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Title: Collected papers, Volume II
Author: Sigmund Freud
Editor: Ernest Jones
Translator: Joan Riviere
Release date: October 28, 2026 [eBook #79872]
Language: English
Original publication: London: Hogarth Press, 1924
Other information and formats: www.gutenberg.org/ebooks/79872
Credits: Stephen M. Kraus at https://readfreud.org/ (This file was produced from images generously made available by The Internet Archive)
*** START OF THE PROJECT GUTENBERG EBOOK COLLECTED PAPERS, VOLUME II ***
THE INTERNATIONAL
PSYCHO-ANALYTICAL
LIBRARY
EDITED BY ERNEST JONES
No. 8
----------------------------------------------------------------------
THE INTERNATIONAL PSYCHO-ANALYTICAL LIBRARY
No. 8.
COLLECTED PAPERS
VOL. II
BY
SIGM. FREUD, M.D., LL.D.
*
AUTHORIZED TRANSLATION
UNDER THE SUPERVISION OF
JOAN RIVIERE
PUBLISHED BY LEONARD & VIRGINIA WOOLF AT THE
HOGARTH PRESS, 52 TAVISTOCK SQUARE, LONDON, W.C.
AND THE INSTITUTE OF PSYCHO-ANALYSIS
M C M X X I V
----------------------------------------------------------------------
COPYRIGHT 1924
_Printed in Great Britain by_ *R. & R. Clark, Limited,* _Edinburgh._
----------------------------------------------------------------------
COLLECTED PAPERS
VOL. II
CLINICAL PAPERS
PAPERS ON TECHNIQUE
----------------------------------------------------------------------
EDITORIAL PREFACE
In the regrouping of the *Collected Papers*, the present volume has
proved to be the most miscellaneous, and can indeed be termed
'Clinical' only _a potiori_. The word 'clinical', however, as the
present writer has expounded at length elsewhere, has greatly widened
in its meaning of late years, and has now come mainly to indicate a
certain characteristic mode of approach to various
problems---psychological, medical, and others.
The third, forthcoming volume will consist of five long case-histories
studied psycho-analytically, and is thus the most valuable as regards
actual clinical material. The fourth volume will contain a number of
papers on 'Metapsychology', together with most of those dealing with
the application of psycho-analysis to non-medical topics.
The present volume contains all the other papers written between 1906
and 1924. Many are purely clinical in the narrower sense, such as
Hysterical Phantasies, Types of Nosogenesis, Disposition to
Obsessional Neurosis, Case of Homosexuality in a Woman, etc.; others
concern matters of wider interest, such as the ascertainment of truth
in legal proceedings, the sexual enlightenment of children, children's
lying, etc., while the first application of psycho-analysis to the
study of character-development will also be found here.
A word should be said about two groups of papers which are more
homogeneous. The last four in the first section were written only this
year, 1924, and one of them has not yet even appeared in German;
Professor Freud, however, kindly supplied the manuscript of it to the
Institute for the purposes of this translation. These are all written
on the basis of his recent important brochure entitled _Das Ich und
Das Es_, of which a separate translation will shortly appear, and they
are so recondite that the reader is advised to postpone the study of
them until he is familiar with the contents of that book.
The second section contains all those papers relating directly to
Technique; six of them were published in a group in the _Zeitschrift_.
It should be pointed out, however, that they were in no sense intended
to form a comprehensive or consecutive exposition of the technique,
but merely deal with certain points arising in the course of
psycho-analytic treatment. In spite of several attempts, no completely
satisfying account of psycho-analytic technique has yet been
provided. Indeed, it is probable that, as with bacteriology and many
other disciplines, no written account of technique can do more than
supplement the only satisfactory method of acquiring it, namely,
first-hand study with someone who possesses a mastery over it.
We wish to express our gratitude to Fräulein Anna Freud for her
invaluable assistance in revising the translation.
----------------------------------------------------------------------
REFERENCES
All the references in the footnotes contain only the title, and in
some cases the date, of the book or paper referred to; further details
will in all cases be found at the end of this volume in the List of
Books and Papers referred to in the Text.
The following abbreviations are used in the footnotes and at the end
in the List of Books and Papers referred to:
1. _Imago_ = _Imago_, Vienna.
2. _Jahrbuch_ = _Jahrbuch für psychoanalytische und
psychopathologische Forschungen_, Vienna.
3. _Sammlung_ = Freud, _Sammlung kleiner Schriften zur Neurosenlehre_,
Vienna.
4. _Zeitschrift_ = _Internationale Zeitschrift für ärztliche
Psychoanalyse_, later called _Internationale Zeitschrift für
Psychoanalyse_, Vienna.
5. _Zentralblatt_ = _Zentralblatt für Psychoanalyse_, Vienna.
----------------------------------------------------------------------
CONTENTS OF VOLUME II
CLINICAL PAPERS PAGE
I. Psycho-Analysis and the Ascertaining of Truth in
Courts of Law (1906) . . . . . . . . . . 13
II. Obsessive Acts and Religious Practices (1907) . . . 25
III. The Sexual Enlightenment of Children (1907) . . . 36
IV. Character and Anal Erotism (1908) . . . . . . . 45
V. Hysterical Phantasies and their Relation to Bi-
sexuality (1908) . . . . . . . . . . . 51
VI. On the Sexual Theories of Children (1908) . . . . 59
VII. ‘Civilized’ Sexual Morality and Modern Nervous-
ness (1908) . . . . . . . . . . . . . 76
VIII. General Remarks on Hysterical Attacks (1909) . . . 100
IX. Psychogenic Visual Disturbance according to
Psycho-Analytical Conceptions (1910) . . . . 105
X. Types of Neurotic Nosogenesis (1912) . . . . . . 113
XI. The Predisposition to Obsessional Neurosis (1913) . 122
XII. A Dream which bore Testimony (1913) . . . . . . 133
XIII. Infantile Mental Life (1913) . . . . . . . . 144
XIV. A Case of Paranoia running counter to the Psycho-
Analytical Theory of the Disease (1915) . . . 150
XV. A Connection between a Symbol and a Symptom
(1916) . . . . . . . . . . . . . . 162
XVI. On the Transformation of Instincts with special
reference to Anal Erotism (1916) . . . . . . 164
XVII. ‘A Child is being Beaten’. A Contribution to the
Study of the Origin of Sexual Perversions (1919) 172
XVIII. The Psychogenesis of a case of Homosexuality in a
Woman (1920) . . . . . . . . . . . . 202
XIX. Certain Neurotic Mechanisms in Jealousy, Paranoia
and Homosexuality (1922) . . . . . . . . 232
XX. The Infantile Genital Organization of the Libido
(1923) . . . . . . . . . . . . . . 244
XXI. Neurosis and Psychosis (1924) . . . . . . . . 250
XXII. The Economic Problem in Masochism (1924) . . . . 255
XXIII. The Passing of the Oedipus-Complex (1924) . . . . 269
XXIV. The Loss of Reality in Neurosis and Psychosis (1924) 277
PAPERS ON TECHNIQUE
XXV. The Future Prospects of Psycho-Analytic Therapy
(1910) . . . . . . . . . . . . . . 285
XXVI. Observations on ‘Wild’ Psycho-Analysis (1910) . . . 297
XXVII. The Employment of Dream-Interpretation in
Psycho-Analysis (1912) . . . . . . . . . 305
XXVIII. The Dynamics of the Transference (1912) . . . . . 312
XXIX. Recommendations for Physicians on the Psycho-
Analytic Method of Treatment (1912) . . . . . 323
XXX. Fausse Reconnaissance (‘Déjà Raconté’) in Psycho-
Analytic Treatment (1913) . . . . . . . . 334
XXXI. Further Recommendations in the Technique of
Psycho-Analysis. On Beginning the Treat-
ment. The Question of the First Communica-
tions. The Dynamics of the Cure (1913) . . . . 342
XXXII. Further Recommendations in the Technique of
Psycho-Analysis. Recollection, Repetition and
Working Through (1914) . . . . . . . . . 366
XXXIII. Further Recommendations in the Technique of
Psycho-Analysis. Observations on Transfer-
ence-Love (1915) . . . . . . . . . . . 377
XXXIV. Turnings in the Ways of Psycho-Analytic Therapy
(1919) . . . . . . . . . . . . . . 392
----------------------------------------------------------------------
CLINICAL PAPERS {11}
----------------------------------------------------------------------
I {13}
PSYCHO-ANALYSIS AND THE ASCERTAINING
OF TRUTH IN COURTS OF LAW[1]
(1906)
There is a growing recognition of the untrustworthiness of
statements made by witnesses, at present the basis of so many
judgements in Courts of Law; and this has quickened in all of you, who
are to become judges and advocates, an interest in a new method of
investigation, the purpose of which is to lead the accused person to
establish his own guilt or innocence objectively. This method is of a
psychological and experimental character, and is based upon
psychological research; it is closely connected with certain views
which have only recently been propounded in medical psychology. I
understand that you are already engaged in testing the utility and
bearing of this new method by means of what one might call 'mock
trials', and I have gladly accepted the invitation of your President,
Professor Löffler, to explain to you more fully the relation of this
method to psychology.
You are all acquainted with the game played at parties, where a word
is called out at random and someone has to add a second word forming a
compound with the first---for example, 'steam', 'ship', giving the
compound word 'steam-ship'. It is nothing more than a modification of
this children's game which the Wundt school has introduced into
psychology under the name of 'association test', and it omits only one
{14} rule of the game. The experiment is as follows: a word (termed
the 'stimulus-word') is called out to the subject, and he replies as
quickly as possible with some other word that occurs to him (the
so-called 'reaction'), his choice of this reaction not being
restricted in any way. The points to be specially observed are the
_time_ required for this reaction, and the very variable _relation_ of
the stimulus-word to the reaction-word. Now it cannot be claimed that
much fresh knowledge was gained as the immediate result of these
experiments. This was to be expected, however, since they were carried
out without any decided aim in view, and without any guiding principle
which could be brought to bear on the results. The experiments only
became significant and fruitful when Bleuler in Zurich and his pupils,
especially Jung, began to pay attention to 'association tests'. Their
experiments acquired practical value when the hypothesis was applied
that the connection between the stimulus-word and the reaction-word
could not be one of chance, but must be determined by a pre-existing
group of ideas in the mind of the person reacting.
It has become customary to call a group of ideas of this kind, having
an influence on the reaction to the stimulus-word, a 'complex'. The
influence works either by the stimulus-word actually touching a
complex directly or by the complex succeeding in getting into touch
with the word by intermediate links. This determination of the
reaction is a very remarkable fact, as you can see by the undisguised
amazement expressed in the literature on the subject. The truth of it
admits of no doubt, however; for as a rule you can lay bare the
particular complex at work by asking the subject of the experiment to
give the reasons for his reaction, and so explain a reaction which
could not otherwise be understood. Examples like those given by Jung,
on pp. 6 and 8--9 of his treatise,[2] are well {15} suited to make us
doubt the existence of chance and of what appears to be arbitrariness
in mental processes.
Let us consider for a moment the early history of the view put forward
by Bleuler and Jung, namely, that these reactions are determined by
complexes in the mind of the subject. In 1901 I published a work[3] in
which I pointed out that a whole series of actions previously held to
be due to chance were on the contrary strictly determined, and to that
extent I have therefore contributed towards circumscribing the field
of mental free will. I took as examples slight slips of memory, tongue
or pen, and the mislaying of objects. I showed that when someone makes
a slip of the tongue it is not chance, nor difficulty in articulation
either, nor similarity in sound that is responsible; but that in every
case a disturbing group of ideas---a complex---can be brought to light
which alters the meaning of the intended speech under the guise of an
apparent slip of the tongue. Further, I took for consideration
people's little actions that are apparently purposeless and due to
chance---their petty habits of playing, fiddling with things and so
on---and revealed them as 'symptomatic actions' connected with a
hidden meaning and intended to give this hidden meaning unobtrusive
expression. I found, moreover, that even a Christian name cannot occur
to the mind by chance, but must have been determined by a powerful
complex; and that the numbers that one may think one chooses
arbitrarily can be traced to the influence of such a hidden complex. A
few years later a colleague of mine, Dr. Alfred Adler, was able to
substantiate this most astonishing statement of mine by some very
striking examples.[4] Once one has accustomed oneself to such a
conception of determinism in mental processes it is a justifiable
deduction, drawn from the study of the psychopathology of everyday
life, that the {16} associations given by a person under experimental
conditions are not arbitrary but are conditioned by the operation of
an idea in his mind.
Now let us return to the association test. In the kind of experiment
we have already referred to, it is the subject under examination who
gives us the origin of his reactions, and this fact has made these
experiments somewhat unprofitable from the point of view of legal
cases. But might we not change the order of things, somewhat as in an
equation with several unknowns which can be solved by interchanging
one or the other (taking either the _a_ or the _b_ as the _x_ we are
seeking)? Up to now in our experiments the complex has been unknown to
us. We tested with any chance stimulus-word, and the subject under
examination revealed the complex which was brought to expression by
means of this word. Suppose we reverse the process. Suppose we start
with some known complex, take chosen words with which to stimulate
reactions in the subject, and put _x_ in the mind of the subject
himself. Is it possible on this basis thus to decide whether the known
complex is present in the subject under examination, by a study of the
associations given as reactions? You observe that this method of
enquiry corresponds exactly with that adopted by an examining judge
who wishes to discover whether an acknowledged fact of which he is
aware is also known to the accused in the rôle of perpetrator. It
seems that Wertheimer and Klein, two pupils of Hans Gross, the
Professor of Criminal Law in Prague, were the first[5] to put into
practice this change in the methods of investigation, a most important
change from your point of view.
You know already from your own experience that in such investigations
several points in the reactions help to decide whether the subject
under examination possesses a complex which you are testing with your
stimulus-word. I will enumerate them for you in {17} order. (1) An
unusual content in the reaction which requires explanation. (2)
Increase of reaction-time, for stimulus-words which have touched the
complex are reacted to after considerable delay (the delay may be
several times longer than the normal reaction-time). (3) Faulty
reproduction. You know what remarkable fact is meant by this. When a
longish series of stimulus-words is repeated after a short interval,
the subject will give the same reactions except where the
stimulus-word has touched a complex, and then another reaction will
often be substituted. (4) Perseveration (or perhaps better
'after-effects'). It often happens that the action of the complex
which has been awakened through an effective ('critical') stimulus
continues after that word has been passed and changes the reactions
(_e.g._ by lengthening the reaction-time) to the non-critical stimuli
which follow immediately after. When all or several of these signs are
simultaneously present it proves that the complex known to us is
present as a disturbing element in the mind of the person under
examination. The disturbance is attributed to the fact that the
complex present in the mind of the subject is charged with feeling,
and enabled to distract his attention from the task of reacting. This
irregularity is regarded as a 'mental betrayal'.
I know that you are at the moment concerned with the potentialities
and pitfalls of this experimental technique, the aim of which is to
lead the accused to betray himself objectively. I would therefore draw
your attention to the fact that an exactly similar method of
discovering hidden material in the mind has been practised for more
than a decade in a very different field of investigation. It is my
purpose to lay before you the points of resemblance and difference in
the two cases.
This field is indeed a very different one from yours. I refer to the
therapy for certain nervous complaints, the so-called psychoneuroses,
of which hysteria and obsessions may be taken as examples. In this
case {18} the method is called psycho-analysis; it was evolved by me
from the 'cathartic' method of therapeutics first practised by Breuer
in Vienna.[6] To allay your surprise I must work out an analogy
between the criminal and the hysteric. In both we are concerned with a
secret, with something hidden. But in order that I may not appear
paradoxical, I must point out the difference at once. In the case of
the criminal it is a secret which he knows and hides from you, but in
the case of the hysteric it is a secret hidden from him, a secret he
himself does not know. How is this possible? Now, through laborious
investigations, we know that all these illnesses are the result of the
patient having succeeded in repressing certain ideas charged with
strong feeling, together with the wishes that arise from them, in such
a way that they play no part in his deliberate thought-processes,
cannot enter into his conscious thoughts, and therefore remain unknown
to him. But from this repressed psychic material (complexes) are
generated the somatic and psychic symptoms, which plague the patient
just as a guilty conscience does. In this one point, therefore, the
difference between the criminal and the hysterical is fundamental.
The task of the therapeutist is, however, the same as the task of the
judge; he must discover the hidden psychic material. To do this we
have invented various methods of detection, some of which lawyers are
now going to imitate.
