ON THE IMPORTANCE OF THE UNCONSCIOUS IN PSYCHOPATHOLOGY[182]

When we speak of a thing as being "unconscious" we must not forget that from the point of view of the functioning of the brain a thing may be unconscious to us in two ways—physiologically or psychologically. I shall only deal with the subject from the latter point of view. So that for our purposes we may define the unconscious as "the sum of all those psychological events which are not apperceived, and so are unconscious."

The unconscious contains all those psychic events which, because of the lack of the necessary intensity of their functioning, are unable to pass the threshold which divides the conscious from the unconscious; so that they remain in effect below the surface of the conscious, and flit by in subliminal phantom forms.

It has been known to psychologists since the time of Leibniz that the elements—that is to say, the ideas and feelings which go to make up the conscious mind, the so-called conscious content—are of a complex nature, and rest upon far simpler and altogether unconscious elements; it is the combination of these which gives the element of consciousness. Leibniz has already mentioned the perceptions insensibles—those vague perceptions which Kant called "shadowy" representations, which could only attain to consciousness in an indirect manner. Later philosophers assigned the first place to the unconscious, as the foundation upon which the conscious was built.

But this is not the place to consider the many speculative theories nor the endless philosophical discussions concerning the nature and quality of the unconscious. We must be satisfied with the definition already given, which will prove quite sufficient for our purpose, namely the conception of the unconscious as the sum of all psychical processes below the threshold of consciousness.

The question of the importance of the unconscious for psychopathology may be briefly put as follows: "In what manner may we expect to find unconscious psychic material behave in cases of psychosis and neurosis?"

In order to get a better grasp of the situation in connexion with mental disorders, we may profitably consider first how unconscious psychic material behaves in the case of normal people, especially trying to visualize what in normal men is apt to be unconscious. As a preliminary to this knowledge we must get a complete understanding of what is contained in the conscious mind; and then, by a process of elimination we may expect to find what is contained in the unconscious, for obviously—per exclusionem—what is in the conscious cannot be unconscious. For this purpose we examine all activities, interests, passions, cares, and joys, which are conscious to the individual. All that we are thus able to discover becomes, ipso facto, of no further moment as a content of the unconscious, and we may then expect to find only those things contained in the unconscious which we have not found in the conscious mind.

Let us take a concrete example: A merchant, who is happily married, father of two children, thorough and painstaking in his business affairs, and at the same time trying in a reasonable degree to improve his position in the world, carries himself with self-respect, is enlightened in religious matters, and even belongs to a society for the discussion of liberal ideas.

What can we reasonably consider to be the content of the unconscious in the case of such an individual?

Considered from the above theoretical standpoint, everything in the personality that is not contained in the conscious mind should be found in the unconscious. Let us agree, then, that this man consciously considers himself to possess all the fine attributes we have just described—no more, no less. Then it must obviously result that he is entirely unaware that a man may be not merely industrious, thorough, and painstaking, but that he may also be careless, indifferent, untrustworthy; for some of these last attributes are the common heritage of mankind and may be found to be an essential component of every character. This worthy merchant forgets that quite recently he allowed several letters to remain unanswered which he could easily have answered at once. He forgets, too, that he failed to bring a book home which his wife has asked him to get at the book-stall, where she had previously ordered it, although he might easily have made a note of her wish. But such occurrences are common with him. Therefore we are obliged to conclude that he is also lazy and untrustworthy. He is convinced that he is a thoroughly loyal subject; but for all that he failed to declare the whole of his income to the assessor, and when they raise his taxes, he votes for the Socialists.

He believes himself to be an independent thinker, yet a little while back he undertook a big deal on the Stock Exchange, and when he came to enter the details of the transaction in his books he noticed with considerable misgivings that it fell upon a Friday, the 13th of the month. Therefore, he is also superstitious and not free in his thinking.

So here we are not at all surprised to find these compensating vices to be an essential content of the unconscious. Obviously, therefore, the reverse is true—namely, that unconscious virtues compensate for conscious deficiencies. The law which ought to follow as the result of such deductions would appear to be quite simple—to wit, the conscious spendthrift is unconsciously a miser; the philanthropist is unconsciously an egoist and misanthrope. But, unfortunately, it is not quite so easy as that, although there is a basis of truth in this simple rule. For there are essential hereditary dispositions of a latent or manifest nature which upset the simple rule of compensation, and which vary greatly in individual cases. From entirely different motives a man may, for instance, be a philanthropist, but the manner of his philanthropy depends upon his originally inherited disposition, and the way in which the philanthropic attitude is compensated depends upon his motives. It is not sufficient simply to know that a certain person is philanthropic in order to diagnose an unconscious egoism. For we must also bring to such a diagnosis a careful study of the motives involved.

