The Termination of a Treatment of Hysteria as an Effect of Failed Interpretation
The present paper discusses the reasons for the termination of the psychoanalytic treatment of a neurotic woman. The patient presented early enough the layout of a hysterical neurosis, built around the question of femininity, for posing which various triangles were created. When jouissance drew the patient to the side of repetition, a psychoanalytic act brought her back to working-through inside transference. The dreams that followed this act led to the emergence of an element that revolved around the mark of femininity on the body, which was linked to the jouissance of the not-whole and thus lied beyond the structure of hysterical desire. This time the analyst failed to encapsulate this element in transference, due to his mistaken attempt at one more interpretation at the phallic level. Consequently, like Freud’s famous case study of Dora, the patient decided to end the treatment. This failure is discussed with regards to Freud’s analysis of Dora and the dream of Irma’s injection, and Lacan’s views on them.
Failure and the Making of Psychoanalysis
Failure is certainly not an unknown word to the psychoanalytic scholar or clinician. Ever since Freud’s time, the history of the psychoanalytic approach to the human mind seems to be marked, but also guided, by impasses. This goes for both its theoretical configuration and clinical application.
A well-known example from Freud’s own clinical practice is the failure in the treatment of Dora, a young hysterical woman the founder of psychoanalysis treated for about three months in late 1900 (1905e). In Fragment of an Analysis of a Case of Hysteria Freud (1905c) admits his failure to notice that his eighteen-year-old patient’s actual love object was neither her intended suitor nor her father; it was the former’s wife, who was also her father’s mistress. In contrast, Freud’s original focus in the case had been a hypothetical Oedipal rather than homosexual desire, as he later remarked (1905e).
Nonetheless, such clinical failures and theoretical impasses, highlighted by Freud himself and influential psychoanalysts of the 20th century like Jacques Lacan, helped advance the theoretical and clinical approach to the human mind and body by psychoanalysis, which may indeed be “best grasped through its own failure” (Gherovici, 2014, p. 48).
A similar failure is discussed in the present paper with regards to the treatment of a case of hysteria and its premature termination by the patient herself.
Catherine’s “turmoil”: From Pragmatic Demand to Hysterical Desire
Catherine came to see me at a public institution near the suburban area of Athens where she resided. I used to work there as a psychotherapist. She was then thirty-two years old, she had been married for five years and had two children.
Catherine’s first words described the “turmoil” she had found herself in for some time now and for which she was seeking help. That signifier referred to the state of financial uncertainty she had bestowed upon her family’s future. This uncertainty had come from her engagement in a legally precarious business plan that had gone wrong. What had happened?
A few years earlier, Catherine used to work as a secretary at a medium-sized industry, which was owned and managed by a married couple in the age of her parents. She had quit that position after her wedding to a man she met in the same premises. Catherine gave birth to her first child, a boy, and stayed home while her husband moved to work as a technician at another company. Then her old bosses, with whom she used to be in rather “familial” terms, made her an offer to earn money without having to work: a “dummy corporation” would be set up on her name, and she would appear to their creditors as a merchant trading with their business. Tempted by the prospect of easy money and reassured of the minor risks of the affair, in which many of her former colleagues had also been involved, Catherine accepted the proposal. Yet very soon the fraud was revealed and people like her found themselves in trouble, owing immense amounts of money to banks. She even risked losing her newly-bought house, which she had acquired with the help of a big mortgage. Her former bosses, who had enticed her and other past employees to engage in the affair, were refusing to help. Catherine said she was very anxious about the future and sought help to alleviate her suffering.
This, initial call for help, might sound as a rather pragmatic request on her behalf, linked, as it is, to an existing problematic situation. Yet, even if Catherine’s demand concerned asking of help in order to get over an actual “turmoil”, in her words about it one could easily make out –and in the future this would become even clearer- her psychical turmoil; one revolving around the figure of a woman to whom she addressed a question. That, along other information, would make me pose early enough the hypothesis of a hysterical structure.
