Psychoanalytic features of the theory of trauma. Rehabilitation of the theory of trauma Fundamentals of the theory of trauma H

The concept of "psychic trauma" first appeared in the scientific literature at the end of the 19th century. The history of modern psychiatry is usually associated with the name of Emil Kraepelin and the publication in 1900 of his textbook Introduction to the Psychiatric Clinic. E. Kraepelin was a student of W. Wundt and created his own concept of psychiatry based on the methods of experimental psychology, in which the key concept of psychiatry is “symptom”.

Mental disorders began to be considered along with somatic diseases, and their cause was seen in external factors such as viruses, toxins and injuries. At the same time, another direction of psychiatry was developing - psychoanalysis, which substantiated the idea that all manifestations of mental disorders are determined by the patient's previous experiences (J. Charcot, Z. Freud "Study of Hysteria" 1893, C. Jung "Psychosis and Its Content" 1907, T. Teeling).

Thus, psychiatry was divided into two areas: medical (nosological), which preached the exogenous nature of mental disorders, and constitutional, which defended the idea of ​​the endogenous origin of mental disorders, and in particular that the mental constitution of the individual, individual characteristics and a unique history of development underlie mental illness. . The constitutional direction of psychiatry was based on the phenomenological approach of Karl Jaspers, the main idea of ​​which was that the main attention should be paid not to symptoms, but to the study of the personality of patients, their experiences and life history by “getting used to” and “feeling” into their inner world. And what, first of all, the psychiatrist has to face when working with patients is a traumatic life experience.

mental trauma- (trauma in translation from Greek - “wound”, “damage”, “result of violence”) - deep and painful experiences of a person associated with traumatic events in his life, extreme accumulations of excitation that he is unable to cope with or that partially overcome by unconscious defense mechanisms leading to the formation of neurotic symptoms. Z. Freud in his work “The Study of Hysteria” wrote: “Any event that causes a feeling of horror, fear, shame, mental pain can have a traumatic effect; and, of course, the likelihood that this incident will take on the character of a trauma depends on the susceptibility of the victim.

It is specific that the trauma does not always manifest itself in its pure form, as a painful memory or experience, it becomes, as it were, a “causative agent of the disease” and causes symptoms, which then, having gained independence, remain unchanged.

The concept of "injury" in the ordinary sense corresponds mainly to bodily injuries, violation of the integrity of the body.

Injuries are mild, severe and incompatible with life, it all depends on the strength of the impact of the source of injury and the protective barrier of the body. According to the laws of homeostasis, everything that disturbs the balance and integrity of the body causes a reaction aimed at restoring a stable state. At the same time, all foreign bodies are rejected by the body, that is, they are forced out. By analogy with physical trauma and the reaction of the body to it, psychic trauma also functions.

The psyche, as well as the internal environment of the body, strives to maintain a stable state, and everything that violates this stability is forced out in the terminology of Z. Freud. Unlike physical trauma, which is always external, psychic trauma can be of an intrapsychic nature, that is, the psyche has the ability to traumatize itself, producing certain thoughts, memories, experiences and affects.

The second significant difference between psychic and physical trauma is that it is invisible and objectified by indirect signs, the main of which is mental pain. The body's reflex reaction to any pain is withdrawal, avoidance, deliverance.

But the main function of pain is informational , it reports the presence of damage and starts the mechanism for the healing and survival of the organism.

mental pain it also informs about psychological distress and triggers the healing mechanism of the psyche - the work of protective mechanisms, in particular the mechanisms of repression and suppression or a response. A response to a traumatic impact is always present, and the more intense the trauma, the stronger the external action or internal experience. The response may be a retaliatory blow, swearing if a person is hit or humiliated, or there may be a feeling of powerlessness and crying. The response allows you to discharge the excessive mental excitation that occurs during trauma. In the case when the increased mental arousal due to circumstances cannot be responded to (including verbally, as you know, words can replace not only actions, but also experiences), the protective mechanisms of the psyche begin to work, transferring the energy of traumatic arousal into bodily symptoms, and discharge occurs in the somatic sphere.

