In psychodynamics, the central idea is the conflict caused by the rejection of certain aspects of one’s own personality. The very expression “dynamics” was borrowed by Freud from the physics of the 19th century to convey the idea of a conflict between two forces, the result of which is a third force directed in the other direction.
Since medical students study only anatomy and physiology (or their separate parts – histology and biochemistry), it is no wonder that the doctor tries to understand the patient’s complaints as symptoms of anatomical or physiological disorders and, accordingly, find a drug treatment path. It is generally accepted that about a third of patients suffer primarily from emotional problems that cannot be cured in this way. This is precisely the reason for the despair that both doctors and patients come to from fruitless attempts at such treatment. Too romantic can be called the idea that it was our time that gave rise to new phenomena in this area: in 1723 the London physician Cheyne wrote that about a third of his patients did not suffer from organic diseases.
If we take into account that (as in the case of Mrs. A.) the patient’s complaints may not be symptoms of a specific disease caused by external causes, but indicate an internal conflict, then it will be possible to fully understand the strange complaints of some patients. The discovery of microorganisms in the last century made it possible to make significant progress in understanding the nature of diseases, but at the same time led to a focus on external causes. This fully meets the need of a person to find guilty outsiders (in a way, an updated theory about devilish intrigues as the cause of disease).
The importance of internal conflict in human misery is important not only for psychiatry, but for all medicine. If a child complains of abdominal pain, this means either some real illness, for example, appendicitis, or unwillingness for some reason to go to school, which is not named because of the fear of causing a negative reaction in adults. A woman complaining about the pain of intimacy, suffers from some somatic disorders (for example, from erosion of the cervix) or simply does not want this intimacy, but for some reason does not consider it possible to say it directly. The problem may not be hidden in the state of the organism, but in the relationship. The level at which the conflict arises may be relatively conscious or deeply unconscious.
A young lonely woman complained to her family doctor about the acute disgust she got from her own nose. The doctor took all this at face value and sent the patient to the surgeon for plastic surgery. The surgeon, not seeing any special deviations in the shape of the nose, advised the woman to first consult with a psychiatrist. However, she insisted on her own: she just did not like the nose (the underlying conflict was deeply unconscious). Gradually, the woman began to realize that it was not her nose that caused her disgust, but herself (the conflict reached consciousness) and especially her homosexual feelings. You can go further and add that her disgust is caused by dissatisfaction with her own sex and, accordingly, the genitals given out by nature. But such dissatisfaction in a substituted form was expressed in claims to the nose.
The concept of conflict is not something made up by people. Ethologists recognize the usefulness of these concepts in explaining animal behavior. A bird, guarding the borders of its possessions, can very aggressively fly into another, being on the very edge of its territory, but then get scared, retreat, again depict an attack, which will be a vivid example of internal conflict. Another form of the bird’s reaction is to fly off a certain distance and begin to furiously hammer the ground with its beak, giving vent to its rage. This behavior, called redirection by ethologists, is termed bias by psychoanalysts.
What aspects of your own personality cause conflicts? We’ll explore this in more detail later when we talk about motivation. The most common distortion of Freud’s views reduces conflicts to the sphere of sex, from which it is readily concluded that psychoanalysis is not universal in nature, it only reflects the specifics of the bourgeois Vienna of the 1880s. Freud did find that the real cause of hysteria in many patients lies in sexual conflict. It is instructive to quote his true words on this matter (1894: 52): “In all the cases I have analyzed, the suppressed conflict was caused by problems of sexual relations … Theoretically, it cannot be considered impossible to manifest itself in any other area. I can only state that I have not yet met any cases caused by other problems. ” Since then, the great importance of conflicts arising “in other areas” has become clear, for example, aggressive feelings can be directed against oneself (states of depression and attempts to commit suicide) or be replaced by psychosomatic symptoms (such as migraines or hypertension).
Depression, bereavement grief, and other losses essential to a person’s self-esteem may not be recognized by the person and find a way out in physical symptoms. This often manifests itself in the aggravation of complaints precisely on the anniversary of the loss suffered (and such a connection may not be realized by the patient himself).
It should not be thought that all forms of mental illness can be explained as a result of internal conflict. There is a genetic predisposition to functional psychosis such as schizophrenia or manic-depressive psychosis. There are also quite rare forms of organic psychoses caused by brain dysfunction, such as brain tumors or vitamin deficiencies. In the context of manifestation of borderline psychoses and deep personality disorders, we are talking about the “harm caused to the personality by the surrounding external conditions and deep-rooted whims and whims, ie. about that which is beyond the control of the person himself ”(Anna Freud, 1976). All this undermines the strength of the individual and its ability to contain and control primitive reactions and impulses. Today, many types of trauma are known, including early weaning, loss (Bowlby, 1973, 1980), and child abuse (Bentovim et al., 1988). Injuries sustained at an early age influence, as has been shown in the study of miraculously surviving victims of the Holocaust and similar disasters, all further development and the emergence of new injuries later (Pines, 1986; Kestenberg and Brenner, 1986; Menzies Lyth 1989; Garland 1991 ).
