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The Primacy of Emotions: a Continuation of Dramatology

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The Primacy of Emotions: a Continuation of Dramatology Archives of Psychiatry and Psychotherapy, 2015; 2 : 61–74 DOI: 10.12740/APP/42669 The primacy of emotions: a continuation of dramatology Henry Zvi Lothane Le coeur a ses raisons que la raison ne connaît point; on le sait en mille choses. (Pascal) Summary: Psychiatry means healing the psyche or soul that belongs to an individual human being, that is, a per- son, with a body and a capacity for acting, feeling, emoting and speaking, perceived by the five senses or imagined, seen figuratively in the mind’s eye, in images of dreams and daydreams. Since the total per- son appears before us with all the characteristics, an all-in-one package, I ask, how is it that psychiatry has lost its psyche? Dramatology approaches human encounters, events, and scenes as dramatic enact- ments of characters in conflict and crisis. It comprises two forms: dramatisation in thought and emotion that involves images and scenes lived in memories, dreams, daydreams, fantasy scenarios, and drama- tisation in act. This paper is a continuation of my earlier publication in this journal. emotions / dramatology / Freud EMOTIONS IN LIFE, DISORDER AND THERAPY cal treatment says more than that: it is treatment that has its beginning in the soul, treatment of For an introduction to the concept of drama- psychical or bodily complaints through means tology, please see Lothane [1]. (Mitteln) which operate from the start and di- Freud’s original insight into the reciprocal re- rectly upon the psyche or the soul of the per- lations of body and soul and its role in interper- son. Foremost among such means is the use of sonal relationships can be seen in an early 1890s words; and words are the essential tool of psy- paper which Freud published in 1905 [2, 3]: chical treatment. “Psychische Behandlung (Seelenbehandlung)”, But ‘mere words’ is like being asked to believe henceforth cited as “Psychical treatment”, which in magic. And he will not be so wrong, for the begins thus: “Psyche is a Greek word which is words which we use in our everyday speech are translated in German as Seele, i.e. soul. One nothing but watered-down magic, [due] to their might guess what is meant by this: the treatment former magical power” (p. 283, my translation). of morbid manifestations of one’s emotional life. Words are the most important means by which But this is not the meaning of the word. Psychi- man seeks to bring his influence to bear on an- other; words are a good method of producing psychical changes in the person to whom they Henry Zvi Lothane: MD, Clinical Professor of Psychiatry, Icahn are addressed. We shall explain how science sets School of Medicine at Mount Sinai. E-mail address: Schreber@lo- about restoring to words a part at least of their thane.com former magical power. So that there is no longer 62 Henry Zvi Lothane anything puzzling in the assertion that the mag- chical, in the animals no less than in human be- ic of words can remove the symptoms of illness, ings” [2, p. 284], as taught by his predecessors. and especially such as are themselves founded Freud’s first mentor was the Viennese internist in psychical states (p. 292). Josef Breuer, who in 1882-1883 told him about In ancient Greek, psyche meant the breath the treatment of Anna O. Freud’s second teach- of life, the life principle, the living or besouled er, in 1885-1886 in Paris, was Jean-Martin Char- body (empsychon) of Aristotle. Freud [4] wrote: cot, who had restored dignity to the despised “the ego is first and foremost a bodily ego” (p. disease of hysteria and the derided treatment 26) – all ideas and feelings have their source of hypnosis [8, 9]. Returning to Vienna in 1886, in the body. In quoting from “Psychical treat- Freud married, and started treating patients ment” I avoided Strachey’s “mental treatment” with psychological and bodily disorders. In for “psychical” is the better English equivalent 1888, he translated the book on suggestion by of seelisch; “mental” denotes cognitive activi- his third mentor, Nancy professor of medicine ty and discursive reason while “psychical” in- Hippolyte Bernheim, who, in contrast to Char- cludes both cognitive activity and Seelenleben, cot, proved that hypnosis “was completely in the the life of feelings and emotions, the hallmark sphere of psychology”, establishing suggestion of Romanticism as against classical intellectual- as “the key to its understanding” [10, p. 75]. In ism, as expressed in Goethe’s Faust, frequently 1889, Freud, reviewing Forel’s book on hypno- quoted by Freud. “Feeling is everything,” says tism, noted “suggestion, familiar to physicians Faust to Gretchen, “name is sound and smoke,” from time immemorial” as a method of healing and “Grey, dear friend, is all theory, And green “by the power