It will interest you, from the point of view of your own profession,
to hear how we physicians proceed in psycho-analysis. When the patient
has recapitulated his history for the first time, we ask him to be
completely passive and to allow all thoughts that occur to him free
expression without any selection, criticism or suppression on his
part. We start, as you see, with an assumption he does not in any way
share, that his thoughts are not arbitrary but are determined by {19}
their reaction to his secret complexes, and may be regarded to a
certain extent as derived from these complexes. You will note it is
the same assumption which helped us to arrive at the significance of
the association test. But although we have impressed upon the patient
the rule to communicate all his thoughts, he does not seem able to
keep to it. He holds back first this and then the other thought, and
gives various reasons to account for this, either that it is
unimportant or that it is irrelevant, or that it is quite
meaningless. We insist that he should communicate the thought in spite
of these objections and that he should follow it up; for this
criticism is precisely evidence to us that the thought belongs to the
'complex' which we are seeking. It is precisely in this attitude of
the patient that we recognize a manifestation of his 'resistance',
which will continue through the whole course of his treatment. I would
only indicate briefly that this conception of resistance has gained
the utmost significance for us in understanding the origin of the
illness as well as the mechanism of the healing process.
Now a similar attitude of criticism of associations does not occur
directly in your tests, whereas we are able in psycho-analysis to
observe all those striking signs of a 'complex' which you notice in
your tests. Even when the patient no longer ventures to evade the rule
which has been imposed upon him, we notice that sometimes,
nevertheless, he hesitates and stops, sometimes pauses in his flow of
ideas. Every hesitation of this kind is to us an expression of his
resistance and an indication of its relation to the 'complex'. Indeed,
for us it is the most important sign of such a significance, just as
for you the lengthening of reaction-time is a very important
indication. We are accustomed to interpret the hesitation in this
light even when the content of the idea held back seems to contain
nothing difficult, and when the patient assures us he cannot imagine
why he should hesitate to communicate it. {20} The pauses which occur
in psycho-analysis are as a rule many times longer than the delays
which you notice in reaction-tests.
The second of your complex-indicators, the alteration of the
reaction-content, also plays its part in the technique of
psycho-analysis. We are wont to regard even the smallest digressions
from the ordinary form of expression in our patients generally as a
sign of some hidden meaning; and for the time being we lay ourselves
open to the ridicule of the patient by such interpretations. We are
literally on the alert for remarks that hint at a double meaning, and
in which the hidden meaning glimmers through the harmless
expression. Not only patients, but colleagues ignorant of the
technique of psycho-analysis and its immediate bearings, are
incredulous and accuse us of petty jokes and of playing with words,
but we are nearly always in the right. After all, it is not difficult
to understand that the only way in which a carefully guarded secret
betrays itself is by distant, or at best by ambiguous, allusions. At
last the patient becomes accustomed to disclosing, by means of
so-called 'indirect representation', all we require in order to
discover the complex.
The third of your complex-indicators, that of error in reproduction
(such as you observe when something repeated a second time shows a
discrepancy with the first), is also made use of in a narrower field
in the technique of psycho-analysis. One task which is often set us is
the interpretation of dreams, _i.e._ the translation of the remembered
dream-content into its hidden meaning. It sometimes happens that we
are uncertain at which point to begin the task, and in this case we
make use of a rule discovered empirically, according to which we let
the dreamer recount his dream again. In doing so he usually changes
the expressions used in some parts whilst faithfully repeating the
rest. These points, in regard to which discrepancies arise in the two
accounts or which are omitted in the second telling, are the points to
which {21} we pay special attention; for the inaccuracy indicates that
the complex is being touched, and promises the best approach to the
secret meaning of the dream.[7]
You will not now suppose that the points of similarity are exhausted
when I state that a phenomenon corresponding exactly to perseveration
does not appear in psycho-analysis. This apparent difference only
arises from the particular conditions of your test. For you do not
allow the effect on the complex time to develop itself. It has
scarcely begun to act when you distract the attention of the subject
under examination by a new and probably harmless stimulus-word, and
then you may observe that the subject delays, being still occupied
with the complex in spite of your interference. On the other hand, in
psycho-analysis we avoid such interruptions, keeping the patient
occupied with his complex, and since in our method everything is, so
to speak, 'perseveration', we cannot observe the phenomenon as an
isolated occurrence.
We may claim that it is by means of this kind of technique that we, on
the whole, succeed in making the patient aware of what he has
repressed, of his secret, and thus in removing the psychological cause
of the symptom from which he is suffering. Before you draw any
conclusions as to the possibilities these successful results offer for
your profession, we will consider some points of difference in the
psychological situation in the two cases.
We have already pointed out the chief difference. With the neurotic,
the secret is hidden from his own consciousness; with the criminal it
is hidden only from you. In the first we have a genuine ignorance
(though not altogether complete), whilst in the latter this ignorance
is merely simulated. Connected with this is another difference more
important in practice. In psycho-analysis the patient consciously
helps to overcome his resistance because he expects to gain something
from the investigation---cure. The criminal, on {22} the contrary,
does not co-operate with you; he would be working against his whole
ego. As a compensation for this, however, you are only endeavouring to
arrive at a conviction objectively; whereas our therapy demands that
the patient himself should also arrive at the same conviction
subjectively. It remains to be seen, however, how far your
difficulties are increased or altered by the lack of co-operation on
the part of the subject; for this is a situation which you can never
bring about in your class experiments, since your colleague playing
the part of the accused is, in spite of his conscious determination
not to betray himself, your co-worker and assistant.
Looking more deeply into the comparison of the two situations, it will
become clear to you that on the whole psycho-analysis is concerned
with a simple, special form of the problem of discovery of hidden
material in the mind; whereas in your profession, on the other hand,
the problem is a much broader one. The case of the psychoneurotic is
regularly concerned with a repressed sexual complex (in the widest
sense of the term), but this is a difference which does not concern
you. There is another point, however, which does. The aim of
psycho-analysis is identical in all cases; the analysis aims at laying
bare the complexes which have been repressed as a result of the
painful feelings associated with them, and which produce signs of
resistance when there is an attempt to bring them into
consciousness. The resistance is localized; it arises at the boundary
between the unconscious and the conscious. In your case we are
concerned with a resistance originating entirely within the conscious
life. You cannot simply discount this difference. You must first
determine experimentally whether the conscious resistance betrays
itself by exactly the same signs as the unconscious resistance does.
Further, in my opinion you cannot yet be certain whether you may
interpret your objective signs of a 'complex' as resistance in the
same way that we psychotherapeutists {23} do. It may happen in the
case of your experimental subjects, though not very often in the case
of criminals, that the complex you touch on is one tinged with
pleasure, and the question then arises whether this complex will give
the same reaction as one charged with painful affect.
I would also lay stress on the consideration that your experiments may
possibly be subject to a complication which naturally does not arise
in psycho-analysis. You may be led astray in your examination by a
neurotic who reacts as though he were guilty even though he is
innocent---because a lurking sense of guilt already existing in him
assimilates the accusation made against him on this particular
occasion. You must not regard this possibility as an idle one; you
have only to think of the nursery, where you can often observe it. It
sometimes happens that a child who has been accused of a misdeed
denies the accusation, but at the same time weeps like a sinner who
has been caught. You might think that the child lies, even while it
asserts its innocence; but this need not be so. The child is really
not guilty of the specific misdeed of which he is being accused, but
he is guilty of a similar misdemeanour of which you know nothing and
of which you do not accuse him. He therefore quite truly denies his
guilt in the one case, but in doing so betrays his sense of guilt with
regard to the other. The adult neurotic behaves in this and in many
other ways just as the child does. People of this kind are often to be
met, and it is indeed a question whether your technique will succeed
in distinguishing such self-accused persons from those who are really
guilty. Finally, one more point: you know that, according to law, you
may not use any procedure which takes the accused off his guard. He
will therefore be aware that his whole effort must be directed to
avoid betraying himself in your experiments; and a further question
then arises, whether you can expect the same reactions when attention
is directed towards the complex as when it {24} is diverted from it?
How far does the conscious intention to avoid self-betrayal affect
reactions in different people?
Just because the situations on which your investigations are based can
be so manifold, psychology takes a very lively interest in its
results, and one would like to suggest that you should not too readily
doubt their practical value. Although my work lies so far from the
sphere of your legal practice, allow me to make one other
suggestion. In spite of the fact that experiments in class are
essential for your training and for the examination of witnesses, you
will never be able to reproduce in your experiments the same
psychological situation as in the examination of a guilty person in
the criminal court. They remain 'mock trials', and no practical
conclusions can be based on them for use in a criminal case. If we do
not wish to give up experimental study, the following alternative
suggests itself: it might be arranged for you, even to the extent of
becoming a duty, to undertake such examinations for a series of years
in all actual cases of accusation _without your conclusions being
allowed to influence the decision of the judge_. It would, indeed, be
best if the latter never knew the conclusions which you drew from your
experiments with regard to the guilt of the accused. After years of
collecting and comparing the results thus obtained, all doubt with
regard to the value of this psychological method of examination should
be solved. I know, however, that the realization of this proposal does
not rest only with you or with your eminent teachers.
----------------------------------------------------------------------
II {25}
OBSESSIVE ACTS AND RELIGIOUS
PRACTICES[8]
(1907)
I am certainly not the first to be struck by the resemblance between
what are called obsessive acts in neurotics and those religious
observances by means of which the faithful give expression to their
piety. The name 'ceremonial', which has been given to certain of these
obsessive acts, is evidence of this. The resemblance, however, seems
to me to be something more than superficial, so that an insight into
the origin of neurotic ceremonial may embolden us to draw by analogy
inferences about the psychological processes of religious life.
Persons who are addicted to obsessive acts or ceremonials belong to
the same class as those who suffer from obsessive thoughts and ideas,
obsessive impulses and the like, and form with them a definite
clinical group, the customary term for which is obsessional
neurosis.[9] But one should not attempt to deduce the character of the
disease from its name, for, strictly speaking, there are other morbid
psychological phenomena which have an equal claim to the 'obsessional
character', as it is called. In place of a definition we must for the
present be content with a detailed description of these conditions,
for it has not yet been possible to demonstrate the essential feature
which probably lies at the root of the obsessional neurosis, {26}
though one seems to find indications of it at every turn in clinical
manifestations of the disorder.
The neurotic ceremonial consists of little prescriptions,
performances, restrictions, and arrangements in certain activities of
every-day life which have to be carried out always in the same or in a
methodically varied way. These performances make the impression that
they are mere 'formalities'; they appear quite meaningless to us. Nor
do they appear otherwise to the patient himself; yet he is quite
incapable of renouncing them, for every neglect of the ceremonial is
punished with the most intolerable anxiety, which forces him to
perform it instantly. Just as trivial as the ceremonial performances
themselves are the occasions which give rise to them, and the kind of
actions which are thereby caricatured, hindered, and invariably also
delayed, _e.g._ dressing and undressing, going to bed, and the
satisfaction of bodily needs. The carrying out of a ceremonial may be
described as the fulfilment of a series of unwritten rules; for
example, in the bed ceremonial the chair must stand in a particular
place by the bed, and the clothes must be folded and laid upon it in a
particular order; the coverlet must be tucked in at the bottom, and
the bed-clothes evenly spread; the pillows must be arranged in such
and such a manner, and the body must lie in a particular
position---only when all is correct is it permissible to go to
sleep. In slight cases the ceremonial appears to be only an
exaggeration of an ordinary and justifiable orderliness, but the
remarkable conscientiousness with which it is carried out, and the
anxiety which follows its neglect, gives the ceremonial the character
of a sacred rite. Any disturbance of it is tolerated with difficulty,
and the presence of other persons during the performance of it is
almost always out of the question.
Any activities whatsoever may become obsessive acts in a wide sense if
they become elaborated by petty modifications or develop a rhythmic
character by {27} pauses and repetitions. A sharp distinction between
'obsessive acts' and 'ceremonials' is not to be expected; as a rule an
obsessive act develops from a ceremonial. Besides these, prohibitions
and hindrances (_aboulia_) complete the picture of the disorder; the
latter only carry further the work of the obsessive acts, for in the
one case a certain activity is interdicted altogether, and in the
other it is only possible when the patient follows the prescribed
ceremonial.
It is remarkable that both compulsions and prohibitions (that one
thing must be done and another may not be done) originally relate only
to the solitary activities of the persons concerned; for a long time
their social activities remain unaffected, so that for many years such
patients can treat their affliction as a private matter and hide it
from others. Moreover, far more persons suffer from these forms of the
obsessional neurosis than ever come to the knowledge of
physicians. For many patients, too, concealment is not a difficult
matter, because it is quite possible for them to fulfil their social
duties during part of the day, after having devoted several hours to
their secret performances in Melusina-like seclusion.
It is easy to see wherein lies the resemblance between neurotic
ceremonial and religious rites; it is in the fear of pangs of
conscience after their omission, in the complete isolation of them
from all other activities (the feeling that one must not be
disturbed), and in the conscientiousness with which the details are
carried out. But equally obvious are the differences, some of which
are so startling that they make the comparison into a sacrilege: the
greater individual variability of neurotic ceremonial in contrast with
the stereotyped character of rites (prayer, orientation, etc.); its
private nature as opposed to the public and communal character of
religious observances; especially, however, the distinction that the
little details of religious ceremonies are full of meaning and are
understood symbolically, while those of neurotics seem silly {28} and
meaningless. In this respect an obsessional neurosis furnishes a
tragi-comic travesty of a private religion. But this, the sharpest
distinction between neurotic and religious ceremonials, disappears as
soon as one penetrates by means of psycho-analytic investigation to
insight into obsessive actions. By this process the outward appearance
of being foolish and meaningless, which is characteristic of obsessive
acts, is completely demolished, and the fact of their having this
appearance is explained. It is found that obsessive acts are
throughout and in all their details full of meaning, that they serve
important interests of the personality, and that they give expression
both to persisting impressions of previous experiences and to thoughts
about them which are strongly charged with affect. This they do in two
ways, either by direct or by symbolic representation, so that they are
to be interpreted either historically or symbolically.
I must here give a few examples to illustrate these remarks. Those who
are familiar with the results of the psycho-analytic investigation of
the psychoneuroses will not be surprised to learn that what is
expressed in an obsessive act or ceremonial is derived from the most
intimate, and for the most part from the sexual, experiences of the
patient.
(_a_) A girl of my acquaintance was under the compulsion to rinse out
the basin many times after washing. The significance of this
ceremonial lay in the proverbial saying, 'Don't throw away dirty water
until you have clean'. The action had the meaning of a warning to her
sister, to whom she was much attached, not to separate from her
unsatisfactory husband until she had established a relationship with a
better man.
(_b_) A woman who was living apart from her husband was subject to a
compulsion to leave the best of whatever she ate; for example, she
would only take the outside of a piece of roast meat. This
renunciation was explained by the date of its origin. It appeared the
{29} day after she had refused marital relations with her husband,
that is to say, had given up the best.
(_c_) The same patient could only sit on one particular chair, and
could leave it again only with difficulty. In connection with certain
details of her married life the chair symbolized to her her husband,
to whom she remained faithful. She found the explanation of her
compulsion in the sentence, 'It is so hard to part from anything
(chair or husband) in which one has once settled oneself.'
(_d_) For a long time she used to repeat a very curious and senseless
obsessive act. She ran out of her room into the next, in the middle of
which stood a table with a cloth upon it. This she pulled straight in
a particular manner, rang for the housemaid, who had to approach the
table, and then sent her off again on some indifferent errand. During
her efforts to explain this compulsion it occurred to her that at one
place on the tablecloth there was a stain and that she always arranged
the cloth so that the housemaid was bound to see it. The whole scene
proved to be a reproduction of an incident in her marriage. On the
wedding-night her husband had met with a not unusual mishap. He found
himself impotent, and 'many times in the course of the night came
hurrying from his room to hers' in order to try again. In the morning
he said he would be shamed in the eyes of the hotel chambermaid who
made the bed, so he took a bottle of red ink and poured its contents
over the sheet; but he did it so clumsily that the stain came in a
place most unsuitable for his purpose. With her obsessive act,
therefore, she was reproducing the bridal night. ('Bed and board'
indeed comprise marriage.)
