtedly, dreams and associations would have provided further relevant material for interpretation. But without a previous systematic and detailed working through of his ego-defense, no interpretation would have affectively penetrated; the result would have been an intellectual knowledge of his passive desires alongside with a violent affective defense against them. The affects belonging to the passivity and the murderous impulses would have continued to remain in the defense function. The final result would have been a chaotic situation, the typical hopeless picture of an analysis rich in interpretations and poor in results.
A few months' patient and persistent work on his ego-defense, particularly its form (complaints, manner of speech, etc.) raised the ego to that level which was necessary for the assimilation of the repressed, it loosened the affects and brought about their displacement in the direction of the repressed ideas. One cannot say, therefore, that in this case two different techniques would have been feasible; there was only one possibility if one was to alter the patient dynamically. I trust that this case makes clear the different concept of the application of theory to technique. The most important criterion of an orderly analysis is the giving of few interpretations which are to the point and consistent, instead of a great many which are unsystematic and do not take into consideration the dynamic and economic element. If one does not let oneself be led astray by the material, if, instead, one evaluates correctly its dynamic position and economic role, then one gets the material later, it is true, but more thoroughly and more charged with affect. The second criterion is a continuous connection between present-day situation and infantile situation. While in the beginning the various elements of the content coexist side by side without any order, this changes into a logical sequence of resistances and contents, a sequence determined by the dynamics and structure of the individual neurosis. With unsystematic interpretation, one has to make one new start after another, guessing rather than knowing one's way; in the case of character-analytic work on the resistances, on the other hand, the analytic process develops as if by itself. In the former case, the analysis will run smoothly in the beginning only to get progressively into more and more difficulties; in the latter case, the greatest difficulties are met in the first few weeks and months of the treatment, to give way progressively to smooth work even on the most deeply repressed material. The fate of every analysis depends on its introduction, that is, the correct or incorrect handling of the resistances. The third criterion, then, is that of tackling the case not in this or that spot which happens to be tangible but at the spot which hides the most essential ego-defense; and the systematic enlarging of the breach which has been made into the unconscious; and the working out of that infantile fixation which is affectively most important at any given time. A certain unconscious position which manifests itself in a dream or an association may have a central significance for the neurosis and yet may at any given time be quite unimportant with regard to its technical significance. In our patient, the feminine attitude toward the brother was of central pathogenic significance; yet in the first few months the technical problem was the fear of theloss of the compensation for the impotence by high ideals. The mistake which is usually made is that of attacking the central pathogenic point of the neurosis which commonly manifests, itself somehow right at the beginning. What has to be attacked instead are the respective important present-day positions which, if worked on systematically, one after the other, lead o f necessity to the central pathogenic situation. It is important, therefore, and in many cases decisive, how, when and from which side one proceeds toward the central point of the neurosis.
What we have described here as character-analysis fits without difficulty into Freud's theory of resistances, their formation and dissolution. We know that every resistance consists of an
id-impulse which is warded off and an ego-impulse which wards it off. Both impulses are unconscious. In principle, then, one would seem to be free to interpret first either the id-impulse or the ego impulse. For example: If a homosexual resistance in the form of keeping silent appears right at the beginning of the analysis, one can approach the id-impulse by telling the patient that he is occupied with thoughts about loving the analyst or being loved by him; one has interpreted his positive transference, and if he does not take flight it will, at best, take a long time before he can come to terms with such a forbidden idea. The better way, then, is to approach first the defense of the ego which is more closely related to the conscious ego. One will tell the patient at first only that he is keeping silent because-"for one reason or another," that is, without touching upon the id-impulse--he is defending himself against the analysis, presumably because it has become somehow dangerous to him. In the first case one has tackled the id aspect, in the latter case the ego aspect of the resistance, the defense.
Proceeding in this manner, we comprehend the negative transference in which every defense finally results, as well as the character, the armor of the ego. The superficial, more nearly conscious layer of every resistance must of necessity be a negative attitude toward the analyst, no matter whether the warded-off id-impulse is hatred or love. The ego projects its defense against the idimpulse to the analyst who has become a dangerous enemy because, by his insistence on the fundamental rule, he has provoked id-impulses and has disturbed the neurotic equilibrium. In its defense, the ego makes use of very old forms of negative attitudes; it utilizes hate impulses from the id even if it is warding off love impulses.