The concept of conflict is even more important in the description of neurotic disorders, when it comes to the internal self-destruction of the personality through suppression and other forms of defense. Neurotic conflicts mainly arise in the field of personal relationships during the period of personality formation, when the conflict is driven inside, and later it determines the nature of relations with others. However, the outcome of the conflict here strongly depends on what is currently happening in the sphere of relations with the immediate environment, as will be shown in detail in the chapters on family therapy and therapy for married couples.
Those aspects of our “I” that contradict our conscious values can be denied, suppressed, alienated – forced out into the unconscious. It is preferable to talk about different levels of awareness and use the term “unconscious” as an adjective rather than as a noun. Then it becomes possible not to imply the existence of the mysterious realm of the “Unconscious”, isolated from the rest of the brain.
Something may be unconscious simply because we have no idea about it at a certain moment (for example, the color of the front door at the time of reading these lines) or because it is easier to live by suppressing unpleasant sensations and painful memories, although we can easily recall them … Freud called these levels preconscious. On the other hand, some ideas may be unconscious, because they are actively suppressed, since thinking about them is intolerable. These are memories, fantasies, thoughts and feelings that contradict our ideas about ourselves and about what is acceptable. Thoughts that can cause too much anxiety, guilt and pain, if you are aware of them. Freud called this level the dynamic unconscious. Suppression can sometimes weaken, as a result of which the unconscious comes out, although, as a rule, in an altered form thanks to protective mechanisms. For example, in a dream in the form of a dream, during stress in the form of symptoms, or under the influence of drugs or alcohol in the form of a manifestation of seemingly alien impulses.
The concept of various psychic levels is created in parallel with the neurological levels, when higher-level centers control more primitive centers that manifest themselves in conditions of weakening of control. Freud, being a neuropathologist by training, was always influenced by the statement of the neuropathologist Hughlings Jackson (1835-1911): “Learn all about dreams – and you will learn all about madness.” In sleep and in a state of madness, the deepest layers of the psyche are most directly revealed. The winged expression “I never dreamed of this” implies several semantic layers: firstly, there is something about which you see dreams, but you will not do it in reality, and secondly (on a deeper level), there is something that we will not allow ourselves see even in a dream.
Some philosophers dispute Freud’s ideas about the unconscious on the grounds that only conscious phenomena can be considered as events of mental life. However, the concept of the unconscious was increasingly discussed throughout the 19th century. Psychologists such as Herbart (1776-1841) emphasized the conflict between the conscious and the unconscious, and the philosopher Schopenhauer (1788-1860), anticipating Freud, wrote: “Resistance of the will to penetrate into the consciousness of what is unacceptable for a person is the place through which the spirit can be struck with madness ”(Ellenberger, 1970: 209).
As the authority of the idea of God declined in medieval Europe, there was a corresponding increase in the desire of people for self-knowledge, which became especially intense at the turn of the 17th century. The word “conscious” appeared in European languages in the 17th century. The dualism of Descartes (1596-1650), separating mind from body and thought from feeling, testified to the close connection of this movement with the following statement: mental processes are limited to the sphere of the conscious. The emphasis on rational thinking was one of the forces that led to the Enlightenment in the 18th century and to many advances in education and political freedom. But this power devalued imagination and emotional life, a natural protest against this was the Romantic movement that began in the early 19th century, typified by such poets as Wordsworth, Keats and Shelley. The idea of “unconscious” mental processes, “hidden at the turn of the 18th century, became essential at the turn of the 19th century and became effective at the turn of the 20th century” (Whyte, 1962: 63). By 1870, “Europe was ready to abandon the Cartesian view of reason as awareness” (ibid: 165). Freud’s doctrine of the unconscious only temporarily lost popularity due to the fact that it was initially focused only on sexuality.
Perhaps this idea has taken root in our thinking so much that there is no room for argument. Evidence for the truth of the concept of unconscious mental activity can be gleaned from the following sources.
Freud always considered dreams to be “the main road to the unconscious.” Of his greatest work, The Interpretation of Dreams (1900), Freud wrote: “This kind of deep insight falls to the lot of a person only once in a lifetime” (Freud, 1900: xxxii). He drew a distinction between the often seemingly absurd external content of the dream and the latent content hidden under the outer shell by censorship, but this censorship can be circumvented by the use of free association. Dreams are “disguised forms of the realization of repressed desires.” This function of fulfilling desires in a dream is a banal evidence. Children dream of holidays, adults dream of forbidden pleasures or those people and places with which attracted memories are associated, to which they would like to return again. Dreams can be an attempt to cope with unpleasant situations or solve problems. Rycroft (1979) emphasized the creative and imaginative aspect of dreams, contrasting them with simple reflections of conflicts and neurotic reactions, and viewing dreams as a non-destructive form of communication in the non-dominant hemisphere of the brain.
