A Reexamination of Freud's Basic Concepts from Studies of Multiple Personality Disorder

Freud derived his fundamental concepts, which became the basis for his metapsychology, primarily from his early experiences with hysteria. These basic concepts included the unconscious, repression, resistance, the Oedipus complex and psychosexual development. Later speculations were predicated upon these postulates. It is contended that these concepts were faulted Uy both his failure to accept Breuer's observations on self-hypnotic (hypnoid) states and Uy his creation of a fantasy theory of sexual molestation. Despite Freud's eminence and his influence upon Western thought, his theories remain controversial. Over the course of his long and productive life he wrote many books and papers, but his fundamental concepts were developed early in his career, primarily from his experiences with patients suffering hysteria. These concepts became the foundation of and remained the key elements in his metapsychology. The origin of dynamic psychiatry has a lengthy history (Ellenberger, 1970; Bliss, 1986), but for the sake of brevity we will begin in 1889 when Pierre Janet in Paris published a remarkable volume on psychological automatisms (1889) in which he expounded the novel thesis that hysterical symptoms were due to noxious childhood experiences which had been isolated and forgotten. Furthermore, he observed that the dissociation of these experiences from the mainstream of consciousness produced a variety of symptoms. The cause of this dissociation or split for Janet was a congenital weakness of psychological synthesis that allowed this fragmentation of the mind to occur. Virtually simultaneously but independently in Vienna, from 1880 to 1882 Josef Breuer was treating "Anna 0.," the most famous case in the annals of psychoanalysis (Breuer & Freud, 1895/ 1957) . "Anna 0." was a severe hysteric who suffered a galaxy of conversion symptoms-probably an undetected multiple personality. Breuer was making identical observations to those of Janet, but he also identified another crucial feature of the hysterical state undetected by Janet. Breuer recognized that "Anna 0." spon taneously was 36 entering "hypnoid" or "self-hypnotic" states. She would enter altered states of consciousness spontaneously, and in these "hypnoid" states a remarkable shift would occur. In her normal alert state she would have no inkling of why a symptom was present, but when she converted to self-hypnosis she would recognize why and how the symptom had been generated. When the forgotten episode was revealed and the feelings attending it were expressed, the symptom would disappear. Furthermore, Breuer asserted that the basis of hysteria was the existence of these hypnoid states that had the power to create an amnesia. In turn, the amnesia created an unconscious so that the individual then had three, rather than the normal two states of mind. The hysteric had the normal waking and sleeping states, but in addition had a hypnoid state. The next element in this tale was introduced in November, 1882, when Breuer told his young friend, Sigmund Freud, the details of this unusual case. It made a deep impression upon Freud, and the two discussed the case on many occasions. There next followed perhaps the most remarkable twist to this tale. Freud rejected Breuer's concept of self-hypnosis. In both the monograph on hysteria (Breuer & Freud, 1895/ 1957) and in his autobiography (Freud, 1948), Freud summed up the issue rather cryptically. In essence, he contended that he had never encountered a "self-hypnotic" hysteria-only "defense" neuroses. Breuer had offered him a potent concept, that of self-hypnosis, but for reasons still not fully explicable Freud had disclaimed it and instead postulated "repression." But why is spontaneous self-hypnosis such a powerful concept? If one accepts the concept, it then explains the amnesias, an unconscious, and resistances. Furthermore, it leads to the question of the phenomena of hypnosis. By the end of the 19th century these were known. Bramwell summarized these hypnotic capabilities in his 1903 textbook on hypnosis. He noted subjects in deep hypnosis were able to demonstrate catalepsy, paralysis and flaccidity of muscles; to affect all sensations-vision, audition, smell, taste, touch, pressure, temperature and pain-and to make them more acute, to diminish or arrest them; to produce anesthesia, analgesia or amnesia; or to induce delusions, hallucinations and illusions. I would summarize this by concluding that deep hypnosis can manipulate all functions of the neocortex with a sense of realism because deep hypnosis creates an inner world that is perceived as real as the real worlda domain of subjectively realistic fantasy and subjectively realistic memory (Bliss, 1986). But the traumas concealed by the amnesia of hypnosis can produce phobias, irrational behaviors, depressions, delusions, hallucinations, mood swings, conversion symptoms and much else. The creation of personalities is only one of its myriad capabilities (Bliss, 1986). It can be shown that almost any symptom and almost any syndrome known to psychiatry can be simulated by this spontaneous self-hypnotic process. If Freud had explored this self-hypnotic process, it might have led him in a quite different direction and his findings might have dictated a different conceptual system. Breuer had observed these self-hypnotic states in "Anna 0 ." and had given the concept to Freud, but Freud had repudiated it. One can only speculate about the reasons for this oversight. Freud was admittedly