The trauma of birth



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THE TRAUMA OF BIRTH

MODERN EDUCATION

WILL THERAPY

TRUTH AND REALITY

THE TRAUMA OF BIRTH


by Otto Rank

Das Trauma der Geburt, 1924;

English translation 1929

INTRODUCTION TO THE DOVER EDITION (1993, out of print)

by E. James Lieberman

One of the most remarkable books in the history of psychology, The Trauma of Birth marked the beginning of the end of the relationship between Sigmund Freud and his favorite disciple, Otto Rank. Rank dedicated the work to his mentor, "the explorer of the unconscious, creator of psychoanalysis." Freud, grateful and gracious, praised it as the greatest advance since the discovery of psychoanalysis. But he had only read the first part. (1)

Das Trauma der Geburt was published in 1924, the year Otto Rank turned forty and made his first visit to the United States. Thus Rank brought his new ideas to America, in English, as soon as the book appeared in German. In New York, Rank was hailed as Freud's emissary, a brilliant man who--unlike Alfred Adler and Carl Jung--could express original ideas while remaining faithful to his mentor. Rank became an honorary member of the American Psychoanalytic Association; professionals and laypersons sought him out for brief therapy. Of course there were some, like the influential psychiatrist A. A. Brill, who were jealous or suspicious. When he and Rank's rivals in Europe aroused Freud's anxiety about Rank's deviation from the narrow path of psychoanalytic orthodoxy, Freud withdrew his support of the new ideas.

Rank, 28 years younger than Freud, had come to his mentor in 1905, just in time to help start up the psychoanalytic movement as Secretary of the Vienna Psychoanalytic Society. A modest stipend enabled him to complete his PhD. at the University of Vienna in 1912. By then Alfred Adler had been expelled from the movement and Carl Jung was about to go. Rank's career was entirely different: clearly Freud's favorite, he became the mainstay of Freud's inner circle-the Committee, or “Ring.”

Then came this book, just a year after The Development of Psychoanalysis, co-authored by Sandor Ferenczi and Rank: both dealt with a more active approach to therapy, and both had Freud's imprimatur until controversy surrounded them. The two books caused a rift in the Committee which Freud could not heal. Pressured by Rank's rivals, he challenged his protégé in letters to New York. Rank, dismayed and furious, counterattacked forcefully, but on his return to Vienna he was reconciled with Freud and the Ring long enough to prepare a move to Paris. From there, beginning in 1926, Rank visited the United States almost every year until finally settling there in 1934. Five years later he died, at 55, a month after Freud passed away in London.

The Trauma of Birth was praised, criticized, misunderstood and, finally, ignored after Rank's break with orthodox analysis. Rich with ideas whose time had not yet come, the book brought a rebuttal by Freud in Inhibition, Symptom, and Anxiety (1926), which included a major revision of Freud's theory of anxiety. Unfortunately, other writers took parts of Rank's thesis and oversimplified or distorted it. A recent reprint of the original German version includes a modern introduction which virtually ignores the text but enthusiastically links Rank to natural childbirth (F. Leboyer), primal scream therapy (Arthur Janov), mind-altering drugs (S. Grof) and intrauterine experience. (2)

Misinterpretations of the birth trauma theory began soon after its appearance. In 1928, the respected psychiatrist Marion Kenworthy, extending Rank's theory into obstetrics, said the child born by Caesarian section "is prone to be less sensitized--he cries less, is markedly less irritated by the contacts of handling, etc.,--than the child delivered through the birth canal." She warned of "profound nervous and emotional shock, a concomitant of every hard birth experience," urging obstetricians to keep pregnant women on diets to produce smaller babies who would be able to get through the birth canal with less trauma! (3) A recent writer asserts, scornfully (but inaccurately), "Rankians proposed that all children be born by Caesarian section to eliminate birth trauma." (4)

Rank bears responsibility for some of the confusion, since he does speak of more and less severe birth traumas. He was too eager to make a strong biological argument, perhaps because he lacked a medical degree with which to bolster his authority. But his basic point is psychological: expulsion from the blissful intrauterine state--separation from the mother―is inevitably traumatic. Caesarian section cannot prevent that. Furthermore, that trauma is the prototype for all anxiety crises: weaning, walking, the Oedipal conflict, willing and choosing anything important--i.e., living creatively--and, finally, dying.

