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Anyone who believes in the occurrence of half-intentional self-injury if I may use a clumsy expression will be prepared also to assume that in addition to consciously intentional suicide there is such a thing as half-intentional self-destruction (self-destruction with an unconscious intention), capable of making skilful use of a threat to life and of disguising it as a chance mishap. For the trend to self-destruction is present to a certain degree in very many more human beings than those in whom it is carried out; self-injuries are as a rule a compromise between this instinct and the forces that are still working against it, and even where suicide actually results, the inclination to suicide will have been present for a long time before in lesser strength or in the form of an unconscious and suppressed trend. I have learned of more than one apparently chance mishap (on horseback or in a carriage) the details of which justify a suspicion that suicide was unconsciously allowed to come about. For example, an officer, riding in a race with some fellow-officers, fell from his horse and was so severely injured that he died some days later. His behaviour on regaining consciousness was striking in some ways; and his previous behaviour had been even more remarkable. He had been deeply depressed by the death of his beloved mother, had had fits of sobbing in the company of his fellow officers, and to his trusted friends had spoken of being weary of life. He had wanted to leave the service to take part in a war in Africa which had not interested him previously;fi formerly a dashing rider, he now avoided riding whenever possible. Finally, before the race, from which he could not withdraw, he expressed gloomy forebodings; with the view that we hold in these matters, it will not remain a surprise to us that these forebodings turned out to be justified. I shall be told that it is not to be wondered at if a person in such a state of nervous depression cannot manage a horse as well as on normal days. To that extent the ingenious judgement delivered by Sancho Panza as governor of his island is psychologically unjust (Don Quixote, Part 2, Chapter 45). A woman dragged a man before the judge alleging he had robbed her of her honour by violence. The two returned struggling, the woman priding herself on the fact that the villain had not been able to take the purse from her. Ferenczi of Budapest has handed over to me for publication the analysis of an ostensibly accidental injury by shooting, which he explains as an unconscious attempt at suicide. He wanted to find out from me whether the bullet that penetrated his left temple on March 20, 1907 could or should be removed by operation.
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The nucleus of the diagonal band of tions that it may also assist in the initiation and monitor- Broca is a white matter and cell body area located near ing of conscious retrieval of episodic memories (Wenk, the nucleus basalis. Papez originally proposed that this looping pathway chronic alcoholism associated with vitamin deficiency was specific for emotional processing. As a result, degeneration of the thalamic dor- clinical presentation of intense emotional symptoms in somedial nucleus and the mammillary bodies occurs. Today, researchers of nondeclarative memory (for example, procedural mem- know this loop has more to do with consolidating infor- ory) are preserved. Moreover, there are cases of damage mation in memory than as a primary emotional proces- specific to the diencephalon region resulting in amnesia, sor. Chapter 5, this area is a subcortical part of the telen- the major output system of the hippocampal formation cephalon surrounding the inferior tip of the frontal horn is the fornix. It contains nearly 1 million fibers and is and is strongly interconnected with limbic structures; some comparable in size with the optic tract (Nauta & Feirtag, neuroscientists consider it part of the limbic system (for ex- 1986). Some in- fornix relays information to the mammillary bodies vestigators have suggested that extensive damage of basal (specifically the medial mammillary nucleus) of the hypo- forebrain structures may be needed to affect memory (Zola- thalamus. From there information is projected to the ante- Morgan & Squire, 1993); thus, looking at the contribu- rior nucleus of the thalamus along the mamillo-thalamic tions of an individual nucleus to memory is probably not tract, from where it then goes to the cingulate gyrus to as profitable as regarding the system as a network. This area It is readily apparent by examining amnesia cases such is important to memory not only for the nuclei within but as H. The basal forebrain also tion circuit can disrupt memory in a manner similar to di- contains numerous connections to the mediotemporal area. The variety of to present a neuroanatomic classification scheme, scien- memory functions this term encompasses most likely re- tists can describe some aspects of nondeclarative memory fiects a collection of different abilities, not necessarily mu- with respect to brain structures, particularly subcortical tually exclusive, and perhaps dependent on different pro- basal ganglia areas. Procedural learning concerns the learn- with practice on certain perceptual motor tasks (Milner ing of procedures, rules, or skills manifested through per- et al. He was learning, with prac- formance rather than verbalization, although conscious tice, without conscious recognition of this learning. One area of nondeclarative memory pletion priming paradigm, a list of words is first presented involves perceptual motor adaptation and skills acquisition. The pursuit rotor requires the examinee to aminers then give patients three-letter word stems (for ex- keep a stylus on a spinning disk, much like having to hold ample, chu, par, cla ) and ask them to a place on a record on a turntable. Perceptually, amnesiacs also show nor- the stem with a word they had already seen than were un- mal adaptive behavior when wearing visual prisms. Be- primed examinees, despite the same level of declarative cause prisms distort visual input, simple acts such as amnesia for the words. Perceptual priming also appears in reaching for an object are misdirected at first.
