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Eukaryotic cells may have evolved from primitive prokaryotes about 2 billion years ago. One hypothesis suggests that some prokaryotic cells lost their cell walls, permitting the cell’s plasma membrane to expand and fold. These folds, ultimately, may have given rise to separate compartments within the cell - the forerunners of the nucleus and other organelles now found in eukaryotic cells. Another key hypothesis is known as endosymbiosis. Molecular studies of the bacteria-like DNA and ribosomes in mitochondria and chloroplasts indicate that mitochondrion and chloroplast ancestors were once free-living bacteria. Scientists propose that these free-living bacteria were engulfed and maintained by other prokaryotic cells for their ability to produce ATP efficiently and to provide a steady supply of glucose. Over generations, eukaryotic cells situated with mitochondria - the ancestors of animals - or with both mitochondria and chloroplasts - the ancestors of plants - evolved.
The first observations of cells were made in 1665 by English scientist Robert Hooke, who used a crude microscope of his own invention to examine a variety of objects, including a thin piece of cork. Noting the rows of tiny boxes that made up the dead wood’s tissue, Hooke coined the term cell because the boxes reminded him of the small cells occupied by monks in a monastery. While Hooke was the first to observe and describe cells, he did not comprehend their significance. At about the same time, the Dutch maker of microscopes Antoni van Leeuwenhoek pioneered the invention of one of the best microscopes of the time. Using his invention, Leeuwenhoek was the first to observe, draw, and describe a variety of living organisms, including bacteria gliding in saliva, one-celled organisms cavorting in pond water, and sperm swimming in semen. Two centuries passed, however, before scientists grasped the true importance of cells.
Many advances have since been made in microscope technology. This article from the 1994 Collier’s Year Book begins with the microscope most young students are familiar with and tracks the breakthroughs in the development of new types of microscopes - including those that use ultrasonic imaging and those that ‘feel’ an object’s surface.
Modern ideas about cells appeared in the 1800s, when improved light microscopes enabled scientists to observe more details of cells. Working together, German botanist Matthias Jakob Schleiden and German zoologist Theodor Schwann recognized the fundamental similarities between plant and animal cells. In 1839 they proposed the revolutionary idea that all living things are made up of cells. Their theory gave rise to modern biology: a whole new way of seeing and investigating the natural world.
By the late 1800s, as light microscopes improved, still furthering scientific abilities to observe chromosomes within the cell. Their research was aided by new techniques for staining parts of the cell, which made possible the first detailed observations of cell division, including observations of the differences between mitosis and meiosis in the 1880s. In the first few decades of the 20th century, many scientists focused on the behavior of chromosomes during cell division. At that time, it was generally held that mitochondria transmitted the hereditary information. By 1920, however, scientists determined that chromosomes carry genes and that genes transmit hereditary information from generation to generation.
During this period, scientists began to understand some of the chemical processes in cells. In the 1920s, the ultracentrifuge was developed. The ultracentrifuge is an instrument that spins cells or other substances in test tubes at high speeds, which causes the heavier parts of the substance to fall to the bottom of the test tube. This instrument enabled scientists to separate the relatively abundant and heavy mitochondria from the rest of the cell and study their chemical reactions. By the late 1940s, scientists were able to explain the role of mitochondria in the cell. Using refined techniques with the ultracentrifuge, scientists subsequently isolated the smaller organelles and gained an understanding of their functions.
The deoxyribonucleic acid (DNA) molecule is the genetic blueprint for each cell and ultimately the blueprint that determines every characteristic of a living organism. In 1953 American biochemist James Watson, left, and British biophysicist Francis Crick, right, described the structure of the DNA molecule as a double helix, somewhat like a spiral staircase with many individual steps. Their work was aided by X-ray diffraction pictures of the DNA molecule taken by British biophysicist Maurice Wilkins and British physical chemist Rosalind Franklin. In 1962 Crick, Watson, and Wilkins received the Nobel Prize for their pioneering work on the structure of the DNA molecule.
While some scientists were studying the functions of cells, others were examining details of their structure. They were aided by a crucial technological development in the 1940s, the invention of the electron microscope, which uses high-energy electrons instead of light waves to view specimens. New generations of electron microscopes have provided resolution, or the differentiation of separate objects, thousands of times more powerful than that available in light microscopes. This powerful resolution revealed organelles such as the endoplasmic reticulum, lysosomes, the Golgi apparatus, and the cytoskeleton. The scientific fields of cell structure and function continue to complement each other as scientists explore the enormous complexity of cells.
The discovery of the structure of DNA in 1953 by American biochemist James D. Watson and British biophysicist Francis Crick ushered in the era of molecular biology. Today, investigation inside the world of cells - of genes and proteins at the molecular level - constitutes one of the largest and fastest moving areas in all of science. One particularly active field in recent years has been the investigation of cell signaling, the process by which molecular messages find their way into the cell via a series of complex protein pathways in the cell.
Another busy area in cell biology concerns programmed cell death, or apoptosis. Millions of times per second in the human body, cells commit suicide as an essential part of the normal cycle of cellular replacement. This also seems to be a check against disease: When mutations build up within a cell, the cell will usually self-destruct. If this fails to occur, the cell may divide and give rise to mutated daughter cells, which continue to divide and spread, gradually forming a growth called a tumor. This unregulated growth by rogue cells can be benign, or harmless, or cancerous, which may threaten healthy tissue. The study of apoptosis is one avenue that scientists explore in an effort to understand how cells become cancerous.
Scientists are also discovering exciting aspects of the physical forces within cells. Cells employ a form of architecture called tensegrity, which enables them to withstand battering by a variety of mechanical stresses, such as the pressure of blood flowing around cells or the movement of organelles within the cell. Tensegrity stabilizes cells by evenly distributing mechanical stresses to the cytoskeleton and other cell components. Tensegrity also may explain how a change in the cytoskeleton, where certain enzymes are anchored, initiates biochemical reactions within the cell, and can even influence the action of genes. The mechanical rules of tensegrity may also account for the assembly of molecules into the first cells. Such new insights - made some 300 years after the tiny universe of cells was first glimpsed - show that cells continue to yield fascinating new worlds of discovery.
The Nervous System signifies of those elements within the animal organism that are concerned with the reception of stimuli, the transmission of nerve impulses, or the activation of muscle mechanisms.
The reception of stimuli is the function of special sensory cells. The conducting elements of the nervous system are cells called neurons; these may be capable of only slow and generalized activity, or they may be highly efficient and rapidly conducting units. The specific response of the neuron - the nerve impulse - and the capacities of the cell to be stimulated make this cell a receiving and transmitting unit capable of transferring information from one part of the body to another.
Each nerve cell consists of a central portion containing the nucleus, known as the cell body, and one or more structures referred to as axons and dendrites. The dendrites are rather short extensions of the cell body and are involved in the reception of stimuli. The axon, by contrast, is usually a single elongated extension, it is especially important in the transmission of nerve impulses from the region of the cell body to other cells.
Although all many-celled animals have some kind of nervous system, the complexity of its organization varies considerably among different animal types. In simple animals such as jellyfish, the nerve cells form a network capable of mediating only a relatively stereotyped response. In more complex animals, such as shellfish, insects, and spiders, the nervous system is more complicated. The cell bodies of neurons are organized in clusters called ganglia. These clusters are interconnected by the neuronal processes to form a ganglionated chain. Such chains are found in all vertebrates, in which they represent a special part of the nervous system, related especially to the regulation of the activities of the heart, the glands, and the involuntary Vertebrate animals have a bony spine and skull in which the central part of the nervous system is housed; The peripheral part extends throughout the remainder of the body. That part of the nervous system located in the skull is referred to as the brain that found in the spine is called the spinal cord. The brain and the spinal cord are continuous through an opening in the base of the skull; Both are also in contact with other parts of the body through the nerves. The distinction made between the central nervous system and the peripheral nervous system is based on the different locations of the two intimately related parts of a single system. Some of the processes of the cell bodies conduct sense impressions and others conduct muscle responses, called reflexes, such as those caused by pain.
In the skin are cells of several types called receptors; each is especially sensitive to particular stimuli. Free nerve endings are sensitive to pain and are directly activated. The neurons so activated send impulses into the central nervous system and have junctions with other cells that have axons extending back into the periphery. Impulses are carried from processes of these cells to motor endings within the muscles. These neuromuscular endings excite the muscles, resulting in muscular contraction and appropriate movement. The pathway taken by the nerve impulse in mediating this simple response is in the form of a two-neuron arc that begins and ends in the periphery. Many of the actions of the nervous system can be explained on the basis of such reflex arcs, which are chains of interconnected nerve cells, stimulated at one end and capable of bringing about movement or glandular secretion at the other.
The cranial nerves connect to the brain by passing through openings in the skull, or cranium. Nerves associated with the spinal cord pass through openings in the vertebral column and are called spinal nerves. Both cranial and spinal nerves consist of large numbers of processes that convey impulses to the central nervous system and also carry messages outward; the former processes are called afferent, and the latter are called efferent. Afferent impulses are referred to as sensory; efferent impulses are referred to as either somatic or visceral motor, according to what part of the body they reach. Most nerves are mixed nerves made up of both sensory and motor elements.
The cranial and spinal nerves are paired; The number in humans are 12 and 31, respectively. Cranial nerves are distributed to the head and neck regions of the body, with one conspicuous exception: the tenth cranial nerve, called the vagus. In addition to supplying structures in the neck, the vagus is distributed to structures located in the chest and abdomen. Vision, auditory and vestibular sensation, and taste is mediated by the second, eighth, and seventh cranial nerves, respectively. Cranial nerves also mediate motor functions of the head, the eyes, the face, the tongue, and the larynx, as well as the muscles that function in chewing and swallowing. Spinal nerves, after they exit from the vertebrae, are distributed in a band-like fashion to regions of the trunk and to the limbs. They interconnect extensively, thereby forming the brachial plexus, which runs to the upper extremities, and the lumbar plexus, which passes to the lower limbs.
Among the motor’s fibers may be found groups that carry impulses to viscera. These fibers are designated by the special name of autonomic nervous system. That system consists of two divisions, more or less antagonistic in function, that emerge from the central nervous system at different points of origin. One division, the sympathetic, arises from the middle portion of the spinal cord, joins the sympathetic ganglionated chain, courses through the spinal nerves, and is widely distributed throughout the body. The other division, the parasympathetic, arises both above and below the sympathetic, that is, from the brain and from the lower part of the spinal cord. These two divisions control the functions of the respiratory, circulatory, digestive, and urogenital systems.
Consideration of disorders of the nervous system is the province of neurology; Psychiatry deals with behavioral disturbances of a functional nature. The division between these two medical specialties cannot be sharply defined, because neurological disorders often manifest both organic and mental symptoms.
Diseases of the nervous system include genetic malformations, poisonings, metabolic defects, vascular disorders, inflammations, degeneration, and tumors, and they involve either nerve cells or their supporting elements. Vascular disorders, such as cerebral hemorrhage or other forms of a stroke, are among the most common causes of paralysis and other neurologic complications. Some diseases exhibit peculiar geographic and age distribution. In temperate zones, multiple sclerosis is a common degenerative disease of the nervous system, but it is rare in the Tropics.
The nervous system is subject to infection by a great variety of bacteria, parasites, and viruses. For example, meningitis, or infection of the meninges investing the brain and spinal cord, can be caused by many different agents. On the other hand, one specific virus causes rabies. Some viruses causing neurological ills effect only certain parts of the nervous system. For example, the virus causing poliomyelitis commonly affects the spinal cord, as Viruses manufacturing encephalitis attack the brain.
Inflammations of the nervous system are named according to the part affected. Myelitis is an inflammation of the spinal cord; Neuritis is an inflammation of a nerve. It may be caused not only by infection but also by poisoning, alcoholism, or injury. Tumors originating in the nervous system usually are composed of meningeal tissue or neuroglia (supporting tissue) cells, depending on the specific part of the nervous system affected, but other types of a tumor may metastasize to or invade the nervous system. In certain disorders of the nervous system, such as neuralgia, migraine, and epilepsy, no evidence may exist of organic damage. Another disorder, cerebral palsy, is associated with birth defects.
Pain, an unpleasant sensory and emotional experience caused by real or potential injury or damage to the body or described in terms of such damage. Scientists believe that pain evolved in the animal kingdom as a valuable three-part warning system. First, it warns of injury. Second, pain protects against further injury by causing a reflexive withdrawal from the source of injury. Finally, pain leads to a period of reduced activity, enabling injuries to heal more efficiently.
Pain is difficult to measure in humans because it has an emotional, or psychological component as well as a physical component. Some people express extreme discomfort from relatively small injuries, while others show little or no pain even after suffering severe injury. Sometimes pain is present even though no injury is apparent at all, or pain lingers long after an injury appears to have healed.
The signals that warn the body of tissue damage are transmitted through the nervous system. In this system, the basic unit is the nerve cell or neuron. A nerve cell is composed of three parts: a central cell body, a single major branching fiber called an axon, and a series of smaller branching fibers known as dendrites. Each nerve cell meets other nerve cells at certain points on the axons and dendrites, forming a dense network of interconnected nerve fibers that transmit sensory information about touch, pressure, or warmth, as well as pain.
Sensory information is transmitted from the different parts of the body to the brain via the spinal cord, which is a complex set of nerves that extend from the brain down along the back, protected by the bones of the spine. About as wide as a finger, the spinal cord is like a cable packed with many bundles of wires. The bundles are nerve pathways for transmitting information. But the spinal cord is more than just a message transmitter, it is also an extension of the brain. It contains neurons that process incoming sensory information, and generates messages to be sent back down to cells in other parts of the body.
In the nervous system, a message-carrying impulse travels from one end of a nerve cell to the other by means of an electrical impulse. When it reaches the terminal end of a nerve cell, the impulse trigger’s tiny sacs called presynaptic vessicles to release their contents, chemical messengers called neurotransmitters. The neurotransmitters float across the synapse, or gap between adjacent nerve cells. When they reach the neighboring nerve cell, the neurotransmitters fit into specialized receptor sites much as a key fits into a lock, causing that nerve cell to ‘fire,’ or generate an electric message-carrying impulse. As the message continues through the nervous system, the presynaptic cell absorbs the excess neurotransmitters, and repackages them in presynaptic versicles in a process called neurotransmitter reuptake.
Information being transmitted between and within the brain and spinal cord travels through the nervous system using both chemical and electrical mechanisms. A message-carrying impulse travels from one end of a nerve cell to another by means of an electric signal. When the electric signal reaches the terminal end of a nerve cell, a gap called a synapse prevents the electric signal from crossing to the next cell. The electric signal triggers the cell to release chemicals called neurotransmitters, which float across the synapse to the neighboring nerve cell. These neurotransmitters fit into specialized receptors found on the adjacent nerve cell, much as a key fits into a lock, generating an electric impulse in the neighboring cell. This new impulse travels to the end of the long cell, in turn triggering the release of neurotransmitters to carry the message across the next synapse. Not all neurotransmitters initiate a message in a neighboring nerve cell. Some specialize in preventing neighboring cells from generating an electrical signal, while others function as helpers, facilitating the message's journey to the brain.
While most of the sensory nerves in the skin and other body tissues have special structures covering their nerve endings, those nerves that signal injury have free nerve endings. These simple nerve endings specialize in detecting noxious stimuli - a catchall term for injury-causing stimuli such as intense heat, extreme pressure, or sharp pricks or cuts. The nerve endings that detect pain are called nociceptors, and the process of transmitting pain signals when harmful stimulation occurs is called nociception. Several million nociceptors are interlaced through the tissues and organs of the body.
When a person experiences an injury, such as a stubbed toe, specialized cells called nociceptors sense potential tissue damage (1) and send an electric signal, called an impulse, to the spinal cord via a sensory nerve (2). A specialized region of the spinal cord known as the dorsal horn (3) processes the pain signal, immediately sending another impulse back down the leg via a motor nerve (4). This causes the muscles in the leg to contract and pull the toe away from the source of injury (6). At the same time, the dorsal horn sends another impulse up the spinal cord to the brain. During this trip, the impulse travels between nerve cells. When the impulse reaches a nerve ending (7), the nerve released chemical messengers, called neurotransmitters, which carry the message to the adjacent nerve. When the impulse reaches the brain (8), it is analyzed and processed as an unpleasant physical and emotional sensation.
