By Georg Groddeck
IT will certainly not have escaped the attentive reader of psycho-analytic literature that we consider the unconscious as the layer of the mind nearest to the physical; a layer that commands instinctual forces which arc not at all, or only to a much lesser extent, accessible to the conscious. Psycho-analytic case histories tell of intestinal disturbances, catarrhs of the throat, anomalies of menstruation, etc., which have developed as reactions to repressed wishes, or which represent such wishes disguised and unrecognizable to the conscious mind. Although the paths linking these phenomena to normal and pathological physiology have always been left open (here I refer, for instance, to the repeatedly stated identity of the mechanism used in hysteria and when expressing emotion), psycho-analysis has confined itself mainly to the study of the physical changes in hysteria conditioned by mental processes.
Dr. Groddeck, in this pamphlet, is the first to make the courageous attempt to apply the results of Freud’s discoveries to organic medicine, and this first step has already led him to such surprising results, new points of view and fresh perspectives, that at least the heuristic value of the step appears beyond any doubt. We have therefore no justification whatever for rejecting out of hand anything from Groddeck’s statements which might startle us now. What he describes is mostly not hypothesis, but fact. He reports that in a great number of purely organic illnesses, such as inflammations, tumours, and constitutional anomalies, he has succeeded in demonstrating that the illness has developed as a defence against unconscious ‘sensitivities’, or that it is in the service of some other unconscious tendencies. He has even succeeded through psychoanalytical work, that is through making such tendencies conscious, in improving, even curing, very severe organic illnesses such as goitre, sclerodermia, and cases of gout and tuberculosis. Groddeck is far from assuming the role of a magician, and he states modestly that his aim was merely to create, through psycho-analysis, more favourable conditions ‘for the it by which one is lived’. He identifies this ‘it’ with Freud’s unconscious.
Such facts, one might say facts in general, cannot be rejected out of hand on any consideration whatever. Their validity depends exclusively on whether or not—if re-examined under identical conditions—they can be proved. Moreover, there is no theoretical reason for declaring such processes impossible.
Dr. Groddeck is a practitioner who did not start with psycho-analysis, but came upon our psychotherapy by chance in his search for a useful treatment of organic illnesses. This explains the far-reaching differences between him and ourselves, both in theory and, particularly, in the meaning attributed to some of the processes and mechanisms in question. There is, however, sufficient agreement to raise the hope that the barrier separating the two series of observations will soon be cut through. Also from the psycho-analytical side some observations have been made public which appear to be remarkably near to Groddeck’s theses.
The sober way, free from all ‘finalistic’ philosophizing, in which Groddeck treats the teleology demonstrable in the organic (a teleology which is determined causally) must be stressed. In this way he happily avoids the rocks on which Adler’s research foundered after a promising beginning.
Further, we must respect this author who, in his great love of truth, in the service of science does not hesitate to expose several weak points and shortcomings of his own physical and mental organization. We eagerly await further communications from Groddeck, particularly case histories and results.
1 German original in Zeitschr. f. Psa. (1917), 4, 346. First English translation.