In the case of normal people the principal function of the unconscious is to effect a compensation and thus produce a balance. All extreme conscious tendencies are softened and toned down through an effective opposite impulse in the unconscious. This compensating agency, as I have tried to show in the case of the merchant, maintains itself through certain unconscious, inconsequent activities, as it were, which Freud has very well described as symptomatic acts (Symptom-handlungen).

To Freud we owe thanks also for having called attention to the importance of dreams, for by means of them, also, we are able to learn much about this compensating function. There is a fine historical example of this in the well-known dream of Nebuchadnezzar in the fourth chapter of the Book of Daniel, where Nebuchadnezzar at the height of his power had a dream which foretold his downfall. He dreamed of a tree which had raised its head even up to heaven and now must be hewn down. This is a dream which is obviously a counterpoise to the exaggerated feeling of royal power.

Now considering states in which the mental balance is disturbed, we can easily see, from what has preceded, wherein lies the importance of the unconscious for psychopathology. Let us ponder the question of where and in what manner the unconscious manifests itself in abnormal mental conditions. The way in which the unconscious works is most clearly seen in disturbances of a psychogenic nature, such as hysteria, compulsion neurosis, etc.

We have known for a long time that certain symptoms of these disturbances are produced by unconscious psychic events. Just as clear, but less recognised, are the manifestations of the unconscious in actually insane patients. As the intuitive ideas of normal men do not spring from logical combinations of the conscious mind, so the hallucinations and delusions of the insane arise, not out of conscious but out of unconscious processes.

Formerly, when we held a more materialistic view of psychiatry we were inclined to believe that all delusions, hallucinations, stereotypic acts, etc., were provoked by morbid processes in the brain cells. Such a theory, however, ignores that delusions, hallucinations, etc., are also to be met with in certain functional disturbances, and not only in the case of functional disturbances, but also in the case of normal people. Primitive people may have visions and hear strange voices without having their mental processes at all disturbed. To seek to ascribe symptoms of that nature directly to a disease of the brain cells I hold to be superficial and unwarranted. Hallucinations show very plainly how a part of the unconscious content can force itself across the threshold of the conscious. The same is true of a delusion whose appearance is at once strange and unexpected by the patient.

The expression "mental balance" is no mere figure of speech, for its disturbance is a real disturbance of that equilibrium which actually exists between the unconscious and conscious content to a greater extent than has heretofore been recognised or understood. As a matter of fact, it amounts to this—that the normal functioning of the unconscious processes breaks through into the conscious mind in an abnormal manner, and thereby disturbs the adaptation of the individual to his environment.

If we study attentively the history of any such person coming under our observation, we shall often find that he has been living for a considerable time in a sort of peculiar individual isolation, more or less shut off from the world of reality. This constrained condition of aloofness may be traced back to certain innate or early acquired peculiarities, which show themselves in the events of his life. For instance, in the histories of those suffering from dementia prÆcox we often hear such a remark as this: "He was always of a pensive disposition, and much shut up in himself. After his mother died he cut himself off still more from the world, shunning his friends and acquaintances." Or again, we may hear, "Even as a child he devised many peculiar inventions; and later, when he became an engineer, he occupied himself with most ambitious schemes."

Without discussing the matter further it must be plain that a counterpoise is produced in the unconscious as a compensation to the one-sidedness of the conscious attitude. In the first case we may expect to find an increasing pressing forward in the unconscious, of a wish for human intercourse, a longing for mother, friends, relatives; while in the second case self-criticism will try to establish a correcting balance. Among normal people a condition never arises so one-sided that the natural corrective tendencies of the unconscious entirely lose their value in the affairs of everyday life; but in the case of abnormal people, it is eminently characteristic that the individual entirely fails to recognise the compensating influences which arise in the unconscious. He even continues to accentuate his one-sidedness; this is in accord with the well-known psychological fact that the worst enemy of the wolf is the wolf-hound, the greatest despiser of the negro is the mulatto, and that the biggest fanatic is the convert; for I should be a fanatic were I to attack a thing outwardly which inwardly I am obliged to concede as right.