(_e_) She started a compulsion to note the number of each
currency-note before parting with it, and this also was to be
interpreted historically. At a time when she had still had an
intention to leave her husband if she could find a more trustworthy
man, she allowed herself to become the object of the attentions of a
man {30} she met at a watering-place, but was in doubt whether he was
altogether in earnest. One day, as she was short of small change, she
asked him to change a 5-kronen piece for her. He did so, and put the
large coin in his pocket, saying with a gallant air that he would
never part with it since it had passed through her hands. At their
later meetings she was frequently tempted to challenge him to show her
the 5-kronen piece, as if to convince herself that she could believe
in his attentions. But she refrained, for the good reason that one
cannot distinguish coins of the same value. Her doubts therefore
remained unsolved; they left her with a compulsion to note the number
of each currency-note by which each one can be distinguished from
others of the same value.
These few examples, selected from many I have met with, are intended
merely to illustrate the statement that in obsessive acts everything
has its meaning and interpretation. The same is true of ceremonials in
the strict sense, only that the evidence for this would require a more
detailed presentation. I quite realize, however, how far we seem to be
getting from any connection between this interpretation of obsessive
acts and the line of thought peculiar to religious practices.
It is one of the features of the disease that the person who is
affected with a compulsion submits to it without understanding its
meaning---or at any rate its chief meaning. It is only under the
influence of psycho-analytic treatment that the meaning of the
obsessive act, and therewith of the impelling motive underlying it,
becomes conscious. We express this important fact by saying that the
obsessive act serves to express _unconscious_ motives and ideas. Here
we seem to find a further departure from religious rites; but we must
remember that as a rule the ordinary religious observer carries out a
ceremonial without concerning himself with its significance, although
priests and investigators may be familiar with its meaning, {31} which
is usually symbolic. In all believers, however, the _motives_
impelling them to religious practices are unknown, or are replaced in
consciousness by others which are advanced in their stead.
The analysis of obsessive acts has already given us some sort of
insight into their causes and into the network of motives which bring
them to effect. One may say that a sufferer from compulsions and
prohibitions behaves as if he were dominated by a sense of guilt, of
which, however, he is ignorant---an unconscious sense of guilt, as one
must call it in spite of the apparent contradiction in terms. The
sense of guilt has its origin in certain early psychological
occurrences, but is constantly revived by temptations which are
renewed at every present opportunity; it gives rise, moreover, to a
state of anxious expectation, or anticipation of misfortune, which
through the idea of punishment is linked with the inner perception of
temptation. When the compulsion is first being formed, the patient is
conscious that he must do this or that lest misfortune occur, and as a
rule the nature of the expected misfortune is also recognized in
consciousness. But the relation between the occasion which gives rise
to this anxiety and the danger to which it refers is already hidden
from him, though it is always capable of demonstration. Thus a
ceremonial begins as an act of defence or security---as a _protective
measure_.
The protestations of the pious that they know they are miserable
sinners in their hearts correspond to the sense of guilt of the
obsessional neurotic; while the pious observances (prayers,
invocations, etc.) with which they begin every act of the day, and
especially every unusual undertaking, seem to have the significance of
defensive and protective measures.
Deeper insight into the mechanism of the obsessional neurosis is
gained when the primary factor underlying it is taken into account:
this is always the repression of an impulse (one component of the
sexual instinct) which is inherent in the constitution of the person,
and {32} which for a while found expression in his childhood but
succumbed later to suppression. In course of this repression a special
type of conscientiousness directed towards opposing the aim of the
impulse is developed; but this mental reaction is felt to be insecure
and constantly threatened by the impulse which lurks in the
unconscious. The influence of the repressed impulse is felt as a
temptation, and anxiety is produced by the process of repression
itself, which is dealt with by directing it towards the future in the
form of anxious expectation. The process of repression which leads to
the obsessional neurosis must be described as imperfectly carried
through and as constantly threatening to break down. It may be
compared, consequently, with an insoluble conflict; fresh mental
efforts are continually required to counterbalance the constant
forward pressure of the impulse. Thus the ceremonial and obsessive
acts arise partly as a defence against temptation and partly as a
protection against the misfortune expected. Against the temptation the
protective measures seem to become rapidly ineffective; then the
prohibitions come into play, for these are intended to keep at a
distance situations which give rise to temptation. We thus see that
prohibitions replace obsessive acts just as a phobia serves to hold
off an hysterical attack. From another point of view a ceremonial
represents the sum of all the conditions under which something not yet
absolutely forbidden becomes permissible, just as the marriage
ceremony of the Church signifies a sanction of sexual enjoyment, which
is otherwise sinful. It is in the nature, moreover, of the obsessional
neurosis---as of all similar affections---that its manifestations
(symptoms, including also the obsessive acts) fulfil the condition of
a compromise between the opposing forces in the mind. Thus they always
reproduce something of the identical pleasure they were designed to
prevent; they serve the repressed impulse no less than the repressing
element. Indeed, as the disease develops the performances which at
{33} first were concerned chiefly with defence approximate ever more
and more nearly to those proscribed actions in which the impulse was
able to find an outlet in childhood.
This state of things has some counterparts in the sphere of religious
life, as follows: the structure of a religion seems also to be founded
on the suppression or renunciation of certain instinctual trends;
these trends are not, however, as in the neurosis, exclusively
components of the sexual instinct, but are egoistic, antisocial
instincts, though even these for the most part are not without a
sexual element. The sense of guilt in consequence of continual
temptation, and the anxious expectation in the guise of fear of divine
punishment, have indeed been familiar to us in religion longer than in
neurosis. Possibly on account of the sexual elements which are also
involved, possibly on account of some characteristic of instincts in
general, the suppression active in religion proves here also to be
neither completely effective nor final. Unredeemed backslidings into
sin are even more common among the pious than among neurotics, and
these give rise to a new form of religious activity, namely, the acts
of penance of which one finds counterparts in the obsessional
neurosis.
We saw a curious feature of the obsessional neurosis, one that seems
to render it unworthy and trivial, in the fact that these ceremonials
are concerned with such petty performances of daily life, and are
expressed in foolish regulations and restrictions in regard to
them. One first understands this remarkable feature of the clinical
picture when one finds that the mechanism of the psychical
displacement, which I first discovered in the formation of dreams,[10]
dominates the mental processes in the obsessional neurosis. It is
already clear from the few examples of obsessive acts given above that
their symbolism and the details of their execution are effected as if
by a displacement from the actual important thing on to an
insignificant one which {34} replaces it, _e.g._ from the husband to
the chair. It is this tendency to displacement which progressively
changes the clinical picture of the symptoms, and eventually succeeds
in turning apparently trivial matters into those of great and urgent
importance. It cannot be denied that in the religious sphere also
there is a similar tendency to a displacement of psychical values, and
indeed in the same direction, so that petty ceremonials gradually
become the essence of religious practices, and replace the ideas
underlying them. It is for this reason that religions are subject to
retroactive reforms which aim at the re-establishment of the original
relative values.
The element of compromise in those obsessive acts which we find as
neurotic symptoms is the feature least easy to find reproduced in
corresponding religious observances. Yet here, too, one is reminded of
this trait in the neurosis when one recalls how commonly all those
acts which religion forbids---expressions of the instincts it
represses---are yet committed precisely in the name of, and ostensibly
in the cause of, religion.
In view of these resemblances and analogies one might venture to
regard the obsessional neurosis as a pathological counterpart to the
formation of a religion, to describe this neurosis as a private
religious system, and religion as a universal obsessional
neurosis. The essential resemblance would lie in the fundamental
renunciation of the satisfaction of inherent instincts, and the chief
difference in the nature of these instincts, which in the neurosis are
exclusively sexual, but in religion are of egoistic origin.
A progressive renunciation of inherent instincts, the satisfaction of
which is capable of giving direct pleasure to the ego, appears to be
one of the foundations of human civilization. Some part of this
repression is effected by means of the various religions, in that they
require individuals to sacrifice the satisfaction of their instincts
to the divinity. 'Vengeance is mine, saith the Lord.' In the
development of the {35} ancient religions one seems to find that many
things which mankind had renounced as wicked were surrendered in
favour of the god, and were still permitted in his name; so that a
yielding up of evil and asocial impulses to the divinity was the means
by which man freed himself from them. For this reason it is surely no
accident that all human characteristics---along with the crimes they
prompt---were freely attributed to the ancient gods, and no anomaly
that it was nevertheless not permissible to justify one's own misdeeds
by reference to divine example.
----------------------------------------------------------------------
III {36}
THE SEXUAL ENLIGHTENMENT OF CHILDREN[11]
(1907)
*An Open Letter to Dr. M. Fürst, Editor of
_Soziale Medizin und Hygiene_*
Dear sir---When you ask me for an expression of opinion on the
matter of sexual enlightenment for children, I assume that what you
want is the independent opinion of an individual physician whose
professional work offers him special opportunities for studying the
subject, and not a regular conventional treatise dealing with all the
mass of literature that has grown up around it. I am aware that you
have followed my scientific efforts with interest, and that, unlike
many other colleagues, you do not dismiss my ideas without a hearing
because I regard the psycho-sexual constitution and certain noxiæ in
the sexual life as the most important causes of the neurotic disorders
that are so common. My _Drei Abhandlungen zur Sexualtheorie_, in which
I describe the components of which the sexual instinct is made up, and
the disturbances which may occur in its development into the function
of sexuality, has recently received favourable mention in your
Journal.
I am therefore to answer the questions whether children may be given
any information at all in regard to the facts of sexual life, and at
what age and in what way this should be done. Now let me confess at
the outset that discussion with regard to the second and {37} third
points seems to me perfectly reasonable, but that to my mind it is
quite inconceivable how the first of these questions could ever be the
subject of debate. What can be the aim of withholding from children,
or let us say from young people, this information about the sexual
life of human beings? Is it a fear of arousing interest in such
matters prematurely, before it spontaneously stirs in them? Is it a
hope of retarding by concealment of this kind the development of the
sexual instinct in general, until such time as it can find its way
into the only channels open to it in the civilized social order? Is it
supposed that children would show no interest or understanding for the
facts and riddles of sexual life if they were not prompted to do so by
outside influence? Is it regarded as possible that the knowledge
withheld from them will not reach them in other ways? Or is it
genuinely and seriously intended that later on they should consider
everything connected with sex as something despicable and abhorrent,
from which their parents and teachers wish to keep them apart as long
as possible?
I am really at a loss to say which of these can be the motive for the
customary concealment from children of everything connected with
sex. I only know that these arguments are one and all equally foolish,
and that I find it difficult to pay them the compliment of serious
refutation. I remember, however, that in the letters of that great
thinker and friend of humanity, Multatuli, I once found a few lines
which are more than adequate as an answer.[12]
> 'To my mind it seems that certain things are altogether too much
> wrapped in mystery. It is well to keep the fantasies of children
> pure, but their purity will not be preserved by ignorance. On the
> contrary, I believe that concealment leads a girl or boy to suspect
> the truth more than ever. Curiosity leads to prying into things
> which would have roused little or no interest if they were talked of
> openly without {38} any fuss. If this ignorance could be maintained
> I might be more reconciled to it, but that is impossible; the child
> comes into contact with other children, books fall into his hands
> which lead him to reflect, and the mystery with which things he has
> already surmised are treated by his parents actually increases his
> desire to know more. Then this desire that is only incompletely and
> secretly satisfied gives rise to excitement and corrupts his
> imagination, so that the child is already a sinner while his parents
> still believe he does not know what sin is.'
I do not know how the case could be better stated, though perhaps one
might amplify it. It is surely nothing else but habitual prudery and a
guilty conscience in themselves about sexual matters which causes
adults to adopt this attitude of mystery towards children; possibly,
however, a piece of theoretical ignorance on their part, to be
counteracted only by fresh information, is also responsible. It is
commonly believed that the sexual instinct is lacking in children, and
only begins to arise in them when the sexual organs mature. This is a
grave error, equally serious from the point of view both of theory and
of actual practice. It is so easy to correct it by observation that
one can only wonder how it can ever have arisen. As a matter of fact,
the new-born infant brings sexuality with it into the world; certain
sexual sensations attend its development while at the breast and
during early childhood, and only very few children would seem to
escape some kind of sexual activity and sexual experiences before
puberty. A more complete exposition of this statement can be found in
my _Drei Abhandlungen zur Sexualtheorie_, to which reference has been
made above. The reader will learn that the specific organs of
reproduction are not the only portions of the body which are a source
of pleasurable sensation, and that Nature has stringently ordained
that even stimulation of the genitals cannot be avoided during
infancy. This period of life, during which a certain {39} degree of
directly sexual pleasure is produced by the stimulation of various
cutaneous areas (erotogenic zones), by the activity of certain
biological impulses and as an accompanying excitation during many
affective states, is designated by an expression introduced by
Havelock Ellis as the period of auto-erotism. Puberty merely brings
about attainment of the stage at which the genitals acquire supremacy
among all the zones and sources of pleasure, and in this way presses
erotism into the service of reproduction, a process which naturally
can undergo certain inhibitions; in the case of those persons who
later on become perverts and neurotics this process is only
incompletely accomplished. On the other hand, the child is capable
long before puberty of most of the mental manifestations of love, for
example, tenderness, devotion, and jealousy. Often enough the
connection between these mental manifestations and the physical
sensation of sexual excitation is so close that the child cannot be in
doubt about the relation between the two. To put it briefly, the child
is long before puberty a being capable of mature love, lacking only
the ability for reproduction; and it may be definitely asserted that
the mystery which is set up withholds him only from intellectual
comprehension of achievements for which he is psychically and
physically prepared.
The intellectual interest of a child in the riddle of sexual life, his
desire for knowledge, finds expression at an earlier period of life
than is usually suspected. If they have not often come across such
cases as I am about to mention, parents must either be afflicted with
blindness in regard to this interest in their children, or, when they
cannot overlook it, must make every effort to stifle it. I know a
splendid boy, now four years old, whose intelligent parents abstain
from forcibly suppressing one side of the child's development. Little
Herbert, who has certainly not been exposed to any seducing influence
from servants, has for some time shown the liveliest interest in that
part of his body {40} which he calls his weewee-maker. When only three
years old he asked his mother, 'Mamma, have you got a weewee-maker,
too?' His mother answered, 'Of course, what did you think?' He also
asked his father the same question repeatedly. At about the same age
he was taken to a barn and saw a cow milked for the first time. 'Look,
milk is coming out of the weewee-maker!' he called in surprise. At the
age of three and three-quarters he was well on the way to establish
correct categories by means of his own independent observation. He saw
how water is run off from a locomotive and said, 'See, the engine is
making weewee, but where is its weewee-maker?' Later on he added
thoughtfully, 'Dogs and horses have weewee-makers, but tables and
chairs don't have them'. Recently he was watching his little sister of
one week old being bathed, and remarked, 'Her weewee-maker is still
tiny; it will get bigger when she grows'. (I have heard of this
attitude towards the problem of sex difference in other boys of the
same age.) I must expressly assert that Herbert is not a sensual child
nor even morbidly disposed; in my opinion, since he has never been
frightened or oppressed with a sense of guilt, he gives expression
quite ingenuously to what he thinks.
The second great problem which exercises a child's mind---probably at
a rather later date---is that of the origin of children, and is
usually aroused by the unwelcome arrival of a baby brother or
sister. This is the oldest and most burning question that assails
immature humanity; those who understand how to interpret myths and
legends can detect it in the riddle which the Theban Sphinx set to
Oedipus. The answers usually given to children in the nursery wound
the child's frank and genuine spirit of investigation, and generally
deal the first blow at his confidence in his parents; from this time
onwards he commonly begins to mistrust grown-up people and keeps to
himself what interests him most. The following letter may show {41}
how torturing this very curiosity may become in older children; it was
written by a motherless girl of eleven and a half who had been
puzzling over the problem with her younger sister.
> '*Dear Aunt Mali*---Please will you be so kind as to write and tell
> me how you got Chris or Paul. You must know because you are married.
> We were arguing about it yesterday, and we want to know the
> truth. We have nobody else to ask. When are you coming to Salzburg?
> You know, Aunt Mali, we simply can't imagine how the stork brings
> babies. Trudel thought the stork brings them in a shirt. Then we
> want to know, too, how the stork gets them out of the pond, and why
> one never sees babies in ponds. And please will you tell me, too,
> how you know beforehand when you are going to have one. Please write
> and tell me _all_ about it. Thousands of kisses from all of
> us.---Your inquiring niece,
>
> '*Lily*.'
I do not think that this touching request brought the two sisters the
information they wanted. Later on the writer developed the neurosis
that arises in unanswered unconscious questions---obsessive
speculating.
