Recruitment Selection Process | Case Study

Recruitment Selection Process | Case Study How does the organization approach the nature and composition of the workforce? For example, does it emphasize low cost or high performance, and internal or external labour markets? The company I am employed with is a furniture company which tends to do most of the hiring based on the high performance and uses internal and external labour markets. Vacancies arise in our company as employees leave the company such as when they retire or resign or get promoted to other positions within our company. Our company ensures that we have developed an adequate plan to replace employees when needed. We decide what requirements we needs such as personnel requirements which will be supplied by either outside candidates or inside candidates. This decision is all based on need and if we have the qualified staff to step up and replace when needed. The company makes sure to comply with all government policies. We make sure to guarantee our valuable employees have long-term employment opportunities. They do this because it would be unfortunate to lose talent to another company. We are flexible to accommodate to changes in the nature of employees and in the way they do business. T hey are adaptable and cost effective in the hiring process. Our company approaches the nature and composition of the workforce by way of looking for the best employees that will help our company grow and become improved and superior. We want a strong employee community within our company so we work hard to build the relationships with our workforce. How many positions are filled annually? How many applications are received for each vacant position? The organization consists of about 150 people which means about approximately 10 hires a year occur from internal promotions or people seeking other types of employment or from turnovers. We do try to keep our employees with us as long as we can since they are our expertise in the field. When we must make new hires we do ask that current employees take on the training of their replacements because we understand that they know the jobs as well as they can. There are approximately 80 applications received each time there is a vacant opening for hire. This is mainly so high a number of people applying because of the current recession we are all facing. A normal amount of candidates would be about 20 for each position advertised. What methods are used to recruit candidates? Recruitment at our company involves attracting the right standard of candidates to apply for job openings. We tend to advertises jobs in different ways depending on the position available. We first looks at the internal replacement plan to fill a job opening. This is a process that lists all the current employees that are looking for a move which is either at the same level or on a promotion basis. We also advertise the post internally on our intranet. If there are no suitable people in this which are developed from the replacement plan, in the process of development or apply from internally then the company needs to start to look externally. For external recruitment, we advertise opening through our website and the available job boards in the stores. Applications are to be filled out online or in the store for positions. The chosen potential candidates are invited for an interview followed by their attendance at our assessment centre for the final stage of the selection process. We will seek the most cost-effective way of attracting the right candidates. We build up our external pool of qualified candidates by advertising the job through advertising, employment agencies, executive recruiters, college recruiting, the internet, referrals and walk-ins. It can become expensive to search for candidates although this is sometimes very necessary to ensure the right types of people are able to learn about our opening. Our company strives to make it easy for candidates to find out about an available job and we have a very simple application process. By accessing our website, a candidate can find out about our local available jobs, management posts and head office positions. The website has an easy to use online application form for people to submit directly through. We always make sure to never discriminate against any individual with respect to employment because of race, color, religion, sex, national origin or age. All people are welcome to apply and be given a fair chance to go through the hiring process if they qualify each stage of the way. What is the general approach to selection (i.e., statistical, judgmental, or a combination of the two)? The general selection approach is through a combination of judgmental and statistical evaluations. Judgmental information is used in terms of that we tend to require an assorted amount of source data based from the managers personal judgments of the individual candidate. We also use the previously collected information such as resumes and application forms in our databases to make these judgment calls. We will use statistical information when we have made our judgments on who will be asked to participate in call backs for the next qualifying measures. The common selection approach we use is to find the essential key qualifications for each qualified candidates and the screening out of all the unqualified candidates. We make sure we have a list the characteristics and skills that are required for job performance. These requirements are the predictors of job performance. Selection involves choosing the most suitable people from those that have applied for an opening while at the same t ime keeping to the employment laws and regulations. Screening candidates is a very extremely important part of our selection process. The initial selection screening in our organization begins with an application form. Our manager uses these to obtain some valid background data. It is also a valuable tool to use the application form data to make predictions about the candidates future performance. For example application forms have been used in my company many times to predict the job success, job tenure and employee theft. A human resources manager will be able to tell a lot from an application form if they have trained extensively and have some experience in this field. The important thing to remember is that the personnel planning and recruiting will directly affect employee commitment. This is because commitment depends on the hiring of employees who have the potential to grow and develop. The