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[p. 292]
OVER and again we have asserted that the mischief—making complex must be located and disposed of as a part of the speedy and permanent cure of so-called nervous disorders—the neuroses—and so this chapter will be devoted to describing the methods which are employed in locating and disposing of these trouble-makers.
1. Direct methods of complex-hunting—Sometimes the medical psychologist feels impelled to employ one of three direct methods in endeavoring to locate trouble-making complexesthat is, when such methods are possible of employment. These so-called direct methods embrace crystal-gazing, automatic writing, and hypnosis. In my opinion it is seldom necessary to resort to any of these, and except in the more serious manifestations of double personality and hysteria, I seriously doubt the wisdom of resorting to hypnosis as a part of the effort to perfect the diagnosis. I have no desire to question the possibilities of hypnotism, both in diagnosis and, to a limited extent, in the treatment of some of these disorders; but I believe that we have equally good, if not more efficient, methods of exploring and training the human mind, which are at the same time entirely free from the objections which may be attached to hypnotism.
Automatic writing, of course, along with crystal-gazing, can be employed only in patients addicted to such anomalies. It would therefore appear that the so-called direct methods of searching for the complex are not those which will be most commonly used in our every-day effort to help the average nervous sufferer.
2. Indirect methods of complex-hunting—Of the various indirect methods of looking for complexes, the one we are probably most familiar with is the study and analysis of dreams; and while I cannot go all the way with Professor Freud in his claims of ability to get to the bottom of most cases of emotional suppression by the analysis of dream-life, I believe that we would do well systematically and painstakingly to inquire into the nature of our patients’ dreams. We often get valuable hints from the dream-life of these nervous sufferers, particularly from dreams that are recurrent. It is highly probable that the inhibiting mechanism—the so-called censor—is much less active during sleep, so that if we can penetrate the symbolism and the conglomerate confusion of dreams, we are often able to possess ourselves of invaluable information as to the basic nature of the patient’s trouble.
Another indirect method of complex-hunting is what is commonly known as the free association test—altho it is ofttimes almost anything but free association, since the very suggestions given out by the doctor so many times influence the patient in carrying out this program. The free association method consists essentially in a program of first getting acquainted with the patient in a succession of conferences, and then encouraging him to talk out his thoughts and troubles fully and freely. The sufferer is allowed to rest in a comfortable chair and is asked to talk about himself, his fears, his worries; he is told to be unsparing of [p. 293] himself, to lay all pride aside, and tell the doctor all that enters consciousness respecting the subject under discussion.
This method is, on the whole, very successful; if the physician is wise and experienced, and is careful in collecting and classifying this material, in time he comes to possess himself of a fairly complete picture of what has been going on in his patient’s mind. It is in reality the talking cure.
Then we have the method of arbitrarily stimulated association, the employment of various stimulus words. The technique of this procedure consists in getting the patient comfortably seated in the office and then, with an ordinary stop-watch in hand, testing him with a list of specially selected words or with some standardized group of words, such as Eder’s list; he is asked to say the word which comes up in his mind, the very first word which is suggested to his consciousness, when he hears one of these test words. It will be found that the average person will develop an individual reaction-time, which ordinarily runs from one and one-half to two seconds; but when a word comes up which is in any way associated, directly or indirectly, with his buried complex, he is liable to delay the reaction-time; the delay is usually so marked that it calls immediate attention to the fact that this word is probably associated with the seat of his troubles.