I do not think that there is even one good reason for denying children
the information which their thirst for knowledge demands. To be sure,
if it is the purpose of educators to stifle the child's power of
independent thought as early as possible, in order to produce that
'good behaviour' which is so highly prized, they cannot do better than
deceive children in sexual matters and intimidate them by religious
means. The stronger characters will, it is true, withstand these
influences; they will become rebels against the authority of their
parents and later against every other form of authority. When children
do not receive the explanations for which they turn to their elders,
they go on tormenting themselves in secret with the problem, {42} and
produce attempts at solution in which the truth they have guessed is
mixed up in the most extraordinary way with grotesque inventions; or
else they whisper confidences to each other which, because of the
sense of guilt in the youthful inquirers, stamp everything sexual as
horrible and disgusting. These infantile sexual theories are well
worth collecting and examining. After these experiences children
usually lose the only proper attitude to sexual questions, many of
them never to find it again.
It would seem that the overwhelming majority of writers, both men and
women, who have dealt with the question of explaining sexual matters
to children have expressed themselves in favour of enlightenment. The
clumsiness, however, of most of their proposals how and when this
enlightenment should be carried out leads one to conclude that they
have not found it very easy to venture this admission. As far as my
knowledge of the literature goes, the charming letter of explanation
which a certain Frau Emma Eckstein gives as written to her
ten-year-old boy stands out conspicuously.[13] The customary method is
obviously not the right one. All sexual knowledge is kept from
children as long as possible, and then on one single occasion an
explanation, which is even then only half the truth and generally
comes too late, is proffered them in mysterious and solemn
language. Most of the answers to the question 'How can I tell my
children?' make such a pitiful impression, at least upon me, that I
should prefer parents not to concern themselves with the explanation
at all. It is much more important that children should never get the
idea that one wants to make more of a secret of the facts of sexual
life than of any other matter not suited to their understanding. To
ensure this it is necessary that from the very beginning everything
sexual should be treated like everything else that is worth knowing
about. Above all, schools should not evade the task of mentioning
sexual {43} matters; lessons about the animal kingdom should include
the great facts of reproduction, which should be given their due
significance, and emphasis should be laid at the same time on the fact
that man shares with the higher animals everything essential to his
organization. Then, if the atmosphere of the home does not make for
suppression of all reasoning, something similar to what I once
overheard in a nursery would probably occur oftener. A small boy said
to his little sister, 'How can you think the stork brings babies! You
know that man is a mammal, do you suppose that storks bring other
mammals their young too?' In this way the curiosity of children will
never become very intense, for at each stage in its inquiries it will
find the satisfaction it needs. Explanations about the specific
circumstances of human sexuality and some indication of its social
significance should be provided before the child is eleven years
old.[14] The age of confirmation would be a more suitable time than
any other at which to instruct the child, who already has full
knowledge of the physical facts involved, in those social obligations
which are bound up with the actual gratification of this instinct. A
gradual and progressive course of instruction in sexual matters such
as this, at no period interrupted, in which the school takes the
initiative, seems to me to be the only method of giving the necessary
information that takes into consideration the development of the child
and thus successfully avoids ever-present dangers.
I consider it a most significant advance in the science of education
that in France, in place of the catechism, the State should have
introduced a primer which gives the child his first instruction in his
position as a citizen and in the ethical obligations which will be his
in time to come. The elementary instruction provided there, however,
is seriously deficient in that it includes no reference to sexual
matters. Here is the omission {44} which stands in such need of
attention on the part of educators and reformers. In those countries
which leave the education of children either wholly or in part in the
hands of the priesthood, the method urged would of course not be
practicable. No priest will ever admit the identity in nature of man
and beast, since to him the immortality of the soul is a foundation
for moral training which he cannot forgo. Here again we clearly see
the unwisdom of putting new wine into old bottles, and perceive the
impossibility of carrying through a reform in one particular without
altering the foundations of the whole system.
----------------------------------------------------------------------
IV {45}
CHARACTER AND ANAL EROTISM[15]
(1908)
Among those whom one tries to help by means of psycho-analytic
treatment, one very often meets with a type of character in which
certain traits are strongly marked, while at the same time one's
attention is arrested by the behaviour of these persons in regard to a
certain bodily function and of the organ connected with it during
their childhood. I can no longer say on what precise occasions I first
received the impression that a systematic relationship exists between
this type of character and the activities of this organ, but I can
assure the reader that no theoretical anticipations of mine played any
part in its production.
My belief in such a relationship has been so much strengthened by
accumulated experience that I venture to make it the subject of a
communication.
The persons whom I am about to describe are remarkable for a regular
combination of the three following peculiarities: they are
exceptionally _orderly_, _parsimonious_, and _obstinate_. Each of
these words really covers a small group or series of traits which are
related to one another. 'Orderly' comprises both bodily cleanliness
and reliability and conscientiousness in the performance of petty
duties: the opposite of it would be 'untidy' and
'negligent'. 'Parsimony' may be exaggerated up to the point of
avarice; and obstinacy may amount to defiance, with which irascibility
and vindictiveness may easily be associated. The two latter
qualities---parsimony and obstinacy---hang {46} together more closely
than the third, orderliness; they are, too, the more constant element
in the whole complex. It seems to me, however, incontestable that all
three in some way belong together.
From the history of the early childhood of these persons one easily
learns that they took a long time to overcome the infantile
_incontinentia alvi_, and that even in later childhood they had to
complain of isolated accidents relating to this function. As infants
they seem to have been among those who refuse to empty the bowel when
placed on the chamber, because they derive an incidental pleasure from
the act of defæcation[16]; for they assert that even in somewhat later
years they have found a pleasure in holding back their stools, and
they remember, though more readily of their brothers and sisters than
of themselves, all sorts of unseemly performances with the stools when
passed. From these indications we infer that the erotogenic
significance of the anal zone is intensified in the innate sexual
constitution of these persons; but since none of these weaknesses and
peculiarities are to be found in them once childhood has been passed,
we must conclude that the anal zone has lost its erotogenic
significance in the course of their development, and that the constant
appearance of this triad of peculiarities in their character may be
brought into relation with the disappearance of their anal erotism.
I know that no one feels inclined to accept a proposition which
appears unintelligible, and for which no explanation can be offered,
but we can find the basis of such an explanation in the postulates I
have formulated in my _Drei Abhandlungen zur Sexualtheorie_. I there
attempt to show that the sexual instinct of man is very complex and is
made up of contributions from numerous components and partial
impulses. The peripheral stimulation of certain specialized parts
(genitals, mouth, anus, urethra), which may be called erotogenic
zones, furnishes {47} important contributions to the production of
sexual excitation, but the fate of the stimuli arising in these areas
varies according to their source and according to the age of the
person concerned. Generally speaking, only a part of them finds a
place in the sexual life; another part is deflected from a sexual aim
and is directed to other purposes, a process which may be called
sublimation. During the period of life which may be distinguished as
the 'sexual latency period', _i.e._ from the end of the fourth year to
the first manifestations of puberty at about eleven,
reaction-formations, such as shame, disgust, and morality, are formed
in the mental economy at the expense of the excitations proceeding
from the erotogenic zones, and these reaction-formations erect
themselves as barriers against the later activity of the sexual
instinct. Now anal erotism is one of those components of the instinct
which in the course of evolution and in accordance with our present
civilizing education has become useless for sexual aims; it would
therefore be no very surprising result if these traits of orderliness,
parsimony, and obstinacy, which are so prominent in persons who were
formerly anal erotics, turned out to be the first and most constant
results of the sublimation of anal erotism.[17]
{48}
The inherent necessity of this relationship is naturally not clear
even to myself, but I can make some suggestions which help towards an
understanding of it. The cleanliness, orderliness, and reliability
give exactly the impression of a reaction-formation against an
interest in things that are unclean and intrusive and ought not to be
on the body ('Dirt is matter in the wrong place'). To bring obstinacy
into relation with interest in defæcation seems no easy task, but it
should be remembered that infants can very early behave with great
self-will about parting with their stools (see above), and that
painful stimuli to the skin of the buttocks (which is connected with
the anal erotogenic zone) are an instrument in the education of the
child designed to break his self-will and make him submissive. As an
expression of defiance or of defiant mockery, a challenge referring to
a caress on this part of the body is used even at the present day, as
in former times---that is, it represents a tender feeling which has
undergone repression. An exposure of the buttocks corresponds {49} to
the reduction of this speech to a gesture; in Goethe's _Götz von
Berlichingen_ we find both speech and gesture introduced most
appropriately as expression of defiance.
The connections which exist between the two complexes of interest in
money and of defæcation, which seem so dissimilar, appear to be the
most far-reaching. It is well known to every physician who has used
psycho-analysis that the most refractory and obdurate cases of
so-called chronic constipation in neurotics can be cured by this
means. This is less surprising if we remember that this function has
shown itself equally amenable to hypnotic suggestion. But in
psycho-analysis one only attains this result when one deals with the
money complex of the persons concerned, and induces them to bring it
into consciousness with all its connections. One might suppose that
the neurosis is here only following a hint from common speech which
calls a person who keeps too careful a hold on his money 'dirty' or
'filthy', but this would be far too superficial an explanation. In
reality, wherever archaic modes of thought predominate or have
persisted---in ancient civilizations, in myth, fairy-tale and
superstition, in unconscious thoughts and dreams, and in the
neuroses---money comes into the closest relation with excrement. We
know how the money which the devil gives his paramours turns to
excrement after his departure, and the devil is most certainly nothing
more than a personification of the unconscious instinctual forces.[18]
The superstition, too, which associates the finding of treasure with
defæcation is well known, and everyone is familiar with the figure of
the 'excretor of ducats' (_Dukatenscheisser_).[19] Even in the early
Babylon cult gold is 'the excrement of Hell', Mammon = ilu manman.[20]
Thus in following {50} common speech, the neurosis, here as elsewhere,
takes the words in their original most significant sense, and wherever
it appears to express a word figuratively it usually only reproduces
its original meaning.
It is possible that the contrast between the most precious substance
known to man and the most worthless, which he rejects as 'something
thrown out', has contributed to this identification of gold with
fæces.
Yet another circumstance facilitates this equivalence in the mental
processes involved in neurosis. The original erotic interest in
defæcation is, as we know, destined to be extinguished in later years;
it is in these years that the interest in money is making its
appearance as something new which was unknown in childhood. This makes
it easier for the earlier impulse, which is in process of
relinquishing its aim, to be carried over to the new one.
If there is any reality in the relation described here between anal
erotism and this triad of character-traits, one may expect to find but
little of the 'anal character' in persons who have retained the
erotogenic quality of the anal zone into adult life, as for example
certain homosexuals. Unless I am greatly mistaken experience on the
whole is fully in accord with this anticipation.
One ought to consider whether other types of character do not also
show a connection with the excitability of particular erotogenic
zones. As yet I am aware only of the intense, 'burning' ambition of
those who formerly suffered from enuresis. At any rate, one can give a
formula for the formation of the ultimate character from the
constituent character-traits: the permanent character-traits are
either unchanged perpetuations of the original impulses, sublimations
of them, or reaction-formations against them.
----------------------------------------------------------------------
V {51}
HYSTERICAL PHANTASIES AND THEIR
RELATION TO BISEXUALITY[21]
(1908)
We are all familiar with the delusional phantasies of paranoiacs
which portray the person's greatness or his sufferings, and occur in
stereotyped forms with almost monotonous regularity. We also come
across numerous accounts of the strange conditions under which certain
perverts carry out their sexual gratification---either in imagination
or in reality. Nevertheless, it may be new to some readers to hear
that quite analogous mental productions are regularly present in all
the psychoneuroses, particularly in hysteria, and that these so-called
hysterical phantasies have important connections with the causes of
the neurotic symptoms.
The common origin and normal prototype of all these phantastic
creations are the so-called day-dreams of adolescence, to which some,
though perhaps inadequate, attention has been given in the literature
on the subject.[22] They occur with perhaps equal frequency in both
sexes; in girls and women they are invariably of an erotic nature, in
men they may be either erotic or ambitious. The importance of the
erotic factor in those of men should not, however, be under-estimated;
a more precise investigation of the day-dreams of a {52} man generally
shows that all his heroic exploits, all his successes, are for the
purpose of pleasing a woman, of being preferred by her to other
men.[23] These phantasies are wish-fulfilments, products of
frustration and desire; they are justly called day-dreams, for they
give us the key to an understanding of night dreams, the nucleus of
which is nothing else than these daytime phantasies, but complicated
and distorted, and misunderstood by the conscious psychic system.[24]
These day-dreams are invested with great interest, carefully cherished
and usually concealed with some shame, as though they belonged to the
person's most intimate possessions. It is easy to recognize a
day-dreamer in the street, however, by his sudden absent-minded smile,
his way of talking to himself, or the hastening of his steps which
marks the climax of the fancied situation. All hysterical attacks
which I have been able to investigate up to the present have proved to
be involuntary day-dreams of this kind breaking in upon ordinary
life. Now our observations leave no room for doubt that phantasies of
this sort may be unconscious as well as conscious in nature, and that
as soon as they become unconscious they may become pathogenic, _i.e._
may express themselves in symptoms or attacks. Under favourable
circumstances consciousness may just be able to capture such an
unconscious phantasy. After I had drawn the attention of one of my
patients to her phantasies, she told me that on one occasion she had
burst into tears in the street, and that, thinking quickly what she
had been crying about, she realized the existence of a phantasy in her
mind that a pianist well known in the town (but not personally
acquainted with her) had entered into an intimate relationship with
her, that she had had a child by him (she was childless), and that he
had deserted her and her child and left them in misery. It {53} was at
this point of her romance that she burst into tears.
Unconscious phantasies have either always been unconscious and formed
in the unconscious, or more often they were once conscious phantasies,
day-dreams, and have been purposely forgotten and driven into the
unconscious by 'repression'. Their content may then either have
remained the same or may have been altered, so that the phantasies
which are now unconscious are derivatives of phantasies that were once
conscious. Now an unconscious phantasy has a very important connection
with the sexual life of the person; it is actually identical with the
phantasy which served the person in his sexual gratification during
the period of masturbation. The masturbatory (in the widest sense,
onanistic) act at that time consisted of two parts, one of which was
the creation of the phantasy, and the other a manipulative performance
for attaining auto-erotic gratification at the climax of the
phantasy. It is known that these two components of the act have first
had to be welded together.[25] Originally the active performance was a
purely auto-erotic proceeding for the purpose of obtaining pleasure
from a particular erotogenic part of the body. Later this performance
became bound up with the idea of a wish emanating from the sphere of
object-love, and served as a partial realization of the situation in
which the phantasy culminated. If the person subsequently renounces
this type of masturbatory gratification with phantasy, the action is
given up, but the previously conscious phantasy becomes an unconscious
one. It may happen that no other form of sexual gratification
supervenes, the person remaining abstinent and not succeeding in
sublimating his libido, that is, in deflecting his sexual excitation
into higher channels; these are, then, the conditions under which the
unconscious phantasy is re-stimulated, and under which it will grow
and spread and, drawing upon the whole might {54} of the person's need
for love, will achieve expression of at least a part of its content in
the form of a morbid symptom.
In this way such unconscious phantasies are the immediate precursors
in the mind of a whole series of hysterical symptoms. The hysterical
symptoms are nothing but the unconscious phantasies made manifest by
'conversion', and in so far as the symptoms are of a somatic kind they
are often enough drawn from within the range of the sexual feelings
and motor innervations that originally accompanied the phantasy while
it was still conscious. In this way the process of discontinuing
masturbation is literally reproduced again backwards; while the final
aim of the whole pathological process, restoration of the original
primary sexual gratification, is achieved, though never, it is true,
completely, yet always by a sort of approximation.
Those who study hysteria find their attention therefore very soon
diverted from the symptoms and directed to the phantasies which give
rise to the symptoms. The technique of psycho-analysis enables us
first of all to infer the unconscious phantasies from the symptoms and
then to enable the patient to become conscious of them. Now it has
been found by this means that the content of the unconscious
phantasies of hysterical patients is in complete accordance with the
conscious ways in which perverts actually obtain gratification; and if
any one requires examples of such situations he need only call to mind
the world-famed orgies of the Roman Emperors, the madness of which, of
course, was the product of the unrestrained power and liberty
possessed by their creators. The delusions of paranoiacs are of a
similar nature but are phantasies which achieve direct access to
consciousness; they are based on the masochistic-sadistic component of
the sexual instinct, and they too have their complete counterpart in
certain unconscious phantasies of hysterical persons. Of practical
importance, too, is the case of hysterical persons who may not express
their phantasies {55} as symptoms, but consciously realize them in
action and thus imagine and actually bring about assaults, attacks, or
sexual aggressions.