An injury triggers pain signals in two types of nociceptors, one with large, insulated axons known as A-delta fibers and one with small, uninsulated axons known as C fibers. The large A-delta fibers conduct signals quickly, and the smaller C fibers transmit information slowly. The difference in the functions of these two fibers becomes obvious to a person who stubs a toe. At first the injured person is aware of a sharp, flashing pain at the point of injury. Generated by the A-delta fibers, this short-lived pain intrudes upon the thoughts and perceptions occurring in the brain. Just as this first pain subsides, a second pain begins that is vague, throbbing, and persistent. This sensation is derived from the C fibers.
Pain information from the A-delta and C fibers travels through the spinal cord to the brain. When it receives the pain message, the spinal cord generates impulses that travel back down to muscles, which lead to a reflexive contraction that pulls the body away from the source of injury. Other reflexes may affect skin temperature, blood flow, sweating, and other changes.
While this reflex action is underway, the pain message continues up the spinal cord to relay centers in the brain. The sensory information is routed to many other parts of the brain, including the cortex, where thinking processes occur
Like all other cells, neurons contain charged ions: Potassium and sodium (positively charged) and chlorine (negatively charged). Neurons differ from other cells in that they are able to produce a nerve impulse. A neuron is polarized - that is, it has an overall negative charge inside the cell membrane because of the high concentration of chlorine ions and low concentration of potassium and sodium ions. The concentration of these same ions is exactly reversed outside the cell. This charge differential represents stored electrical energy, sometimes referred to as membrane potential or resting potential. The negative charge inside the cell is maintained by two features. The first is the selective permeability of the cell membrane, which is more permeable to potassium than sodium. The second feature is sodium pumps within the cell membrane that actively pump sodium out of the cell. When depolarization occurs, this charge differential across the membrane is reversed, and a nerve impulse is produced.
Depolarization is a rapid change in the permeability of the cell membrane. When sensory input or any other kind of stimulating current is received by the neuron, the membrane permeability is changed, allowing a sudden influx of sodium ions into the cell. The high concentration of sodium, or action potential, changes the overall charges within the cell from negative to positive. The local changes in ion concentration triggers similar reactions along the membrane, propagating the nerve impulse. After a brief period called the refractory period, during which the ionic concentration returned to resting potential, the neuron can repeat this process.
Nerve impulses travel at different speeds, depending on the cellular composition of a neuron. Where speed of impulse is important, as in the nervous system, axons are insulated with a membranous substance called myelin. The insulation provided by myelin maintains the ionic charge over long distances. Nerve impulses are propagated at specific points along the myelin sheath; These points are called the nodes of Ranvier. Examples of myelinated axons are those in sensory nerve fibers and nerves connected to skeletal muscles. In non-myelinated cells, the nerve impulse is propagated more diffusely.
The nervous system has two divisions: The somatic, which allow voluntary control over skeletal muscle, and the autonomic, which is involuntary and controls cardiac and smooth muscle and glands. The autonomic nervous system has two divisions: The sympathetic and the parasympathetic. Many, but not all, of the muscles and glands that distribute nerve impulses to the larger interior organs possess a double nerve supply; in such cases the two divisions may exert opposing effects. Thus, the sympathetic system increases heartbeat, and the parasympathetic system decreases heartbeat. The two nervous systems are not always antagonistic, however. For example, both nerve supplies to the salivary glands excite the cells of secretion. Furthermore, a single division of the autonomic nervous system may both excite and inhibit a single effector, as in the sympathetic supply to the blood vessels of skeletal muscle. Finally, the sweat glands, the muscles that cause involuntary erection or bristling of the hair, the smooth muscle of the spleen, and the blood vessels of the skin and skeletal muscle are actuated only by the sympathetic division.
Voluntary movement of head, limbs, and body is caused by nerve impulses arising in the motor area of the cortex of the brain and carried by cranial nerves or by nerves that emerge from the spinal cord to connect with skeletal muscles. The reaction involves both excitation of nerve cells stimulating the muscles involved and inhibition of the cells that stimulate opposing muscles. A nerve impulse is an electrical change within a nerve cell or fiber: Measured in millivolts, it lasts a few milliseconds and can be recorded by electrodes.
The human brain has three major structural components: The large dome-shaped cerebrum, the smaller somewhat spherical cerebellum, and the brainstem. Prominent in the brainstem is the medulla oblongata (the egg-shaped enlargement at the center) and the thalamus (between the medulla and the cerebrum). The cerebrum is responsible for intelligence and reasoning. The cerebellum helps to maintain balance and posture. The medulla is involved in maintaining involuntary functions such as respiration, and the thalamus act as a relay center for electrical impulses traveling to and from the cerebral cortex. Lack of blood flow to any part of the brain results in a stroke, permanent damage that interferes with the functions of the affected part of the brain.
Movement may occur also in direct response to an outside stimulus, thus, a tap on the knee causes a jerk, and a light shone into the eye makes the pupil contract. These involuntary responses are called reflexes. Various nerve terminals called receptors constantly send impulses into the central nervous system. These are of three classes: exteroceptors, which are sensitive to pain, temperature, touch, and pressure; interoceptors, which react to changes in the internal environment; and proprioceptors, which respond to variations in movement, position, and tension. These impulses terminate in special areas of the brain, as do of those special receptors concerned with sight, hearing, smell, and taste.
Whereas most major nerves emerge from the spinal cord, the 12 pairs of cranial nerves project directly from the brain. All but 1 pair relay motor or sensory information (or both); the tenth, or vagus nerve, affects visceral functions such as heart rate, vasoconstriction, and contraction of the smooth muscle found in the walls of the trachea, stomach, and intestine.
Muscular contractions do not always cause actual movement. A small fraction of the total number of fibers in most muscles is usually contracting. This serves to maintain the posture of a limb and enables the limb to resist passive elongation or stretch. This slight continuous contraction is called muscle tone.
In 1946 Axelrod joined the laboratory of American pharmacologist Bernard Brodie at Goldwater Memorial Hospital in New York. The pair conducted research on pain-relieving drugs called analgesics. They identified a pain-relieving chemical known as acetaminophen. This drug was later developed and marketed by the drug company Johnson & Johnson under the brand-name Tylenol.
In 1949 Axelrod took a position at the National Heart Institute, a branch of the National Institutes of Health (NIH). Their Axelrod studied how the body processes certain drugs that cause behavioral changes, including amphetamines, ephedrine, and mescaline. He identified a group of enzymes that help these drugs break down in the body. These enzymes, called cytochrome-P450 monoxygenases, have been studied extensively by other scientists, particularly in cancer research.
Realizing that career advancement in the sciences requires a doctoral degree, in 1954 Axelrod took a leave of absence from his job at the National Heart Institute to attend The George Washington University. He earned his doctorate in pharmacology in 1955. That same year he was named chief of pharmacology at the National Institute of Mental Health (NIMH) another branch of NIH.
At NIMH, Joseph Axelrod began research on neurotransmitters. A nerve cell releases a neurotransmitter to spur a neighboring cell into action. In the 1950s most scientists believed that a neurotransmitter became inactive once it stimulated a neighboring cell. But Axelrod’s research found that the neurotransmitter returns to the first nerve cell, in a process known as reuptake, where it is broken down by enzymes or repackaged for reuse. This research led to the creation of a number of drugs that prevent the reuptake process, enabling a neurotransmitter to remain active for a longer period of time.
Axelrod’s research revolutionized the understanding of many mental-health disorders, including depression, anxiety, and schizophrenia. Prior to his research, psychiatry focused on the relationship of life experiences to mental health problems. But Axelrod's research proved that mental-health disorders were often the result of complicated brain chemistry. His research spurred the development of new drugs that advanced the treatment of mental-health conditions. Among these are selective serotonin reuptake inhibitors, including the antidepressants fluoxetine, sold under the brand name Prozac, sertraline(Zoloft) and paroxetine (Paxil).
Scientists who study the biochemistry of learning and memory often focus on the marine snail Aplysia because its simple nervous system allows them to study the effects of various stimuli on specific synapses. A change in the snail's behavior due to learning can be correlated with a change at the level of the synapse. One exciting scientific frontier is discovering the changes in neurotransmitters that occur at the level of the synapse.
Other researchers have implicated glucose, a sugar and insulin(a hormone secreted by the pancreas) as important to learning and memory. Humans and other animals given these substances show an improved capacity to learn and remember. Typically, when animals or humans ingest glucose, the pancreas responds by increasing insulin production, so it is difficult to determine which substance contributes to improved performance. Some studies in humans that have systematically varied the amount of glucose and insulin in the blood have shown that insulin may be the more important of the two substances for learning.
Scientists also have examined the influence of genes on learning and memory. In one study, scientists bred strains of mice with extra copies of a gene that helps build a protein called N-methyl-D-aspartate, or NMDA. This protein acts as a receptor for certain neurotransmitters. The genetically altered mice outperformed normal mice on a variety of tests of learning and memory. In addition, other studies have found that chemically blocking NMDA receptor impairs learning in laboratory rats. Future discoveries from genetic and biochemical studies may lead to treatments for memory deficits from Alzheimer's disease and other conditions that affect memory.
Alzheimer's Disease, progressive brain disorders that causes a gradual and irreversible decline in memory, language skills, perception of time and space, and, eventually, the ability to care for oneself. First described by German psychiatrist Alois Alzheimer in 1906, Alzheimer's disease was initially thought to be a rare condition affecting only young people, and was referred to as prehensile dementia. Today late-onset Alzheimer's disease is recognized as the most common cause of the loss of mental function in those aged 65 and over. Alzheimer's in people in their 30s, 40s, and 50s, called early-onset Alzheimer's disease, occurs less frequently, accountings for less than 10 percent of the estimated 4 million Alzheimer's cases in the United States.
Although Alzheimer's disease is not a normal part of the aging process, the risk of developing the disease increases as people grow older. About 10 percent of the United States population over the age of 65 is affected by Alzheimer's disease, and nearly 50 percent of those over age 85 may have the disease.
Alzheimer's disease takes a devastating toll, not only on the patients, but also on those who love and care for them. Some patients experience immense fear and frustration as they struggle with once commonplace tasks and slowly lose their independence. Family, friends, and especially those who provide daily care suffer immeasurable pain and stress as they witness Alzheimer's disease slowly take their loved one from them.
The from the onset that is proceeded in the beginning of Alzheimer's disease is usually very gradual. In the early stages, Alzheimer's patients have relatively mild problems learning new information and remembering where they have left common objects, such as keys or a wallet. In time, they begin to have trouble recollecting recent events and finding the right words to express themselves. As the disease progresses, patients may have difficulty remembering what day or month it is, or finding their way around familiar surroundings. They may develop a tendency to wander off and then be unable to find their way back. Patients often become irritable or withdrawn as they struggle with fear and frustration when once commonplace tasks become unfamiliar and intimidating. Behavioral changes may become more pronounced as patients become paranoid or delusional and unable to engage in normal conversation.
Eventually Alzheimer's patients become completely incapacitated and unable to take care of their most basic life functions, such as eating and using the bathroom. Alzheimer's patients may live many years with the disease, usually dying from other disorders that may develop, such as pneumonia. Typically the time from initial diagnosis until death is seven to ten years, but this is quite variable and can range from three to twenty years, depending on the age of the onset, other medical conditions present, and the care patients receive.
The brains of patients with Alzheimer's have distinctive formations - abnormally shaped proteins called tangles and plaques - that are recognized as the hallmark of the disease. Not all brain regions show these characteristic formations. The areas most prominently affected are those related to memory.
Tangles are long, slender tendrils found inside nerve cells, or neurons. Scientists have learned that when a protein-called tau becomes altered, it may cause the characteristic tangles in the brain of the Alzheimer’s patient. In healthy brains provides structural support for neurons, but in Alzheimer's patients this structural support collapses.
Plaques, or clumps of fibers, form outside the neurons in the adjacent brain tissue. Scientists found that a type of protein, called amyloid precursor protein, forms toxic plaques when it is cut in two places. Researchers have isolated the enzyme beta-secretes, which is believed to make one of the cuts in the amyloid precursor protein. Researchers also identified another enzyme, called gamma secretes, that makes the second cut in the amyloid precursor protein. These two enzymes snip the amyloid precursor protein into fragments that then accumulate to form plaques that are toxic to neurons.
Alzheimer's patients have lower levels of neurotransmitters, chemicals that carry complex messages back and forth between the nerve cells. For instance, Alzheimer's disease seems to decrease the level of the neurotransmitter acetylcholine, which is known to influence memory. A deficiency in other neurotransmitters, including somatostatin and corticotropin-releasing factor, and, particularly in younger patients, serotonin and norepinephrine, also interferes with normal communication between brain cells.
The causes of Alzheimer's disease remain a mystery, but researchers have found that particular groups of people have risk factors that make them more likely to develop the disease than the general population. For example, people with a family history of Alzheimer's are more likely to develop Alzheimer's disease.
Some of the most promising Alzheimer's research is being conducted in the field of genetics to learn the role a family history of the disease has in its development. Scientists have learned that people who are carriers of a specific version of the apolipoprotein E gene (apoE genes), found on chromosome 19, are several times more likely to develop Alzheimer's than carriers of other versions of the apoE gene. The most common version of this gene in the general population is apoE3. Nearly half of all late-onset Alzheimer’s patients have the fewer in common apoE4 versions, however, and research has shown that this gene plays a role in Alzheimer's disease. Scientists have also found evidence that variations in one or more genes located on chromosomes 1, 10, and 14 may increase a person’s risk for Alzheimer's disease. Scientists have identified the gene variations on chromosomes 1 and 14 and learned that these genes produce mutations in proteins called presenilins. These mutated proteins apparently trigger the activity of the enzyme gamma secretase, which splices the amyloid precursor protein.
Researchers have made similar strides in the investigation of early-onset Alzheimer's disease. A series of genetic mutations in patients with early-onset Alzheimer's has been linked to the production of amyloid precursor protein, the protein in plaques that may be implicated in the destruction of neurons. One mutation is particularly interesting to geneticists because it occurs on a gene involved in the genetic disorder Down syndrome. People with Down syndrome usually develop plaques and tangles in their brains as they get older, and researchers believe that learning more about the similarities between Down syndrome and Alzheimer's may further our understanding of the genetic elements of the disease.
Some studies suggest that one or more factors other than heredity may determine whether people develop the disease. One study published in February 2001 compared residents of Ibadan, Nigeria, who eat a mostly low-fat vegetarian diet, with African Americans living in Indianapolis, Indiana, whose diet included a variety of high-fat foods. The Nigerians were less likely to develop Alzheimer’s disease compared to their U.S. counterparts. Some researchers suspect that health imposes on high blood pressure, atherosclerosis (arteries clogged by fatty deposits), high cholesterol levels, or other cardiovascular problems may play a role in the development of the disease.
Other studies have suggested that environmental agents may be a possible cause of Alzheimer's disease; for example, one study suggested that high levels of aluminum in the brain may be a risk factor. Several scientists initiated research projects to further investigate this connection, but no conclusive evidence has been found linking aluminum with Alzheimer's disease. Similarly, investigations into other potential environmental causes, such as zinc exposure, viral agents, and food-borne poisons, while initially promising, have generally turned up inconclusive results.
Some studies indicate that brain trauma can trigger a degenerative process that results in Alzheimer's disease. In one study, an analysis of the medical records scribed upon veterans of World War II (1939-1945) linked serious head injury in early adulthood with Alzheimer's disease in later life. The study also looked at other factors that could possibly influence the development of the disease among the veterans, such as the presence of the apoE gene, but no other factors were identified.
