Part 35

Again, when amnesia results it may cover a past epoch—retrograde amnesia—without obvious reason for the chronological line of cleavage. In short the suppression by dissociation of a specific psychological element—remembrance, perception, sentiment, etc.—not only tends to rob the personality of a whole psychological system in which it is organized but of other faculties, the relation of which to the specifically dissociated element is obscure. It seems as if the dissociation sometimes followed physiological as well as psychological lines.[254] It is in accordance with this principle that instincts and sentiments which are not immediately concerned in the specific conflict nor antagonistic to the dissociating emotion are often suppressed. Thus it is that hysterics, as we have seen by examples, have lost so many emotions (instincts) and the sentiments involving them, though they are so excitable to the emotions that are retained. In the case of B. C. A. the secondary personality B, the resultant (as I interpret the case) of the conflict between the play instinct and sentiments of duty, responsibility, etc., lost the parental instinct with the emotion of tender feeling (McDougall) and that of fear, with their corresponding sentiments. She was shockingly devoid of filial and maternal love and, indeed, of affection, in the true sense, for her friends. Likewise Sally (in the case of Miss B.), also the product of conflict between the impulses of the play instinct and those of the religious emotions, was entirely devoid of fear, of the sexual, and of certain other instincts not antagonistic to the dominating play instinct. She had lost also a great many, if not all, sentiments involving the tender feeling. As in the examples given of dissociation of motor, sensory, and other functions, the dissociative line of cleavage had excluded more than was engaged in the conflict. Of course, there always must be some reason for the direction taken by any line of cleavage, following the application of force, whether the fracture be of a psycho-physiological organism or of a piece of china; but when the conditions are as complex as they are in the human organism their determination becomes a difficult problem. When we come to study multiple personality we shall see that the suppression of instincts plays an important rôle.

=Amnesia.=—It is a general rule that when a person passes from a condition of extreme dissociation to the normal state there is a tendency for _amnesia_ to supervene for the previous dissociated state (multiple personalities, epileptic and hysterical fugues, hypnotic and dream states, etc.). Likewise in everyday life it frequently happens, when the dissociation effected by emotion results in an extremely retracted field of consciousness, that, after this emotional state has subsided and the normal state has been restored, memory for the excited retracted state, including the actions performed, is abolished or impaired. Even criminal acts committed in highly emotional states (anger, “brain storms,” etc.) may be forgotten afterwards. In other words, in the normal state there is in turn a dissociation of the residua of the excited state. The experiences of this latter state are not lost, however, but only dissociated in that they cannot be synthesized with the personal consciousness and thereby reproduced as memory. That they may be still conserved as neurographic residua is shown in those cases suitable for experimental investigation where they can be reproduced by artificial devices (hypnotism, abstraction, etc.).

Thus B. C. A. could not recall a certain emotional experience although it made a tremendous impression upon her, disrupted her personality, and induced her illness. In other respects her memory was normal. Janet has described this amnesia following emotional shocks, notably in the classical case of Mme. D.

1. On first thought it seems strange that a person cannot remember such an important experience as that, for example, of B. C. A., when for all else the memory is normal. That this experience had awakened conflicting ideas and intense, blazing emotions with great retraction of the field of consciousness of the moment is shown by the history. Later there was found to be a hiatus in the memory, the amnesia beginning and ending sharply at particular points, shortly before and shortly after this experience. In other words, the extremely dissociated and retracted emotional field could not be synthesized with the personal consciousness or, one might say, with the sentiment of self. In hypnosis, however, this could be done and the memory recovered. Freud has proposed an ingenious theory involving a particular mechanism by which such amnesic effects are produced. According to this theory the dissociated experience cannot be recalled because it is so painful that it cannot be tolerated by consciousness; i.e., attempted emergence as memory meets with the resistance of conflicting subconscious thoughts, acting as a censor or guardian, and the experience is repressed and prevented from entering consciousness. (It would be, perhaps, within the scope of this theory to say that the impulsive force of the conflicting sentiments (involving pride and self-respect and the instinct of anger) awakened at the moment of the experience continued more or less subconsciously to repress the memory of the whole experience.)

