We have seen that a possible view of the case of the patient R. is that interest was no longer under his control, but was controlled by a region of the pysche beyond consciousness. This can be called the unconscious control of interest. This implies a theory, and means that the force that reveals itself as interest may be under a double control. It can be deflected in a certain direction in consciousness, but at times the power of deflection is overshadowed by an opposing power, operative in the unconscious. We have also seen that the second control, though it cannot be investigated by a direct examination of the contents of consciousness, can be got in touch with through the dream which springs up in the sleeping mind as a product of the deeper levels of the psyche.
In the case of the patient R. the results of this unconscious control did not reveal themselves in any physical symptom. The check operated in the psychical field, causing a rapid fall in what might be called the pressure of ideas, and a consequent state of mental blankness, which gradually produced a sense of loss of confidence and general inadequacy. At the same time there was an impulse that continually urged him to work—that, at least, was his interpretation of the force.
The next case to be considered affords an example of a similar condition with one difference. The check set up by the unconscious control of interest did not reveal itself in the mind but in the body. The patient 0. suffered from writer's cramp. That is, so soon as he took a pen in hand, the muscles necessary for the movements of writing became contracted, and the contraction was beyond his conscious control. His work was of such a nature that writing was an essential, though not a constant, occupation.
The conscious estimate of his position was as follows. He saw no reason why he should give up his work. As is common in this disease, there were brief periods of improvement. Sometimes he could write quite easily; at other times writing was so laborious that it was practically impossible. Yet he felt a cure was possible, and he had already tried various devices, such as special pens, new positions of the hand and elbow, as well as writing with the left hand. He fancied his left hand also had a tendency to spasm. I propose to discuss one dream that he experienced.
" I was in the desert. Before me was a tremendously tall wall or rampart. I was cowering at its foot in terror."
This short dream was vivid and apparently had impressed the patient. In a half-laughing way he remarked that he was certainly " up against it." There was no possibility of getting over or round that wall. The nature of the symbolism employed is interesting. The scene is cast in the desert—that is, in a barren, unproductive spot. The wall is of tremendous proportions — that is, some kind of emphasis is suggested. The wall bars all progress. Finally, the dreamer is in terror. Why should he be in terror ? Presumably, from a consideration of the dream itself, because he cannot proceed and realizes that the wall is insurmountable.
Before estimating the significance of the dream there are a few points that can be added to what has already been given in the conscious estimate of the patient. It is always valuable to note those circumstances under which the neurosis of a patient improves. In the case of the patient 0. there were times when the control of the muscles employed in writing was adequate, and even normal. The patient had noticed that this happened particularly when he was in a position of authority in the concern in which he worked—that is, when those over him were away and the management of affairs became his own. Another point is that the patient was in some respects a disappointed man, in that he had hoped for, and had been led to expect, a far better position at his time of life than he actually had, and this appeared to be due to no fault of his own. The kind of work he did was invaluable to the business, and a substitute would have been difficult to find.
Apart from work he led a quiet and rather solitary life. He showed by his manner that he dreaded the idea that he might have to give up his work. It has already been mentioned that he felt a cure was possible. He clung to that idea. It was a kind of impulse comparable, possibly, to the impulse that existed in the patient R.
In the light of this anamnesis the dream can now be given some significance. The wall he is up against suggests a symbolic way of putting some powerful force acting counter to the conscious striving : it emphasizes a non-realized or inadequately realized factor. In this case the half-laughing way in which he observed that he was certainly "up against it " suggests it was an inadequately realized factor. The laugh prevented the serious consideration behind the phrase. It might be thought that if this factor required such a striking symbol to represent its power, the outlook for the patient was sinister. But emphasis is required in proportion to the refusal to realize ; if a person refuses to entertain a certain idea, the force required to change his view must be proportionately exaggerated. In short, the exaggeration of the symbol might be looked on as due to some correspondingly exaggerated denial in the conscious attitude. That, at least, is a tentative explanation of some kinds of emphasis in dreams. It does not explain all. In the dream of Nebuchadnezzar, the immense tree whose branches covered the whole earth was an emphatic way of representing an emphatic and relatively actual state of affairs.
It was simply a graphic summing-up of a situation that had gone beyond some limit, or of an overdevelopment in some particular direction. As a further illustration I may be allowed to introduce the following example at this point. It was the dream of a young man whose interest seemed to consist largely in matters of dress. He dreamed he was in his bedroom which had assumed gigantic proportions. His wardrobe towered high above his head, and piles of clothes hedged him in. The dream was a nightmare—that is, it was accompanied by a helpless sense of terror. We might see in this simply a graphic way of representing an actual situation ; a symbolism portraying vividly the application of his interest in one direction, and suggesting it was very much too emphasized to be normal, by introducing the emotion of fear.