Saturday, April 12, 2008

The Principle of Opposites and Freud

Freud was a widely read and deeply astute observer of human behaviour.  Added to this he was also exceptionally intelligent.  Consequently he would have been well aware of the notion or theory that the world is characterized by “opposites.”  This contention runs throughout much of ancient Greek philosophy as well as in a lot of ancient spiritualities like that of Taoism.  Even those ancient Greek philosophers who rejected the notion that the opposites should be accorded an important role in describing Reality (e.g., Anaximines) had to at least argue against the prevailing common opinion. Doctrines of “opposites” continued throughout Greek philosophy and medical theory.

Lists of “opposites” that commonly appear in the above mentioned philosophies and spiritualities would be: Hot – Cold; Dry – Wet;  Limit – Unlimited;  Odd – Even;  Right – Left;  One – Plurality;  Male – Female;  Resting – Moving;  Straight – Crooked;  Light – Darkness;  Good – Bad (Evil);  Square – Oblong; Big - Small; Black - White; Up - Down; Over - Under; In - Out etc. (You might like to add your own pairs to this list!)

[However, Greek philosophy showed a considerable predilection for the conflicting nature of these opposites.  Also it is interesting to note that they placed the moral categories of Good and Bad in their list of opposites as well as the neutral categories which simply describe the physical universe.  Indeed some of them like the Pythagoreans thought that all the terms of the Left Hand Side of the above pairs like that on the Right could be grouped together.  Hence, Limit or Limitation becomes the principle of goodness while the Unlimited becomes the principle of Evil.  Note also that the Pythagoreans place ‘male’ (good) on the Left  and  ‘female’ (bad) on the Right. Anaximander saw the universe as a perpetual battleground between opposing warring principles.  We might like to note also that the Persian religious leader Zoroaster, with whom the Greeks sometimes linked Pythagoras, also saw the universe in a similar manner.]

So much for the principle of opposites in ancient philosophy and ancient religions.  The Romantic poets like Wordsworth and S.T. Coleridge also firmly subscribed to this theory or principle of opposites.  Our very own national poet W.B. Yeats referred to this exact same principle as his theory of antinomies.  I'm sure this principle must have been advocated in the German Romantic Movement also.  Hence, our man Freud would have been very well acquainted with this central principle from early on in his studies.

This principle of opposites could also be called, of course, a principle of dualism.  Freud was highly dualistic in his approach believing in opposing forces within the human psyche.  It is here that I wish to describe his two opposing principles, that of the Death Instinct ( or Thanatos) over against the Life Instinct (or Eros).  Dr. Anthony Storr in his wonderful book on Freud is interesting to read with respect to these opposing urges or instincts.  He quotes Freud as emphasising that there is an instinct which is "an urge inherent in organic life to restore an earlier stage of things."  This earlier stage of things is naturally the inorganic stage.  He goes on quoting Freud in saying that "we shall be impelled to say that 'the aim of all life is death' (Storr, Freud: A Very Short Introduction, Oxford 1989, 2001, p. 66)

Here we have stated clearly Freud's assertion of what he calls the "death instinct", the ultimate expression of the Nirvana principle,that is,  sweet and eternal release from all suffering.  Freud had elaborated what he had always wanted, namely a dualistic scheme in which all phenomena of mental life could eventually be traced to the interaction of or conflict between two drives or two urges or two instincts called Life (Eros) and Death (Thanatos).  Having worked out this overall schema Freud went on logically to deduce other facts from these basic principles or axioms, e.g., he now considered that aggression was derived from the Death Instinct being redirected towards the external world.  Another conclusion that our learned founder of psychoanalysis came up with was that Civilization itself was a giant process in the service of Eros, namely a process pushing humankind towards Unity.

The imprint of this foot in the sand illustrates nicely the principle of opposites - fullness and emptiness. Again I took this picture on Donabate Strand about 1 year ago!

Wednesday, April 09, 2008

The Exceptional Josef Breuer (1842-1925) and Sigmund Freud

Perhaps Josef Breuer is the most underestimated of influences on the thought and work of Sigmund Freud.  Another Jew, Breuer was born in Vienna, Austria, in 1842. His father, Leopold Breuer, taught religion in Vienna's Jewish community. Breuer's mother died when he was quite young, and he was raised by his maternal grandmother and educated by his father until the age of eight. He graduated from the Akademisches Gymnasium of Vienna in 1858 and then studied at the university for one year, before enrolling in the medical school of the University of Vienna. He passed his medical exams in 1867 and went to work as assistant to the internist Johann Oppolzer at the university.  He was not only a brilliant physician who had a large private practice but also a psychiatrist and a physiologist of note.  He used any extra money he earned from his practice to engage in his physiological and psychiatric studies and researches.   He is famous for the following discoveries: (i) The Hering-Breuer reflex, that is the reflex reactions originating in the lungs and mediated by the fibres of the vagus nerve: inflation of the lungs, eliciting expiration, and deflation, stimulating inspiration, (ii) Mach-Breuer theory which was a theory to explain the reactions of the vestibular organ in the ear.  But it is for a third theory that is most widely known in psychiatric and psychological circles, namely the eponymous Breuer's theory which influenced Freud considerably.  This theory states that the symptoms of built-up or suppressed affections and psychic traumas not dealt with can be eliminated through recalling and working on one's feelings in conversations.