The mentally unbalanced man tries to defend himself against his own unconscious, that is to say, he battles against his own compensating influences. The man already dwelling in a sort of atmosphere of isolation, continues to remove himself further and further from the world of reality, and the ambitious engineer strives by increasingly morbid exaggerations of invention to disprove the correctness of his own compensating powers of self-criticism. As a result of this a condition of excitation is produced, from which results a great lack of harmony between the conscious and unconscious attitudes. The pairs of opposites are torn asunder, the resulting division or strife leads to disaster, for the unconscious soon begins to intrude itself violently upon the conscious processes. Then odd and peculiar thoughts and moods supervene, and not infrequently incipient forms of hallucination, which clearly bear the stamp of the internal conflict.

These corrective impulses or compensations which now break through into the conscious mind, should theoretically be the beginning of the healing process, because through them the previously isolated attitude should apparently be relieved. But in reality this does not result, for the reason that the unconscious corrective impulses which thus succeed in making themselves apparent to the conscious mind, do so in a form that is altogether unacceptable to consciousness.

The isolated individual begins to hear strange voices, which accuse him of murder and all sorts of crimes. These voices drive him to desperation and in the resulting agitation he attempts to get into contact with the surrounding milieu, and does what he formerly had anxiously avoided. The compensation, to be sure, is reached, but to the detriment of the individual.

The pathological inventor, who is unable to profit by his previous failures, by refusing to recognise the value of his own self-criticism, becomes the creator of still more preposterous designs. He wishes to accomplish the impossible but falls into the absurd. After a while he notices that people talk about him, make unfavourable remarks about him, and even scoff at him. He believes a far-reaching conspiracy exists to frustrate his discoveries and render them objects of ridicule. By this means his unconscious brings about the same results that his self-criticism could have attained, but again only to the detriment of the individual, because the criticism is projected into his surroundings.

An especially typical form of unconscious compensation—to give a further example—is the paranoia of the alcoholic. The alcoholic loses his love for his wife; the unconscious compensation tries to lead him back again to his duty, but only partially succeeds, for it causes him to become jealous of his wife as if he still loved her. As we know, he may even go so far as to kill both his wife and himself, merely out of jealousy. In other words, his love for his wife has not been entirely lost, it has simply become subliminal; but from the realm of the unconscious it can now only reappear in the form of jealousy.

We see something of a similar nature in the case of religious converts. One who turns from protestantism to catholicism has, as is well known, the tendency to be somewhat fanatical. His protestantism is not entirely relinquished, but has merely disappeared into the unconscious, where it is constantly at work as a counter-argument against the newly acquired catholicism. Therefore the new convert feels himself constrained to defend the faith he has adopted in a more or less fanatical way. It is exactly the same in the case of the paranoiac, who feels himself constantly constrained to defend himself against all external criticism, because his delusional system is too much threatened from within.

The strange manner in which these compensating influences break through into the conscious mind derives its peculiarities from the fact that they have to struggle against the resistances already existing in the conscious mind, and therefore present themselves to the patient's mind in a thoroughly distorted manner. And secondly, these compensating equivalents are obliged necessarily to present themselves in the language of the unconscious—that is, in material of a heterogeneous and subliminal nature. For all the material of the conscious mind which is of no further value, and can find no suitable employment, becomes subliminal, such as all those forgotten infantile and phantastic creations that have ever entered the heads of men, of which only the legends and myths still remain. For certain reasons which I cannot discuss further here, this latter material is frequently found in dementia prÆcox.

I hope I may have been able to give in this brief contribution, which I feel to be unfortunately incomplete, a glimpse of the situation as it presents itself to me of the importance of the unconscious in psychopathology. It would be impossible in a short discourse to give an adequate idea of all the work that has already been done in this field.

To sum up, I may say that the function of the unconscious in conditions of mental disturbance is essentially a compensation of the content of the conscious mind. But because of the characteristic condition of one-sidedness of the conscious striving in all such cases, the compensating correctives are rendered useless. It is, however, inevitable that these unconscious tendencies break through into the conscious mind, but in adapting themselves to the character of the one-sided conscious aims, it is only possible for them to appear in a distorted and unacceptable form.