Artistic and scientific creativity
Many writers, artists and composers, describing the process of creativity, say that they are seized by some kind of inner force that is not completely subject to conscious control. Often the creative process takes place in a dream. Kekule, investigating the problem of the structure of benzene, saw in a dream a snake devouring its tail, which immediately prompted him to think about the ring structure of the benzene molecule (Findley, 1948). Coleridge is said to have composed the Kubla Khan poem while under the influence of opium (Koester, 1964). Playwright Eugene O’Neill claimed that in his dream he dreamed of several completed scenes and even two whole plays. When he went to bed, he tuned himself in, repeating: “My little subconscious, bring me a tidbit” (Hamilton, 1976). In a letter, Mozart described a living manifestation of his creative genius, when ideas rush upon him: “I do not know when and how they come, and I can’t cause them to appear … In my imagination I hear parts that do not follow one after another, but all all at once … All this invention, creation takes place in a pleasant living dream ”(Vernon, 1970: 55).
Unlike the flashes of inspiration that enlightened Mozart, Bertrand Russell felt a slow process of “subconscious bearing” before the final insight came:
“It turned out that after the appearance of the preliminary design of a book on some issue and a serious preparatory stage, I needed a period of unconscious bearing, which cannot be accelerated and which proceeds as if something interferes with intentional reflections … Having endured the problem at the unconscious level through intense concentration, I expect it to mature in depth and unexpectedly appear in the form of a dazzlingly clear solution, so that all that remains is to write down what has appeared at the moment of insight ”(Storr, 1976: 65).
In addition to describing the creative process taking place in a dream, many playwrights and writers reported that their characters live their own lives as if in reality. Pirandello showed this process in the play Six Characters in Search of an Author. In his diary, he wrote: “Someone lives my life. And I do not know anything about him ”(preface to Pirandello, 1954).
We have already seen how, after a trip to Paris, Freud developed the theory according to which hysterical states – paralysis, anesthesia, ataxia – can be caused by a patient’s perception of which he is not aware. A similar state can occur as a result of external influence (hypnosis) or from within (self-hypnosis). These hysterical symptoms, according to Freud’s assumption, are constructed, like dreams, in the form of a compromise between the demands of repressed impulses and the resistance to censorship by one’s own self (Freud, 1925: 45).
One young woman went to the hospital with complaints of her left arm. It turned out that she had just received a course of psychotherapy in a group where she was very annoyed by the male psychotherapist sitting to her left, but she did not dare to say this directly. The complaints about her arm arose as a compromise between the desire to hit him and the fear that kept him from doing this, although she found the courage to tell the doctor about everything. In order to fully understand what happened to the patient, it is necessary to know her history. The woman became angry with the therapist for his intention to leave the group. As a child, she herself was abandoned, and she was taken up by elderly spouses who did not allow “bad behavior” and threatened to abandon the girl if she did not behave well.
A person can be hypnotized and given the instruction to completely forget what the hypnotist will suggest to him, but after a certain time interval at the snap of the fingers, which the hypnotist will produce, the person will cross the room and open the window. A person brought out of hypnosis opens a window on a signal. If you ask him why he did it, he will be slightly embarrassed and answer that the room is too hot.
This example shows how an unconscious idea (suggested under hypnosis) generates a complex sequence of actions and, moreover, rational explanations for these actions in response to a question about the reasons.
If we make a slip of the tongue or forget about something, it can be viewed as a slight malfunction of the brain, but more often than not (and this was the first to suggest Freud in Psychopathology of Everyday Life (1901)), there is an emotional motivation for what happened. For example, we forget about the appointment or the name of the one who causes our irritation, but this happens unintentionally, apart from our consciousness.
A certain young woman didn’t show up for the meeting. Later, she met the chairman and began to apologize to him: “Dr. H. made me surrender, or rather, give time to another occupation.” Was it just a slip of the tongue, or an expression of a hidden desire, or (most likely) an expression of internal protest against the fact that she was forcibly forced to do something?
Behind the “psychopathology of everyday life” one can often see the simultaneous coexistence of many levels of consciousness. Drivers often catch themselves thinking “far, far”, but at the same time continue to adequately react to the traffic situation. Often people notice that a popular melody has become attached to them, as it were, for no reason, although through associations one can always find a connection with some flashing mood, word or semi-conscious idea.
Subthreshold Perception, Selective Attention, and Perceptual Defense
Sound and light stimuli that arise below a certain threshold cause psychophysiological reactions that are not noticed by consciousness. About 30 years ago, there was a huge buzz in the United States about the use of subthreshold advertising: the message “Eat cornflakes” flashed on the movie screen for a split second, such exposure was not enough for viewers to consciously perceive the message, but enough for a sharp increase in sales of cornflakes. A host of experimental results (Dixon, 1971) indicate that the threshold of perception depends on motivation (for example, we see what we want to see, but are blind to what we do not want). It seems that there is some kind of filtering mechanism functioning at a subthreshold, unconscious level, which is very similar to Freud’s assumptions about the mechanism of sleep censorship.
Sometimes beginners who begin to assimilate the image of psychodynamic thinking wonder how these distant events remain unconscious and stay dormant for a long time until (for good or for evil) they cause some reactions, like underground currents that suddenly burst to the surface. This seems more natural to writers. Thomas Hardy wrote: “I can bury a feeling in my heart and thoughts and after 40 years exhume it, and it does not lose its freshness and sharpness in the least” (Gittings, 1975: 5).