2. If expressed in the following form I think the theory would equally well explain such amnesias, be in conformity with certain known hypnotic phenomena and, perhaps, be more acceptable: An experienced desire not to face, or think of, i.e., to recall to memory, a certain painful experience is conserved in the usual way. When an attempt is made to recall the episode _this desire becomes an active subconscious process_ and inhibits the memory process. The analogue of this we have in posthypnotic amnesia induced by suggestion. In the hypnotic state the suggestion is given that the subject after waking shall have forgotten a certain experience, a name, or an episode. After waking the conative force[255] of the suggested idea, functioning _entirely subconsciously_ (as there is complete forgetfulness for the hypnotic state), inhibits the memory of the test experience in that there is found to be amnesia for the latter. One may say there has been a subconscious conflict followed by inhibition of one of the belligerents. That antecedent thoughts of the individual can likewise become activated as subconscious processes and come into conflict with other processes and inhibit them, thus preventing them from becoming conscious, we have already seen. The antagonism of the motives in the two processes is often obvious. Numerous examples of inhibitions (induced by conflicts with subconscious ideas, emotions, and conations) of mental processes which could afterwards be recalled to memory in a secondary state of personality have been recorded in the case of Miss B.[256] Likewise in B. C. A. similar phenomena were testified to as due to subconscious conflicts.[257] There would seem to be no question therefore of either the occurrence of subconscious conflicts or their efficiency in producing amnesia.

3. However all this may be, there is no need for us now to enter into the question of mechanisms. Certain it is, though, that we often forget what we want to forget, which means memories that are unpleasant; and certain types of pathological amnesia answer to the Freudian mechanism or some modification of it. Certain amnesias undoubtedly follow deliberate wishes to put certain experiences out of mind, just as they follow hypnotic suggestions that they shall be forgotten. A very neat example is that of the observation previously given (Lecture III, p. 74) of the subject who, in a moment of despair and resentment against criticism, expressed a wish to forget her own marriage name, and lo! and behold! on waking the next day she found she could not recall it. But amnesias of this kind differ in an important respect from the classical amnesias of hysteria. In the latter variety the dissociation is so extensive that reproduction cannot be effected by any associated idea of the personal consciousness; for reproduction another state of consciousness (hypnosis, alteration of personality, etc.) with which the forgotten experience is synthesized must be obtained or the subconscious must be tapped. In the former variety although the reproduction cannot be effected through an idea with which it stands in affectively painful association, it can be by some other indifferent idea or complex with which it is systematized. For instance, in the case of the phobia for the ringing of bells in a tower which we have studied, the original episode could not be recalled in association with the object of the phobia, notwithstanding that this object was an element in the episode, but it was readily recalled in association with contemporary events of the subject’s life. In the case of C. D., who had experienced a painful episode of fainting the same amnesic relations obtained.

4. On the other hand there are other forms of amnesia which the _Freudian mechanism is totally inadequate to explain_, or of which it offers only a partial explanation. I refer to the persisting amnesias of reproduction exemplified by much of the common forgetfulness of every-day life (often due to dis-interest); by the amnesias for whole systems of experiences in hypnotic states, in different phases of multiple personality, fugues, and deliria; by certain retrograde, general, and continuous amnesias of hysteria, alcoholic amnesia, etc. In some of these the amnesia is a dissociation of systems undoubtedly effected by the force of emotional impulses discharged by antagonistic complexes. This is to view the amnesia from its psychological aspect. But it may also be viewed from its _correlated physiological aspect_.

Let us note first that reproduction is a synthetic process which requires some sort of dynamic association between the neurogram underlying an idea present in the personal consciousness and the conserved neurograms of a past experience. From this view we may in the future find the explanation of amnesia (resulting from the dissociative effect of emotion) in the configuration of the physical paths of residua traveled and engraved by an emotional experience. The emotional discharge may have prevented an associative path of residua being established with the dissociated experience.[258]

5. Amnesia is too large a subject for us to go into its mechanisms at this time and we are not called upon to do so. It is enough to point out _the different forms of amnesia_ which at times are the resultants of emotion. Inasmuch as experiences are organized in complexes and still further in large systems, which include settings (that give meaning to the particular experiences) and other associated sentiments, instincts and other innate dispositions, the dissociation of a single experience may involve a large complex of experiences, or a whole system of such, and result either in a simple amnesia alone or in an alteration of personality accompanied by amnesia. Such amnesias are generally classified as _localized_, _systematized_, _general_, or _continuous_.

6. The first, as it seems to me, is also in principle systematized, the distinction being clinical rather than psychological. By _localized_ is meant an amnesia extending over an epoch of time. Thus, in the instance already cited, Miss B. suddenly found that she could not recall a single moment of a particular day, although previously she had remembered well the incidents, owing to a distressing experience the memory of which had tormented her during the whole day. The amnesia was localized in time. It was the result of a suggestion which I gave in hypnosis that the painful experience only should be forgotten; but unexpectedly the remembrances of the whole day disappeared. In other words, the dissociation of a particular remembrance robbed the personal consciousness of all other remembrances with which it was systematized. That it was so systematized was made evident by the fact that throughout the course of the day it had so dominated her mind that she was continuously under its emotional influence. The amnesia was therefore not only localized but _systematized_ with the day’s experiences. It is to be noted that the hypnotic suggestion necessarily exerted its dissociating force subconsciously after waking.