This method of psycho-analytic investigation, which proceeds from the
conspicuous symptoms to the hidden unconscious phantasies, reveals
everything that can be found out about the sexuality of
psychoneurotics, including the fact which is the subject of this short
preliminary publication.[26]
The reason why the relationship between the phantasies and the
symptoms is no simple one but very complicated, is in all probability
due to the obstacles which the unconscious phantasies meet with in
seeking to find expression.1 As a rule, _i.e._ when the neurosis is
fully developed and has persisted for some time, a particular symptom
corresponds not to a single unconscious phantasy, but to several such;
and this correspondence, moreover, is no arbitrary one but obeys
definite laws. At the beginning of the illness these complications
are not likely to be all fully developed.
For the sake of general interest I will here trespass beyond the
continuity of my argument and try to describe the nature of hysterical
symptoms in a series of successively exhaustive formulas. They do not
contradict one another, but they consist partly in attempts at greater
completeness and more precise classification, and partly of
applications of different points of view.
1. The hysterical symptom is the memory-symbol of the operation of
certain (traumatic) impressions and experiences.
2. The hysterical symptom is a substitute, produced by 'conversion',
for the reactivation of these traumatic experiences by association.
3. The hysterical symptom is, like other mental products, the
expression of a wish-fulfilment.
{56}
4. The hysterical symptom is a realization of an unconscious phantasy
which serves as a wish-fulfilment.
5. The hysterical symptom serves the purposes of sexual gratification
and represents a part of the sexual life of the person (corresponding
to one of the components of his sexual instinct).
6. The hysterical symptom corresponds to the recurrence of a form of
sexual gratification which was real in infantile life and has since
been repressed.
7. The hysterical symptom arises as a compromise between two opposing
affects or instinctual trends, of which one is attempting to express a
partial impulse or component of the sexual constitution, while the
other tries to suppress it.
8. The hysterical symptom may represent various unconscious non-sexual
impulses, but can never dispense with a sexual significance.
Among these various definitions the seventh is the one which defines
the hysterical symptom most completely as the realization of an
unconscious phantasy, and the eighth recognizes the proper
significance of the sexual factor. Some of the previous formulas lead
up to this and are contained in it.
The connection between the symptoms and the phantasies makes it easy
to arrive, by psycho-analysis of the former, at a knowledge of the
components of the sexual instinct dominating the person concerned,
which I have described in my _Drei Abhandlungen zur Sexualtheorie_. In
some cases, however, investigation by this means yields an unsuspected
result. It shows that for many symptoms it is not enough to resolve
only one unconscious sexual phantasy or even a number of them, of
which one, the most important and fundamental, is of a sexual nature;
to resolve the symptom one has, on the contrary, to deal with two
sexual phantasies, of which one has a masculine and the other a
feminine character, so that one of these phantasies has its source in
a homosexual trend. This {57} new statement does not alter our seventh
formula; an hysterical symptom must necessarily be a compromise
between a libidinal and a repressing force, but incidentally it may
represent a combination of two libidinal phantasies of an opposite
sexual character.
I shall refrain from giving examples of this law. I have found from
experience that short condensed analyses always fail in the convincing
effect for which they are intended, and I must leave an account of
fully analysed cases for another time.
I will, therefore, merely state the following formula and explain its
import.
9. An hysterical symptom is the expression of both a masculine and a
feminine unconscious sexual phantasy.
I must expressly mention that I cannot claim the same general validity
for this formula as for the others. As far as I can see, it applies
neither to all the symptoms of one case nor to all cases. On the
contrary, it is not hard to find cases in which the antithetical
sexual impulses have found expression in separate symptoms, so that
the symptoms of the heterosexuality and the homosexuality can be as
clearly distinguished from each other as the underlying latent
phantasies. Nevertheless, the condition stated in this ninth formula
is frequent enough, and important enough when it occurs to deserve
particular emphasis. It seems to me to mark the highest degree of
complexity in the way in which an hysterical symptom can be
determined, and one may expect, therefore, to meet with it only when a
neurosis has persisted for a long time and undergone considerable
organization.[27]
The bisexual nature of hysterical symptoms can nevertheless be
demonstrated in numerous cases, and this is in any event an
interesting confirmation of my view that the assumption of a bisexual
predisposition {58} in man[28] is particularly clearly brought out by
psycho-analysis of neurotics. A quite analogous condition occurs when
anyone in his conscious masturbatory phantasies pictures himself both
as the man and as the woman in an imagined situation; further
counterparts of this are found in certain hysterical attacks in which
the patient acts at one and the same time both parts of the underlying
sexual phantasy---for instance, in one case I observed, the patient
pressed her dress to her body with one hand (as the woman) while
trying to tear it off with the other (as the man). These simultaneous
contradictory actions largely obscure the situation which is otherwise
so plastically portrayed in attacks, and thus serve very well to
conceal the unconscious phantasy which is actually at work.
In treatment by psycho-analysis it is very important to be prepared
for the bisexual meaning of a symptom. One need not then be surprised
or misled if a symptom seems to persist with undiminished force though
one of its sexual meanings has already been resolved. It is then still
being maintained by the perhaps unsuspected opposite sexual trend. In
the treatment of such cases one may also observe how the patient finds
an easy way of _evading_ analysis of one sexual meaning by diverting
his associations constantly to the opposite meaning, as if along a
parallel line.
----------------------------------------------------------------------
VI {59}
ON THE SEXUAL THEORIES OF CHILDREN[29]
(1908)
The material on which the following synthesis is built up is derived
from many sources. First, from the direct observation of what children
say and do; secondly, from what adult neurotics consciously remember
of their childhood and retail during psycho-analytic treatment; and
thirdly, from the conclusions, reconstructions and unconscious
memories translated into consciousness which result from the
psycho-analysis of neurotics.
That the first of these three sources has not alone supplied all that
is worth knowing on the subject is due to the attitude of adults
towards childish sexual life. Children are not credited with any
sexual activities, therefore no pains are taken to observe anything of
the kind, while on the other hand any expressions of such a thing
which would be worthy of attention are suppressed. Consequently the
opportunity of gaining information from this most genuine and fertile
source is greatly restricted. Whatever we derive from the uninfluenced
communications of adults concerning their conscious childhood is at
best subject to the objection that it is perhaps falsified in looking
back and, further, has to be estimated in the light of the fact that
the persons in question have later become neurotic. The material from
the third source is subject to all the attacks that are in general
directed against the trustworthiness of psycho-analysis and the
reliability of the conclusions drawn from it, so that {60} no
justification of it can be attempted here; I will only assert that
those who know and make use of the psycho-analytic technique acquire
extensive confidence in its results.
I cannot guarantee the completeness of my collection, but I can answer
for the care taken in gathering the material.
There remains a difficult question to decide. How far ought one to
take for granted what is here reported about children in general as
being true of all children, _i.e._ of every individual child? Pressure
of education and the varying intensity of the sexual instinct
certainly render possible great individual variations in the sexual
behaviour of children, and, above all, these things influence the date
at which the childish interest in sexuality appears. Therefore I have
not arranged my material according to the successive epochs of
childhood, but have included in one recital what applies to various
children, in one early, and in another late. It is my conviction that
no child---none, at least, who is mentally sound, still less one who
is mentally gifted---can avoid being occupied with sexual problems in
the years _before_ puberty.
I do not think much of the objection that neurotics are a special
class of people marked by a degenerative disposition, whose child-life
must not be regarded as evidence of the childhood of others. Neurotics
are human beings like every one else, and cannot be sharply
differentiated from normal people; in their childhood they are not
easily distinguishable from those who later remain healthy. It is one
of the most valuable results of our psycho-analytic investigations to
have found that their neuroses have no special mental content peculiar
to them, but that, as C. G. Jung has expressed it, they fall ill of
the same complexes with which we who are healthy also have to
contend. The difference is only that the healthy know how to overcome
these complexes without great and practically demonstrable harm; while
the suppression of {61} these complexes in nervous people only
succeeds at the price of costly substitute-formations, thus in
practice proving unsuccessful. In childhood nervous and normal people
naturally approximate much more closely than in later life, so that I
cannot recognize it as an error in method to make use of the
communications of neurotics concerning their childhood as analogies
for normal child-life. Since those who later become neurotics very
frequently include in their constitution an especially strong sexual
instinct and a disposition to precocity and to premature expression of
this impulse, they enable us in this way to recognize much of the
infantile sexual activities more plainly and more correctly than, with
our blunted talent for observation of ordinary children, would
otherwise be possible. The true value of these communications by adult
neurotics can only be estimated, to be sure, when a collection of the
childhood-memories of adult healthy people, made after the manner of
Havelock Ellis, has also been taken into account.
In consequence of both external and internal unfavourable
circumstances, the following remarks apply chiefly to the sexual
development of one sex only, namely, the male. The value of a
compilation such as I attempt here, however, need not be merely
descriptive. The knowledge of the infantile sexual theories in the
form in which they appear in childish thoughts can be of interest in
various directions---for instance, surprisingly so for an
understanding of myths and fairy-tales. They are indispensable for the
understanding of the neuroses, where these childish theories are still
in operation and have acquired a determining influence upon the form
taken by the symptoms.
* *
*
If, forgetting our mortality and imagining ourselves to be merely
thinking beings, gazing, for instance, from another planet, we could
apprehend the things of this earth afresh, perhaps nothing would
arrest our {62} attention more forcibly than the existence of two
sexes among human beings, who otherwise resemble each other so closely
and yet emphasize their difference even in the most superficial
indications. Now it does not seem that children also choose this
fundamental fact as the starting-point of their investigations
concerning sexual problems. Since they have known a father and a
mother as far back as they can remember in life, they accept their
existence as a reality which needs no further inquiry, and in just the
same way does a boy behave towards a little sister from whom he is
only separated by a slight difference of age, by one or two years. The
child's desire for knowledge does not awaken spontaneously on this
point at all, as it would if prompted perhaps by an inborn need to
seek for causes, but arises under the goad of a self-seeking impulse
which dominates him when he is confronted by the arrival of a new
child---perchance at the end of the second year. Those children whose
own nursery at home does not become divided up in this way are
nevertheless able as a result of their own observations to put
themselves in the place of others who are in this situation in other
homes. The loss of the parents' care and concern, which they actually
experience or with justice fear, the presentiment that they must from
now and for ever share all possessions with the newcomer, has the
effect of awakening the emotions of the child and sharpening its
thinking capacities. The elder child expresses unconcealed hostility
against the newcomer, which finds vent in unfriendly criticisms of it,
in wishes that 'the stork should take it back again', and occasionally
even in attempts at little outrages upon the helpless creature lying
in the cradle. A greater difference of age as a rule modifies the
expression of this primary hostility; just as in somewhat later years,
if brothers and sisters fail to appear, the wish for a playmate like
those observed elsewhere obtains the upper hand.
Under the stimulus of these feelings and anxieties {63} the child thus
comes to consider the first of the great problems of life, and asks
itself the question where children come from, which at first runs,
'Where did this particular tiresome child come from?' The after-echo
of this first riddle seems to be observable in the innumerable riddles
of myths and sagas. The question itself, like all inquiry, is a
product of dire necessity, as if to thought were entrusted the task of
preventing the repetition of an event so greatly feared. At the same
time, we may assume, the child's thinking becomes independent of the
stimulus, and continues its activity as a separate impulse towards
investigation. Where a child is not already too much intimidated, it
takes sooner or later the shortest way by demanding answers from its
parents or attendants, who signify for it the source of all
knowledge. This way, however, fails. The child receives either evasive
answers or a rebuke for its curiosity, or is dismissed with that
mythologically significant information which in German runs: 'The
stork brings the children; it fetches them out of the water'. I have
grounds for supposing that far more children than parents suspect are
dissatisfied with this solution, and respond to it with pronounced
doubt, which, however, is not always outspoken. I know of a
three-year-old boy who, to the terror of his nurse, was missed after
receiving this enlightenment, and found at the edge of the big lake of
the castle, where he had run, in order to see the children in the
water! I know of another who could allow his disbelief only
hesitating expression by saying he knew better, it was not storks who
bring the children, but herons. It appears to me from much of the
evidence conclusive that children refuse to believe the stork theory,
and that from the time of this first deception and rebuff they nourish
a mistrust against adults, have the presentiment of something
forbidden which is being withheld from them by the 'grown-ups', and
consequently conceal their further investigations by secrecy. With
this, however, it comes about that they {64} experience the first
occasion of a 'psychical conflict', in that ideas for which they 'by
instinct' feel a preference, but which adults consider 'naughty', come
into opposition with others which are maintained by the authority of
the adults without being acceptable to them themselves. Out of these
mental conflicts there may soon arise a 'mental dissociation'; the one
idea which is bound up with 'being good', but also with a cessation of
thinking, becomes the prevailing conscious one; the other, for which
meanwhile the inquiries prosecuted have brought new evidence, which is
not supposed to count, becomes suppressed and unconscious. The nuclear
complex of neurosis is formed in this way.
Lately, by the analysis of a five-year-old boy[30] which his father
undertook and permitted me to publish, I have received an irrefutable
proof of a piece of knowledge towards which the psycho-analysis of
adults had for long led me. I now know that the changes in the mother
during pregnancy do not escape the sharp eyes of a child, and that the
latter is very well able subsequently to establish the correct
connection between the increase in size of the mother's body and the
appearance of a baby. In the case mentioned, the boy was three and a
half when his sister was born, and four and three-quarters when he
showed his better knowledge by the most unmistakable allusions. This
precocious knowledge is, however, always kept secret, and later, in
connection with the future fate of childish sexual inquiry, is
repressed and forgotten.
The stork fable, therefore, is not one of the infantile sexual
theories; indeed, the observation of animals, who hide so little of
their sexual life and to whom children feel so closely related,
strengthens their disbelief. With the knowledge independently obtained
that babies grow in the mother's body, a child would be on the right
path to solve the problem on which it {65} first tries its thinking
powers. Its further progress is stopped, however, by a piece of
ignorance which cannot be made good, and by false theories which the
condition of its own sexuality imposes on it.
These false sexual theories, which I will now describe, all have one
very curious characteristic. Although they go astray in a grotesque
way, yet they all, each one of them, contain a bit of the real truth,
so that they are analogous to those adult attempts at solution, which
we call flashes of genius, of the problems of the universe that are
too difficult for human comprehension. What is correct and hits the
mark in these theories is to be explained by their origin in those
components of the sexual instinct which are already active in the
childish organism; for it is not due to an arbitrary mental act or to
chance impressions that these notions arise, but to the necessities of
the psychosexual constitution, and this is why we are able to speak of
typical sexual theories in children, this is why we find the same
false ideas in all children whose sexual life is accessible to us.
The first of these theories begins with a neglect of
sex-differentiation, the neglect to which we called special attention
at the commencement as being characteristic of children. It consists
in attributing to everybody, including women, a penis just like the
one the boy knows of from his own body. It is precisely in that sexual
constitution which we must recognize as a normal one that the penis is
already in childhood the governing erotogenic zone, the most important
autoerotic sexual object, and the estimate of its value is logically
reflected in the impossibility of imagining a person similar to the
self without this essential part. If a little boy obtains a sight of
the genitals of a little sister, what he says will show that his
prejudice is already strong enough to influence the perception; he
does not remark on the lack of the penis but _invariably_ says, as if
consoling and reconciling: that her 'widdler' is still small, but when
she is bigger it {66} will soon grow. The idea of a woman with a penis
returns still later in the dreams of adults; in a state of nocturnal
sexual excitation he throws down a woman, exposes her and prepares for
coitus; then on beholding the well-formed penis at the site of the
female genitals, the dream and excitation break off. The numerous
hermaphrodites of classic antiquity faithfully reproduce this once
general infantile idea; one may observe that to most normal people
they cause no offence, while actual hermaphroditic formations of the
genitals in nature nearly always excite the greatest abhorrence.