If we adhere to the rule of tackling resistances from the ego side, we always dissolve, at the same time, a certain amount of negative transference, of hatred. This obviates the danger of overlooking the destructive tendencies which often are extremely well hidden; it also strengthens the positive transference. The patient also comprehends the ego interpretation more easily because it is more in accordance with conscious experience than the id interpretation; this makes him better prepared for the latter which follows at a later time.
The ego defense has always the same form, corresponding to the character of the patient, whatever the repressed id-impulse may be. Conversely, the same id-impulse is warded off in different ways in different individuals. If we interpret only the id-impulse, we leave the character untouched. If, on the other hand, we always approach the resistances from the defense, from the ego side, we include the neurotic character in the analysis. In the first case, we say immediately what the patient wards off. In the latter case, we first make clear to him that he wards off "something," then, how he does it, what are the means of defense (characteranalysis); only at last, when the analysis of the resistance has progressed far enough, is he told--or finds out for himself--what it is he is warding off. On this long detour to the interpretation of the id-impulses, all corresponding attitudes of the ego have been analyzed. This obviates the danger that the patient learns something too early or that he remains affectless and without participation.
Analyses in which so much analytic attention is centered upon the attitudes take a more orderly and logical course while the theoretical research does not suffer in the least. One obtains the important infantile experiences later, it is true; but this is more than compensated for by the emotional aliveness with which the infantile material comes up after the analytic work on the character resistances.
On the other hand, we should not fail to mention certain unpleasant aspects of a consistent character-analysis. It is a far heavier burden for the patient; he suffers much more than when one leaves the character out of consideration. True, this has the advantage of a selective process: those who cannot stand it would not have achieved success anyhow, and it is better to find that out after a few months than after a few years. Experience shows that if the character resistance does not give way a satisfactory result cannot be expected. The overcoming of the character resistance does not mean that the character is altered; that, of course, is possible only after the analysis of its infantile sources. It only means that the patient has gained an objective view of his character and an analytic interest in it; once this has been achieved a favorable progress of the analysis is probable.
e) The loosening of the character armor.
As we said before, the essential difference between the analysis of a symptom and that of a neurotic character trait consists in the fact that the symptom is, from the beginning, isolated and objectively looked at while the character trait has to be continually pointed out so that the patient will attain the same attitude toward it as toward a symptom. Only rarely is this achieved easily. Most patients have a very slight tendency to look at their character objectively. This is understandable because it is a matter of loosening the narcissistic protection mechanism, the freeing of the anxiety which is bound up in it.
A man of 25 came to analysis because of some minor symptoms and because he suffered from a disturbance in his work. He showed a free, self-confident behavior but often one had the impression that his demeanor was artificial and that he did not establish any genuine relationship with the person to whom he talked. There was something cold in his manner of talking, something vaguely ironical; often he would smile and one would not know whether it was a smile of embarrassment, of superiority or irony.
The analysis began with violent emotions and ample acting out. He cried when he talked about the death of his mother and cursed when he described the usual upbringing of children. The marriage of his parents had been very unhappy. His mother had been very strict with him, and with his siblings he had established some sort of relationship only in recent years. The way in which he kept talking intensified the original impression that neither his crying nor his cursing or any other emotion came out really fully and naturally. He himself said that all this was not really so bad after all, that he was smiling all the time about everything he was saying. After a few hours, he began to try to provoke the analyst. For example, he would, when the analyst had terminated the session, remain lying on the couch ostentatiously for a while, or would start a conversation afterwards. Once he asked me what I thought I would do if he should grab me by the throat. Two days later, he tried to frighten me by a sudden hand movement toward my head. I drew back instinctively and told him that the analysis asked of him only that he say everything, not that he do things. Another time he stroked my arm in parting. The deeper meaning of this behavior which could not be interpreted at this time was a budding homosexual transference manifesting itself sadistically. When, on a superficial level, I interpreted these actions as provocations, he smiled and closed up even more. The actions ceased as well as his communications; all that remained was the stereotyped smile. He began to keep silent. When I pointed out the defensive character of his behavior, he merely smiled again and, after some period of silence, repeated, obviously with the intention of making fun of me, the word "resistance." Thus the smiling and the making fun of me became the center of the analytic work.
