As I said, we will take the knowledge we have gained, not the doubts we have aroused, as the starting point for further research. However, two conclusions based on the analysis of the first two cases, although interesting, have not been discussed.

We feel that the patients in these two examples were "fixed" at some point in the past and didn't know how to get rid of them, so that they were divorced from the present and the future. They seem to escape from the world by getting sick; It is tantamount to taking up the time when monks and nuns retire to the temple to spend the rest of their lives. As far as the first patient is concerned, the marriage that ended long ago has had an infinite impact on her life. Her symptoms enabled her to maintain a relationship with her husband; In her symptoms, we can hear voices defending him, forgiving him, praising him and sympathizing with him. At that time, although she was young and could attract other men, she kept her loyalty to him with all kinds of magical reasons, true or false. So she didn't meet strangers, didn't decorate, and it was not easy to stand up when she sat down; And don't sign, don't give gifts, lest her belongings fall into the hands of others.

As far as the second patient is concerned, young women's sex with their fathers before puberty is now a masterpiece. She also knows that she can't marry someone else because she is ill. We can guess that she is ill because she can't get married and can always be attached to her father.

We can't help but ask: how or why does a person adopt such a strange and useless attitude towards life, if this attitude is common to mental disorders and not unique to these two patients. In fact, this is indeed a common and important feature of all kinds of neuropathy. Bleuel's first hysteria patient was her father, who was seriously ill, and she insisted when she was a nurse. Although she has recovered, since then, she has always felt that she can't cope with life because she can't cope with women's work. From the analysis, we know that the symptoms and results of each patient are enough to make us cling to a certain period of past lives. In most cases, this past period is often the earliest stage in life history, such as childhood or even as early as lactation.

The psychopath who is most similar to this behavior can be named as "traumatic neuropathy" as an example of the recent wartime prevalence in Europe. This disease naturally occurs before the war, for example, after a train accident or other terrible life-threatening experiences. Traumatic neuropathy is basically different from those that occur naturally and are often analyzed and treated by us. We can't explain this kind of neuropathy from the viewpoint of other kinds of neuropathy, and I want to tell you why later. However, it should be emphasized that this disease is completely different from other kinds of neuropathy. As far as traumatic neuropathy is concerned, it is obvious that persistence during trauma is the root of the disease. These patients often recall the situation caused by their trauma in their dreams; As far as hysteria can be analyzed, it seems that the attack of hysteria is to completely recall this situation. These patients didn't seem to be able to cope with this situation fully in the past, and now they still seem unable to finish the work. We must pay special attention to this layer, because we can understand the so-called "economy" concept of spiritual journey. The word "trauma" really just means this economy. If in a short time, the brain is stimulated to the highest degree, so that it can't adapt in a normal way, thus permanently disturbing the distribution of the effective ability of the brain, this experience is called traumatic.

Because of this analogy, we also call the persistent experience of neuropathy "traumatic". Therefore, we provide a simple condition for neuropathy; In other words, if a person can't cope with strong emotional experience, the result will be neuropathy, so the cause of neuropathy is similar to traumatic disease. In fact, during the period from 1893 to 1895, Bleuel and I formulated the first formula to reduce the new facts we observed to theory, which is very consistent with this view. That is, as far as the first young woman separated from her husband is concerned, it does not violate this statement; Because she can't "regret" her marriage in name only, she still clings to her traumatic situation. However, as far as the second girl attached to her father is concerned, she immediately saw the lack of this formula. First, the little girl's worship of her father is a very common experience, and it tends to weaken with age, so the application of the word "trauma" loses its meaning here; Secondly, from the course of disease, it shows that the persistence of the first sex seemed completely harmless at that time, and it took several years to show the symptoms of obsessive-compulsive neuropathy. Therefore, the causes of neuropathy are very complicated and diverse; However, we feel that the view of "trauma" does not need to be abandoned as a wrong view, because it may be used as an explanation in other ways.

Therefore, we have to give up the way we just adopted. Since this road is impassable, it must be studied again to have a satisfactory way out. But before leaving this "traumatic persistence" problem, we should notice that this phenomenon can be seen everywhere except neuropathy; Every kind of neuropathy contains such a persistence, but not every kind of persistence will lead to neuropathy, or all of them will be combined with neuropathy, or all of them will occur when neuropathy occurs. For example, sadness can be regarded as a good example or prototype of emotional obsession with something in the past. Like neuropathy, it has completely lost its relationship with the present and the future. However, most people can understand the difference between sadness and neuropathy. On the other hand, some mental disorders can be called morbid sadness.