Similarly in multiple personality, one alternating phase often has complete amnesia for the preceding epoch belonging to another phase. This amnesia may extend over a period of from a few minutes to years, according to the length of time that the second phase was in existence. It is therefore localized. But it is also systematized, not in the sense of relating to only a particular category of remembrances, such as those of a particular object—father, child, etc.—but in the sense of bearing upon all the experiences organized within a large system of sentiments, instincts, settings, etc., characteristic of the second personality. With the dissociation of this system the remembrances of its experiences go, too. Undoubtedly the dissociating force is that of the awakened sentiments, etc., of the succeeding phase. These are always antagonistic to those of the dissociated phase, although those of the one are not necessarily painful to the other. They are simply incompatible with one another, and it may quite well be that their force is subconsciously discharged. Systematized amnesia, on the other hand, may not be localized, bearing as it may only on a particular category of remembrances, let us say of a foreign language with which the subject previously was familiar.

7. The _retrograde_ type of localized amnesia is common following emotional shocks. The case of Mme. D., made classical by Charcot and Janet, is a very excellent example. This woman lost not only all memory of the painful emotional state into which she was thrown by the brutal announcement of her husband’s death, but of the _preceding_ six weeks. The amnesia for the episode might be accounted for on the theory of conflict, but it is difficult to explain the retrograde extension unless it be there was some systematization covering the six weeks’ period within the mental life of the patient not disclosed by the examination.

_General and continuous amnesia_, the one covering the whole previous life of the subject, the other for events as fast as they are experienced, also, though rarely, occur as the sequence of emotion.

=Subconscious traumatic memories.=—When an emotional complex has once been organized by an emotional trauma and more or less dissociated from the personality by the conflicting emotional impulses, it is conserved as a neurogram more or less isolated. The fact of amnesia for the experience is evidence of its isolation in that it cannot be awakened and synthesized with the personal consciousness. Now, given such an isolated neurogram, observation shows that it may be excited to autonomous subconscious activity by associative stimuli of one kind or another. It thus becomes an emotional subconscious memory-process and may by further incubation and elaboration induce phenomena of one kind or another.

This is readily understood when it is remembered that such a memory, or perhaps more precisely speaking its neurogram, is organized with one or more emotional dispositions (instincts) and these dispositions by their impulsive forces tend when stimulated to awaken the memory and carry its ideas to fulfillment. The subconscious memory thus acquires a striving to fulfil its aim. We ought to distinguish in this mechanism between the isolation of the neurogram and that of the process. The former is antecedent to the latter.

The phenomena which may be induced by such a subconscious memory may be of all kinds such as we have seen are induced by subconscious processes and emotions—hallucinations, various motor phenomena, disturbances of conscious thought, dreams and those phenomena which we have seen are the physiological and psychological manifestation of emotion and its conflicts, etc.

Undoubtedly the _mental feebleness_, manifested by a feeling of exhaustion or fatigue, which so frequently is the sequel of intense conscious emotion, favors the excitation to activity of such subconscious autonomous processes or memory when antecedent isolation has occurred. This enfeeblement of personality probably is the more marked the larger the systems included in the dissociation. Certain it is that in fatigued states, whether induced by physical or mental “storm and stress,” subconscious processes become more readily excited. The greater the dissociation the greater the mental instability and liability to autonomous processes. Time and again it was noted, for instance in the case of Miss B. and B. C. A., that when the primary personality was exhausted by physical and emotional strain, the subconscious personality was able to manifest autonomous activity producing all sorts of phenomena (when it could not do so in conditions of mental health) even to inhibiting the whole primary personality.[259] The direct testimony of the subconscious personality was to the same effect.

