Wittgenstein and Freud

Freud’s patients suffered from many symptoms, but there was nothing wrong with their bodies. The problem was their minds. But how could the mind cause changes in the body or were the real causal factors events in the nervous system? This puzzle was one of the biggest medico-scientific challenges of the time, and Freud was keen to step up to it.

His first attempt to do so is contained in the Studies on Hysteria, which he co-authored with Josef Breuer. The studies sought to explain the most puzzling aspects of hysteria including the multiple forms it takes, the difficulty of identifying the precipitating cause and the absence of a link between potential causes and their symptomatic consequences. Physical investigation had provided no leads, nor did the patient’s own account of their illness, but when the patient was in a hypnotic state (doctor-induced or self-induced), progress became possible. In this state, the patient was able to recall the specific events that led to their hysterical symptoms, and when they re-experienced those events, this had a cathartic effect, eliminating the symptoms those events related to.

Freud’s ground-breaking conclusion was that hysterics suffered mainly from reminiscences. Their problems arose from psychic traumas which they could not remember (or only remembered in a whitewashed form). These experiences had a pathological impact on their bodies and on their behaviour until they were consciously processed. The recovered memories made sense of their otherwise inexplicable symptoms. It became possible to understand why one patient, Anna O, lost the ability to speak in her native tongue and could only speak English or why she was unable to drink water out of a cup. Once the gaps in her conscious experience had been eliminated, the symptoms disappeared. 

As scientists, Freud and Breuer wanted to explain their therapeutic success. They sought to do this on two levels – the psychological and the physiological. Their explanations were built on the traditional philosophical account of the mind, interpreted in a materialistic way. The mental representations, which according to philosophers constituted the contents of consciousness, were treated like physical objects. According to Freud and Breuer, the psychic trauma – or more precisely the memory of the trauma – acted “like a foreign body which long after its entry must be considered an agent that is still at work”. Like a virus, the memory in the hysteric’s mind caused their body to malfunction.

But how can a memory become pathological? In line with tradition, Freud and Breuer see experiences as consisting of mental representations and affects, but they are keen to explain the mind physiologically, so they treat the latter as a reflection of increased excitation in the nervous system. They claim that, in normal people, this excitation is disposed of through physical activity (shouting, crying, etc) or by the mnemic image of the event interacting with the other images in the individual’s mind so the excess excitation dissipates. But, in hysterics, the affect is not expressed at the time and the mnemonic image is isolated from other images in their minds. With the normal escape routes blocked, the excitation manifests itself in their hysterical symptoms. When the individual re-experiences the past event, the excess excitation drains away through the movements that accompany the re-experiencing (talking, crying, sighing etc) and through a re-integration of the mnemic image(s) with the rest of the individual’s experience that allows the normal diffusion process to occur. 

The above account sounds plausible, but the purported explanations don’t really add any value. All they do is translate the psychological facts into a scientific-sounding language. It is certainly true that when we experience emotions, we want to express them. We do shout when we are angry, leap around when we are joyful, and cry when we are sad. Generally, when we experience something, we want to talk about it. But do we do this because the movements of the mouth and larynx help drain the excitations in our nervous systems? Similarly, it is true that trying to ignore difficult issues can lead to problems. A feeling or an idea can “fester” in our minds. In this situation, talking to other people can be really helpful as can facing up to the thoughts and feelings we are trying to avoid. But do the benefits of these activities really arise from the fact that they facilitate the dispersal of excitation over a larger body of mental representations?

This may seem unfair. After all, Freud and Breuer want to offer a scientific explanation of hysteria (and their proposed new treatment of it), so they can’t just point to obvious aspects of human behaviour, particularly since explanations on that level quickly come to an end. Why do we cry when we are sad? Why do we move about when we are excited? Well, we just do. If we do want to go beyond this, the most relevant point philosophically is that crying is an expression of feeling sad. It is one of the outward criteria on the basis of which we ascribe this particular inner state. The same goes for excitement and the behaviour that expresses it. If someone said: “I am really excited, but I am happy to sit still and I have no desire to talk or do anything.”, we would not know what to make of their statement. If we are to judge them to be excited, their excitement must express itself. A wheel that turns without affecting anything else is not part of any mechanism. 

But Freud and Breuer are scientists and they are committed to finding explanations. Their focus is on the central nervous system, and since hysterics seem over-excited (and over-excitable), they assume that they must be suffering from an over-excited nervous system. In the theoretical chapter of the Studies, which Breuer wrote, he acknowledges the paucity of knowledge about how the nervous system functions. Indeed, he says that his explanations will make little mention of the brain but will present psychical processes in the language of psychology. But this is not entirely true. The desire to provide scientific explanations drives him to make lots of (unfounded) claims about the functioning of the nervous system.

Breuer starts by claiming that there are two states of the central nervous system – a waking state and a state of dreamless sleep. He suggests that consciousness is the only way of knowing anything about these states and notes, that, since we are completely unconscious in the latter state, we know nothing about it. Fortunately, there is another state – dream sleep – where we do have some awareness. He highlights four features of this state. Firstly, intentions do not lead to voluntary movements. Secondly, sensory stimuli are registered (reflected in our dreams) but they are not registered as perceptions. Thirdly, ideas that emerge do not activate all related ideas, e.g. the idea of uncle Bill comes into consciousness but not the idea that he is dead (so in the dream we can talk to him). Fourthly, incompatible ideas can be present without mutually inhibiting each other (“I dreamt I was in the house, but the next moment I was in the garden”). Things are very different when we are awake. Then, intentions lead to movements, sensory stimuli lead to perceptions, ideas are connected to other ideas, and incompatible ideas inhibit each other so that a coherent idea (or succession of ideas) is created.