Anxiety and mental distress
Some traits of our own personality or some facts from our experiences are unacceptable for our consciousness because they cause anxiety and mental suffering. The concept of mental suffering may seem strange at first glance to those who are used to considering suffering as physical. They believe that pain can be real (physical) or imaginary (psychological). However, all pain and suffering are phenomena highly related to psychic experience, be it somatic or psychological pain. Moreover, physical pain depends on the mood and state of the moment – in the heat of battle, severe wounds can go unnoticed. The old English expression “sore” unites the two kingdoms – psyche and soma, as we say “feeling sore” in both senses. We say that trauma is inflicted both bodily and mental. No wonder they say “headache” about a tormenting problem, “bald head eaten” – about a person. All of these expressions highlight how physical pain reflects the relationship between mental and physical pain.
For a short time, the person is able to endure significant anxiety, for example, in extreme circumstances, or significant mental distress and depression (after suffering bereavement). But this emotional discomfort can be combated through a number of defense mechanisms. If the stress is too strong, the defense mechanism may not be able to cope with it. Then the state of decompensation sets in and mental or somatic illness begins.
The state of anxiety, of course, is far from always unnatural for a person. Anxiety is associated with arousal, which is a normal response to a threatening situation, and prepares a person for a fight or flight. In ancient times, this feeling had an initial value in terms of survival. And now we experience anxiety in situations of competition and competition, which helps to raise the creative forces of the individual and inspire him for optimal activities. If anxiety is excessive or disproportionate, it can be considered maladaptive and unnatural. The anxiety that comes with having to speak in public can be annoying because you can’t defuse that anxiety.
The problem of anxiety and its overcoming is central to most descriptions of the nature of neuroses. Freud formulated the nature of anxiety differently in his early and later works. Initially, he believed that anxiety is generated by defense mechanisms, later he argued that defense mechanisms are excited as a result of anxiety.
In an early model (1894), there was a more physiological approach: it was assumed that anxiety is an expression of undischarged sexual energy, or libido. The classic example of such a statement is interruption of intercourse, which generates symptoms of anxiety due to failure to achieve discharge. Although this model has now been largely abandoned, there are situations in which it is applicable. For example, in a dangerous situation, a person does not feel anxiety as long as he is completely absorbed in salvation from impending danger. The feeling of anxiety arises when everything is over. Freud (1926) revised his ideas about anxiety as an uncharged libido and began to interpret it as a response of the individual to the threat of internal sexual or aggressive urges. Nevertheless, although the early model of anxiety in relation to sexual urges has largely been abandoned, the idea of ”actual neuroses” as the result of undischarged aggressive urges remains useful in explaining psychosomatic disorders (McDougall, 1974).
Bowlby made some interesting comments on the relationship between worry, discouragement, and protection. A small child attached to his mother, when separated from her, expresses his despair in three distinct phases: protest, despair and rejection. Bowlby (1973: 27) writes: “The phase of protest reflects the problem of separation anxiety, the phase of despair reflects grief and discouragement, and the phase of rejection reflects defense.” The essence of the remark is that the three types of reactions are phases of one process, and only by considering them in this way, one can understand their true meaning. Freud viewed these three stages of the separation response in reverse order. First of all, he realized the importance of protection (Freud, 1894); somewhat later – despondency (Freud, 1917) and, finally, he approached the revision of his ideas about the meaning of anxiety (Freud, 1926).
Initially, Freud dealt with the problem of anxiety and defense mechanisms against it, observing neurotic states: hysteria, obsessive states and phobias. Only later did he turn his attention to depression, the clinic of which seems to be a much larger problem: in psychiatry, more than half of patients suffer from depression. The simplest way to determine the link between anxiety and depression is to say that, as much as anxiety is a response to the threat of loss, depression is a consequence of actual loss.
Freud in his work “Sadness and Melancholy” (1917) sees a similarity between loss and depression in the manifestations of sadness, despair, loss of interest in the outside world, inhibition of activity.
“Sadness is usually a reaction to the loss of a loved one or to some abstract loss that is significant for a person: the loss of homeland, freedom, ideals, etc.…. In melancholy, the painful condition is caused in most cases by situations not associated with death, and extends to feelings of disrespect, neglect and disappointment, which include the opposite feelings of love and hate.
In other words, in melancholy or depression, the loss is not necessarily external, but rather internal in nature, associated with a person’s self-esteem. Depression, for example, can result from a failed attempt to achieve some desired goal that is vital to self-esteem (Pedder, 1982).
Otherwise, this thought can be expressed as follows: painful contradictions arise between the subjective ideal representation of myself (I am what I would like to be) and the real “I” (I am what I really am). These contradictions can cause physical distress (Joffe and Sandler, 1965), resulting in the following reactions. The normal reaction is protest, when a fight is preferred to flight, directing their aggression against the source of pain. A person may try to cope with pain through adaptation, and a mature strong personality can endure pain and overcome the frustration and damage done to self-esteem. There are several other (though less healthy) ways of responding to unbearable mental suffering. Failure to recover the desired state often results in a state of helplessness, which, according to Ioffe and Sandler (1965: 395), “is a fundamental psychobiological response, referring to the most basic responses, such as anxiety. Its roots are in the primary psychophysiological state, which manifests itself in helplessness in the face of any physical and mental suffering. “
One of the reactions to the state of helplessness is complete surrender and transition to physical illness, described by Engel (1967) as a “defeat complex”, often preceding physical illness. Another response is the transformation of mental pain into psychogenic bodily suffering (Merskey and Spear, 1967). The third is falling into depression.