Alzheimer’s disease is only positively diagnosed by examining brain tissue under a microscope to see the hallmark plaques and tangles, and this is only possible after a patient dies. As a result, physicians rely on a series of other techniques to diagnose probable Alzheimer's disease in living patients. Diagnosis begins by ruling out other problems that cause memory loss, such as stroke, depression, alcoholism, and the use of certain prescription drugs. The patient undergoes a thorough examination, including specialized brain scans, to eliminate other disorders. The patient may be given a detailed evaluation called a neuropsychological examination, which is designed to evaluate a patient’s ability to perform specific mental tasks. This helps the physician determine whether the patient is showing the characteristic symptoms of Alzheimer's disease - progressively worsening memory problems, language difficulties, and trouble with spatial direction and time. The physician also asks about the patient's family medical history to learn about any past serious illnesses, which may give a hint about the patient's current symptoms.
Evidence shows that there is inflammation in the brains of Alzheimer's patients, which may be associated with the production of amyloid precursor protein. Studies are underway to find drugs that prevent this inflammation, to possibly slow or even halt the progress of the disease. Other promising approaches center on mechanisms that manipulate amyloid precursor protein production or accumulation. Drugs are in development that may block the activity of the enzymes that cut the amyloid precursor protein, halting amyloid production. Other studies in mice suggest those vaccinating animals with amyloid precursor protein can produce a reaction that clears amyloid precursor protein from the brain. Physicians have started vaccination studies in humans to determine if the same potentially beneficial effects can be obtained. There is still much to be learned, but as scientists better understand the genetic components of Alzheimer’s, the roles of the amyloid precursor protein and the tau protein in the disease, and the mechanisms of nerve cell degeneration, the possibility that a treatment will be developed is more likely.
The responsibility for caring for Alzheimer's patients generally falls on their spouses and children. Care givers must constantly be on guard for the possibility of Alzheimer's patients wandering away or becoming agitated or confused in a manner that jeopardizes the patient or others. Coping with a loved one's decline and inability to recognize familiar face causes enormous pain.
The increased burden faced by families is intense, and the life of the Alzheimer's care giver is often called a 36-hour day. Not surprisingly, care givers often develop health and psychological problems of their own as a result of this stress. The Alzheimer's Association, a national organization with local chapters throughout the United States, was formed in 1980 in large measure to provide support for Alzheimer's care givers. Today, national and local chapters are a valuable source for information, referral, and advice.
But, some of the most promising Alzheimer's research is being conducted in the field of genetics to learn the role a family history of the disease has in its development. Scientists have learned that people who are carriers of a specific version of the apolipoprotein E gene (apoE genes), found on chromosome 19, are several times more likely to develop Alzheimer's than carriers of other versions of the apoE gene. The most common version of this gene in the general population is apoE3. Nearly half of all late-onset Alzheimer’s patients have the fewer in common apoE4 versions, however, and research has shown that this gene plays a role in Alzheimer's disease. Scientists have also found evidence that variations in one or more genes located on chromosomes 1, 10, and 14 may increase a person’s risk for Alzheimer's disease. Scientists have identified the gene variations on chromosomes 1 and 14 and learned that these genes produce mutations in proteins called presenilins. These mutated proteins apparently trigger the activity of the enzyme gamma secretase, which splices the amyloid precursor protein.
Researchers have made similar strides in the investigation of early-onset Alzheimer's disease. A series of genetic mutations in patients with early-onset Alzheimer's has been linked to the production of amyloid precursor protein, the protein in plaques that may be implicated in the destruction of neurons. One mutation is particularly interesting to geneticists because it occurs on a gene involved in the genetic disorder Down syndrome. People with Down syndrome usually develop plaques and tangles in their brains as they get older, and researchers believe that learning more about the similarities between Down syndrome and Alzheimer's may further our understanding of the genetic elements of the disease.
Other studies have suggested that environmental agents may be a possible cause of Alzheimer's disease; for example, one study suggested that high levels of aluminum in the brain may be a risk factor. Several scientists initiated research projects to further investigate this connection, but no conclusive evidence has been found linking aluminum with Alzheimer's disease. Similarly, investigations into other potential environmental causes, such as zinc exposure, viral agents, and food-borne poisons, while initially promising, have generally turned up inconclusive results.
Alzheimer’s disease is only positively diagnosed by examining brain tissue under a microscope to see the hallmark plaques and tangles, and this is only possible after a patient dies. As a result, physicians rely on a series of other techniques to diagnose probable Alzheimer's disease in living patients. Diagnosis begins by ruling out other problems that cause memory loss, such as stroke, depression, alcoholism, and the use of certain prescription drugs. The patient undergoes a thorough examination, including specialized brain scans, to eliminate other disorders. The patient may be given a detailed evaluation called a neuropsychological examination, which is designed to evaluate a patient’s ability to perform specific mental tasks. This helps the physician determine whether the patient is showing the characteristic symptoms of Alzheimer's disease - progressively worsening memory problems, language difficulties, and trouble with spatial direction and time. The physician also asks about the patient's family medical history to learn about any past serious illnesses, which may give a hint about the patient's current symptoms.
Defining of a better understanding of the states of consciousness is not at all simple, is agreed-upon definition of consciousness exists. Attempted definitions tend to be tautological (for example, consciousness defined as awareness) or merely descriptive (for example, consciousness described as sensations, thoughts, or feelings). Despite this problem of definition, the subject of consciousness has had a remarkable history. At one time the primary subject matter of psychology, consciousness as an area of study, that the idea that something conveys to the mind, from which of critics has endlessly debated the meaning of the ascribing interactions that otherwise to ascertain the quality, mass, extent or degree of terminological statements that its standard unit or mixed distributive analysis, is such, that a conceptualized form of its reasons to posit of a direct interpretation whose interference became of the total demise, even so, there is the result reemerging to become a topic of current interests.
Most of the philosophical discussions of consciousness arose from the mind-body issues posed by the French philosopher and mathematician René Descartes in the 17th century. Descartes asked: Is the mind, or consciousness, independent of matter? Is consciousness extended (physical) or unextended (nonphysical)? Descartes attempted to apply the rational inductive methods of science, and particularly of mathematics, to philosophy. Before his time, philosophy had been dominated by the method of Scholasticism, which was entirely based on comparing and contrasting the views of recognized authorities. Rejecting this method, Descartes stated, ‘In our search for the direct road to truth, we should busy ourselves with no object about which we cannot attain a certitude equal to that of the demonstration of arithmetic and geometry.’ He therefore determined to hold nothing true until he had established grounds for believing it true. The single sure fact from which his investigations began was expressed by him in the famous words Cogito, ergo sum,’I think, therefore I am.’ From this postulate that a clear consciousness of his thinking proved his own existence, he argued the existence of God. God, according to Descartes's philosophy, created two classes of substance that make up the whole of reality. One class was thinking substances, or minds, and the other was extended substances, or bodies.
Scientists have long considered the nature of consciousness without producing a fully satisfactory definition. In the early 20th century American philosopher and psychologist William James suggested that consciousness is a mental process involving both attention to external stimuli and short-term memory. Later scientific explorations of consciousness mostly expanded upon James’s work. In this article from a 1997 special issue of Scientific American, Nobel laureate Francis Crick, who helped determine the structure of DNA, and fellow biophysicist Christof Koch explain how experiments on vision might deepen our understanding of consciousness.
The overwhelming question in neurobiology today is the relation between the mind and the brain. Everyone agrees that what we know as mind is closely related to certain aspects of the behavior of the brain, not to the heart, as Aristotle thought. Its most mysterious aspect is consciousness or awareness, which can take many forms, from the experience of pain to self-consciousness. In the past the mind (or soul) was often regarded, as it was by Descartes, as something immaterial, separate from the brain but interacting with it in some way. A few neuroscientists, such as Sir John Eccles, still assert that the soul is distinct from the body. But most neuroscientists now believe that all aspects of mind, including its most puzzling attribute - consciousness or awareness - are likely to be explainable in a more materialistic way as the behavior of large sets of interacting neurons. As William James, the father of American psychology, said a century ago, consciousness is not a thing but a process.
Exactly what the process is, however, has yet to be discovered. For many years after James penned The Principles of Psychology, consciousness was a taboo concept in American psychology because of the dominance of the behaviorist movement. With the advent of cognitive science in the mid-1950s, it became possible once more for psychologists to consider mental processes as opposed to merely observing behavior. In spite of these changes, until recently most cognitive scientists ignored consciousness, as did almost all neuroscientists. The problem was felt to be either purely ‘philosophical’ or too elusive to study experimentally. It would not have been easy for a neuroscientist to get a grant just to study consciousness.
In our opinion, such timidity is ridiculous, so a few years ago we began to think about how best to attack the problem scientifically. How to explain mental events as being caused by the firing of large sets of neurons? Although there are those who believe such an approach is hopeless, we feel it is not productive to worry too much over aspects of the problem that cannot be solved scientifically or, more precisely, cannot be solved solely by using existing scientific ideas. Radically new concepts may indeed be needed—recall the modifications of scientific thinking forced on us by quantum mechanics. The only sensible approach is to press the experimental attack until we are confronted with dilemmas that call for new ways of thinking.
There are many possible approaches to the problem of consciousness. Some psychologists feel that any satisfactory theory should try to explain as many aspects of consciousness as possible, including emotion, imagination, dreams, mystical experiences and so on. Although such an all-embracing theory will be necessary in the long run, we thought it wiser to begin with the particular aspect of consciousness that is likely to yield most easily. What this aspect may be is a matter of personal judgment. We selected the mammalian visual system because humans are very visual animals and because so much experimental and theoretical work has already been done on it.
It is not easy to grasp exactly what we need to explain, and it will take many careful experiments before visual consciousness can be described scientifically. We did not attempt to define consciousness itself because of the dangers of premature definition. (If this seems like a copout, try defining the word ‘gene’ - you will not find it easy.) Yet the experimental evidence that already exists provides enough of a glimpse of the nature of visual consciousness to guide research. In this article, we will attempt to show how this evidence opens the way to attack this profound and intriguing problem.
Visual theorists agree that the problem of visual consciousness is ill posed. The mathematical term ‘ill posed’ means that additional constraints are needed to solve the problem. Although the main function of the visual system is to perceive objects and events in the world around us, the information available to our eyes is not sufficient by itself to provide the brain with its unique interpretation of the visual world. The brain must use past experience (either its own or that of our distant ancestors, which is embedded in our genes) to help interpret the information coming into our eyes. An example would be the derivation of the three-dimensional representation of the world from the two-dimensional signals falling onto the retinas of our two eyes or even onto one of them.
Visual theorists also would agree that seeing is a constructive process, one in which the brain has to carry out complex activities (sometimes called computations) in order to decide which interpretation to adopt of the ambiguous visual input. ‘Computation’ implies that the brain acts to form a symbolic representation of the visual world, with a mapping (in the mathematical sense) of certain aspects of that world onto elements in the brain.
Ray Jackendoff of Brandeis University postulates, as do most cognitive scientists, that the computations carried out by the brain are largely unconscious and that what we become aware of is the result of these computations. But while the customary view is that this awareness occurs at the highest levels of the computational system, Jackendoff has proposed an intermediate-level theory of consciousness.
What we see, Jackendoff suggests, relates to a representation of surfaces that are directly visible to us, together with their outline, orientation, colour, texture and movement. (This idea has similarities to what the late David C. Marr of the Massachusetts Institute of Technology called a ‘2 1/2-dimensional sketch’. It is more than a two-dimensional sketch because it conveys the orientation of the visible surfaces. It is less than three-dimensional because depth information is not explicitly represented.) In the next stage this sketch is processed by the brain to produce a three-dimensional representation. Jackendoff argues that we are not visually aware of this three-dimensional representation.
An example may make this process clearer. If you look at a person whose back is turned to you, you can see the back of the head but not the face. Nevertheless, your brain infers that the person has a face. We can deduce as much because if that person turned around and had no face, you would be very surprised.
The viewer-centered representation that corresponds to the visible back of the head is what you are vividly aware of. What your brain infers about the front would come from some kind of three-dimensional representation. This does not mean that information flows only from the surface representation to the three-dimensional one; it almost certainly flows in both directions. When you imagine the front of the face, what you are aware of is a surface representation generated by information from the three-dimensional model.
It is important to distinguish between an explicit and an implicit representation. An explicit representation is something that is symbolized without further processing. An implicit representation contains the same information but requires further processing to make it explicit. The pattern of coloured dots on a television screen, for example, contains an implicit representation of objects (say, a person's face), but only the dots and their locations are explicit. When you see a face on the screen, there must be neurons in your brain whose firing, in some sense, symbolizes that face.
We call this pattern of firing neurons an active representation. A latent representation of a face must also be stored in the brain, probably as a special pattern of synaptic connections between neurons. For example, you probably have a representation of the Statue of Liberty in your brain, a representation that usually is inactive. If you do think about the Statue, the representation becomes active, with the relevant neurons firing away.
An object, incidentally, may be represented in more than one way—as a visual image, as a set of words and their related sounds, or even as a touch or a smell. These different representations are likely to interact with one another. The representation is likely to be distributed over many neurons, both locally and more globally. Such a representation may not be as simple and straightforward as uncritical introspection might indicate. There is suggestive evidence, partly from studying how neurons fire in various parts of a monkey's brain and partly from examining the effects of certain types of brain damage in humans, that different aspects of a face - and of the implications of a face - may be represented in different parts of the brain.
First, there is the representation of a face as a face: two eyes, a nose, a mouth and so on. The neurons involved are usually not too fussy about the exact size or position of this face in the visual field, nor are they very sensitive to small changes in its orientation. In monkeys, there are neurons that respond best when the face is turning in a particular direction, while others seem to be more concerned with the direction in which the eyes are gazing.
Then there are representations of the parts of a face, as separate from those for the face as a whole. Further, the implications of seeing a face, such as that person's sex, the facial expression, the familiarity or unfamiliarity of the face, and in particular whose face it is, may each be correlated with neurons firing in other places.
What we are aware of at any moment, in one sense or another, is not a simple matter. We have suggested that there may be a very transient form of fleeting awareness that represents only rather simple features and does not require an attentional mechanism. From this brief awareness the brain constructs a viewer - centered representation - what we see vividly and clearly—that does require attention. This in turn probably leads to three-dimensional object representations and thence to more cognitive ones.
Representations corresponding to vivid consciousness are likely to have special properties. William James thought that consciousness involved both attention and short-term memory. Most psychologists today would agree with this view. Jackendoff writes that consciousness is ‘enriched’ by attention, implying that whereas attention may not be essential for certain limited types of consciousness, it is necessary for full consciousness. Yet it is not clear exactly which forms of memory are involved. Is long-term memory needed? Some forms of acquired knowledge are so embedded in the machinery of neural processing that they are almost certainly used in becoming aware of something. On the other hand, there is evidence from studies of brain-damaged patients that the ability to lay down new long-term episodic memories is not essential for consciousness to be experienced.
It is difficult to imagine that anyone could be conscious if he or she had no memory whatsoever of what had just happened, even an extremely short one. Visual psychologists talk of iconic memory, which lasts for a fraction of a second, and working memory (such as that used to remember a new telephone number) that lasts for only a few seconds unless it is rehearsed. It is not clear whether both of these are essential for consciousness. In any case, the division of short-term memory into these two categories may be too crude.
If these complex processes of visual awareness are localized in parts of the brain, which processes are likely to be where? Many regions of the brain may be involved, but it is almost certain that the cerebral neocortex plays a dominant role. Visual information from the retina reaches the neocortex mainly by way of a part of the thalamus (the lateral geniculate nucleus); another significant visual pathway from the retina is to the superior colliculus, at the top of the brain stem.
The cortex in humans consists of two intricately folded sheets of nerve tissue, one on each side of the head. These sheets are connected by a large tract of about half a billion axons called the corpus callosum. It is well known that if the corpus callosum is cut, as is done for certain cases of intractable epilepsy, one side of the brain is not aware of what the other side is seeing. In particular, the left side of the brain (in a right-handed person) appears not to be aware of visual information received exclusively by the right side. This shows that none of the information required for visual awareness can reach the other side of the brain by traveling down to the brain stem and, from there, back up. In a normal person, such information can get to the other side only by using the axons in the corpus callosum.