In effect, for the first six months of the treatment, the majority of Catherine’s sessions were occupied by her relationship with the couple of fraudulent industrialists, and more specifically, that of the woman. How could they have done such a thing to her, and, more importantly, how could the woman, Mary, have treated her like this? Mary was the age of Catherine’s mother and Catherine had admitted having “daughterly” feelings for her. More specifically, she hoped that Mary could teach her “how to raise a proper family”. However, in a later session she revealed that Mary was far from the ideal role-model as mother and wife: She had not been her current husband’s first wife. She was the proverbial secretary with whom the factory owner had an extra-marital affair, which ended up with him getting divorced and marrying Mary.
The significant role played by Mary in Catherine’s psychical organisation was portrayed in a number of dreams. In the first of them: “I am in the presence of Mary, who is discussing a legal case with someone. I do not speak, whereas I am ‘boiling’ inside”. In another dream “Mary’s family are preparing for a wedding, and are thus dressed immaculately, indifferent to Catherine’s troubles”. Catherine says that this was indeed the way the couple responded to the trouble they had brought upon their former employees: they would stroll the city streets with their expensive cars, indifferent to her turmoil.
We therefore get a first illustration of the figures along which hysterical desire is laid out: the hysteric, a man with whom she identifies –for the moment the divorced and remarried factory owner- and the other woman, with regards to whom the question of her being is addressed.
Soon enough, another version of this triangle would appear; a new turmoil would hit Catherine, which this time had to do with her husband. The temporary misfortune –and challenge for the analyst- would be that, apart from another illustration of the layout of the hysteric’s desire, an expression of the jouissance that lies at its heart would also emerge.
From Truth to Jouissance
One day, six months after the beginning of her treatment, Catherine rushed into the office overwhelmed with anxiety. She could not sit and asked whether she could stand during the session. I conceded, asking what was going on. She announced that she had discovered that her husband had an extra-marital affair with a woman called Helen. She was a friend of the couple and their baby-girl’s godmother.
That revelation had come from Catherine coming across a secret mobile phone and an e-mail account of her husband’s. He initially denied the accusation, saying that his wife had misunderstood his communication with Helen. Catherine did not believe him and spent the following months collecting “evidence” of the affair, in pursuit of an apology. This she did by accessing secretly his e-mail accounts and by bugging his computer and car with the help of a private investigator. Eventually her husband admitted his infidelity, apologised and ended the affair. Yet this did not make Catherine feel better. In fact, she continued looking for evidence with even greater passion, this time not in pursuit of an apology, but of the truth.
In effect, a pattern was soon established in the treatment: Catherine started bringing to her sessions the evidence of the terminated affair. She would carry print-outs of e-mails and text messages to read out, and even photographs of her husband’s mistress to show me. I refused to look at them. Yet she carried on, with the “evidence” growing session-by-session, like a snow-ball.
It was obvious that repetition had taken the upper hand. I was thinking that if the treatment were to be continued, it was imminent that Catherine was distanced from the jouissance linked to what she called the “pursuit of the truth”. What she had been doing was an action outside the treatment that clearly “invalidate[d]” the patient’s “prospects of recovery” (Freud, 1914g, p. 153).
In effect, that behaviour of hers came to an end thanks to an intervention of mine, which took place when one day she brought the largest pile of documents she had ever done. The intervention, aiming at encouraging Catherine to confront that information “inside transference”, took place in the form of a psychoanalytic act.
On that day, Catherine had left, as usual, her large pile of documents rest on the desk that stood between us. By marking the end of the session I grabbed the pile and asked her: “will you be needing these?” She replied with hope: “do you want to read them?” to which I only answered “it is better if they stayed with me”. For reasons that are explained further below, it is important to note that reading the evidence was not my intention and I made that very clear to Catherine. If I did, the manoeuvre would mean that I also believed that the solution to her suffering laid in the “truth” of the evidence.