On the other hand, a defense mechanism such as loss denial may be sufficient to cope with pain, at least temporarily. Let’s give an example.
The middle-aged woman had severe depression. She knew that her father died when she was only ten years old. The girl was told that he was missing, most likely died during the war. But the hope of her father’s return did not leave her all these 30 years, forcing her to shudder in anticipation at any knock on the door. During psychotherapeutic treatment, the woman recalled with horror the episode when her brother, a ten-year-old girl, who entered the room, told her about a man in the garage, covered in blood. At that moment, she instantly realized that her father had committed suicide, but immediately rejected this guess from herself. Only through the painful process of recognizing the fact of her father’s death and the terrible circumstances of his death, she was able to begin the struggle to overcome her despondency and depression.
The following sections will take a closer look at protection mechanisms.
The inclusion of various defense mechanisms is one of the ways to approach those aspects of oneself that, if conscious, can cause intolerable anxiety and mental suffering.
Each of us applies protection in certain situations. The question is to what extent and when. Sometimes overly carried away psychiatrists speak out in the sense that no protection should ever be used, denouncing it as a kind of modern form of sin. The opposite of this point of view is an unprovoked attack on someone’s defense, which is just as unjustified as any form of aggression. Another parallel with religion is the belief in the neurotic’s ideas that sinning in thoughts is just as bad as in deed, so there is no choice: either completely suppress sexual urges and the urge to kill, or obey them and act in accordance with these urges. … The peculiarity of a mature personality lies in the ability to recognize and tolerate such inclinations, preventing them from manifesting outside acceptable situations.
Freud (1894) was the first to use the term “defense” when studying the behavior of patients with hysteria. Later, he called this form of defense repression and described some other forms. In 1936, his daughter Anna listed nine forms of defense mechanisms (regression, repression, reactive formation, alienation, inaction, projection, introjection, turning against oneself, turning into the opposite). She also added the tenth normal mechanism – sublimation, as well as two additional ones (idealization and identification with the aggressor). Melanie Klein emphasized that protection, which takes place in the form of splitting and projective identification (Segal, 1964), occurs in both normal and painful development. Below is given and considered a list of mechanisms, although not exhaustive all possible, but includes the most common forms.
As it was shown at the beginning of the previous section, we all at certain moments suppress our unpleasant or uncomfortable inner urges, or even completely supplant something that is not acceptable to our consciousness. This is completely natural, unless it is taken to extremes. Before the advent of effective anesthesia, a surgeon with a sensitive soul had to suppress his reaction to the patient’s screams in order to provide him with the necessary help. In extreme cases, when, for example, people claim that they do not have anger or sexual arousal, they simply supplant these feelings in themselves in the most merciless way.
We may deny or cast out unpleasant events in our outer life, such as a bad deal or failure on an exam. There is evidence that up to 40% of widowed people retain the illusion of the presence of a deceased spouse and 14% actually believe they see and hear the deceased (Parkes, 1972). This is a form of denial of painful loss, quite normal in exceptional circumstances. Feelings of phantom pain in amputated limbs can also be understood as some form of loss denial. Interestingly, phantom pain occurs more often with unexpected amputations (for example, as a result of an accident) than with amputations that were preceded by a long illness, i.e. appropriate mental preparation. A sharper form of denial is hysterical flight or amnesia. During the war, the soldiers resorted in a hysterical state from the front line, where, in front of them, a shell covered all their comrades, and were forced to somehow reject this intolerable memory from themselves. In peacetime, patients sometimes appear who do not remember their name, the place where they live, and who have forgotten any details of their past life. As a rule, such phenomena are a consequence of committing some absolutely unbearable actions for consciousness (for example, the accidental murder of his wife during a violent quarrel).
We often alienate unacceptable feelings from ourselves and even attribute them to others. “The pot calls the kettle smoked.” Jesus Christ spoke about this: “Why do you notice a speck in your neighbor’s eye, but you don’t see a beam in your own?” The accusation of one’s own shortcomings on neighbors, neighbors, residents of another area, foreigners, foreigners is as old as the world. This is a natural, albeit tragic, dangerous human trait. In extreme manifestations, it reaches paranoia, when its own hostile and sexual manifestations are declared alien and even directed against the individual himself.
Sometimes people behave in such a way as if not only their feelings, but also important aspects of their personality are transferred to others (for example, a mother, unconsciously transferring feelings of her own deprivation in childhood to her child, spoils him and interferes with his independent development, but this behavior helps the mother to cope with the pain of the desire for intimacy and dependence, which she did not realize in childhood. The child’s needs are not taken into account, the mother sees in him a part of her “I”, forcing him to play this imposed role). In the professional language of the Klein psychoanalysts, such a phenomenon is called projective identification (Segal, 1964; Ogden, 1982).
In the same aspect, one can also consider the splitting, consisting in the complete separation of good and bad in oneself and in others, which is reflected in the constant interest of children in heroes and villains, good fairies and evil witches (Bettelheim, 1975). Clinically, the phenomenon of splitting can be observed in the separation of good and bad feelings, idealization and contempt both in relation to oneself and in relation to others.
