Clinical psychoanalysis may be said to have begun with the publication of Studies in Hysteria by Sigmund Freud in collaboration with Josef Breuer in 1895. But there had been preliminary theoretical papers – On the Psychical Mechanisms of Hysterical Phenomena: Preliminary Communication, in 1893, also a joint collaboration, and Freud's The Neuro-Psychoses of Defence, in 1894. In the latter paper Freud gives a particularly clear summary of the physicalist assumptions then underlying his work: 

I should like, finally, to dwell for a moment on the working hypothesis which I have made use of in this exposition of the neuroses of defence. I refer to the concept that in mental functions something is to be distinguished – a quota of affect or a sum of excitation – which possesses all the characteristics of a quantity (although we have no means of measuring it), which is capable of increase, diminution, displacement and discharge, and which is spread over the memory-traces of ideas somewhat as an electric charge is spread over the surface of a body. 

This hypothesis, which, incidentally already underlies our theory of "abreactions" in our "Preliminary Communication" (1893), can be applied in the same sense as physicists apply the hypothesis of a flow of electric fluid. It is provisionally justified by its utility in co-ordinating and explaining a great variety of psychical states. (S.E. 3:60-61)

Such an approach to human psychology was entirely in keeping with Freud's earlier medical training and the intellectual tradition to which he had been exposed. Freud began his medical studies in the University of Vienna in the autumn of 1873. He took as an elective that year Professor Carl Claus's General Biology and Darwinism and by his third year settled into the Physiological Institute of Ernst Brücke. Brücke was one of the revolutionary figures in German physiology during the mid-19th century. In 1845 he banded together with Hermann Helmholtz and Emil du Bois-Reymond to oppose the vitalistic theories of their teacher Johannes Müller. When, in 1847, they were joined by Carl Ludwig, who had not been a student of Müller's, they formed the Berlin Physicalist Society or Berliner Physicalische Gesellschaft. It became popularly known as the "Helmholtz School of Medicine", though its most influential member was not Helmholtz but du Bois-Reymond who first outlined the group's philosophy in a letter to a friend in 1842: 

Brücke and I pledged a solemn oath to put into power this truth: no other forces than the common physical-chemical ones are active within the organism. In those cases which cannot at the time be explained by these forces one has either to find the specific way or form of their Action by means of the physical-mathematical method, or to assume new forces equal in dignity to the chemical-physical forces inherent in matter, reducible to the forces of attraction and repulsion. (Sulloway, 1979, p.14)

While at first glance this may appear a laudable attempt to elevate the empirical at the expense of the mystical, one is nonetheless struck by the quasi-religious tone of the declaration. A "solemn oath" is pledged "to put into power this truth." There seems a quality of reaction formation suggesting, not surprisingly, that these scientists were struggling with themselves as much as with Müller, their teacher. Indeed, Frank Sulloway, in Freud, Biologist of the Mind (1979) has pointed out that there were other contemporary biologists, such as Karl Vogt and Ludwig Büchner, who espoused a far more extreme form of 19th century mechanism-materialism. Carl Ludwig treated the subject of dreams in his writings in the language of psychology, while Brücke, Helmholtz and du Bois-Reymond all showed a more sophisticated appreciation of higher mental functioning than their purely physicalist manifesto would suggest. By the time Freud became Brücke's student, more than 30 years after du Bois-Reymond's letter, Adolf Fick, a student of Ludwig's, had already written, "The absolute dominance of the mechanistic- mathematical orientation in physiology has proved to be an Icarus flight." (Sulloway, p.66)

Nonetheless, while this view may not have maintained "absolute dominance" it still exerted great influence. Add to this Brücke's enormous importance to Freud as a teacher and mentor. It was under Brücke's tutelage that Freud, between 1877 and 1882, published five scientific papers, two on the neuroanatomy of Petromyzon planeri, one on the gonadal structure of the eel, one on a new method of preparing nerve tissue for microscopic examination, and a study of the nerve cells of the crayfish. When it was clear that Freud would not be able to obtain an assistantship with Brücke -- there were only two posts available and both were held by relatively young men -- it was Brücke who encouraged Freud to enter private practice and who later was influential in obtaining for him the fellowship that enabled him to study with Charcot in Paris. Freud's third son Ernst was named after Brücke. And it was in Brücke's Physiological Institute that Freud first met Josef Breuer.

