Sigmund Freud Psychoanalysis Post-Traumatic Stress Disorder

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Sigmund FreudPsychoanalysisPost-Traumatic
Stress Disorder
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Investigations of Trauma

• 1880s 1900 hysterical women
• post- W W I shell shock
• Post W W II combat neurosis
• post- Vietnam P.T.S.D.

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Trauma-Induced Syndrome

• Hyperarousal panic anxiety
• Intrusive re- flashbacks
• experiencing acting-out trauma
• in disguised form
• Constriction / dissociation
• numbing trance altered states
• (often drug-aided)

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Dialectic of Trauma

• Oscillation of re-experiencing and constrictive
  defense
• Fits / outbursts epileptic-like seizures
• violence
• Amnesia forgetting, repression
• Paralyses immobility
• Losses of voice silencing
• cant describe trauma

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Discovery of the Unconscious1775 - 1895
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Cast of Characters

• Fr. Johann Gassner
• Franz Mesmer
• Fr. Hell
• Freulin Oesterlin
• Antoin LaVoisier
• Joseph Guillotin
• Ben Franklin
• Marquis de Puysegur

• Phneas Parkhurst Quimby
• Mary Baker Eddy
• Jean Charcot
• Anna O
• ( Bertha Pappenheim)
• Joseph Breuer
• Sigmund Freud

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Father Johann Gassner

• Swiss country priest renowned exorcist
• Public healing spectacles

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Fr. Johann Gassnerexorcism
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Father Johann Gassner

• 1775 Target of Papal inquiry
• Ruled unorthodox
• Banished to small parish
• Last gasp of official exorcism

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Franz Mesmer
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Franz Mesmer

• Viennese physician
• Thesis on effects of planets on illnesses
• Universal fluid (like ether)
• Planets set up tide that affects humans

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Franz Mesmer

• 1744 Treated Freulein Oesterlin
• Father Hell told of efforts to cure with
  magnetism
• Periodic violent fits crises
• Related to planetary motion?
• Tried liquid with iron filings magnets
• Felt evil feelings flow away
• Cured married Mesmers son

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Mesmers Theory

• Scientific similar to electricity
• Universal energy / fluid
• Disease imbalance, loss of fluid
• Cure channeling restoring fluid
• Crises re-balance fluid

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Mesmers Theory

• Cures not due to magnets alone
• Energy / fluid concentrated in his body affects
  patients
• Animal Magnitism

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Baquetlike Leyden Jar,collects
storesanimal magnetic fluid
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Magnetic Healing in Paris
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Mesmer as Quack?
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Mesmerism as scandal
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Mesmerism as scandal
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Mesmerism as scandal
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Mesmerism as scandal
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1784 Royal Commission
Guillotin
Franklin
LaVoisier
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1784 Royal Commission

• No evidence of magnetic fluid
• Cures due to imagination
• Danger in erotic ties of women patients to
  magnetizer

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After Royal the Commission
Mesmerism eclipsed by French revolution
Napoleonic Wars
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Louis Pinel unchains the insane
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Marquis de Puysegur

• Disciple of Mesmer
• Magnetized servant
• Hyper-alert sleep
• Couldnt remember after awakening
• Cured by suggestion during magnetic sleep

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Puysegur
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Puysegurs Theory

• Artificial somnambulism
• Not caused by magnetic fluid
• Brought about my magnetizers will patients
  compliance

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Puysegurs Theory

• The entire doctrine of Animal Magnetism is
  contained in the two words Believe and Want. I
  believe that I have the power to set into action
  the vital principle of my fellow men I want to
  make use of it this is all my science and all
  my means. Believe and Want, sirs, and you will
  do as well as I

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Mid- 19th century

• Study of mental illness
• Study of natural magentic states
• Fugue states
• Amnesia
• Multiple personality

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Spiritism Mediumship in U.S
Phineas Quimby
Mary Baker Eddy
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Christian Science Church, Boston
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1880s Jean Charcot
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Hysteria

• Epileptic-like fits, crises, convulsions
• Sensory impairments paralyses
• Amnesia
• Charcot discovered
• Symptoms dont follow anatomy
• glove hysteria
• Hypnotic suggestion could produce artificial
  hysterical symptoms

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Charcot Demonstrating Hysteria
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Charcots Theory of Hysteria

• Hypnosis is abnormal state, due to defect in
  nervous system
• Traumatic event ? hypnoid state (in those with
  defect) ? inadvertant suggestion ? hysterical
  symptom

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Studies on HysteriaJ. Breuer S. Freud1895
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Joseph Breuer Anna O
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Anna O
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Anna O
She once woke up during the night in great
anxiety about the patient, who was in a high
fever she was under the strain of expecting the
arrival of a surgeon from Vienna who was to
operate Anna was sitting at the bedside with
her right arm over the back of her chair. She
fell into a waking dream and saw a black snake
coming towards the sick man from the wall to bit
him
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Anna O
She tried to keep the snake off, but it was
as though she was paralyzed. Her right arm, over
the back of the chair, had gone to sleep and had
become anesthetic and paretic and when she
looked it it the fingers turned into little
snakes with deaths heads
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Anna O
When the snake vanished, in terror she tried
to pray. But language failed her she could
find no tongue in which to speak, till at last
she thought of some childrens verses in English
and then found herself able to think and pray in
that language. The whistle of the train that was
bringing the doctor whom she expected broke the
spell.
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Anna O
Next day, in the course of a game, she threw
a quoit into some bushes and when she went to
pick it out, a bent branch revived her
hallucination of the snake, and simultaneously
her right arm became rigidly extended.
Thenceforward the same thing invariably occurred
whenever the hallucination was recalled by some
object with a more-or-less snake-like appearance.
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Anna O onset of cough
She began coughing for the first time when
once, as she was sitting at her fathers bedside,
she heard the sound of dance music coming from a
neighboring house, felt a sudden wish to be
there, and was overcome with self-reproaches.
Thereafter, throughout the whole length of her
illness she reacted to any markedly rhythmical
music with a tussis nervosa nervous cough.
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Anna O onset of cough