What happens in psychoanalysis is called conversion.

Psychosomatic psychotherapy considers the symbolic meaning of conversion symptoms localized in the body as follows:

- resentment that a person could not "swallow" is localized in the swallowing area in the form of diseases of the throat, thyroid gland, and resentment that a person could not "digest" - in the gastrointestinal tract;

- "trauma of a broken heart" or a situation taken to heart has localization in the heart;

- guilt causes nausea, vomiting, vasospasm, and sexual guilt - frequent urination, enuresis, cystitis;

- "unshed" tears and suppressed crying cause intestinal upset and rhinitis (tears find another way out);

- powerless rage and passive irritability from a life situation, lack of support and support - disorders of the musculoskeletal system;

- injuries of humiliation and blows to pride - problems with blood vessels, headaches, hypertension;

- preverbal injuries - speech disorders.

Z. Freud pointed out that, despite the fact that somatization contributes to the discharge of mental stress that has arisen, a specific “mental core” or “switching point” is formed in the psyche, associatively associated with all the “attributes” of the resulting mental trauma. And this "mental core" will be activated whenever the situation resembles traumatic experiences, simultaneously triggering pathological response mechanisms. Z. Freud calls this process the phenomenon of "compulsive repetition." Thus, psychic trauma has a very "good memory", and its victims suffer mainly from memories and pathological response patterns realized unconsciously. Z. Freud noted that his patients are not only captured by painful experiences of the distant past, but also desperately cling to them, because they have some special value, there is a fixation on a trauma that can last a lifetime.

The theory of trauma, which played a prominent role in the early stages of psychoanalysis, was associated with psychic trauma as the cause of mental disorders. This idea arose from Z. Freud during the period of using the cathartic method of treatment in the treatment of hysteria.

Initially, Z. Freud believed that sexual harassment, which his patients reported to him, really took place and so traumatized the child's psyche that it subsequently led to neurotic disorders.

Unpleasant painful experiences are repressed, and the affects associated with them do not find expression, continue to develop unconsciously and begin to manifest themselves in the form of psychosomatic symptoms. Z. Freud believed that using the psychoanalytic method, with the help of memories, repressed traumatic experiences can be brought to a conscious level. And if you show a suppressed affect and steadfastly overcome it, then it is possible to get rid of both the trauma and the symptom. This happened to the first patient of psychoanalysis, Anna O., who, while caring for her terminally ill father, could not realize her sexual and aggressive impulses, because she was afraid to upset him. She repressed these impulses, which caused her to develop a number of symptoms: paralysis, convulsions, inhibition, mental breakdown.

As soon as she re-experienced and brought to resolution the corresponding affects, the symptoms disappeared, which proved the existence of a causal relationship between suppressed impulses and neurosis as their consequence. Thus, it became clear that the external situation (trauma, fear of losing his father) and internal motives (the desire to become close to him, perhaps even sexually, and at the same time the desire for his death) are equally responsible for the appearance of a neurosis.

Later, Z. Freud noted that the stories of patients about sexual harassment often turn out to be fiction and fantasy, which gave rise to the transition to the position of the theory of instincts (drives). Z. Freud's new hypothesis boiled down to the following: the sexually colored stories of patients are the product of their morbid fantasies, but these fantasies, although in a distorted form, reflect their real desires and inclinations.

Returning to Freud's theory of trauma, it should be noted that cases of sexual abuse by adults so injure the child's psyche that they are unable to endure these terrible and frightening experiences, which as a result are forced into the unconscious, and then presented in the form of psychopathology. At the same time, the situation is not only and not so much in the psychic trauma itself received in early childhood, but in pathogenic memories of it, which remain unconscious, but cause sexual arousal during puberty and at a later age. At the same time, Z. Freud believed that one should not expect the presence of one traumatic memory and, as its core, the only pathogenic representation, but one must be prepared for the presence of several series of partial traumas and linkages of pathogenic trains of thought.

