The Case for Psycho-Analysis
By C. E. M. JOAD 'rum flood of books on psycho-analysis with which these islands were inundated a few years ago is now happily receding from our shores. In America, however, it is still in full spate, and it appears recently to have reached the Colonies. On no other assumption is it possible to account for the fact that a course of lectures on psycho-analysis should have been given under the auspices of the Depart- ment of Philosophy of the University of Witwatersrand, a course which forms the basis of Dr. Sachs's recently pub- lished work. They seem to have been good lectures, and that they should have been given is all to the good. But why was the Department of Philosophy invoked to sponsor them ?
The rambling and ambiguous structure of psycho-analysis possesses two outstanding features, neither of which has the remotest connexion with philosophy. First, there is its origin in medical practice. Psycho-analysis, as Dr. Sachs does well to emphasize, began as a school of psychiatry, not as a department of psychology. On the contrary, it ignores academic psychology, dispenses with the laboratory of the psychological experimentalist, disavows mental tests, dis- dains to put rats in mazes or kittens in cages, and does not scrutinize the saliva of dogs. When it recognizes the existence of academic psychology at all, it does so only to denounce it for its vicious intellectualism.
As a movement within psychiatry, psycho-analysis wages war against materialism in all its forms. You cannot, it insists, explain mental and nervous disorders in terms of bodily occurrences ; or very rarely. There is no necessary lesion in the brain of a madman, no observable abnormality in the nervous system of a neurotic; at least, there need not be. What distinguishes the madman or the neurotic are faulty habits of thought and action, inadequate organization of will, lack of emotional balance. But the psycho-analyst does not stop here. He carries the war into the enemy's territory and proceeds to interpret bodily in terms of mental disturbances. Illness, he insists, is properly to be regarded as a form of escape from life, more particularly as a way of resolving a conflict between two principles—the pleasure principle (our demand for the immediate gratification of our impulses) and the reality principle (the obstacles in the external world which thwart our demand)—which has become too acute to be tolerated. As Dr. Sachs puts it, " a neurotic symptom . . . is an abnormal outlet for thwarted instinctual energy, repressed wishes, and anxiety and fear associated with such conditions." Now from this point of view many, some hold all, bodily disorders may be regarded as " neurotic symptoms." The statement sounds on the face of it rather startling. Is a corn, one wonders, a symptom of an inadequate reaction to life and not, as it appears to be, a response to an ill-fitting boot ? But the apparent wildness of some psycho- analytical assertions is mitigated when we remember that their background is a complete denial of the common-sense distinction between mind and body, a distinction upon which the division of disorders into two categories, psychological and physiological, ultimately rests.
That disorders of the body may originate in the mind, as when we become ill through worry, or of the mind in the body, as when, having had sleepy sickness, we find that our moral character deteriorates and that we are unable to keep our hands from picking and stealing, has, of course, always been widely recognized. But psycho-analysis goes further and insists that, in so far as disorders are concerned, body and mind are literally indistinguishable. The process which we know as bodily illness is, it asserts, in its origin and interpretation the same as the process which we know as nervous breakdown ; it is fundamentally an escape from an intolerable psychological situation.
Dr. Sacks urges this point with considerable force. Young men, he assures us, contract venereal diseases as a form of self-punishment for sin ; they even apparently contrive to get run over for the same reason : " Many accidents have the same psychological basis of seeking for suffering and self-
Psycho-Analysis : Its Meaning and Practical Applications. By Wulf Sachs, M.D. (Cassell. 6s.) punishment." Possibly : possibly not ! But Freud has at least this to his credit, that he has disabused medical prac- titioners once and for all of the old-fashioned notion that there is a category of bodily diseases such that, when you have them, you are really ill, and another category of functional diseases such that, when you have them, you are not malty ill but only think you are. Insisting on a monistic view of the human organism, insisting that is to say, on treating body and mind as a single whole, Freud discards the distinction as inadmissible.
So far he is in line with the general trend of modern thought. Mind-body interaction is a fact of every day experience ; if I am nervous, I turn pale ; if angry, pink. If I have too much to drink, I see two lamp-posts instead of one ; if too much to eat, I suffer from nightmare and the " blues." The mind, in short, influences the body, the body the mind. Yet, if they are treated as two distinct entities or substances, it is impossible to understand how such interaction could occur. The body is matter possessing the usual attributes of matter, weight, shape, position in space and the rest. The mind is usually conceived as shape- less, weightless and spaceless. Ilow, then, bring two such disparate substances together ?
It is from this difficulty that the modern conception of " mind-body " as a single whole arises. In the light of this conception many of Freud's paradoxes become intelli- gible. To think you are ill, in short, is to be ill, and the valetudinarian deserves more sympathy than he usually receives.
It is from this point of view that the unconscious is most fruitfully to be regarded. Something, it is agreed, " goes on " in our personalities of whose " goings on" we are unaware. We can only note their results. How are we to conceive this something ? Before Freud the attempt was usually made on physiological lines. Psychologists and physiologists alike spoke of underlying tensions, patterns and settings of the nervous system, traumata and lesions. The attempt was not very successful. Try to think of an unconscious motive in physiological terms and the invocation of even the most complex system of neurones will afford you little assistance. A neurone, in fact, simply will not do. The concept of the " unconscious " is thus in origin and essence nothing more nor less than the outcome of the need to stick to psychological terms when travelling outside the limits of conscious experi- ence. As such it is a tool which has been found to be of great therapeutic value. Pragmatically the unconscious is above reproach.
Would that it had remained pragmatic. But it has not. For the second outstanding feature of psycho-analysis is the eagerness with which the vulgar have rushed to embrace it. For this eagerness there is, as Dr. Sachs points out, a perfectly good psycho-analytical interpretation. Most of us live dull and uneventful lives. Nevertheless, we like to think that we are gay dogs at heart who could be desperately wicked if we let ourselves go. Under the influence of psycho-analysis people have been induced to conceive of the unconscious as a sort of underground prisoner living in a dungeon, breaking out at long intervals upon our daylight respectability with dark groans and strange atavistic lusts. At least, he would break out were it not for the iron strength of our self- control.
These conceptions have no doubt given pleasure to many persons of the most blameless morality and afforded them some consolation for the irreproachable dullness of their lives. They are, of course, a travesty of psycho-analysis ; yet it cannot be denied that for this travesty Freud no less than his interpreters must accept his share of responsibility. There is something ghoulish in this popular excitement, and psycho- analysts have not always resisted the temptation to pander to it. It is to Dr. Sachs's credit that he has on the whole resisted it, and although the claims which he makes for psycho-analysis are at times exaggerated, his book constitutes as reasonably sober and moderate a statement of the case as any with which I am acquainted.
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