The Trauma of Birth sets forth a number of interrelated ideas which are crucial to all of Rank's subsequent work in theory and therapy: the pre-Oedipal phase of development; the importance of the mother; end-setting in therapy (whether brief or long-term); separation; the notion of will; and self-creation or psychological rebirth. The book sparkles with gems of insight set in solid historical, philosophical, anthropological, artistic and literary foundations. Lay readers who feel dazzled or bewildered by some of the theoretical acrobatics should take solace in the fact that Freud had similar feelings.

Rank gives Freud credit for various ideas in the book, notably that birth is the primal anxiety, and that setting termination time in analysis can be useful. Rank wrote this book to praise Freud, not to defy him. Rank's hope and need for Freud's approval kept him from seeing the hazards of leaping forward, farther than Freud was willing to let him go. Perhaps such faith in a mentor is essential for a disciple to take the big creative risk. The alternative--not to care--is unthinkable in the case of these two remarkable men.

Nowadays we forget the degree to which Freud's psychology was father-centered prior to The Trauma of Birth. Rank was quite aware of this pervasive ideology in science and society: "It has been noticed, especially in recent times, that our whole mental outlook has given predominance to the man's point of view and has almost entirely neglected the woman's" (p. 36). This sets Rank apart as the first feminist in Freud's inner circle. Today, of course, we take for granted that the mother-child relationship is crucial in the earliest formative phase of development, but then psychoanalytic theory presented a strong father threatening castration, and a mother whose importance was more erotic than nurturing.

The birth trauma is followed by two normal developmental separations: weaning and walking. Only later does the Oedipal drama become central--and then modified somewhat. (5) The debate over Rank's theory raged around this point, since the Oedipus complex had become synonymous with Freudian theory and clinical practice. To Rank, separation from the analyst at the end of treatment recreated the birth trauma. Analysts and patients confirmed Rank's observation that the ending of treatment brought forth dreams and strong emotions replete with birth symbolism. And Rank brings in Socrates as midwife to the birth of the self through insight (p. 181): the perfect example of knowledge aiding experience. Rank felt that analysis was often too intellectually ritualized, blocking rather than facilitating change, which depends upon experience as much as insight.

As the table of contents indicates, this book ranges through art, anthropology, religion, philosophy and psychology, with an anchor in biology: Rank chose “anchor” to describe the biologically rooted anxiety which is the crux of his thesis (p. 187). To sum up: we are violently expelled from uterine bliss, threatened with asphyxia along the way. Our lives are dedicated to finding that bliss again, by adapting the world-as-mother to ourselves or vice versa. We repress the birth trauma and the prenatal memory of bliss, but play out the representations of both in every aspect of living and dying. We are anchored to life in large part by (literally) breathtaking anxiety that prevents regression to a state of fetal mindlessness, on the one hand, or suicide, on the other. Life is hard, and the periods before and afterwards are infinitely better (not the Nietzschean epigraph) but we are trapped in our human status, half animal, half divine.

We are trapped, and anxiety keeps us from simply exiting. Having said this, Rank takes us in big leaps from era to era and culture to culture, cradle to coffin, Sphinx to Eden to Golgotha. He is a virtuoso interpreter of “the whole development of mankind, even of the actual fact of becoming human” (p. xxvii).