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But word-presentations, for their part too, are derived from sense- perceptions, in the same way as thing-presentations are; the question might therefore be raised why presentations of objects cannot become conscious through the medium of their own perceptual residues. Probably, however, thought proceeds in systems so far remote from the original perceptual residues that they have no longer retained anything of the qualities of those residues, and, in order to become conscious, need to be reinforced by new qualities. Moreover, by being linked with words, cathexes can be provided with quality even when they represent only relations between presentations of objects and are thus unable to derive any quality from perceptions. Such relations, which become comprehensible only through words, form a major part of our thought-processes. As we can see, being linked with word-presentations is not yet the same thing as becoming conscious, but only makes it possible to become so; it is therefore characteristic of the system Pcs. With these discussions, however, we have evidently departed from our subject proper and find ourselves plunged into problems concerning the preconscious and the conscious, which for good reasons we are reserving for separate treatment. The Unconscious 3024 As regards schizophrenia, which we only touch on here so far as seems indispensable for a general understanding of the Ucs. The most superficial reflection shows us how much more radically and profoundly this attempt at flight, this flight of the ego, is put into operation in the narcissistic neuroses. If, in schizophrenia, this flight consists in withdrawal of instinctual cathexis from the points which represent the unconscious presentation of the object, it may seem strange that the part of the presentation of this object which belongs to the system Pcs. We might rather expect that the word- presentation, being the preconscious part, would have to sustain the first impact of repression and that it would be totally uncathectable after repression had proceeded as far as the unconscious thing- presentations. It turns out that the cathexis of the word-presentation is not part of the act of repression, but represents the first of the attempts at recovery or cure which so conspicuously dominate the clinical picture of schizophrenia. These endeavours are directed towards regaining the lost object, and it may well be that to achieve this purpose they set off on a path that leads to the object via the verbal part of it, but then find themselves obliged to be content with words instead of things. It is a general truth that our mental activity moves in two opposite directions: either it starts from the instincts and passes through the system Ucs. This second path must, in spite of the repression which has taken place, remain traversable, and it lies open to some extent to the endeavours made by the neurosis to regain its objects. When we think in abstractions there is a danger that we may neglect the relations of words to unconscious thing- presentations, and it must be confessed that the expression and content of our philosophizing then begins to acquire an unwelcome resemblance to the mode of operation of schizophrenics. Among these we may include such affective states as grief and being in love, as well as the state of sleep and the phenomenon of dreaming. We may add that when they go to sleep they carry out an entirely analogous undressing of their minds and lay aside most of their psychical acquisitions. Thus on both counts they approach remarkably close to the situation in which they began life. Somatically, sleep is a reactivation of intrauterine existence, fulfilling as it does the conditions of repose, warmth and exclusion of stimulus; indeed, in sleep many people resume the foetal posture.