In the "Introduction to Psychoanalysis Lectures", Z. Freud showed that the so-called "traumatic neuroses", which are the result of railway and other disasters, as well as the result of war, are in close analogy to the nervously ill. At the core of these neuroses lies a fixation on the moment of trauma. The traumatic situation is constantly repeated in the dreams of patients and it seems that it remains for them an insoluble actual problem.

The very concept of trauma acquires economic meaning, i.e. appears to be related to the amount of energy. Therefore, S. Freud calls a traumatic experience, which in a short time leads the psyche to such a strong increase in excitation that its normal processing or getting rid of it becomes impossible, as a result of which long-term disturbances in energy expenditure may occur. The psychodynamics of psychic trauma is such that even long-standing experiences have a tangible impact on the psyche, and the memory of them does not become less significant and painful over the years. Z. Freud noted that the decrease in the severity of traumatic experiences is essentially dependent on whether an energetic reaction (motor and emotional) to it followed immediately after the traumatic impact, or whether such a reaction was not possible, and it was suppressed. In this regard, early childhood traumas have such a strong pathological effect on the psyche, since the child is not able to respond vigorously to the traumatic impact. The reaction to trauma has a wide range of reactions: from immediate to delayed for many years and even decades, from ordinary crying to a cruel act of revenge and retaliatory aggression. And only when the person reacted to the traumatic event in full, the affect gradually decreases. Z. Freud characterizes this with the expressions “to throw out feelings” or “to cry out” and emphasizes that the insult that was answered is remembered differently than the one that had to be endured.

In the theory of trauma, external trauma and the internal psychological shock that accompanies it play a special role, while in the theory of instincts, internal motives and conflicts dominate. In the first case, a person is a victim of external circumstances, in the second - their culprit. In the first case, the cause of neurotic disorders are real events, in the second - fictitious (fantasy). Z. Freud's outstanding achievement is that, through trial and error, he came to the conclusion that along with injuries, there are instincts and internal psychological motives that control people's behavior. Modern psychoanalysis adheres to both the theory of trauma and the theory of instincts in explaining the cause of neuroses, believing that both theories are right. Many people do suffer from their instinctive impulses that make them feel overwhelmed, but also many mental disorders are observed from defective parent-child relationships, in which parents either did not respond to the needs of children, or unconsciously used them or simply treated them cruelly.

Z. Freud pointed out that mental trauma does not always contribute to the emergence of neuroses. There are times when tremendous traumatic events knock out a person so much that he loses interest in life, but such a person does not necessarily become neurotic. Various factors play a significant role in the formation of a neurosis, including constitutional features, infantile experiences, fixation on memories, regression, and internal conflicts.

In the work “Beyond Pleasure”, Z. Freud correlated psychic trauma with the mechanisms of protecting the human body from the dangers that threaten it. He called traumatic such strong excitations from the outside that are able to break through the defense against irritations. External trauma causes a breakdown in the energy of the body and sets in motion protective mechanisms. But the stimuli can be so strong that the organism is unable to restrain the psychic apparatus from being overwhelmed by a large number of stimuli. The body's last line of defense against irritants is fear. Z. Freud put forward a position on the close relationship between trauma and fear. He considered fear from the point of view of the reproduction of affective states corresponding to the memories that a person has. These affective states are embodied in mental life as sediments of traumatic experiences of the past and, in situations corresponding to these experiences, are reproduced as symbols of memories.

According to Z. Freud, real fear is the fear of a known danger, while neurotic fear is the fear of a danger that is unknown to man. In the case when a person experiences physical helplessness in the face of a real danger or mental helplessness in the face of the danger of his drives, a trauma occurs. Self-preservation of a person is connected with the fact that he does not wait for the onset of a traumatic situation of danger, but foresees, anticipates it. The expectation situation becomes a situation of danger, upon the occurrence of which a signal of fear arises, which resembles a previously experienced traumatic experience. Therefore, fear is, on the one hand, the expectation of trauma, and on the other hand, its softened reproduction, which, when danger occurs, is given as a signal for help.