I have already given a fulsome description of hysteria in my last post.  Suffice it to say, this condition, which was strangely and culturally diagnosed in women only, had a broad array of symptoms like paralyses, tremors, losses of feeling in limbs and other sundry assorted symptoms which as far as any doctor could say had absolutely no apparent physical or physiological base.  Needless to say, then, most of Freud's contemporaries in the medical world dismissed hysterical patients as malingerers or con artists or fakers.  However, Freud, who had studied under Charcot and also at the famous Nancy School under Hippolyte M. Bernheim believed otherwise.  To Freud's great credit he took these "strange characters" seriously in their suffering.  The researchers at Nancy had been somewhat successful in treating hysteria by hypnotizing patients and then suggesting while they were in this state that their symptoms would disappear.  Sometimes, though not always I hasten to add, they did.

When Freud returned to Vienna he reported a certain small amount of success with his patients using hypnosis.  It is at this stage that our man Josef Breuer enters the picture.   Breuer, as we've said, was an amazingly versatile physician with a private practice, but who, in his spare time, did original research into physical and mental phenomena that interested and intrigued him.   Enter also, the famous "Anna O" or Bertha Pappenheim (1859-1936)  While nursing her terminally ill father this poor girl developed a host of debilitating and socially awkward hysterical symptoms.  Let us return to Professor Fancher's magisterial work for a lucid description of Breuer's then newly discovered cathartic method for the treatment of hysteria:

Gradually, and working together virtually as collaborators, doctor and patient devised a cathartic method that removed her symptoms... In this treatment, Breuer hypnotized Pappenheim and then asked her to try to recall the first time she had experienced a physical sensation like one of her symptoms.  Often the "hypnosis" facilitated the recall of a previously "forgotten"  but highly emotion-laded memory associated with the symptom.  Upon remembering such an incident, she would give vent to its previously suppressed emotion.  Following this emotional "catharsis" the symptoms would disappear. (Pioneers of Psychology, 367)

In short, then, when Anna or Bertha could recall the first moment at which a particular hysterical symptom appeared and then re-experience the accompanying emotion, the symptom disappeared.  Breuer called his famous treatment catharsis.  Breuer and Freud went on collaborate on a book called Studies on Hysteria (1895) wherein they made the very famous statement "hysterics suffer mainly from reminiscences." (Fancher, op.cit., 368)  Needless to say, these reminiscences were invariably painful and were pushed deep down and well away from consciousness.    Hence, Freud theorised that there must be a mechanism in the psyche which tended to banish these memories from consciousness.  Freud was to call this first mechanism of defence Repression.  This latter defence mechanism would go on to become one of the cornerstones of the psychoanalytic theory of neuroses.  Of course, Freud and Breuer in our above short quotation did not mean mere memories by their term "reminiscences" but rather memories of fraught and emotionally charged instances or experiences.  These over-wrought experiences are very painful and are pushed as far away from consciousness as possible.  Thereby, these repressed experiences become disease-producing pathogenic ideas.  To return briefly once more to Fancher, we read:

Thus Freud and Breuer referred to many hysterical symptoms as conversions (of emotional into physical energy).  With hypnotic assistance, however, patients could regain conscious access to their pathogenic ideas, and thus to the normal expression of their stragulated emotional energy.  The causes of their symptoms could thus be removed. (Ibid., 368)

Sunday, April 06, 2008

Jean-Martin Charcot (1825-1893) influences Freud

Charcot's primary focus was neurology - a medical specialty dealing with disorders of the nervous system.   He named and was the first to describe multiple sclerosis. Born in Paris, Charcot worked and taught at the famous Salpêtrière Hospital for thirty three years. His reputation as an instructor drew students from all over Europe. In 1882, he established a neurology clinic at Salpêtrière, which was the first of its kind in Europe.  On the neurological front he added more symptoms to James Parkinson's clinical description and then subsequently attached the name Parkinson's Disease to this particular syndrome. He made a lot of original discoveries which are beyond the scope of this small post.

Our interest here is his notable influence on Freud's thinking.  Professor Raymond E. Fancher in his magisterial Pioneers of Psychology quotes the following description of Charcot's methodology from Freud's own writings:

He used to look again and again at the things he did not understand, to deepen his impression of them day by day, till suddenly an understanding of them dawned on him.  In his mind's eye  the apparent chaos presented by the continual repetition of the same symptoms then gave way to order: the new [diagnostic] pictures emerged, characterized by the constant combination of certain groups of symptoms.

