Reflections about Freud's on aphasia and contemporary science
by Ana-Maria Rizzuto *(La versione italiana di questo lavoro è stata pubblicata sul N. 2/1997 della rivista Psiche)
Freud's first and little known book On Aphasia. A Critical Study (1891) is not only the foundation of the entire building of psychoanalysis (Stengel, 1953; Forrester, 1980; Rizzuto, l990) but a major and lasting contribution to the understanding of speech as indicator that each person is constituted as an exclusively particular being. In it Freud includes notions that remain to be studied by neuroscientist, psycholinguists, developmental and cognitive scientists, and other disciplines investigating humans as speaking beings. The book presents a speculative neuropsychological model for the function of speech in normal and diseased individuals. It introduces the notion of speech as a spontaneous activity (Rizzuto, 1993) which always depends on the individual's will to speak while it explores what could motivate a person to want to speak spontaneously. The early and never modified model of the speech apparatus did not explicitly include, except in passing remarks, the function of the affect involved in the speech function. The momentous discovery that symptoms disappeared "when the patient had described that event [source of the symptom] in the greatest possible detail and had put the affect into words' was presented for the first time in Studies on Hysteria (1893-1895) in the joint explanation of the mechanisms of hysterical phenomena written by Breuer and Freud (p. 6).
The model of the speech apparatus and its organization prepared the way for the later expansion into essential analytic concepts. The technique of free association and its theoretical bases rest on the manner in which the speech apparatus is "arranged for associations" (E. 89; G. 9l). The spontaneous functioning of the apparatus would naturally follow pre-established associative links that lead from verbal word associations to object representations and their affective, experiential, bodily, and historical registries. The model also anticipated the notion of unconscious processes in establishing that the formation of word and object representations leaves behind a physiological correlate , a 'modification', that implies the 'possibility of memory'. The stimulation in the cortex of previously registered physiological states could bring about the reproduction of a psychic object representation1. This possibility gives the representation the potential to recur by itself (E.: 58, G.: 56) (Rizzuto, 1990). Such capacity for self activating recurrence pronounces the existence of unconscious mental processes in which object representations are dominant.
Verbalizing experience at the service of the affective expression and
integration of memories, fantasies, perceptions, and beliefs accumulated
in the complex process of development constitutes the core of the analytic
enterprise and technique. Adult verbalizations to infants, in turn, establish
the everyday process by means of which speechless but listening new born
children become constituted in the course of development into persons and
social and cultural beings. The accumulated knowledge of a century of psychoanalytic
practice has added complexity and subtlety of the analytic understanding
of language as the indispensable gate to discover the conscious and unconscious
motivations and processes underlying psychic life and intentionality. Lacan
(1901-1981) made language the corner stone of his new reading of Freud
and added to it his own version of the analytic function of speech and
language. Lacan, however, restricted the breadth of the Freudian word by
limiting it to signifiers and the signified, neglecting the bodily and
affective component of the spoken word. The Freudian word is always, according
to the model of the speech apparatus, the complex and highly organized
processing of the perceptions, registrations, and neuro-symbolic transmutations
of a bodily mind.
In this paper, I will review briefly Freud's main contributions to the understanding of the speech function and, then, reflect on what psychoanalysts may ask the neuroscientists, the developmentalists, the linguists, the social scientist to research in order to elucidate Freud's core discovery: the therapeutic function of human speech.