The situation was difficult. Apart from the few general data about his childhood, I knew nothing about him. All one had to deal with, therefore, were his modes of behavior in the analysis. For some time, I simply waited to see what would be forthcoming, but his behavior remained the same for about two weeks. Then it occurred to me that the intensification of his smile had occurred at the time when I had warded off his aggressions. I tried to make him understand the meaning of his smile in this connection. I told him that no doubt his smile meant a great many things, but at the present it was a reaction to the cowardice I had shown by my instinctive drawing back. He said that may well be but that he would continue to smile. He talked about unimportant things, and made fun of the analysis, saying that he could not believe anything I was telling him. It became increasingly clear that his smile served as a protection against the analysis. This I told him repeatedly over several sessions but it was several weeks before a dream occurred which had reference to a machine which cut a long piece of brick material into individual bricks. The connection of this dream with the analytic situation was all the more unclear in that he did not produce any associations. Finally he said that, after all, the dream was very simple, it was obviously a matter of the castration complex, and--smiled. I told him that his irony was an attempt to disown the indication which the unconscious had given through the dream. Thereupon he produced a screen memory which proved of great importance for the further development of the analysis. He remembered that at the age of about five he once had "played horse" in the backyard at home. He had crawled around on all fours, letting his penis hang out of his pants. His mother caught him doing this and asked what on earth he was doing. To this he had reacted merely by smiling. Nothing more could be learned for the moment. Nevertheless, one thing had been learned: his smile was a bit of mother transference. When I told him that obviously he behaved in the analysis as he had behaved toward his mother, that his smile must have a definite meaning, he only smiled again and said that was all well and good but it did not seem plausible to him. For some days, there was the same smile and the same silence. on his part, while I consistently interpreted his behavior as a defense against-the analysis, pointing out that his smile was an attempt to overcome a secret fear of me. These interpretations also were warded off with his stereotyped smile. This also was consistently interpreted as a defense against my influence. I pointed out to him that apparently he was always smiling, not only in the analysis, whereupon' he had to admit that this was his only possible way of getting through life. With that, he had unwillingly concurred with me. A few days later he came in smiling again and said: "Today you'll be pleased, Doctor. `Bricks,' in my mother-tongue, means horse testicles. Swell, isn't it? So you see, it is the castration complex." I said that might or might not be true; that, in any case, as long as he maintained this defensive attitude, an analysis of the dreams was out of the question; that, no doubt, he would nullify every association and every interpretation with his smile. It should be said here that his smile was hardly visible; it was more a matter of a feeling and an attitude of making fun of things. I told him he need not be afraid of laughing about the analysis openly and loudly. From then on, he was much more frank in his irony. His association, in spite of its fun-making implication, was nevertheless very valuable for an understanding of the situation. It seemed highly probable that, as happens so often, he had conceived of the analysis in the sense of a danger of castration; at first he had warded off this danger with aggression and later with his smile. I returned to the aggressions in the beginning of the analysis and added the new interpretation that he had tried to test me with his provocations, that he wanted to see how far he could go, how far he could trust me. That, in other words, he had had a mistrust which was based on an infantile fear. This interpretation impressed him visibly. He was struck for a moment but quickly recovered and again began to disavow the analysis and my interpretations with his smiling. I remained consistent in my interpretations; I knew from different indications that I was on the right track and that I was about to undermine his ego defense. Nevertheless, he remained equally consistent in his smiling attitude for a number of sessions. I intensified my interpretations by linking them up more closely with the assumed infantile fear. I told him that he was afraid of the analysis because it would revive his infantile conflicts which he thought he had solved with his attitude of smiling but that he was wrong in this belief because his excitation at the time when he talked about his mother's death had been genuine after all. I ventured the assumption that his relationship with his mother had not been so simple; that he had not only feared and ridiculed but also loved her. Somewhat more serious than usually, he related details concerning the unkindness of his mother toward him; one time when he had misbehaved she even hurt his hand with a knife. True, he added, "Well, according to the book, this is again the castration complex, isn't it?" Nevertheless, something serious seemed to go on in him. While I continued to interpret the manifest and latent meaning of the smiling as it appeared in the analytic situation, further dreams occurred. Their manifest content was that of symbolical castration ideas. Finally he produced a
dream in which there were horses, and another where a high tower arose from a fire truck. A huge column of water poured from the tower into a burning house. At this time, the patient suffered from occasional bedwetting. The connection between the "horse dreams" and his horse game he realized himself, although accompanied by smiling. More than that, he remembered that he had always been very much interested in the long penes of horses; he thought that in his infantile game he had imitated such a horse. He also used to find a great deal of pleasure in urinating. He did not remember whether as a child he used to wet his bed.