The outcome of the act was what one might call a temporary “triumph for the treatment” (Freud, 1914g, p. 153). Catherine stopped immediately looking for “evidence” and attempted to confront her suffering through words instead of acts. After some time, she compared the tendency to look for the evidence of the affair to the behaviour of a “drug addict”, a parallelism I find very appropriate considering that in substance abuse jouissance is also overwhelming the stage.
Yet Catherine’s re-engagement in transference also offered me access to what lied behind the female figures who were the interests of the men she identified with. This was first shown in a new dream: “I am at home and I am looking for my husband. I know I can find him in the bathroom. I enter the bathroom and I look for him in the shower. Yet in his place I find Benedictine!”.
Benedictine was a female figure who had marked Catherine’s childhood vividly. She was a middle-aged woman native to Africa, where Catherine was born and spent a significant part of her childhood. A good friend of her mother’s, Benedictine was a self-motivated single woman who owned and managed on her own a small business. On describing her upbringing in Africa, Catherine spoke for the first time about something different to women for whom men abandon their spouses. The stories of adultery did not end, but this time they involved more intimate secrets.
About the Dark Continent
Catherine had indeed been born in an African country which used to host a prosperous Greek community. Her Greek parents had migrated there in the second half of the 20th century. She was their third child, following the birth of a boy and another girl. After her birth the family moved back to Greece. Yet when she was four years old, her parents split due to her father’s infidelity. It is implied –and later confirmed- that, apart from women, her father had a sexual affair with his wife’s uncle, who was a missionary.
After the separation, Catherine’s mother decided to leave her older children with their grandmother and return to Africa with her youngest daughter. She would pursue a career as a saleswoman who travelled across the country selling jewellery to women who were well-off. As a result, Catherine had to live with her mother’s brothers’ families. There she was treated as an outcast among her cousins, who were all boys. She was reproached for being the least beautiful and the least behaved child. She hated her uncles and aunts, especially for the way they treated their native servants and the indigenous population in general.
Catherine saw her mother rarely, when the latter was back from her business trips. She loathed her father.
In fact, Catherine’s father only appeared once after the divorce, thanks to his daughter’s manipulative behaviour at the age of about seven. Catherine had been sent to Greece for holidays and had not seen her mother for long. In order to see her again, she expressed the wish to meet her father, who was also in Africa, because she supposedly missed him. Her mother gave in to her demand, bringing her indeed back to Africa, but the encounter with the father was nothing but failure. Both him and Catherine showed complete indifference and could not wait for the time to pass and part.
When Catherine reached puberty the two women abandoned the country. They returned to Greece, where Catherine finished school and soon found a job at the business described earlier. She never returned to Africa, but the dark continent had marked many aspects of her subjectivity, which were revealed later in the treatment; from her psychical organisation to her mere body with a corporeal mark described below.
However, another trouble arose for the treatment soon after these enlightening revelations, this time due to actual circumstances. It was a forced change in its setting, which would temporarily endanger its continuation.
The Dreams of the Corporeal Mark and their Treatment
As was noted above, Catherine’s treatment had begun in a public institution. Yet the financial and social “turmoil” that has hit Greece for more than seven years now had already started taking its toll on public services. Thus, the service in question was abolished and no option for the continuation of the patients’ treatments in public settings was offered. I asked Catherine whether she would consider continuing the treatment in my private practice, which she accepted.
However, the change in the setting initially brought a worsening in the transference that had been built during the first year and half of our sessions. Catherine became less talkative. She would ask for clearer guidance, complaining that I was always too vague and I spoke little. She also told me she had second thoughts about continuing the treatment. My response was indeed to speak more, since it was as if things had started from scratch. Soon enough, Catherine caught up with her previous conduct and brought again dreams that revolved around her question on femininity.
Here are two dreams she brought in one day: in the first
“I am at Mary’s industry, where I am seeing, among others, Mary and members of her family. Among them there is Mary’s brother, George. George, who is sitting on a leather couch, constitutes an ‘exception’, since, thanks to his marriage, he left the family business and ‘escaped’ what I could not”.