=Mental confusion.=—Fortunate is the person who has never felt embarrassment when the attention of others has been directed to himself, or when some act or thought which he wished to conceal has become patent to others, or when called upon without warning to make a speech in public. Unless one is endowed with extraordinary self-assurance he will become, under such or similar circumstances, bashful, self-conscious, and shy, his thought confused, and he will find it difficult to respond with ready tongue. Associated ideas _à propos_ of the matter in hand fail to enter consciousness, his thoughts become blocked even to his mind becoming a blank; he hesitates, stammers, and stands dumb, or too many ideas, in disorderly fashion and without apparent logical relation, crowd in and he is unable to make selection of the proper words. In short, his mind becomes confused, perhaps even to the extent of dizziness. The ideas that do arise are inadequate and are likely to be inappropriate, painful, and perhaps suspicious. The dominating emotion is early reinforced by the awakening of its ally, the fear instinct, with all its physiological manifestations. Then tremor, palpitation, perspiration, and vasomotor disturbances break out. Shame may be added to the emotional state.

1. This reaction becomes intelligible if we regard it as one of conflict resulting in painful bashfulness and shame, inhibition of thought; the excitation of painful ideas, amnesia, and limitation of the field of consciousness. The self-regarding sentiment is awakened and dominates the content of consciousness. The conflict is primarily between two instincts organized within this sentiment—that of self-abasement (negative self-feeling) and that of self-assertion (positive self feeling). The impulsive force of the former, awakened by the stimulus of the situation—let us say the presence and imagined criticism of others—opposes and contends with that of the latter which is excited by the desire of the person to display his powers and meet the occasion. The result of the struggle between the two impulses is emotional agitation or _bashfulness_. If this bashfulness is “qualified by the pain of baffled positive self feeling” there results the emotion of shame.[260] But these emotional states are not the whole consequences of the conflict. Almost always fear comes to the rescue as a biological reaction for the protection of the individual and impels to flight. The impulsive force of this instinct is now united to that of self-abasement and the conjoined force inhibits or blocks the development of ideas, memories, and speech symbols appropriate to the occasion and dissociates many perceptions of the environment. On the other hand, the self-regarding sentiment evokes various associative abasing ideas of self and related memories. The victim is fortunate if unfounded suspicions and other painful thoughts (through which criticism of self is imagined and the situation falsely interpreted) do not arise. Or there may be an oscillation of ideas corresponding to the conflicting sentiments and instincts. A person in such a condition experiences mental confusion and embarrassment. The condition is often loosely spoken of as self-consciousness and shyness.

2. Painfully emotional _self-consciousness_ of this type as the sequence of special antecedent psychogenetic factors is frequently met with as an obsession. Then fear, with its physiological manifestations, is always an obtrusive element. Individuals who suffer from this psychosis sometimes cannot even come into the presence of strangers or any public situation without experiencing an attack of symptoms such as I have somewhat schematically described. The phenomena may be summarized as bashfulness, emotion of fear, inhibition, dissociation, limitation of the field of consciousness, ideas of self, confusion of thought and speech, inappropriate and delayed response, delusions of suspicion, tremor, palpitation, etc.

=The symptomatic structure of the psychoneuroses.=—When studying the physiological manifestations of emotion (Lecture XIV), we saw how a large variety of disturbances of bodily functions, induced by the discharge of emotional impulses, may be organized into a symptom-complex which might, if repeatedly stimulated, recur from time to time. On the basis of these physiological manifestations we were able to construct a schema of the physiological symptoms occurring in the emotional psycho-neuroses. We obtained a structure of such symptoms corresponding to the facts of clinical experience. We then went on in the next lecture to examine the psychological disturbances induced by emotion and found a number of characteristic phenomena. The view was held that emotion is the driving force which bears along ideas to their end and makes the organism capable of activity. We found conflicts between opposing impulses resulting in repression, dissociation, and inhibition of ideas and instincts, and limitation of the field of consciousness. We saw that sentiments in which strong emotions were incorporated tended to become dominating, to the exclusion of other sentiments from consciousness, and to acquire organic intensity and thereby to be carried to fruition. We saw also that the dominating emotional discharges might come from sentiments within the field of consciousness, and therefore of which the individual is aware, or from entirely subconscious sentiments of which he is unaware. And we saw that conflicts might be between entirely conscious sentiments or between a conscious and a subconscious sentiment, and so on. (Indeed, a conflict may be between two subconscious sentiments as may be experimentally demonstrated with corresponding phenomena.)

Now the practical significance of these phenomena of emotion, both as observed in every-day life and under experimental conditions, lies in the fact that they enable us to understand the symptomatic _structure_, and up to a certain point the psychogenesis of certain psychoneuroses of very common occurrence. (For a complete understanding of the psychogenesis of any given psychoneurosis, such as a phobia, we must know all the antecedent experiences which formed the setting and gave meaning to the dominating ideas and determined the instincts which have become incorporated with them to form sentiments. This we saw when studying the settings in obsessions (Lectures XII and XIII).)