Kitabı oku: «The Interpretation of Dreams / Толкование сновидений», sayfa 11

In the course of my psychoanalysis of neurotics, I have indeed already subjected many thousand dreams to interpretation, but I do not now wish to use this material in the introduction to the technique and theory of dream interpretation. Quite apart from the consideration that I should expose myself to the objection that these are dreams of neuropathic subjects, the conclusions drawn from which would not admit of reapplication to the dreams of healthy persons, another reason forces me to reject them. The theme which is naturally always the subject of these dreams, is the history of the disease which is responsible for the neurosis. For this purpose there would be required a very long introduction and an investigation into the nature and logical conditions of psychoneuroses, things which are in themselves novel and unfamiliar in the highest degree, and which would thus distract attention from the dream problem. My purpose lies much more in the direction of preparing the ground for a solution of difficult problems in the psychology of the neuroses by means of the solution of dreams. But if I eliminate the dreams of neurotics, I must not treat the remainder too discriminatingly. Only those dreams still remain which have been occasionally related to me by healthy persons of my acquaintance, or which I find as examples in the literature of dream life. Unfortunately in all these dreams the analysis is lacking, without which I cannot find the meaning of the dream. My procedure is, of course, not as easy as that of the popular cipher method, which translates the given dream content according to an established key; I am much more prepared to find that the same dream may cover a different meaning in the case of different persons, and in a different connection I must then resort to my own dreams, as an abundant and convenient material, furnished by a person who is about normal, and having reference to many incidents of everyday life. I shall certainly be with doubts as to the trustworthiness of these “self-analyses.” Arbitrariness is here in no way avoided. In my opinion, conditions are more likely to be favourable in self-observation than in the observation of others; in any case, it is permissible to see how much can be accomplished by means of self-analysis. I must overcome further difficulties arising from inner self. One has a readily understood aversion to exposing so many intimate things from one̕s own psychic life, and one does not feel safe from the misinterpretation of strangers. But one must be able to put one̕s self beyond this. “Toute psychologiste,” writes Delbœuf,²⁶ “est obligé de faire l̕aveu même de ses faiblesses s̕il croit par là jeter du jour sur quelque problème obscure.” And I may assume that in the case of the reader, the immediate interest in the indiscretions which I must commit will very soon give way to exclusive engrossment in the psychological problems which are illuminated by them.

I shall, therefore, select one of my own dreams and use it to elucidate my method of interpretation. Every such dream necessitates a preliminary statement. I must now beg the reader to make my interests his own for a considerable time, and to become absorbed with me in the most trifling details of my life, for an interest in the hidden significance of dreams imperatively demands such transference.

Preliminary statement: In the summer of 1895 I had psychoanalytically treated a young lady who stood in close friendship to me and those near to me. It is to be understood that such a complication of relations may be the source of manifold feelings for the physician, especially for the psychotherapist. The personal interest of the physician is greater, his authority is less. A failure threatens to undermine the friendship with the relatives of the patient. The cure ended with partial success, the patient got rid of her hysterical fear, but not of all her somatic symptoms. I was at that time not yet sure of the criteria marking the final settlement of a hysterical case, and expected her to accept a solution which did not seem acceptable to her. In this disagreement, we cut short the treatment on account of the summer season. One day a younger colleague, one of my best friends, who had visited the patient – Irma – and her family in their country resort, came to see me. I asked him how he found her, and received the answer: “She is better, but not altogether well.” I realise that those words of my friend Otto, or the tone of voice in which they were spoken, made me angry. I thought I heard a reproach in the words, perhaps to the effect that I had promised the patient too much, and rightly or wrongly I traced Otto̕s supposed siding against me to the influence of the relatives of the patient, who, I assume, had never approved of my treatment. Moreover, my disagreeable impression did not become clear to me, nor did I give it expression. The very same evening, I wrote down the history of Irma̕s case, in order to hand it, as though for my justification, to Dr. M., a mutual friend, who was at that time a leading figure in our circle. During the night following this evening (perhaps rather in the morning) I had the following dream, which was registered immediately after waking:-

Dream of July 23–24, 1895

A great hall – many guests whom we are receiving – among them Irma, whom I immediately take aside, as though to answer her letter, to reproach her for not yet accepting the “solution.” I say to her: “If you still have pains, it is really only your own fault.” She answers: “If you only knew what pains I now have in the neck, stomach, and abdomen; I am drawn together.” I am frightened and look at her. She looks pale and bloated; I think that after all I must be overlooking some organic affection. I take her to the window and look into her throat. She shows some resistance to this, like a woman who has a false set of teeth. I think anyway she does not need them. The mouth then really opens without difficulty and I find a large white spot to the right, and at another place I see extended grayish-white scabs attached to curious curling formations, which have obviously been formed like the turbinated bone – I quickly call Dr. M., who repeats the examination and confirms it… Dr. M.̕s looks are altogether unusual; he is very pale, limps, and has no beard on his chin… My friend Otto is now also standing next to her, and my friend Leopold percusses her small body and says: “She has some dulness on the left below,” and also calls attention to an infiltrated portion of the skin on the left shoulder (something which I feel as he does, in spite of the dress)… M. says: “No doubt it is an infection, but it does not matter; dysentery will develop too, and the poison will be excreted… We also haveimmediate knowledge of the origin of the infection. My friend Otto has recently given her an injection with a propyl preparation when she felt ill, propyls… Propionic acid… Trimethylamine (the formula of which I see printed before me in heavy type)… Such injections are not made so rashly… Probably also the syringe was not clean.