However, it seems that this man has escaped something even more significant for Catherine’s psychical life than simply the family business. Catherine informs me that rumours in the factory, which she agreed to, went that George was a closeted homosexual. In fact, she is using the rather old-school Greek term γυναικωτός, which literally means “womanly”. This homosexual man, married to a woman, may therefore be able to provide Catherine with an answer about femininity without the mediation of sexuality.
The second dream begins with Catherine also sitting on a couch, an element that is pointing to her identification with George, the “castrated” man through whom the question of femininity can be posed in the way described above.
“Then, a huge black chandelier falls in ‘slow motion’ from the ceiling and lands on the floor, without cracking at all. On it stand three owls, who fly in the room and then out of the window”.
Catherine’s associations are about wisdom; she remembers the boyfriend she had before she met her husband. That man was very ugly, yet managed to make her like him thanks to his incessant talking for three hours! In this dream we see on the one hand a castrated man (closeted homosexual or ugly man) and on the other the “turmoil” of feminine jouissance that overwhelms the stage under the signifier “black”.
Step-by-step, Catherine’s discourse was obviously moving beyond her husband’s adultery and other men’s conduct. Indeed, the topic of her sessions was now her two children. In fact, this move from the stories of adultery to motherhood would bring me closer to the “secret” of the mark of femininity, which in Catherine’s case is linked to the signifier “black” –as in the black chandelier, the native African servants she felt pity for and Benedictine, the African self-motivated woman. Moreover, the reference to birth will show how this signifier “bites” the body.
One of those dreams:
“I am in my mother’s courtyard. There, two black dogs bite me on my two wrists. I hear someone say ‘those dogs became angrier and more jealous since we have had the baby’”.
In this formation of the unconscious it is revealed that motherhood for Catherine has probably set a bar on femininity, which seems to be fighting back. In the past she has made the following remark about motherhood and femininity with regards to both Helen and Mary: “she must be ridiculed about what she did as a woman, but I cannot judge her as a mother”.
The second dream, which will link femininity to a corporeal mark and reveal the analyst’s recklessness, is a very small one: “there is a big pimple on the back side of my leg. The pimple breaks and pus comes out of it”.
The first thing that comes to Catherine’s mind is, I dare say, apocalyptic: She tells me that on the same spot on her leg she has a birth mark, which has the shape of the African continent!
Her following association will set the challenge I will fail to live up to. “What does this dream make you think of?” I ask. Catherine is lost. “I don’t really know”, she says. “I guess… it will be healed?” My response is to repeat that phrase by stressing the last words (be healed). This I am doing because in Greek to “heal” or “get better” (γιάνει) is equivocal to the name Yannis (Γιάννη). This is the name of her five-year-old son, but also my first name. I am attempting for a second time to drag into transference an element of jouissance. But Catherine does not get it and I have to repeat it twice so that she can hear the equivocation. “I see”, she says and leaves puzzled.
Unfortunately, and unexpectedly, the end has come. Catherine comes to the following session to announce that it is going to be the last one. She informs me that she has lost her job and she cannot pay for her sessions anymore. I offer her other options for payment but she refuses. She is determined. I am also asking her to come back or contact me whenever she feels the need to. She is thanking me gently but never does so. I have not heard from her since. So what has happened in this case?
To understand the reasons behind the successful act of withholding the “evidence” of the illegitimate affair and the logic of the termination of the treatment due to the failed interpretation of the last dream, we need to revisit the structure of hysteria. And which case could be more enlightening on this issue than one that was also prematurely ended by the patient on the occasion of dream interpretation and which has sealed the history of psychoanalysis, that is, Dora’s case?
