Thus this little girl's hysteria resulted from a struggle between her conscious feelings and her unconscious wishes, with the result that the latter gained the upper hand, leading to the hysterical blindness. Like many hysterical patients, paradoxical as it may seem, she gained something by being nervously ill, in this case the gain being a relief from household drudgery which would follow if she could not see what to do. Every dream, like every hysterical symptom, is a gain, a wish fulfilled.

For instance, an important and distressing symptom of many functional nervous disturbances is the feeling of unreality, in which the surroundings appear far off, like looking through the wrong end of an opera glass, vague, and dream-like, in which it seems as if the individual were partially or completely cut off from the physical universe. These unreality feelings frequently arise because the subject finds that reality is too painful to bear, because he feels that he cannot struggle successfully with the perplexities of life. Consequently the subject comes to live in an ideal, dream world of his own making and building, where everything is set to right, and where there are no difficulties and struggles. This ideal world is really the land of his heart's desire, and so calm is it, so safe does he feel, that he finally chooses the world of his own ideas rather than the world of physical reality. Thus the unreality gains the upper hand and finally dominates the personality. The neurotic thus comes to live within himself or rather within the unreality of his neurosis. The inherent factor, the real mechanism at the bottom of every neurosis, is a mental conflict. It follows from this that although there may be a congenital disposition to nervousness, no one of us is born with a nervous disease, but we acquire it as a result of a maladaptation to surroundings, of not adequately meeting the issues of life, or from our repressed emotions and mental conflicts. In many nervous disturbances, there is a withdrawal from the world of reality and from the issues and conflicts of life, which are all evaded by first consciously living in a world of painless unreality from which these issues are absent and which finally gains the upper hand.

Psycho-analysis as carried out through a study of the dreams is of value not only in the nervously sick, but in the normal individual as well. It enables us to know our own weaknesses and prejudices, the causes of our successes or failures, our repressions, vague fears, and superstitions, and to point out the path for the remedying of these mental and moral and ethical defects. Freud states concerning this point:

"Whoever has had the opportunity of studying the concealed psychic feelings of persons by means of psycho-analysis can also tell something new concerning the quality of unconscious motives which express themselves in superstition. Nervous persons afflicted with compulsive thinking and compulsive states, who are often very intelligent, show very plainly that superstition originates from repressed hostile and cruel impulses. The greater part of superstition signifies fear of impending evil, and he who has frequently wished evil to others, but because of a good bringing up has repressed the same into the unconscious, will be particularly apt to expect punishment for such unconscious evil in the form of a misfortune threatening him from without."1

1 "Psychopathology of Everyday Life." p. 311.

As an example, a neurotic man, whom I had the occasion to psycho-analyze, one day, in the course of treatment, brought me the two following dreams:

Dream 1. He seemed to be running an elevator, and with him was a man whose foot became caught between the elevator and the well, as the former was ascending, but nevertheless he kept on running the elevator.

Dream 2. He seemed to be talking with a man and then started to mount the seat of a wagon, and as he did so, the man reached the seat before him, as if to steal the horse and wagon. Thereupon, in a manner which was not altogether clear in the dream, he toppled the wagon over, and it then seemed as if the wagon were full of iron bars. These fell upon the man and pinioned him down, and he stood on top of the pile and called for the police.

Apparently these two dreams were meaningless, except that they showed a wish on the part of the subject to bring injury and disaster to each man. It developed that he disliked the man in the first dream for his arrogance, while the man in the second dream he had known ever since both were little boys. This latter person once threw a stone and struck the subject on the back of the head, and since then he had often thought that this head injury may have been responsible for his nervous disturbance. Hence the scheme of revenge in both cases and the repressed wish that evil might befall each, although this wish was only fulfilled in the dream and never in reality. In the course of the analysis, it developed that the subject was very superstitious. He would not cross a funeral procession but would wait for the procession to pass, because he felt if he did so that he would develop some mental trouble. Walking under a ladder always signified to him that bad luck would follow. Sometimes, in order to prove to himself that he was not superstitious (a kind of a defence reaction), he would purposely, for instance, sit at a table making thirteen or laugh at people who wouldn't do so, yet all the time feeling that evil or death would overtake him. Thus his superstitious fear of impending evil arose because he wished disaster would happen to others, not consciously so, but repressed into the unconscious and only appearing in his dreams. The fear of evil happening to him was therefore a reversal of his repressed wish that evil might happen to others.

The end of all psycho-analysis is twofold: first, to educate the patient to become an independent personality by directly freeing him from his neurosis and therefore from his infantile limitations, so that when the dependence of the physician is cut off, the patient can be put on his own feet, so to speak; and secondly, to relieve the repressed emotions so that they may be indulged in freely and unhampered, partly by conscious control and partly by conducting those emotions to a higher and less objectionable goal. This last process is termed sublimation, and if properly carried out in the hands of a skilled psycho-analyst, the repressed instincts become unchained and thereby can no longer produce a neurosis, and the conflict between repression and the attempt on the part of the individual to find an outlet for the repression, which is the process that causes the nervous malady, disappears.

It is the dream which guides us into the patient's unconscious, repressed emotions; it is through the dream, too, that the final sublimation, the freeing from the neurosis, is reached.