A different part of the brain - the hippocampal system - is involved in one-shot, or episodic, memories that, over weeks and months, it passes on to the neocortex. This system is so placed that it receives inputs from, and projects to, many parts of the brain. Thus, one might suspect that the hippocampal system is the essential seat of consciousness. This is not the case: evidence from studies of patients with damaged brains shows that this system is not essential for visual awareness, although naturally a patient lacking one is severely handicapped in everyday life because he cannot remember anything that took place more than a minute or so in the past.
In broad terms, the neocortex of alert animals probably acts in two ways. By building on crude and somewhat redundant wiring, produced by our genes and by embryonic processes, the neocortex draws on visual and other experience to slowly ‘rewire’ itself to create categories (or ‘features’) it can respond to. A new category is not fully created in the neocortex after exposure to only one example of it, although some small modifications of the neural connections may be made.
The second function of the neocortex (at least of the visual part of it) is to respond extremely rapidly to incoming signals. To do so, it uses the categories it has learned and tries to find the combinations of active neurons that, on the basis of its past experience, are most likely to represent the relevant objects and events in the visual world at that moment. The formation of such coalitions of active neurons may also be influenced by biases coming from other parts of the brain: for example, signals telling it what best to attend to or high-level expectations about the nature of the stimulus.
Consciousness, as James noted, is always changing. These rapidly formed coalitions occur at different levels and interact to form even broader coalitions. They are transient, lasting usually for only a fraction of a second. Because coalitions in the visual system are the basis of what we see, evolution has seen to it that they form as fast as possible; otherwise, no animal could survive. The brain is handicapped in forming neuronal coalitions rapidly because, by computer standards, neurons act very slowly. The brain compensates for this relative slowness partly by using very many neurons, simultaneously and in parallel, and partly by arranging the system in a roughly hierarchical manner.
If visual awareness at any moment corresponds to sets of neurons firing, then the obvious question is: Where are these neurons located in the brain, and in what way are they firing? Visual awareness is highly unlikely to occupy all the neurons in the neocortex that are firing above their background rate at a particular moment. We would expect that, theoretically, at least some of these neurons would be involved in doing computations - trying to arrive at the best coalitions - whereas others would express the results of these computations, in other words, what we see.
Fortunately, some experimental evidence can be found to back up this theoretical conclusion. A phenomenon called binocular rivalry may help identify the neurons whose firing symbolizes awareness. This phenomenon can be seen in dramatic form in an exhibit prepared by Sally Duensing and Bob Miller at the Exploratorium in San Francisco.
Binocular rivalry occurs when each eye has a different visual input relating to the same part of the visual field. The early visual system on the left side of the brain receives an input from both eyes but sees only the part of the visual field to the right of the fixation point. The converse is true for the right side. If these two conflicting inputs are rivalrous, one sees not the two inputs superimposed but first one input, then the other, and so on in alternation.
In the exhibit, called ‘The Cheshire Cat,’ viewers put their heads in a fixed place and are told to keep the gaze fixed. By means of a suitably placed mirror, one of the eyes can look at another person's face, directly in front, while the other eye sees a blank white screen to the side. If the viewer waves a hand in front of this plain screen at the same location in his or her visual field occupied by the face, the face is wiped out. The movement of the hand, being visually very salient, has captured the brain's attention. Without attention the face cannot be seen. If the viewer moves the eyes, the face reappears.
In some cases, only part of the face disappears. Sometimes, for example, one eye, or both eyes, will remain. If the viewer looks at the smile on the person's face, the face may disappear, leaving only the smile. For this reason, the effect has been called the Cheshire Cat effect, after the cat in Lewis Carroll's Alice's Adventures in Wonderland.
Although it is very difficult to record activity in individual neurons in a human brain, such studies can be done in monkeys. A simple example of binocular rivalry has been studied in a monkey by Nikos K. Logothetis and Jeffrey D. Schall, both then at M.I.T. They trained a macaque to keep its eyes still and to signal whether it is seeing upward or downward movement of a horizontal grating. To produce rivalry, upward movement is projected into one of the monkey's eyes and downward movement into the other, so that the two images overlap in the visual field. The monkey signals that it sees up and down movements alternatively, just as humans would. Even though the motion stimulus coming into the monkey's eyes is always the same, the monkey's percept changes every second or so.
Cortical area MT (which some researchers prefer to label V5) is an area mainly concerned with movement. What do the neurons in MT do when the monkey's percept is sometimes up and sometimes down? (The researchers studied only the monkey's first response.) The simplified answer - the actual data are rather more messy - is that whereas the firing of some of the neurons correlates with the changes in the percept, for others the average firing rate is relatively unchanged and independent of which direction of movement the monkey is seeing at that moment. Thus, it is unlikely that the firing of all the neurons in the visual neocortex at one particular moment corresponds to the monkey's visual awareness. Exactly which neurons do correspond to awareness remains to be discovered.
We have postulated that when we clearly see something, there must be neurons actively firing that stand for what we see. This might be called the activity principle. Here, too, there is some experimental evidence. One example is the firing of neurons in a specific cortical visual area in response to illusory contours. Another and perhaps more striking case is the filling in of the blind spot. The blind spot in each eye is caused by the lack of photoreceptors in the area of the retina where the optic nerve leaves the retina and projects to the brain. Its location is about 15 degrees from the fovea (the visual center of the eye). Yet if you close one eye, you do not see a hole in your visual field.
Philosopher Daniel C. Dennett of Tufts University is unusual among philosophers in that he is interested both in psychology and in the brain. This interest is much to be welcomed. In a recent book, Consciousness Explained, he has argued that it is wrong to talk about filling in. He concludes, correctly, that ‘an absence of information is not the same as information about an absence.’ From this general principle he argues that the brain does not fill in the blind spot but rather ignores it.
Dennett's argument by itself, however, does not establish that filling in does not occur; it only suggests that it might not. Dennett also states that ‘your brain has no machinery for [filling in] at this location.’ This statement is incorrect. The primary visual cortex lacks a direct input from one eye, but normal ‘machinery’ is there to deal with the input from the other eye. Ricardo Gattass and his colleagues at the Federal University of Rio de Janeiro have shown that in the macaque some of the neurons in the blind-spot area of the primary visual cortex do respond to input from both eyes, probably assisted by inputs from other parts of the cortex. Moreover, in the case of simple filling in, some of the neurons in that region respond as if they were actively filling in.
Thus, Dennett's claim about blind spots is incorrect. In addition, psychological experiments by Vilayanur S. Ramachandran [see ‘Blind Spots,’ Scientific American, May 1992] have shown that what is filled in can be quite complex depending on the overall context of the visual scene. How, he argues, can your brain be ignoring something that is in fact commanding attention?
Filling in, therefore, is not to be dismissed as nonexistent or unusual. It probably represents a basic interpolation process that can occur at many levels in the neocortex. It is, incidentally, a good example of what is meant by a constructive process.
How can we discover the neurons whose firing symbolizes a particular percept? William T. Newsome and his colleagues at Stanford University have done a series of brilliant experiments on neurons in cortical area MT of the macaque's brain. By studying a neuron in area MT, we may discover that it responds best to very specific visual features having to do with motion. A neuron, for instance, might fire strongly in response to the movement of a bar in a particular place in the visual field, but only when the bar is oriented at a certain angle, moving in one of the two directions perpendicular to its length within a certain range of speed.
It is technically difficult to excite just a single neuron, but it is known that neurons that respond to roughly the same position, orientation and direction of movement of a bar tend to be located near one another in the cortical sheet. The experimenters taught the monkey a simple task in movement discrimination using a mixture of dots, some moving randomly, the rest all in one direction. They showed that electrical stimulation of a small region in the right place in cortical area MT would bias the monkey's motion discrimination, almost always in the expected direction.
Thus, the stimulation of these neurons can influence the monkey's behavior and probably its visual percept. Such experiments do not, however, show decisively that the firing of such neurons is the exact neural correlate of the percept. The correlate could be only a subset of the neurons being activated. Or perhaps the real correlate is the firing of neurons in another part of the visual hierarchy that are strongly influenced by the neurons activated in area MT.
These same reservations apply also to cases of binocular rivalry. Clearly, the problem of finding the neurons whose firing symbolizes a particular percept is not going to be easy. It will take many careful experiments to track them down even for one kind of percept.
It seems obvious that the purpose of vivid visual awareness is to feed into the cortical areas concerned with the implications of what we see; from there the information shuttles on the one hand to the hippocampal system, to be encoded (temporarily) into long-term episodic memory, and on the other to the planning levels of the motor system. But is it possible to go from a visual input to a behavioral output without any relevant visual awareness?
That such a process can happen is demonstrated by the remarkable class of patients with ‘blindsight.’ These patients, all of whom have suffered damage to their visual cortex, can point with fair accuracy at visual targets or track them with their eyes while vigorously denying seeing anything. In fact, these patients are as surprised as their doctors by their abilities. The amount of information that ‘gets through,’ however, is limited: blindsight patients have some ability to respond to wavelength, orientation and motion, yet they cannot distinguish a triangle from a square.
It is naturally of great interest to know which neural pathways are being used in these patients. Investigators originally suspected that the pathway ran through the superior colliculus. Recent experiments suggest that a direct albeit weak connection may be involved between the lateral geniculate nucleus and other visual areas in the cortex. It is unclear whether an intact primary visual cortex region is essential for immediate visual awareness. Conceivably the visual signal in blindsight is so weak that the neural activity cannot produce awareness, although it remains strong enough to get through to the motor system.
Normal-seeing people regularly respond to visual signals without being fully aware of them. In automatic actions, such as swimming or driving a car, complex but stereotypical actions occur with little, if any, associated visual awareness. In other cases, the information conveyed is either very limited or very attenuated. Thus, while we can function without visual awareness, our behavior without it is rather restricted.
Clearly, it takes a certain amount of time to experience a conscious percept. It is difficult to determine just how much time is needed for an episode of visual awareness, but one aspect of the problem that can be demonstrated experimentally is that signals received close together in time are treated by the brain as simultaneous.
A disk of red light is flashed for, say, 20 milliseconds, followed immediately by a 20-millisecond flash of green light in the same place. The subject reports that he did not see a red light followed by a green light. Instead he saw a yellow light, just as he would have if the red and the green light had been flashed simultaneously. Yet the subject could not have experienced yellow until after the information from the green flash had been processed and integrated with the preceding red one.
Experiments of this type led psychologist Robert Efron, now at the University of California at Davis, to conclude that the processing period for perception is about 60 to 70 milliseconds. Similar periods are found in experiments with tones in the auditory system. It is always possible, however, that the processing times may be different in higher parts of the visual hierarchy and in other parts of the brain. Processing is also more rapid in trained, compared with naive, observers.
Because it appears to be involved in some forms of visual awareness, it would help if we could discover the neural basis of attention. Eye movement is a form of attention, since the area of the visual field in which we see with high resolution is remarkably small, roughly the area of the thumbnail at arm's length. Thus, we move our eyes to gaze directly at an object in order to see it more clearly. Our eyes usually move three or four times a second. Psychologists have shown, however, that there appears to be a faster form of attention that moves around, in some sense, when our eyes are stationary.
The exact psychological nature of this faster attentional mechanism is at present controversial. Several neuroscientists, however, including Robert Desimone and his colleagues at the National Institute of Mental Health, have shown that the rate of firing of certain neurons in the macaque's visual system depends on what the monkey is attending to in the visual field. Thus, attention is not solely a psychological concept; it also has neural correlates that can be observed. A number of researchers have found that the pulvinar, a region of the thalamus, appears to be involved in visual attention. We would like to believe that the thalamus deserves to be called ‘the organ of attention,’ but this status has yet to be established.
The major problem is to find what activity in the brain corresponds directly to visual awareness. It has been speculated that each cortical area produces awareness of only those visual features that are ‘columnar,’ or arranged in the stack or column of neurons perpendicular to the cortical surface. Thus, the primary visual cortex could code for orientation and area MT for motion. So far experimentalists have not found one particular region in the brain where all the information needed for visual awareness appears to come together. Dennett has dubbed such a hypothetical place ‘The Cartesian Theater.’ He argues on theoretical grounds that it does not exist.
Awareness seems to be distributed not just on a local scale, but more widely over the neocortex. Vivid visual awareness is unlikely to be distributed over every cortical area because some areas show no response to visual signals. Awareness might, for example, be associated with only those areas that connect back directly to the primary visual cortex or alternatively with those areas that project into one another's layer 4. (The latter areas are always at the same level in the visual hierarchy.)
The key issue, then, is how the brain forms its global representations from visual signals. If attention is indeed crucial for visual awareness, the brain could form representations by attending to just one object at a time, rapidly moving from one object to the next. For example, the neurons representing all the different aspects of the attended object could all fire together very rapidly for a short period, possibly in rapid bursts.
This fast, simultaneous firing might not only excite those neurons that symbolized the implications of that object but also temporarily strengthen the relevant synapses so that this particular pattern of firing could be quickly recalled - a form of short-term memory. If only one representation needs to be held in short-term memory, as in remembering a single task, the neurons involved may continue to fire for a period.
A problem arises if it is necessary to be aware of more than one object at exactly the same time. If all the attributes of two or more objects were represented by neurons firing rapidly, their attributes might be confused. The colour of one might become attached to the shape of another. This happens sometimes in very brief presentations.
Some time ago Christoph von der Malsburg, now at the Ruhr-Universität Bochum, suggested that this difficulty would be circumvented if the neurons associated with any one object all fired in synchrony (that is, if their times of firing were correlated) but out of synchrony with those representing other objects. Recently two groups in Germany reported that there does appear to be correlated firing between neurons in the visual cortex of the cat, often in a rhythmic manner, with a frequency in the 35- to 75-hertz range, sometimes called 40-hertz, or g, oscillation.
Von der Malsburg's proposal prompted us to suggest that this rhythmic and synchronized firing might be the neural correlate of awareness and that it might serve to bind together activity concerning the same object in different cortical areas. The matter is still undecided, but at present the fragmentary experimental evidence does rather little to support such an idea. Another possibility is that the 40-hertz oscillations may help distinguish figure from ground or assist the mechanism of attention.
Are there some particular types of neurons, distributed over the visual neocortex, whose firing directly symbolizes the content of visual awareness? One very simplistic hypothesis is that the activities in the upper layers of the cortex are largely unconscious ones, whereas the activities in the lower layers (layers 5 and 6) mostly correlate with consciousness. We have wondered whether the pyramidal neurons in layer 5 of the neocortex, especially the larger ones, might play this latter role.
These are the only cortical neurons that project right out of the cortical system (that is, not to the neocortex, the thalamus or the claustrum). If visual awareness represents the results of neural computations in the cortex, one might expect that what the cortex sends elsewhere would symbolize those results. Moreover, the neurons in layer 5 show a rather unusual propensity to fire in bursts. The idea that layer 5 neurons may directly symbolize visual awareness is attractive, but it still is too early to tell whether there is anything in it.
Visual awareness is clearly a difficult problem. More work is needed on the psychological and neural basis of both attention and very short-term memory. Studying the neurons when a percept changes, even though the visual input is constant, should be a powerful experimental paradigm. We need to construct neurobiological theories of visual awareness and test them using a combination of molecular, neurobiological and clinical imaging studies.
We believe that once we have mastered the secret of this simple form of awareness, we may be close to understanding a central mystery of human life: how the physical events occurring in our brains while we think and act in the world relate to our subjective sensations - that is, how the brain relates to the mind.
There have been several relevant developments since this article was first published. It now seems likely that there are rapid ‘on-line’ systems for stereotyped motor responses such as hand or eye movement. These systems are unconscious and lack memory. Conscious seeing, on the other hand, seems to be slower and more subject to visual illusions. The brain needs to form a conscious representation of the visual scene that it then can use for many different actions or thoughts. Exactly how all these pathways work and how they interact is far from clear.
There have been more experiments on the behavior of neurons that respond to bistable visual percepts, such as binocular rivalry, but it is probably too early to draw firm conclusions from them about the exact neural correlates of visual consciousness. We have suggested on theoretical grounds based on the neuroanatomy of the macaque monkey that primates are not directly aware of what is happening in the primary visual cortex, even though most of the visual information flows through it. This hypothesis is supported by some experimental evidence, but it is still controversial.