In the book Freud offered two uneven contributions. The first is the construction of a theoretical neurological model of what he, together with the neurologists of the time, called the "speech apparatus". Freud's apparatus, however, was the service of a function not considered by his colleagues: people's "spontaneous speech." The second is a series of related observations concerning the actual function of speech in a concrete individual. It was there were he started. The peculiar patterns of speech of three remarkable lady patients, Anna O., Emmy von N., and Frau Cecilia urged Freud's curiosity about the psychic changes they could achieve with the expression of their own words (Rizzuto, 1989) Breuer had observed that Anna O. "could be relieved ... if she was induced to express in words the affective fantasy by which she was at the moment dominated" (Freud, 1925, p. 20, my italics). Anna O. herself called it "the talking cure." Breuer who had made the observation and the great Charcot, to whom Freud earnestly presented the findings during his visit to Paris in 1885, did not see anything too extraordinary in it. Freud's reaction was momentous: "The state of things he [Breuer] had discover seemed to me to be of so fundamental a nature that I could not believe it could fail to be present in any case of hysteria if it had been proved to occur in a single one." From that moment on he began to use Breuer's technique with his own patients to confirm the power of the talking cure. He was so taken that he "worked at nothing else (Freud, 1925,p. 21). He was also compelled by the imperious manner of his formidable patient Frau Emmy von N. who, as Freud reported, had commanded him "in a definitely grumbling tone that I was not to keep on asking her where this and that came from, but to let her tell me what she had to say" (Freud, 1893-95, p. 63, my italics). Frau Cecilia M. gave Freud another lesson about the function of speech. She "was taking a verbal expression literally and in feeling the "stab in the heart" ... as a real event she was ... simply reviving once more the sensations to which the verbal expression owes its justification' (1893-1895, p. 181). Under the influence of these willful patients, Freud was accumulating significant knowledge: people have to speak and to be listen to; words sometimes "mean" the sensory enactment of what they represent; talking had the potential to cure symptoms that no other know medical procedure or medication could change. This was Freud's living and speaking 'laboratory' for the creation of his "speculative" model of a speech apparatus. Unlike modern cognitive or other neuroscientists, Freud did not begin his studies on the function of speech by fragmenting it into its components parts to study them individually. His laboratory was the total living person of his patients in the act of speaking and being listened to. What he intended to explain was how there is in the human mind a special "apparatus" that organizes what people and patients conceive about what they want to do with their words to themselves and others.
Freud had been trained as a rigorous scientist under Professor Ernst Brücke's leadership at the University of Vienna. He knew how to research and to reason following the strict foundations of the scientific method. In 1885 he had learned the power of detailed observation of human behavior from the great Professor Jean Charcot at the University of Paris. Facing the task of having to solve the riddle of human speech, its normal function and its pathology, in particular the aphasias, he combined in the effort Charcot's attentiveness to details of human behavior with Brucke's strict scientific method and rigorous thinking. The result was a book skillfully reasoned in which he established the essential components of the speech function as they are still accepted today. The context of Freud's research was the great interest among contemporary neurologists in understanding the pathophysiology of the different modalities of aphasias. Broca and Wernicke had found the centers that carry their names and localized the functions of articulating speech and listening to it. The dominant theories accepted the anatomical localization of function and classified aphasias as those due to the destruction of a center or those due to the severance of the connecting neural pathway between them. Freud observed that his colleague's speech apparatuses, composed only of centers and their white fiber associations, could not serve a person that wanted to speak. At best it could function as a complex reflex arc useful to repeat words heard from others. Freud was interested in the intentional and spontaneous component of normal speech in ordinary circumstances. He set out to construct a model that could support his key point: "We speak when we intend to speak by using our speech apparatus" (E. p 21, G. p. 22). The personal pronoun "we" must be stressed as an indicator that speech is only and exclusively a function of the total person. That "we" is painfully absent in the scientific study of the function of speech.
The systematic analysis of the cases presented by his colleagues prompted
Freud to rejected several of their premises. He discarded the notion of
speech centers and the concomitant location of speech functions. Their
apparent existence, Freud conclude, resulted from the artifactual post-mortem
examination of the damaged tissue of aphasic patients. Freud refused to
accept the localization of psychic representations linked to the speech
function. He insisted that neurologists must not search for the anatomical
substratum of mental activity because such an activity is always the result
of a process spread widely over large portions of the brain. The stimulation
of physiological activities must not be confused with a psychological representation
such as the living spoken word. Freud concluded that the anatomical areas
connected with the speech function contained only the potentially stimulable
physiological cortical elements of sensory or motor neural pathways. For
Freud large areas of the cortex were involved in the moment of a speech
act. This conclusion emerged from the way Freud constructed the model of
the speech apparatus (Fig. 1).