On another occasion of discussing the infantile meaning of his smile he thought that possibly his smile on the occasion of the horse game had not been derisive at all but an attempt to reconcile his mother, for fear that she might scold him for his game. In this way he came closer and closer to what I had now been interpreting for months from his behavior in the analysis. The smiling, then, had changed its function and meaning in the course of time: originally an attempt at conciliation, it had later become a compensation of an inner fear, and finally, it also served as a means of feeling superior. This explanation the patient found himself when in the course of several sessions he reconstructed the way which he had found out of his childhood misery. The meaning was: "Nothing can happen to me, I am proof against everything." It was in this last sense that the smile had become a defense in the analysis, as a protection against the reactivation of the old conflicts. The basic motive of this defense was an infantile fear. A dream which occurred at the end of the fifth month revealed the deepest layer of his fear, the fear of being left by his mother. The dream was the following: "I am riding in a car, with an unknown person, through a little town which is completely deserted and looks desolate. The houses are run down, the windowpanes smashed. Nobody is to be seen. It is as if death had ravaged the place. We come to a gate where I want to turn back. I. say to my companion we should have another look. There is a man and a woman kneeling on the sidewalk, in mourning clothes. I approach them to ask them something. As I touch them on the shoulder they jump and I wake up, frightened." The most important association was that the town was similar to that in which he had lived until he was four years of age. The death of his mother and the infantile feeling of being left alone were clearly expressed. The companion was the analyst. For the first time, the patient took a dream completely seriously, without any smiling. The character resistance had been broken through and the connection with the infantile had been established. From then on, the analysis proceeded without any special difficulty, interrupted, of course, by the relapses into the old character resistance as they occur in every analysis.
It goes without saying that the difficulties were far greater than may appear from this brief synopsis. The whole resistance phase lasted almost six months, characterized by derision of the analysis for days and weeks on end. Without the necessary patience and the confidence in the efficacy of consistent interpretation of the character resistance, one often would have been inclined to give up.
Let us see whether the analytic insight into the mechanism of this case would justify some other technical procedure. Instead of putting the emphasis consistently on the mode of behavior, one might have thoroughly analyzed the patient's scarce dreams. Possibly he might have had associations which one could have interpreted. It may not be important that previous to the analysis the patient did not dream or forgot all his dreams and did not produce any dreams with a content relevant to the analytic situation until after the consistent interpretation of his behavior. One might object that the patient would have produced these dreams spontaneously anyhow; this cannot be argued because it cannot be proved one way or the other. At any rate, we have ample experience which teaches us that such a situation as presented by our patient can hardly be solved by passive waiting alone; if so, it happens by accident, without the analyst having the reins of the analysis in his hand. Let us assume, then, that we had interpreted his associations in connection with the castration complex, that is, tried to make him conscious of his fear of cutting or of being cut. Perhaps this would have finally also led to a success. But the very fact that we cannot be sure that it would have happened, that we must admit the accidental nature of the occurrence, forces us to refute such a technique which tries to circumvent an existing resistance as basically un-analytic. Such a technique would mean reverting to that stage of analysis where one did not bother about the resistances, because one did not know them, and where, consequently, one interpreted the meaning of the unconscious material directly. It is obvious from the case history that this would mean, at the same time, a neglect of the ego defenses.
One might object again that while the technical handling of the case was entirely correct one did not understand my argument; that all this was self-evident and nothing new, that this was the way all analysts worked. True, the general principle is not new; it is nothing but the consistent application of resistance analysis. Many years of experience in the Technical Seminar showed, however, that analysts generally know and recognize the principles of resistance technique, while in practice they use essentially the old technique of the direct interpretation of the unconscious. This discrepancy between theoretical knowledge and practical action was the source of all the mistaken objections to the systematic attempts of the Vienna Seminar to develop the consistent application of theory to therapy. If they said that all this was trite and nothing new, they had their theoretical knowledge in mind; if they objected that it was all wrong and not "Freudian" analysis, they thought of their own practice, which, as we have said, was quite different.