A few days ago we had a case in which the patient was running right along on average time— 1.5 seconds—and when we struck the word that was associated with his undiscovered complex he became paralyzed, as far as speech was concerned—in fact, could not think of anything for half a minute. It was a very marked demonstration of the value of this method, especially in certain types of patients. The standardized list of one hundred words, which we so often use for this purpose (Eder’s List[1]), is as follows:
| 1. head | 26. blue | 51. frog | 76. wait |
| 2. green | 27. lamp | 52. try | 77. cow |
| 3. water | 28. carry | 53. hunger | 78. name |
| 4. sing | 29. bread | 54. white | 79. luck |
| 5. dead | 30. rich | 55. child | 80. say |
| 6. long | 31. tree | 56. speak | 81. table |
| 7. ship | 32. jump | 57. pencil | 82. naughty |
| 8. make | 33. pity | 58. sad | 83. brother |
| 9. woman | 34. yellow | 59. plum | 84. afraid |
| 10. friendly | 35. street | 60. marry | 85. love |
| 11. bake | 36. bury | 61. home | 86. chair |
| 12. ask | 37. salt | 62. nasty | 87. worry |
| 13. cold | 38. new | 63. glass | 88. kiss |
| 14. stalk | 39. habit | 64. fight | 89. bride |
| 15. dance | 40. pray | 65. wool | 90. clean |
| 16. village | 41. money | 66. big | 91. bag |
| 17. pond | 42. silly | 67. carrot | 92. choice |
| 18. sick | 43. book | 68. give | 93. bed |
| 19. pride | 44. despise | 69. doctor | 94. pleased |
| 20. bring | 45. finger | 70. frosty | 95. happy |
| 21. ink | 46. jolly | 71. flower | 96. shut |
| 22. angry | 47. bird | 72. beat | 97. wound |
| 23. needle | 48. walk | 73. box | 98. evil |
| 24. swim | 49. paper | 74. old | 99. door |
| 25. go | 50. wicked | 75. family | 100. insult |
[p. 294]
The writing cure is another method which has been employed advantageously in a certain type of cases. Every now and then I run across a patient who does not talk freely, but who, the moment he leaves the office, thinks of things he should have brought to my attention—topics which he much desired to discuss. I teach these patients to bring memoranda with them to the office for discussion, and in certain types, where there seems to be a desire to write, I encourage them to write out everything that is going through their minds—to practise thus a sort of psycho-motor catharsis. It seems to do them a great deal of good, and they sometimes write out one hundred pages of manuscript a day. While it takes time to read this material, it proves to be of immense help in analyzing the patient’s emotional life. I have come to depend a great deal, in certain cases, upon the help of this writing proclivity.
To sum up: the group of indirect methods of complex-exploration includes dreamanalysis, free association, controlled association, and writing.
Perhaps it would be in order to explain more fully what happens in the case of the word-association test or the controlled association probe of the mind when relevant data are contacted with. How do we know, in testing out a patient, when we have struck a word that is associated in some way with his buried complex? We have already mentioned the fact of prolonged association-time. We should also call attention to the fact that sometimes, when we strike a lead during this test, the subject will repeat the stimulus word. We are, for instance, using “man” as the test word. Instead of expressing the word suggested by man, the patient will simply repeat “man” one or more times. This sometimes indicates that you have struck a line of thought which leads directly to the buried complex.
We also suspect that we are getting warm on the trail of the complex when the patient responds with a very unusual word, especially if there is a delay in this response. More particularly are we impressed with the close proximity of the hidden complex when the patient fails to respond to the test word—at least for one-half minute or more. We likewise suspect that we are on the trail when the patient responds with two or more words and seems a bit over-anxious to impress us with his ability to respond to that particular test word. There is also sometimes significance to be attached to a pretended misunderstanding of the stimulus word, and some investigators think there is significance to be attached to the interpolation of “yes” or some other exclamation, either before or after the reaction.
[p. 295]
When you are nearing the buried complex, some individuals show a tendency to repeat the response to the preceding stimulus word, and in that way spar for time to avoid responding to the stimulus word which is associated with their offending complex. Sometimes there is a tendency to whisper the response to the stimulus word that is in complex association, and in certain highly hysteric individuals there may be laughter, crying, coughing, or stammering, in the response. We also notice in some cases, when we strike a word that has to do with a hidden complex, that the patient will look around quickly and name some object that is within sight in the room, obviously a word having no connection whatever with the stimulus word.