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It is a quite regular thing for the mood attaching to an experience and the subject-matter of that experience to come into different relations to the primary consciousness. I collected from her very numerous and convincing proofs of the existence of a psychical mechanism of hysterical phenomena such as I have put forward above. Personal considerations unfortunately make it impossible for me to give a detailed case history of this patient, though I shall have occasion to refer to it from time to time. This state was certainly not a unique one, though I do not know if it has hitherto been recognized. The patient had experienced numerous psychical traumas and had spent many years in a chronic hysteria which was attended by a great variety of manifestations. One day an old memory suddenly broke in upon her clear and tangible and with all the freshness of a new sensation. For nearly three years after this she once again lived through all the traumas of her life long-forgotten, as they seemed to her, and some, indeed, never remembered at all accompanied by the acutest suffering and by the return of all the symptoms she had ever had. The only way of relieving her was to give her an opportunity of talking off under hypnosis the particular reminiscence which was tormenting her at the moment, together with all its accompanying load of feelings and their physical expression. When I was prevented from doing so, so that she was obliged to say these things to a person in whose presence she felt embarrassed, it sometimes happened that she would tell him her story quite calmly and would subsequently, in hypnosis, produce for me all the tears, all the expressions of despair, with which she would have wished to accompany her recital. For a few hours after a purgation of this kind during hypnosis she used to be quite well and on the spot. After a short interval the next reminiscence of the series would break its way in. But this reminiscence would be preceded some hours earlier by the mood which was proper to it. She would become anxious or irritable or despairing without ever suspecting that this mood did not belong to the present moment but to the state to which she would next be subject. During this transition period she would habitually make a false connection to which she would obstinately cling until her next hypnosis. After a short discussion, she clearly recognized this; but her next hypnosis brought to light a recollection of an occasion, twelve years earlier, which had aroused severe self-reproaches in her though, incidentally, she no longer subscribed to them in the least. Studies On Hysteria 66 I then got her to tell me the history of her pains in the leg. She began in the same way as yesterday and then went on with a long series of instances of experiences, alternately distressing and irritating, which she had had at the same time as her pains in the leg and the effect of which had each time been to make them worse, even to the point of her having bilateral paralysis of the legs with loss of sensation in them. Concerning the latter, I only learnt that they succeeded some curious restless states accompanied by depression which had been there previously.
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They are distinguished from parapraxes by their lack of another intention with which they are in collision and which is disturbed by them. On the other hand, they merge insensibly into the gestures and movements which we regard as expressions of the emotions. These chance actions include all sorts of manipulations with our clothing, or parts of our body or objects within our reach, performed as though in play and apparently with no purpose, or, again, the omission of these manipulations; or, further, tunes that we hum to ourselves. I suggest that all these phenomena have a sense and can be interpreted in the same way as parapraxes, that they are small indications of more important mental processes and are fully valid psychical acts. But I do not propose to linger over this fresh extension of the field of mental phenomena; I shall return to the parapraxes, in connection with which problems important for psycho-analysis can be worked out with far greater clarity. The most interesting questions which we have raised about parapraxes and not yet answered are perhaps these. We have said that parapraxes are the product of mutual interference between two different intentions, of which one may be called the disturbed intention and the other the disturbing one. The disturbed intentions give no occasion for further questions, but concerning the latter we should like to know, first, what sort of intentions emerge as a disturbance to others, and secondly what is the relation of the disturbing intentions to the disturbed onesfi Introductory Lectures On Psycho-Analysis 3169 If you will allow me, I will once more take slips of the tongue as representatives of the whole class and I will reply to the second question before the first. In a slip of the tongue the disturbing intention may be related in its content to the disturbed one, in which case it will contradict it or correct it or supplement it. Or the more obscure and more interesting case the content of the disturbing intention may have nothing to do with that of the disturbed one. We shall have no difficulty in finding evidence of the former relation in instances we already know and in similar ones. In almost every case in which a slip of the tongue reverses the sense, the disturbing intention expresses the contrary to the disturbed one and the parapraxis represents a conflict between two incompatible inclinations. Introductory Lectures On Psycho-Analysis 3170 the other sort of relation between the two mutually interfering intentions seems puzzling. If the disturbing intention has nothing to do with the disturbed one, where can it have come from and why is it that it makes itself noticeable as a disturbance at this particular pointfi