In the understanding of the founder of psychoanalysis, there is another close connection between trauma and neurosis, which is rooted in the past in the relationship of the child with the mother. Thus, the situation in which the mother is absent turns out to be traumatic for the child, especially when the child experiences a need that the mother must satisfy. This situation simply turns into a danger, if this need is relevant, then the child's fear becomes a reaction to the danger. Subsequently, the loss of his mother's love becomes a stronger danger for him and a condition for the development of fear.

From the point of view of Z. Freud, the decisive moment for the outcome and consequences of an injury is not its strength, but the preparedness or unpreparedness of the organism, which is expressed in its potential. It is specific that trauma does not always manifest itself in its pure form, as a painful memory or experience. It becomes, as it were, a "causative agent" and causes various symptoms (phobias, obsessions, stuttering, etc.). According to his own observations, Z. Freud noticed that symptoms can disappear when it is possible to resurrect with all emotionality in memory, re-experience and pronounce a traumatic event. Later, these observations formed the basis of psychoanalytic psychotherapy and debriefing of work with mental trauma.

The main provisions of the theory of trauma Z. Freud:

Psychic traumas play an important role in the etiology of neuroses;

The experience acquires a traumatic character due to the quantitative factor;

With a certain psychological constitution, something becomes trauma that under another would not cause similar consequences;

All psychic traumas belong to early childhood;

Mental traumas are either experiences of one's own body, or sensory perceptions and impressions;

The consequences of trauma are of two kinds - positive and negative;

The positive consequences of trauma are associated with an effort to regain its weight, i.e. remember the forgotten experience, make it real, relive its repetition, let it be reborn to some other person (fixation on the trauma and its obsessive repetition);

The negative consequences of trauma are associated with defensive reactions in the form of avoidance and phobias;

Neurosis is an attempt to heal from trauma, the desire to reconcile the parts of the “I” that broke away under the influence of trauma with the rest of the parts.

An excerpt from the book: "Psychology of Experiences" by A.S. Kocharyan, A.M. fox

It is necessary to mention a difficult problem known since the emergence of theories of the psychoanalytic tree of knowledge: the antagonism between the theory of trauma and the theory of instincts. In my summary, I would like to emphasize with all certainty that modern psychoanalytic theory and practice stem from the theory of instincts. It circumvented, or rather supplanted, the so-called trauma theory. This theory, which played a prominent role in the early development of psychoanalysis (see the drawing of the psychoanalytic tree), was associated with trauma, (literally translated from Greek - “wound”, “damage”, “result of violence”). In a figurative sense and in connection with the field of the psyche, this means “shock”, “shock”.

Initially, Freud believed that the sexual harassment reported by his first patients actually took place. He believed that adult harassment hurts children so much that the childish self is unable to endure their spiritual consequences, let alone process them. Unpleasant, painful experiences are repressed, while the affects associated with them do not find expression, continue to develop unconsciously and lead to attempts to indirectly end the unbearable torment and, as a result, to neurotic disorders. Without knowing all the relationships, it is impossible to trace the origin of these disorders from mental trauma, but with the help of trauma memories and using the psychoanalytic method, they can be brought back to the level of consciousness. For this, according to Freud, it is necessary to manifest a suppressed affect and steadfastly overcome the consequences of the trauma - the symptom that has arisen. This happened to the first patient of psychoanalysis, Anna O., who, while caring for her terminally ill father, could not realize her sexual and aggressive impulses, because she was afraid to upset him. She repressed these impulses, which caused her to develop a number of symptoms: paralysis, convulsions, inhibition, mental breakdown. As soon as she re-experienced and brought to resolution the corresponding affects, the symptoms disappeared - which proved the existence of a causal relationship between the suppressed causes and the neurosis as their consequence. Thus, the therapeutic methods of "opening" eliminate the causes of neuroses. This example demonstrates that an external situation (trauma, fear of losing a father) and an internal motive (a desire to become close to him, perhaps even get sexually close, and at the same time, a desire for his death) are equally responsible for the appearance of a neurosis.