Rank cites many authors, including some Freud would view askance, like Stekel, Jung, Adler and Tausk. Rank does find fault with Jung and Adler, and always praises Freud, yet with the praise comes some audacious analysis. Rank credits Josef Breuer with the discovery of psychoanalysis as did Freud (p. 183); Rank commends Freud's diligence on the difficult path and faults those who defected, but then also criticizes those Freudians who “interpreted the master's teachings all too literally” (p. 184): this must have galled his conservative rivals on the Committee, and shows how confident he was of his mentor's favor. Rank then takes up the separation of Freud and Breuer, “the severance of the pupil from his master” (p. 186), a brilliant piece of analysis, unintentionally prophetic of what was about to happen in his own life. Freud's break with Breuer occurred when the younger man was 40! (6)

Could Rank have failed to see the parallel in the present situation? Just as a virtuoso musician may miss notes in an otherwise brilliant performance, so Otto Rank overreaches now and then, or misses something apparent to the outsider. Rank lived through Freud's breaks with Adler, Stekel, Jung and Tausk and he knew about Breuer and Fliess. But Rank also knew he was unique in Freud's checkered history of collegial relationships; he expected to be able to spread his wings and still return to the nest. He was wrong, and both men were hurt deeply by the break.

Rank probably could have remained under Freud's wing by yielding, but would not or could not. As for Trauma of Birth, Rank admitted “some of the criticism is just,” but defended his general position and rebutted Freud's arguments forcefully. (7)

Freud believed that the analysand presents a baby to the analyst at the end of therapy. This book, a birthday present to Freud, was Rank's baby. Freud did not like it any more than Laius liked Jocasta's baby. I find an ironic Oedipal metaphor here: The baby could not live in Freud's house; Rank would not kill it, so he had to leave.

Did the baby, like Oedipus, kill the father? Hardly: Freudian analysis flourished, especially in the United States, Rank's adopted home. The book was not translated into English until 1929, without the original dedication. In 1930 A. A. Brill denounced Rank as mentally ill, and ousted him from the American Psychoanalytic Association. Worse yet, Rank's analysands who wanted to be members of the American or the International Psychoanalytic Association had to be reanalyzed by an orthodox Freudian!

This reprint appears in the midst of a Rankian renaissance and at a time when brief therapy has become part of the mainstream. Otto Rank is the founding father of brief therapy, and even orthodox psychoanalysts are belatedly discovering this man's indispensable contributions to the Freudian enterprise. After over half a century, I hope this book will join the works of Freud and Ferenczi again in their timeless search for understanding of the human psyche and society.

--E. JAMES LIEBERMAN

1. Freud to Ferenczi, 24 March 1924. See Lieberman, E.J., Acts of Will: The Life and Work of Otto Rank. New York: Free Press, 1985 (paperback ed. Univ. Massachusetts Press 1993), pp. 219 ff.

2. Das Trauma der Geburt und seine Bedeutung für die Psychoanalyse. von Peter Orban. Frankfurt: Fischer, 1988.

3. Kenworthy, M. “The Pre-natal and early post-natal phenomena of consciousness.” In The Unconscious: A Symposium, Intro. Ethel S. Dummer. Freeport, NY: Books for Libraries Press, 1966 (Knopf, 1928), pp. 178-200.

4. Feher, Leslie. The Psychology of Birth. York: Continuum , p. 14.

5. Lieberman , E.J. “Why Oedipus loved his father,” in The Harvard Mental Health Letter,:12 (June) 1991.

6. Rank returns to the Freud-Breuer conflict in Seelenglaube uns Psychologie (1930); Acts of Will, p. 323.

7. Rank, O. Literary Autobiography (1930). In Journal of the Otto Rank Association (30):3-38, 1981. See also his review of Freud's Hemmung, Symptom und Angst in Mental Hygiene :176-188, 1927, also in JORA ,2 (7): 34-50,1969, translated from Genetische Psychologie, Teil I (1927), 24-40.

There is an old story that King Midas had hunted for the wise Silenus, the companion of Dionysus, for a long time in the woods without catching him. But when he finally fell into his hands, the King asked: “What is the very best and the most preferable thing for Man?” The demon remained silent, stubborn, and motionless; until he was finally compelled by the King, and then broke out into shrill laughter, uttering these words: “Miserable, ephemeral species, children of chance and of hardship, why do you compel me to tell you what is most profitable for you not to hear? The very best is quite unattainable for you: it is, not to be born, not to exist, to be Nothing. But the next best for you is—to die soon.”