more qualified candidates that have applied the higher chances of the selection standards are able to be. Selection at my company begins with the most effective testing and interviewing techniques available. This ensures that those selected for an interview will have the best fit with our job requirements. In the first stages of screening, our selectors will look carefully at each candidates resume. This information helps to summarize the candidates education and job history to date. A well-written and positive resume helps us to assess whether a candidate matches the individual skills need for the job specifications for the position. The company also provides a tool that can help to match individuals with careers on our website page. People interested in working for us can see where they might fit into our company before applying that way there will be less disappointment if they are not chosen for an interview. Statistical is used in terms of an individual assessment includes the knowledge, skills, and ability testing, personality assessment, work sample tests and assessment screenings . We usually try to use the predictive validation test developed specifically for the type of job and the industry in which our company operates within. The tests we choose tend to be based ones which will depend on the job we are hiring for at the time such as in the warehouse or in the office. We believe our test conditions should always be consistent. We hold the tests in areas that are reasonably quiet, private, well ventilated and well lit. We also make sure that the entire group of candidates takes the tests under the same evaluation setting. Once completed the test results are to be held in the strictest confidence. They are given only to the individuals who have a valid need for the test results. We use the tests that measure the attributes that are important for each type of job success. This choice is usually based on the experience, previous candidate search and gut instincts of the person performing the tests. We usually use more than one test in a sequence aimed at measuri ng a variety of possible predictors such as companionability, assertiveness, and mathematical ability. For legal reason we always make sure that the tests have accurate measures before they are used in evaluating a candidates potential ability to perform well on the job. The fact that similar tests may have proven successful in the same industry is not sufficient enough for us to use them unless we have done our own validation of these tests. If we are using a new test we tend to check the accuracy of it by testing it on the existing employees on the job. We then compare the candidates test scores with our current employees to confirmation the validation of these new tests. The one disadvantage is that current employees might not be representative of the new candidates. We use tests as one of a variety of the selection techniques as they are used to supplement the interviews and background checks. The process we use to select external candidates has several stages. Candidates who pass the initial screening process of the application form and resume than has the opportunity to attend our assessment screenings. The assessment screenings takes place in our store and is run by our managers. These assessment screenings help to provide consistency in the selection process. Candidates are given various exercises which include team-work activities or problem solving exercises. These involve real life examples of problems they might have to encounter at the workplace. Candidates that have been approved by the assessment screenings then have an opportunity to have an interview. Managers for the job being hired for are offered take part in the interview to make sure that the candidate fits the job requirements. Our company conducts the interview by following the layout of plan the interview, establish the rapport, question the candidate, close the interview and then review the data. Sele ction and testing of prospective employees is of great importance in my workplace. There are very good reasons why the process of selection and testing is crucial. Performance is extremely crucial to have from an employee since selecting an employee with the right level of performance should always be chosen for the job. Employees who do not have the right level of skills or who are cause difficulties or complicate matters will not be able to perform effectively. To have the most cost effective screening is important because it is expensive to recruit and hire employees. It is estimated that for an administrative assistant who earns $30,000 a year the cost of recruitment is around $12,000. This takes into consideration the total cost of the search fees; interviewing time, reference checking or using a company to search on our behalf. The cost of hiring employees could be proportionally high and this is a quite significant reason to make sure we hire the right candidates. We are always reviewing and updating our hiring process and making sure specific industry standards are reviewed on a regular basis to ensure that the selection and testing process is fair. Even if a candidate is not able to make it through the hiring process for which ever reason when we chose to not invite them to the next step or they drop out the process we always make sure to keep accurate records. We believe it is extremely important to keep accurate records of why each candidate was rejected during the hiring process. The detailed records of why each candidate was rejected will be held to assist in the research on the trends in recruitment and to evaluate the performance of our recruitment process. We also hold on to them for legal reason should the need ever arise to provide proof of our fair practices. What selection devices or methods are employed? The common selection devices and methods we use include the following: ability tests such as physical, cognitive or psychomotor, knowledge tests, structured interviews, personality tests, the methodical collection of biographical data, and work samples. We must always be evaluating the evidence regarding the degree to which the selection tools predict job performance and the substantiation they put on the validity of the selection tools. Are these selection devices or methods validated? How? The candidate selection devices and methods are usually validated or shown to be job relevant using one or more of the following types of validity. The selection devices are validated through such methods as the