Is consciousness determinative, or is it determined? English philosophers such as John Locke equated consciousness with physical sensations and the information they provide, whereas European philosophers such as Gottfried Wilhelm Leibniz and Immanuel Kant gave a more central and active role to consciousness.
The philosopher who most directly influenced subsequent exploration of the subject of consciousness was the 19th-century German educator Johann Friedrich Herbart, who wrote that ideas had quality and intensity and that they may suppress or may facilitate or place of one another. Thus, ideas may pass from ‘states of reality’ (consciousness) to ‘states of tendency’ (unconsciousness), with the dividing line between the two states being described as the threshold of consciousness. This formulation of Herbart clearly presages the development, by the German psychologist and physiologist Gustav Theodor Fechner, of the psychophysical measurement of sensation thresholds, and the later development by Sigmund Freud of the concept of the unconscious.
The experimental analysis of consciousness dates from 1879, when the German psychologist Wilhelm Max Wundt started his research laboratory. For Wundt, the task of psychology was the study of the structure of consciousness, which extended well beyond sensations and included feelings, images, memory, attention, duration, and movement. Because early interest focussed on the content and dynamics of consciousness, it is not surprising that the central methodology of such studies was introspection; that is, subjects reported on the mental contents of their own consciousness. This introspective approach was developed most fully by the American psychologist Edward Bradford Titchener at Cornell University. Setting his task as that of describing the structure of the mind, Titchener attempted to detail, from introspective self-reports, the dimensions of the elements of consciousness. For example, taste was ‘dimensionalized’ into four basic categories: sweet, sour, salt, and bitter. This approach was known as structuralism.
By the 1920's, however, a remarkable revolution had occurred in psychology that was to essentially remove considerations of consciousness from psychological research for some 50 years: Behaviourism captured the field of psychology. The main initiator of this movement was the American psychologist John Broadus Watson. In a 1913 article, Watson stated, ‘I believe that we can write of some psychology and never use the term’s consciousness, mental states, mind . . . imagery and the like.’ Psychologists then turned almost exclusively to behaviour, as described in terms of stimulus and response, and consciousness was totally bypassed as a subject. A survey of eight leading introductory psychology texts published between 1930 and the 1950's found no mention of the topic of consciousness in five texts, and in two it was treated as a historical curiosity.
Beginning in the later part of the 1950s, are, however, the grounded interests in the foundational subject of consciousness, for returning from its absence were subjects and techniques relating to altered states of consciousness: sleep and dreams, meditation, biofeedback, hypnosis, and drug-induced states. Much in the surge in sleep and dream research was directly fuelled by a discovery relevant to the nature of consciousness. A physiological indicator of the dream state was found: At roughly 90-minute intervals, the eyes of sleepers were observed to move rapidly, and at the same time the sleepers' brain waves would show a pattern resembling the waking state. When people were awakened during these periods of rapid eye movement, they almost always reported dreams, whereas if awakened at other times they did not. This and other research clearly indicated that sleep, once considered a passive state, were instead an active state of consciousness.
American psychiatrist William Glasser developed reality therapy in the 1960s, after working with teenage girls in a correctional institution and observing work with severely disturbed schizophrenic patients in a mental hospital. He observed that psychoanalysis did not help many of his patients change their behaviour, even when they understood the sources of it. Glasser felt it was important to help individuals take responsibility for their own lives and to blame others less. Largely because of this emphasis on personal responsibility, his approach has found widespread acceptance among drugs - and alcohol-abuse counsellor’s, correction’s workers, school counsellors, and those working with clients who may be disruptive to others.
Reality therapy is based on the premise that all human behaviour is motivated by fundamental needs and specific wants. The reality therapist first seeks to establish a friendly, trusting relationship with clients in which they can express their needs and wants. Then the therapist helps clients explore the behaviours that created problems for them. Clients are encouraged to examine the consequences of their behaviour and to evaluate how well their behaviour helped them fulfill their wants. The therapist does not accept excuses from clients. Finally, the therapist helps the client formulate a concrete plan of action to change certain behaviours, based on the client’s own goals and ability to make choices.
During the 1960's, an increased search for ‘higher levels’ of consciousness through meditation resulted in a growing interest in the practices of Zen Buddhism and Yoga from Eastern cultures. A full flowering of this movement in the United States was seen in the development of training programs, such as Transcendental Meditation, that were self-directed procedures of physical relaxation and focussed attention. Biofeedback techniques also were developed to bring body systems involving factors such as blood pressure or temperature under voluntary control by providing feedback from the body, so that subjects could learn to control their responses. For example, researchers found that persons could control their brain-wave patterns to some extent, particularly the so-called alpha rhythms generally associated with a relaxed, meditative state. This finding was especially relevant to those interested in consciousness and meditation, and a number of ‘alpha training’ programs emerged.
Another subject that led to increased interest in altered states of consciousness was hypnosis, which involves a transfer of conscious control from the character interpretation belonging in the dependent sector, whose occasions, as basic of an idea or the principal object of attention, in the course of its immediate composition, and like the substance to a particular individual finds to the subject that the modification as when of transferring to that of another person. Hypnotism has had a long and intricate history in medicine and folklore and has been intensively studied by psychologists. Much has become known about the hypnotic state, relative to individual suggestibility and personality traits; the subject has now been largely demythologized, and the limitations of the hypnotic state are fairly well known. Despite the increasing use of hypnosis, however, much remains to be learned about this unusual state of focussed attention.
Finally, many people in the 1960's experimented with the psychoactive drugs known as hallucinogens, which produce deranging disorder of consciousness. The most prominent of these drugs is lysergic acid diethylamide, or LSD; mescaline; and psilocybin; the latter two have long been associated with religious ceremonies in various cultures. LSD, because of its radical thought-modifying properties, was initially explored for its so-called mind-expanding potential and for its psychotomimetic effects (imitating psychoses). Little positive use, however, has been found for these drugs, and their use is highly restricted.
Scientists have long since considered the nature of consciousness without producing a fully satisfactory definition. In the early 20th century American philosopher and psychologist William James suggested that consciousness be a mental process involving both attention to external stimuli and short-term memory. Later scientific explorations of consciousness mostly expanded upon James’s work. In the article from a 1997 special issue of Scientific American, Nobel laureate Francis Crick, who helped determine the structure of DNA, and fellow biophysicist Christof Koch explains how experiments on vision might deepen our understanding of consciousness.
As the concept of a direct, simple linkage between environment and behaviour became unsatisfactory in recent decades, the interest in altered states of consciousness may be taken as a visible sign of renewed interest in the topic of consciousness. That persons are active and intervening participants in their behaviour has become increasingly clear. Environments, rewards, and punishments are not simply defined by their physical character. Memories are organized, not simply stored, an entirely new area called cognitive psychology has emerged that centre on these concerns. In the study of children, increased attention is being paid to how they understand, or perceive, the world at different ages. In the field of animal behaviour, researchers increasingly emphasize the inherent characteristics resulting from the way a species has been shaped to respond adaptively to the environment. Humanistic psychologists, with a concern for self-actualization and growth, have emerged after a long period of silence. Throughout the development of clinical and industrial psychology, the conscious states of persons in terms of their current feelings and thoughts were of obvious importance. The role of consciousness, however, was often de-emphasized in favour of unconscious needs and motivations. Trends can be seen, however, toward a new emphasis on the nature of states of consciousness.
The term ‘transference’, is that we attributed the therapeutic results to the transference without further definition of the word. We will now consider more closely the emotional relationship that is thus designed. During a psychoanalytic treatment, the patient allows the analyst to play a predominating role in his emotional life. This is of great importance in the analytic process. After his treatment is over, this situation is changed. The patient builds up feelings of affection for and resistance to his analyst that, in their ebb and flow, so exceed the normal degree of feeling that the phenomenon has long attracted the theoretical interest of the analyst. Freud studied this phenomenon thoroughly, explained it, and gave it the name ‘transference’, we most probably will understand the significance of the transference phenomenon impressed Freud so profoundly that he continued through the years to develop his ideas about it.
In all afforded efforts, to refuse to consider the demise of forebears as too merely disdain, that we cannot reproduce of all Freud’s research about transference but for an instance of obligation, would be used to indicate the requirement by the immediate need or purpose upon such condition that might point beyond a normal or acceptable limit, as to an excessive amount of which something does not or cannot extend to their essentials. When we speak of the transference in connexion with social reeducation, we mean the emotional responses of the education or counsellor or therapist, as the case maybe, without meaning that it takes place in the same way as in an analysis. The ‘countertransference‘ is emotional aptitude of the teacher toward the pupil, the counsellor toward his charge, the therapist toward the patient. The feeling that the child develop for the mentor is conditioned by a much earlier relationship to someone else. We must take cognisance of this fact in order to understand these relationships. The tender relationships that go to up the child’s love life are no longer strange to us. Many of these have already been touched upon in the foregoing literature. We have learned how the small boy takes the father and mother as love objects. We have followed the strivings that arise out of this relationship, the Oedipus situation, we have seen how this runs its course and terminates in an identification with the parents. We have also had opportunity to consider the relationship between brothers and sisters, how their original rivalry is transformed into affection through the pressure of their feeling for the parents. We know that the boy at puberty must give up his first love object within the family and transfers his libido to individuals outside the family.
Our present purposes we will consider the effects of these first experiences from a certain angle. The child’s attachment to the family, the continuance and the subsequent dissolution of these love relationships within the family, not only leave a deep effect on the child through the resulting identifications, they determine at the same the actual forms of this love relationships in the future. Freud compares these forms, without implying too great a rigidity, to copper plates for engraving. He has shown that in the emotional relationships of our later life we can do nothing but make an imprint from one or another of these patterns that we have established in early childhood.
Why Freud chose the term ‘transference’ for the emotional relationship between patient and analyst is easy to understand. The feelings that arose long ago in another situation are transferred upon the analyst. To the counsellor of the child, the knowledge of the transference mechanism is indispensable. In order to influence the dissociable behaviour, he must bring his charge into the transference situation. The study of the transference in the dissociable child shows regularly a love life that has been disturbed in early childhood by a lack of affection or an undue amount of affection. A satisfactory social adjustment depends on certain conditions, among them an adequate constitutional endowment and early love relationships that have been confined within certain limits. Society determines these limitations, just as definitely as the later love life of an individual is determined by early form his libidinal development. The child develops normally and assumes his proper place in society, if he can cultivate within the privacy to such relationships as can favourably carry over into the schools and from there into the ever-broadening world around him. His attitude toward his parents must be such that it can be carried over onto the teacher, and that toward his brothers and sisters must be transferred to his schoolmates. Every new contact, according to the degree of authority or maturity that the person represents, repeats a previous relationship with very little deviation. People whose early adjustment to succeed or supervene from such a normative course have no difficulties in their emotional relations with others, and they are able to form new ties, to deepen them, or to break them off without conflict when the situation demands it.
We can easily see why an attempt to change the present order of society always meets with resistance and where the radical reformer will have to use the greatest leverage. Our attitude to society and its members has a certain standard form. It gets its imprint from the structure of the family and the emotional relationships set up within the family, therefore, the parents, especially the father, assume overwhelming responsibility for the social orientation of the child. The persistent, ineradicable libidinal relationships carried over from childhood are facts with which social reformers must reckon. If the family represents the best preparation for the present social order, which seems to be the case, then the introduction of a new order means that the family must be uprooted and replaced by a different personal world for the child. It is beyond our scope to attempt a solution of this question, which concerns those who strive to build up a new order of society. We are remedial educators and must recognize these sociological relationships. We can ally ourselves with whatever social system will, but we have the path of our present activity well marked out for us, to bring dissociable youth into the line with present-day society.
If the child is harmed through too great disappointment or too great indulgence in his early life, he builds up reaction patterns that are damaged, incomplete, or too delicate to support the wear and tear of life. He is incapable of forming libidinal object relationships that are considered normal by society. His unpreparedness for life, his inability to regulate his conscious and unconscious libidinal striving and to confine his libidinal expectations within normal bounds, creates an insecurity in relation to his fellow men and constitute one of the first and most important condition’s fo r their development of delinquency. Following this point of view, we look for the primary causes of dissociable behaviour in early childhood, where the abnormal libidinal ties are established. The word ‘delinquency’ is an expression used to describe a relationship to people and things that are at variance with what society approve in the individual.
It is not immediately clear, from which are pointed from the particular form of the delinquency, just what libidinal disturbances in childhood have given rise to the dissociable expression. Until we have a psychoanalytically construed scheme for the diagnosis of delinquency, we may content ourselves by separating these forms into two groups: (1) Borderline neurosis cases with dissociable symptoms, and (2) Dissociable cases for which are in part, the ego giving to develop of the dissociable behaviour, and showing no trace of neurosis. In the first type, the individual finds himself in an inner conflict because of the nature of his love relationships, a part of his own personality forbids the indulgence of libidinal desires and strivings. The dissociable behaviour results from this conflict. In the second type, the individual finds himself in open conflict with his environment, because the outer world has frustrated his childish libidinal desires.
While these matters under discussion should enhance our understanding and conditions in terms through which the past and present are to be understood. Despite their brevity, these discussions, to a better kind, as their discerning intendment would not only make in agreement of an acceptation in meaning but understood by their endeavour upon undertaking of our present concerns and considerations, that in issues regarding the transference and the conditions for loving, with which Freud’s views may be best approached through his introduction of the idea of conditions for loving that project the analysis of transferences. For example, Freud says, in this context that, . . . each individual, . . . has acquired a specific method of his own in this conduct of his erotic life - that is, in the precondition of falling in love which he lays down, in the instincts he satisfies and the aim he sets himself in the course of it’. In another place, Freud is advising the analyst to adopt a special attitude toward erotic transference; this is the attitude that combines attentiveness, neutrality, non-gratification, and insistence on analyzing the erotic feelings as ‘unreal’ but necessary features of the treatment. he goes on to describe the consequence of maintaining this attitude in the following words: ‘The patient, whose sexual repression is of course not yet removed but merely pushed into the back-ground, will then feel safe enough to allow all her preconditions for loving, all the phantasies springing from her sexual desires, all the detailed characteristics of her state of being in love, to come to light, and from these she will herself open up the way to the infantile roots of her love (1915). And, in a number of papers dating from about the same time, that is between the years of 1910 and 1922, he describes particular conditions for loving. Among these are the man’s condition that the woman he loves sexually must somehow be degraded or in need of rescue or that there be an injured third party in the interpersonal configuration, also. In the instance of male homosexuality, in addition to the partner’s possessing a penis, there is the condition that the young man who is loved be the same age that the lover was when he developed his dominant identification with his mother (1922).
The child’s attachment to the family, the continuance and the subsequent dissolution of these love relationships within the family, not only leave a deep effect on the child through the resulting identifications, they determine at the same the actual forms of this love relationships in the future. Freud compares these forms, without implying too great a rigidity, to copper plates for engraving. He has shown that in the emotional relationships of our later life we can do nothing but make an imprint from one or another of these patterns which we have established in early childhood.
Why Freud chose the term ‘transference’ for the emotional relationship between patient and analyst is easy to understand. The feelings which arose long ago in another situation are transferred upon the analyst. To the counsellor of the child, the knowledge of the transference mechanism is indispensable. In order to influence the dissocial behaviour, he must bring his charge into the transference situation. The study of the transference in the dissocial child shows regularly a love life that has been disturbed in early childhood by a lack of affection or an undue amount of affection. A satisfactory social adjustment depends on certain conditions, among them an adequate constitutional endowment and early love relationships which have been confined within certain limits. Society determines these limitations, just as definitely as the later love life of an individual is determined by early form his libidinal development. The child develops normally and assumes his proper place in society, if he can cultivate within the privacy to such relationships as can favourably be carried over into the schools and from there into the ever-broadening world around him. His attitude toward his parents must be such that it can be carried over onto the teacher, and that toward his brothers and sisters must be transferred to his schoolmates. Every new contact, according to the degree of authority or maturity which the person represents, repeats a previous relationship with very little deviation. People whose early adjustment to succeed or supervene from such a normative course have no difficulties in their emotional relations with others, and they are able to form new ties, to deepen them, or to break them off without conflict when the situation demands it.