This method of going on the trail of a complex and endeavoring to locate it by word association is not altogether easy, and is not invariably successful, especially in the hands of a novice; but it is of great value in many cases, and is a part of the technique which every psychotherapist employs in his effort to run down hidden and mischief—making constellations and complexes. One thing we should emphasize, and that is that there is no standardized pattern of reaction for different sorts of nervous disorders. There is no typical method of reacting for hysteria, dementia præcox, etc.
All these methods of exploring the mind are limited, not only by the skill and experience of the operator, but by the suggestibility and temperamental type of the patient. One of the reasons why hypnotism has fallen into the discard as a method of exploring the mind is that its very technique contributes to the suggestibility of the patient. You are liable to get what you are looking for—to find what you expect—because you have made the patient more suggestible; he has to be amenable to suggestion to be under the influence of hypnosis. So in all these methods there is to some degree this tendency on the part of the patient to give the doctor what he is looking for—thus yielding to suggestibility.
I have found it very valuable to check up all this work in the psychologic laboratory with as many tests as possible, using instruments of precision. Many years ago I devised a group of tests which can be varied and which are of great value in helping us to check our observations; in this way the laboratory work contributes to the stabilization of our less precise methods of study and observation.
We must not overlook the fact that there may be very little difference between a normal complex and a morbid, mischief-making complex; for the normal mind is filled with an enormous number of normal associations of this sort, altho they vary in accordance with the individual’s tastes and temperament. There is a vast difference between the complex that is built up around the love of a woman and the complex centering upon a love of languages or a hatred of chemistry or physics. Yet all these are normal. We build up such mental associations in accordance with our likes and dislikes.
One of the earmarks of the morbid complex is an abnormal tendency of the patient to forget it; it cannot be voluntarily recalled in a short time. There is a definite and persistent tendency on the part of the subconscious to crowd the memory of it down into a psychic [p. 296] corner where, altho we cannot recall it, it can continue to exist and become more and more potent for mischief. In other words, while the buried complex is not voluntarily recallable, it continues to influence our psychic state and daily life, as well as to crowd itself into our dreams. In fact, it would seem that the more deeply and successfully these complexes are buried, the more likely they are to seek gratification and manifestation in the dream-life.
It would thus appear that the abnormal or buried complex requires outside help to effect its resurrection and final elimination. We usually find that these morbid complexes are associated with some of the master emotional urges, one or another of our five so-called life-drives.
The shell-shock neuroses observed during and immediately following the World War afforded final and conclusive proof that not all neurotic symptoms are of sex origin; subsequent study of this question has shown that the desire for power, the superiority complex, may sometimes be the overdevelopment of a perfectly normal defense reaction against a pre-existing inferiority complex. We know that many times the inferiority complex is set up by the fact that an individual is small in stature, has poor health, or has other defects of development in limb or organ. Someone has suggested that anti-vivisectionists are simply an illustration of a defense reaction against the primitive urge of cruelty.
We observe the tendency on the part of many neurotics to seek out special healers and irregular practitioners because they dread going to a regular and competent physician, who will either ridicule their miseries or, more likely, tell them the plain and frank truth. No doubt the prosperity of the healing cults is in a considerable measure due to this defense reaction on the part of neurotics, who are trying to dodge the real truth about themselves. I think there is little doubt that substitution and compensation, in a certain measure, really tend to prevent many a disagreeable complex from coming up into the consciousness. They are, after all, a subtle form of defense reaction.
Patients can do very much that is helpful, if they are disposed to be thoroughly frank with themselves, in analyzing their own emotional life. It is impossible, of course, for any of us to have the gift of seeing ourselves as others see us; but neurotic sufferers, if they get a start in the right direction, may go far toward solving their own puzzles.
In this connection it may be observed that the technique of self-analysis may tend to make the patient introspective, to lead him into the habit of spying upon himself. This possible objection is quickly answered by the fact that neurotic sufferers are already introspective, sometimes almost to the point of hypochondria. We are merely teaching them how to think about themselves truthfully and logically instead of indulging in groundless fears and self-sympathy; we are merely substituting a helpful, controlled, and well-directed form of self-analysis for the “wild and woozy” self-consciousness they have been in the habit of indulging.
