A
ABASIA
Ger.: Abasie. – Sp.: abasia. – Fr.: abasie. – It.: abasia. – Port.: abasia.
This term refers to a type of affection characteristic of conversion hysteria*, although it is also found in some neurological disorders. It consists of great difficulty in walking which may even make it absolutely impossible even without paralysis of the lower limbs, the patient being able to perform correctly other types of movement. It is the predominant symptom* of Elisabeth von R.*, one of the most famous patients of Freud’s early period.
[Fräulein Elisabeth von R.] … had been suffering for more than two years from pains in her legs and … had difficulties in walking … She walked with the upper part of her body bent forward, but without making use of any support. Her gait was not of any recognized pathological type, and moreover was by no means strikingly bad. All that was apparent was that she complained of great pain in walking and of being quickly overcome by fatigue both in walking and in standing, and that after a short time she had to rest, which lessened the pains but did not do away with them altogether. The pain was of an indefinite character; I gathered that it was something in the nature of a painful fatigue. A fairly large, ill-defined area of the anterior surface of the right thigh was indicated as the focus of the pains, from which they most often radiated and where they reached their greatest intensity. In this area the skin and muscles were also particularly sensitive to pressure and pinching (though the prick of a needle was, if anything, met with a certain amount of unconcern). This hyperalgesia of the skin and muscles was not restricted to this area but could be observed more or less over the whole of both legs. The muscles were perhaps even more sensitive to pain than the skin; but there could be no question that the thighs were the parts most sensitive to both these kinds of pain. The motor power of the legs could not be described as small, and the reflexes were of medium strength. There were no other symptoms, so that there was no ground for suspecting the presence of any serious organic affection. The disorder had developed gradually during the previous two years and varied greatly in intensity.
(1895d, pp. 135–6)
In the case history of “Elisabeth von R.”, Freud was able to reconstruct quite exhaustively each element of hysterical conversion corresponding to its associative part and to connect them with different moments in which, through those elements, hysterogenic zones* had formed a certain type of connection with her sister’s husband. All formed part of a global incestuous phantasy, far from the conscious, in the relationship with this brother-in-law towards which her paralysis symbolically expressed a linguistic expression: “not being able to take a single step forward” (1895d, p. 176).
During treatment the cure of hysterical symptoms is produced when all these traumatic events (in this case conflictive rather than traumatic) return to conscious memory cathected with moments of libidinal hyperexcitation (the subject’s hyperexcitability could make them traumatic) as proof of their participation in a global incestuous idea (hyperexcitation is therefore produced by the incestuous character of primarily repressed infantile sexuality*).
Through analysis, the symptom’s meaning enters the secondary process*, after which the wish* may be expressed in words and discharged by abreaction*. Consequently, symptomatic bodily expression is no longer necessary.
The symptom’s meaning has two aspects: as a mnemic symbol* of events that produced excitation or contiguities with it, leaving behind hyperalgesia or anaesthesia in these hysterogenic zones. The other aspect is its global quality, its blocking action as an anticathexis* of the incestuous wish of which love for her brother-in-law is a derivative too close for the patient’s psyche. Her astasia-abasia, a motor disorder opposing the repressed wish, corresponds to this fact. It is a metaphor whose meaning is the opposite of satisfaction of the wish, in favour of defensive ego repression*.
ABREACTION
Ger.: Abreagieren. – Sp.: abreacción. – Fr.: abréaction. – It.: abreazione. – Port.: ab-reação.
This is the major mechanism of the psychotherapeutic cure proposed by Breuer and Freud in the “Preliminary Communication” (On the Psychical Mechanism of Hysterical Phenomena: Preliminary Communication, 1893).
The cure consisted basically of verbal expression of the repressed traumatic event associated with liberation of the affect* repressed at the time of the trauma*, neither of which was accessible to memory* in normal waking life. To induce their re-experience, the technique most utilized was hypnosis:
each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words.
(S.E. 2, p. 6)
Abreaction consisted of discharge of the retained affect together with the presentation* responsible for it, which had been separated from the conscious* when the symptom* formed, at which time it was relegated to a “second consciousness”. It was retrieved through hypnosis. When the traumatic scene was then remembered and verbalized, the corresponding affect that for different causes had not been discharged at the time was “abreacted”.