validity of subject, concept, or criteria. It is by these means Does the organization attempt to evaluate the effectiveness of its RS system? If so, how? Which model does it apply? After we have established the accuracy of the tests we administer the test and hire the employees based on their test scores. At a later date compare the success candidates with their test scores with their performance on the job. The recruitment and selection methods are important for finding out the shortcoming of our processes. These test scores contribute to an organizations success by improving the performance and well-being of its employees. They help to identify how behaviors and attitudes can be improved through hiring practices, training programs, and feedback systems. Our company does attempt to evaluate the effectiveness of its recruitment and selection system through the job analysis procedures. The Job analysis is illustrated as the foundation of the successful employee selection efforts and the performance management initiatives. A job analysis involves the methodical compilation of information about the specific job that was hired for. Job analysis methods are often do ne through two approaches in our workplace. The first approach being the task oriented job analysis this involves an examination of the responsibilities, obligations or experience required by the job. The second approach is the worker oriented job analysis which involves an assessment of the knowledge, skills, abilities and other characteristics (KSAOs) which are essential to successfully perform the work. Job analysis data is often amassed using a variety of qualitative and quantitative techniques. The information gathered from a job analysis is then used to create job related selection procedures, performance evaluations and criteria or training curriculums. The other uses of the job analysis information include job evaluations for the purpose of determining compensation levels and job revamping. It is important to know the Job attitudes such as their job satisfaction, commitment, organizational citizenship and retaliation on the company. The job analyst individual may use qualitative methods such as critical occurrence disc ussions and focal point assemblys to collect data components on the workplace performances. Is the RS system integrated into the organizations strategic management system? If so, how? If not, how would you describe the relationship between the two systems? The recruitment selection process is integrated into the organizations strategic management system by To what extent does RS abide by human rights principles at each stage of the process? Be specific. At each step of the recruitment selection process human rights principles are abided by strictly because it is very important to maintain ethics and local and national legislation. We always make sure that we never exclude anyone before they have had a chance to qualify on their own merits. We are an equal opportunity employer and are open to hiring any individual for any position as long as they qualify for the position. In what other ways could the RS process be evaluated either positively or negatively? The way that the recruitment selection process can be evaluated positively is when there is leadership through the employees that have been with the company a lot longer than the newer employees this provides a means of advancement for all in the company. Happy employees are a sign that the recruitment and selection process is working. Leadership should be a process by where the elder employed employees are positively supporting, influencing and motivating the other workers. These leaders could be members in a position of power such as managers or supervisors or they can be their own fellow workers. This should lead to employees working passionately and efficiently towards achieving the workplace endeavors and purposes. The workplace leaders behave as the ones who identify the potential of a worker and try to put that into actuality. A leader can be a positive leader or a negative leader which could upset the whole of the workplace or bring it to a place of achieving goals. Workers a re performing at high standards and understanding and achieving much in the workplace. The leaders influence within an organization can be derived from two crucial sources which is that persons personal characteristics and their position or power within the given organization. These personality elements such as their knowledge base, their individual personality, their capacity to successfully work with others, and their established level of exertion. Positional power is derivative from the leaders position within our organization and the authority encouraged in their behavior. This is either directly or indirectly by the organizations controlling faction to make available either opportunities or restriction for their personal performance levels. The leaders responsibility is to use their positive influence to persuade and encourage individuals within the workplace to focus themselves regarding the achievement of the organizations objectives. There are differences that should be distinguished between leadership and management. The way that the recruitment selection process can be evaluated negatively is through counterproductive behavior within the workplace. Counterproductive actions can be seen as employee behavior that departs from the objective of our b usiness. These actions can be deliberate or accidental and result from an extensive sequence of fundamental rationales and incentives. The types of common counterproductive behavior with most observed assessments within the workplace are the following: job turnover, accidents, job performance, absenteeism, theft, violence, substance use, and sexual harassment. In light of the above issues, what recommendations would you make to improve the RS process in the organization? The recommendations that the recruitment selection process can be improved in the organization is through better testing methods that could be suited to each type of personality since not all test are accurate for each person. It would be important to make sure when hiring candidates that during the probation period that the new hires are regularly evaluated and let go if they are not reaching the company expectations. It may have been a lot of money to make this new hire but it will be well worth not keep a good employee if they are producing to the standards they should be. Make sure all incidents are reported from the start to