When hiding unacceptable feelings, you can go to the opposite extreme. For example, such is the excessive stiffness observed when trying to hide the temptation to behave at ease. Excessive cleanliness can be helpful. But it can take unhealthy forms with neuroses, when many hours of ablution ritual is observed daily. The psychodynamic explanation for such neurotic states is an attempt to hide hostile feelings. A person who carefully checks three or seven times (magic numbers!), Whether he turned off the gas, might be horrified, realizing that he is suppressing his unconscious desire to harm others. Instead, he explains his behavior by the fact that he seeks to save gas – an example of the rational justification of unconscious processes.
Another example of the rational foundation of the unconscious is the case of post-hypnotic behavior already described above. The expression “the grapes are green” is an excellent illustration of this phenomenon: the fox, desperate to reach the grapes, consoles herself that the grapes are not yet ripe.
Conversion and psychosomatic reactions
The unacceptable feelings often turn into physical symptoms. Such are, for example, hysterical conversions and psychosomatic disorders. An unreleased rage can, for example, lead to migraines or high blood pressure.
A very experienced and accustomed to restraining herself, the nurse-nurse did not allow herself to show the irritation that boiled in her at the sight of stupid mistakes made by young colleagues, believing that this would harm them. Each time she held back her rage, which that same evening led to violent migraines. After completing a course of psychotherapy, the woman learned to better cope with her irritation and express it in an adequate form. Once, with surprise and joy, she said that she was able to point out the mistake in the correct form and in the evening she really managed to avoid a migraine attack.
In hysterical conditions, the symptoms may have elements of symbolism reflecting the underlying fantasy of the patient, as in the example described earlier with the supposedly poorly functioning hand, which was caused by a defensive reaction to the desire to hit his therapist. Nowadays, psychosomatic disorders are less often interpreted in such a symbolic way, but such situations happen, especially when it comes to people with limited imagination, whose feelings are expressed physically, whose speech is specific and who are not used to talking beyond necessity. The term “alexithymic” is used to describe people who do not express their feelings in words (Nemiah and Sifneos, 1970). This happens in post-traumatic and sexually perverse patients and patients with psychosomatic disorders (Taylor, 1987).
We all, to a greater or lesser extent, try to avoid situations that cause unpleasant sensations – the spectacle of an accident, the need to speak in public, etc. Some phobias – fear of spiders or thunderstorms – often go back to early childhood, easily explained by the traumatic events that once happened to a small child. The so-called “agoraphobia” (fear of open spaces) is also easily explained. It usually arises in adolescence and testifies not so much to a fear of open space as to a fear of collision with people in places overwhelmed with people. This is a social phobia.
A certain young woman, professing the lofty ideals of marital and premarital purity, married a man who had several premarital relationships. A few years later, the husband’s job required him to be absent in the evenings, and the wife had free time to attend evening classes. But she developed agoraphobia to such an extent that the woman was generally unable to go out without being accompanied by her husband. During the psychotherapy sessions, it was possible to reveal that agoraphobia was based on the fear that her suppressed impulses to flirt with men could break through and in this way try to “level the score” with her husband, whose premarital relationship she knew. One day, a woman was treating their married friend to dinner, who, leaving, kissed her in gratitude for the dinner, which was quite acceptable from the point of view of social norms. But, having slapped him in the face, she cursed him as a “dirty beast”, projecting her own unconscious unclean thoughts on him.
If we dare not express our feelings directly in front of the one who caused them, then we usually transfer them to someone. A classic feuilleton plot: the boss pours out his anger on the deputy, he – on the next in the hierarchy, and so on to the very bottom, when the messenger kicks the cat in their hearts. A similar phenomenon is observed among animals. This is called a redirect. A common form of substitution is directing unspent anger towards oneself, which leads to self-destructive behavior and even masochism. This is especially noticeable in states of depression and suicidal moods.
It is absolutely normal and even highly desirable on a day off to drop your usual adult duties and return (regress) to childhood to swim, play, etc. In the face of adversity that we cannot cope with – a serious illness, an accident – we often behave like children, refusing to make independent decisions.
Sleep can turn out to be a normal day-to-day regression where we try to escape the problems we face in reality. For a child who has already learned to ask and does not wet the bed, the appearance of a newborn brother or sister often causes regression, manifested in the fact that the bed will be wet again. In adolescent girls with anorexia nervosa due to a ludicrous diet, the disorder may be a manifestation of regression caused by the horror of repressed adolescent sexuality (Crisp, 1967).
Depersonalization and confusion of consciousness
Both of these terms are well known from the general course of psychiatry. Depersonalization is a state in which the patient considers himself to be some kind of unreal being, separated from his own feelings and from everyone around him like a glass wall. Confusion is a state of disorientation in time and space, usually resulting from somatic brain dysfunction.
However, complaints of confusion are not always organic. Sometimes confusion becomes a protective veil under which a person tries to hide, torn apart by intolerable conflict between irreconcilable contradictions of feelings, for example, love and hate. The same defense mechanism can manifest itself in depersonalization (Lader, 1975).