Once the affect has been obtained, the traumatic scene loses its pathogenic value, becoming identical to another presentation, and the symptom consequently ceases.
We therefore define abreaction as an actual affective discharge produced during the cure of an affect corresponding to a psychical trauma from the past, not discharged at that time but meanwhile persisting in a second consciousness, far from associative commerce, a position from which it generated symptoms and hysterical attacks*.
The basic scheme, though mainly centred on re-experiencing the traumatic scene with affective discharge and recollection*, did not include its working through since the concept of unconscious* had not yet acquired conceptual clarity (it is mistaken for the preconscious*, for example) but operated instead through what he calls the “second consciousness”; it is nevertheless quite similar to Freud’s elaborations in the first and even the second topic.
It also follows important psychoanalytic rules such as making conscious the unconscious and filling in some mnemic lacunae.
The centre of the scene is occupied by symptomatic relief, a place from which it was removed over time, perhaps too far, so that now it is important to recall this modification in order to restore it to its proper place in the mechanism of the cure by a new “turn of the screw”.
ABSTINENCE
Ger.: Abstinenz. – Sp.: abstinencia. – Fr.: abstinence. – It.: astinenza. – Port.: abstinência.
This refers to a fundamental technical rule of psychoanalysis by which the psychoanalyst must avoid any action that may serve to satisfy the patient’s repressed wishes* during and within the analytic process. Freud stipulates: “Analytic treatment should be carried through, as far as is possible, under privation – in a state of abstinence” (Lines of Advance in Psycho-Analytic Therapy, 1919, p. 162).
The psychoanalytic function is to induce the patient to speak and to help the patient to make conscious these unconscious wishes. The terrain of the cure must remain in the domain of words. The wish* must remain in the terrain of unconscious fantasy* and not be put into action; the analytic function is to transform it into words and thereby make it apt for thinking and working through. A part of it always remains unsatisfied and provides a motor for analysis. If it were put into action without words, it would become a repetition* of a repressed scene of infantile sexuality* and would most likely be traumatic for the patient. But most importantly, it would lead to impossibility for the cure.
The strictest abstinence is recommended when transference love* appears at some moment in a person’s analysis, and the analyst seemingly faces two possible alternatives: (1) to interrupt the treatment (only a momentary solution, but not for the patient’s cure, since the patient will probably repeat the same situation with another therapist, having missed this opportunity to understand unconscious complexes that have determined his or her history, which is no less than the history of psychical structuring); (2) to respond affirmatively to the patient’s demands (with which a new love match could be formed, but the possibility of cure would be interrupted as it would be in the first alternative). Freud describes a third alternative for this awkward situation that may arise. This third solution is simply to continue with the analysis, considering the patient’s demand as simply another element of resistance*, also unconscious to the patient’s conscious knowledge. Transference love is not the only situation of this kind that may arise and may require abstinence. Any situation that would involve any degree of intimacy or that belongs more to the terrain of action* than of words requires it as well. It depends on the analyst’s skill in each particular case to recognize it and bring it back to the terrain of words, thereby returning it to psychoanalytic terrain par excellence. Therefore, the rule of abstinence pertains to psychoanalytic technique* and hence to the ethics* of treatment.
ABSTRACT THOUGHT
Ger.: Abstraktes Denken. – Sp.: pensamiento abstracto. – Fr.: pensée abstraite. – It.: pensiero astratto. – Port.: pensamento abstrato.
This type of thought* is first achieved with the appearance of words and later when their degree of binding* is greater (compared to common thought*). It is the highest level of theoretical thought, rising above action and words, and separating from what it represents, sometimes so much so that it risks loss of its distinction from the thing as in schizophrenic thought (The Unconscious, 1915).
This type of thought gives priority to metaphors and symbols in its functioning, and ignores more concrete and direct meanings, choosing others that encompass the former but take them further and expand them.
The ability for abstraction, the most complex level of thought activity, is acquired in adolescence; although it is separate from immediate action, it may promote and produce it in the long term in an individual or human group. The person who has thought it needs to dedicate arduous ego work to make it understood on this level due to the high levels of complexity it may reach. It may also come to nothing, especially when the distance from concrete meanings is very great. Or it may be utilized as rationalization* attempting to withdraw from what is real. What is real is generated by experiences with things* and traces left by them in the psychical apparatus*: thing-presentations* which must ultimately provide the underpinnings for all levels of thought.