A colleague once asked me what I would have done in the following case: For the past four weeks he had been treating a young man who kept consistently silent but was otherwise very nice and showed a very friendly behavior before and after the analytic session. The analyst had tried all kinds of things, had threatened to break off the analysis and finally, when even dream interpretation failed, had set a date for the termination of the analysis. The scarce dreams had been filled with sadistic murder. The analyst had told the patient that, after all, he should realize from his dreams that in his phantasy he was a murderer. But it did not help. The colleague was not satisfied with my statement that it was incorrect to interpret such deep material in the presence of an acute resistance, no matter how clearly the material might appear in a dream. He thought there was no other way. When I told him that, first of all, the silence should have been interpreted as a resistance, he said that could not be done, for there was no "material" available to do it with. Is not the behavior itself, the silence during the hour in contrast to the friendly attitude outside, "material" enough? Does not this situation show clearly the one thing at least, that the patient expresses, with his silence, a negative attitude or a defense? And that, to judge from his dreams, it is a matter of sadistic impulses which, by his over-friendly behavior, he tried to compensate and camouflage? Why does one dare to deduce certain unconscious processes from a slip such as a patient's forgetting some object in the consultation room, and why does one not dare to deduce the meaning of the situation from his behavior? Is the total behavior less conclusive material than a slip? All this did not seem plausible to my colleague; he continued to insist that the resistance could not be tackled because there was "no material." There could be no doubt that the interpretation of the murderous impulses was a technical error; it could only have the effect of frightening the patient and of putting him all the more on his guard.
The difficulties in the cases presented in the Seminar were of a very similar nature: It was always the same underestimation or the complete neglect of the behavior as interpretable material; again and again the attempt to remove the resistance from the id side instead of by analysis of the ego defense; and finally, almost always, the idea--which was used as an alibi--that the patient simply did not want to get well or that he was "all too narcissistic."
In principle, the loosening of the narcissistic defense is not different in other types than in the one described. If, say, a patient is always affectless and indifferent, no matter what material he may be presenting, then one is dealing with the dangerous affect-block. Unless one works on this before anything else one runs the danger of seeing all the material and all the interpretations go to waste and of seeing the patient become a good analytical theorist while otherwise he remains the same. Unless one prefers in such a case to give up the analysis because of "too strong narcissism" one can make an agreement with the patient to the effect that one will continue to confront him with his affect-lameness but that, of course, he can stop whenever he wants to. In the course of time--usually many months, in one case it took a year and a half--the patient begins to experience the continued pointing out of his affect lameness and its reasons as painful, for in the meantime one has acquired sufficient means of undermining the protection against anxiety which the affectlameness presents. Finally the patient rebels against the danger which threatens from the analysis, the danger of losing the protective psychic armor and of being confronted with his impulses, particularly with his aggression. This rebellion activates his aggressivity and before long the first emotional outburst in the sense of a negative transference occurs, in the form of an attack of hatred. That achieved, the road becomes clear. When the aggressive impulses make their appearance, the affect-block is breached and the patient becomes capable of being analyzed. The difficulty consists in bringing out the aggressivity.
The same is true when narcissistic patients express their character resistance in their way of talking; they will talk, for example, always in a haughty manner, in technical terms, always highly correctly or else confusedly. Such modes of talking form an impenetrable , barrier and there is no real experiencing until one analyzes the mode of expression itself. Here also, the consistent interpretation of the behavior results in narcissistic indignation, for the patient does not like to be told that he talks so haughtily, or in technical terms, in order to camouflage his feeling of inferiority before himself and the analyst, or that he talks so confusedly because he wants to appear particularly clever and is unable to put his thoughts into simple words. In this manner, one makes an important breach in the neurotic character and creates an avenue of approach to the infantile origin of the character and the neurosis. Of course, it is insufficient to point out the nature of the resistance at one time or another; the more stubborn the resistance, the more consistently does it have to be interpreted. If the negative attitudes against the analyst which are thus provoked are analyzed at the same time the risk of the patient's breaking off the analysis is negligible.