We can easily see why an attempt to change the present order of society always meets with resistance and where the radical reformer will have to use the greatest leverage. Our attitude to society and its members has a certain standard form. It gets its imprint from the structure of the family and the emotional relationships set up within the family, therefore, the parents, especially the father, assume overwhelming responsibility for the social orientation of the child. The persistent, ineradicable libidinal relationships carried over from childhood are facts with which social reformers must reckon. If the family represents the best preparation for the present social order, which seems to be the case, then the introduction of a new order means that the family must be uprooted and replaced by a different personal world for the child. It is beyond our scope to attempt a solution of this question, which concerns those who strive to build up a new order of society. We are remedial educators and must recognize these sociological relationships. We can ally ourselves with whatever social system will, but we have the path of our present activity well marked out for us, to bring dissociable youth into the line with present-day society.
If the child is harmed through too great disappointment or too great indulgence in his early life, he builds up reaction patterns which are damaged, incomplete, or too delicate to support the wear and tear of life. He is incapable of forming libidinal object relationships which are considered normal by society. His unpreparedness for life, his inability to regulate his conscious and unconscious libidinal striving and to confine his libidinal expectations within normal bounds, creates an insecurity in relation to his fellow men and constitute one of the first and most important condition’s for their development of delinquency. Following this point of view, we look for the primary causes of dissocial behaviour in early childhood, where the abnormal libidinal ties are established. The word ‘delinquency’ is an expression used to describe a relationship to people and things which are at variance with what society approve in the individual.
It is not immediately clear, from which are pointed from the particular form of the delinquency, just what libidinal disturbances in childhood have given rise to the dissociable expression. Until we have a psychoanalytically construed scheme for the diagnosis of delinquency, we may content ourselves by separating these forms into two groups: (1) Borderline neurosis cases with dissociable symptoms, and (2) Dissociable cases for which are in part, the ego giving to develop of the dissociable behaviour, and showing no trace of neurosis. In the first type, the individual finds himself in an inner conflict because of the nature of his love relationships, a part of his own personality forbids the indulgence of libidinal desires and strivings. The dissocial behaviour results from this conflict. In the second type, the individual finds himself in open conflict with his environment, because the outer world has frustrated his childish libidinal desires.
The differences in the forms of dissociable behaviour are important for many reasons. At present, they are significant to us because of the various ways in which the transference is established in these two types, we know that with a normal child the transference takes place of itself through the kindly efforts of the responsible adult. The teacher in his attitude repeats the situations long familiarly to the child, and thereby evokes a parental relationship. He does not maintain this relationship at the same level, but continually deepens it as long as he is the parental substitute.
When a neurotic child with symptoms of delinquency comes into the institution, the tendencies to transfer his attitude toward his parents to the persons in authority are immediately noticeable. The worker will adopt the same attitude toward the dissocial child as to the normal child, and bring him into positive transference, if he acts toward him in such a way as to prevent a repetition with the worker of the situation with the parents which led to the conflict. In psychoanalysis, on the other hand, it is of greatest importance to let this situation repeat itself. In a sense the worker becomes the father or the mother, but still not wholly so, he represents their claims, but in the right moment he must let the dissocial child know that he has insight into his difficulties and that he will not interpret the behaviour in the same way as do the parents. He will respond to the child’s feeling of a need for punishment, but he will not completely satisfy it.
He will conduct in himself be entirely differently in the case of the child who in open conflict with society. In this instance he must take the child’s part, be in agreement with his behaviour, and in the severest cases even give the child to understand that in his place he would behave just the same way. The guilt feelings found so clearly in the neurotic cases with dissocial behaviour are present in these cases also. These feelings do not arise, however, from the dissocial ego, but have another source.
Why does the educator conduct himself differently in dealing with this second type? These children, too, he must draw into a positive transference to him, but what is applicable and appropriate for a normal or a neurotic child would achieve opposite results. Otherwise the worker would bring upon himself all the hate and aggression which the child bears toward society, thus leading the child into a negative instead of positive transference, and creating a situation in which the child is not amenable to training.
Even so, what was said about psychoanalysis theory is only a bare outline, that much deeper study of the transference is necessary to anyone interested in re-educational work from the psychoanalytic point of view. The practical application of this theory is not easy, since we deal mostly with mixed types, such that the attitude of the counsellor cannot be as uniform as having enough verbal descriptions for evincing of individual forms of dissociated behaviour to enable us to offer detailed instructions about how to deal with them. At present our psychoanalytic knowledge is such that a correct procedure cannot be stated specifically for each and every dissocial individual.
The necessity for bringing the child into a good relationship to his mentor is of prime importance. The worker cannot leave this to chance, he must deliberately achieve it and he must face the fact thus no effective work is possible without it. It is important for him to grasp the psychic situation of the dissocial child in the very first contact he makes with him, because only this can be known in what attitude to adopt. There is a further difficulty in that the dissocial child takes pains to hide his real nature: He misrepresents himself and lies. This is to be taken for granted, it should not surprise or upset us. Dissocial children do not come to us of their own volition but are brought to us, very often with the threat, ‘You’ll soon find out what’s going to happen to you.’ Generally parents resort our help only after every other means, including corporal punishment, have failed. To the child, we are only another form of punishment, an enemy against whom he must be on his guard, not a source of help to him. There is a great difference between this and the psychoanalytic situation, where the patient comes voluntarily for helping. To the dissocial child, we are a menace because we represent society, with which he is in conflict. He must protect himself against this terrible danger and be careful what he says in order not to give himself away. It is hard to make some of these delinquent children talk, remain unresponsive and stubborn. One thing they all have in common: They do not tell the truth. Some lie stupidly, pitiably, others, especially the older ones, show great skill and sophistication. The extremely submissive child, the ‘dandily’, the very jovial, or the exaggeratedly sincere, some especially hard to reach. This behaviour is so much to be expected that we are not surprised or disarmed by it, the inexperienced teacher or adviser is easily irritated, especially when the lies are transparent, but he must not let the child be aware of this. He must deal with the situation immediately without telling the child that he can see that coming through were attributive values about his attitudinal behaviour.
There is nothing remarkable in the behaviour of the dissociable, but it differs only quantitatively from normal behaviour. We all hide our real selves and use a great deal of psychic energy to mislead our neighbours. We masquerade more or less, according to necessity. Most of us learn in the nursery the necessity of presenting ourselves in accordance with the environmental demands, and thus we consciously or unconsciously build up a shell around ourselves. Anyone who has had experience with young children must have noticed how they immediately begin to dissimulate when a grown-up comes into the room. Most children succeed in behaving in the manner which they think is expected of them. Thus they lessen the danger to themselves and at the same time they are casting the permanent moulds of their mannerisms and their behaviour. How many parents really bother themselves about the inner life of their children? Is this mask necessarily for life? I do not know, but it often seems that the person on whom childhood experiences have forced the dissocial individual masquerades to a greater extent, and more consciously, then the normal. He is only drawing logical deductions from his unfortunate disagreeable authority? Why should he be sincere with those people who represent disagreeable authority? This is an unfair demand.
We must look further into the differences between the situation of social retraining and the analytic situation. The analyst expects to meet in his patient unconscious remittances which prevent him from being honest or make him silent: But the treatment is in vain when the patient lies persistently. Those who work with dissociable children expect to be lied to. To send this child away because he lies are only giving in to him. We must wait and hope to penetrate this mask which covers the really psychic situation. In the institution it does not matter if this is not achieved immediately, it means merely that the establishment of the transference is postponed. In the clinic, however, we must work more quickly. Taking with the patient does not always suffice, and we must introduce other remedial measures. Generally, we see the delinquent child, only, in at least as infrequent to a smattering of times, but we are forced to take some steps after the first few interviews, to formulate some tentative conception of the difficulty and to establish a positive transference as quickly as possible. This means we must get at least a peep behind the mask. If the child is not put in an institution, he remains in the old situation under the same influences which caused the trouble. In such cases we wish to establish the transference as quickly as possible, to intensify the child`s positive feelings for us that are aroused while the child is with us, and to bring them rapidly to such a pitch that they can no longer be easily disturbed by the old influences. To carry on such work successfully presupposes a long experience.
Let us now go against our theoretical concerns and considerations and see how the analyst and the patient seek to grasp upon a try to solve situational thoughts for which the transference, and, moreover, its mask on which can be understood that feelings and a better understanding the differentiation that intentionality that allies with others and exclusively its need to achieve to some end.
Even so, there are few current problems concerning the problem of transference that Freud did not recognize either implicitly or explicitly in the development of the theoretical and clinical framework. For all essential purposes, moreover, his formulations, in spite of certain shifts in emphasis, remain integral to contemporary psychoanalytic theory and practice. Recent developments mainly concern the impact of an ego-psychological approach, the significance of object relations, both current and infantile, external and internal, the role of aggression in mental life, and the part played by regression and the repetition compulsion in the transference. Nevertheless, analysis of the infantile Oedipal situation in the setting of a genuine transference neurosis is still considered as a primary goal of psychoanalytic procedure.
Originally, transference was ascribed to displacement on the analyst of repressed wishes and fantasies derived from early childhood. The transference neurosis was viewed as a compromise formulation similar to dreams and other neurotic symptoms. Resistance, defined as the clinical manifestation of repression, could be diminished or abolished by interpretation mainly directed toward the content of the repressed. Transference resistance, both positive and negative, was inscribed to the threatened emergence of repressed unconscious material in the analytic situation. Presently, as with the development of a structural approach, the superego had been portrayed as the heir to the genital Oedipal situation, also was the recognition as playing a leading role in the transference situation. The analysis was subsequently viewed not only as the object by displacement of infantile incestuous fantasies, but also as the substitute by projection for the prohibiting parental figures which had been internalized as the definitive superego. The effect of transference interpretation in mitigating undue severity of the superego has, therefore, been emphasized in many discussions of the concept of transference.
Certain expansions in the structural approach related increasingly to the recognition of the role that had earlier objective relations, in the development of the superego. This had affected the current concepts of transference, in that this connection, the significance of the analytic situation as a repetition of the early mother-child relationship has been stressed from different points for viewing to such equally important developments related to Freud’s revised concept of anxiety which can only lead to theoretical developments in the field of ego psychology. However, this brought about their related clinical changes in the work of many analysts. As a result, attention was no longer the main attraction that had focussed on the content of the unconscious. In addition, increasing importance was attributed to the defence processes by means of which the anxiety which would be engendered if repression and other related mechanisms were broken down, was avoided in the analytic situation. Differences in the interpretation of the role of the analyst and the nature of transference developed from emphasis, on the one hand, on the importance of early object relations, and on the other, from primary attention to the role of the ego and its defences. These defences first emerged clearly in discussion of the technique of child analysis, in which Melanie Klein and Anna Freud, the pioneers in the fields of thought as playing the leading roles.
From a theoretical point of view, discussion foreshadowing the problems which face us today was presented in 1934 in a well-known paper by Richard Sterba and James Strachey, and further elaborated at the Marienbad Symposium at which Edward Bibring made an important contribution. The importance of identification with, or introjection of, the analyst in the transference situation of identification with, or introjection of, the analysts in the transference situation were clearly indicated. The therapeutic results were attributed to the effect of this process In mitigating the need for pathological defences. Strachey, however, considerably influenced by the work of Melanie Klein, regarded transference as essentially a projection onto the analyst of the patient’s own superego. The therapeutic process was attributed to subsequent introjection of a modified superego as a result of ‘mutative’ transference. Sterba and Bibring, on the other hand, intimately involved with development of the ego-psychological approach, reemphasised the central role of the ego, postulating a therapeutic split and identification with the analyst as an essential feature of transference. To some extent, this difference of opinion may be regarded as semantic. If the superego is explicitly defined as the heir of the genital Oedipus conflict, then earlier intra-systematic conflicts within the ego, although they may be related retrospectively to the definite superego, much, nevertheless, are defined as contained within the ego. Later divisions within the ego of the type indicated by Sterba and very much expanded by Edward Bibring in his concept of therapeutic alliance between the analyst and the healthy part of the patient’s ego, must also be excluded from superego significance. In contrast, those whom attribute pregenital intra-systemic conflicts within the ego primarily to the introjection of objects, consider that the resultant state of internal conflict appears like the dynamic idea that something conveys to the mind as having an endless meaning attached to the coherence of the therapeutic situation and seen in the later conflicts between ego and superego. In that way, they believe that these structures developed simultaneously and suggest that no sharp distinction should be made between pre-oedipal, oedipal, and post-oedipal superego.
The differences, however, are not entirely verbal, since those whom attribute superego formations to the early months of life tend to attribute significantly too early object relation which differs from the conception of those who stress control and, neutralization of instinctual energy as primary functions of the ego. This theoretical difference necessarily implies some disagreement as how the dynamic situation both in childhood and in adult life, inevitably reflected in the concept of transference and in hypotheses as to the hidden nature of the therapeutic process. From one point of view, the role of the ego is central and crucial at every phase of analysis. A differentiation is made between transference as therapeutic alliance and the transference neurosis, which, on the whole, is considered a manifestation of resistance. Effective analysis depends on a sound and stable therapeutic alliance, a prerequisite for which is the existence, before analysis, of a degree of mature superego functions, the absence of which in certain severely disturbed patients and in young children may preclude traditional psychoanalytic procedure. Whenever indicated, interpretation’s manifestations, which means, in effect, that the transference must be analysed. The process of analysis, however, is not exclusively ascribed to transference interpretation. Other interpretations of unconscious material, whether related to defence or to early fantasies, will be equally effective provided they are accurately timed and provide a satisfactory therapeutic alliance has been made. Those, in contrast, whom stress the importance of early object relations emphasizes the crucial role of transference as an object relationship, distorted though this may be of a variety of defences against primitively unresolved conflicts. The central role of the ego, both in the early stages of development and in the analytic process, are definitely accepted. The hidden nature of the ego is, however, considered at all times to be determined by its external and internal objects. Therapeutic process indicated changes in ego function results, therefore, primarily from a change in object relations though interpretation of the transference situation, finds of less differentiation as made between transference as for being the therapeutic alliance and transference neurosis as a manifestation of resistance. Therapeutic progress depends almost exclusively on transference interpretation. Other interpretations, although at times, are not, in general, considered an essential feature of the analytic process. From this point of view, the preanalytic maturity of the patient’s ego is not stressed as considered potentially suitable for traditional psychoanalytic procedure.
These differences in theoretical orientation are not only reflected in the approach to children and disturbed patients. They may also be recognized in significant variations of technique in respect to all clinical groups, which inevitably affect the opening phases, understanding of the inevitable regressive features of the transference neurosis, and handling of the germinal phases of analysis. By its emphasis as drawn on or upon the main problems, and, by contrast, rather than similarity, our efforts will be to avoid to detailed discussions of controversial theory regarding the hidden nature of early ego development by a somewhat arbitrary differentiation between those who relate ego analysis to the analysis of defences and those who stress the primary significance of object relations both in the transference, and in the development and definitive structure of the ego. Needless to say, this involves some oversimplification, where I hope that it may, at the same time, clarify certain important issues. To take, on or upon the analysis of patients we are generally agreeing to be suitable for classical analytic procedure, the transference neurosis. Those which emphasis the role of the ego and the analysis of defences, not only maintain Freud’s conviction that analysis should proceed from surface to depth, but also consider that early material in the analytic situation derives, that, in general, from defensive processes rather than from displacement onto the analyst of early instinctual fantasies. Deep transference interpretation in the early instinctual fantasies. Deep transference interpretation in the early phases of analysis will, therefore, rather be meaningless to the patient since its unconscious significance is so inaccessible, or, if the defences are precarious, will lead to premature and possibly intolerable anxiety. Premature interpretation of the equally unconscious automatic defensive processes by means of which instinctual fantasy kept unconscious is also ineffective and undesirable. There are, nonetheless, differences of opinion within this group, as to how far analysis of defence can be separated from analysis of content. Waelder, for example, has stressed the impossibility of such separation. Fenichel, however, considered that at least theoretical separation should be made and indicated that, as far as possible, analysis of defence should precede analysis of unconscious fantasy. It is, nevertheless, generally agreed that the transference neurosis develops, as a rule after ego defences have been sufficiently undermined to mobilize previously hidden instinctual conflict. During both the early stages of analysis, and at frequent points after development of the transference neurosis, defences against the transference will become a main feature of the analytic situation.