management and make sure that management is doing something about these reported issues. If not then maybe management that is condoning these types of workplace behaviors needs to be looked at also. It is never alright to turn a blind eye to unsavory situations in the workplace in hopes of the events that are occurring will go away. It is best to be on top o f each and every event as it happens and that consequences are being given as needed. A happy and productive workplace is the goal of every business but we must all do our part to be successful in having this outcome. Having current employees fill out confidential questionnaires and surveys on how they feel working for our company and what changes they would like see put into place. Freuds Cases of Hysteria: Birth of Psychoanalysis Freuds Cases of Hysteria: Birth of Psychoanalysis Abstract This thesis returns to the original case histories that Freud wrote on the patients he treated for hysteria. Here in these early works, the beginnings of psychoanalytical theory take shape in the acceptance of purely psychological theories of hysteria. Catharsis leads to the first inklings of repression which requires the use of free association, which again leads into Freuds attempt to explain the strange neuroses he sees through seduction theory, which is again transformed as his thinking moves on. Through Anna O, Frau Emmy von N. and Dora, Freud discovered the seeds of what would become his all-encompassing theory of the human psyche. Modern reinterpretations (e.g. Rosenbaum Muroff, 1984) of those early cases that form the basis of modern psychoanalysis have come and gone, but the original texts remain as historical testament to the fermenting of those fundamental ideas. Introduction Hysteria has been a hugely popular subject for research in psychoanalysis and in the history of ideas. Its roots are clearly signalled by the Greek word from which the word comes: uterus. Indeed the uterus was seen by Egyptians as a mobile organism that could move about of its own will when it chose to do so this caused the disturbances only seen (or acknowledged) in women. Treatments for this disease included trying to entice the uterus back into the body with the use of attractive-smelling substances as well as the driving down of the uterus from above by the eating of noxious substances. Just under four thousand years later, the formulation and treatment of hysterics had barely improved. The history of hysteria shows how it has often been seen as a physical disorder, rather than a mental one. Borossa (2001) describes some of the most common symptoms of hysteria as involving paralysis of the limbs, coughing, fainting, the loss of speech and parallel to this the sudden proficiency in another language. The change of viewpoint that lead up to Freuds analysis was slow in coming, and, as Bernheimer (1985) describes, only showed the first signs of changing in the seventeenth century with the first questions being raised that perhaps hysteria had its origins in a mental disturbance of some kind. Antecedent to Freuds interest in hysteria, it was the clinical neurologist, Charcot, who had a great influence on the field and accepted, by his methods, a more psychological explanation. Although sexual factors had long been implicated in the aetiology of hysteria (Ellenberger, 1970), Charcot did not agree that they were a sine qua non although he did maintain that they played an important part. He treated patients using a form of hypnosis and eventually his formulation of how hysteria was produced and treated was closely intertwined with the hypnosis itself. It was this use of hypnosis that interested Freud and it was the implication of sexual factors in hysteria that was eventually to become influential. It seemed that hysteria and hypnosis might offer Freud the chance to investigate the link between mind and body (Schoenwald, 1956). Anna O: The First Psychoanalytical Patient The literature often describes Anna O as the first ever patient of psychoanalysis. As it is notoriously difficult to define precisely what psychoanalysis might mean because of its shifting nature through time, this is a claim that is clearly interpretational. Still, the fact that this claim is made raises the interest into precisely what it was that marked out Anna Os treatment and the theories accompanying it from what had gone before. Although Anna O was not a patient of Freud, but a patient of his close colleague at the time, Joseph Breuer, he took a great interest in her case and its treatment, and from it flowed some of the foundational aspects of psychoanalysis both through the analysis of this case and Freuds reaction and reinterpretation of it. One of the reasons that Freud was interested in Anna O was that she represented an extremely unusual case of hysteria. Anna O had first been taken ill while she had been taking care of her dying father. At first she suffered from a harsh cough which soon expanded into a range of other perplexing symptoms. Freud Breuer (1991) describe these symptoms as going through four separate stages. The first stage, the latent incubation, occurred while she was nursing her dying father she had become weak, was not eating and would spend much of the afternoons sleeping, which was then unexpectedly followed by a period of excited activity in the evenings. The second stage, which had begun around the time Breuer started treating her, contained a strange confluence of symptoms. Her vision was affected by a squint, she could no longer move any of the extremities on the right side of her body. The third stage, which roughly coincided with the death of her father, heralded alternating states of somnam bulism with relative normality. The fourth stage, according to Breuer, is the slow leaking away of these symptoms up until June 1882, almost two years after she had first come to see her physician. The question is, how had these symptoms been interpreted and what had Breuer done in claiming to effect a cure? It is in the case of Anna O that the most basic elements of a new talking cure can be seen. As told by Breuer, it is a treatment that grew organically, as if by its own power, as he continued to see the patient. Often, in the afternoons, when the patient would habitually fall into an auto-hypnotic state, she would utter odd words or phrases, which, when questioned by those around her, would become elaborated into stories, sometimes taking the form of fairytales. These stories told to Breuer, changed in character over the period of Anna Os treatment, moving