When once started on a program of self-analysis you should make a careful written notation of all situations which stimulate or tend to bring about, or contribute to, your [p. 297] unpleasant and objectionable nervous reaction, whether that reaction be temper, depression, anxiety, or what not. Sit down and make a note of every recent appearance of the objectionable emotional reaction. Study the antecedents of these occasions. See if you can locate what led up to each explosion, each particular emotional sprawl, of the kind of which you have elected to cure yourself. Set down the particular words, the exact moment, and the actual situation of this pre-temper or pre-depression reaction. Carefully study what you were doing and in just what state of mind you were at the time the undesirable nervous manifestation made its appearance.
If you are going to practise self-analysis I would suggest that you spend one-half to three-quarters of an hour daily in letting your consciousness soar aimlessly while you gently guide it back into your past life and observe what channels it see ms to drift into. Note where it pauses, observe what it tends to gravitate toward, and in this way you may gain helpful hints as to the real nature of your nervous troubles. Look back into your early life and frankly endeavor to recognize your earliest emotional shocks, serious disappointments, strong resentments; seek to identify your very early loves and hates, as well as to isolate your early ambitions and more profound nervous disturbances.
Make a careful study of your individual technique for formulating excuses for yourselfyour alibis. Become increasingly skillful in detecting the tendency to camouflage; in other words, develop a technique of fairness in dealing with yourself, in observing and classifying your psychic reactions and emotional behavior. The real secret of self-analysis consists in being wholly frank and honest with yourself, in being true and sincere, willing to face the facts and react to the demands and difficulties of a real world as a real man or a real woman.
Self-understanding is an indispensable pre requisite to self-treatment and self-cure. No patient can sincerely and effectively ridicule his fears unless he really and truly understands the nature and origin of these fears. Thoroughgoing explanation must precede all attempts on the part of the patient intelligently to treat himself and otherwise to bring about those adjustments which are so essential to permanency of cure in the case of these functional nervous disorders, the so-called psychoneuroses.
Every human being craves not only sympathy but recognition in some line of human endeavor. We all enjoy the idea of being distinguished, and so sometimes when we fail to hear the applause of our friends—when we find we are not distinguished in any of the ordinary channels of human endeavor, and at the same time are facing extraordinary difficulties—we are able to avoid the unpleasant realities, and to enjoy sympathy and distinction, by developing a first-class honest-to-goodness case of so-called nervous breakdown. In still other cases, disappointed and depressed individuals develop a group of physical symptoms which are more or less puzzling to the average physician, and thus they achieve a kind of distinction as semi-invalids and chronic ailers. It cannot be doubted that certain types of neurotics really come to enjoy this sort of poor health, and take pleasure in going about reciting their miseries to the doctor and telling their friends about their unique nervous disorders.
[p. 298]
These neurotic symptoms, if properly organized and exploited, serve not only to enable the ir owners to retreat from the difficulties and responsibilities of real life, but provide a host of sympathetic friends and neighbors, and gratify, in some measure, at least, a trio of commonplace human desires, namely:
The wise physician is always engaged in giving his patients suggestions, whether he is aware of it or not. There is suggestion value in the very attitude of the patient coming as a pupil to the doctor as a teacher. But suggestion is only of temporary value in dealing with mental and nervous disorders; the real cure consists in finding out the truth and facing it, and then reeducating and retraining, putting in the place of these undesirable and unreliable reactions, desirable and wholesome methods of viewing life and reacting to one’s environment.
If suggestion is going to be practised, there is no reason why the patient shouldn’t learn to talk to himself in this transiently helpful way. But there is one thing we may be sure of, and that is that passive and half-hearted suggestions are not going to get very far in the presence of real and long-established fear complexes. If your phobias and fears have reached the place where they may be recognized as a complex, if they are able to produce physical symptoms, if there is a definite emotional tone in their arousal, then you will not be able to do very much with suggestion and reasoning, whether you attempt it on yourself or whether the doctor endeavors to apply it.