If this idea of woman with a penis becomes 'fixated' in a child, it
resists all the influences of later life and makes the man incapable
of dispensing with a penis in his sexual object, so that such a
person, if otherwise he has a normal sexual life, must become
homosexual, seeking his sexual object in men who through other
physical and mental qualities remind him of women. Real women, as they
become known to him later, are excluded from being sexual objects to
him because they lack the essential sexual attraction; indeed, in
connection with another impression of childhood-life they may become
abhorrent to him. A child who is chiefly dominated by penis-excitation
usually produces pleasure by stimulation of it with his hand, is
detected doing this by his parents or by the persons in charge of him,
and is terrorized by the threat that his penis will be cut off. The
effect of this 'castration threat' is in direct proportion to the
value set upon this part of the body, _i.e._, quite extraordinarily
deep-rooted and persistent. Sagas and myths testify to the revolt in
the childish feelings, to the horror which is then linked to the
castration complex, and this later is remembered with corresponding
reluctance by consciousness. The woman's genitalia, seen subsequently
and regarded as mutilated, recall this threat, and thus awaken in the
homosexual horror instead of pleasure. This reaction is not altered
by his learning through science that {67} the childish assumption is
not so far wrong after all, namely, that a woman also possesses a
penis. Anatomy has recognized the clitoris within the female pudenda
as an organ homologous to the penis, and the physiology of sexual
processes has been able to add that this little penis which no longer
grows behaves in the childhood of the woman like a genuine and real
penis, that it is the site of excitations which leads to its being
touched, that its excitability gives the sexual activity of little
girls a male character, and that it needs an effort of repression in
the years of puberty to make the woman develop through discarding this
male sexuality. The fact that the sexual function of many women is
crippled by their obstinately clinging to this clitoris
excitability---so that they remain anæsthetic in coitus, or that
repression succeeds so excessively that its action is partly nullified
by hysterical compensatory formations---all this shows that the
infantile sexual theory that a woman possesses a penis like a man has
some truth in it.
One can easily observe that little girls are quite in agreement with
their brothers' estimate. They develop a great interest in this part
of a boy's body, but this interest is at once dominated by
jealousy. They feel themselves injured; they make attempts to urinate
in the position that is possible to the boy by his possession of the
big penis, and when they express the wish, 'I should love to be a
boy', we know what lack the wish is to remedy.
If children could follow the hint given them by the excitation in the
penis, they would get a little nearer to the solution of their
problems. That the baby grows in the mother's body is obviously not a
sufficient explanation. How does it get there? What starts it
developing there? That the father has something to do with it is
probable; indeed, he declares that the baby is also _his_ child.[31]
The penis, too, certainly also has its share in these mysterious
happenings; it testifies to this by the accompanying excitation in it
{68} during all this thought-work. Along with this excitation obscure
impulses are roused, which the child does not know how to account
for---to do something violent, to press in, to knock to pieces, to
burst open a hole somewhere. But when the child seems thus in a fair
way to arrive at the existence of the vagina, and to attribute to the
father's penis an act of incursion into the mother which should create
the baby in the body of the mother, the inquiry breaks off helplessly;
for at this point there stands in the way the theory that the mother
possesses a penis like a man, and the existence of the cavity which
receives the penis remains undiscovered to the child. One can readily
surmise that the lack of success of this effort of thought facilitates
a rejection and forgetting of it. These speculations and doubts,
however, become the prototype of all later thought-work on problems,
and the first failure has a crippling effect for ever after.
Their ignorance of the vagina again makes it possible for children to
have a conviction which constitutes the second of their sexual
theories. If the baby grows in the body of the mother and is then
detached from it, this can only happen by the sole possible way of the
anal aperture. The child must be expelled like excrement, like a
motion. If in later childhood the same question is the subject of
solitary reflection or of a discussion between two children, then the
explanations probably are that the baby comes out of the navel, which
opens, or that the belly is slit and the child taken out, as happens
to the wolf in the tale of Little Red Riding-Hood. These theories are
expressed aloud and later consciously remembered; they no longer
contain anything shocking. These same children have then completely
forgotten that in earlier years they believed another sexual theory,
which since then has undergone the subsequent repression of the anal
sexual components. At that time an evacuation was something which
could be spoken about in the nursery without shame; the child was
still not so far distant {69} from his constitutional coprophilic
inclinations; it was no degradation then to come into the world like a
mass of fæces, which had not yet been attainted by disgust. The
_cloaca_ theory, which is valid for so many animals, was the most
natural and the only one which could force itself upon the child as
probable.
Then, however, it was only logical that the child should refuse to
grant women the painful monopoly of giving birth to children. If
babies are born through the anus then a man can give birth just as
well as a woman. A boy can therefore fancy that he too has children
of his own without our needing to accuse him of feminine
inclinations. It is only his still active anal erotism at work.
If the cloaca theory of birth is preserved in consciousness in later
years of childhood, which occasionally happens, it is then accompanied
by another solution of the question concerning the origin of children,
one which, it is true, is no longer the original one. It is like that
in fairy-tales. One eats some particular thing and from this one gets
a child. The insane re-animate this infantile birth theory. A maniac,
for instance, will lead the visiting physician to a heap of fæces
which she has deposited in a corner of her cell, and say to him,
laughing, 'That is the child I bore to-day'.
The third of the typical sexual theories appears in children when
through some unforeseen domestic occurrence they witness parental
sexual intercourse, concerning which they are then able to obtain only
a very incomplete idea. Whatever detail it may be that comes under
their observation, whether it is the position of the two people, or
the sounds, or certain accessory circumstances, in all cases they
arrive at the same conclusion, that is, at what we may call the
_sadistic conception of coitus_, seeing in it something that the
stronger person inflicts on the weaker by force, and comparing it,
especially the boy, to a fight as they know it from their childish
play, in which, by the way, an admixture of sexual excitation is also
not wanting. {70} I have not been able to establish whether children
recognize this procedure which they observe between the parents as the
necessary missing link in the problem of the birth of children; more
often it appears that this connection is overlooked by children for
the very reason that they had interpreted the love-act as an act of
violence. But this sadistic conception itself gives the impression of
a re-appearance of that obscure impulse towards cruel activity which
was linked up with penis-excitation when the child first reflected
upon the puzzle of where children come from. The possibility cannot be
excluded that that precocious sadistic impulse, which might have led
to discovery of the mystery of coitus, itself appeared first under the
influence of very dim memories of parental intercourse for which the
child had obtained material, without at the time making use of it,
when it shared the bedroom of its parents in the first years of its
life.[32]
The sadistic theory of coitus, which by itself becomes a false guide
where it might have led to enlightenment, is again the expression of
one of the inborn components of the sexual instinct, any one of which
may be more or less strongly marked in any particular child, and thus
the sadistic conception is to a certain extent true; in part it
divines the essence of the sexual act and the 'antagonism of the
sexes' which precedes it. Often, too, the child is in a position to
support this conception by accidental observations which it
understands in part correctly, in part falsely. In many marriages the
wife, in fact, regularly opposes the matrimonial embrace, which to her
brings no pleasure and the risk of a fresh pregnancy, and thus to the
child who is supposed to be asleep (or pretending to be asleep) the
mother might give an impression that could only be explained as
meaning warding off an act of violence. At other times the whole
marriage presents to the observant child {71} the spectacle of an
unceasing quarrel, expressed by loud words and unfriendly gestures, so
that the child need not wonder that this quarrel goes on in the night,
too, and is finally decided by the very same means which the child
himself is accustomed to make use of in its intercourse with its
brothers, sisters and companions, that is, by a fight.
The child also regards it as a confirmation of his idea if he
discovers spots of blood in the bed or on his mother's linen. These
are to him a proof that in the night an attack of this kind by the
father on the mother has again taken place, while we should rather
take the fresh spots of blood to mean that sexual intercourse for the
time being had ceased. Much of the inexplicable 'horror of blood' in
the nervous finds its explanation in this connection. The child's
mistake again covers a small part of the truth, for in certain
well-known circumstances a trace of blood is indeed regarded as a sign
of initiated sexual intercourse.
In less direct connection with the insoluble problem of where children
come from, the child occupies itself with the question of what the
nature and the content is of the state called 'being married'; and it
answers the question differently according to its accidental
observations of its parents combined with its own impulses which are
still invested with pleasurable feeling. All that these answers appear
to have in common is that marriage promises pleasurable gratification,
and presupposes a disregard for modesty. The idea I have most
frequently met with is that 'one urinates before the other'; a
variation of this which sounds as if it signified better knowledge
symbolically is that 'the man urinates into the woman's chamber'. On
other occasions the meaning of marriage is supposed to be that the two
persons show their buttocks to each other (without shame). In one case
in which training had succeeded in postponing sexual knowledge
especially late, a fourteen-year-old girl who had already begun to
menstruate arrived at the idea from reading {72} that being married
signified 'mixing blood', and since her own sister had not yet had a
period the lustful girl attempted to outrage a visitor who confessed
that she was just menstruating, so as to compel her to take part in
this 'mixing blood'.
The infantile ideas about the nature of marriage, which are not seldom
retained by the conscious memory, have great significance for the
symptoms of later neurotic illness. They come into evidence first of
all in childish games, in which one does with the other whatever it is
that constitutes being married, and then later on the wish to be
married can choose the infantile form of expression when it appears in
a phobia or some similar symptom which at first sight seemed
incomprehensible.[33]
These are the most important of the typical sexual theories that
children produce spontaneously in early childhood-years under the
influence of the components of the sexual instinct. I know that the
material is far from complete and that I have not established a full
connection between it and the rest of child-life. I can here add a few
supplementary remarks which otherwise every experienced person would
have missed in my account. Thus, for instance, the significant theory
that one gets a child by a kiss, which obviously betrays a
pre-eminence of the erotogenic mouth zone. In my experience this
theory is exclusively feminine and is sometimes met with as pathogenic
in girls whose sexual curiosity had undergone very strong inhibition
in childhood. One of my female patients through an accidental
observation happened upon the theory of the 'couvade', which is well
known among many races as a general practice, and probably has the
purpose of contradicting that doubt about paternity that is never
quite to be overcome. After the birth of his child, a rather strange
uncle of hers remained for days at home and received visitors in his
night-shirt, {73} so she concluded that both parents had a share in
the birth and must go to bed.
About the tenth or eleventh year information about sexual matters
comes to children. A child who has grown up unchecked in its social
relations, or who in some other way has found a good opportunity for
observation, communicates to other children what he knows, because by
doing so he can feel himself to be grown-up and superior. What
children learn in this way is mostly correct, that is, the existence
of the vagina and its use is revealed to them, but otherwise the
enlightenment which they get from one another is frequently mixed with
false ideas, and burdened with the remains of older infantile sexual
theories. It is scarcely ever complete and sufficient to solve the
original problems. Just as formerly with the ignorance of the vagina,
so now ignorance of the semen prevents understanding of the whole
process. The child cannot guess that out of the male sexual organ
another substance can be expelled besides urine, and occasionally an
'innocent' girl on her wedding night is still indignant because the
man has 'urinated into her'. This information acquired before puberty
links up with a fresh impetus in childish inquiries; the theories
which the child now produces, however, have no longer the typical and
original stamp, which was characteristic of the early primary ones as
long as the infantile sexual components were uninhibited and
untransformed and could come to expression in these theories. The
later intellectual efforts to solve the sexual puzzle seemed to me not
worth the trouble of collecting, nor have they much claim to a
pathogenic significance. Their multiplicity is naturally mainly
dependent upon the nature of the first information received, their
significance consists rather in that they re-awaken the unconscious
vestiges of that first period of sexual interest, so that not seldom
masturbatory sexual activities and a part of the detachment of feeling
from the parents is linked up with them. Hence the {74} condemning
judgement of teachers that such information at this age 'corrupts'
children.
A few examples may show what elements often enter into these later
speculations by children about sexual life. A girl had heard from her
school companions that the man gives the woman an egg, which she
hatches in her body. A boy who had also heard of the egg, identified
it with the testicle, which is vulgarly called by the same name, and
thereupon puzzled his head how the content of the scrotum could always
become renewed. The information given seldom reaches as far as to
prevent important doubts on the matter of sexual processes. Thus girls
may come to expect that coitus happens only on one single occasion but
lasts very long, for twenty-four hours, and that from this one
occasion come all the successive children. One would suppose that this
child had knowledge of the process of propagation in certain insects:
however, this conjecture was not confirmed and the theory appeared to
be an independent creation. Other girls ignore the time of gestation,
the life in the womb, and suppose that the child appears immediately
after the night of the first connection. Marcel Prévost has turned
this mistake of young girls into an amusing story in one of his
_Lettres de femmes_. Hardly to be exhausted and perhaps in general
not uninteresting is this theme of the later sexual inquiries of
children, or of adolescents who have been delayed at a childish stage;
but it lies further from my purpose, and I must only call special
attention to the fact that many errors are invented by children in
order to contradict older, better but now unconscious and repressed
knowledge.
The way in which the child behaves when he receives information also
has its significance. In many children sexual repression has gone so
far that they will not hear anything, and these may also succeed in
remaining ignorant until even later (apparently, at least) till the
knowledge dating from early childhood comes to light in the
psycho-analysis of neurotics. I {75} know also of two boys between ten
and thirteen years old, who certainly listened to sexual information
but gave their informant the averting answer: 'It is possible that
your father and other people do such things, but I know for certain
that my father would never do it'. However this later attitude in
children towards satisfying their sexual curiosity may vary, we can
postulate a thoroughly uniform behaviour in them in early years and
believe that at that period they were all eager to find out what it is
the parents do with each other to make the babies.
----------------------------------------------------------------------
VII {76}
'CIVILIZED' SEXUAL MORALITY AND
MODERN NERVOUSNESS[34]
(1908)
In his recently published book on sexual ethics, von Ehrenfels dwells
on the difference between 'natural' and 'civilized' (cultural) sexual
morality. By 'natural' sexual morality he understands that system of
control which enables a race to preserve its health and efficiency; by
'civilized', that system which when followed spurs man to more
intensive and productive cultural activity. According to him this
contrast is best elucidated by comparing the innate character of a
people with its cultural attainments. While referring to von
Ehrenfels' paper[35] for the better appreciation of this significant
line of thought, I shall take from it only so much as I need to
establish the connection with my own contribution to the subject.
It is natural to suppose that under the domination of a 'civilized'
morality the health and efficiency in life of the individuals may be
impaired, and that ultimately this injury to the individual, caused by
the sacrifices imposed upon him, may reach such a pitch that the
'civilized' aim and end will itself be indirectly endangered. Indeed,
von Ehrenfels points to a series of injurious effects, responsibility
for which he attributes to the code of sexual morality at present
prevailing in our Western society; and although he fully acknowledges
its high value for the furtherance of civilization, he concludes by
judging it to be in need of reform. {77} Characteristic of present-day
sexual morality is the extension of the demands made upon women on to
the sexual life of the male, and the taboo on all sexual intercourse
except in monogamous marriage. Even so, consideration of the natural
difference in the sexes necessitates less condemnation of lapses in
the male, and so in effect admission of a double code of morality for
him. But a society which accepts this double code cannot attain to
'love of truth, honesty and humanity'[36] except to a certain narrowly
limited degree, and must incline its members to concealment of the
truth, to euphemism, to self-deception, and to the deception of
others. Civilized sexual morality does worse, indeed, than this, for
by glorifying monogamy it cripples virile selection---the sole
influence by which an improvement of the race can be attained, for
among civilized peoples vital selection is reduced to a minimum by
humane and hygienic considerations.[37]
Among the injurious effects attributed to sexual morality the
physician misses precisely the one whose significance we are now to
consider. I refer to the way in which it promotes modern nervousness,
which under our present social conditions is rapidly
spreading. Occasionally a nervous patient will himself draw the
physician's attention to the part played in the causation of his
sufferings by the opposition between his constitution and the demands
of civilization, and will remark: 'We in our family have all become
nervous because we wanted to be something better than what with our
origin we were capable of being.' The physician is also frequently
given matter for thought by observing that neurosis attacks precisely
those whose forefathers, after living in simple, healthy, country
conditions, offshoots of rude but vigorous stocks, came to the great
cities where they were successful and were able {78} in a short space
of time to raise their children to a high level of cultural
attainment. But, most cogent of all, neurologists themselves have
loudly proclaimed the connection between the 'increasing nervousness'
of the present day and modern civilized life. A few extracts from the
opinions of eminent observers will show clearly upon what they base
this connection.
W. Erb:[38] 'The original question may now be summarized thus: Are
those causes of nervousness which have been put before you so markedly
on the increase under modern conditions of life as to declare those
conditions responsible? This question can be answered without
hesitation in the affirmative, as a cursory glance at our modern life
and its character will show.