If the whole structure of a person's life is fundamentally shaken by traumatic experiences, he can really lose his vitality, lose interest in the present and the future, and indulge in memories forever; But this unfortunate person is not necessarily a psychopath. Therefore, we should not attach too much importance to this feature and regard it as an attribute of neuropathy, although this feature is also universal and important.

Now please tell us the second conclusion from the analysis; We don't need to limit this conclusion. As far as the patient in the first case is concerned, we all know her boring compulsion and the cordial memories caused by it; We also discussed the relationship between the two, and we also deduced the purpose of compulsory action from this relationship. However, one factor has been completely ignored, which deserves our full attention. When the patient continues to move, he doesn't know the relationship between his actions and past experience; This relationship is hidden behind; What kind of impulse forced her, she could hardly answer. Later, due to the influence of treatment, I suddenly realized this relationship and could speak it out. Even then, she didn't understand that the purpose of this action was to correct her past painful events in order to raise the price of her dear husband. After a long time and a lot of efforts, she realized and admitted that this motive could be the driving force to realize forced action.

The scene on the morning after the wedding and the patient's gentleness to her husband constitute what we call the "meaning" of forced action. But she can't understand two aspects of this meaning. She doesn't know why she acted, and she doesn't know where she will go when she wants to stop. Therefore, she has been carrying out some spiritual process in her heart, and forced action is its result; She knew the result as usual; But the process before this result is unknown in consciousness. Bernheim tried hypnosis and ordered the hypnotized person to open an umbrella in the bedroom five minutes after waking up. The hypnotized person did it on time, and I don't know why. That's what our patients do. This is what we call the unconscious process; What happened in our hearts. As long as someone can give a more correct and scientific explanation, we are all willing to give up the speculation about the existence of subconscious psychological processes. If they can't do it, we are willing to stick to this assumption; In case someone protests that in science, the subconscious is only a temporary measure, and it is nominal, then we have to refute his words. Some unrealistic things can actually produce something as obvious as forced action!

As far as the second patient is concerned, it is basically the same. She made a rule that the pillow should not touch the bedstead, but she didn't know the cause, significance and strength of this rule. She treated this rule calmly, or resisted or resolutely refused to implement it; But they are all invalid and must be realized. Although she tried to explore the reason, it was in vain. No one can know the source of these symptoms, thoughts and impulses of obsessive-compulsive neuropathy. They can resist the resistance that normal spiritual life can't resist, so even from the patient's own point of view, they feel that they are powerful monsters from another world or ghosts mixed in the whirlpool of human beings. Among these symptoms, there is obviously a special mental activity area isolated from other aspects. In other words, these symptoms can be subconscious evidence; It is for this reason that clinical psychiatry, which only recognizes consciousness psychology, is helpless to these symptoms and can only be called a symbol of special degeneration. The concept of compulsion and impulse itself are the same as the implementation of compulsion, and they are not subconscious. Because if they don't invade consciousness, they won't cause symptoms. However, the psychological processes discovered through analysis and the chain relationship discovered through explanation are indeed subconscious, at least until patients understand the process because of analysis and research.

In addition, please consider the following points: 1 All the symptoms of various mental disorders are enough to confirm all the facts of these two examples; 2 patients don't know the meaning of symptoms anytime and anywhere; From the analysis, these symptoms seem to originate from the subconscious psychological process, but under various smooth conditions, these processes can be transformed into consciousness. Therefore, you can know that psychoanalysis is useless without the subconscious part of the mind. We are used to treating the subconscious as what we have. Maybe you have to admit that those who only know the word subconscious, but never analyze it, or never interpret dreams, or never explore the meaning and purpose of mental illness, are not qualified to speak on this issue at all. I want to reiterate this matter to attract your attention; Psychoanalysis can not only discover the significance of neurosis symptoms, but also show that there is undeniable evidence for the existence of subconscious psychological processes-or, at least, it seems necessary for us to make this assumption.

But there is another layer. Because of Bleuel's second discovery-this is his own achievement, which I think is more important than the first discovery-we have a clearer understanding of the relationship between the subconscious and neuropathy. It turns out that not only the meaning of symptoms is always subconscious; Moreover, there is a substitution relationship between symptoms and subconscious; The existence of symptoms is only the result of this subconscious activity. About this floor, you will soon understand. Bleuel and I shared the following idea: every time we encounter a symptom, we can conclude that there is some subconscious activity in the patient's heart, which contains the meaning of the symptom. On the contrary, this meaning must be subconscious first, and then symptoms can appear. Symptoms do not arise from the process of consciousness; As long as the subconscious process becomes consciousness, the symptoms will be eliminated. You can immediately know that this is the way out of psychotherapy and a way to eliminate symptoms. Bleuel used this method to restore the health of his patients, or to remove the shackles of symptoms; He found a way for patients to introduce symptomatic subconscious processes into consciousness, and those symptoms were eliminated.