This dream has an advantage over many others. It is at once clear with what events of the preceding day it is connected, and what subject it treats. The preliminary statement gives information on these points. The news about Irma̕s health which I have received from Otto, the history of the illness upon which I have written until late at night, have occupied my psychic activity even during sleep. In spite of all this, no one, who has read the preliminary report and has knowledge of the content of the dream, has been able to guess what the dream signifies. Nor do I myself know. I wonder about the morbid symptoms, of which Irma complains in the dream, for they are not the same ones for which I have treated her. I smile about the consultation with Dr. M. I smile at the nonsensical idea of an injection with propionic acid, and at the consolation attempted by Dr. M. Towards the end the dream seems more obscure and more terse than at the beginning. In order to learn the significance of all this, I am compelled to undertake a thorough analysis.

Analysis

The hall – many guests, whom we are receiving.

We were living this summer at the Bellevue, in an isolated house on one of the hills which lie close to the Kahlenberg. This house was once intended as a place of amusement, and on this account has unusually high, hall-like rooms. The dream also occurred at the Bellevue, a few days before the birthday of my wife. During the day, my wife had expressed the expectation that several friends, among them Irma, would come to us as guests for her birthday. My dream, then, anticipates this situation: It is the birthday of my wife, and many people, among them Irma, are received by us as guests in the great hall of the Bellevue.

I reproach Irma for not having accepted the solution. I say: “If you still have pains, it is your own fault.”

I might have said this also, or did say it, while awake. At that time I had the opinion (recognised later to be incorrect) that my task was limited to informing patients of the hidden meaning of their symptoms. Whether they then accepted or did not accept the solution upon which success depended – for that I was not responsible. I am thankful to this error, which fortunately has now been overcome, for making life easier for me at a time when, with all my unavoidable ignorance, I was to produce successful cures. But I see in the speech which I make to Irma in the dream, that above all things I do not want to be to blame for the pains which she still feels. If it is Irma̕s own fault, it cannot be mine. Should the purpose of the dream be looked for in this quarter?

Irma̕s complaints; pains in the neck, abdomen, and stomach; she is drawn together.

Pains in the stomach belonged to the symptom-complex of my patient, but they were not very prominent; she complained rather of sensations of nausea and disgust. Pains in the neck and abdomen and constriction of the throat hardly played a part in her case. I wonder why I decided upon this choice of symptoms, nor can I for the moment find the reason.

She looks pale and bloated.

My patient was always ruddy. I suspect that another person is here being substituted for her.

I am frightened at the thought that I must have overlooked some organic affection.

This, as the reader will readily believe, is a constant fear with the specialist, who sees neurotics almost exclusively, and who is accustomed to ascribe so many manifestations, which other physicians treat as organic, to hysteria. On the other hand, I am haunted by a faint doubt – I know not whence it comes – as to whether my fear is altogether honest. If Irma̕s pains are indeed of organic origin, I am not bound to cure them. My treatment, of course, removes only hysterical pains. It seems to me, in fact, that I wish to find an error in the diagnosis; in that case the reproach of being unsuccessful would be removed.

I take her to the window in order to look into her throat. She resists a little, like a woman who has false teeth. I think she does not need them anyway.

