Concept
Birth trauma
Otto Rank's thesis that birth, as the infant's first and prototypical separation from the mother, is the source of all later anxiety. The wish to return to the womb, and the anxiety bound up with it, recur in his view in symptoms, in myth, religion and art, and in the analytic situation itself, whose ending repeats the separation; later conflicts such as the Oedipus complex appear as repetitions of this primal trauma.
Development
1924
introduced by Otto Rank
Rank set out the birth trauma as the root of anxiety and of the unconscious in Das Trauma der Geburt (1924).
In The Trauma of Birth (1924)
1926
critiqued by Sigmund Freud
In Hemmung, Symptom und Angst Freud kept birth as the prototype of anxiety but rejected Rank's claim that it explains the neuroses.
In Inhibitions, Symptoms and Anxiety (1926)
Relations
- 1924 introduced by Otto Rank
Rank set out the birth trauma as the root of anxiety and of the unconscious in Das Trauma der Geburt (1924).
- 1924 diverges from Oedipus complex
Rank made the separation at birth, rather than the Oedipal conflict, the nucleus of the neuroses, treating the Oedipus complex as a later repetition of it.
- 1926 critiqued by Sigmund Freud
In Hemmung, Symptom und Angst Freud kept birth as the prototype of anxiety but rejected Rank's claim that it explains the neuroses.
- 1931 gave rise to Life fear and death fear
Rank traced the first experience of life fear to the act of birth, recasting his earlier birth-trauma theory as a fear of separation and individuation.
Works
- 1924
Otto Rank's *Das Trauma der Geburt und seine Bedeutung für die Psychoanalyse* (1924; English: *The Trauma of Birth*) was written in April 1923 and dedicated to Freud for his birthday on 6 May 1923. Rank presents it as a consistent extension of Freud's method. Following the analytic material down to its deepest layer, he arrives at the separation from the mother at birth. He calls it the "primal trauma" (Urtrauma) and the ultimate biological substrate of the psychical. His starting point is the analytic situation. In the dreams of the final phase of treatment, patients regularly represent the detachment from the analyst as a birth. The transference libido is at bottom maternal, and the cure is the belated, at last successful mastering of the birth trauma (Preface; "Die analytische Situation"). The anxiety the newborn experiences is the first content of perception. Once it is anchored in the psyche, it forms the primal repression (Urverdrängung) that bars the libido from striving back to the pleasurable intrauterine state. Every later anxiety reproduces it, beginning with the child's fear of the dark and of being alone. The middle chapters follow the birth trauma through the individual and through culture. Birth is the "primal castration" (Urkastration). Weaning and castration repeat the separation, and the Oedipus complex is its third repetition. Infantile sexual theories, the perversions and coitus itself are partial returns to the womb. The neuroses reproduce birth or the fetal state, as in hysterical conversion symptoms, phobias, obsessional brooding on origins and death, and the alternation of melancholia and mania. Psychosis is a failed attempt at cure. Under the heading of "symbolic adaptation", Rank finds the womb again in sleep and dreams and in the house, the temple, the city and the state. It returns in the hero, who overcompensates a severe birth, and in fairy tales and paradise myths. Religions move from mother goddesses and anxiety to a father god and guilt. Rank derives art from the sculptural reproduction of the maternal vessel and of one's own coming into being. Its Greek form idealizes the detachment of the human body from the animal mother (the Sphinx, the centaurs, Prometheus, the Trojan horse). Philosophy circles the same problem: Thales' water as the womb of all things, Plato's Eros and cave, and Kant's thing-in-itself. Socrates, the midwife's son, is in Rank's account the forerunner of analytic therapy. The two concluding chapters draw the theoretical and clinical consequences. Breuer's original discovery was that symptoms depend on forgotten traumas and on "conversion". Rank links it to the birth trauma, so that conversion becomes identical with the emergence of the psychical out of bodily innervation. The truly unconscious, Freud's Es, is "the embryonic that lives on unchanged in the growing ego". The primal fantasies (castration, the primal scene, Oedipus) have a real prenatal substrate. Rank therefore finds Jung's appeal to inherited phylogenetic memory unnecessary. The death drive and the compulsion to repeat aim at restoring the state before birth. Woman can reproduce the primal situation in pregnancy and childbirth. Man must compensate through identification with the mother and through cultural creation. From this Rank explains both the male character of culture and the social disparagement of women as consequences of primal repression. In therapy the analyst acts as a "midwife". The patient should not reproduce the birth trauma unconsciously at the parting from the analyst. Instead, the analyst should uncover it early in the transference and work it through, with a fixed end to the treatment. Analysis cannot change the unconscious itself, only the ego's attitude toward it. The neurotic has "got stuck a little earlier, in the birth trauma". Culture, art and above all psychoanalysis are more or less successful attempts to overcome it.
