having the thought: ‘Now he is free and can marry me’” (1961f, 184). She became so guilt-ridden by this sudden eruption of passion that she developed an amnesia of the incident. The repression of her wish, consequently, led to a conversion hysteria. The specifically neurotic component of this resolution to her distress, according to Freud, is that “it took away from the value of the change that had occurred in reality, by repressing the instinctual demand which had emerged—that is, her love for her brother-in-law” (184). On the other hand, had she developed a psychotic response to her anguish, her “reaction would have been a disavowal of the fact of her sister’s death” (184; emphasis added).
Just as two steps are necessary to generate a neurosis, two steps are also required for the development of a psychosis. Whereas repression of the id entails the first step in a neurosis, psychosis follows a disavowal of reality. And just as the second step in a neurosis—in fact, the neurosis itself—establishes a compensation toward the damage done to the id by displacing the repressed desire onto a symptom, one would expect the second-stage movement in the psychosis to “make good” the damage done to reality. “The second step of the psychosis is indeed intended to make good the loss of reality, not, however, at the expense of a restriction of the id—as happens in neurosis at the expense of the relation to reality—but in another, more autocratic manner, by the creation of a new reality which no longer raises the same objections as the old one that has been given up” (184–85).
The apparent differences between neurosis and psychosis diminish in their respective second stages. Each is supported by the same trends. The second stage in both neurosis and psychosis is designed to aid the id in its aversion to reality. Both represent “a rebellion on the part of the id against the external world, of its unwillingness—or, if one prefers, its incapacity—to adapt itself to the exigencies of reality, to Avayxn [Necessity]” (185). But now the distinctions become more complicated. Having suggested that neurosis and psychosis differ more in their first reaction to reality than in the second, “reparative,” response, Freud attempts to separate their respective outcomes. “In neurosis a piece of reality is avoided by a sort of flight, whereas in psychosis it is remodelled. Or we might say: in psychosis, the initial flight is succeeded by an active phase of remodelling; in neurosis, the initial obedience is succeeded by a deferred attempt at flight. Or again, expressed in yet another way: neurosis does not disavow the reality; it only ignores it; psychosis disavows it and tries to replace it” (185). The basic difference seems to revolve around what he means by avoid or flight on the one hand, and the terms remodel and disavow on the other. Obviously, the key to these distinctions should ultimately rest on what Freud means by reality, because his argument rests on the proposition that (a) the neurotic merely ignores reality and takes flight from it, whereas (b) the psychotic disavows reality and attempts to remodel it. Freud suggested that, ideally, the healthy individual combines aspects of both the neurotic and psychotic, when his behavior “disavows the reality as little as does a neurosis, but [if] it then exerts itself, as does a psychosis, to effect an alteration of that reality” (185).
What, however, is the nature of this reality that we seek to disavow while striving to alter it? Freud suggests that reality is essentially perceptual. In fact, the psychotics’ wish to alter it is potentially healthy, if only they didn’t need to “disavow” it beforehand. Their decision to reject reality in the first place leads them to alter their perceptions of what is real by way of hallucinations, so they become “faced with the task of procuring for [themselves] perceptions of a kind which shall correspond to the new reality” (186). Freud suggested earlier (see chapter 2) that our original and most startling experience of reality is a perceptual one, the so-called perception of the absence of a penis in girls. In “The Infantile Genital Organization” (1961e), Freud said, “We know how children react to their first impressions of the absence of a penis. They disavow the fact and believe that they do see a penis, all the same. They gloss over the contradiction between observation and preconception by telling themselves that the penis is still small and will grow bigger” (143–44). Of course, in order for a hallucination of this kind to occur, the child—or, as the case may be, the psychotic—must, as Freud confirms, believe in it. In other words, the psychotic loss of reality is the consequence of (a) denial of an intolerable reality, and (b) adopting a delusional belief in its place. The denial of reality—the first step to psychosis—doesn’t in and of itself occasion psychotic symptoms. Step two—the subsequent delusion that attempts to “repair” the impact of step one—is actually the psychotic symptom, comprising a phantasy that, according to Freud, is inherently distressing, even persecutory. The delusion, then, is the key to psychosis. What is its ostensible purpose? Freud says that, “In regard to the genesis of delusions, a fair number of analyses have taught us that the delusion is found applied like a patch over the place where originally a rent had appeared in the ego’s relation to the external world” (1961g, 151).
The denial of reality—such as the hypothetical disavowal of her sister’s death, in the example Freud used—creates a “rent,” a hole, in the situation that the person is in. This hole, however, becomes intolerable. Although the neurotic is able to survive “gaps” in his memory, a world can’t so easily be maintained if the holes we inflict in it remain empty. They need to be replaced with something. But what? According to Freud, with a delusion, a “false belief” that becomes fixed—like a brick in a wall—in the place it becomes inserted, to insure that the “banished” reality stays banished. This is the step—the crucial step, it turns out—that Freud neglected to elaborate in his analogy of the woman whose sister was dying. Had she, as Freud speculated, disavowed her sister’s death as a way of avoiding a morally compromising attraction to her brother-in-law, she would have needed to follow this step with another in order to effect a psychosis, in order to insure that her denial would be safe from the encroachments of reality. For example, she might have adopted the delusion that her brother-in-law, the man whom she secretly loved, was conspiring to murder her sister. This type of delusion is consistent with the persecutory phantasies we frequently encounter in paranoia. In fact, Freud believed that the object of paranoid phantasies is the original object of one’s love. In his famous book on Judge Schreber, Freud’s only case study of psychosis, written in 1911, he said:
It appears that the person to whom the delusion ascribes so much power and influence, in whose hands all the threads of the conspiracy converge, is, if he [she] is definitely named, either identical with some one who played an equally important part in the patient’s emotional life before his illness, or is easily recognizable as a substitute for him. (1958f, 41)
This is why denial of reality, in and of itself, doesn’t comprise a psychosis. After all, denial isn’t an infrequent occurrence in neurosis. But if denial isn’t “supported” by a delusional accomplice, its survival is fragile. It remains open to refutation, in life as well as in treatment. In order to enter the domain of the truly “psychotic,” the piece of denied reality has to be “patched” with a delusion. But why is this delusion frequently—indeed, always—distressing? Freud proposed that
this fact is without doubt a sign that the whole process of remodelling is carried through against forces which oppose it violently. . . . On the model of a neurosis . . . we see that a reaction of anxiety sets in whenever the repressed instinct makes a thrust forward, and that the outcome of the conflict is only a compromise and does not provide complete satisfaction. Probably in a psychosis the rejected piece of reality constantly forces itself upon the mind, just as the repressed instinct does in a neurosis. (1961g, 186)
In other words, the neurotic and psychotic share similar aims and employ similar methods. Neurotics seek to protect their relationship with reality—epitomized by the object of their desire—by repressing their desire for that object. Psychotics, however, seek to protect their desire by remodelling the reality—either the object of desire or whoever assumes its place—which frustrates them. Either method—the neurotics’ or the psychotics’—keeps the conflict alive because, in fact, neither neurotics nor psychotics are prepared to “dissolve” their desire when they meet insurmountable frustration, by allowing themselves, according to Freud, to experience it. The (neurotics’) “repressed” desire returns in the form of a symptom because it’s never been wholeheartedly abandoned. Likewise, the psychotics’ “disavowed” reality