Anna Freud (1936) defined the state of sublimation as “the substitution of an instinctive goal in accordance with higher social values.” This is the most developed and mature defense mechanism that allows one to partially express unconscious motives in a modified, socially acceptable and even desirable form. For example, murderous lust may find a partial outlet in slaughterhouse work or in violent sports. The impulses break away from their primitive and obvious roots and are redirected in a different direction, manifesting themselves as phenomena of a higher order.
One very intelligent young man of 18, from a family that did not encourage the expression of feelings, grew up very secretive and insecure. He was very insecure, avoided girls, and even at 16, reading about the biological aspects of reproduction shocked him. From early childhood, the young man was fond of playing with tin soldiers and collected a huge collection. This collection gave an outlet in a sublimated form to his need for competition, in the desire to show himself, etc.
In addition to the well-known neurotic manifestations, sublimation contributes to the enrichment of both the individual and society. Freud viewed culture as a sublimation of deeply hidden and dark needs and at the same time the embodiment of the highest impulses. Franz Kafka (1920) expressed something similar in the form of the following aphorism: “All virtues are individual, all vices are social, what passes for social virtues (love, lack of self-interest, justice, self-sacrifice) are just surprisingly weakened social vices.” …
Vital parts of the personality can only be expressed in dreams and fantasies. Culture makes it possible to indirectly express what is simply impossible to express otherwise. One of the prime examples is the carnival. Culture provides an outlet for the life of society at all levels – from primitive instincts to the highest ethical ideals. Unconscious strivings require their expression.
Any attempt to understand the origins of both healthy and painful human behavior in all their complexity, sooner or later, will certainly come to the problem of motivation. Playwrights, novelists and poets, exploring the realm of human passions – love and hate, heroism and self-destruction – long before scientific specialists came to a solution to this problem.
Of course, there are several types of innate behavior – from primitive reflexes to complex ones that are highly dependent on learning, for example, the behavior of a mother caring for a child. There are physiological needs for air, food and water, which, when unmet, generate powerful motivations for behavior. But in modern Western society, as a rule, there are no obstacles to meeting these basic needs. Areas that generate conflicts require more attention.
Instincts are defined as “innate, biologically determined impulses to act” (Rycroft, 1972). This term has been used since the 16th century and comes from the Latin designation for impulse. In the 19th century, the concept of instinct received a special coloring in the light of the development of the physical sciences and began to simplify the following idea: the instinctive behavior of animals is just as primitive as the reactive motion of a liquid. Today biologists prefer to talk about innate patterns of possible behavior, recognizing their much greater complexity. Such patterns or “motivational systems” (Rosenblatt and Thickstun, 1977) require a certain external triggering mechanism in order to be activated. However, at times we subjectively feel that our own impulses seem to arise within us against our will. We prefer to use the term “motivational drive” to convey both mental and bodily biological aspects.
It was already mentioned in the introduction that different schools of psychodynamics define motivational drives in different ways and highlight the most important of them in different ways. However, they all emphasize the conflict of motivational urges, with a significant proportion of schools focusing on sexual and aggressive urges. Other important motivations are related to food, attachments, parenting and social behavior. This is best illustrated with a brief historical background.
As has already been shown, Freud, in the early stages of his research, was confronted with strikingly frequent sexual conflicts, especially in hysterical women. Jung (1875-1961), opposing an excessive emphasis on sexuality, coined the term “libido”, by which he understood the existence of broader general vital forces. Adler (1870-1937) attached even greater importance to aggressiveness and the desire for power. Initially, Freud, taking on faith the stories of his patients about sexual abuse that they experienced in childhood by adults, saw the cause of neurotic conflicts in the suppression of these traumatic memories. Later, through introspection, and also feeling that child abuse could not happen as often as his theory suggested, Freud realized that he was wrong. He decided that the stories of his patients were mostly based not on actual facts, but on children’s fantasies about their own desires. He came to the conclusion that very often psychic reality is much more important than physical. Recently, however, there has been renewed talk of recognizing the reality and prevalence of the problem of child sexual abuse (Bentovim et. Al., 1988).
Freud’s discovery of the importance of infantile sexuality is reflected in his book Three Essays on the Theory of Sexuality (1905). Prior to this publication, it was generally accepted that the development of a normal heterosexual orientation was considered to re-emerge during puberty (a myth that illustrates Botticelli’s painting of the birth of Venus rising from the waves as a fully formed woman). Freud noted that this view ignores the phenomena of homosexuality, sexual perversion, child masturbation, and sexual curiosity. He came to consider sexual urges as phenomena that appear from birth and go through various stages as they develop (oral, anal, phallic, etc.), depending on which erogenous zones give pleasure at one stage or another. The most famous is the Oedipus phase (about 3-5 years), named after the hero of the Oedipus myth, who unknowingly killed his father and married his own mother, and then blinded himself (symbolic castration) upon learning of his terrible crime.
In recent years, perhaps under the influence of Adler and the destructiveness of World War I, Freud began to pay more attention to the manifestations of human aggressiveness.
The debate about whether aggressiveness is an innate or acquired property in response to frustration and deprivation is far from over. Both views are valid.