This approach, has already been indicated, is based on certain definite premises regarding the hidden natures and function of the ego in respect to the control and neutralization of instinctual energy and unconscious fantasies, while the importance of early object relations is not neglected, the conviction that early transference interpretation is ineffective and potentially relations are not neglected, the conviction and unconscious fantasy. The conviction that early transference interpretation is ineffective and potentially dangerous is related to the hypothesis that the instinctual energy available to the mature ego has been neutralized from unconscious fantasies, meaning at the beginning of analysis, for all effective purposes, relatively or absolutely divorced from its unconscious fantasy, as yet, there are a number of analysts of differing theoretical orientation of ego function from unconscious sources, but consider that unconscious fantasy continues to operate in all conscious mental activity. The analysts also construct upon the whole of their existing in the emphasis to the crucial significance of primitive fantasies, in respect to the development of the transference situation. The individual entering analysis will inevitably have unconscious fantasies concerning the analyst derived from primitive sources. This material, although deep in a sense, is, nevertheless, strongly current and accessible to interpretation. Klein, in addition, creates the development and definitive structure of the superego to unconscious fantasy determined by the earliest phases of object relationships. She emphasizes the role of early introjective and projective processes in relation to primitive anxiety ascribed to the death instinct and related aggression drive fantasies. The unresolved difficulties and conflict of the earliest period continue to colour object relations throughout life. Failure to achieve an essentially satisfactory object relationship in this early period, and failure to master relative loss of that object without retaining its good internal representative, will not only affect all object relations and definitive ego function, but more specifically determine the nature of anxiety-provoking fantasies on entering the analytic situation. According to this point of view, therefore, early transference uninterpreted, even thought it may relate to fantasies derived from an early period of life, should result not in an increase, but a decrease of anxiety
In considering next problems of transference in relation to analysis of the transference neurosis, two main points must be kept in mind. First, as already indicated, those who emphasize the analysis of defence tend to make a definite differentiation between transference as therapeutic alliance and the transference neurosis as a compromise formation which serves the purposes of resistance. In contrast, those who emphasize the importance of early object relations view the transference primarily as a revival or repetition, sometimes attributed to symbolic processes of early struggles in respect to objects. Still, there is no sharp differentiation made between the early manifestations of transference and the transference neurosis. In view, to what is more, of the weight given to the role of unconscious fantasy and internal objects in every phase of mental life, healthy and pathological functions, though differing in essential respect, do not differ with regard to their direct dependence on unconscious sources.
In the second place, the role of regression in the transference situation is subject to wide differences of opinion. It was, of course, one of Freud’s earliest discoveries that regression had of its earliest points of fixation, and is a cardinal feature, not only in the development of neurosis and psychosis, but also in the revival of earlier conflicts in the transference situation. With the development of psychoanalysis and its application to an ever increasing range of received increased attention. The significance of the analytic situation as a means of fostering regression as a prerequisite for the therapeutic work has been emphasized by Ida Macapline in a recent paper. Differing opinions as to the significance, value, and technical handling of regressive manifestoes from the basis of important modifications of analytic technique, which will be considered, however, in respect to the transference neurosis, the view recently expressed by Phyllis Greenacre, that regression, and indispensable features would be generally accepted. It is also a matter of generally based agreement that a prerequisite for successful analysis is revival and repetition in the analytic situation of the struggle of primitive stages of development. Those who emphasize defence analysis, however, tend to view regression as a manifestation of resistance, as a primitive mechanism of defence employed by the growth sets of the transference neurosis. Analysis of these regressive manifestations with their potential dangers depends on the existing and continued functioning of adequate ego strength to maintain therapeutic alliance at an adult level. Those, in contrast, who stress the significance of transference as a revival of the early mother-child relationship does not emphasize regression as an indication of resistance or defence, the revival of these primitive experiences in the transference situation is, in fact, regarded as can essential prerequisite for satisfactory psychological maturation and true geniality. The Kleinian school, as already indicated features the continued activity of primitive conflicts in determining essential features of the transference at every stage of analysis. Their increasing overt revival in the analytic situation, therefore, signifies a reopening of the analysis, and in general, is regarded as an indication of diminuation rather than increase of resistance. The dangers involved according to this point of view and are determined more but to the failure to mitigate anxiety by suitable transference interpretation. By this failure to obtainably achieve, in the early phases of analysis, a sound and stabling therapeutic alliance is based on the maturity of the patient’s essential ego characteristics.
In considering, briefly, the terminal phases of analysis, many unresolved problems concerning the goal of the therapy and definition of a completed psychoanalysis must be kept in mind. Distinction must also be made between the technical problems of the terminal phase and evaluation of transference after the analysis has been terminated, there is widespread agreement as to the frequent revival in the terminal phases of primitive transference manifestations apparently resolved during the early phases of primitive transference manifestation, apparently resolved during the early phase of analysis has been terminated. Balint, and those who accept Ferenczi’s concept of primary passive love, suggest that some gratification of primitive passive needs may be essential for successful termination. To Klein, the terminal phases of analysis also represent a repetition of important features of the early mother-child relationship. According to her point of view, this period represents, in essence, a revival of the early weaning situation. Completion depends on a mastery of early depressive struggles culminating in successful introjection of the analysis as a good object. Although, in this connection, emphasis differs considerably, it should be noted that those who stress the importance of identification with the analyst as a basis for therapeutic alliance, also accept the inevitability of some permanent modifications of a similar nature. Those, however, who make a definite differentiation between transference of the transference neurosis as a main prerequisite for successful termination. The identification based on therapeutic alliance must be interpreted and understood, particularly with reference to the reality aspects of the analyst’s personality. In spite, therefore, of significant important differences there are, as already indicated in connection with the earlier papers of Sterba and Strachey, important points of agreement in respect to the goal of psychoanalysis.
The differences already considered and noted that indicate some basic current problems of transference. So far, however, discussion has been limited to variations within the framework of a traditional technique. We must consider problems related to overt modifications, so as the essential expanding context of use between variations introduced in respect to certain clinical conditions. Often as a preliminary to classical psychoanalysis, and modifications based on changes on basic approach which lead to significant alterations with regard both to the method and to the aim of therapy. It is generally agreed that some neurosis, borderline patients and the psychosis. The nature and meaning of such changes are, however, viewed differently according to the relative emphasis placed on the ego and its defences, on underlying unconscious conflicts, and on the significance and handling of regression in the therapeutic situation.
In ‘Analysis Terminable and Interminable’, Freud suggested that certainly inaccessible to psychoanalytic procedure. Hartmann has suggested that in addition to these primary attributes, other ego characteristics, originally develop for defensive purposes, and the related neutralized instinctual energy at the disposal of the ego, may be relatively or absolutely divorced from unconscious fantasy. This not only explains the relative inefficacy of early transference interpretation, but also hints of possible limitations in the potentialities of analysis attributable to secondary autonomy of the ego which is considered to be relatively irreversible. In certain cases, moreover, it is suggested that analysis of precarious or seriously pathological defences - particularly those concerned of aggressive impulses - may be not only ineffective, but dangerous. The relative failure of ego development in such cases not only precludes the development of a genuine therapeutic alliance, but also raises the risk of a serious regressive, often predominantly hostile transference situation. In certain cases, therefore, preliminary period of psychotherapy is recommended in order to explore the capacities of the patient to tolerate traditional psychoanalysis. In others, as Robert Knight in his paper on borderline states, and as many analysts’ working with psychotic patients have suggested, psychoanalytic procedure is not considered applicable. Instead, a therapeutic approach based on analytic understanding which, in essence, utilizes an essentially implicit positive transference as a means of reinforcing, rather than analysing the precarious defences of the individual, is advocated. In contrast, Herbert Rosenfeld approached even severely disturbed psychotic patients with minimal modifications of psychoanalytic techniques. Only changes which the severity of the patient’s condition enforces are introduced. The dangers of regression in therapy are not emphasized since primitive fantasy is considered to be active under all circumstances. The most primitive period is viewed in terms of early object relations with special stress on prosecutory anxiety related to the death instinct. Interpretation of this primitive fantasy in the transference situation, is best offered the opportunity of strengthening the severity-threatened psychosis mainly to serve traumatic experiences, particularly of deprivation in early infancy. According to this point of view, profound regression offers an opportunity to fulfil, in the transference situation, primitive needs which had not been met at the appropriate level of development. Similar suggestions have been proposed by Margolin and others, in the concept of anaclitic treatment. Serious psychosomatic diseases, that approach the premise that the inevitable regression is shown by certain patients and should be utilized in therapy, as a means for gratifying, in their extremely permissive transference situation. Having distinctive or certain limits in the burdensome instant for demanding to that which has not been met in infancy, as this must, in the connection of being taken to understand that the gratifications recommended in the treatment of severely disturbed patients are determined by their conviction. Of these patients are incapable of developing transference as we understand it, in the connection with neurosis and must therefore be handled by a modified technique.
The opinions so far considered, however, much of them, as mine differ in certain respects, are, nonetheless, all based on the fundamental premise that an essential difference between analysis and other methods of therapy depends on whether or not interpretation of transference is an integral feature of technical procedure. Results based on the effects of suggestions are to be avoided, as far as possible, whenever traditional technique is employed. This goal has, however, tp establish a point by appropriate objective means, that corroborated evidence that proved the need for better a state of being even more difficult to achieve than Freud expected when he first discerned the significance of symptomatic recovery based on positive transference. The importance of suggestion, even in the most strict analytic methods, has been repeatedly stressed by Edward Glover and others. Widespread and increasing emphasis as to the part played by the analyst’s personality in determining the nature of the individual transference also implies recognition of unavoidable suggestive tendencies in the therapeutic process. Many analysts today believe that the classical conception of analytic objectivity and anonymity cannot be maintained. Instead, thorough analysis of reality aspects of the therapist’s personality and point of view is advocated as an essential feature of transference analysis and an indispensable prerequisite for the dynamic changes already discussed in relation to the termination of analysis. It thus remains the ultimate goal of psychoanalyst’s whenever their theoretical orientation, to avoid, as far as is humanly possible, results based on the unrecognized or unanalysed action of suggestion, and to maintain, as a primary goal, the resolution of such results through consistent and careful interpretation.
There are, however, a number of therapists, both within and outside the field of psychoanalysis, who consider that the transference situation should not be handled only or mainly as a setting for interpretation even in the treatment or analysis of neurotic patients. Instead, they advocate utilization of the transference relationship for the manipulation of corrective emotional experience. The theoretical orientation of those utilizing this concept of transference may be closer to, or more distant form, a Freudian point of view according to the degree to which current relationships are seen as determined by past events. At one extreme, current aspects and cultural factors are considered of predominant importance, at the other, mental development is viewed in essentially Freudian terms and modifications of technique are ascribed to inherent limitations of the analytic method rather than to essentially changed conceptions of the early phases of mental development. Of this group, Alexander is perhaps the best example. It is thirty years since, in his Salzburg paper, he indicated the tendency for patients to regress, even after apparently successful transference analysis of the oedipus situation to narcissistic dependent pregenital levels which prove stubborn and refractory to transference interpretation. In his more recent work, the role of regression in the transference situation has been increasingly stressed. The emergence and persistence of dependent, pregenital commands for something as or is if one’s right or due requirements are challenged in measuring moderations of a wide range of clinical conditions. It is argued, that its indications that the encouragement of a regressive transference situation is undesirable and therapeutically ineffective. The analyst, therefore, should when this threatens adopt a definite role explicitly differing from the behaviour of the parents in early childhood in order to bring about therapeutic results through a corrective emotional experience in the transference situation. This, it is suggested, will obviate the tendency to regression, thus curtailing the length of treatment and improving therapeutic results. Limitations of regressive manifestations by active steps modifying traditional analytic procedure in a variety of ways are also frequently indicated, according to this point of view.
It will be clear that to those who maintain the conviction that interpretation of all transference manifestations remain an essential feature of psychoanalysis, the type of manifestation as described, even though based on a Freudian reconstruction of the early phases of mental developments, and represent a major modification. It is determined by a conviction that psychoanalysis, as a therapeutic method, has limitations related to the tendency to regression, which cannot be resolved by traditional technique. Moreover, the fundamental premises on which, and the conception of corrective emotional experience is based minimizing the significance of insight and recall. It is essentially, suggested that corrective emotional experience alone may bring about qualitative dynamic alterations in mental structure, which can lead to a satisfactory therapeutic goal. This implies a definite modification on the analytic hypothesis whose current problems are determined by their defences against the direct opposition to the instinctual impulses and the intentional object, to which had been set up during the decisive periods of early development. An analytic result therefore depends on the revival, repetition and mastery of earlier conflict in the current experience of the transference situation with insight an indispensable feature of an analytic goal.
Since certain important modifications are related to the concept of regression in the transference situation, it should be considered that this concept is in relation to the repetition compulsion, that transference, essentially is a revival of earlier emotional experience, must be regarded as a manifestation of the repetition compulsion is generally accepted. It is, however, necessarily to distinguish between repetition compulsion as an attempt to master traumatic experience and repetition compulsion as an attempt to return to a real or fantasized earlier state of rest or gratification. Lagache, in a recent paper, has connected by or as if by the affirming relatedness as associated to the corresponding divergence in the repetition compulsion to an inherent need to appear in the problems that had previously been left unsolved. From this point of view, the regressive aspects of the transference situation are to be regarded as a necessary preliminary to the mastery of unresolved conflict, as too, the regressive aspects of transference are mainly attributed to a wish to return to an earlier state of rest or narcissistic gratification, to the maintenance of the status quo in preference to any progressive action, to which Freud’s original conception of the death instinct. There is a good deal to suggest that both aspects of the repetition compulsion may bee seen in self-destructive forces tend to be stronger that progressive libidinal impulses, the potentialities of the analytic approach will inevitably appear to be limited. In those, in contrast, in whom that regard the reappearance in the transference situation of earlier conflicts as an indication of tendencies to master and progress will continue to feel that the classical analytic method remains the optimal approach to psychological illness wherever it is applicable.
Clarification check over the position or peculiar state as occupying a spatial point in temporal conditions, with a significant relevance to the amplitude larger in extent or a greater capacity that the average infinitive period has of time. Whereas in absence or termination must reflect on or upon the fearing analysis if the transference, as compelling of a generally acknowledged focal point, this itself may debase the appropriate factor that generates, in every degree. The exemplifying analytic technique that would react upon the discipline needed to utilize the new values, whereby, they can be ascribed as the commonality in holding the services to a suspicious self-direction and comprehensive understanding, in that of whatever is humanly affiliated to the best as can be, and yet, the advocacy to the analysis of the transference is generally acknowledged as the central feature of analytic technique? Freud regarded transference and resistance as facts in the observational conceptuality for which of representing the state of inventions. He writes, . . . that the theory of psychoanalysis in an attempt to account for two striking and unexpected facts of observation which emerge whenever an attempt is made. Evidently the symptoms of a neurotic source, may in his past life, inhabit the sources of experiential recall to the past or the introspective reflections. In the state of affairs, in that for being the latent characterizations announced as the factoring responsibility for the transference and of resistance . . . one which takes the other side of the problem, while accepting as such, to the latencies and the hidden values non-accepting for new interactions as brought through a hypothesis that will hardly escape the charge of misappropriation of properties by attempting endeavour to re-associate the essentially established personalization, that if the pursuit in calling them a psychoanalyst’. Rapaport (1967) argued, in his posthumously published paper on the methodology of psychoanalysis, that transference and resistance inevitably follow from the fact that the analytic situation is interpersonal.
Despite this general agreement on the centrality of transference and resistance in technique, in that, the analysis of transference is not pursued as systematically and comprehensively affirmed, however, it could be and should be. The relative privacy for which psychoanalytic work makes it impossible for one or of that of any-other, to skilfully improve upon the attemptive conceptual representation as comprehended of issues, its assumption to state this view as anything more that impressions, involving on that of what in the analysis of the transference and to states awareness in the number of reasons that an important aspect in the analysis of the transference of the transference, namely in the resistance, by the awareness of the transference is especially, and often adhering to the analytic procedures that interact among cultural inhibitors, but that will be distinguished as such, that its ranging manifold of distancing non-localities as founded of the analyst’s.