Let us return for a moment to Freud's "working hypothesis" that "in mental functions something is to be distinguished – a quota of affect or a sum of excitation – which possesses the characteristics of a quantity ..." From this follows Freud's analysis of this "quantity" in terms of its economic, dynamic and topographic aspects, as outlined in his 1915 paper The Unconscious. (S.E. 14:181)

Freud maintained that in healthy individuals this "quantity" was dissipated along the nervous pathways of everyday physical and mental activity. But in hysteria a certain quota becomes pathologically "converted" into somatic channels. From the economic point of view, the organism strives to maintain a constant low level of psychic energy. This "principle of constancy" was the basis for the "pleasure-unpleasure principle" whereby a rise in the level of excitation is experienced as unpleasure, while its discharge through the appropriate reflex channels is experienced as pleasure. Both defecation and sexual orgasm may be seen as paradigms. The aim of "cathartic therapy", as espoused by Breuer and Freud, was to uncover major sources of "strangulated affect" and facilitate their discharge, or "abreaction", along more normal pathways.

The working hypothesis also contained a dynamic aspect. Psychical forces may inhibit one another, be in conflict or act in combination. Breuer and Freud suggested three mechanisms for the "strangulation of affect" in hysteria: (a) when a strong affect, such as fright, is experienced by an individual during either involuntary or self-induced "hypnoid states"; (b) when a strong affect is not permitted immediate or adequate conscious discharge, for example insults that have to be endured in silence, or inexpressible grief over the loss of a loved one; (c) when there is a psychic defence against ideas intolerable to the ego, such as forbidden sexual ideas. Freud's clinical findings led him to emphasise the second and third mechanisms.

The topographic aspect of the hypothesis lay in the notion of an "unconscious" portion of the mind. The term "the unconscious", or das Unbewusste was first used by Breuer in his discussion of the case history of Anna O (S.E. 2:45). Breuer also coined the term "inadmissible to consciousness", or Bewusstseinsunfähig, which Freud later used frequently. It was Freud's clinical work that led to the discovery that defences against distressing ideas could induce a "splitting of the mind" independent of hypnoid states and, of course, it was Freud's particular genius to learn that access to this dynamic unconscious could be gained via free association rather than hypnosis.

Other important influences on Freud's early thinking, different from but quite compatible with Brücke and the Physicalist Society, were Charles Darwin and the biologist Ernst Haeckel (Sulloway, 1979, pp.257-264). For Darwin, such apparently useless phenomena as the human appendix, or the tail and gill slits of the early stages of the human embryo, were signs of our evolutionary history. Haeckel in 1866 formulated what he called the "fundamental biogenetic law" that "ontogeny recapitulates phylogeny". Thus the developing embryo recapitulates the history of the species. Haeckel noted that multicellular animal organisms follow a common pattern in early embryological development. The fertilised zygote invaginates to create a primitive stomach, a mouth and later an anal orifice. He developed the notion of primitive gastraea, from the classical Greek word for stomach, as a basic form from which all higher organisms were descended. The science writer Wilhelm Bölsche developed this into a theory of the evolution of sexual sensitivity. He hypothesised that this sensitivity became dispersed from the original "skin" of the pre-invaginated gastraea to later evolving and increasingly specialised organs of sexuality. Bölsche included in this basic phylogenetic sequence (1) the gastaeal mouth, followed by (2) the primitive cloaca, (3) the anus and (4) the genitals.

Bölsche did not extend these biogenetic views to the sphere of human infancy. Freud clearly did, and used this "biogenetic law" to underpin his theory of infantile sexual development and it was on this biogenetic basis that he called the infant's attachment to the breast "sexual" rather than "sensual" as Jung and many others would have preferred. Indeed this was a major theoretical difference between Freud and Jung that contributed to their ultimate estrangement. Freud was adamant: "Psychoanalysis stands or falls with the recognition of the sexual component instincts, of the erotogenic zones and of the extension thus made possible of the concept of a 'sexual function' in contrast to the narrower 'genital function'." (S.E. 12:323) In a further extension of "ontogeny recapitulates phylogeny" the growing child is seen as passing through stages of psychosexual development recapitulating the sexual history of the race. In his Introductory Lectures on Psycho-Analysis (1916) Freud wrote: 