Hysteria and the Question of Femininity
Indeed, the history of psychoanalysis is marked to such an extent by the clinical phenomenon of hysteria that, borrowing Lacan’s play-of-words (hystoire) (1976, p. 571) evoked by Soler on discussing hysteria (1996, p. 262; 2002, p. 47), one might not be wrong in speaking of a “hystory” of psychoanalysis. Women suffering from hysterical symptoms, like Anna O. and Fräulein Elisabeth von R., were the ones for whom –and by whom- this clinical method was first configured, helping thus Freud, alongside Breuer, discover the significance of unconscious memories (1895d). On the other hand, it was also hysterical patients, like Dora (1905e), who at points indicated the limits of Freud’s hitherto theoretical constructions.
When Dora’s case was published, it had already been five years since the publication of The Interpretation of Dreams, the volume that is considered the “birth certificate” of psychoanalysis, (1900a). Five years later, and before the publication of Dora, Freud published another influential, and even more controversial paper than the Interpretation of Dreams; the notorious Three Essays on the Theory of Sexuality (1905d).
In the Three Essays, Freud discussed, among others, a number of topics that he would use emphatically in his reading of Dora’s case. Such were the stages of psychosexual development –of which the oral stage would be discussed with regards to Dora’s symptoms- and children’s Oedipal wishes (1905d). Moreover, in the first of the three essays, Freud discussed extensively homosexuality. Yet, followed by an outcome similar to Catherine’s case, it would only be too late when this would be used for an approach of the core of Dora’s problems.
The protagonists of Dora’s case and their relations are not unfamiliar to the psychoanalytic reader: a peculiar quartet has been going on for a few years among Dora, her father, Herr K. –a Viennese businessman and Freud’s acquaintance- and Frau K., whom Dora knows to be her impotent father’s mistress. Dora reproaches her father for having “abandoned” her to Herr K.’s arms so that he can enjoy the company of Frau K. Herr K. is not innocent on his part, since he has made advances towards Dora twice, when she was 14 and when she was 16. In fact, the second incident was followed by Dora slapping Herr K. in the face, when he told her that he got nothing from his wife (Freud, 1905e).
Freud focused on two dreams that Dora brought in the framework of her treatment, which lasted for a few months. He read both as indicative of her jealousy for her father’s relationship with another woman following her falling-out with Herr K., and of Dora’s interest in sexuality (Freud, 1905e). Yet he failed to see that the actual object of Dora’s interest was not her father or Herr K., but Frau K.
As an effect, after narrating the second dream, which described her father having passed away and her reading alone a big book (which was associated to the look-out for “dirty” words in a dictionary and a book on the physiology of love) Dora announced to Freud that she had decided to end her treatment. In effect, only after the termination of the treatment Freud would make out Dora’s interest for Frau K. as an expression of a homosexual investment of the libido.
On his part, Lacan accuses Freud of “bias” (1951, p. 182) and “prejudice” (1970, p. 95). Moreover, he will suggest that what Dora, and the hysteric in general, is looking for is not her father’s love, but an answer to the “mystery” of her “own femininity” (Lacan, 1951, p. 180). Later on, he will supplement this by stating that the hysteric is looking for an answer to the question of her jouissance (1964) that comes through knowledge (1970, p. 97). In Dora’s case the figure towards whom the question of femininity, formulated by Lacan (1958, p. 378) as “what it means to be a woman”, was addressed, was, of course, Frau K. Thus, based on Freud’s own retrospective observation about homosexuality and Lacan’s reading of hysteria, we are not surprised that Dora left the stage of the treatment due to Freud’s Oedipal interpretation.
Nevertheless, and despite the failure in Dora’s treatment, Freud did not stop wondering about the woman’s relation to what Lacan will call jouissance. More than two decades after the publication of her case, and having in between studied the question of female sexuality as this was discussed by female psychoanalysts, he described the woman’s sexual life as a “dark continent” for psychology (Freud, 1926e, p. 212) –a very appropriate term for the Catherine’s case.
In contemporary psychoanalysts’ elaborations on this “dark continent”, it is highlighted that femininity must be distinguished from hysteria (Morel, 2002; Soler, 2002). In spite of hysteria questioning femininity, and for this reason exactly, this neurotic structure makes assuming a feminine position impossible (Benvenuto, 2015; Cavasola, 2015).