Freud's model of the word organization (1891 , p. 77)
What is most peculiar about Freud's speech apparatus is that it does not exist as such. It borrows from structures serving many other functions, each with its own specific perceptual or executive function. It takes up all the afferent pathways of every modality of sensory impression to construct its capability to form object-representations. The apparatus has no afferent pathway of its own. In the efferent way it also borrows from other structures at the service of diverse functions such as the muscles of motor articulation. Freud's central conclusion is that what is specific to this virtual apparatus is its property to serve the establishment of associations between its component parts. Its nature--Freud says emphatically--is that of its association mechanisms. Aphasias result not from the destruction of the so called centers but from the functional disruptions that anatomical lesions impose on the associative process of the function of speech.
The key question for a theory of spontaneous speech is to understand what could motivated a person to speak to another. Why was Freud's job to listen to what Frau Emmy von N. had to say? Freud tried to construct a model of the formation of the word in the virtual speech apparatus that could answer that question. What the patient had to say, Freud concluded, had to come from some internal stimulation After much reflection he concluded: "All stimulations to speak spontaneously come from the region of the object associations" (E.:78; G. 81). These are associations linking composite object representations, conceived by Freud in very specific manner. An object representation (Vorstellung) is the result of an extraordinarily complex bodily process. Philosophically, Freud believed that we cannot know things in themselves but only perceive them through our sensory organs. Things affect our bodies, and the body processes the information following the pre-established pathways of the nervous systems. The question is then: "In what manner is the body reproduced in the cerebral cortex' (E.: 50; G.: 50) to form a functionally viable object representation available to the speech function. Freud observed that all the afferent pathways interconnect in multiple ways and that they find relays in gray nuclei which in turn receive input from other areas. The final input arriving at the sensory cortical areas is no longer the direct organ perception but its hierarchical transformation trough its own multilayered and multicentered neurological structures. The conclusion Freud draws from it is astonishing: the transformational process occurs in this way because they are at the service of representing the body "not topographically but only in manner suited to the function [of language] (E.: 53; G.: 55). With this sentence Freud had anticipated present day neuroscientific and evolutionary theories of a whole human organism structured by Darwining and Balwinian2 selection to function as a speaking being (Deacon, 1997; Edelman, 1982, 1992). Terrence W. Deacon (1997), has made this affirmation the central point of his understanding of evolutionary anthropology. He says in The symbolic species:
The evolutionary miracle is the human brain .... The changes in this organ responsible for this miracle were direct consequences of the use of words. And I don't mean this in a figurative sense. I mean that the major structural and functional innovations that make human beings capable of unprecedented mental fits evolved in response to the use of something as abstract and virtual as the power of words. Or, to put this miracle in simple terms, I suggest that an idea changed the brain (pp. 321-322).
Freud had assumed that the transformations in the gray matter nuclei of the sensory processes arriving from the periphery of the sense organs were guided by the principle that they have to produce cortical representations at the service of the language function. This means that he believed that the subcortical structures could also subserve the needs of speech. This is what Deacon explicitly describes as the evolutionary transformation of the brain by the progressive use of speech. It is true that Freud could not have said as much, but his intuition and understanding of brain function 107 years ago anticipated today's evolutionary anthropology.
