Page:Freud - Selected papers on hysteria and other psychoneuroses.djvu/10

vi the author's works which fully illustrate his theories and at the same time show the gradual evolution of his psychology.

That Freud's views have undergone some changes, or rather modifications, within the last fifteen years we readily admit; but who will blame the surgeon for modifying or rejecting some technique of his operation, if after years of careful work he feels justified in so doing? Surely such an action merits applause rather than reproach. It was only after carefully investigating for years that Freud saw fit to change some of his views, yet nothing was really totally discarded.

It is quite unnecessary to discuss here the whys and wherefores of the modifications in question, these are fully explained in the text. But it will not be mal à propos to say a few words concerning the technique of the treatment.

For reasons given in the book the author has abandoned hypnotism and used the pressure procedure, but this in turn was given up because it was cumbersome for both doctor and patient and proved to be utterly needless.

The technique is as follows: The patient lies on his back on a lounge, the physician sitting behind the patient's head at the head of the lounge. In this way the patient remains free from all external influences and impressions. The object is to avoid all muscular exertion and distraction, thus allowing thorough concentration of attention on the patient's own psychic activities. The patient is then asked to give a detailed account of his troubles, after having been told before to repeat everything that occurs to his mind, even such thoughts as may cause him embarrassment or mortification. On listening to such a history one invariably notices many memory gaps, both in reference to time and causal relations. These the patient is urged to fill in by concentration of attention on the subject in question, and by repeating all the unintentional thoughts originating in this connection. This is the so-called method of "free association!" The patient is required to relate all his thoughts in the order of their sequence even if they seem irrelevant to him. He must do away with all critique and remain perfectly passive. It is in this way that we fathom the original meaning of the symptom. But as the thoughts which originate in this manner are of a disagreeable and painful nature they are pushed back with the greatest