The surprising origin of psychotherapy
Today I will meet my therapist and improve my self!
This is an assertion whose enabling conditions have a surprising history. Meeting someone with the intention of fixing your soul (your brain, your compulsive desiring and meaning-making) rests on a tall stack of historical preconditions.
Entering into communication for the purpose of fixing the self (qua object) did not evolve from meetings for advice or counsel, from the helping and problem solving that goes on inside the typical advice-giving session. Rather, it began as a neurological ambition.
Ideally, the soul-fixing encounter would be a meeting between an engineer and a brain. The best procedure would circumvent the subject, with all its self-delusions, and deal with a physical object that is causally determined and subject to known physical laws. That was Freud’s ambition when he went to school.
Sadly, reliably reengineering the self by physical manipulation cannot be done, even today. But what if we could trick the person to speak on behalf of the brain? What if we could give the brain a voice and in this way diagnose the problem not as a molecular process but as something man-sized that we can handle with the man-sized granularity of language? What if we could put talk in the service of microscopy?
When Freud visited Bernheim in 1889, psychotherapy was hypnotherapy. After certain events, Freud wondered if he could do psychotherapy without inducing hypnotic trance. That is: he wondered if he could access the unconscious directly through consciousness rather than by means of hypnotic trance.
What events? Freud brought one of his patients (Anna von Lieben) to Nancy to be hypnotized by Bernheim. Bernheim failed, and his explanation was that rich and educated people were harder to hypnotize. The best patients were poor, rural, and uneducated because they have been socialized to be obedient and passive and also hold physicians in awe. More evidence that hypnosis itself is suggestion.
So it looks like Freud’s choice to abandon hypnosis was a practical solution to a practical problem—smart rich people were not easy to hypnotize. In order to keep his business open, he had to modify his technique.
Freud found avenue for effective yet non-hypnotic practice in Bernheim’s confession that post-hypnotic amnesia (the very distinguishing essence of proper hypnotic induction) was not hard and fast. In every case, the supposedly inaccessible memories could be accessed if you pushed the patient hard enough:
The abandonment of hypnosis seem to make the situation hopeless, until [I] recalled a remark of Bernheim’s to the effect that that things that had been experienced in a state of somnambulism were only apparently forgotten and that they could be brought into recollection at any time if the physician insisted forcibly enough that the patient knew them. (Freud 1922)
With this opening, psychoanalysis was invented:
The writer therefore endeavored to insist on his unhypnotized patients giving him their associations, so that from the material thus provided he might find the path leading to what had been forgotten or fended off. He noticed later that the insistence was unnecessary and that copious ideas almost always arose in the patient’s mind, but that they were held back from being communicated and even from becoming conscious by certain objections put by the patient in his own way. It was to be expected—though this was still unproved and not until later confirmed by wide experience—that everything that occurred to a patient setting out from a particular starting-point must also stand in an internal connection with that starting-point; hence arose the technique of educating the patient to give up the whole of his critical attitude and of making use of the material which was thus brought to light for the purpose of uncovering the connections that were being sought. A strong belief in the strict determination of mental events certainly played a part in the choice of this technique as a substitute for hypnosis. (Freud 1922)
Freud’s early failures to access hidden causes of suffering were overcome by pressuring his patients to announce whatever came to mind—no matter how trivial. The force he was fighting was none other than the patients’ own resistance to therapy.
Free irruption, applied to suffering, will naturally descend to that suffering’s roots. This idea is, of course, fallacious. Saying that irrupted images or stories are disclosive of true causes is just as ridiculous as LRH saying that any past life memory recalled during backwards time track journeying carry their own validity.
By approaching irruption as symptomatic of underlying causes, a whole new game emerged. Instead of catharsis, there was symptom-expression, and everything said was a puzzle. This new relation of the hypnotist to the patient was so new, Freud said, it deserved a new name:
The new technique altered the picture of the treatment so greatly, brought the physician into such a new relation to the patient and produced so many surprising results that it seemed justifiable to distinguish the procedure from the cathartic method by giving it a new name. The present writer gave this method of treatment, which could now be extended to many other forms of neurotic disorder, the name of psycho-analysis.