Freud was well aware that it was paradoxical, even perhaps contradictory, to speak of “unconscious ideas,” but as I have already indicated, he was driven by his clinical experience rather than by considerations of philosophical consistency. If conceptualizing what was going on in his patients in terms of the notion of unconscious ideas fit his clinical observations better than any other hypothesis, and if the result was the relief of the painful symptoms and debilitating conditions presented by his patients, then he embraced the notion, all the while supposing that it would at least in theory be possible eventually to give an entirely neurological explanation of what he was observing.
Five questions presented themselves with regard to the unconscious mental contents, and Freud explored all five in the very greatest detail for many years. For purposes of clarity rather than narrative and temporal accuracy, I will discuss each in turn. The first question was: Why is it so difficult for patients to access these unconscious ideas and, by accessing them, to relieve the symptoms? The second question was: How can a doctor get access to the contents of the unconscious? The third question was: What is the content of the unconscious? What can we learn about what resides in the unconscious? The fourth question was: What are the laws or rules that govern the way in which the materials of the unconscious function, and is there any way in which those laws or rules are different from the laws or rules governing conscious thinking? The fifth question was: In light of the answers to the first four questions, what is the most effective therapeutic strategy for treating patients afflicted with the sorts of problems Freud was dealing with?
Just to anticipate our answers, so that you will understand where we are going, the answer to the first question, in a word, turned out to be “repression;” The answer to the second question was dreams, jokes, slips of the tongue, and free association. The answer to the third question, in two phrases, was “infantile wishes” and “sex.” The answer to the fourth question, in a three word phrase, was “primary thought processes.” And the answer to the fifth question was psychoanalysis. But that encapsulates a very great deal, so let us get to work.
First: Why is it so difficult for patients to access the unconscious ideas and, by accessing them, to relieve the symptoms?
The ideas consigned to the unconscious are quite unlike the ideas in the pre-conscious. For the most part, I can access the ideas in the pre-conscious when I need to, but even when I cannot do so with ease, I am delighted to be reminded of them. With a snap of the fingers I say, “That’s it! Why couldn’t I remember that?” One of my own most irritating senior moments was my repeated inability at a certain point to call to mind the name of Kathleen Battle, a marvelous operatic soprano, but always, when the name finally came to me, I was delighted to have recovered it. By contrast, Freud’s patients resisted recalling the materials in the unconscious, sometimes protesting vehemently that they could not possibly have such ideas. Freud described these ideas as not forgotten, but repressed. There was no way that he could possibly identify the neurological correlates of this phenomenon, so he described it anthropomorphically by saying that in the mind there is a Censor who stands at the border between the conscious and the unconscious and blocks access of the conscious mind to its unconscious contents. We shall eventually introduce familiar language invented by Freud to describe the various functions of the mind – the Id [or “it”], the Ego [or “I”], the Superego [or “that which is above the I.”] But always he assumed that eventually it would be possible to cash this language in for neurological descriptions and explanations.
What was new and revolutionary in Freud’s description here was the claim that there is a dynamic relationship between the parts of the mind – that effort and energy is expended in maintaining that relationship. “Repression,” unlike “forgetting,” implies an active doing of something, which in turn implies purpose, none of which is conveyed by the passive description “forgetting.” Inevitably, one is led to ask why the mind represses certain contents, why it resists so powerfully recalling them, even though the recalling of them will relieve painful or debilitating symptoms that the patient insists she wants relieved. The obvious hypothesis is that the recalling of the repressed ideas will, for some reason, be even more painful to the patient than the symptoms, so that, faced, in effect, with a choice between acknowledging the unconscious ideas and getting rid of the symptoms, or denying the ideas and continuing to suffer the symptoms, the patient urgently, sometimes even angrily, chooses to deny the ideas and suffer the symptoms.
This behavior is, of course, completely unlike that of most patients who come to a doctor seeking relief. For the most part, medical treatment is carried out by the doctor without anything more than the passive consent of the patient. Indeed, in some cases, the patient may even be under anesthesia when the treatment is applied. To be sure, a cure may involve some cooperation by the patient – take these pills, stop smoking, eat healthier foods, exercise – and the patient may be derelict in carrying out the doctor’s instructions. But very rarely can the patient be described as resisting being cured. Freud spent a good deal of time figuring out what was going on, why, and how to deal with it.
Second: How can a doctor get access to the contents of the unconscious?
As we have seen, Freud, following Charcot, began by using hypnosis to access unconscious thought contents, but for a variety of reasons this technique was of limited usefulness. First of all, some patients were hard to hypnotize. Secondly, merely bringing the repressed content to consciousness frequently did not, of itself, result in a relief of symptoms. Nor were the “cures” in many cases permanent. Recognizing the dynamic nature of the repression, Freud sought other ways to get at the unconscious. Very early on, it occurred to him that dreams might give him the access he needed.
By the time Freud came along, there was a very long and rich tradition of dream interpretation in Western culture, as well as in many other cultures as well. For millennia, people had been viewing dreams as omens of the future, as messages from the gods, or as contacts with the spirit world. In opposition to these traditions, a number of scientifically trained or influenced authors had offered purely physiological explanations of dreams – as responses to sounds hear during sleep, as reactions to bodily sensations induced by bedclothes, as a response to intestinal distress, and all manner of other physical influences.
Everyone had observed certain familiar and puzzling facts about the remembered content of dreams. Some dreams are recalled by the dreamer, upon waking, as quite realistic, filled with familiar people and places doing familiar things. Other dreams seem to consist of several incidents or story fragments that have nothing to do with one another. In some dreams, people appear who are long dead. In others, impossible and seemingly magical things happen – people fly like birds, animals talk, people die and come back to life. Some dreams are reported as filled with images in full color. Other dreams are reported as spare, monochromatic.
It occurred to Freud that perhaps the content of dreams was, in some way, a slipping of repressed ideas past the Censor, who could be thought of as letting down his guard, or napping, during sleep. Since the ideas, when they appear in dreams, do not lead to action – we do not really do anything when we are asleep, no matter what we may be dreaming – the Censor might be less concerned about the eruption into consciousness of dangerous or unacceptable, and hence repressed, ideas. [I will not keep repeating that Freud understood this to be anthropomorphic language that must, ultimately, be replaced by proper neurological explanations. I rely on you to keep that fact ever in the back of your minds.]