Freud drew another striking conclusion. Talking about the nervous fibers transmitting the transformed sensory impressions he affirmed: "They contain the periphery of the body as - to borrow an example from the subject with which we are concern here - a poem contains the alphabet, i.e. in a reordering of the individual topographic elements, in manifold connections serving other purposes, whereby several [topographic elements] are represented several times, others not at all" (E.: 53; G.: 55). The rhyme, metrics, musicality, and depth of the emotional meaning present in poetry are very apt to convey the transformation of sensation into emotionally colored object representations constitutive of the human word. Here too, Freud anticipated present day knowledge about the multiplicity of simultaneous sensory registrations of a multi modal brain
Finally, to make sure that he is clear about the subject, Freud affirms that sensation cannot occur without associative processes: "The associative process is intrinsic to the representation itself" (E.:57; G.: 58-9). Present day studies in cognitive neuroscience amply confirm Freud's theoretical assertion. Kosslyn and Sussman (1995) affirm that "There is no such a thing as immaculate perception". Discussing the role of imagery in perception they conclude:
Imagery is used to complete fragmented perceptual inputs, to match shape during object recognition, to prime the perceptual system when one expects to see a specific object, and to prime the perceptual system to encode the results of specific movements. According to the present analysis, imagery acts as a bridge not only between perception and memory but also between perception and motor control. The functions of mental imagery in perception and motor control have apparently shaped its properties even when it is used autonomously (p. 1035).
Imagery in this description is a broad term for the multitude of associative processes that take place continuously during the perceptive process and eventuate at the cortical level in the complex multi modal object representations that constitute the object representation component of the potential spoken word.
In Freud's theory, the formation of verbal component of the spoken (and
later written) word is organized around the sound images heard from others
and the kinesthetic images of pronouncing sounds in reproducing the sounds
of words heard. The two essential components of the word link customarily
by connecting the sound component of the spoken word to the visual component
of object representation. If the visual component is not available the
speech apparatus may resort to other sensory modality of the object representation
to make it available for speech. The two components together constitute
the symbolic word for human discourse. The speech apparatus, however, indispensable
as it is, is but a tool for the concrete moment of speech. Speaking itself
is the capacity a person has to willingly symbolize in words the inexhaustible
representations generated in the course of life's experiences by a bodily
mind that wants to express itself to others.
Freud's insistence on the use of the associative pre-conscious and conscious word in free association was based on the assumption that personal knowledge of one's internal mentation and affective states could only be achieved by the mediation of the speech apparatus in a person who had made a conscious commitment to speak to the analyst. This means that all consciousness depends on the left hemisphere where the broadly located virtual speech apparatus is located. Present day research by cognitive neuroscientists completely support such premise. Gazzaniga (1995) says:
The modular organization of the human brain has now been well established .... What is clear is that they [modules] operate largely outside the real of awareness and announce their computational products to various executive systems that result in behavior or cognitive states. Catching up with all this parallel and constant activity seems to be a function of the left's hemisphere interpreter's module. The interpreter is the system of primary importance to the human brain. It is what allows for the formation of beliefs, which in turn are mental constructs that free us from simply responding to stimulus-response aspects of everyday life. In many ways it is the system that provides the story line for the narrative of our lives (p. 1394).
Gazzaniga defines consciousness not as another system of the brain circuitry but as reflecting "the affective component of specialized systems that have evolved to enable human conscious processes" (p. 1397). The question that remains to be asked is if consciousness is dependent on language or if language is one among other brain circuitries that enable conscious awareness. Rolls, in (1995)presenting the perspective of cognitive neuroscience, believes that there is "a close association between linguistic processing and consciousness" The symbolic organization of language in linking arbitrary words to representation and experience gives flexibility to behavior by allowing anticipated planning of potential actions while "nonlinguistic behavior would be driven by learned reinforcement associations." Rolls suggests that "consciousness may be the state when this type of processing is performed". He concludes:
This is consistent with the points made above that the brain systems that are required for consciousness and language are either very similar or the same. According to this explanation, the feeling of anything is the state that is present when linguistic processing, involving thoughts of the second or higher order, is being performed (p. 1102).