of personality and the influence the golden tree of life.” Freud also extolled the of words” [11, p. 94]. romantic Naturphilosophie, the philosophy of na- In 1892-1893, in the first volume of a periodi- ture, as having “achieved the greatest advances cal founded that year, the Zeitschrift für Hypno- alike as a science and an art” [2, p. 283], for ex- tismus, Suggestionstherapie, Suggestionslehre und ample, with its pairs of polarities, both antag- verwandte psychologische Forschungen, whose ed- onistic and complementary, such as body and itorial board boasted Dr Sigm. Freud (Vienna) soul, day and night, matter and spirit, male and alongside Prof. H. Bernheim (Nancy), Prof. Forel female, object and subject, conscious and uncon- (Zürich), and Dr Liebeault (Nancy), Freud pub- scious, logic and intuition, real and ideal, reason lished “A Case of Successful treatment by Hyp- and imagination. notism” [12]. In “Psychical treatment” Freud operational- The central idea of psychical treatment was ised psychotherapy as therapy of the word, as the role of emotions in life, disorder, and psy- Entralgo [5] would call it – or the talking cure chotherapy. Since the last was born of medicine, [treatment] as Anna O., called it – which Freud Freud claimed that “it is not until we have stud- restated thus [6]: “nothing takes place in a psy- ied the pathological phenomena that we can get cho-analytic treatment but an interchange (Aus- an insight into normal ones.”[2, p. 286]. Howev- tausch) of words between the patient and the an- er, he also knew that the commonest, everyday alyst. The patient talks and tells about his past example of the influence of the psychical upon experiences and present impressions, complains, the bodily, and one that is observed in everyone, confesses to his wishes and emotional impulses. is offered by what is known as the “expression The doctor listens, directs the patient’s processes of the emotions” (Ausdruck der Gemütsbewegun- of thought, exhorts, gives him explanations. To gen). A man’s states of mind are manifested, al- this day words have retained their ancient magi- most without exception, in the tensions and re- cal power” (p. 17). Freud omitted mentioning in- laxations of his facial muscles, his eyes, in the terpersonal nonverbal communication via emo- amount of blood in the vessels of the skin, in the tions and bodily motions. He would incorporate modifications of his vocal apparatus, and in the such ideas in The Interpretation of Dreams [7]. At movements of his limbs and in particular of his this stage, he studied “the indisputable recipro- hands (p. 286), in extraordinary changes that oc- cal connection between the bodily and the psy- cur in the circulation, in the excretions and the tensions under the influence of fear, of rage, of Archives of Psychiatry and Psychotherapy, 2015; 2: 61–74 The primacy of emotions: a continuation of dramatology 63 psychical pain, of sexual delight (p. 287). Strict- in “pictures of imagination, dreams, and fanta- ly speaking, all psychical states, including those sies” (p. 280). The “needs of the total person- that we usually regard as “processes of thought” ality” lead to the “principle that the emotional are to some degree “affective” and not one of life [is] the nucleus of psychic experiences and them is without bodily manifestations or the ca- the immediate expression [of] the life forces” (p. pability to modify bodily processes. Even when 283). All of this is part of “the life experiences of a person is quietly engaged in thinking in ideas the individual, the life situation, the inner histo- (or images), there is a constant series of excita- ry” (p. 300). Schilder [14] argued against “psy- tions, corresponding to the content of these ide- chic elements”; emotions of joy, fear and grief as, which are discharged in smooth and striated and feelings are localised in the body: anxiety muscles (p. 288). in the heart, restlessness or peace in the geni- It is essential to underscore the similarities and tals, one is feeling happy around the stomach. differences between feelings and emotions. A In emotions we are aware of a great participa- feeling is an impression, a perception, an aware- tion of the self and the body when directed to- ness of something experienced, a self state. wards a situation which we perceive. This defi- An emotion is a motion, an expression, ex- nition immediately ends the artificial separation: perienced as Bewegung, a feeling-driven mo- every situation comprises perception, sensation, tion in oneself and addressed at another per- feeling, emotion and motility, in the total aspect son. Freud spoke of psychic reality, I propose of behaviour (pp. 177-180). the term emotional reality inseparable from the Polymath Schilder would have embraced the person’s living body. Similar ideas are found in work of today’s neuroscientists working on the Paul Schilder [13, 14].
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