• Wish to leave father and join friends at dance
• Self-reproaches
• Cough as symptom
• ? Incompatible Idea

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Anna OBertha Pappenheim
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Transference

• Transference Anna O had fallen in love with Dr.
  Breuer
• Counter-Transference Dr. Breuer had fallen in
  love with Anna O
• Hysterical childbirth

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Bertha Pappenheim

• Suffered relapse, hospitalized
• As Paul Berthold translated Vindication of the
  Rights of Women
• Wrote play, The Rights of Women
• Director of orphanage destitute girls
• Saved girls from prostitution
• Founder of social work and leader of womens
  rights

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Bertha Pappenheim

• Silenced as dutiful daughter in conservative
  home?
• Tension intensified by fathers illness, nursing
  role, self-reproaches?
• Talking cure with Breuer helped cure her?
• Found voice in womens movement
• ? Hysteria as pathological reaction to cultural
  silencing personal trauma or incompatible idea?

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Summary

• Trauma painful memory
• incompatible idea
• Symptom conversion hysteria
• Treatment re-experiencing

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Sigmund Freud
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Martha Bernays
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Freud and his daughter
Freud and his mother
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Freuds Office
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Hypnosis to Free Association

• Freud was lousy hypnotist
• Head pressing
• Ideas often embarrassing, immoral, anti-social,
  sexual
• Resistance
• Free association
• Excavating layers of mind/memory

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Freuds Couch
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Freuds Antiquities
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Only a cigar?
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Freud in exile, early 1930s
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1896 Etiology of Hysteria

• Recent event traumatic because it reawakened
  childhood trauma
• 18 cases childhood seduction or molestation
• Seduction theory of hysteria

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Seduction Theory of Hysteria
In 1895 and 1896 Freud, in listening to his
women patients, learned that something dreadful
and violent lay in their past. The psychiatrists
who had heard these stories before Freud had
accused their patients of being hysterical liars
and had dismissed their memories as fantasy.
Freud was the first psychiatrist who believed his
patients were telling the truth Jeffrey Mason,
Assault on Truth
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Seduction Theory of Hysteria
Freud announced his discovery in a paper which
he gave in April 1896 to the Society for
Psychiatry and Neurology in Vienna, his first
major public address to his peers. The paper met
with total silence. Afterwards, he was urged
never to publish it, lest his reputation be
damaged beyond repair. The silence around him
deepened, as did his loneliness. But he defied
his colleagues and published The Aetiology of
Hysteria, an act of great courage. Jeffrey
Mason, Assault on Truth
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Reaction to Etiology Paper

• Freud discovers that one remembered seduction
  could not have occurred
• Today false memory syndrome
• Freud officially abandons seduction theory
• Develops theory of infantile sexuality

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Psychoanalytic Theory

• Post-1896 self-analysis
• 1900 The Interpretation of Dreams
• 1905 Theory Infantile Sexuality
• 1905 Dora case
• tries to convince Dora she lusts for Herr K

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Infantile Sexuality

• Libido desire / drive / instinct for sensuous
  pleasure
• In children diffuse, not explicitly sexual
• polymorphous perversity

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Infantile Sexuality

• Develops through stages toward normal adult
  heterosexuality
• Oral ? Anal ? Phallic / Oedipal
• Early developments must be repressed sublimated

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Oral Stage (birth 2)

• nursing, sucking
• pleasure lips mouth satiety
• anxiety hunger, abandonment
• Oral character
• Anxiety about nurturance, separation
• Eating, smoking, drinking to calm anxiety
• Passivity Dependency

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Anal Stage (2 4)

• Defecation (control of sphincter)
• Pleasure sensation of defecating, making
  messes, defiance
• Anxiety dirtying, loss of control, chaos, fear
  of punishment
• Anal character
• Order, control, cleanliness, neatness
• Constrictive / impulsive emotional style

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Phallic / Oedipal Stage (5 7)

• Attachment to mother sexualized
• Punitive father threatens attachment to /
  dependence on mother
• Threat experienced as castration anxiety
• Sexualized attachment to mother repressed
• Identification with father masculinity

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Boys Oedipal Complex

• Accept as correct?
• Reject as wrong?
• Describes psychological consequences of
  authoritarian fathering?

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Girls Oedipal Complex?

• Discovery of castration
• Rejection of mother sexualized attachment to
  father (with unconscious wish for penis)
• Shift of attachment from father to man
• Wish for penis becomes wish for baby
• Re-identification with mother

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Girls Oedipal Complex

• Accept as correct?
• Reject as wrong?
• Describes psych. consequences of patriarchal
  power?

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Oedipal Conflict Resolution

• polymorphous perverse erotism repressed
• ( bisexuality, oral/anal, masturbation, etc. )
• Identification with same-sex parent
• ? ideal authority internalized as conscience
• Societal authorities prohibitions internalized
• ( God country king / premier / sultan /
  fuhrer )
• Personality crystallizes

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Post-Oedipal Development

• Latency 7 12 sexuality repressed
• Puberty 13 - 15 re-awakens Oedipal (and
  possibly pre-Oedipal) conflicts
• ? adolescent rebellion acting out

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Freud A Cultural Psychology?
U.S. vs. 72 non-Western cultures early 1950s