The Truth of the Subject is the Truth of the Unconscious: Hysteria

The Truth of the Subject is the Truth of the Unconscious: Hysteria

For my first official blog I will simplify a quote from Dr. Eugenie Georgaca’s 1st excellent presentation on Lacan.

(Which you can find here - http://www.youtube.com/watch?v=Iy5lyRZSkPg)

Lacan can often appear overly difficult and enigmatic, but if one understands Lacan then one also understands Freud; Freud’s theory is very much elucidated by Lacan’s unique conceptualizations and writing. For now, however, we will focus on Freud in order to give credence to Lacan’s claim about the unconscious.

I will begin by discussing Dr. Georgaca’s first claim: the truth of the subject is the truth of the unconscious (subject, i.e. – the patient). This may sound enigmatic and a bit “out there” at first sight, but I will demonstrate how reasonable this claim actually is.

Let us apply this claim about the unconscious to a form of psychopathology: hysteria (aka conversion disorder). For those of you who are not familiar with hysteria, please see Freud and Breuer’s Studies on Hysteria (or search for hysteria or conversion disorder on Google). Hysteria is a type of psychological disorder in which a person will show a peculiar physical symptom which persists without having a physical, organic basis. Hysterical symptoms commonly include paralysis of the hands, temporary blindness, deafness/ringing in one’s ear, a horse voice/inability to speak, etc… So what causes hysterical symptoms?

Repression is the root-cause of all hysterical symptoms. When we (our “ego”) experience an event, memory, or idea as traumatic/distressing, this event is often “pushed out” (i.e., repressed) of our conscious awareness and enters an area of the mind known as “the unconscious.” All repressed memories are wholly unconscious, but they do not remain stagnant: they push for recognition and exert their force in the form of these, seemingly nonsensical, hysterical symptoms. Hysterical symptoms are what we refer to in psychoanalysis as “The return of the repressed.” Since the trauma cannot present itself directly (in the form of language, emotion, context, and meaning) due to its distressing and/or incomprehensible nature, it finds indirect pathways through which it can find an “energetic release” and/or “substitute satisfaction.”

For a great presentation on repression please see Mark Solm’s recent neuropsychoanalytic presentation entitled “What is Repression” - www.veoh.com/videos/v6319112tnjW7EJH (veoh accounts are free, and well worth it!)

In Studies on Hysteria Freud states, “Hysterics suffer mainly from reminisces” (p. 7). Basically, a particular event/memory continues to haunt these individuals, not in the direct form of memories and/or flashbacks, but in the indirect form of physical symptoms which symbolically represent the disagreeable/traumatic occurrence. For example, if one’s hand is hysterically paralyzed, then it may be due to touching something that one shouldn’t have touched perhaps; if one cannot see (hysterical blindness), then is there something one wishes to avoid seeing?

There are many other examples of hysterical symptoms such as these in the medical/psychological literature, but the point I want to make is that the origin of these symptoms is unconscious. The patient has no conscious awareness as to why he/she possesses the odd hysterical symptom, and in this sense there is no self-conscious knowledge that the patient possesses as to the true nature of his/her symptom. This proves Dr. Georgaca’s initial claim (which was both Freud and Lacan’s original claim): the truth of the subject is the truth of the unconscious.

Hysteria is not the only type of psychopathology with an underlying unconscious basis: obsessional neurosis, compromise formations, and various repetition-compulsions often include unconscious psychodynamic mechanisms.

So, how is hysteria treated? To answer this question let us return to this essay’s initial thesis: the truth of the subject is the truth of the unconscious. A hysterical symptom is the result of a repressed memory, idea, or wish. As such, the truth of a hysterical symptom’s nature lies in the unconscious, which can be thought of as the symptom’s “control room” from which it operates. This “truth” must be brought to light; the doctor must help the patient bring what is unconscious into consciousness; to bring the operator out of the underground control room and to the surface, to see the light of day.

This is achieved by the work of psychoanalysis, hypnosis, and/or psychodynamic psychotherapy. Here Freud’s original formula, to the best of my knowledge, still stands: the patient must be brought to remember the origin of the symptom (through psychoanalysis and/or hypnosis), to put it into words as much as he/she can (the process of symbolization, context, and meaning), to remember it as vividly as he/she can, and to experience the emotion which accompanies it (the event, memory, wish, etc).

Thus making the unconscious conscious, and, as stated by Freud, “Where Id was, ego shall be.” This general formula is how the hysteric can be helped to eliminate the hysterical symptom.

Note: For a recent neurological explanation of hysteria, please see V.S Ramachandran’s lecture series “The Emerging Mind: Part 5 - Neuroscience, the new philosophy”

The Purpose of this "Return to Freud"

The tides are turning and psychoanalysis is reemerging as a force, not only in the world of clinical psychology, but also in nearly all intellectual spheres of thought; from philosophy to neuroscience, from critical theory to political analysis.

We can see this change taking place through the recent popularity of organizations such as The Philoctetes Center (http://www.philoctetes.org/), which calls upon psychoanalysts, philosophers, and neuroscientists to participate in discussions with the aim of comparing and integrating these ever-converging fields of knowledge. Mark Solms, who successfully defended Freud’s dream theory in April 2006, at the Center for Consciousness Studies in Arizona, has been establishing links between his medical practice (cognitive and behavioral neuropsychology) and psychoanalytic theory (www.dreamdebate.com) (http://www.neuro-psa.org.uk/download/SAorig.pdf). Vilayanur S. Ramachandran, one of the world’s foremost neurologists, has recently stressed the prevalence of Freud’s “ego defenses” among his own patients in clinical neurology (http://www.veoh.com/videos/v15598629Wqrq8dHY).

These examples (which are among many others) exemplify how Freud has returned in the contemporary scientific scene: a return of the repressed perhaps? The purpose of this blog is to assist this return to Freud. I will focus on rendering the most seemingly complex aspects of psychoanalytic theory intelligible. I will also focus my energy on the recent and on-going integration of psychoanalysis, neuroscience, and philosophy; this integration is not only possible, it is the wave of the future.

Its time to stop focusing on milk-toast psychotherapy manuals, as well as unrealistic institutionalized ideology in psychology, which is all-to-prevalent in today’s overly bureaucratic system of academia (as well as in practice). In other words, WE NEED TO GO BACK TO FREUD, to really understand the theory, and to REALLY know what he said and did. This is absolutely crucial for the progression of our field, as well as for the care of patients in need of knowledgeable and experienced clinicians who can offer real psychotherapeutic help.

I will do my best to contribute to his movement, and I offer my readers all of my knowledge, distilled, into clear and concise essays.