- 1926
Inhibitions, Symptoms and Anxiety
Inhibitions, Symptoms and Anxiety (Hemmung, Symptom und Angst), published in 1926 by the Internationaler Psychoanalytischer Verlag, is Freud's major revision of his theory of anxiety and his first systematic account of defence within the structural model of ego, id and super-ego set out in The Ego and the Id (1923). The book opens by distinguishing inhibition, a restriction of an ego function undertaken as a precaution or through an impoverishment of energy, from the symptom, the sign and substitute of an instinctual satisfaction that has not taken place and the result of repression. Its central move reverses Freud's earlier view that repressed libido is transformed directly into anxiety. Re-examining the animal phobias of Little Hans and the Wolf Man, he concludes that in both the motive force of repression was castration anxiety, the ego's fear of an external danger: anxiety makes repression, not repression anxiety. The ego is the sole seat of anxiety. It produces anxiety as a signal when it anticipates danger, and through the pleasure principle the signal enables it to inhibit the threatening process in the id. Anxiety is traced to a situation of helplessness before mounting excitation, of which birth is the prototype. Freud separates the traumatic situation, in which anxiety arises automatically, as in the actual neuroses, from the danger situation, in which the ego reproduces a weakened form of it as a warning. The danger situations form a developmental series, each tied to a phase: psychical helplessness in the immature ego, loss of the object in early childhood, castration in the phallic phase, the super-ego's anger and loss of its love in latency, and finally the fear of death, read as the super-ego projected onto the powers of fate. Neurosis arises where people go on reacting to danger situations long outgrown; symptoms are formed to remove the ego from the danger situation that anxiety signals. Neurotic anxiety is anxiety about an instinctual danger the ego does not know, as realistic anxiety is about a known one. The book compares symptom formation in phobia, conversion hysteria and obsessional neurosis. In obsessional neurosis, regression to the anal-sadistic stage, a severe super-ego and reaction formations shape the symptoms, and Freud describes undoing and isolation as defensive techniques beside repression. He reinstates 'defence' as the general term for all the ego's protective techniques, repression being one of them. He discusses Otto Rank's The Trauma of Birth (1924), crediting it with linking every danger situation to separation from the mother but rejecting the claim that the severity of the birth trauma decides who becomes neurotic; he names instead the long helplessness of the human infant, the interruption of sexual development between early childhood and puberty, and the ego's imperfect means of guarding against internal danger. The addenda distinguish five kinds of resistance and separate anxiety, the reaction to the danger that object loss brings, from pain, the reaction to the loss itself, and from mourning.