The need for this differentiation is clearly viewed in Catherine’s case, which can also explain the reasons behind the termination of her treatment. The end came when the analyst insisted on the side of hysteria and failed to attempt an interpretation of a formation of the unconscious on the side of the “dark continent”. But let us take things from the beginning.
Between Hysteria and Femininity
It is obvious that, from an early age in Catherine’s life, a man can become an instrument in order for her to have access to a woman. An example is her last encounter with her father at the age of seven: she pretends to want to see him so that she is flown from Greece back to Africa and sees her mother. Her father agrees to see his daughter, but he cannot wait for the time to pass and leave, exactly as she does.
Apart from Catherine using a man to have access to the woman, in this narration we also see a sign of her father holding the role of the symbolic, rather than the imaginary other with whom the hysteric identifies. This is because, like Dora, Catherine’s father is also marked by a trait we could compare to the former’s “impotence”: his known sexual relations with the male missionary, which deviate from his sexual interest in women. In fact, in the future Catherine will only refer to her father by diminishing nicknames describing his immoral lifestyle. In accordance to our hypothesis of hysterical structure, Catherine’s father is a figure who “classically incarnates the symbolic Other for the hysteric” (Voruz, 2007, p. 163). In addition, in this little scene we can see what Lacan puts quite aptly about the encounter with the father: that it is “forever missed” (1964, p. 60).
In the first steps of Catherine’s treatment, we see her more than eager to speak about her betrayal, first by the couple of factory owners and then by her husband and his mistress, in a way similar to Dora’s complaint about her father having abandoned her at the arms of Herr. K. Unsurprisingly, when her husband terminates the affair, she becomes even more upset. Why?
The turn for the worse might initially make no sense. Yet if we have learnt something from more than a century of psychoanalysis, this is that common sense does not identify with subjective reality. Catherine’s distress following the termination of the affair can be explained on the basis of our hypothesis of hysteria, because this meant that the other woman was temporarily removed from the stage. By stopping his contact with Helen, Catherine’s husband deprived his wife of access to the figure towards whom the question of femininity was at the time addressed. Yet, like Dora, for Catherine a “link should be preserved with that third element that enabled her to see the desire” (Lacan, 1964, p. 38). Therefore, the end of the affair was like Herr K.’s remark to Dora that he got nothing from his wife. If the other woman, whose place on this occasion is occupied by Helen, disappears from the stage, the hysteric herself can now be desired, instead of “the other woman she shelters behind” (Voruz, 2007, p. 163). The change of register, which could mean that Catherine herself could come to the place of the object of desire, is viewed clearly in the change of words with which she described the devastating pursuit of the “evidence”: she initially sought an apology. Yet with the apology came what she had not bargained for, that is, the termination of the affair. Therefore, she would now pursue with even greater passion the “evidence” of the affair, claiming that she was now looking for the truth.
This remark of hers –and the behaviour accompanying it- proves true Lacan’s reference to the hysteric’s discourse in the Seminar XVII, when he says that the position of truth is “sisterly” to that of jouissance (1970, p. 67), in the lesson Miller has entitled exactly Truth, the sister of jouissance (Lacan, 1969-1970). Catherine’s pursuit of truth was in fact a pursuit with regards to jouissance, which Lacan compares to the jar of the Danaids: “once you have started it, you never know where it will end. It begins with a tickle and ends in a blaze of petrol” (1970, p. 72).
My act at that point, the confiscation of the documents, puts a temporary halt to repetition and draws Catherine back to working-through in transference. And then comes the dream of Benedictine, thanks to the presence of whom in the place of Catherine’s husband in the bathroom, we have a first allusion to what could be viewed as Catherine’s relation to femininity beyond the hysterical question. What characterised that woman, in contrast to Mary or Helen, was that she was a woman with no man. We could thus suggest that something about this figure could be related to the feminine side of Lacan’s formulae of sexuation, which is found beyond the phallus and where lay what Lacan calls and the jouissance of not-whole (1973, p. 78).