In the theory of trauma, a special role is played by external trauma and the internal psychological shock that accompanies it. in the theory of instincts, internal motives dominate. In the first case, the patient is the victim of external circumstances, in the second he is the culprit: this essential discrepancy persists up to the present day and will undoubtedly determine the future of psychoanalysis. Table 2 summarizes the main difference between the theories.

After Freud began to constantly learn from his patients that they had been sexually attacked by relatives, doubts about this crept into his head, which he expressed in a letter to Wilhelm Fliess dated September 21, 1897: “I no longer believe in my neurotic ... continuing disappointments in trying to bring the analysis to its full conclusion ... lack of complete success ”- this was what confused Freud. The following quote also applies to this: “Suddenly, then. that in all cases, without exception, the father is accused of perversions (and my own experience is no exception), the frequency of hysteria under such circumstances is surprising, although the frequency of this kind of perverse tendencies towards children is hardly so great. So, Freud abandoned the theory of trauma, replacing it with the theory of instincts, using which one can close one's eyes to serious evidence of sexual (and, it should be added, aggressive) trauma and not notice how often parents harm children, although the prospect of a logical solution to this problem is still far from exhausted (Masson, 1984).

At the same time, this, of course, is an outstanding achievement of Freud, who through "trial and error" came to the conclusion that along with trauma, there are instincts and internal psychological motives (including sexual motives) that control people. At the same time, the arguments in favor of sexual fantasies and the corresponding behavior of children are most often not experimental experiments in psychological laboratories, but everyday observations, in which every unprejudiced observer sees sufficient grounds for a psychoanalytic theory of instincts.

Table 2. Comparisons between trauma theories and instinct theory.

Here are the brothers of three and five years old pounding on the bottom of the cradle of a newborn sister and cheerfully shouting: “Now we will kill Eva!” Here is a three-year-old Wolfgang bluntly declares: “I want to be with my mother! When I grow up, I will marry her." He says this without considering his father's obvious reaction. But, without a doubt, already in these words of his, he eliminated him*. Those who carefully observed the behavior of children noticed similar scenes in any family.

Instincts are aimed at pleasure, they require action that causes pleasure. They seek satisfaction first in the form of "pre-enjoyment" through the stimulation of the erogenous zones, and then - through the pleasure in orgasm. They achieve their goal with the help of another person or self-gratification. Psychic incarnations of the manifestation of instincts are desires, fantasies and ideas, regularly accompanied by affects, emotions and, of course, passions. In the psychoanalytic theory of instincts, instincts are the first causes (causae prima) of all motives for our most ordinary actions. At the same time, they are usually unconscious, but they are expressed in dreams, "errors of behavior", in jokes, as well as in the symptoms of neurotics and in the perverse behavior of patients with sexual deviations.

Related to the theory of instincts is the confrontation between the sexual theories of psychoanalysis and the much less differentiated theory of aggressiveness; We will return to this confrontation later.

Personally, I am of the opinion that both sides are right. Many of my patients suffer from instinctive impulses that make them feel overwhelmed; these impulses, both sexual and aggressive, cause them anxiety. However, most patients complain of insurmountable mental disorders. One of two things: either the parents did not understand them too well, misinterpreted their needs, did not devote the necessary time to them, but did not leave them alone when they wanted to, or the parents unconsciously used them, not to say, abused them, or even just treated badly.

In this regard, we will talk about "traumatic neuroses", that is, about neuroses that return to traumas, to emotional wounds. These wounds are so painful that the child feels wounded in his self-esteem and, as a result, develops a "narcissistic neurosis", that is, a neurosis characterized by painful self-esteem. I drew attention to this back in 1968 (before Kohut) in a small article and emphasized the importance of the assessment of reality in the emergence of modern neuroses in the anniversary collection dedicated to Wolfgang Loch (Kutter, 1975). At the same time, I pointed out one of the varieties of post-classical neuroses associated with a violation of self-identification in a fatherless society, and a group of post-classical neuroses associated with a lack of a mother in a motherless society.

About how social traumas unite people in Western countries, and why Watergate and the Holocaust are so important to Americans. T&P highlighted the main theses of the speech.