from those that were light and poetic, through to those that contained dark and frightening imagery. The unusual thing about these stories was that after they were told, it was as though a demon had been released from the patient and she became calmer and open to reason, cheerful even, often for a period of twenty-four hours afterwards. There seemed to be, staring Breuer in the face, some kind of connection between the stories that Anna O told him and the symptoms which she was manifesting. It was here that Freud was to find the roots of a purely psychological explanation of hysteria. Breuer describes numerous examples of this connection. On one occasion Anna O appeared to be suffering from an uncontrollable thirst and was given to demanding water, although when it was brought, she would refuse to touch it. After six weeks of this continuing, one day, again in an auto-hypnotic state, she started to tell a story about a friend who had allowed her dog to drink out of a glass. This had apparently caused the patient considerable distress and seemed to have led to pent-up anger, which was expressed on this occasion to Breuer. Afterwards Breuer was surprised to find that her previous craving and then abhorrence of water had disappeared. Other similar connections between symptoms and a story told by the patient were also s een by Breuer so that eventually he came up with the theory that the patient could be cured systematically by going through the symptoms to find the event that had caused their onset. Once the event had been described, as long as it was with sufficient emotional vigour, the patient would show remission of that symptom. It was by this method that Breuer claimed to have effected a cure of Anna O over the period of the treatment. It is from this case, although not in the immediate reporting by Breuer, that some of the most fundamental principles of psychoanalysis begin to form. An element of the story that has now passed into psychoanalytic legend, with some accepting its truth while others rejecting it, provides a more dramatic ending to the therapeutic relationship than that presented by Breuer. According to Freud (1970) in his letters, he pieced together an alternative account of what had happened at the end of Anna Os therapy. According to Freud, Breuer had been treating Anna O in the way he had discovered, as previously described, and had finally reached the point where her symptoms had been removed. Later that day he was called back to his patient to find her in considerable apparent pain in her abdomen. When she was asked what was wrong she replied that, Dr. Bs child is coming! This immediately sent Breuer away from her at the highest speed as he was not able to cope with this new revelation. He then p assed her onto a colleague for further treatment as he had already realised that his wife was jealous of his treatment of Anna O and this new revelation only compounded the problem. Forrester (1990) draws attention to the fact that Breuer acknowledged the importance of sexuality in the causes of neuroses. But despite this, he backed away from Anna Os case as soon as it came to the surface. As Forrester (1990) points out, Freud sees this as Breuers mistake and sees in it the birth of a psychoanalysis, especially one of its most important aspects: transference, and more specifically: sexual transference. Through the way that Breuer describes Anna Os progress in his new type of therapy, the path which the theory of hysteria and its treatment takes gradually emerges. Although Anna Os case was reported later it was Breuer Freud (1893) that used her case as the basis for their theory of hysteria. Breuer Freud (1893) state that they believe that the symptoms of hysteria have, at their root cause, some kind of causal event, perhaps occurring many years before the symptoms expose themselves. The patient is unlikely to easily reveal what this event is simply because they are not consciously aware of what it is, or that there is a causal connection. They are not worried by the seeming disproportionate nature of the precipitating event and subsequent symptoms. In fact they welcome this disproportionate nature as a defining characteristic of hysteria. Their analysis likens the root cause, or pathogenesis, of hysteria to that caused by a traumatic neurosis    perhaps similar to what we would now call post-traumatic stress disorder. The patient has, therefore, suffered a psychical trauma that manifests itself in this hysteria. The idea that the psychical trauma simply has a precipitating effect on the symptoms is dismissed by the authors referring to the evidence they have from the case studies of the remarkable progress their patients made after the memory of the psychical trauma has been exorcised through its explication and re-experiencing. Importantly, in defining the problem, Breuer Freud (1893) see the symptoms as a kind of failure of reaction to the original event. The memory of the event can only fade if the reaction to that event has not been suppressed. And it is here that there is a clear precursor to ideas central to later Freudian theory about the nature and causes of repression. In normal reactions to psychical traumas, the authors talk of a cathartic effect resulting in a release of the energy. The reverse of this, the suppression of catharsis (Freeman, 1972), is seen here as the cause of the symptoms adequately evidenced by the new treatment of a kind of delayed catharsis that appears to release the patient from their symptoms. What, then, are the mechanisms by which a psychical trauma of some kind is not reacted to sufficiently? Two answers are provided here, the first that because of the circumstances of the trauma, it was not possible to form a reaction in other words the reactions is suppressed. The second is that a reaction may not have been possible due to the mental state of the person at that time for example during a period of paralysing fear. The circumstances in which the failure of a reaction occurs is also instrumental in the burying of these thoughts and feelings and helps to explain why the patient themselves is not able to access them in the normal ways. Frau Emmy von N. Freuds interest in hysteria and in hypnosis was certainly piqued by both Charcot and Breuer and having collaborated on the latters work with Anna O including the belief that he had found a theory of practical benefit it was only a matter of time before he became further involved in the treatment of hysteria himself. Reported as the second case history in The Studies