(Freud quoted in Fancher, op.cit., 350)

From this we can see than our man Charcot was an exceptional clinician.  No wonder he was called the "Napoleon of the Neuroses" in his time. Fancher describes him as a "master showman," who "imitated the symptoms of various neurological diseases, engaged patients in dramatic dialogue, and had them wear hats with long feathers whose different vibrations illustrated different kinds of tremors." (Ibid., 349)  This great neurologist also named the "grand mal" and "petit mal" forms of epilepsy.  However, it was his work on patients suffering from hysteria that was to influence Freud greatly.

A note on Hysteria:

The traditional symptoms of hysteria are: hallucinations, somnambulism, fits of violent emotion,, epileptic seizures, functional anaesthesia, functional paralysis and dissociation.  Now, even to the unprofessional eye, there is a hugely broad array of symptoms - too broad in fact.  The Penguin Dictionary of Psychology has this to say:

The problems with a general classification like this with such an array of symptoms are enormous.  The lack of understanding of the disorder may quite possibly, be due to the fact that there is no single disorder here at all.  In all likelihood what we have is a variety of maladaptive behaviours each of which exists more or less independently of the others with the hysterical syndrome existing only in the mind of the diagnostician.  (Opus citatum, Arthur S. Reber, 1985, 337)

As well as that, for some reason, hysteria was only ever diagnosed in women, never in men.  As the dictionary further points out the more recent DSMs do not list this disease at all, but happily break the phenomenon into three of four disorders that embrace all those symptoms listed above.  So one can see a particularly cultural and sexual bias here immediately.  Like his clinical observation of epilepsy Charcot distinguished between what he called Grande Hystérie and Petite Hystérie.

As I have pointed out both Freud and Alfred Binet acknowledged Charcot as an exceptionally brilliant clinician and an equally formidable diagnostician - well able to spot and clinically describe problems, even though some of his therapies and cures were later debunked.  Between October 1885 and February 1886 Freud had worked under Charcot whose teaching on hysteria awoke his interest in the problems of the neuroses as opposed to the organic diseases of the nervous system. Charcot had demonstrated to Freud that hypnosis could be used to distinguish hysterical paralysis (or neurotic paralysis) from organic paralysis of the CNS (Central Nervous System).  Freud now could see clearly that strange and misguided ideas could cause neuroses and paralysis.  Such paralysis could be cured and and reactivated artificially and cured again and again.

Charcot was noble enough to admit his errors on hypnotism, and privately predicted that his theories on hysteria would not long survive him.  However, he did achieve much.  He had a profound influence on his students as an eminent clinician; he was among the first to explore interactions between emotional and physical factors; he put hypnosis centre stage in the medical field; brought respectability to psychopathology and even influenced later studies into "mob hysteria."

Above a picture of Charcot.

Influence of Ernst Brücke (1819-1892) on Freud

Ernst Wilhelm Ritter von Brücke was the son of Johann Gottfried Brücke, a painter of portraits.  He was a very famous German physiologist and doctor who was born born June 6, 1819 in Berlin, Germany and who died January 7, 1892, Vienna, Austria.  He was to have a profound influence on Freud, leading the latter to abandon his earlier enthusiasm for Brentano and for pursuing studies in philosophy at a later date.  Now Freud was transfixed by the modern teachings of the great physiologist Brücke who has lent his name to many important discoveries among which we may name (i) the Bezold-Brücke phenomenon, that is a change to the perception of colours under the effects of increased light intensity and (ii) the Brücke's muscle which refers to the longitudinal fibres of the ciliary muscle.  It is beyond the scope of these preliminary notes to say much more on this great scientist's anatomical discoveries.  What we are about is his influence on our man Freud.

A note on Vitalism:

Under this heading one could in fact group a whole miscellany of beliefs which were united by the strong conviction that living organisms are not to be explained in terms of their material composition or their physico-chemical performances or actions and re-actions.  Such beliefs were to be found in the writings of Hans Driesch (1867-1941) and Henri Bergson (1859-1941).  These scholars argued that living things are animated by a vital principle such as entelechy (Driesch's term) or an élan vital or life force (Bergson's terminology).  I advert to vitalism here because it is usually contrasted with mechanism or even materialism - a whole system of beliefs to which modern biology and indeed medicine owe all their great triumphs.

Raymond E. Fancher in his magisterial Pioneers of Psychology ( W.W. Norton & Company, 1999) has this to say on Ernst Brücke's influence on Freud:

[He] became for Freud the figure "who carried more weight with me than anyone else in my whole life."  Together with Hermann Helmholtz, Emile du Bois-Reymond, and other students of Johannes Muller, Brucke had been a founder of the enormously productive "new physiology" which rejected vitalism and sought mechanistic explanations for all organic phenomena... Tremendously impressed by Brucke and his mechanistic physiology, Freud began devoting all his spare time to volunteer research... he worked well, and by 1880 had published four articles on neuroanatomy, and looked forward to a career in that field.

(op.cit., 371)

As a result Freud remained a determinist or reductionist or mechanist throughout his life, believing that all vital phenomena like thoughts, feelings or phantasies are rigidly determined by cause and effect.

Above I have uploaded an image of Ernst Brucke