ACTION
Ger.: Aktion. – Sp.: acción. – Fr.: action. – It.: azione. – Port.: ação.
The psychic process is a presentational path that must conclude in action which may be immediate or mediate. This action was carried out first by the neuromuscular system previous to the introduction of any “prostheses” that mankind may have invented to extend our range of power and possibilities.
In any case, also from the beginning of life, the child performs other types of action in relation to immediate affective discharge (internal change*) with no particular aim other than affective discharge itself; the second step in this determination may be reached by screaming, this action gradually acquiring characteristics of language*. In these cases, in spite of progress, previous stages persist and affective expression continues as such: it is partly action but not action such as to “change the face of the Earth”. That is to say, it aims to change the internal medium of the body and the psyche but not the external medium (although it may also act on it indirectly).
The other type of action is specific action* which we discuss separately.
Thought* activity is planning for action*, directly or indirectly, although it does not replace it (except in obsessional thought* but only as part of this pathology) and must conclude with it, either before or afterwards, with the exception perhaps of reproductive thought: conscious recollection in which the act of remembering may not require an action, although it does not necessarily dispense with it. Action may be purely sexual; in this case it is the culmination of love* for the object*, or may be desexualized, creating culture*, as in the case of sublimation*.
Repression* greatly restricts possibilities of action or, even worse, diverts it from its aim since the possibility to access the repressed presentation* is lost. Psychoanalysis recovers these repressed presentations and enables the ego to think about them and lead them to action, or not, as a product of conscious thought, in which case problems of ethics* intervene. When the thing-presentation* is repressed – that is to say, does not find any word-presentation to access the conscious*, since this presentation is decathected* and anticathected* – subjects may perform actions that are not products of thought but instead repetition compulsions*. Hence, in regard to scenes corresponding to traumatic* situations or to anticathexes against them, preconscious* ego* thought* is unable to correct or control them since their meaning and even their existence is unknown.
ACTIVITY AND PASSIVITY
Ger.: Aktivität und Passivität. – Sp.: activo-pasivo. – Fr.: actif-passif. – It.: attivo-passivo. – Port.: ativo-passivo.
We may discuss several polarities in psychical life: subject (ego*)–object* (external world) and pleasure*–unpleasure*; active–passive is one of these.
Activity is a universal characteristic of Trieb* related to pressure (Drang); that is to say, its motor factor, the sum of force or measure of demand of work that it represents. All Trieb, in this sense, is a fragment of activity.
But are there passive Triebe?
Trieb is active in its pressure, peremptory quality, and motor factor, but may be active or passive in relation to its aim.
Vicissitudes of Trieb previous to repression* allude to the aim: for example, turning round upon the subject’s own self* and reversal into the opposite*. The clearest examples are the pairs: sadism*–masochism and to look at–to be looked at, in which those with an active aim (sadism, to look at) pass over to a passive aim (masochism, to be looked at).
In the subject’s life, especially in infantile prehistory, traumatic situations* may occur which fixate to the Trieb or its aim, transforming it from active into passive, which later becomes a character trait* or other pathology.
In his analysis of the “Wolf Man”, Freud showed how in the initially ambivalent Trieb (both active and passive) the active tendency predominated at first. Following a traumatic event (seduction by his sister), preceded by a threat of castration, Trieb returned from its incipient and precocious genitality to the anal-sadistic phase with a passive aim, which produced a change in his character from kind to naughty, masochistically seeking paternal punishment. This passivity remained fixated and led to a character trait of the adult “Wolf Man”. It also appeared in one of his most unruly hysterical symptoms, his constipation.
In Little Hans we find some examples of an alternating pair “to look at–to be looked at” which are deferred* and repressed*, transformed into the dam against Trieb that is shame*.
Triebe with an active or passive aim are present in both boys and girls. Most commonly, the passive ones predominate in girls and the active in boys, to which cultural customs of course effectively contribute.
After puberty they practically take on a masculine (active) or feminine (passive) quality.
Trieb with a passive aim retains the narcissistic object (the ego) unlike the active ...