Rolls conclusions not only confirm Freud's insistence on the function of language in conscious awareness but even concludes that the neural mechanisms involved are essentially the same. Furthermore, he asserts that subjective awareness of feeling is dependent on linguistic processing. This last statement, so close to Breuer and Freud's early discovery, may offer the possibility of elaborating a neuroscientific theory of why the analytic peculiar processing of words in free association has such significant impact on the emotional transformation of subjective feelings. These speculations cannot be dealt with in this brief paper.
The near equation between the brain systems supporting consciousness and language brings up again the question of the neurological structure of the speech apparatus. Freud had made it clear that it was a virtual organization without neurological structures of its own. Present day research by cognitive and developmental psycholinguists after vain efforts to find "dedicated organs" for the language function leads to the conclusion that "it is still difficult to locate the 'language organ' precisely" (Mehler and Christophe, 1995, p. 944).
Freud's century-old theory of language is still capable of withstanding
the conclusions of present day advanced neuroscientific and neurolinguistic
The practicing analyst may ask researches to develop experiments and hard core research to create believable scientific models to discuss some questions that I consider extremely interesting and useful. Here are some that I use as samples to illustrate the point. What is the physiological effect of the spoken word upon the sense organs, the internal organs, the organism physiology? Samuels (1977) has demonstrated the pathological physiology involved in "voodoo" death. Among other emotional factors capable of eliciting and emotional crisis, the loss of status or self-esteem as a member of the community may cause sympathetic overactivity which, in turn, produces cardiac damage-contraction band necrosis of the heart muscle, responsible for the person's death. This physiological storm relates "to events impossible for the victims to ignore and to which they response is overwhelming excitation, resignation or both" (p. 294). This crisis situation may be caused by life disrupting words conveying an overwhelming reality. Obviously this is an extreme case of physical pathology with demonstrable anatomical lesions. The curative function of the word may offer a counterpart. In the course of human history there has always been a manner of attempting to heal by using words, be there in magical, religious or human contexts. Lain Entralgo (1958) reports in his book La curación por la palabra en la antigüedad clásica the manners in which the word was used as an adjuvant in the treatment of medical illness. He mentions Gorgias, the sophist, who compared the action of conversational words to that of medicines (p. 132). It is a common analytic experience that frequently the analysand's minor ailments and others not so minor, may improve or disappear as the result of the analytic working through. This is not always the consequence of direct interpretation of conflict but may come as an unintended effect of the analytic changes undergone by the patient.
Developmental scientists in the last twenty years have started a systematic study of the communicative aspect of relatedness from the beginning of life. Those studies have already offered much but there is still a great need to investigate in detail the semantic, symbolic, cognitive function of words and their affective interpersonal communicative power in organizing the development of psychic structure. I have described (Rizzuto, 1988) the pathological development of the sense of self and of the use of language in patients with eating disorders, whose mothers suffered from an inability to relate to them in meaningful words.
Much remains to be researched by analysts and psycholinguists about the psychic function of words, syntax, prosody and other constitutive aspects of the spoken word. What is the psychic function of grammatical functions? Do verbs "do" something psychically for us? What about other grammatical functions? I have presented in a psychoanalytic paper an aspect of the psychic function of personal pronouns (Rizzuto, 1993).
Finally, we practicing analyst may join those colleagues (Bucci, 1997;
Mehler, Canestry, and Argentieri (1993), and many others whose research
has already offered new ways of understanding the function of words, intra-psychically
and intra-analytically during the verbal transformative process of analytic
1) Object representation does not refer in this context to a human object but a thing representation.
2) "Balwin suggested that learning and behavioral flexibility can play
a role in amplifying and biasing natural selection because these abilities
enable individuals to modify the context of natural selection that affects
their future kin" (Deacon, 1997, p. 322).
Amati-Mehler, J., Argentieri, S., & Canestri, J. (1993). The Babel
of the unconscious Mother tongue and foreign languages in the psychoanalytic
dimension. Madison, CT: International Universities Press.
Ana-María Rizzuto, M. D.