In forming our judgment of the two courses of [instinctual] development – both of the ego and of the libido – we must lay emphasis on a consideration that has not often hitherto been taken into account. For both of them are at bottom heritages, abbreviated recapitulations, of the development all mankind has passed through from its primaeval days over long periods of time. In the case of the development of the libido, this phylogenetic origin is, I venture to think, immediately how in one class of animals the genital apparatus is brought into closest relation to the mouth, while in another it cannot be distinguished from the excretory apparatus, and in yet others it is linked to the motor organs – all of which you will find attractively set out in W Bölsche's valuable book (1911-1913). Among animals one canfind, so to speak in petrified form, every species of perversion of the [human] sexual organization. (S.E. 16:354)

While Freud thought and wrote as an heir to Darwin as well as Brücke and the physicalist, anti-vitalist school, he also, as Neville Symington has pointed out, belonged to the Romantic tradition (Symington, 1986). This tradition emphasised the thing-in-itself, not existing for any other purpose such as the glory of God, and not subjected to functionalist-scientific explanations. That one's authentic feeling should be the principal source of creativity was the guiding principle of composers like Schumann and Brahms. Freud used the Romantic method of free association while subjecting it to a non-Romantic, even physicalist, scientific enquiry.

The physicalist tradition offered Freud the foundation of scientific rationality he thought essential for psychoanalysis. Yet it has its clear limitations. It cannot allow for intentionality, or any manifestations of subjectivity. It was not until his Structural Theory, in The Ego and the Id (1923) that Freud developed the concept of an Ego capable of such functions. Freud had to follow his clinical findings into areas where physicalist thinking could not always help him. Yet he did so, apparently, with some regret. He acknowledged that the neurophysiology of his day was not sufficiently developed but hoped that one day neurophysiological correlates to psychoanalytic data might be possible. It seems this is beginning to happen now, with the development of new brain-imaging techniques and advances in neuropharmacology. For example, if we examine the function of the central neurotransmittor 5-hydroxy-tryptamine, or serotonin, we find that the serotonin system appears to modulate norepinephrine responsiveness and arousal. Animals with serotonin depletion display hyperirritability, hyperexcitability and hypersensitivity, an "exaggerated emotional arousal and/or aggressive display to relatively mild stimuli", behaviours which bear a striking resemblance to human subjects with Post-Traumatic Stress Disorder. Decreased serotonin function has also been correlated with hostility, impulsivity and self-directed aggression in patients with depression and with borderline personality disorder, and this latter group has frequent histories of severe childhood trauma. Moreover, the social influences on neurotransmittor levels have been illustrated by studies in non-human primates showing that serotonin levels are highly correlated with position in the social hierarchy, and that environmental changes can profoundly affect both social hierarchies and the serotonin levels of animals within those hierarchies (van der Kolk 1996, pp.223-224). This would suggest that one of the neurophysiological correlates of a good psychotherapeutic relationship for a distressed patient may be a gradual restoration of serotonin levels. The mode of action of the Selective Serotonin Re-uptake Inhibitor class of drugs, e.g. Prozac, which have been found helpful in treating depression, obsessional thinking in OCD. and involuntary preoccupation with traumatic memories in patients with PTSD., is also to restore depleted levels of this neurotransmitter. 

Thus, neurophysiological structure changes in response to experience. The Los Angeles psychoanalyst Allan Schore has described how early interactions between mother and child shape a child's affect regulatory processes at a brain level.  

Of particular importance is the shaping of the right orbito-frontal cortex through mutual face-to-face interactions. Disturbed interactions become encoded as interactive representations in the late maturing right orbito-frontal area, the executive regulator of the entire right brain. This system is centrally involved in attachment functions and in regulating bodily states, and so the psycho-biological misattunements of an early growth inhibiting environment are imprinted into this developing system, thereby structuralizing attachment disorders which later manifest themselves as failures of affect regulation. Recent studies show that this area is the most plastic part of the brain and that successful psychological treatment produces significant changes in the metabolic activity of this area and in its subcortical connections. In other words, what gets disrupted in infancy can get repaired in psychotherapy.  