Man, after all, is ruled by his heart and not by his head. I have learned that I can reason with purely intellectual fears, superstitions and hoodoos-I can talk my patient out of a certain type of fear or phobia; but when the fear has been long established, in brief, when fear has an emotional consort—then it is not immediately subject to reason. If your emotions are hooked up with your fears, it will require education and reeducation, training and retraining —in fact, there must be a radical reconstruction, resulting finally in the displacement of the morbid complex by an effectively acting normal complex. After all, faith is the only known cure for fear.
Of course, autosuggestion works best in those cases where the patient most perfectly understands the nature of his trouble and most sincerely and honestly desires to effect a cure. And we must remember the great value of imagination in dealing with these nervous disorders. You are not going to accomplish so much by the exercise of sheer will power as by cultivating decision and utilizing the great power of imagination, really acting the part of the victor for the time being; and then, in time, you will actually come to enjoy and experience those things which at first you merely pretended.
[p. 299]
Before the days of Freud, psychotherapists depended almost exclusively on hypnotism to locate the offending complex. Freud made one advance, at least, in that he got away from hypnotism, tho in my opinion he depended too much upon dreams. We have all come to accept many of Freud’s ideas of repression, conflict, transference, and so on, even tho we reject his hypothesis of the libido and are not disposed to believe in his theory of the almost exclusive sex nature of our psychic conflicts.
Following Freud came Jung with his extravert and introvert theories, the extravert being one who fundamentally functions by feelings, and the introvert one who is more or less preoccupied with his purely thought life. Jung postulated a conflict between these two types, and sought for the trouble in the present conflict and not so much in the past life, as Freud was wont to do.
So we have come up through a metamorphosis in the matter of emotional study. Freud sought to bracket everything in life as pleasure—the avoidance of pain. Jung laid emphasis on adaptation to conditions of life, self-preservation; and Adler followed with his hypothesis of the power urge. I have, of course, made it clear in a former chapter that I have lately come to group my patients’ conflicts into five grand divisions—the life urge, the sex urge, the power urge, the religious urge, and the social urge.
Reeducation is merely the term we have come to employ to embrace all the methods which are used in getting the patient out of the dominance of these morbid complexes and back into normal reactions and relations to life. We find it necessary to teach our patients to think accurately and sincerely, to be honest with themselves, largely to cease day-dreaming and get down to “brass tacks”; to meet difficulties squarely and to face obstacles bravely. In other words, what we are aiming at is the development of stamina.
We start out with the idea of training these wabbly, nervous individuals to accept the idea that there is far more real pleasure in directive thinking and actual achievement—in meeting the difficulties of life and surmounting them—than in day-dreaming and the shirking of responsibility.
Of course, we all want periods of freedom from responsibility. We want our week-end relaxation and our annual vacations, holidays, etc. They are all efforts to get away from the stress and strain of our complex modern life. We also seek for relief of this nature in novel reading and attendance upon the theater. It is only the abnormal indulgence of the fantasy-life that must be combated.
This reeducation or reconstruction consists, briefly, in training the patient in the art of getting pleasure out of the reality of performance and achievement, in place of seeking for it in the indulgence of fantasy. It is in connection with this desire to be enlisted in the attainment of an ideal—this perfection-hunger which is so laudable and which we all have more or less—that religion serves a great purpose in inspiring us with the ideal of infinity in our efforts at perfection attainment, inasmuch as it exhorts us to be “perfect even as our Father in Heaven is perfect.”
[p. 300]
As we grow up we must do something to deliver ourselves from the fetters of the more or less Narcissistic view of life, in which we were the center of things, and in which we could, in fancy, realize the fulfillment of every wish. Sooner or later we must distinguish between the possible and the impossible, become reconciled to the actual conditions of life, reckon with the fact of time, formulate long-distance plans, and learn to carry on a protracted struggle to realize our ambitions. No longer can we rub Aladdin’s lamp and have one of the genii come forth to do our bidding and enable us to realize our dreams, regardless of time, space, and circumstance.