on Hysteria, (Breuer Freud, 1991) a patient of Freuds, Frau Emmy von N., exhibited symptoms that typified hysteria and Freud resolved to treat her. He reports that the patient was 40 years old, was from a good family and of high education and intelligence. She had been widowed at a young age, leaving her to look after her two children this she ascribed as the cause of her current malady. Freud describes her first meeting as being continually interrupted by the patient breaking off, and suddenly displaying signs of disgust and horror on her face while telling him to, Keep still! and other similar remonstrations. Apart from this the patient also had a series of tics, some facial, but the most pronounced being a clacking sound which littered her utterances. Freuds initial treatment was more physical than mental. She was told to take warm baths and be given massages. This was combined with hypnosis in which Freud simply suggested that she sleep well and that her symptoms would lessen. This was helped by the fact that Freud reports that Frau Emmy von N. was an extremely good hypnotic subject he only had to raise his finger and make a few simple suggestions to put her into a trance. Freud wonders whether this compliance is due to previous exposure to hypnosis and a desire to please. A week later Freud asked his patient why she was so easily frightened. She replied with a story about a traumatic experience that had occurred when she was younger her older brothers and sisters had thrown dead animals at her. As she described these stories to Freud, he reports that she was, panting for breath as well as displaying obvious difficulty with the emotions that she was dealing with. After these emotions have been expressed, she became calmer and more peaceful. Freud also uses touch to reinforce his suggestion that these unnerving images have been removed. Under hypnosis, Freud continued to elicit these stories that demonstrated why she was so often nervous. She explained to Freud that she had once had a maidservant who told her stories of life in an asylum including beatings and patients being tied to chairs. Freud then explained to her that this was not the usual situation in asylums. She had also apparently seen hallucinations at one point, seeing the same person in tw o places and being transfixed by it. While she had been nursing her dying brother, who was taking large quantities of morphine for the pain he was in, he would frequently grab her suddenly. Freud saw this as part of a pattern of her being seized against her will and resolved to investigate it further. It was a few days after this that quite a significant point in the therapy came. Emmy von N. was again explaining about the frightening stories of the asylum and Freud stopped himself from correcting her, intuitively realising that he had to let her give full vent to her fears, without redirecting her course. This is perhaps a turning point in the way in which Freud treated his patient, made clearer by the historical context in which this scene operates. While still seen as authority figures now, physicians were much stronger authority figures then. This combined with the greater imbalance of power between men and women would have meant that the patient would be naturally hesitant about taking any control over their own treatment. Forrester (1990) sees this as a shift in the pattern of authority between the doctor and the patient that originated in Breuers treatment of Anna O a move from the telling the patient what to do, to listening to what the patient has to say. Forrester (1990 ) constructs the relationship that Freud began to build with Emmy von N. as more of a framework of authority within which the patient was able to express her thoughts and feelings to the doctor and in this sense the doctors job is to help the patient keep up this outpouring of stories. At this stage of the development of the therapy, the facilitation of the story-telling is being achieved by hypnosis, although later Freud was to move away from this. How great the shift in the power balance was, it is difficult to tell a this distance, but what is clear from the case report is that Emmy von N.s case provided a much more convoluted series of psychical traumas and symptoms than that presented by Anna O. While Anna Os symptoms seemed to match the traumatic events rather neatly, Emmy von Ns mind was not nearly as well organised. At one point Freud discovers that taking the lift to his office causes his patient a considerable amount of stress. To try and examine where this comes from he explores whether she has had any previous traumatic experiences in lifts a logical first step within the theoretical framework. Coincidentally, it appears, the patient mentions that she is very worried about her daughter in relation to elevators. The next logical step then should be that talking about this fear should release the affect and lead to catharsis, but this is not what Freud finds. The next part of the puzzle is revealed when he finds out t hat she is currently menstruating, then finally the last part falls into place when he finds out that as her daughter has been suffering ovarian problems, she has had to travel in a lift in order to meet with her doctor. After some deliberation Freud realises that there is in fact a false connection between the patients menstruation and the worry at her daughter using a lift. It is this confusion of connections that Freud begins to realise is a form of defence to the traumatic thoughts. Freuds Treatment of Hysteria In the final part of Studies in Hysteria Freud sets out his theory of hysteria and what he has learnt about its treatment. Not only does this part of the book recap some of the themes already discussed but it also highlights some future direction in which Freuds work would travel. Two key signposts are seen: first in his stance on hypnotism, and secondly in his view on what constitutes hysteria. In an attempt to be of benefit to patients with hysteria, who he believed this treatment would help, he tried to treat as many as possible. The problem for him was how to tell the difference between a patient with hysteria and one without. Freud chose an interesting solution to what might have been a protracted problem of diagnosis. He simply treated patients who seemed   to have hysteria and let the results of that treatment speak for themselves. What this immediately did was to widen out the object of his enquiry to neuroses in general. Picking up on the lightly touched theme of sexual tr ansference between