Problems in the physiological regulation between infant and mother lead to a lack of differentiation between self and other in borderline states or, in more cohesive narcissistic states, an impairment in self-esteem regulation and a disturbance in the representation of the self in relation to others. Such people cannot generate the complex symbolic representations needed to modulate stress-induced negative states but, instead, will frequently access "pathological internal representations that encode a dysregulated self-in-interaction with a misattuning-other. (Shore, 1998)

Freud's physicalist tradition was essentially that of a one-person psychology. Libido must always be pleasure-seeking. The object is sought principally as a means of discharge of instinctual tension. Ronald Fairbairn specifically challenged this when he declared, "Libido is not pleasure-seeking. Libido is object-seeking." Even then, Fairbairn could not escape the term "libido", with all its physicalist connotations. What Fairbairn proposed was a more humanistic psychoanalysis in which Freud's original proposition must be turned 180 degrees. We do not use the object to discharge our instinctual drive. We use our instinctual drive as a bridge to the object (Fairbairn, 1952).

The physicalist model, as we said, allows no place for subjectivity, and a core element of that subjectivity is that human beings are essentially hermeneutic creatures. We do not remember the past or perceive the present like a photographic plate but are constantly interpreting, creating structures of meaning. The seduction theory of hysteria was based upon an archeological model, and Freud was for all his life an avid collector of archeological items -- statues, pots and figurines. According to the seduction theory a traumatic memory can be retrieved unaltered like a buried artefact. Freud came to question this view and replace it with a theory of unconscious internal structures comprising instinctual drives, object attachments, identifications and defenses. In this way the limits of the physicalist model were being stretched to admit the interpretation and structuralisation of experience.

This has in recent years become a controversial issue, with Jeffrey Masson's claim that Freud deliberately suppressed evidence of real sexual abuse of his patients in order not to fall out of favour with the Viennese medical establishment. One can be drawn into paranoid splitting on this issue only if one contends that all memories of abuse, repressed or otherwise, are factually true, or all such memories are never true. Freud took neither position, but the weight of his interest was now directed toward his theories of drive and defense. His ideal remained that of the detached and scholarly observer. The intersubjective emphasis in modern psychoanalysis (Stolorow et al., 1987) means acknowledging the act of observation alters what is observed, and that the analytic encounter involves separate, overlapping and mutually influencing subjectivities. Whatever phenomena arise during the course of a therapy, including memories of abuse, can only be understood within this intersubjective context.

 Although we may say that Freud was responsible for the first two object relations papers – Mourning and Melancholia (1917) which spoke of the lost object becoming split and internalised, and The Ego and the Id (1923) where aspects of the parent are described as being internalised as part of the formation of the superego, the physicalist underpinnings of his thinking would not allow him to develop an object relational approach further, as the Kleinian and British Independent schools were able to do. Rather, from 1920 onwards he set about radically revising his theory of instinct.

Freud initially hypothesised separate ego and libido instincts, the former directed toward the preservation of the self and the latter toward the preservation of the race. In his paper On Narcissism (1914) he began to blur this distinction, when he proposed that the ego itself is the id's first object and therefore the self-preservative instincts of the ego are subordinated to the sexual drives of the id. Thus his dualism became undermined.

He was able to restore it in 1920 with the publication of "Beyond the Pleasure Principle" which now proposed a new dualism of Life and Death instincts, or Eros and Thanatos. This dualism also helped him to clarify the clinical phenomena of fixation to trauma and the compulsion to repeat, since he was now able to contrast the developmental forces of evolution (progression) and involution (regression) (Sulloway, 1979, p.413).

The death instinct is a controversial and troubling aspect of Freud's thinking, but we can see it arising inevitably from the physicalist tradition to which he, in large part, belonged. Of all the streams of psychoanalytic theory, only the Kleinian school seems to have taken up the death instinct with any degree of enthusiasm, and even here Melanie Klein developed the concept in her own way, as innate destructiveness. For Freud the death instinct was primarily an expression of "an urge inherent in organic life to restore an earlier state of things", so that a primal state of non-life appeared to be the ultimate historical aim of all life (Sulloway, 1979, p.413). Destructiveness was a secondary manifestation. W.B. Yeats' poem The Wheel, published in 1928, expresses the Freudian view most eloquently:

Through winter-time we call on spring,
And through the spring on summer call,
And when abounding hedges ring
Declare that winter's best of all;

And after that there's nothing good
Because the spring-time has not come
Nor know that what disturbs our blood
Is but its longing for the tomb.