'This is already clearly evidenced by an array of general facts: the
extraordinary achievements of modern times, the discoveries and
inventions in every field, the maintenance of progress in the face of
increasing competition, have been gained and can be held only by great
mental effort. The demands on the ability of the individual in the
struggle for existence have enormously increased, and he can meet them
only by putting forth all his mental powers; at the same time the
needs of the individual, and the demand for enjoyment, have increased
in all circles; unprecedented luxury is displayed by classes hitherto
wholly unaccustomed to any such thing; irreligion, discontent, and
covetousness are spreading widely through every degree of society. The
illimitable expansion of communication brought about by means of the
network of telegraphs and telephones encircling the world has
completely altered the conditions of business and travel. All is hurry
and agitation: night is used for travel, day for business; even
"holiday trips" keep the nervous system on the rack; important
political, industrial, financial crises carry excitement into far
wider circles than formerly; participation in political life has
become quite general; political, religious, and {79} social struggles,
party-interests, electioneering, endless associations of every kind
heat the imagination and force the mind to ever greater effort,
encroaching on the hours for recreation, sleep and rest; life in large
cities is constantly becoming more elaborate and more restless. The
exhausted nerves seek recuperation in increased stimulation, in
highly-seasoned pleasures, only thereby to become more exhausted than
before; modern literature is concerned predominantly with the most
questionable problems, those which stir all the passions---sensuality
and the craving for pleasure, contempt of every fundamental ethical
principle and every ideal demand; it brings pathological types,
together with sexual psychopathic, revolutionary and other problems,
before the mind of the reader. Our ears are excited and overstimulated
by large doses of insistent and noisy music. The theatres captivate
all the senses with their exciting modes of presentation; the creative
arts turn also by preference to the repellent, ugly and suggestive,
and do not hesitate to set before us in revolting realism the ugliest
aspect offered by actuality.
'This merely general picture suffices to show a series of dangers in
our modern cultural evolution, the details of which may be filled in
by a few strokes!'
Binswanger:[39] 'Neurasthenia especially has been described as
essentially a modern disorder, and Beard, to whom we are first
indebted for a general description of it, believed that he had
discovered a new nervous disease which had developed specifically in
America. This assumption was of course erroneous; nevertheless the
fact that an _American_ physician was the first to perceive and
maintain---as the fruit of great experience---the particular symptoms
of this disorder cannot fail to point to a close connection between
them and the modern way of life---the unbridled lust and haste for
gold and possessions, those immense advances in technical spheres
which have reduced to insignificance {80} all limitations of time and
space where communication is concerned.'
Von Krafft-Ebing:[40] 'The mode of life of innumerable civilized
peoples shows at the present time an abundance of anti-hygienic
factors which make it easy to understand the deplorable increase of
nervousness, for these harmful factors take effect first and foremost
on the brain. Changes have taken place in the political and social,
and particularly in the mercantile, industrial and agricultural
conditions of civilized peoples, in the course of no more than the
last decade, which have abruptly transformed professional life,
citizenship and property at the direct cost of the nervous system;
this is then called upon to meet the increased social and domestic
demands by a greater expenditure of energy, unredressed by any
satisfactory forms of recuperation.'
Of these and many other similarly-worded opinions I have to observe,
not that they are erroneous, but that they show themselves
insufficient to explain in detail the manifestations of nervous
disturbance, and that they leave out of account the most important
ætiological factor. If one passes over the less definite forms of
'nervousness' and considers the actual forms of nervous disease, the
injurious influence of culture reduces itself in all essentials to the
undue suppression of the sexual life in civilized peoples (or classes)
as a result of the 'civilized' sexual morality which prevails among
them.
The proof of this statement I have attempted to establish in a series
of technical papers.[41] It cannot be repeated here; still I will at
this point put forward the most important arguments arising from my
researches.
Close clinical observation empowers us to distinguish two groups of
nervous disorder, the true neuroses, and the psychoneuroses. In the
former, the disturbances (symptoms), whether bodily or mental, appear
to {81} be of a toxic character. The phenomena are essentially the
same as those due to excess or deficiency of certain
nerve-poisons. These neuroses, usually designated collectively as
'neurasthenia', can be induced by certain injurious influences in the
sexual life, without any hereditary taint being necessarily present;
indeed, the form taken by the disease corresponds with the nature of
these noxiæ, so that not seldom the clinical picture can be directly
employed as a key to the particular sexual ætiology. Any such regular
correspondence between the form of nervous disorder present and the
other injurious influences of civilization to which the writers quoted
above attribute so much is, however, entirely absent. It may,
therefore, be maintained that the sexual factor is the essential one
in the causation of the true neuroses.
With the psychoneuroses, hereditary influence is more marked, and the
causation less transparent. A peculiar method of investigation known
as psycho-analysis has, however, enabled us to recognize that the
symptoms of these disorders (hysteria, obsessional neurosis, etc.) are
psychogenic, and depend upon the operation of unconscious (repressed)
ideational complexes. This same method has taught us what these
unconscious complexes are, and has shown us that, speaking quite
generally, they have a sexual content. They originate in the sexual
needs of unsatisfied people, and represent a kind of substitute for
gratification of them. So that we must regard all factors which
operate injuriously upon the sexual life and suppress its activity or
distort its aims as likewise pathological factors in the
psychoneuroses.
The value of the theoretical distinction between the toxic and the
psychogenic neuroses is, of course, in no way lessened by the fact
that disturbances arising in both sources are to be observed in most
nervous people.
Anyone who is prepared to look with me for the ætiology of nervousness
pre-eminently in influences which cripple the sexual life, will
willingly give his {82} attention to some further
considerations, to be appended here, which are intended to review the
question of increasing nervousness in a broader application.
Our civilization is, generally speaking, founded on the suppression of
instincts. Each individual has contributed some renunciation---of his
sense of dominating power, of the aggressive and vindictive tendencies
of his personality. From these sources the common stock of the
material and ideal wealth of civilization has been accumulated. Over
and above the struggle for existence, it is chiefly family feeling,
with its erotic roots, which has induced the individuals to make this
renunciation. This renunciation has been a progressive one in the
evolution of civilization; the single steps in it were sanctioned by
religion. The modicum of instinctual satisfaction from which each one
had abstained was offered to the divinity as a sacrifice; and the
communal benefit thus won was declared 'holy'. The man who in
consequence of his unyielding nature cannot comply with the required
suppression of his instincts, becomes a criminal, an outlaw, unless
his social position or striking abilities enable him to hold his own
as a great man, a 'hero'.
The sexual instinct---or, more correctly, the sexual instincts, since
analytic investigation teaches us that the sexual instinct consists of
many single component impulses---is probably more strongly developed
in man than in most of the higher animals; it is certainly more
constant, since it has almost entirely overcome the periodicity
belonging to it in animals. It places an extraordinary amount of
energy at the disposal of 'cultural' activities; and this because of a
particularly marked characteristic that it possesses, namely, the
ability to displace its aim without materially losing in
intensity. This ability to exchange the originally sexual aim for
another which is no longer sexual but is psychically related, is
called the capacity for sublimation. In contrast with this ability for
displacement in which lies its value for civilization, the sexual {83}
instinct may also show a particularly obstinate tendency to fixation,
which prevents it from being turned to account in this way, and
occasionally leads to its degenerating into the so-called
abnormalities. The original strength of the sexual instinct probably
differs in each individual; certainly the capacity for sublimation is
variable. We imagine that the original constitution pre-eminently
decides how large a part of the sexual impulse of each individual can
be sublimated and made use of. In addition to this, the forces of
environment and of intellectual influence on the mental apparatus
succeed in disposing of a further portion of it by sublimation. To
extend this process of displacement illimitably is, however, certainly
no more possible than with the transmutation of heat into mechanical
power in the case of machines. A certain degree of direct sexual
satisfaction appears to be absolutely necessary for by far the greater
number of natures, and frustration of this variable individual need is
avenged by manifestations which, on account of their injurious effect
on functional activity and of their subjectively painful character, we
must regard as illness.
Further aspects are opened up when we take into consideration the fact
that the sexual instinct in man does not originally serve the purposes
of procreation, but has as its aim the gain of particular kinds of
pleasure.[42] It manifests itself thus in infancy, when it attains its
aim of pleasurable gratification not only in connection with the
genitalia, but also in other parts of the body (erotogenic zones), and
hence is in a position to disregard any other than these easily
accessible objects. We call this stage that of auto-erotism, and
assign to the child's training the task of circumscribing it, because
its protracted continuance would render the sexual instinct later
uncontrollable and unserviceable. In its development the sexual
instinct passes on from auto-erotism to object-love, and from the
autonomy {84} of the erotogenic zones to the subordination of these
under the primacy of the genitals, which come into the service of
procreation. During this development a part of the self-obtained
sexual excitation is checked, as being useless for the reproductive
functions, and in favourable cases is diverted to sublimation. The
energies available for 'cultural' development are thus in great part
won through suppression of the so-called perverse elements of sexual
excitation.
It would be possible to distinguish three stages in cultural
development corresponding with this development in the sexual
instinct: first, the stage in which the sexual impulse may be freely
exercised in regard to aims which do not lead to procreation; a second
stage, in which the whole of the sexual impulse is suppressed except
that portion which subserves procreation; and a third stage, in which
only _legitimate_ procreation is allowed as a sexual aim. This third
stage represents our current 'civilized' sexual morality.
If we regard the second of these stages as our standard, we must
acknowledge that a number of people, on account of their constitution,
are not equal to its demands. With whole classes of individuals, the
development of the sexual impulse referred to above, from auto-erotism
to object-love, with its aim of union of the genitalia, has not been
correctly and sufficiently completed. As a result of this disturbance
of development there arise two kinds of harmful deviation from normal
or 'civilized' sexuality; and these are related to one another almost
as positive to negative. They are, first (disregarding altogether
those persons with an over-powerful and uncontrollable sexual instinct
in general), the different varieties of perverts, in whom an infantile
fixation on a preliminary sexual aim has impeded the establishing of
the primacy of the reproductive function; secondly, the homosexuals or
inverts, in whom, in a way not yet quite understood, the sexual aim
has been deflected from the opposite sex. If the injurious results of
these two {85} forms of disturbance in development are less than might
have been expected, this can be directly ascribed to the complicated
co-ordination within the sexual instinct, which makes it possible for
the sexual life to express itself finally in some form or other, even
if one or more components of the instinct have been excluded from
development. The constitution of those suffering from inversion---the
homosexuals---is indeed often distinguished by the sexual impulse
lending itself to 'cultural' sublimation in a special degree.
Stronger developments of the perversions and of homosexuality,
especially if exclusive, do indeed make those who harbour them
socially unadaptable and unhappy, so that even the cultural demands of
the second stage must be recognized as a source of suffering for a
certain proportion of human beings. The fate of those persons who
differ constitutionally in this way from their fellows depends on
whether they are endowed with comparatively stronger or weaker sexual
impulses in an absolute sense. In the latter case, that of an impulse
which is on the whole weaker, perverts succeed in completely
suppressing those tendencies which bring them into conflict with the
moral demands of their level of civilization. But this, from the ideal
point of view, remains also their only achievement, because for this
repression of their sexual instinct they make use of all those
energies which otherwise they would employ in cultural activity. They
are at once inwardly stunted, and outwardly crippled. What we shall
presently say about the state of abstinence (of men and women)
demanded by the third state of culture applies to these also.
Where the sexual instinct is very strong but yet perverted, there are
two possible outcomes. In the first, which it is not necessary to
consider further, the afflicted person remains perverted, and has to
bear the consequences of his deviation from the prevailing level of
culture. The second way is much more interesting. Here, under the
pressure of education and social {86} demands, a suppression of the
perverse impulse is indeed attained, but it is of such a kind as not
to be a true one, and can be better described as a miscarriage of
suppression. The inhibited sexual impulses are not expressed as
such---and to that extent the inhibition is successful---but they are
expressed in other ways which are quite as injurious to the person
concerned, and make him quite as useless to society as satisfaction of
these suppressed impulses in their original form would have done; and
in this lies the failure of the process, which in the long run far
outweighs the success of the suppression. The
substitute-manifestations which thus present themselves in consequence
of suppression of the impulses constitute what we describe as
neurosis, in particular the psychoneuroses.[43] Neurotics are that
class of people, naturally rebellious, with whom the pressure of
cultural demands succeeds only in an apparent suppression of their
instincts, one which becomes ever less and less
effective. Consequently their co-operation in civilized life is
maintained only by means of a great expenditure of energy, combined
with inner impoverishment, and at times it has to be suspended
altogether during periods of illness. I have, however, described the
neuroses as the 'negative' of the perversions, because in the neuroses
the perverse tendencies come to expression from the unconscious part
of the mind, after the repression, and because they contain the same
tendencies in a state of repression that manifest perverts exhibit.
Experience teaches that for most people there is a limit beyond which
their constitution cannot comply with the demands of civilization. All
who wish to reach a higher standard than their constitution will
allow, fall victims to neurosis. It would have been better for them if
they could have remained less 'perfect'. The realization that
perversion and neurosis stand to one another as positive and negative
is often unambiguously confirmed by observations made on {87} members
of the same family. Quite often in one family the brother will be
sexually perverted, while the sister, who as a woman is endowed with a
weaker sexual instinct, becomes a neurotic---one whose symptoms,
however, express the same tendencies as the perversion of the brother
who has a more active sexual impulse. Accordingly in many families the
men are healthy, but from the social point of view undesirably
immoral; while the women are high-principled and over-refined, but
highly neurotic. It is one of the obvious injustices of social life
that the standard of culture should demand the same behaviour in
sexual life from everyone---a course of conduct which, thanks to his
nature, one person can attain without effort, whereas it imposes on
another the severest mental sacrifices; though, indeed, the injustice
is ordinarily nullified by disregard of the commands of morality.
These considerations have been confined so far to what applies to the
second stage of cultural development, postulated as interdicting every
'perverse' sexual activity, so-called, but allowing the free practice
of 'normal' sexual intercourse. We have found that even when the line
between sexual freedom and restriction is drawn at this point, a
number of persons have to be ruled out as perverse, while others who
endeavour not to be perverse, and yet constitutionally should be so,
are forced into neurosis. It is now easy to predict the result which
will ensue if sexual freedom is still further circumscribed, and the
standard demanded by civilization is raised to the level of the third
stage, which taboos every sexual activity other than that in
legitimate matrimony. Under these conditions the number of strong
natures who openly rebel will be immensely increased: and likewise the
number of weaker natures who take refuge in neurosis owing to their
conflict between the double pressure from the influences of
civilization and from their own rebellious constitutions.
{88}
We propose to answer three questions which now arise:
1. What is the task that is laid upon the individual as a result of
the demands of the third cultural stage?
2. Whether the legitimate sexual satisfaction allowed may be said to
offer reasonable compensation for the abstention in other directions?
3. In what relation the possible injurious effects of this abstention
stand to the benefit accruing to culture?
The answer to the first question touches a problem which has often
been discussed and cannot here be treated exhaustively, _i.e._ that of
sexual abstinence. The third stage of our civilization demands from
both sexes abstinence until marriage, and lifelong abstinence for all
who do not enter into legal matrimony. The position sanctioned by
every authority, that sexual abstinence is not harmful and not
difficult to maintain, has also obtained a good deal of support from
physicians. It may be said that the task of mastering such a mighty
impulse as the sexual instinct is one which may well absorb all the
energies of a human being. Mastery through sublimation, diverting the
sexual energy away from its sexual goal to higher cultural aims,
succeeds with a minority, and with them only intermittently; while the
period of passionate youth is precisely that in which it is most
difficult to achieve. Of the others, most become neurotic or otherwise
come to grief. Experience shows that the majority of those who compose
our society are constitutionally unfit for the task of
abstinence. Those who would have fallen ill even under moderate sexual
restrictions succumb to illness all the earlier and more severely
under the demands of our present civilized sexual morality; for we
know no better security against the menace to normal sexual life
caused by defective predisposition and disturbances in development
than sexual satisfaction itself. The greater the disposition to
neurosis, the less can abstinence be tolerated. For in proportion as
the component-impulses have been excluded from development (as {89}
described above) they become precisely thereby less controllable. But
even those who would have retained their health while complying with
the demands of the second stage of civilization will in many cases
succumb to neurosis in the third stage; for the psychical value of
sexual satisfaction increases under privation. The frustrated libido
is now put in the position of spying out one or other of the weaker
spots which are seldom wanting in the structure of the sexual life, so
that it may break through at that point as a neurotic
substitute-gratification in the form of a morbid symptom. Anyone who
understands how to penetrate to the factors conditioning nervous
illness will soon be convinced that its increase in our society
originates in the greater stringency of sexual restraint.
