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Imagination and Reality

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A collection of essays, introduced by Masud Khan and J.D. Sutherland, on a variety of subjects including: observations on a case of vertigo; on idealization, illusion, and catastrophic disillusion; the nature and function of the analyst's communication to the patient; beyond the reality principle; and, the analysis of a detective story.

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1. A contribution to the study of the dream screen

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INTRODUCTION

In this paper I wish to report an example of a dream without visual content of the type described by Lewin in his paper, ‘Sleep, the Mouth and the Dream Screen’ (1946), and to make some suggestions as to the clinical and theoretical significance of such dreams.

In his second paper on the dream screen Lewin (1948) writes:

The dream screen is defined as the blank background upon which the dream picture appears to be projected. The term was suggested by the motion picture, because, like its analogue in the cinema, the dream screen is either not noted by the dreaming spectator, or it is ignored due to the interest in the pictures and action that appear on it. However in certain circumstances the screen plays a role of its own and becomes perceptible… .

Like other formal elements in dreams the screen has a meaning in itself. It

represents the idea of ‘sleep’; it is the element of the dream that betokens the fulfilment of the cardinal wish to sleep, which Freud considered responsible for all dreaming. Also it represents the maternal breast, usually flattened out, as the infant might perceive it while falling asleep. It appears to be the equivalent or the continuation in sleep, of the breast hallucinated in certain predor-mescent states, occasionally observed in adults (Isakower, 1938).

 

2. Some observations on a case of vertigo

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At the age of 45 a married man, who despite lifelong neurotic difficulties had always enjoyed excellent physical health, began to suffer from attacks of vertigo, in which the world appeared to be rotating on a vertical plane in front of him. During and intermittently between attacks he was deaf in his left ear and suffered from tinnitus. Some attacks lasted only a few minutes, others for as long as twenty-four hours. The more severe ones were accompanied by vomiting and signs of vasomotor collapse. When he was examined by an otologist the only demonstrable physical signs were slight middle-ear deafness on the left side, insufficient to account for the degree of deafness subjectively experienced, and a perforated left ear-drum, which was presumed to be the result of otitis media in childhood. The occurrence of the classical triad of symptoms, vertigo, deafness, and tinnitus in association with typical physical signs, led to a diagnosis of Meniere’s Disease being made.

A year later, for reasons apparently unconnected with his attacks of vertigo, he was referred to me for analysis. Fairly soon after beginning treatment it became clear to both of us that the attacks formed an integral part of his neurosis and that the vertigo, tinnitus, and deafness all had a psychological meaning.

 

3. On idealization, illusion, and catastrophic disillusion

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Fairly soon after the beginning of her analysis a patient reported a dream in which the moon fell out of the sky into a dustbin. The night, however, remained bright as another moon was shining in its place. Her only comment on the dream was the rather sarcastic one that, of course, her previous psychotherapist would have said that the moon stood for either the breast or the vagina. In the absence of further associations, no interpretation was attempted and the dream was never referred to again. I shall return later to the significance of what was for this patient a characteristic piece of behaviour—giving me material which was tantalizing in its apparent significance, but doing so in such a way that I was unable to make any use of it.

I was reminded of this dream when, some months later, I was reading an English translation of some poems by Giacomo Leopardi, the Italian romantic poet of the early nineteenth century. One, an early fragment written when the poet was 21, describes a dream in which the moon falls out of the sky and burns itself out in a field. The dreamer then looks up at the sky and is frozen with terror at the sight of the hole from which the moon has been torn. I quote the poem in full. It is written in the form of a dialogue between the dreamer, Alcetas, and his companion, Melissus.2

 

4. Symbolism and its relationship to the primary and secondary processes

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The purpose of this paper is to discuss the relationship of symbolic processes to ego-functioning. I have started by restating Freud’s initial formulation of the differences between the primary and secondary processes with special reference to Winni-cott and Milner’s concept of illusion (Section I). I have then gone on to suggest reasons why, in my opinion, it is not only misleading to restrict, as some writers do, the concept of symbolism to the use of symbols by the primary process, but also incompatible with Freud’s later views on the nature and development of the ego (Section II). In this section I have been much influenced by Milner arid Kubie, both of whom have written in favour of an extension of the classical analytical concept of symbolism. In the third and last section I have attempted to reformulate the theory of symbolism on the basis of the assumption that symbolization is a general capacity of the mind which is based on perception and which may be used either by the primary or the secondary process. My immense debt to Jones’s classic paper ‘The Theory of Symbolism’ (1916) will be obvious throughout, even when I take up a position diverging from his.

 

5. The nature and function of the analyst's communication to the patient

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Susanne Langer in her study of symbolism, Philosophy in a Mew Key, observes that ‘the great contribution of Freud to the philosophy of mind has been the realization that human behaviour is not only a food-getting strategy, but is also a language; that every move is at the same time a gesture’. By this I understand her to mean two things. First, that psychoanalysis has shown that human behaviour is actuated not only by the need to satisfy instinctual impulses by using appropriate objects but also by a need to maintain a meaningful contact with these objects; and secondly, that human activity is intrinsically symbolic, and comprises an attempt to communicate something. An essential part of her thesis is that the various ‘impractical’, apparently unbiological activities of man, such as religion, magic, art, dreaming, and symptom-formation—i.e. just those aspects of human life which have become the peculiar domain of psycho-analytical research— arise from a basic human need to symbolize and communicate, and are really languages.