In his summarising paper Psycho-Analysis (1926) Freud declared that psychoanalysis offered a science of man and his unconscious mind rather than a mode of psychotherapy. He had come to believe that the power and persistence of the death instinct provided a firm counter-weight to therapeutic zeal. But then we must remember that therapeutic zeal was quite foreign to Freud's nature. At the very beginning of his psychoanalytic work, in Studies in Hysteria, he had declared soberly the aim of psychoanalytic therapy was to turn "hysterical misery into ordinary human unhappiness."

Developing the concept of a death instinct shows Freud being true to the physicalist spirit expressed in du Bois-Reymond's 1842 letter: "In those cases that cannot at the time be explained by these [physical-chemical] forces one has either to find the specific way or form of their action by means of the physical-mathematical method, or to assume new forces equal in dignity to the chemical-physical forces inherent in matter, reducible to the forces of attraction and repulsion."

Alternative hypotheses may be offered for the clinical phenomena that led Freud to propose a death instinct, but they all involve different forms of a less physicalistic object relations theory. For example, Ronald Fairbairn described the child's early attachment to caregivers as being based on "primary identification", which is similar to Winnicott's notion of the caregiver as "subjective object" or, in Kohut's terminology, "selfobject". Fairbairn proposed that the child could not but attach to the caregiver and internalise these experiences, both frustrating and gratifying. Thus within the ego there is a split "exciting object" and "rejecting object" to which fragments of the ego attach -- the "libidinal ego" and the "antilibidinal ego" respectively. The paired rejecting object- antilibidinal ego, which Fairbairn also called the "internal saboteur", directs aggression toward the paired exciting object - libidinal ego, thereby entrenching within the mind a construction of the earliest dysphoric relations with caregivers, an internal identification with the aggressor. This is consistent with Schore's later description of "a dysregulated self-in-interaction with a misattuning-other."

There may be experienced a hostility toward one's own smallness and dependence, or a guilt or anxiety about any therapeutic progress that loosens the bond with these internal objects. But, from this viewpoint, what stands against the evolutionary impulse is not the death instinct but sadistic identifications, separation anxiety and/or separation guilt.

But here I am referring to the polarities within psychoanalytic theory -- constitutional versus environmental factors, drive theory versus attachment theory, death instinct versus reactive destructiveness or the "frustration-aggression hypothesis". Freud's thinking could embrace both sides of each of these polarities but the weight of his argument favoured constitutional factors, drive theory and the death instinct. Some understanding of his background in the physicalist tradition may help us appreciate why this was so.

REFERENCES

FAIRBAIRN, W.R.D. (1952) Psychoanalytic Studies of the Personality, Routledge.

FREUD, S.  

(1894)The Neuro-Psychoses of Defence. S.E. 3:43-61
(1896) Studies in Hysteria (with Josef Breuer) S.E. 2.
(1914) On Narcissism. S.E. 14:69-102.
(1915) The Unconscious. S.E. 14:161-204.
(1916) Introductory Lectures on Psychoanalysis. S.E. 15-16.
(1917) Mourning and Melancholia. S.E. 14:237-258.
(1920) Beyond the Pleasure Principle. S.E. 18:1-64.
(1923) The Ego and the Id. S.E. 19:1-59.
(1926) Psychoanalysis. S.E. 20:261-270.

SCHORE, A.N. (1998) Interview with Michael Moskowitz PhD, ed. The Neurological and Developmental Basis for Psychotherapeutic Intervention. Jason Aronson, New York, 1997.

STOLOROW, R., BRANDCHAFT, B., ATWOOD, G. (1987) Psychoanalytic Treatment - An Intersubjective Approach. The Analytic Press, Hillsdale, N.J.

SULLOWAY, F. (1979) Freud: Biologist of the Mind. Basic Books, New York.

SYMINGTON, N. (1986) The Analytic Experience. Free Association Books,       London.

VAN DER KOLK, B.A. (1996) The Body Keeps the Score: Approaches to the Psychobiology of Posttraumatic Stress Disorder, in Traumatic States, van der Kolk, Mcfarlane, Weisaeth, eds. The Guildford Press, New York.