It is paradoxical that Western societies, dominating in many areas, are consolidated not around technological progress, successes or routine practices, but in the places of their failures. They define their identity through the construction of traumas.

An important place in this process is the formation of solidarity. The concept of solidarity is much broader and more complex than is commonly believed - it is not associated exclusively with involvement in the ethics of a common cause or common struggle. In addition to deep concepts of false and true, solidarity can affect purely cognitive things - for example, the use of a common language by all.

In the 1970s, Watergate became a significant injury. Thanks to him, a divided society, unable to come to an agreement, united again. Subsequently, Nixon even managed to win the election, but now this scandal is a very important event for the Americans.

The solidarity of football fans is easy to recognize. Much more difficult is the case with individuals who build their lives on the belief that it is natural for people to differ from each other. How to recognize the common foundations of solidarity among them? This is a methodological problem for a sociologist and a practical problem for the whole society: without visible markers, self-identification in society becomes impossible.

The French sociologist Emile Durkheim argued that the sacred can manifest itself in two modes - positive and negative. The positive one lies in the reproduction of the social order, its symbols and practices, strengthening something already proclaimed. The negative mode is associated with the violation of these norms. The paradox lies in the fact that the boundaries between the two modes are not obvious both for researchers and for the individuals themselves. And they are highlighted precisely at the moment of trauma - a phenomenon around which a consensus is being formed.

One of the most significant traumas for Americans is the Holocaust, which is known to almost everyone, while having a rather vague idea of ​​​​the history of World War II. In the 1970s, Watergate became a significant injury. Thanks to him, a divided society, unable to come to an agreement, united again. It is noteworthy that the injury takes time to fully develop and have an impact. After Watergate, Nixon even managed to win the election, but now this scandal is a very important event for Americans.

In non-Western countries, including Russia, traumas often have the opposite effect - they increase intransigence and reduce solidarity to extremely low levels. This phenomenon is now being actively studied by domestic sociologists.

The full speech of sociologist Dmitry Kurakin can be viewed on the website

Chapter 3

The hypothesis about the psychogenic origin of some mental disorders was formulated by the eminent French psychiatrist Jean Martin Charcot even earlier - around 1883, but, strictly speaking, it has not been scientifically worked out in any way. Freud, who studied with Charcot in Paris in 1885, unlike many of his colleagues, immediately and completely accepted this idea, which was further strengthened in the process of his joint work with Joseph Breuer.

I have already written about this quite popularly and in detail in another small book - "Elementary Psychoanalysis" and here I will only remind you that even before starting to collaborate with Freud, Breuer developed his own method of psychotherapy. After immersing patients in a hypnotic state, he asked them to describe in detail various traumatic situations that had taken place in the past. In particular, it was proposed to recall the beginning, the first manifestations of mental suffering and events that could be the cause of certain psychopathological symptoms. However, Breuer did not advance further than this methodical device. Later, already in the joint research of Freud and Breuer, it was found that sometimes only one story about these situations in a state of hypnosis (in a sense, a "violent memory") led to the release of patients from their suffering. Breuer called this phenomenon "catharsis" by analogy with the term proposed by Aristotle to refer to the phenomenon of "purification through tragedy", when, perceiving high art and experiencing fear, anger, despair, compassion or torment together with the actor, the viewer purifies the soul. Here we again meet the already mentioned position about the need to re-experience (emotional) trauma directly in the process of therapy and, referring to the 100-year experience of psychotherapy, we must admit that if the affective component is absent, the effectiveness of the therapeutic process is usually low.

A little later, during the first psychoanalytic sessions, Freud draws attention to the fact that in the stories of his patients there is almost always an increased fixation on topics and psycho-traumatic experiences, one way or another connected with attempts or results of their seduction in childhood, mainly by close relatives. , and most often - daughters by fathers. In general, and this is well known from clinical practice, such situations are indeed not uncommon in families with a burdened psychiatric history. Later, the recognition of the role of traumatic situations in early childhood, and especially childhood sexual trauma as a trigger mechanism for psychopathology, became one of the main postulates of psychoanalysis (and is in fact generally recognized). But Freud's first reports of this, presented to the Viennese medical community, caused an uproar and ultimately led to a break with Breuer, who (as well as many others) did not accept the idea of ​​sexual trauma.