Breuer concludes that, when we are asleep, the different parts of the brain are not connected. But, when we are awake, the paths of connection and conduction are “fully traversable by excitations of the psychical elements”. He infers from this that a certain level of intracerebral tension is necessary if brain cells are to conduct. He supports this claim by noting that being awake without doing anything is itself tiring. He suggests that, when we are in a state of expectation, the level of excitation is even higher – as demonstrated by the fact that this state is even more tiring. He then claims that, when the brain is doing something, the level of excitation is between the exceptionally high level of expectation and basic level of being awake. Finally, he suggests that the extra excitation in the brain when it is doing something is not distributed evenly. This is supported by the fact that physical exertion interferes with thinking and that when we focus on one of our senses, we are less aware of inputs from the others. 

Having created a theoretical framework out of nothing, Breuer develops it further. He claims that the fact that we wake up spontaneously “proves that the development of energy [necessary for the waking state] is based on the vital processes of the cerebral elements themselves”. Fired up, we become like caged animals, and, unless we find a release for the excitation, we experience unpleasure. When we have bodily needs, the level of excitation increases further to enable the brain to meet those needs. If we do not manage to do this, there is continual increase in excitation and in unpleasure. But, when we undertake the actions necessary to satisfy our bodily needs, the unpleasure disappears, since the additional excitation has been used up (and the generator of the excitation switched off). 

Acknowledging Freud, Breuer claims these points demonstrate that there is a tendency in the organism to keep intracerebral excitation constant. He claims that there must be a level of excitation which is optimal (where the brain works at its best) and suggests that this explains why the organism tries to keep excitation at this level. Above this level, the brain seeks to dispose of any excess by using it up in sensory and ideational activity or in purposeless motor action. In some circumstances, excitation beyond the optimal may be useful (e.g. when we are hyping ourselves up to do something), but is often counter-productive (we become nervous). Indeed, too much excitation over an extended period can have a negative impact on the functioning of the nervous system, leading it to short-circuit. 

What should we make of these complex theoretical claims? At best, they constitute possible explanations – shots in the dark as to what one might find if it was possible to investigate the relationship between the central nervous system and the mind. In the absence of empirical investigation, however, the explanations have no value. Claiming that the level of intracerebral excitation in a person’s brain was high but then fell below the optimal level is just a strange way of saying that the person was alert and focused but got tired and started to think less clearly.

Freud and Breuer would have liked to explain everything on the physiological level, but they often have to operate on the psychological level. This is the case when Breuer discusses the important concept of unconscious ideas. Bizarrely, he starts by expressing surprise at the fact that we possess consciousness at all – as if we might have had no awareness at all of the ideas in our minds. Anyway, somehow we do possess this capacity, which means we can observe ideas emerging and succeeding each other inside our heads. We call the ideas we have awareness of “conscious ideas”, and Breuer suggests we call the other ideas in our minds “unconscious ideas”. Their existence is demonstrated by the fact that we forget things. For example, Breuer sometimes forgets that he has a medical visit to make and later remembers this. Not only does his remembering the appointment prove that it was always somewhere in his head, but his uneasiness until he remembered it shows that the idea was making itself felt even when he was not conscious of it.

Breuer seeks to apply this framework to hysteria. He suggests that in normal people, ideas are either active (and conscious) or non-active but potentially available to consciousness. But in hysterics there are ideas that are not available to consciousness and are still active. How is that possible? One hypothesis is that these ideas may be invisible due to a lack of intensity. But he rules this out on the grounds that these ideas are sufficiently intense to generate motor reactions in the hysteric. Another hypothesis is that it is the affect (or the pleasure/unpleasure linked to it) that makes an idea observable and that the hysterical reaction that occurs when an idea is about to become conscious eliminates the affect and so keeps the idea outside consciousness. But this too does not work, since the hysterics’ unconscious ideas typically have a marked affect. Breuer’s solution is to invoke hypnoid states as a deus ex machina, claiming that there must exist a pathological state of the nervous system where ideas that would normally be visible get split off from the rest of the mind and remain active even while being invisible.

Breuer highlights the split in the hysteric’s mind by describing what occurs when (as is common) hysterics have some awareness during an attack. In this case, “the conscious waking ego stands alongside the ideas which normally reside in the darkness of the unconscious but which have now gained control over the muscular apparatus and over speech”. This is a powerful way of capturing the experience of the hysteric, but it is little more than a dramatic image. Breuer provides no explanation of what the conscious waking ego is (presumably something other than an idea or mental representation) nor of how the unconscious ideas manage to seize control of the bodily functions. The fault does not lie with Breuer. It lies with the philosophical account of the mind that he is trying to build on.

To sum up, neither Freud and Breuer’s psychological explanations nor their physiological explanations add any value. The success of Anna O’s “chimney sweeping” is explained neither by the claim that this activity provided an escape for the excitation trapped in her nervous system nor by the claim that it reintegrated a complex of affect-laid mnemic images that had formed themselves into a secondary consciousness and seized control of the muscular apparatus of her body.

The best way to understand Freud and Breuer’s therapeutic breakthrough is in everyday psychological terms. People have experiences they find hard to deal with and if they refuse to face up to them, this affects them mentally and physically. The picture of an emotionally-charged idea split off from the rest of the mind and wreaking havoc on the individual’s life is a one way of capturing this psychological phenomenon. Freud was right to want to build on it. It did not have provided him with the basis for a new scientific theory (nor with a solution to the mind/body problem), but it did lead him towards a powerful new way of thinking about human nature.