Nietzsche : The Birth of Tragedy.

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CONTENTS


page

Preface xi

The Analytic Situation 1

Infantile Anxiety 11

Sexual Gratification 30

Neurotic Reproduction 46

Symbolic Adaptation 74

Heroic Compensation 106

Religious Sublimation 117

Artistic Idealization 141

Philosophic Speculation 167

Psychoanalytical Knowledge 183

The Therapeutic Aspect 200

Index 218

vii

TEXT ILLUSTRATIONS



Page

Ixion on the Wheel. (Picture taken from a vase in Berlin) . 134

Tantalus. (On a Sarcophagus) . . . 135

Lukas Cranach. Crucifixion . . . 139

Lukas Cranach. Crucifixion (1502) . . 140

Sphinx. (Terra-cotta Relief from Tenos) . . 145

The Sun God in the Lotus Flower (Berlin) . 153

The Riders coming from the City of Troy. . . (Picture from a Pitcher from Tragliatella) 154

Prometheus tortured by an Eagle. (Stone in the British Museum) ..... 156

IX

PREFACE

The following arguments indicate a first attempt to apply the psychoanalytic way of thinking, as such, to the comprehension of the whole development of mankind, even of the actual fact of becoming human. It would be more correct not to use the word “apply,” for it is not a question of one of the usual works on the “Application of Psychoanalysis to the Mental Sciences”; rather it is a matter of making psychoanalytic thought productive for our entire conception of mankind and history. This finally represents the history of mind, that is, the history of the development of the human mind and of the things created by it.

This particular viewpoint, still too new to be quite clearly grasped, is made accessible to us through Psychoanalysis by reason of the prodigious extension of our consciousness, which at the present time enables us to recognize part of the deepest Unconscious as such, and to understand its mode of operation. As scientific knowledge itself is no more than a conscious comprehension of previously latent facts, it is only logical that every particle of the extension of our consciousness, gained by analysis, should be converted into understanding. It is now shown at a quite definite point of psychoanalytic knowledge, which we shall soon characterize more definitely, that there is also a considerable part of organic or biological development which can be

xi

understood only from the psychical side; that is, from the side which, together with all the residue of development, includes also our own instrument of knowledge, which has suddenly become definitely more efficient through our progressive knowledge of the Unconscious.



We have taken certain new individual psychoanalytic experiences solely as a starting-point for a more comprehensive view and for general knowledge; but we believe that in so doing we have opened up the way to something essentially different from the hitherto prevailing “application” of Psychoanalysis. Thus we also lay stress on the fact that we want to keep ourselves free from an overestimation of the psychoanalytic doctrine of the Unconscious as applied to therapy, without thereby departing from the psychoanalytic way of thinking. But at the same time we extend this line of thought in both directions. It is, then, no accident that Psychoanalysis, as soon as it began to develop from a therapeutic procedure into a doctrine of the Unconscious, almost simultaneously deviating from its original medical field, invaded and enriched well-nigh every mental science, and finally itself became one of the most important of mental movements of the present day. The psychic patient, from whose material and by whose help Psychoanalysis was discovered and developed, will always remain the native source for further investigation and extension of the doctrine. Yet this origin is of no more importance today than, for instance, the country from which Columbus set forth, and which furnished the bold explorer with practical means for his voyage.

xii


We have attempted in the first place to sketch in the following pages a part of the further development of psychoanalysis itself, as it has proceeded from the consistent application of the method created by Freud, and from the doctrine based on the method. Then, starting from this basis, we have tried to gain a general and a wider knowledge through a direct comprehension of the Unconscious. Whoever is familiar with the particular course of psychoanalytic investigation will not be astonished to find that starting both generally and in individual cases from the upper layers of consciousness, and penetrating ever further into its hidden depths, this method ultimately reaches a point at which it finds its natural limitation, but likewise also its foundation. After a thorough examination of the Unconscious, its psychical content and complicated mechanism of conversion into the conscious, by the analysis both of abnormal and of normal people, we have come up against the final origin of the psychical unconscious in the psycho-physical, which we can now make biologically comprehensible as well. In attempting to reconstruct for the first time from analytic experiences the to all appearances purely physical birth trauma with its prodigious psychical consequences for the whole development of mankind, we are led to recognize in the birth trauma the ultimate biological basis of the psychical. In this way we gain a fundamental insight into the nucleus of the Unconscious on which Freud has constructed which may claim to be comprehensive and scientific. In this sense, the following arguments are only possible and intelligible on the basis of the whole body of knowledge gained