The immediate effect of the analytic loosening of the character armor and the narcissistic protection mechanism is twofold: First, the loosening of the affects from their reactive anchoring and hiding places; second, the creation of an avenue of approach to the central infantile conflicts, the Oedipus complex and the castration anxiety. An enormous advantage of this procedure is that
one not only reaches the infantile experiences as such, but that one analyzes them in the specific manner in which they have been assimilated by the ego. One sees again and again that one and the same piece of repressed material is of different dynamic importance according to the stage which has been reached in the loosening of the resistances. In many cases, the affect of the infantile experiences is absorbed in character defenses; with simple interpretation of the contents, therefore, one may be able to elicit the memories but not the corresponding affects. In such cases, interpretation of the infantile material without previous loosening of the affect energies which are absorbed in the character is a serious mistake. It is responsible, for example, for the hopelessly long and relatively useless analyses of compulsive characters. If, on the other hand, one first frees the affects from the defense formations of the character, a new cathexis of the infantile, impulses takes place automatically. If the line of character-analytic resistance interpretation is followed, remembering without affect is practically out of the question; the disturbance of the neurotic equilibrium which goes with the analysis of the character from the very beginning makes it practically impossible.
In other cases, the character has been built up as a solid protective wall against the experiencing of infantile anxiety and has served well in this function, although at the expense of much happiness. If such an individual comes to analysis because of some symptom, this protective wall serves equally well as character resistance and one realizes soon that nothing can be done unless this character armor which covers up and absorbs the infantile anxiety is destroyed. This is the case, for example, in "moral insanity" and in many manic, narcissistic-sadistic characters. In such cases one is often confronted with the difficult question whether the symptom justifies a deep-reaching character-analysis. For one must realize that the character-analytic destruction of the characterological compensation temporarily creates a condition which equals a breakdown of the personality. More than that, in many extreme cases such a breakdown is inevitable before a new, rational personality structure can develop. One may say, of course, that sooner or later the breakdown would have occurred anyhow, the development of the symptom being the first sign. Nevertheless, one will hesitate about undertaking an operation which involves so great a responsibility unless there is an urgent indication.
In this connection another fact must be mentioned: characteranalysis creates in every case violent emotional outbursts and often dangerous situations, so that it is important always to be master of the situation, technically. For this reason, many analysts will refuse to use the method of character-analysis; in that case, they will have to relinquish the hope for success in a great many cases. A great many neuroses cannot be overcome by mild means. The means of character-analysis, the consistent emphasis on the character resistance and the persistent interpretation of its forms, ways and motives, are as potent as they are unpleasant for the patient. This has nothing to do with education; rather, it is a strict analytic principle. It is a good thing, however, to point out to the patient in the beginning the foreseeable difficulties and unpleasantness.
f) On the optimal conditions for the analytic reduction o f the present-day material to the infantile.
Since the consistent interpretation of the behavior spontaneously opens the way to the infantile sources of the neurosis, a new question arises: Are there criteria to indicate when the reduction of the present-day modes of behavior to their infantile prototypes should take place? This reduction, we know, is one of the cardinal tasks of analysis, but this formulation is too general to be applied in everyday practice. Should it be done as soon as the first signs of the corresponding infantile material appear, or are there reasons for postponing it until a certain later time? First of all it must be pointed out that in many cases the purpose of the reduction-dissolution of the resistance and elimination of the amnesia-is not fulfilled: either there is no more than an intellectual understanding, or the reduction is refuted by doubts. This is explained by the fact that--as is the case with the making conscious of unconscious ideas--the topical process is complete only if combined with the dynamic-affective process of the becoming conscious. This requires the fulfilment of two conditions: first, the main resistances must be at least loosened up; second, the idea which is to become conscious-or, in the case of the reduction, is to enter a new association-must become charged with a certain minimum of affect. Now, we know that the affects are usually split off from the repressed ideas, and bound up in the acute transference conflicts and resistances. If, now, one reduces the resistance to the infantile situation before it has fully developed, as soon as there is only a trace of its infantile origin, then one has not fully utilized its affective energies; one has interpreted the content of the resistance without also having mobilized the corresponding affect. That is, dynamic considerations make it necessary not to nip the resistance in the bud, but, on the contrary, to bring it to full development in the transference situation. In the case of chronic, torpid character incrustations there is no other way at all. Freud's rule that the patient has to be brought from acting out to remembering, from the present day to the infantile, has to be complemented by the further rule that first that which has become chronically rigid must be brought to new life in the actual transference situation, just as chronic inflammations are treated by first changing them into acute ones. With character resistances this is always necessary. In later stages of the analysis, when one is certain of the patient's cooperation, it becomes less necessary. One gains the impression that with many analysts the immediate reduction of as yet completely immature transference situations is due to the fear of strong and stormy transference resistances; this fits in with the fact that--in spite of better theoretical knowledge-- resistances are very often considered something highly unwelcome and only disturbing. Hence the tendency to circumvent the resistance instead of bringing it to full development and then treating it. One should not forget the fact that the neurosis itself is contained in the resistance, that with the dissolution of every resistance we dissolve a piece of the neurosis.