I had never had occasion to inspect Irma̕s aural cavity. The incident in the dream reminds me of an examination, made some time before, of a governess who at first gave an impression of youthful beauty, but who upon opening her mouth took certain measures for concealing her teeth. Other memories of medical examinations and of little secrets which are discovered by them, unpleasantly for both examiner and examined, connect themselves with this case. “She does not need them anyway,” is at first perhaps a compliment for Irma; but I suspect a different meaning. In careful analysis one feels whether or not the “background thoughts” which are to be expected have been exhausted. The way in which Irma stands at the window suddenly reminds me of another experience. Irma possesses an intimate woman friend, of whom I think very highly. One evening on paying her a visit I found her in the position at the window reproduced in the dream, and her physician, the same Dr. M., declared that she had a diphtheritic membrane. The person of Dr. M. and the membrane return in the course of the dream. Now it occurs to me that during the last few months, I have been given every reason to suppose that this lady is also hysterical. Yes, Irma herself has betrayed this to me. But what do I know about her condition? Only the one thing, that like Irma she suffers from hysterical choking in dreams. Thus in the dream I have replaced my patient by her friend. Now I remember that I have often trifled with the expectation that this lady might likewise engage me to relieve her of her symptoms. But even at the time I thought it improbable, for she is of a very shy nature.She resists, as the dream shows. Another explanation might be that she does not need it; in fact, until now she has shown herself strong enough to master her condition without outside help. Now only a few features remain, which I can assign neither to Irma nor to her friend: Pale, bloated, false teeth. The false teeth lead me to the governess; I now feel inclined to be satisfied with bad teeth. Then another person, to whom these features may allude, occurs to me. She is not my patient, and I do not wish her to be my patient, for I have noticed that she is not at her ease with me, and I do not consider her a docile patient. She is generally pale, and once, when she had a particularly good spell, she was bloated¹⁸. I have thus compared my patient Irma with two others, who would likewise resist treatment. What can it mean that I have exchanged her for her friend in the dream? Perhaps that I wish to exchange her; either the other one arouses in me stronger sympathies or I have a higher opinion of her intelligence. For I consider Irma foolish because she does not accept my solution. The other one would be more sensible, and would thus be more likely to yield. The mouth then really opens without difficulty; she would tell more than Irma¹⁹.

What I see in the throat; a white spot and scabby nostrils.

The white spot recalls diphtheria, and thus Irma̕s friend, but besides this it recalls the grave illness of my eldest daughter two years before and all the anxiety of that unfortunate time. The scab on the nostrils reminds me of a concern about my own health. At that time I often used cocaine in order to suppress annoying swellings in the nose, and had heard a few days before that a lady patient who did likewise had contracted an extensive necrosis of the nasal mucous membrane. The recommendation of cocaine, which I had made in 1885, had also brought grave reproaches upon me. A dear friend, already dead in 1895, had hastened his end through the misuse of this remedy.

I quickly call Dr. M., who repeats the examination.

This would simply correspond to the position which M. occupied among us. But the word “quickly” is striking enough to demand a special explanation. It reminds me of a sad medical experience. By the continued prescription of a remedy (sulfonal) which was still at that time considered harmless, I had once caused the severe intoxication of a woman patient, and I had turned in great haste to an older, more experienced colleague for assistance. The fact that I really had this case in mind is confirmed by an accessory circumstance. The patient, who succumbed to the intoxication, bore the same name as my eldest daughter. I had never thought of this until now; now it seems to me almost like a retribution of fate – as though I ought to continue the replacement of the persons here in another sense; this Matilda for that Matilda; an eye for an eye, a tooth for a tooth. It is as though I were seeking every opportunity to reproach myself with lack of medical conscientiousness.

Dr. M. is pale, without a beard on his chin, and he limps.

Of this so much is correct, that his unhealthy appearance often awakens the concern of his friends. The other two characteristics must belong to another person. A brother living abroad occurs to me, who wears his chin clean-shaven, and to whom, if I remember aright, M. of the dream on the whole bears some resemblance. About him the news arrived some days before that he was lame on account of an arthritic disease in the hip. There must be a reason why I fuse the two persons into one in the dream. I remember that in fact I was on bad terms with both of them for similar reasons. Both of them had rejected a certain proposal which I had recently made to them.

My friend Otto is now standing next to the sick woman, and my friend Leopold examines her and calls attention to a dulness on the left below.

My friend Leopold is also a physician, a relative of Otto. Since the two practise the same specialty, fate has made them competitors, who are continually being compared with each other. Both of them assisted me for years, while I was still directing a public dispensary for nervous children. Scenes like the one reproduced in the dream have often taken place there. While I was debating with Otto about the diagnosis of a case, Leopold had examined the child anew and had made an unexpected contribution towards the decision. For there was a difference of character between the two similar to that between Inspector Brassig and his friend Charles. The one was distinguished for his brightness, the other was slow, thoughtful, but thorough. If I contrast Otto and the careful Leopold in the dream, I do it, apparently, in order to extol Leopold. It is a comparison similar to the one above between the disobedient patient Irma and her friend who is thought to be more sensible. I now become aware of one of the tracks along which the thought association of the dream progresses; from the sick child to the children̕s asylum. The dulness to the left, below, recalls a certain case corresponding to it, in every detail in which Leopold astonished me by his thoroughness. Besides this, I have a notion of something like a metastatic affection, but it might rather be a reference to the lady patient whom I should like to have instead of Irma. For this lady, as far as I can gather, resembles a woman suffering from tuberculosis.

An infiltrated portion of skin on the left shoulder.

I see at once that this is my own rheumatism of the shoulder, which I always feel when I have remained awake until late at night. The turn of phrase in the dream also sounds ambiguous; something which I feel… in spite of the dress. “Feel on my own body” is intended. Moreover, I am struck with the unusual sound of the term “infiltrated portion of skin.” “An infiltration behind on the upper left” is what we are accustomed to; this would refer to the lung, and thus again to tuberculosis patients.