The strangest thing is that Freud gradually, as it were, moved away from it - not so much from the idea of ​​​​sexuality, but from the actual mental trauma, subsequently paying more and more attention to the theory of drives, which in modern psychoanalysis almost supplanted the theory of trauma. This is even more surprising due to the fact that both theories are consistent, and one does not exclude the other. And besides, not fully sharing the principle of sexuality, after 30 years of practice, I cannot but admit that up to 70% of my patients had some kind of sexual trauma in early childhood, caused by one of their immediate family members. These traumas are extremely pathogenic, the child is wounded in his brightest feelings, and at the same time - wounded by the very adult from whom, first of all, he tends to expect love and protection. In such cases, severe (narcissistic) neuroses can develop, associated with painful self-esteem and damage done to the sense of self-esteem.

As is well known, after some time and, as some historiographers of psychoanalysis note, to a certain extent in favor of public opinion, Freud qualitatively transforms his hypothesis and makes an unexpected conclusion that it would be wrong to accuse all fathers of perversion, since in the stories of neurotic patients about the circumstances of the occurrence of affective experiences, it is very difficult, and often impossible, to distinguish truth from fiction (and with this, I think, any practitioner will agree, regardless of his attitude to psychoanalysis). The essence of the transformation of Freud's hypothesis was as follows: the sexually colored stories of patients can only be the product of their morbid fantasies, but these fantasies, albeit in a distorted form, reflect their real desires and drives. Thus, in the new interpretation of Freud's hypothesis, it was no longer about the perversion of fathers, but about the unconscious desire of daughters to be seduced by their fathers. But this was not the main thing: in this new construction, the theory of trauma gave way to the theory of drives, the “patient-victim” was transformed into the “culprit” of his own troubles, and cruel “reality” was equated with “fantasy” (from the point of view of psychic reality, which can be no less cruel - the latter is certainly true, but besides it there is simply reality).

But that was a little later, and now we will return to the theory of trauma. Freud believed that cases of sexual abuse by adults so hurt children that they are unable to bear these terrible, incomprehensible, unknown and even alien experiences, which as a result are forced out (from memory and consciousness). But since the affective (pathological) process is already running and in most cases cannot stop, it is qualitatively transformed (into a symptom) - and instead of repressed suffering, about which the child has no one to turn to, his “substitute” appears, which can be presented, including the traumatized adult - this or that psychopathology.

Let me explain this with a specific example. For example, in one of my patients who came to therapy (when she was about 30) for occasional gas incontinence, this symptom first appeared at the age of 8, and the trauma was the seductive behavior of the mother, who, after quarrels with her father, usually came to bed with her daughter and realized her pathological complexes there, caressing herself and her daughter. With no other way to avoid it, the patient produced a symptom of a defensive nature that made her unpleasant as a sexual object.

Such psychopathology is very often present in an explicit or latent form since childhood, but the main thing is that its cause usually remains inaccessible to consciousness. However, with the help of the psychoanalytic method, these memories can be brought to a conscious level, how to “manifest” the repressed affect, free it, in the language of Freud, from the “soot of unnaturalness” and “stench”, and then, in the process of mental processing, make it really past, really forgotten and thus overcome the consequences of psychic trauma - certain symptoms of actual mental suffering (and their somatic equivalents).

Let us emphasize once again the most important difference between Freud's early and later theoretical developments: in the theory of trauma, external "unfavorable" circumstances play a special role, with the recognition of the possibility of their existence in objective reality. In the theory of drives, the main ones are internal motives and the fantasies induced by them. In the first case, the patient turns out to be a victim of external (introduced) conditions, and in the second, he himself is the source of his own suffering and disappointment. Drives are focused on getting pleasure, manifesting themselves in highly variable desires, fantasies and ideas aimed at some object, and usually projected into the future. Experiences of trauma, on the contrary, are most often rigidly connected with a single event and turned into a painful past.