- 1926
Technik der Psychoanalyse (Technique of Psychoanalysis) is Otto Rank's three-volume treatise on psychoanalytic treatment, published by Deuticke in Leipzig and Vienna between 1926 and 1931. Read in sequence, the volumes record Rank's passage from a reformer of Freudian technique to the founder of his own "will therapy". Volume I, Die analytische Situation, illustriert an der Traumdeutungstechnik (The Analytic Situation, Illustrated by the Technique of Dream Interpretation, 1926), grew out of a course on practical dream interpretation that Rank gave to English and American analysts in 1921–22. Volume II, Die analytische Reaktion in ihren konstruktiven Elementen (The Analytic Reaction in Its Constructive Elements, 1929), and Volume III, Die Analyse des Analytikers und seiner Rolle in der Gesamtsituation (The Analysis of the Analyst and His Role in the Total Situation, 1931, with a preface written in Paris in 1930), were written after Rank's break with Freud. Jessie Taft translated them into English as Will Therapy (1936). Volume I continues the programme Rank had set out with Sándor Ferenczi in Entwicklungsziele der Psychoanalyse (1924): no systematic technique had yet been published, and the curative agent is lived experience in treatment rather than intellectual recollection. Its central concept is the "analytic situation". Whatever the patient produces is to be related first to the present relationship with the analyst, not mined for history. Behind the Oedipal father transference Rank finds an earlier tie to the mother (Mutterbindung) that does not depend on the analyst's sex, so that for the patient's libido the analytic situation is essentially a mother situation. He therefore extends to every case a device Freud had used with the Wolf Man: fixing a date for the end of treatment (Terminsetzung). Set once the patient's libido has passed over to the analyst, the date lets the patient live the separation as a birth and a weaning, and so dissolves the transference. The analysis is described as a time-limited course of the libido, from detachment from the mother to identification with the analyst as father and ego ideal, and resistance is read as a gauge of that course. The practical part demonstrates the method through dream series from Rank's patients. The dreams are treated as reactions to the analytic situation and grouped by its phases. Motifs once read historically, such as a "family-tree" dream and even Freud's Wolf Man dream, are reinterpreted as images of the consulting room and of the patient's rivals there. Rank closes by warning that analysis may project into the patient's past what in fact happens between doctor and patient. Volume II opens by laying the foundation of a will therapy ("Grundlegung einer Willenstherapie"). The neurotic suffers not, as Freud held, from repressed sexual wishes but from a conflict of will and guilt: a strong will that he denies and cannot affirm without guilt. Freud's agents of cure (making the unconscious conscious, catharsis, transference) keep the patient passive. Resistance should instead be understood as counter-will (Gegenwille), the most valuable expression of will in therapy, and the therapist should act as a counter-will against which the patient's will can grow strong rather than be broken. The fundamental rule becomes "say what you want". Cure comes from a new experience in the present (Neuerleben), beyond repetition and transference. Reconstructing the past, by contrast, serves the denial of the present. The chapters are built on paired opposites: understanding and denial, past and present, sameness and difference, love and compulsion, separation and guilt, fate and self-determination. The treatment culminates in a separation that the patient must will for himself, without a debt of gratitude, so that neurotic guilt becomes the creative guilt of becoming an individual. Rank's criticism here extends to Adler and Jung as well as Freud. Volume III turns to the analyst. The analyst is not a technician applying a remedy but is himself the remedy, a person whom the patient re-creates as an auxiliary ego (Hilfs-Ich). Rank describes his own technique as consisting in having none. He distinguishes "ideological" from "dynamic" therapy. General psychological truths, such as the Oedipus complex, castration and even his own birth trauma, help the individual little, and analytic theories are in part the self-justification of a therapist type. The chapter "Lebensangst und Todesangst" sets out a double anxiety, whose two poles a person moves between throughout life. Fear of life is the fear of individuation and separation, first felt at birth. Fear of death is the fear of losing the individuality so gained. The end phase, with its fixed date, is presented as the therapeutic agent proper, an "education to willing". In it the patient's revolt against continuing the analysis is the first sign of recovery, and the analyst becomes an "auxiliary reality". The book ends with the claim that the only therapy is real life. The treatise is the main statement of Rank's clinical thought. It traces his development from the birth-trauma technique of the mid-1920s to a therapy of will, focused on the present relationship between patient and therapist.
See also
Linked from
People
References
- The Trauma of Birth1924Evidence for a relation
- Inhibitions, Symptoms and Anxiety1926Evidence for a relation
- Technique of Psychoanalysis1926Evidence for a relation