The topic of aggression between representatives of the same biological species was developed by zoologists (Lorenz, 1966). One example of such aggression is the division of territory. Another example is the struggle of males, which helps to select the best individuals for procreation. This phenomenon is especially common among animals leading a herd-nomadic lifestyle (antelopes, bison, etc.), for which the presence of strong males capable of protecting the herd is especially important. In higher primates, aggression is manifested when establishing status in the hierarchy. Social stability is promoted by such a situation in which each member of the group “knows his place”. As for the importance of a strict hierarchy in human society, it is very ambiguous. While undoubtedly a useful phenomenon in an army conducting hostilities, or in an operating team of surgeons, hierarchy can constrain the growth and initiative of an individual where it is not determined by obvious necessity.
The early-stage view of sexuality as a pursuit of pleasure, present from birth, has been very useful in explaining motivation, although some scholars have criticized it for over-focusing on the individual and his satisfaction. Object relations theorists (Fairbairn, 1952; Guntrip, 1961; Winnicott, 1965; Balint, 1968; Greenberg and Mitchell, 1983) have proclaimed the basic human need for the desire to establish relationships (in a broad sense) with other people. In contrast to the theory of seeking satisfaction, for each age, represented by different stages, they believed that different stages at different ages express a different need – different ways of establishing relationships with people (starting with the mother). This method corresponds to different developmental stages of a growing organism and begins with feeding. Instead of an infant seeking satisfaction in an oral impulse, this theory sees an explanation in a couple — mother and child — who find satisfaction in establishing a feeding relationship.
Harlow’s (1958) famous work on baby chimpanzees contains dramatic examples of such object attachments. Taken from their real mothers, little monkeys were attached to dolls and dummies, demonstrating an example of object attachment over hunger (they were fed from bottles – separately).
Bowlby (1969), continuing to develop the problem of weaning from the mother, which he began to investigate back in 1952, came to the conclusion that attachment is an important initial aspiration in humans as well. He argued that “attachment behavior is a form of behavior that is distinct from eating behavior and from sexual behavior, although it is no less significant in human life” (Bowlby, 1975). Attachment behavior peaks between nine months and three years of age. Perhaps the roots of this behavior are related to “adaptation to the environment during evolution” to protect the helpless infant from predators.
However, these biological urges and relationship-building behaviors do not exhaust human activity. Human babies are characterized by curiosity and thirst for knowledge, which Piaget writes about (1953). Should they be viewed simply as a derivative of sexual curiosity, later “sublimated” into the form of scientific and creative research? Or do they represent an independent urge leading to one of human’s most unique creative achievements? Storr (1976) argues that the preservation of children’s ability to play in adults is the basis of human creativity.
Exploratory behavior and attachment behavior are inversely related to each other. The child on the beach, carried away by exploring the surroundings, moves further and further from the mother, and then, frightened, runs back. He returns to her to calm down, gain confidence, how to “recharge the batteries”, and then again embarks on his research.
We need such a base throughout our lives: man is a social animal. About another social animal, the bee, Maeterlinck (1901: 31) wrote: “It is worth isolating it and, no matter how good the food and comfortable environment, it will die in a few days from loneliness. Overcrowding, a common settlement give her an invisible medicine, no less necessary for her than honey. There is no doubt that a person also experiences a natural need to communicate with his own kind, when he can find and realize himself. It remains debatable whether this behavior is a primary social instinct. In more advanced societies, social behavior outgrows biological needs, responding to the satisfaction of psychological needs. Social connections create a structure in which an individual struggles to gain self-worth through relationships with other people. The first social connection is the mother-child structure, then the family, then school, work, sexual partners, a new family and wider social ties. A person’s sense of self and awareness of his own worth depends on the presence and his interaction with other people throughout his life.
The school of American psychologists who made their mark in the 1930s – Fromm, Horney, Sullivan and Erickson – were called neo-Freudians. Representatives of the new school attached particular importance to the interpersonal aspect as opposed to the intrapsychic one. The conflicts and breakdowns seen in these relationships of support and self-determination lead to despair and illness. We are coming to an ever clearer awareness of the need to overcome loneliness and find a replacement for collapsing family and group ties, in other words, to support and correct the need of individuals and communities for cooperation and close ties.
Whatever definition of motivation we have to stop at, the basic concept of psychodynamics remains the conflict of primitive impulses. Freud revised his own theories of instincts several times, but dual conflicting ideas were always present in his writings. At first, he saw a conflict in the contradiction between the instinct of self-preservation and the instinct of procreation, later – between love for oneself (narcissism) and love for others; Finally, Freud poeticly formulated the conflict between the life instinct and the death instinct, echoing with Schiller, who said that until the spirit begins to rule the world, power will be divided between “hunger and love.”
Science and literature continue to understand the complexities of human motivation. Perhaps the current stage of development of knowledge is not yet mature enough for a clearer classification of motivation, in any case, this task lies outside the scope of this book. Psychotherapy is more concerned with impulses, urgent needs, and fantasies that lead to despair and conflict. Behind them are forces that emerge from the depths of the personality and are aptly named by Sandler (1974) “unconscious indisputable needs.” If we fail to get along with such a vital part of our nature, then this leads to obvious mental illness or, at least, to neurotic suffering and inhibitions.