 

6. An enquiry into the function of words in the psychoanalytical situation

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In this paper I shall attempt to formulate certain ideas about the function of words in the psycho-analytical situation. In doing so I shall continue a line of thought that I began in my paper on symbolism (Chapter 4 in the present collection), in which, following Milner (1952) and Kubie (1953), I took the view that it is misleading to restrict the analytical concept of symbolism to the use of symbols by the primary process, and suggested that words should be included within the general category of symbols even though they can be differentiated from other symbols on the grounds: (a) that their immediate symbolic connexions remain conscious, (b) that the displacement of cathexis from the thing-representation is only partial, the word remaining linked to and yet distinguishable from its referent, and (c) that they are conventionalized. These differentiating characteristics enable words to be used by the secondary process for purposes of communication even though they also continue to carry cathexes derived from instinctual sources. In the last paragraph of my paper on symbolism I suggested that it is this dual function of words that makes psycho-analytical treatment possible.

 

7. On the defensive function of schizophrenic thinking and delusion-formation

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The material to be presented in this paper is derived from an analysis which ended with the committal of the patient to a mental hospital, where he was diagnosed schizophrenic. As many analysts would never have started with such a patient, while others would have adopted some modification of technique, probably including management and control of the patient’s environment, I must begin by mentioning a number of facts which will, I hope, make it comprehensible that such a patient should have been in analysis and prevent my listeners being distracted from my main theme, which is theoretical, by queries about technique and doubts whether I knew what kind of patient I had on my hands. The relevant facts are, briefly:

(i) The analysis was undertaken on the initiative of the patient’s father, who was well aware both that his son had a psychotic illness and that psycho-analysis is a form of treatment designed for neurotic disorders. He knew therefore that his son’s treatment was experimental and that he could be given no assurance of a cure.

 

8. Beyond the reality principle

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1. There are two types, modes or forms of mental functioning.

2. Under conditions of ‘ideal’ or ‘normal’ mental health these are integrated and analysis of the totality of mental activity into discrete types of function is impossible.

3. In all forms of mental ill-health, however, dissociation occurs and the specific characteristics of both types of mental functioning become observable,

‘A complete divergence of their trends, a total severance of the two systems, is what above all characterizes a condition of illness.’ (Freud, 1915, p. 194.)

4. These two types of mental functioning were called by Freud the primary and secondary processes, which he conceived as being actuated by the pleasure and reality principles. According to Freud the primary processes precede the secondary in individual development and are or become unconscious, while the secondary processes arise as a result of growth and experience of external reality and are conscious. He also held that the primary processes have an intrinsic connexion with dream imagery (‘thing-representations’), fantasy, and wish-fulfilling hallucinatory tendencies, and the secondary processes with verbal imagery (‘word-representations’) and ‘reality-adaptation’.

 

9. The analysis of a detective story

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Of the various psycho-analysts who have discussed the psychology of the detective story only one, Geraldine Pedersen-Krag, has put forward a specific hypothesis to account for their popularity. In her article ‘Detective Stories and the Primal Scene’ (1949) she suggests that it arises from their ability to reawaken the interest and curiosity originally aroused by observation of the primal scene. According to her the murder is a symbolic representation of parental intercourse and

the victim is the parent for whom the reader (the child) had negative oedipal feelings. The clues in the story, disconnected, inexplicable and trifling, represent the child’s growing awareness of details it had never understood, such as the family sleeping arrangements, nocturnal sounds, stains, incomprehensible adult jokes and remarks … The reader addicted to mystery stories tries actively to relive and master traumatic infantile experiences he once had to endure passively. Becoming the detective, he gratifies his infantile curiosity with impunity, redressing completely the helpless inadequacy and anxious guilt unconsciously remembered from childhood.

 

10 The effect of the psychoneurotic patient on his environment

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The only environment of which the analyst of a psychoneurotic has any certain knowledge is the setting within which psychoanalytical treatment takes place, this setting comprising the room in which the analyst and patient meet and the analyst himself in it, and the analyst, instead of allowing the patient to have any effect on his room or himself, adopts a particular technical procedure, viz. interpretation, in order to prevent any effects that the patient intends from actually occurring. As a result, it could be argued, the analyst is doubly disqualified from discussing the effect of the psychoneurotic on his environment. First, he never sees the environment in which the patient lives out his illness and therefore never knows what effect his patient actually has, even though he may know a lot about what the patient is trying to do to his spouse, parents, friends, etc., and may also know a lot about what the patient imagines he is doing; but the analyst has no direct knowledge of what the effects actually are, or of what resistance or compliance the psychoneurotic^ efforts actually encounter. Secondly, he adopts a technique, that of interpretation, which precludes ‘effects on the environment’, at any rate in the ordinary, expected sense of the phrase, from occurring within the environment in which he does see the patient.

 

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