Breuer and Anna O mentioned earlier, Freud made his feelings about the roots of neurotic problems quite clear, and in the process set the agenda for psychoanalysis for the next century or more. He believed that one of the primal factors in neuroses lay in sexual matters. In particular Freud came to acknowledge that peoples neuroses rarely came in a pure form, as the early and almost impossibly neat case of Anna O had signposted, and that in fact people were more of a mixed bag. Looking back through the cases reported in Studies on Hysteria Freud explains that he came to see a sexual undercurrent in his notes that had not been at the forefront of his mind when he had treated the patients. Especially in the case of Anna O as already noted Freud felt Breuer had missed a trick. What these ideas seem to be adding up to is almost a rejection of hysteria, if not as a separate diagnosis, certainly as a category of disease practically amenable to treatment. Freud, however, is defensive about rejecting the idea of hysteria as a separate diagnosis, despite the fact that that is the direction in which his thoughts are heading. At this stage he believes it can be treated as a separate part of a patients range of symptoms and the effect of this treatment will be governed by its relative importance overall. Those patients, like Anna O, who have relatively pure cases of hysteria will respond well to the cathartic treatment, while those diluted cases will not. The second key signpost for the future of psychoanalysis was Freuds use of hypnosis. What he found was that many of the patients he saw were simply not hypnotisable Freud claims unwillingness on their part but other writers are of the opinion that he was simply not that good at it (Forrester, 1990). This was a problem for Freud because Breuers formulation of the treatment for hysteria required that events were recollected that were not normally available to a person. Hypnosis had originally proved a good method and indeed in Anna Os case the only method for gaining access to these past events. In response, Freud now turned away from hypnosis to develop his own techniques for eliciting the patients traumatic events. These were quite simple: he insisted that the patient remember what the traumatic event was, and if they still could not, he would ask the patient to lie down and close their eyes nowadays one of the archetypal images of patient and analyst. Freud saw the patients relu ctance of his patients to report their traumatic events as a one of the biggest hurdles in his coalescing form of therapy. He came up with the idea that there was some psychical force within the patient that stopped the memories from being retrieved. From the patients he had treated, he had found that the memories that were being held back were often of an embarrassing or shameful nature. If was for this reason that the patient was activating psychical defence mechanisms. At this stage he hoped to be able to show in the future that it was this defence or repulsion of the traumatic event to the depths of the memory that was causing so much psychical pain to the patient. Overcoming this psychical force, Freud found, was not as simple as insisting, and he developed some further techniques. Patients would easily drift off their point or simply dry up and it needed more powerful persuasion to return them to the traumatic event. One particular technique he found extremely useful and would almost invariably use it when treating patients. This involved placing his hand on the patients head and instructing them that when they feel the pressure they will also see an image of their traumatic event. Having assured the patient that whatever they see, they should not worry that this image is inappropriate or too shameful to discuss, then they are asked to attempt a description of the image. Freud believed that this system worked by distracting the patient, in a similar way as hypnosis, from their conscious searching for the psychical trauma and allowed their mind to float free. Even using the new technique of applying pressure, it did not provide direct access to the psychical trauma. What Freud found was that it tended to signal a jumping off point or a way-station, somewhere on the way to or from the trauma. Sometimes the image produced would provide a new starting point from which the patient could work, sometimes it fitted into the flow of the subject of discussion. Occasionally the new image would bring a long-forgotten idea to the patients mind which would surprise them and initially seem to be unrelated, but later turn out to have a connection. Freud was so pleased with his new pressure technique that, in complex cases, he would often use it continuously on the patient. This procedure would bring to light memories that had been hitherto completely forgotten, as well as new connections between these memories and even, sometimes, thoughts that the patient doesnt even believe to be their own. Freud is careful to point out that although his pressure technique was useful, there were a number of very strong forms of defence that stopped him gaining easy access to the patients psychical trauma. He often found that in the first instance, applying pressure by his hand to the patient would not work, but when he insisted to the patient that it would work the next time, it often would. Still, the patient would sometimes immediately reinterpret or, indeed, begin to edit what was seen, thus making the reporting much less useful. Freud makes it clear that sometimes the most useful observations or memories of the patient are those that they consider to be of least use or relevance. Also, the memories will tend to emerge in a haphazard fashion, only later, and with the skill of the analyst, being fitted together into a coherent picture. Freud refers to this as a kind of censoring of the traumatic events, as though it can only be glimpsed in a mirror or partially occluded around a corne r. Slowly but sure the analyst begins to build up a picture with the accretion of material. There is nothing, Freud believed that is not relevant every piece of information is a link in the chain, another clue to the event that has traumatised the psyche. Another major component of psychoanalysis makes its first appearance in the Studies on Hysteria. Freud describes a final defence or block against the work of treating hysteria in the very relationship between the patient and doctor. Indeed, Freud sees this defence is sure to arise, and perhaps the most difficult defence of all to overcome. The