xii


psychoanalytically, about the construction and the functioning of our own psychical instrument.

If it has thus become possible to give a biological basis to the Unconscious, that is, to the psychical proper, discovered and investigated by Freud, then a second purpose of this work is to arrange synthetically, in its wide connection with the mechanics of the Unconscious thus founded, the whole psychical development of man as shown from the analytically recognized importance of the birth trauma and in the continually recurring attempts to overcome it. We notice, moreover, with astonishment how, without compulsion, we succeed in linking the deepest biological layer of the Unconscious to the highest manifest content of the mental productions of mankind. In this way the foundation and the principle correspond with, and harmoniously supplement one another, or as Freud himself expresses it in his latest work: “What has belonged to the depths in the individual psychical life, becomes the highest in the human psyche in the sense of our valuation, through the formation of an ideal.”1

Whilst attempting in the following pages to trace the mechanism of this “ideal-formation” in the development of man right to its biological basis, we recognize through all the complicated transformations of the Unconscious— which Psychoanalysis first taught us to understand—how the deepest biological content ultimately almost unchanged, though indiscernible only through our own inner repression, yet remains tangible as manifest form even in the highest

1 The Ego and the Id, 1923.

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intellectual accomplishments. There is apparent in this a normal and universally valid psycho-biological law, the full significance of which is neither to be estimated nor exhausted within the compass of the arguments we have outlined here. But the chief purpose of this work is to draw attention to this biologically based law of the form which determines the content, and here and there to suggest to the imagination rather than to wish to solve, the wider problems which loom up from behind. But to be able to set forth the whole problem at all, and to risk at least the first steps towards its solution, this we owe to the instrument of investigation and to the way of thinking which Freud has given us in Psychoanalysis.



xv

THE TRAUMA OF BIRTH



THE ANALYTIC SITUATION

As a preliminary to my task of pursuing a little further the investigation of the Unconscious from my psychoanalytic experiences and observations, I should like to refer to a fundamental principle which has hitherto guided psychoanalytic investigation. Freud has occasionally remarked that Psychoanalysis was really invented by the first patient whom Breuer treated in the year 1881, and whose case (Anna O-) was published many years later (1895) in the Studien über Hysterie. The young girl, who understood only English in her nervous states, called the soothing hypnotic speeches to her doctor the talking cure, or jokingly referred to them as chimney sweeping. And in later years, when hostility was shown to psychoanalytic experiences and results on account of their astonishing novelty, and they were criticized as being productions of the author’s perverted imagination, Freud used to hold up against these stupid objections the argument that no human brain would have been able to invent such facts and connections, if they had not been persistently forced on it by a series of similar observations. In this sense, therefore, one may say that not only the basic idea of Psychoanalysis but also its further development is largely due to the patients whose valuable efforts supplied an accumulation of material which, though

1

fragmentary in character and unequal in worth, was eventually condensed by means of Freud’s power of observation into general notions, principles, and laws.