Bleuel's discovery is not the result of reasoning, but the cooperation of patients, and then this lucky observation can be made. Don't compare this matter with what you already know in order to understand it; You should admit that this is basically a new fact and can be used to illustrate many other facts. Therefore, I want to extend this matter as follows.

The formation of symptoms is actually a substitute for other things subconsciously. Some mental processes, under normal circumstances, must develop until the patient's consciousness is clearly known. If it can't develop like this; Or these processes are suddenly blocked and become subconscious, then symptoms will follow. Therefore, symptoms are a substitute; If we can use psychotherapy to restore this process, then we can finish the work of eliminating symptoms.

Bleuel's discovery is still the basis of psychoanalytic therapy. From the later research results, it can be proved that the process of symptoms disappearing from the subconscious becomes the process of consciousness, although there will be unexpected difficulties in implementing this statement. Our treatment work is to turn subconscious things into conscious things; Only after this change happens can our work be completed.

Now let's talk about a few digressions, or you will speculate that the effect of this treatment is too easy to complete. According to our conclusion, mental illness is because it doesn't know the spiritual course it should know. This is very similar to Socrates' famous saying that sin becomes ignorance. When analyzing, experienced analysts often know what the patient's subconscious emotions are. So it shouldn't be too difficult to treat him. You just need to tell him this knowledge to avoid his ignorance. At least one aspect of the subconscious meaning of symptoms can be easily treated in this way, although on the other hand-the relationship between the patient's past experience and symptoms-is not easy to infer; Because the analyst doesn't know all the patient's experiences, he has to wait until the patient remembers. But at this level, many times it can be obtained by false means. We may ask the patient's relatives and friends about his past life; They usually know what caused his trauma; Or you can tell things that the patient doesn't know, because these things happen in the patient's early childhood. Now, if these two methods are combined, the source of patients' ignorance may not be difficult to eliminate in a short time.

If only it were like this! But things were unexpected at first. This knowledge is different from that knowledge. There are different kinds of knowledge, and they have no equal value in psychology. Moliere put it well, "Ily a fagots et fagots". What doctors know is different from what patients know, and the effect is different. Doctors tell patients that what they know is useless. This may not be accurate enough. We can say that this method is not enough to make the symptoms disappear; But it also has another function, which enables the analysis to be carried out, and its first result is often a firm denial. The patient already knows what he didn't know before-the meaning of symptoms, but what he knows is still limited. Therefore, we know that there is more than one kind of ignorance. We need to have a deep understanding of psychological problems in order to know the difference between these ignorance. But the sentence "knowing the meaning of symptoms can make them disappear" is still correct. The necessary condition is that this knowledge must be based on the patient's inner change, which can only be achieved in psychotherapy for this purpose. So we encounter many problems here, which can soon be regarded as the dynamics of symptom composition.

I have to stop here and ask, don't you think what I said is too abstruse and messy? Do I often say a paragraph to limit it? Cause a series of thoughts and let them fall; So you don't understand? If so, I'm very sorry. But I am very reluctant to sacrifice truth for simplicity. I'd rather let you fully feel the complexity and arduousness of this subject. I believe that if you can't accept what I told you for a while, it's no harm. I know that every listener and reader can arrange the facts he has heard and read to suit his own mind, shorten and simplify them and extract what he wants to remember. Generally speaking, this sentence is good: the more you listen at the beginning, the richer you will get in the end. Therefore, I hope that although my words are complicated, you understand what I said about the subconscious mind, the meaning of symptoms and the relationship between them. You may also know that our future efforts will follow two directions: 1 Know how people get sick and how to adopt a neurotic attitude towards life: this is a clinical problem; 2 know how they started from mental illness and produced pathological symptoms; This is still a psychodynamic problem, and these two problems must have an interrelated point.