However, it must first be to distinguish between two types of interpretation of the transference. That one is an interpretation of resistance to the awareness of transference, the other, is an interpretation of resistance to the resolution of transference. The distinction has clearly been best spelled out in the form from which copies or reproductions can be produced, as to cause to make its awareness and yielding values as grounded in the cognisance to Greenson (1967) and Stone (1967). The first kind of resistance may be called decence transference, although this term emphases the terminological characterization by its term is mainly employed to refer to a phrase of analysis and carried within the general resistance to the transference of wishes, it can also be used for a more isolated instance of transference of defence. With some oversimplification, one might say that in resistance to the awareness of transference, the transference, the transference is what does the resisting.
Another connected description of stating this distinction between resistance and the awareness of transference and resistance to the resolution of transference is between implicit and indirect references to the transference and explicitly or directly referential to the transference. The interpretation of resistance to awareness of the transference is intended to make the implicit transference explicit. While the interpretation of resistance to the resolution of transference is intended to make the patient realize that the already explicit transference does indeed include a determinant from the past.
It is also important to distinguish between the general concept of an interpretation of resistance to the resolution of transference and a particular variety of such an interpretation, namely, a genetic transference interpretation - that is, an interpretation of how an attitude in the present is an inappropriate carry-over from the past. While there is a tendency among analysts to deal explicit references to the transference primarily among analyses to deal explicitly the references to the transference as primarily by a genetic transference interpretation, there are other ways of working toward a revolution of the transference. However, this argument does so implicate that not only is not enough emphasis being given to interpretation of the transference in the here and now, that is, to the interpretation of implicit manifestations of the transference, but also that interpretations intended to resolve the transference as manifested in explicit references to the transference should be primarily in the here and now, rather than genetic transference interpretations.
A patient’s statement that he feels the analyst is ‘sharp-worded’, for example, is, at least to begin with, likely best dealt with not by interpreting that this is a displacement from the patient’s feeling that his father was harsh, but by as elucidation of some other aspect of this here and now attitude, such as what has gone on in the analytic situation that seems to the patient to justify his feeling or what was the anxiety that made it so difficult for him to express his feelings. How the patient experiences the actual situation is an example of the role of the actual situation in a manifestation of transference, which will be a major point of relevant significance.
Of course, both interpretations of the transference in the here and now and genetic transference interpretations are valid and constitute a sequence. We presume that a resistance to the transference ultimately rests on the displacement onto the analysts of attitudes from the past.
Because Freud’s case histories focus much more on the yield of analysis than on the details of the process, they are readily but perhaps incorrectly construed as emphasizing work outside the transference much more than work within the transference, and, even within the transference, emphasizing genetic transference interpretations much more than work with the transference in the here and now (Muslin and Gill, 1978). The example of Freud’s case reports may have played a role in what is to be considered as the common maldistribution of emphasis in these two respects - not enough on the transference and, within the transference, not enough on the here and now.
Transference interpretations in the here and now and genetic transference interpretations are, of course, exemplified in Freud’s writings and are in the repertoire of every analyst, but they are not distinguished sharply enough.
Both participants in the analytic situation are motivated to avoid these interactions. Flight away from the transference and to the past can be a relief to both the patient and the analyst.
These aligning measures have been divided into five categorical divisions and placed into the following parts: (1) The principle that the transference should be encouraged to expand as much as possible within the analytic situation because the analytic work is best done within the transference. (2) The interpretation of disguised allusion to the transference as a main technique for encouraging the expansion of the transference within the analytic situation, (3) The principle that all transference has a connection with something in the present actual analysis situation, (4) How the connection between transference and the actual analytic situation is used in interpreting resistance to the awareness of transference, and (5) The resolution of transference within the here and now and the role of genetic transference interpretation.
The importance of transference interpretations will surely be agreeing to by all analysts, the greater effectiveness of transference interpretations than interpretations outside the transference will be agreeing to by many, but what of the relative roles of interpretation of the transference and interpretation outside the transference?
Freud can be interpreted as either of saying that the analysis of the transference in auxiliary to the analysis of the neurosis or that the analysis of the transference is equivalent to the analysis of the neurosis. The first position is stated in his saying (1913) that the disturbance of the transference has to be overcome by the analysis of transference resistance in order to get on with the work of analysing the neurosis. It is also implied in his reiteration that the ultimate task of analysis is to remember the past, to fill in the gap in memory. The second position is stated in his saying that the victory must be won on the field of the transference (1912) and that the mastery of the transference neurosis ‘coincides with getting rid of the illness which was originally brought to the neurosis (1917). In this second view, he says that after the resistance is overcome, memories appear relatively without difficulty.
These two different positions also find expression in the two different ways in which Freud speaks of the transference. In `Dynamics of Transference` he refers to the transference, on the one hand, as `the most powerful resistance to the treatment`(1912) but, on the other hand, as doing us the inestimable service of making the patient’s . . . , immediate impulses and manifests, when all is said and done, it is impossible to destroy anyone in absentia or in effigies (1912).
It can be agreed that his principal emphasis fails on the second position. He wrote once, in summary, ‘Thus our therapeutic work falls into two phases in the first, all the libido is forced from the symptoms into the transference and concentrated there, in the second, the struggle is waged around this new object and the libido is liberated from it`(1912).
The detailed presentations that he advocated that the transference should be encouraged to expand as much as possible within the analytic situation lies in clarification that resistance is primarily expressed by repetition, and repetition takes place both within and outside the analytic situation, but that the analyst seeks to deal with it primarily within the analytic situation, that repetition can be not only in the motor sphere (acting) but also in the psychical sphere, and that the psychical sphere is not confined to remembering but includes the present, too.
Freud`s emphasis that the purpose of resistance is to prevent remembering can obscure his point that resistance shows itself primarily by repetition, whether inside or outside the analytic situation. `The greater the resistance, the more extensively, and will act out (repetition)replace remembering`. Similarly in `The Dynamics of Transference` Freud said that the main reason that the transference is so well suited to serve the resistance is that the unconscious implies does not want to be remembered . . . but endeavour to reproduce themselves . . . (1918), the transference is a resistance primarily insofar as it is a repetition.
The point can be restated in terms of the relation between transference and resistance. The resistance expresses itself in repetition, that is, in transference both inside and outside the analytic situation. To deal with the transference. Therefore, is equivalent to dealing with the resistance. Freud emphasized transference within the analytic situation so strongly that it has come to mean only repetition within the analytic situation, even though, conceptually speaking, repetition outside the analytic situation is transference too, and Freud once used the term that way. `We soon perceive that the transference is itself only a piece of repetition and that the repetition is a transference of the forgotten past not only onto the analyst but also onto all the other aspects of the current situation. We . . . find . . . the compulsion to repeat, which now replaces the impulsion to remember, not only in his personal attitude to his analyst but also in every other activity and relationship which may occupy his life at the time . . . (1914).
It is important to realize that the expansion of the repetition inside the analytic situation, whether or not in a reciprocal relationship to repetition outside the analytic situation, is the avenue to control the repetition: `The main instrument . . . for curbing the patients compulsion to repeat and for turning it into a motive for remembering lies in the handling of the transference. We render the compulsion harmless, and indeed useful, by giving it the right to assert itself in a definite field`(1914).
Kanzer has discussed this issue in a good manner in his paper on ‘The Motor Sphere of the Transference’ (1966). He writes of a ‘double-pronged stick-and-carrot’ technique by which the transference is fostered within the analytic situation and discouraged outside the analytic situation. The ‘stick’ is the principle of abstinence as exemplified in the admonition against making important decisions during treatment, and the ‘carrot’ is the opportunity afforded the transference to expand within the treatment, ‘in almost complete freedom’ as in a ‘playground’ (Freud, 1914). As Freud put it, ‘Provided only that the patient shows compliance enough to respect the necessary conditions of the analysis, we regularly succeed in giving all the symptoms of the illness a new transference meaning, and in replacing his ordinary neurosis by a ‘transference neurosis’ of which he can be cured by the therapeutic work’ (1914).
The reason it is desirable for the transference to be expressed within the treatment is that there, it `is at every point accessible to our intervention`(1914). In a later statement he made the same point this way. `We have followed this new edition - the transference-neurosis - of the old disorder from its start, we have observed its origin and growth, and we are especially well able to find our way about in it since, as its object, we are situated at it’s very centre, (1917), it is not that the transference is forced into the treatment, but that it is spontaneously but implicitly present and is encouraged to expand there and become explicit
Freud emphasized acting in the transference so strongly that one can overlook the repetition in the transference, but does not of necessity for its enactment or recognition that gives validity to acts of a subordinate conformation as ratified in support of explicit authoritative permission. Repetition need not go as far as motor behaviour, it can also be expressed in attitudes, feelings, and intentions, and, indeed, the repetition often does take such form rather than motor action. The importance of making this clear is that Freud can be mistakenly read to mean that repetition in the psychical sphere can only mean remembering the past, are when he writes that the analyst as prepared for a perpetual struggle with his patient to keep in the psychical sphere all the impulses which the patient would like to direct into the motor sphere, and he celebrates it as a triumph for the treatment if he can bring it about that something the patient wishes to discharge in action are disposed if through the work of remembering (1914).
It is true that the analyst’s efforts are to convert acting in the motor sphere into awareness in the psychical sphere, but transference may be in the psychical sphere to begin with, albeit disguised. The psychical sphere includes awareness in the transference as well as remembering.
One of the objections one hears, from both analysts and patient, to a heavy emphasis on interpretation of associations about the patients real life primarily in terms of the transference is that it means the analyst is disregarding the importance of what goes on in the patients real life. The criticism is not judicial. To emphasize the transference meaning is not to deny or belittle other meanings, but to focus on the one of several meanings of the content that is the most important for the analytic process, for the reasons of positing the addition for one coming to any falsifiable conclusion.
To a considerable degree in which interpretations of resistance to the transference can be, or at lease appear to the patient to be, a belittling of the importance of the patients outside life is to make the interpretation as though the outside behaviour is primarily an acting out of the transference. The patient may undertake some actions in the outside world as an expression of and resistance to the transference, that is, acting out. But the interpretation of associations about actions in the outside world as having implications for the transference needs mean only that the choice of outside action to figure in the associations is co-determined by the need to express a transference indirectly. It is because of the resistance to awareness of the transference that the transference to be disguised. When the disguise is unmasked by interpretation, it becomes clear that, despite the inevitable differences between the outside situation and the transference situation, the content is the same for the analysis of the necrosis that coincides (Freud wrote that the mastering of the transference neurosis only coincides with getting rid of the illness which was originally brought to the treatment (1917)).
The analytic situation itself fosters the development of attitudes with primary determinants in the past, i.e., transference. The analyst’s reserve provides the patient with few and equivocal cues. The purpose of the analytic situation fosters the development of strong emotional responses, and the very fact that the patient has a neurosis means, as Freud said, that’ . . . it is a perfectly normal and intelligible thing that the libidinal cathexis [we would now add negative feelings] of someone who is partly unsatisfied, a cathexes which are held ready in anticipation, should be directly as well to the figure of the analyst (1912).
While the analytic setup itself fosters the expansion of the transference within the analytic situation, the interpretation of resistance to the awareness of transference will further this expansion.
There are essentially importantly resistances on the part of both patient and analyst to awareness of the transference. On the patient’s part, this is because of the difficulty in recognizing erotic and hostile impulses toward the very person to whom they have to be disclosed. On the analyst’s part, this is because the patient is likely to attitude the very attitudes to him which are most likely to cause him discomfort. The attitudes the patient believes the analysts has toward him are often the ones the patient is least likely to voice, in a general sense because of a feeling that it is impertinent for him to concern himself with the analyst’s feelings, and in a more specific sense because the aptitudes as held by the analyst are often attitudes the patient feels the analyst will be comfortable about having ascribed to him. It is for this reason that the analyst must be especially alert to the attitudes the patient believes he has, not only to the attitudes the patient does have toward him. If the analyst is able to see himself as a participant in an interaction, as he will become much more attuned to this important area of transference, which might otherwise escape him.
The investigations of attitudes are ascribed to the analyst makes easier the subsequent investigation of the intrinsic factors in the patient that played a role in such ascription. For example, the exposure of the fact that the patient ascribes sexual interests in him to the analyst, and generally to the patient, alternatively the subsequent exploration of the patient’s sexual wish toward the analyst, and genetically the parent.
The resistance to the awareness of these attitudes is responsible for their appearing in various disguises in the patient’s manifested associations and for the analyst’s reluctance to unmask the disguise. The most commonly recognized disguise is by displacement, but identification is an equally important one. In displacement, the patient’s attitudes are narrated for being toward a third party. In identification, the patient attitudes to himself attitudes he believes the analyst has toward him.
To encourage the expansion of the transference within the analytic situation, the disguises in which the transference appears have to be interpreted in the case of displacement the interpretation will be of allusions to the transference in association not manifestly about the transference. This is a kind of interpretation every analyst often makes. In the case of identifications, the analyst interprets the attitudes that the patient ascribes to himself the identification with which an attitude and subsequently attributed to the analyst. Lipton (1977) has recently described this form of disguise allusion in the transference with illuminating illustration.
In his autobiography, Freud wrote, ‘The patient remains under the influence of the analytic situation as hopefully of a latter position or a period of decline, as though he is not directing responsibly for the mental activities onto a particular subject. Justly in assuming that nothing will occur, as not of some reference to the situation (1925). Since associations are obviously often not directed about the analytic situation, the interpretation of Freud’s remark rests on what he meant by the ‘analytic situation’.
It is believed that Freud’s meaning can be clarified by reference to a statement he made in, ‘The Interpretation of Dreams’. He said that when the patient is told to say whatever comes into his mind, his associations become directed by the ‘purposive ideas inherent in the treatment’ and that there are two such inherent regressive themes, one relating to the illness and the other - concerning which, Freud said, the patient has ‘no suspicion’; - relating to other analyst’s relating to the patient has ‘no suspicions’ - relating to the analyst (1900). If the patient has ‘no suspicions’ of the theme relating to the analyst, such that the theme appears only in disguise, the patient ‘s associations, it is contended that Freud’s remark not only specifies the themes inherent in the patient ‘s identifications’, but means that the associations are simultaneously directed by these two purposive ideas, not something by one and sometimes by the other.
One crucially important reason that the early and continuing presence of the transference is not always recognized in that it is considered to be absent in the patient who is talking recognized is that it is considered to be absent in the patient who is talking freely and apparently without resistance. As (Muslin and Gill, 1976) pointed out in a paper on the early interpretation of transference resistance, to the transference is probably present from the beginning, even if the patient is talking apparently freely. The patient may well be talking about issues not manifestingly about the transference which are nevertheless, also allusions to the transference, but the analyst has to be alert to the pervasiveness of such allusory discernment about them.
The analyst should progress on the working assumption, that the patient’s associations have transference implications pervasively, that with which this assumption is not to be confused with denial or neglect of the current aspects of the analytic situation. It is theoretically always possible to give precedence to a transference interpretation if one can only discern it through its disguise by resistance. This is not to dispute the desirability of learning as much as one can about the patient, if only to be a position to make more correct interpretations of the transference. One therefore, does not interfere with an apparently free flow of associations, especially early, unless the transference threatens the analytic situation to the point where its interpretation is mandatory rather than optional.
With the recognition that evens apparently freely associating patient may also be showing resistance to awareness of the transference, this formulation should not interfere as long a useful information being gathered should relace Freud’s dictum that the transference should not be interpreted until it becomes a resistance (1913).
It can be argued that every transference has some connection to some aspect of the current analytic situation, in the sense that the past can exert an influence only insofar as it exists in the present. Of course, all the determinants of a transference are current in the sense that what I am distinguishing is the current reality of the analytic situation, that is, what actually goes on between patient and analyst in the situation from how the patient is currently constituted as a result of his past.