But there is something that both theories have in common: both traumas and drives are necessarily accompanied by affects, emotions and passions.

Why are we talking about this in such detail? There are too many real mental traumas in the modern world. And modern psychoanalysis has become too concentrated on the theory of drives. And in those cases when the therapist, faced with a real psychic trauma, continues to think stereotypically and act within the framework of a well-learned theory of drives, he is unlikely to be able to help his patient, who simply does not understand - why are they talking to him “completely not about that”? Similar ideas are indirectly expressed by other authors. Thus, discussing the specifics of traumas associated with the loss of one of the family members (in this case, a child), Alain Gibaud notes that parental grief, as well as the grief of a child due to the loss of a mother, can hardly be adequately interpreted within the framework of an oedipal situation, because these injuries are qualitatively different.

Let me remind you once again that Freud discovered all this and clinically studied it in great detail already by 1895. But then, after the publication of The Interpretation of Dreams, for some period he “cooled” towards the theory of trauma, but, as we will see later, he did not abandon it at all. In concluding this section, I also note that, referring to Freud's subsequent works, we will not unnecessarily "plunge" into the theory of drives, which, much more often than previously thought, turns out to be of little use in situations of psychic trauma.

In order not to be misunderstood, I must emphasize that this statement does not in any way diminish the significance (more precisely, the historical significance) of Freud's theory of drives and its subsequent development in the works of his numerous students and followers, including outside psychoanalysis (considering that that certain provisions of this theory are organically implied in almost all modern methods of psychotherapy).

Primary trauma theory(O.Rank)

The theory is created in the conceptual framework of depth psychology. The focus of her attention is psychoanalytic. examination of the culture characteristics. Rank was the first of the psychoanalysts to apply the interpretative method to the analysis of symbols, the products of the collective creativity of humanity, the universe, art. He began to analyze mythology, l-ru, art from the so-called. deep unconscious content of collective experience. The scientist did not share the causal paradigm of the theory of 3. Freud. In his understanding, personal not determined in its development. It freely interprets meanings and initiates actions.

One of the central concepts of the concept is the trauma of birth. Rank's idea is that the appearance of a human. creatures into the world is associated with a situation that causes anxiety. Personal development is associated with two conflicting tendencies: the fear of life and the fear of death. The first is associated with a tendency to individualization, separation from others, the second - with a merger, dependence.

Differentiating himself from others, the child begins to manifest a rudimentary form of desire - counter-will, that is, the ability to oppose his will to others. If the negativistic will destroys the bond between the child and the parents, he begins to feel guilty as specific. expression of fear of life. If the connection between the child and parents is not destroyed, the opposition is transformed into a will, which reduces the fear of life and the fear of death. Influence of will on conflicting human tendencies. psyche determines whether there will be personal. strive for new opportunities or wallow in routine.

Rank singled out three types of personalities: normal adapted (people from the crowd, without self-determination), neurotic and creative type of the artist. The first expresses a tendency to unite with people, but does not support the development of one's own. individuality. He is reliable, but at the same time conforming, superficial and incapable of understanding and satisfying his own. desires. This type develops as a result of the suppression of the manifestations of one's own by the parents. will, initiative of the child.

The neurotic personality shows a tendency to separate from people, negativism; it expresses opposition more than will. Such a person is critical of others and at the same time experiences guilt, feels unworthy, wrong.

The type of artist represents an ideal development in which a strong will develops, and the fear of life and fear of death are minimal. He is able to enter into close people. relations without humility and suppression, not focusing on accepted norms. His thoughts, feelings, actions are characterized by a high degree of differentiation and integration. The results of the activity are original and at the same time useful and valuable for people.

Rank's ideas largely determined the future fate of psychoanalysis, analytical psychology, influenced humanistic, existential and transpersonal psychology, and significantly expanded the horizons of cultural experience. They are widely known and used in lit. criticism, cultures, anthropology. It is impossible not to specifically note the influence of his approach on lit. plots and motifs of works of art.