first of the three circumstances in which it may arise is a simple, probably small, breakdown in the relationship between the physician and patient. It might be that the patient is unsure about the physicians techniques or alternatively has felt slighted in the treatment in some way. This can be rectified with a sensitive discussion. The second of the three circumstances occurs when the patient becomes fearful that they will lose their independence because of a reliance on their treating physician. As almost all of Freuds patients who had hysteria were women, this could be conceived as a sexual reliance. The third circumstance is where the pati ent begins to take the problem that they are trying to resolve and transfer it onto the physician, thereby seeing their problem there instead of where it really exists. Freud provides the straightforward example of the sexual transference of a female patient of his who suddenly developed the vision of kissing him. He reports that the patient could not be analysed any further until this block had been addressed. The mechanism by which this transference happens, he posits, is that the patient creates a false connection between the compulsion which is the basis for their treatment and the therapist, rather than its original recipient. In treating these defences Freud makes it clear that the main aim should be to make the patient aware that this problem exists, and then once they are aware of it, the problem is largely dealt with. The challenge, then, is getting the patient to admit to these potentially embarrassing feelings. The Aetiology of Hysteria The development of Freuds theory of the aetiology of hysteria provides one of the most insightful, and sometimes controversial, areas of his work. The formation of the theory, like the work on its treatment, provided another important testing ground for some of the basic elements of what would later become psychoanalysis. Previous authors, including Breuer in the joint work with Freud in Studies on Hysteria, gave great weight to the heredity factors in the causes of hysteria. Freud meanwhile acknowledged these ideas, but in Heredity and the Aetiology of the Neuroses (Freud, 1896b) set out the three factors he believed were important and began to formulate a new theory. The causes of hysteria could be broken down into: (1) Preconditions this would include hereditary factors, (2) concurrent causes which are generalised causes and (3) specific causes, these being specific to the hysteria itself. It is in these specific causes he believed he had found an important contribution to aetiology of the condition. One of the common factors of the patients Freud was seeing, and the one he was coming to see as defining, was in their sexual problems. He reports that while many suffered from a range of different symptoms such as constipation, dyspepsia and fatigue, almost all of them had some kind of sexual problems. These ranged from the inability to achieve orgasm to a more general inability to have a satisfying sexually relationship. Freud saw this as a very significant problem as he maintains that the nervous systems needs to be regularly purged of sexual tension. This pattern across his patients, and the development of his theory of traumatic psychical events, led him to wonder what past events could have caused the sexual dysfunction the patients with hysteria were manifesting. Radically, and expecting no small amount of opposition to the idea, Freud advanced the theory that these neuroses were caused by sexual abuse before the age of sexual maturity. Of the thirteen cases that Freud had tre ated at the time of the paper, all of them had been subject to sexual abuse at an early age. However, Freud does make it clear that the information about their sexual lives is not obtained without some considerable pressure, and it only emerges in a fragmentary way that has later to be pieced together by the therapist. At this early stage of the theory, Freud believed that the sexual abuse left a psychical trace and formed the traumatic experience which was locked away in the depths of the mind. These ideas were much further developed and expanded on in Further remarks on the neuro-psychoses of defence (Freud, 1896a). Earlier Freud had grouped together hysteria with hallucinatory states and obsessions (Freud, 1894) and had begun to formulate the idea that all of these conditions had a common aetiology. In particular, Freud felt these were all part of an area where the ideas of psychological defences and psychological repression were important. Freud had found that patients he had seen had suffered sexual abuse sometimes as early as two years old and up to the age of ten, which he drew as an artificial cut-off point. What other theorists saw as a heredity, Freud saw as the confluence of factors for example if a boy had been sexually abused when he was five then it was likely that his brother would have been abused by the same person. Rather than seeing heredity as a separate factor in hysteria, he saw the sexual abuse as a replacement for heredity, sometimes exclusively, as the root cause in itself. The theory shows an interesting divergence in the analysis of obsessional neuroses. Here, Freud believed that the obsessional neuroses were caused by a sexual activity   in childhood rather than the sexual passivity typical of abuse. These ideas linked in neatly to the greater preponderance of obsessional neuroses in males. A logical division is therefore made with the females, the apparently more passive sex suffering from hysteria, while the apparently more active sex suffering from obsessions. In searching for the aetiology of these two conditions, it is here that Freud prefigures his future thinking on stages of sexual development by introducing the idea that the development of neuroses and/or hysteria is/are dependent on when the sexual abuse occurs in the developmental stages of the child, with sexual maturation providing the cut-off point. In The Aetiology of Hysteria Freud again makes clear his divergence from his mentor, Charcot, in claiming that heredity is not the most important factor in the aetiology of hysteria (Freud 1896c). Freud (1896c) travels back through the life-histories of the patients he has treated looking for the original source of the psychical trauma, discounting all sexual experiences at puberty and later. It is only in pre-pubescent children, when the potential for harm is at its greatest that there lies a sufficient cause. Freuds theory revolves around the idea that at a