An allusion to the jouissance of not-whole can be viewed in Catherine’s other frequent narration with regards to Africa: that she was always outraged by the behaviour of people like her father and uncles towards the indigenous population who were being used as servants. She remembers how she loathed those masters and gave secretly to the native children candy and fruit, something about which her aunts would reproach her.
Therefore, in Catherine’s psychical life, Africa is not only linked to the secret of her father’s adultery, which is undoubtedly the prototype for the industrialist’s and her husband’s conduct, but also to the maltreated native servants. We therefore see the “twofold” truth of the hysteric, on the one hand the castration of the master and on the other privation (Voruz, 2007, p. 174), both being linked to the dark continent, which here must be stressed that in Greek is called the “black continent” (η μαύρη ήπειρος). Other signifiers that point to the same direction are the “black chandelier” and the “black dogs” that appear in different dreams.
With this layout in mind, my attempt at an interpretation of Catherine’s last dream certainly proves out of place. When I repeated the word that sounded like my name I was obviously attempting to bring this element, the mark of the dark continent on the body, under the aegis of the signifier of the phallus, which guarantees equivocation. However, it seems that the corporeal element that was referred to was not of the same register to the evidence of the affair I had confiscated in the past. It did not have to do with phallic signification; it did not pass through the signifier of desire between Catherine’s husband and his mistress. Being in the shape of the “black continent”, it was rather of the same register to the figure of Benedictine, the African servants, the black dogs and the black chandelier.
This was probably one of those occasions, when an aspect of a woman’s jouissance that has to do with the not-whole, that is, not on the side of hysteria and phallic jouissance, arises. In her paper on Feminine Conditions of Jouissance, Morel (2002) writes of the incompatibility of hysteria and femininity, but also of the possibility of their extensions intersecting. “The analyst must not forget”, Morel remarks, “that a not-whole woman’s jouissance is related to the Other in such a way that, at any moment, it can give rise to manifestations that are as unpredictable as they are unexpected” (2002, p. 89).
In what other way could I therefore have tried to interpret this formation of the unconscious? In retrospect, it seemed to me that this dream might have been better treated like another one from the corpus of Freud’s works; not one dreamt by Dora, but by Freud himself.
Between Dora and Irma
If the interpretation of Dora’s dreams marks a failure in Freud’s treatment of a neurotic case, that of his own dream of Irma’s injection certainly marks a success. In fact, it marks much more: the very beginning of psychoanalysis. This is because the dream of Irma’s injection is the first dream the founder of psychoanalysis claims to have analysed completely, and thus the one to open the Interpretation of Dreams (1900a).
In a few words, in this dream the Freuds are entertaining and among their guests is Irma, a former patient for whom Freud has recently gotten bad news. Irma is examined by him and a number of his colleagues in the mouth, to reveal a horrendous vision, beyond which lies the chemical type of an injection that one of Freud’s colleagues was too hasty to administer to her (1900a).
Although Freud indeed analyses one-by-one the components of the dream to confirm his theory of wish-fulfilment, there are parts of it that remain incomplete, with him remarking that further associations could be generated by the existing parts (Freud, 1900a). Yet, apart from those elements that could be analysed further, there are also parts that will remain un-analysable, or, to put it differently, parts of the dream beyond which one cannot go. Freud notes that there is at least one such spot in every dream, which he characterises as the “dream’s navel”, its point of contact with the unknown (Freud, 1900a, p. 111).