uncomfortable with hypnosis, although he did use it for several years. Another factor was his legitimate concern with the defensive component of the hysterical process; his preoccupation with this idea of defense may have closed his mind to other considerations. This concept was valid, but unfortunately it was only one important element in the process. I contend that the more powerful concept was the self-hypnosis, which contrived the defense. The major reason for the repudiation of Breuer's observation could have been what I would consider bad luck. Freud may have had the ill fortune not to have patients like "Anna 0." early in his career. I speculate that once he came to his final conclusions and rejected "self-hypnosis," his mind then probably closed to this possibility. Whatever the reasons, he was deprived of the concept. By the end of the 19th century, there was an abundance of information about the capabilities of hypnosis readily available, and he might well have unravelled their implications. Instead, he posited "repression," which was a euphemism for "forgetting." It contained little conceptual direction, whereas self-hypnosis would have led to the wellknown amnesia of hypnosis, which is the defensive capability of hypnosis. This, in turn, goes to the concept of a hypnotic concealment, ergo a hypnotic unconscious. Instead of recognizing a variety of unconscious processes, he was forced to postulate an unconscious with a confusing conglomerate of elements which defied scientific examination. In his letters to Fleiss, Freud wrote (1948) that the theory of repression became the foundation stone of the understanding of neuroses. If he had replaced "repression" with "self-hypnosis," such a sweeping generalization would not have been possible since many people are poor hypnotic subjects. In the same volume, he also stated that the theory of resistance, repression, the unconscious, sexual life, and infantile experiences were the principle constituents of the theoretical structure of psychoanalysis. I will now address what I perceive to be the second conceptual problem, which is important but less fundamental than the first (i.e ., the rejection ofthe implications of the "self-hypnosis" paradigm). Freud initially discovered sexual molestation by fathers of their daughters as the basis for . later neuroses (Freud, 1896a/ 1949, 1896b/ 1949, 19051 1949) . These memories had been "repressed," but later were revealed in therapy. I would suggest instead that they had been self-hypnotically concealed. But there then came an embarrassing insight. Freud reversed himself and became convinced that what his patients reported were not real experiences but were fan tasies (Freud, 1905/ 1949, 1954). This was startling, because logically it led to the assumption that young children must have heterosexual fantasies. What was his evidence for the reversal of this opinion? He asked whether perverted acts against children could be so common, but that seemed "hardly credible." At the time this was certainly a powerful objection, but it could only have been settled by a careful inquiry directed at the other persons who were involved. Freud was in no position to pursue such investigations, and logically this assumption should have remained moot. There was next his legitimate consideration that in the unconscious there is no criterion of reality, so that truth cannot be distinguished from an emotional fiction. I would revise this somewhat, but my conclusion would be identical. In the state of spontaneous deep hypnosis, within the unconscious domain that it creates, fantasies can become perceived as facts, so that when the individual exits this state, not realizing where he has been, the experience can be perceived as very real, and can be believed. He finally cited the fact that such memories never emerge in the deliria of even the most severe psychoses. This may not be a valid observation. In hysterical psychoses elements of such experiences may be found, but again even in these disturbed states a total emergence is often defended. This repudiation of real infantile sexual traumas by Freud proved to be a second turning point in his scientific career. Henceforth, these repressed infantile recollections would be considered to be fantasies-an assumption and a reversal of opinion destined to move psychoanalytic theory in new directions. Such vivid fantasies in children could only mean that children were not sexually innocent. They must have had a rich early sexual life which had gone undetected. Furthermore, if girls had fantasized seduction by their fathers, it indicated, following this reasoning, that they wished such experiences. Why else should such fantasies be present? As a result of this speculation, he had "stumbled for the first time upon the Oedipus complex," and it became a fundamental assumption of psychoanalysis. The concept of infantile sexual fantasies had ineluctably led to the Oedipus Complex, ann also to castration fears, psychosexual development, and further elaborations. Unfortunately, my data and much contemporary information support Freud's original hypothesis, but rejects his later reversal, which logically then mandated many of his favorite concepts. All evidence indicates that incest and the abuse, of children are surprisingly common. These infantile traumas, be they sexual abuse, physical abuse or psychological injuries, in at least many cases really occurred. A few may be concealed by screen memories, but the amnesias are not dictated by fantasies. Since Freud's conceptual system has profoundly influ-