Only in this path of investigation, along which Psychoanalysis has gone step by step, striving against all kinds of resistances, can Freud’s statement, that the patient somehow is really always right although he himself does not know how and why, be fully estimated. But the analyst has to show him this by revealing connections which were repressed, by filling in memories previously forgotten, and by disclosing the “meaning” of the illness and of its symptoms. Psychologically too the patient is right, because the Unconscious— although by means of pathologic distortion—speaks through him as it has spoken formerly through the mouths of geniuses, prophets, founders of religions, artists, philosophers, and discoverers. For not only is the psychological knowledge which is based on intuition a step towards the grasping and understanding of the Unconscious, but the capability of recognition itself presupposes to a certain extent a removal and overcoming of repression, behind which we can “reveal” the things sought for. The scientific value of psychoanalyses applied to others lies in the fact that they enable us, often by great effort, to remove the repressions in others which we cannot detect in ourselves; and thus we gain insight into new fields of the Unconscious. If I now refer to the objective method of investigation by Psychoanalysis, it is because, under the abundance of astonishing impressions of the same kind, I was forced to the conclusion that the Unconscious is once more right at the very point where hitherto we dared to follow it only hesitatingly and incredulously.

In a number of analyses, most of which were successfully

2

accomplished, I noticed that in the end-phase of the analysis the healing process was quite regularly represented by the Unconscious in the typical birth symbolism, which to a large extent is already known to us. I have also attempted, in a hitherto unpublished work (written in the winter of 1921-22), entitled Zum Verständnis der Libidoentwicklung im Heilungsvorgang (“Concerning the Understanding of the Libido Development in the Healing Process”),1 to show the theoretical importance of these astonishing facts in connection with other characteristic features of the healing process (for instance, the identification with the analyst, etc.). I mentioned there that it is obviously a matter of the well-known rebirth-phantasy, in which the patient’s desire for recovery expresses its accomplishment. In the same way patients frequently speak, in their convalescence, of feeling “new born.” I emphasize also the unmistakable part of the work of sublimation, which lies in the fact that the patient is now able to renounce the infantile libido fixation, expressed in the Œdipus complex, in favour of the analysis. He does this finally by renouncing the phantasy of the infant child, which he—as the mother—wishes to present to the father, and by considering himself the new-born (spiritual) child (of the analyst).



In spite of this conception, regularly emerging from the analytic material which I there briefly mentioned, and which without doubt seems justified within the limits of the healing process, I was struck on the one hand by the infantile character of the “rebirth-phantasy,” and on the other hand by its “anagogic” character, which has been valued to excess by Jung to the neglect of its libidinal tendencies, and hence has been misleading theoretically.

1 See Internat. Zschr. für Psychoanalyse, ix., 4, 1923.

3

The existence of such ideas has never been denied;1 what puzzled me was that the real basis of thoughts of this kind was missing.



So I left the matter, till one day, in a specially obvious case, it became clear to me that the strongest resistance to the severance of the libido transference at the end of the analysis is expressed in the form of the earliest infantile fixation on the mother. In numerous dreams belonging to this end-phase, the finally undeniable fact forced itself upon us again and again that the fixation on the mother, which seems to be at the bottom of the analytic fixation (transference), includes the earliest physiological relation to the mother’s womb. This rendered the regularity of the rebirth-phantasy intelligible and its underlying reality analytically comprehensible. The patient’s “rebirth-phantasy” is simply a repetition in the analysis of his own birth. The freeing of the libido from its object, the analyst, seems to correspond to an exact reproduction of the first separation from the first libido object, namely of the newborn child from the mother.

Since patients, irrespective of sex, and uninfluenced by the analyst (who was himself ignorant of the fact), seemed to create this terminal situation quite regularly, it became clear that this was a matter of fundamental import, and that here again one would have to have the courage to follow on the track of the Unconscious and to take it seriously. It is proved, then, without doubt that the essential part of the work of analysis, the solving and freeing of the libido “neurotically” fixed on the analyst, is really neither

1 Cf. Freud, “History of an Infantile Neurosis,” Collected Papers, vol. iii., p. 583 ff., and the discussion involved there which we continue and attempt to solve in the last chapter but one.

