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Journal of Postgraduate Medicine, Vol. 51, No. 3, July-September, 2005, pp. 240-241 Students Corner Curious clicks - Sigmund Freud Sheth DN, Bhagwate MR, Sharma N Seth G. S. Medical College And K. E. M. Hospital, Mumbai Code Number: jp05088 He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. If his lips are silent, he chatters with his fingertips, betrayal oozes out from him at every pore." These are the words of a man who discovered fundamental truths about the mind by solving the mysterious laws and mechanisms that govern human beings, but who himself still remains a mystery. He is Sigmund Freud. Born as Sigismund Schlomo Freud on May 6, 1856 in Freiberg, Moravia [Czech republic] to Jacob and Amalia Freud,[1],[2] he changed his name to Sigmund at the age of 22 because he was not comfortable using a long name. He qualified as a neurologist from the University of Vienna in 1881. In 1886, Freud got married to Martha Bernays who was once his patient.[1],[2] He could not meet her because of his work and had a long distance courtship with her for seven years. It was during this period that he went to Paris to learn the art of Hypnosis, which was then in vogue for treatment of hysteria, from Jean Martin Charcot.[2] Martha was a typical Jewish haus frau [housewife] and was supportive of Freud throughout his life. Freud shared his most intimate thoughts with her. He had six children with Martha and of these six, Anna was the youngest and his dearest. In 1895, he published Studies in Hysteria with Breur, whose famous patient Anna O, called hypnosis "talking cure". This led him onto the golden road of psychoanalysis, which started, with abreaction a combination of catharsis and hypnosis.[3] But, abreaction failed due to the forces of repression and resistance from patients. This led him to develop ′free association′ - a technique that allowed the patients to say whatever came to their mind without censoring any thoughts.[3],[5] Freud′s innovation was to treat all of human consciousness as a book, where nothing is written down without a reason. That tells us why his theories are so uninhibited. In the Victorian era there were many restrictions. Sex and sexual impulses were not spoken of openly. Freud was a lone rebel against these prevailing hypocritical norms. He explored the most forbidden terrain of the unfathomable human mind - the unconscious. The unconscious is that part of the mind which is the storehouse of all the repressed, guilt-provoking, unfulfilled, forbidden thoughts which are traumatic to the conscious mind. He divided the mind into three parts - conscious, pre-conscious and unconscious. He stated that human beings are irrational and instinct-driven which potentiates conflict to the view that science, religion and society are based on rational behaviour and order.[4] Freud faced a lot of opposition for his bold theories from his contemporaries. It was not perversion but it was the need of the hour to address these issues and bring reality out of the closet. Dora′s case illustrates this. Dora Ida Bauer 1898 was one of the most fascinating patients in Freud′s career. This eighteen-year-old married female presented with a repertoire of symptoms- dyspnoea, hysterical choking, depression, fainting spells, suicidal ideations and aphonia. He used the technique of free association with Dora, which led her to narrate two vague and remote dreams. It was after listening to these dreams, that Freud concluded, "dreams are the royal road to exploring what lay in this [unconscious] previously uncharted area of mind".[1] Dora′s dreams were not mere fantasies but were realities projected in a different way. Freud analysed that the somatic symptoms were a manifestation of guilt-arousing feelings due to attraction towards a boyfriend and immense hatred for her father. Based on these revelations Freud compiled Interpretation of Dreams 1900. But Freud′s relative inability to empathize with Dora, or rather acknowledge that he empathized with her, made Dora non-compliant to therapy. This made Freud realise about the existence of ′transference′ and ′counter-transference′ in psychoanalysis. Experts say that Freud included his own dreams along with those of his patients. But Freud himself strongly disagreed on this issue, perhaps using the defence mechanism of ′denial′! Freud proposed the theory of childhood sexuality challenging the concept that sexuality was absent in childhood and that it appeared only at puberty. This was followed by the works which talk about the erogenous zones in the human body down the developmental stages.[6] In 1912, Freud gave his most controversial theory till date, the Oedipus complex- present in the phallic stage of human development. Until World War I, Freud′s theories were based on the concept that man is driven by the pleasure principle. But moved by the annihilation of human life during the war, Freud wrote Beyond the Pleasure Principle 1920 and put forth the theory of death instinct. He said, "The aim of all life is death and life is an eternal battle between the two pugnacious forces in the mind - Eros [life instinct] and Thanatos [death instinct]".[1] Freud also gave the concept of Das Ich und das Es translated as the Ego and the Id 1923 which formed the framework of the basic structure of the human psyche. [1],[2],[3],[4],[5],[6] This theory put forth that the individual experiences a basic conflict between the Id- driven by gratification and the Superego which is internalised and inhibitory in nature. The Ego performs the function of control and regulation of instinctual drives by judgement which are in relation to reality, thus trying to resolve the conflict between id and superego. Freud wrote "Neurosis is a result of a conflict between the ego and the id; the person is at war with himself. A psychosis is a similar disturbance between the ego and the outside world." Freud′s theory of death instinct can be called an intuition, because in 1923 Freud was diagnosed as having leucoplastic growth of jaw and palate for which he underwent a series of operations obliging him to wear prosthesis.[2] Yet in 1926, he gave his most accepted and popular work, The Defense Mechanisms which was elaborated further by his daughter Anna Freud.[5] Anna also served as a subject for many experiments in child psychology conducted by Freud. In 1930, Freud was awarded "the Goethe prize". This award was instrumental in silencing active opposition from society for his work. In 1933, however, psychoanalysis was banned by Adolf Hitler. After Austria was conquered, Freud and his family were extricated from the Gestapo and allowed to migrate to London. He spent the rest of his life in London. When he could not bear the agony of living with the malignancy, he asked his physician Schur to give him an overdose of morphine. Thus Freud was ′mercy-killed′on September 23, 1939,[2] passing on the legacy of psychoanalysis to his beloved daughter Anna Freud. Anna went on to become the successor and torch-bearer of Freudian ideology. In spite of all the adverse conditions, Freud was able to develop a fundamental approach to the treatment of psychiatric disorders. This was possible only because of his focus and passion. His contributions are valuable not only in the field of psychiatry but also in the entire field of medicine. References
Copyright 2005 - Journal of Postgraduate Medicine |
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