One of the most important things for the nervous patient to learn is to have a real object in life, to have a well-formulated plan for attaining this goal, and then to stay on the job and see it through; of course, this aim must be one that is not only possible but reasonably probable; and it is a good plan for the average nervous individual to have two objects-an immediate and a remote one-and to lay plans for the attainment of both. These two aims should be more or less in harmony and largely reciprocal.
In selecting an objective in life, get one that is not only possible, but possible for you. Too many heartbreaks come to nervous people because they have tried to play the rôle of a round peg in a square hole. If you have not been able to choose a program, write down all the things you would like to do, then take hold of the problem in a “hard boiled” way and check off those that are impossible for you; question-mark those that are improbable, eliminate those that are conflicting, decide which you can and should attempt, and thus make an end of traveling around in circles and indulging in vain wishes and impossible fancies. Get down to business, go into action, start somewhere, and, having decided what is your proper goal, keep your eyes on it until you arrive.
“What are you going to do?” I asked a woman who had experienced twelve or fifteen years of failure, tho she had a college education. “I just don’t know,” she said. I got her to write down a few things she would like to do, and she wrote—“study medicine,” “teach school,” “take up music,” “be a private secretary.” But she had no good reason for these choices. When I asked her why she wanted to study medicine, she said it was an honorable profession, everyone respected a doctor and if she could get hold of some wealthy patients she might make money quickly, and then she could travel and see the world. There you go! Trying to plant a crop one day and reap the harvest the next. This woman was not choosing sanely and reasonably; she was not allowing a sufficient interval between seed-time and harvest. Her reason for taking up music was that she had some little ability, that some rich person might get interested in her and finance her, and then she could sing in grand opera. There it is again—no real reason—just fantasy! Fairy stories lived over again in adult life. She had more reason for selecting teaching. It was the only honest choice in the whole group. Her only reason for wanting to be a private secretary (and she would not admit this at first) was that she might get a job with some millionaire or great business man who might be a bachelor or a widower, and might fall in love with her and marry her, and then all her problems would be solved. She would have a home and freedom from responsibility.
[p. 301]
The purpose of repeating this unfortunate woman’s experience is merely to show how not to start the program of reeducation when it comes to the subjugation of nerves. The conquest of nerves is to be effected by real, honest, sincere thinking—by practical planning, and by persistently carrying forward these plans regardless of obstacles—until in the end we acquire the habit of successfully reacting to our environment. There is no other way of achieving what we call stamina—of developing a strong character.
This is where Jung and others improved upon Freud, who thought that a patient could be cured by merely discovering the buried com plex—by what he calls psychic catharsis. Jung, Dubois and others have more properly insisted upon the importance of reeducation, of getting the patient away from his distressing life and into an ordinary and practical technique of living.
In order successfully to master these neurotic complexes, the victim of nerves must make up his mind to understand himself thoroughly. The habit of dodging all undesirable thoughts and feelings must be abandoned. There must be an expansion of the idea of the conscious grasp of the personality. These nervous people must make up their minds to become masters of themselves, psychically and emotionally. They must not allow the knowledge of defects to breed within them either an inferiority complex, or, as a defense reaction, an obnoxious superiority complex.
Knowing ourselves as we really are, and notwithstanding our defects or mediocrity, we should accept the facts bravely and turn right around to master the situation, play the game, and not bewail the handicap. We should capitalize the abilities we have and learn how to make the best of them. An important step toward that end is learning to give up all sham and pretension. Thousands of people would immediately augment both the ir happiness and health if they would quit putting on an artificial front, indulging in so much sham and pretense.
From Studies in Word Association, by C. G. Jung; published by Dodd, Mead & Co., Inc. ↩︎