There is another reason why it is necessary to bring the resistance to full development. Because of the complicated structure of each resistance, one comprehends all its determinations and meanings only gradually; the more completely one has comprehended a resistance situation, the more successful is its later interpretation. Also, the double nature of the resistance--present-day and historical-makes it necessary first to make fully conscious the forms of ego defense it contains; only after its present-day meaning has become clear should its infantile origin be interpreted. This is true of the cases who have already produced the infantile material necessary for an understanding of the resistance which follows. In the other, more numerous cases, the resistance must be brought to full development for no other reason than that otherwise one does not obtain enough infantile material.
The resistance technique, then, has two aspects: First, the comprehension of the resistance from the present-day situation through interpretation of its present-day meaning; second, the dissolution of the resistance through association of the ensuing infantile material with the present-day material. In this way, one can easily avoid the flight into the present-day as well as into the infantile, because equal attention is paid to both in the interpretation work. Thus the resistance turns from an impediment of the analysis into its most potent expedient.
g) Character-analysis in the case of amply flowing material.
In cases where the character impedes the process of recollection from the beginning, there can be no doubt about the indication of character-analysis as the only legitimate way of introducing the analysis. But what about the cases whose character admits of the production of ample memory material, in the beginning? Do they, also, require character-analysis as here described? This question could be answered in the negative if there were cases without a character armor. But since there are no such cases, since the narcissistic protection mechanism always turns into a character resistance--sooner or later, in varying intensity and depth-there is no fundamental difference between the cases. The practical difference, though, is this: In cases such as described above, the narcissistic protection mechanism is at the surface and appears as resistance immediately, while in other cases it is in deeper layers of the personality so that it does not strike one at first. But it is precisely these cases that are dangerous. In the former case one knows what one is up against. In the latter case, one often believes for a long period of time that the analysis proceeds satisfactorily, because the patient seems to accept everything very readily, shows prompt reactions to one's interpretations, and even improvements. But it is just in these patients that one experiences the worst disappointments. The analysis has been carried out, but the final success fails to materialize. One has shot all one's interpretations, one seems to have made completely conscious the primal scene and all infantile conflicts; finally the analysis bogs down in an empty, monotonous repetition of the old material, and the patient does not get well. Worse still, a transference success may deceive one as to the real state of affairs, and the patient may return with a full relapse soon after his discharge.
A wealth of bad experiences with such cases suggested as a rather self-evident conclusion that one had overlooked something. This oversight could not refer to the contents, for in that respect these analyses left little to be desired; it could only be an unrecognized latent resistance which nullified all therapeutic endeavor. It was soon found that these latent resistances consisted precisely in the great willingness of the patients, in the lack of manifest resistances. In comparing them with successful cases, one was struck by the fact that these analyses had shown a constantly even flow, never interrupted by violent emotional outbursts; more importantly, they had taken place in almost constant "positive" transference; rarely, if ever, had there been violent negative impulses toward the analyst. This does not mean that the hate impulses had not been analyzed; only, they did not appear in the transference, or they had been remembered without affect. The prototypes of these cases are the narcissistic affectlame and the passive-feminine characters. The former show a lukewarm and even, the latter an exaggerated "positive" transference.
These cases had been considered "going well" because they procured infantile material, that is, again because of a one-sided overestimation of the contents of the material. Nevertheless, all through the analysis, the character had acted as a severe resistance in a form which remained hidden. Very often, such cases are considered incurable or at least extremely difficult to handle. Before I was familiar with the latent resistances of these cases, I used to agree with this judgment; since then, I can count them among my most gratifying cases.
The character-analytic introduction of such cases differs from others in that one does not interrupt the flow of communications and does not begin the analysis of the character resistance until such time as the flood of communications and the behavior itself has unequivocally become a resistance. The following case will illustrate this as it will again show how character-analysis leads of itself into the most deeply repressed infantile conflicts. We shall follow this analysis farther along than those previously described, in order to show the logical development of the neurosis in the transference resistances.