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more nor less than allowing the patient to repeat with better success in the analysis the separation from the mother. But this is by no means to be taken metaphorically in any way—not even in the psychological sense. For in the analytic situation the patient repeats, biologically, as it were, the period of pregnancy, and at the conclusion of the analysis—i.e., the re-separation from the substitute object —he repeats his own birth for the most part quite faithfully in all its details. The analysis finally turns out to be a belated accomplishment of the incompleted mastery of the birth trauma. This conclusion, to which I was forced by a mass of heterogeneous material, but especially by dreams which will be published in a wider connection, immediately aroused in me certain objections to which I will only allude, since they were soon removed by further experiences. It is possible, I reflected, that owing to my individuality, or owing to a special application of the technique which, according to the classical Freudian method, begins, though it certainly does not end, with the disintegration of “complexes”—it is possible, however, that I may be driving back the Ego of the patient to earlier and yet earlier libido positions,1 so that finally it would not be surprising if, in the terminal stage of the analysis, the last flight of the libido were to the intrauterine stage. One might even hold that this would be the final result in the case of very prolonged analyses. On the other hand, I would like to emphasize that first of all it is not a matter of a mere phenomenon of regression, in the meaning of the “womb-phantasy” familiar to us all, which has long been considered by



1 Ferenczi accepted a similar assumption for the process of disintegration in progressive paralysis. Hollos-Ferenczi, Psychoanalysis and the Psychic Disorders of General Paresis.

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Psychoanalysis to be a typical primal phantasy. But it is a matter of much more substantial reproductions under the influence of a real repetition compulsion. Further, my analyses, as far as I know, are some of the shortest in duration, lasting from four to eight months at the very longest.



But this and other thoughts of a similar kind, which came to me at the beginning, soon disappeared under the following overwhelming impression. In focussing attention analytically on these facts one noticed that people, theoretically and therapeutically entirely uninfluenced, showed from the very beginning of their treatment the same tendency to identify the analytic situation with the intrauterine state. In some cases, started at the same time, but differing completely in type and character of neurosis, the patients of both sexes identified the analyst with the mother from the beginning in a very decided manner, and in their dreams and reactions they put themselves back again into the position of the unborn.1 Hence the real transference-libido, which we have to solve analytically in both sexes, is the mother-libido, as it existed in the pre-natal physiological connection between mother and child.

When one has become more accustomed to this conception it almost seems as if one had always tacitly, or rather unconsciously, worked with it in view; but at the same time one notices with astonishment how much goes to support it, how many dark and enigmatic problems in analysis, and especially in the healing process, vanish at a stroke as soon

1 I shall also publish the proof for this just as it came under my observation, in a work On the Technique of Dream Interpretation in Psychoanalyses (already partly published in the first volume of The Technique of Psychoanalysis).

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as one is able to grasp the full meaning and the fundamental importance of this fact.



Above all, the analytic situation, which historically has developed from the hypnotic state,1 seems to challenge a direct comparison between the Unconscious and the primal state. Consider only the restful position in a half-darkened room, the dreamy state of phantasy (hallucinations) almost free from any of the claims of reality, the presence and at the same time the uncertainty of the libido object, and so on. This unconscious conception of the analytic situation explains why the patient, in his associations, which unconsciously have ultimately in view the primal mother situation, is able spontaneously to go back into his childhood and so bring the analyst to recognize the importance of infantile material and infantile impressions. Also the consciously directed associations correspond to an asymptotic approach to that primary attitude of transference in which the patient unconsciously puts himself from the beginning.

The increased memory capacity, especially for forgotten (repressed) impressions of childhood, occurring in the analysis, is thus to be explained (like the similar phenomenon in hypnosis) by the tendency of the Unconscious, encouraged by the suggestion of the doctor (transference), to reproduce the real, that is, the primal, situation, as automatically happens, for example, in the likewise hypermnesic state of the dream, of certain neurotic conditions (double conscience)

1 The hypnotic sleep, as all similar conditions in the dreams of rebirth, appears as a typical element of the intrauterine state; it may be assumed that the essence of hypnosis itself, the capacity of being hypnotized, goes back to the primal relation of the child to the mother. Moreover, Paul Bjerre expressed a similar thought many years ago (Das Wesen der Hypnose).