I don't want to discuss it further today; However, since the class is not over yet, please pay attention to another feature of the above two analyses; This is memory blank or amnesia, and only later can we fully understand its importance. You already know that psychoanalytic treatment can be summarized as the following formula: all pathogens in the subconscious must enter consciousness. Now this formula can be changed into another formula: that is, all the memory defects of the patient must be supplemented, in other words, we must try to eliminate his amnesia; You may be surprised to hear this. In fact, the meaning of this sentence is still the same; In other words, we must admit that there is an important relationship between the development of symptoms and amnesia. But if you consider the first patient analyzed before, you will find that this view of amnesia is difficult to prove; Because of the situation that evokes compulsive action, the patient has not forgotten it, but he still understands and remembers it; I have never forgotten other factors that form symptoms. As far as the second example is concerned, the girl who held the forced ceremony also has the same memory, but it is not clear. Her behavior a few years ago, such as insisting that the door between her parents and the bedroom was open and that her mother should stop sleeping in her father's bed, has never been forgotten. She clearly remembers it, but she is consciously uneasy. It is particularly noteworthy that in the first case, although the patient has practiced her compulsion countless times, she has never felt similar to the scene after the wedding night; In other words, when she was asked to directly explore the source of her impulse, she never remembered. Similarly, as far as the girl in the second case is concerned, not only is her ceremony rehearsed as usual every night, but the situation produced by her ceremony is not bad at all. There is no real forgetting or memory loss; But the clues that should be innocent and can be used to evoke memories have been cut. This kind of memory disorder is enough to produce obsessive-compulsive disorder; As for hysteria, it is different. Hysteria usually manifests itself in a wide range of forgetfulness. Generally speaking, the analysis of every single symptom of hysteria can lead to clues of the whole impression in the past; These impressions can be said to have been really forgotten. On the one hand, this clue can be traced back to the earliest childhood, so the forgetting of hysteria seems to have a consistent relationship with the forgetting of infancy, so we don't understand that the earliest impression of spiritual life is due to the forgetting of infancy. On the other hand, to our surprise, all the recent experiences of patients are easily forgotten, especially the causes of illness or aggravation. If not completely forgotten, at least some of them will not be remembered. Those important details are either completely forgotten or replaced by hallucinations. Generally speaking, the memory of recent experience always tries to avoid the attention of analysts, leaving an amazing blank in the patient's whole experience; It was not until the end of the analysis that the memories of recent experiences emerged in consciousness.

These memory impairment, as I have said, are the characteristics of hysteria. Sometimes the onset of hysteria, a symptom state, has occurred, but there is no need to leave traces of memory. Because obsessive-compulsive disorder neuropathy is different from this, we can infer that these forgetfulness phenomena are part of the psychological essence of hysteria, rather than the commonness of general neuropathy. The importance of this difference can be reduced by the following discussion. The meaning of symptoms is a mixture of two factors; That is, its origin, its origin, trend or reason, its destination or reason, in other words, the impression and experience of 1 symptoms, and the purpose of 2 symptoms. The source of symptoms can be analyzed into various impressions, all from the outside world. They must be conscious at first, but later they can be forgotten and become subconscious. As for the causes or trends of symptoms, it is often an internal process, which may be conscious at first, but it may never be conscious and stay in the subconscious forever. Therefore, whether the source of symptoms or the impression on which symptoms depend is forgotten is as unimportant as hysteria; As for the trend of symptoms, it may be subconscious at first, so it is enough to let symptoms rely on the subconscious. This is true of both hysteria and obsessive-compulsive disorder.

Since we attach so much importance to the subconscious of spiritual life, it is inevitable that human beings will dislike psychoanalysis. Don't be surprised by this, thinking that this resistance is due to the difficulty in understanding the subconscious mind or obtaining evidence of its existence. I believe it has a deeper motive. Human self-esteem has suffered two major blows from science. For the first time, we know that our earth is not the center of the universe, but only a small spot in the infinite universe system. We owe this discovery to Copernicus, although Alexander's theory also expressed similar views. For the second time, biological research deprived people of the privilege of creation, and became one of the animals with indelible animality: this kind of "value revaluation" was advocated by Charles Darwin, Wallace and their predecessors in our time, and also aroused the strongest resistance of contemporary people. However, people's self-esteem has suffered the third most uncomfortable blow from modern psychological research; Because this kind of research proves to our "self" that even in our own room, we can't be our own masters. As long as we can get a little information about the inner subconscious process, we have to be complacent. In fact, it is not only our psychoanalysts who want humans to observe their hearts, but also not from us; We just insist that this is our duty and firmly support it with empirical evidence that everyone regards as secret. This is the main reason why the world generally criticizes psychoanalysis and even ignores the attitude and rigorous logic of scholars. Besides, on the other hand, we are forced to disturb the peace of the world, as you will soon know.