In the dream of Irma’s injection, Freud locates this part in the “false teeth” aspect, which was his description of how Irma was reluctant to open her mouth for examination. However, there seem to be other elements too in the dream beyond which Freud cannot go. The horrendous view of the inside of Irma’s mouth, with its white patches, turbinal bones and scabs, could be one such spot. Lacan compares this view, this “real Medusa’s head” to the “abyss of the feminine organ from which all life emerges” (1954, p. 164). This could therefore be viewed as an encounter with the real, which provokes anxiety. Yet, as Lacan points out, Freud is a tough guy, and does not back in front of his wish to know. He wants to move beyond this real, and finds that what lies there is nothing but the word, that is, the chemical type of “propyl, propyls… propionic acid”. Seynhaeve (2016) suggests viewing this dream as a “dream of the pass”, alluding to the institutional procedure, introduced by Lacan, which leads to the end of one’s analysis by the presentation of their case to a group of appointed psychoanalysts, and then to the psychoanalytic community. Seynhaeve argues that the dream of Irma’s injection marks the end of Freud’s self-analysis and his moving forward (2016).
Based on this short presentation and the discussion of this dream’s signification, we could explain further, with the help of a few more information, why my interpretation of Catherine’s dream was not in the right direction and led to the termination of her treatment, whereas in Freud’s case this led to the “end” of his analysis. It seems that, just like Otto, Freud’s reckless friend in the dream, I suggested the wrong “solution” too.
At the time when this dream was generated, Catherine was speaking about the birth of her children and the presence of her husband’s mistress at the hospital. She would also speak about Helen’s implication with Catherine’s daughter, whose godmother she had become. Therefore, when I heard the narration of this dream I had in mind childbirth: a swollen part in the lower part of a woman’s body breaks and exhorts fluid, I thought. Thus came “Yanni”, the equivocation to her words “it will be healed”, with a view to relating it to the birth of her son and to myself. It is ironic that the dream might indeed have to do with childbirth; it might have been right in this. Yet, as Catherine’s associations very clearly indicated, that was not the birth of her children. The birth in question, which took place in Africa, was obviously her own. This was when her body was marked with the shape of the “black continent”, which was for her later linked to the jouissance of not-whole.
I therefore, unlike Freud, hesitated to take a step that could resemble his brave attempt to surpass the horror of the inside of Irma’s mouth. Instead of heading towards the mark of the “not-whole”, I backed off and tried to bring Catherine back to the game of equivocation that works in transference. Yet, as was remarked above, despite questioning femininity, hysteria, like motherhood, can become an obstacle to answering this question.
Thus, the attempt to grasp this element in transference in that way showed the neglect of the change of register at which the issue of femininity was approached. It seems that this mark of the dark continent was beyond equivocations, play-of-words and associations, and had to be treated accordingly. Yet, instead of Freud in the case of the dream of Irma’s injection, I acted in a way similar to his interpretation of Dora’s case; being, in the end, unable to rise to the occasion of treating the mark of the dark continent as it deserved, that is, not on the side of the phallus, but the not-whole.
Catherine’s case, with its ups and downs, successes and failures, can prove didactic with regards to the relation of hysteria to femininity and to the relation of that dipole to transference and repetition.
In the discussion of the development of her case above, I referred to the presence of the twofold hysterical truth, which concerns the castrated master and the jouissance of not-whole (Voruz, 2007). With a view to summarising more practical aspects of the treatment, the following last paragraphs are dedicated to the handling of transference and its relation to repetition.
With regards to the two terms, Freud remarks that there is transference to be found in repetition and repetition to be found in transference (1914g). In his papers on the dynamics of transference, as well as in Inhibitions, Symptoms and Anxiety (1926d) Freud develops how the analyst can use those indications of repetition that hinder the treatment on the side of transference. All in all, the relation between the two can be viewed like a “tug-of-war” or, to use Freud’s words, a “perpetual struggle” (1914g, p. 153), where the one or the other takes the upper hand.
In Catherine’s case, it was seen that when, on the occasion of the discovery of her husband’s adulterous affair, repetition took over, an act managed to return her working-through in the framework of transference. On the other hand, transference hit a wall when the corporeal mark of the dark continent, which is related to femininity in a way beyond the hysterical triangle, arose.
The analysis of her case and its premature termination can teach us of the prospect of cases where the options offered by the analyst may not only be on the side of transference, but, as Freud showed with his conduct in relation to the dream of Irma’s injection, on the side of the word.
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