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or of psychotic regressive formations (the so-called “archaic thoughts”). In this sense all memories of infancy must, to a certain extent, be considered as “cover-memories”; and the whole capacity for reproduction in general would be due to the fact that the “primal scene” can never be remembered, because the most painful of all “memories,” namely the birth trauma, is linked to it by “association.” The almost incredible findings of the technique of “free associations” received in this way their biological basis. But we will not yield to the temptation to tackle the whole psycho-physical problem of memory from this Archimedean point, from which the whole process of repression starts, and which is analytically easy to undo.1 One can only advance the supposition that the primal repression of the birth trauma may be considered as the cause of memory in general—that is, of the partial capacity for remembering. Thus the fact that detached memories remain with one as if specially chosen out shows on the one hand that they have been absorbed by the primal repression, and on the other hand that they will be reproduced2 later on as a substitute for the really repressed, the primal trauma.



It is therefore quite natural that the analytic resistance to the giving up of this phase of the mother-binding, once

1 See the last chapter.

2 It would lead us too far to pursue this important theme in detail. In the case of one patient with a phenomenal memory, it was analytically easy to establish that her entire skill rested on the intense repression of a severe birth trauma. Her whole association mechanism was built up on numerous dates of birth, taken from relatives, acquaintances, and historical persons. From this a new light fell on the problematical analysis of the occurrence of numbers, in which almost always birth dates appear as the centres of association. See also further remarks below as to time.

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really experienced, should concern the father (substitute), who actually initiated the primal severance from the mother and so became the first and lasting enemy. The task, then, of the analyst, who in the course of the treatment represents both objects of the infantile libido, is to sever this primal fixation on the mother, a task which the patient was unable to accomplish alone. The analyst has also to deal with the libido thus freed and to make it capable of being further transferred to the father or mother image, according to the sex of the patient. When the analyst succeeds in overcoming the primal resistance, namely the mother-fixation, with regard to his own person in the transference relation, then a definite term is fixed for the analysis, within which period the patient repeats automatically the new severance from the mother (substitute) figure, in the form of the reproduction of his own birth. Thus the frequent question as to when an analysis is at an end seems in this sense to be answered. A definite length of time for the termination of this process (i.e., birth) is naturally necessary and maintains its biological explanation and justification from the following conception— viz., that the analysis has to make it possible for the patient subsequently to overcome the birth trauma by fixing a corresponding time-limit, which from this therapeutic standpoint can, to a great extent, be regulated.1 Naturally the patient constantly shows the tendency behind all his resistances to prolong2 indefinitely the analytic situation



1 Cf. my explanation in the joint work with Ferenczi, Development of Psychoanalysis.

2 It is well known how frequently the length of pregnancy (seven to ten months) is preferred, but this concerns not merely the familiar phantasy of pregnancy (child by father), but in the deepest layer refers to one’s own birth.



Cf. also the well-known cures of Dejdrine, who treats his patients

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which yields him such considerable satisfaction. And from the very beginning this tendency must become the object of analysis.



This also follows quite automatically through a strict observance of the Freudian rule, which prescribes that the patient must be seen daily at the same time and for a full hour. Each of these hours represents for the patient’s Unconscious an analysis in miniature with the renewed fixation and gradual solving, which, as is well known,1 the patients often dislike very much at the beginning. They already take the daily dismissal in the meaning of the freeing from the mother as a too active therapy, whilst on the other hand the general inclination to run away from the analyst is to be explained as the tendency towards an all too direct repetition of the birth trauma, which is just what the analysis has to replace by a gradual detachment.

as prisoners; locks them up in a dark room from everyone, and has their food brought to them through an opening; after a certain time they are glad to be discharged from this dungeon.

1 Many of them cannot wait till the analyst sends them away, but wish to decide this themselves, and often look at the time; others —or even the same—want to shake hands at their departure, etc. Cf. the passing symptom described by Ferenczi, “Schwindelempfindung am Schluss der Analysenstunde” (Zschr., 1914) (“Sensation of Dizziness at the end of the Hour of Analysis”), where the patient reacts to the psychical trauma of sudden separation with an analogous disturbance of his equilibrium, as an hysterical symptom.

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