We thus come closer to the question whether sexual intercourse in
legitimate marriage can offer full compensation for the restraint
before marriage. The abundance of the material supporting a reply in
the negative is so overwhelming that we are obliged to make only the
briefest summary of it. We must above all keep in mind that our
civilized sexual morality also restricts sexual intercourse even in
marriage itself, for it compels the married couple to be satisfied, as
a rule, with a very small number of acts leading to conception. As a
consequence of this, satisfying sexual intercourse occurs in marriage
only over a period of a few years, allowing also, of course, for
intervals of abstention on hygienic grounds required by the woman's
state of health. After these three, four or five years, marriage
ceases to furnish the satisfaction of the sexual needs that it
promised, since all the contraceptives available hitherto impair
sexual enjoyment, disturb the finer susceptibilities of both partners,
or even act as a direct cause of illness. Anxiety for the consequences
of sexual intercourse first dissipates the physical tenderness of the
married couple for each other, and usually, as a more remote result,
also the mental affection between them which was destined to succeed
{90} the originally tempestuous passion. Under the spiritual
disappointment and physical deprivation which thus become the fate of
most marriages, both partners find themselves reduced again to their
pre-conjugal condition, but poorer by the loss of an illusion, and are
once more driven back to their determination to restrain and
'side-track' their sexual instinct. We will not inquire how far a man
in mature years succeeds in this task; experience seems to show that
he very frequently makes use of that amount of freedom which is
allowed him even by the strictest sexual code, though but reluctantly
and furtively. The 'double' code of morality conceded to the male in
our society is the plainest possible admission that society itself
does not believe in the possibility of adherence to those precepts
which it has enjoined on its members. But experience also shows that
women, as the true guardians of the sexual interests of the race, are
endowed with the power of sublimation only in a limited degree; as a
substitute for the sexual object the suckling child may suffice, but
not the growing child, and under the disappointments of matrimony
women succumb to severe, lifelong neurosis affecting the whole course
of their lives. Marriage under the present cultural standard has long
ceased to be a panacea for the nervous sufferings of women; even if we
physicians in such cases still advise matrimony, we are nevertheless
aware that a girl must be very healthy to 'stand' marriage, and we
earnestly counsel our male inquirers not to marry a girl who has been
neurotic. Marital unfaithfulness would, on the other hand, be a much
more probable cure for the neurosis resulting from marriage; the more
strictly a wife has been brought up, the more earnestly she has
submitted to the demands of civilization, the more does she fear this
way of escape, and in conflict between her desires and her sense of
duty she again will seek refuge in a neurosis. Nothing protects her
virtue so securely as illness. The conjugal state, which is held out
to the youthful among civilized {91} people as a refuge for the sexual
instinct, thus proves inadequate even to the demands of the later
period which it covers; beyond all question, it fails to compensate
for the earlier abstention.
To our third question, even he who admits the injurious results thus
attributable to civilized sexual morality may reply that the cultural
gain derived from the sexual restraint so generally practised probably
more than balances these evils, which after all, in their more
striking manifestations, affect only a minority. I own myself unable
to balance gain and loss precisely: nevertheless I could advance a
good many considerations as regards the loss. Returning to the theme
of abstinence, already touched on, I must insist that yet other
injurious effects besides the neuroses result therefrom, and that the
neuroses themselves are not usually appraised at their full
significance.
The retardation of sexual development and sexual activity at which our
education and culture aim is certainly not injurious to begin with; it
is seen to be a necessity, when one reflects at what a late age young
people of the educated classes attain independence and begin to earn a
living. Incidentally, one is reminded here of the intimate relation
existing between all our civilized institutions, and of the difficulty
of altering any part of them irrespective of the whole. But the
benefit, for a young man, of abstinence continued much beyond his
twentieth year, cannot any longer be taken for granted; it may lead to
other injuries even when it does not lead to neurosis. It is indeed
said that the struggle with such powerful instincts and the consequent
strengthening of all ethical and æsthetic tendencies 'steels' the
character; and this, for some specially constituted natures, is
true. The view may also be accepted that the differentiation of
individual character, now so much in evidence, only becomes possible
with sexual restraint. But in the great majority of cases the fight
against sexuality absorbs the available energy of the character, and
this at the very time when {92} the young man is in need of all his
powers to gain his share of worldly goods and his position in the
community. The relation between possible sublimation and indispensable
sexual activity naturally varies very much in different persons, and
indeed with the various kinds of occupation. An abstinent artist is
scarcely conceivable: an abstinent young intellectual is by no means a
rarity. The young intellectual can by abstinence enhance his powers
of concentration, whereas the production of the artist is probably
powerfully stimulated by his sexual experience. On the whole I have
not gained the impression that sexual abstinence helps to shape
energetic, self-reliant men of action, nor original thinkers, bold
pioneers and reformers; far more often it produces 'good' weaklings
who later become lost in the crowd that tends to follow painfully the
initiative of strong characters.
In the results produced by efforts towards abstinence the stubbornness
and insubordination characteristic of the sexual instinct also come to
expression. Civilized education attempts, in a sense, only a temporary
suppression of it up to the period of matrimony, intending then to
give it free rein in order to make use of it. Extreme measures,
however, are more successful in effecting repression of the instinct
than are moderate ones; but then suppression very often goes too far,
with the unwished-for result that when the sexual instinct is set free
it shows itself permanently impaired. For this reason complete
abstinence during youth is often not the best preparation for marriage
in a young man. Women dimly recognize this, and among their suitors
prefer those who have already proved themselves men with other
women. The injurious results which the strict demand for abstinence
before marriage produces are quite particularly apparent where women
are concerned. Clearly, education does not look lightly on the task of
suppressing the sensuality of the girl until marriage, for it employs
the most drastic measures. It not only forbids sexual intercourse and
sets a high {93} premium upon the preservation of sexual chastity, but
it also protects the developing young woman from temptation by keeping
her in ignorance of all the facts concerning the part she is ordained
to play, and tolerates in her no love-impulse which cannot lead to
marriage. The result is that when the girl is suddenly allowed by
parental authority to fall in love, she cannot accomplish this mental
operation and enters the state of marriage uncertain of her own
feelings. As a result, the artificial retardation in the development
of the love-function provides nothing but disappointments for the
husband, who has treasured up all his desires for her. Psychically she
is still attached to her parents, whose authority has brought about
the suppression of the sexual feeling; and physically she shows
herself frigid, which prevents her husband finding any great enjoyment
in relations with her. I do not know whether the anæsthetic type of
woman is also found outside the range of civilized education, but I
consider it probable. In any case this type is directly cultivated by
education, and these women who conceive without pleasure show later
little willingness to endure frequent childbirths, accompanied as they
are by pain: so that the training that precedes marriage directly
frustrates the very aim of marriage. When later the retarded
development of the wife becomes rectified, and during the climax of
her womanly life the full power to love awakens in her, her relation
to her husband has been long undermined. As a reward for her previous
submission, there remains for her only the choice between unappeased
desire, infidelity, or neurosis.
The behaviour of a human being in sexual matters is often a prototype
for the whole of his other modes of reaction to life. A man who has
shown determination in possessing himself of his love-object has our
confidence in his success in regard to other aims as well. On the
other hand, a man who abstains, for whatever reasons, from satisfying
his strong sexual instinct, will also assume a conciliatory and
resigned {94} attitude in other paths of life, rather than a
powerfully active one. A particular application of the general
statement that the course of the sexual life is typical for the way in
which other functions are exercised is easily demonstrable in the
entire female sex. Their training excludes them from occupying
themselves intellectually with sexual problems, in regard to which
naturally they have the greatest thirst for knowledge, and terrifies
them with the pronouncement that such curiosity is unwomanly and a
sign of immoral tendencies. And thus they are thoroughly intimidated
from all mental effort, and knowledge in general is depreciated in
their eyes. The prohibition of thought extends beyond the sexual
sphere, partly through unavoidable associations, partly automatically,
acting precisely in the same way as the prohibition of religious
speculation among men, and the taboo of any thought out of harmony
with loyalty in faithful subjects. I do not support Moebius in the
view he has put forward, which has met with so much opposition, that
the biological contrast between intellectual work and sexual activity
explains the 'physiological mental weakness' of women. On the
contrary, I think that the undoubted fact of the intellectual
inferiority of so many women can be traced to that inhibition of
thought necessitated by sexual suppression.
In considering the question of abstinence, far too little distinction
is made between two forms of it, namely, abstention from any kind of
sexual activity at all, and abstention from heterosexual
intercourse. Many who are proud of maintaining abstinence successfully
have only been able to achieve it with the help of masturbation and
other similar means of satisfaction, which are connected with the
auto-erotic sexual activities of early childhood. But this very
connection makes these substitutive measures of sexual satisfaction by
no means harmless; they predispose to the numerous forms of neurosis
and psychosis, which are conditional on a regression of the sexual
life to its infantile form. {95} Nor does masturbation at all
correspond to the ideal demands of civilized sexual morality, and it
therefore drives young people into the same conflicts with the ideals
of education which they design to escape by abstinence. Further, the
character is undermined in more ways than one by this indulgence;
first, because it shows the way to attain important aims in an otiose
manner, instead of by energetic effort, in line with the view that the
attitude to sex is the prototype of the attitude to life; and
secondly, because in the phantasies accompanying this gratification
the sexual object is exalted to a degree which is seldom to be
reproduced in reality. A witty writer, K. Kraus in the Vienna
_Fackel_, has, as it were, expressed this truth paradoxically in the
cynical saying: 'Coitus is merely an unsatisfactory substitute for
onanism!'
The severe standard demanded by civilization and the arduous task of
abstinence have combined to make avoidance of the genital union of the
sexes the main point of abstinence, whilst favouring other forms of
sexual activity---two results which may be said to betoken obedience
by halves. The so-called perverse forms of intercourse between the
sexes, in which other parts of the body assume the rôle of the
genitalia, have undoubtedly become of greater social significance
since normal intercourse has been so remorselessly tabooed in the name
of morality---and also on grounds of hygiene because of the
possibility of infection. These activities, however, cannot be
regarded as so harmless as irregularities of a similar kind interwoven
with a normal love-intercourse: ethically they are reprehensible, for
they degrade the love-relationship of two human beings from being a
serious matter to an otiose diversion, attended neither by risk nor by
spiritual participation. The spread of the homosexual means of
gratification must be regarded as a further consequence of the
difficulties placed in the way of normal sexual life; and in addition
to those who are constitutionally homosexual, or who become so in {96}
childhood, must be reckoned the great number of those in whom, by
reason of the check on the main stream of the libido, the lateral
channel of homosexuality is forced open in maturer life.
All these unavoidable and unintended consequences of the insistence
upon abstinence unite in one general result: they strike at the roots
of the condition of preparation for marriage, which according to the
intentions of civilized sexual morality should after all be the sole
heir of all sexual tendencies. All those men whose libido, as the
result of masturbatory or perverse sexual practices, has become
habituated to situations and conditions of satisfaction other than the
normal develop in marriage a diminished potency. And all those women
who could preserve their virginity only by similar means show
themselves anæsthetic to normal intercourse in marriage. A marriage
begun with impaired capacity to love on both sides succumbs to the
process of dissolution even more quickly than otherwise. As a result
of the diminished potency of the man, the woman will not be satisfied
and will remain anæsthetic, whereas a powerful sexual experience might
have been the means of overcoming the disposition to frigidity that
results from her education. The prevention of conception is also more
difficult to such a couple than to a healthy pair, because the
weakened potency of the man tolerates the use of contraceptives
badly. In such perplexity, sexual intercourse comes to be regarded as
the source of all difficulties and is soon abandoned, and with it the
fundamental condition of married life.
I call upon all who have studied these matters to aver that I am not
exaggerating, but am describing conditions glaringly evident to any
observant eye. The uninitiated can hardly believe how rarely normal
potency is to be found in the men, and how often frigidity in the
women, among those married couples living under the sway of our
civilized sexual morality; what a degree of renunciation, often for
both partners, is {97} associated with marriage, and of how little the
marriage comes to consist, instead of bringing the happiness that was
so ardently desired. I have already shown that neurosis is the most
obvious way of escape from these conditions. I would, however, further
point out how such a marriage will increasingly affect the only
child---or the limited number of children---which spring from it. On
appearance it looks as if we then had an inherited condition to deal
with, but closer inspection shows the effect of powerful infantile
impressions. As a mother, the neurotic woman who is unsatisfied by her
husband is over-tender and over-anxious in regard to the child, to
whom she transfers her need for love, thus awakening in it sexual
precocity. The bad relations between the parents then stimulate the
emotional life of the child, and cause it to experience intensities of
love, hate and jealousy while yet in its infancy. The strict training
which tolerates no sort of expression of this precocious sexual state
lends support to the forces of suppression, and the conflict at this
age contains all the elements needed to cause lifelong neurosis.
I return now to my earlier assertion that, in appraising the neuroses,
their full significance is seldom reckoned with. I do not mean by this
the insufficient appreciation of these states exhibited in the
frivolous dismissal of them on the part of relatives, or in the
magniloquent assurances on the part of physicians that a few weeks of
cold-water cure or a few months of rest and convalescence will cure
the condition---these are merely the opinions of ignorant physicians
and laymen, and mostly nothing but forms of speech designed to afford
the sufferer a short-lived consolation. Rather, it is established that
a chronic neurosis, even if it does not completely paralyse existence,
represents for the person concerned a heavy handicap in life, much the
same as tuberculosis or a cardiac affection. We might in a measure
compound with this if neurotic illness merely excluded from communal
activity a number of {98} individuals in any case infirm, and
permitted the remainder to take their share at the cost of merely
subjective disabilities; but I would rather draw attention to the
point of view that the neuroses, as far as they extend and in whomever
they occur, always succeed in frustrating the social purpose, and
thereby actually do the work of the socially inimical mental forces
which have been suppressed. So that in paying for compliance with its
own exorbitant prescriptions by increased neurosis, society cannot
claim an advantage purchased by sacrifice---cannot indeed claim any
advantage whatever. Let us examine, for example, the frequent case of
a woman who does not love her husband, because, owing to the
conditions of the consummation of her marriage and the experience of
her married life, she has no cause to love him; but who ardently
wishes to do so, because this alone corresponds to the ideal of
marriage in which she has been brought up. She will then suppress in
herself all impulses which seek to bring her true feelings to
expression and contradict her ideal endeavours, and will take
particular pains to play the part of a loving, tender and obedient
wife. The result of this self-suppression will be a neurotic illness,
and this neurosis will in a short time have taken revenge upon the
unloved husband and have caused him precisely as much dissatisfaction
and trouble as would have arisen merely from an acknowledgement of the
true state of affairs. This example is literally typical of what
neurosis can do. A similar miscarriage of compensation can be observed
after suppression of other socially inimical impulses not directly
sexual. A man, for example, who has become excessively 'kind-hearted'
as the result of powerful suppression of a constitutional tendency to
harshness and cruelty, often loses by so doing so much energy that he
does not achieve the full measure of his compensatory impulses, and on
the whole does rather less good than he would have done without
suppression.
{99}
Let us add that together with the restrictions on sexual activity in
any nation there always goes an increase of anxiety concerning life
and of fear of death, which interfere with each individual's capacity
for enjoyment, and do away with his willingness to incur risk of death
in whatever cause---showing itself in a diminished inclination to
beget offspring, thus excluding any people or group of such a type
from participation in the future. We may thus well raise the question
whether our 'civilized' sexual morality is worth the sacrifice which
it imposes upon us, the more so if we are still so insufficiently
purged of hedonism as to include a certain degree of individual
happiness among the aims of our cultural development. It is certainly
not the physician's business to come forward with proposals for
reform, but it seemed to me that, by pointing out what significance
the injurious results of our sexual morality, enumerated by von
Ehrenfels, have in connection with the increase in modern nervousness,
I could supplement the account he gives of them, and could thus
support the urgency of such reform.
----------------------------------------------------------------------
VIII {100}
GENERAL REMARKS ON HYSTERICAL ATTACKS[44]
(1909)
_A_. When one psycho-analyses a patient subject to hysterical attacks
one soon gains the conviction that these attacks are nothing but
phantasies projected and translated into motor activity and
represented in pantomime. It is true that these phantasies are
unconscious but otherwise they are of the same nature as those that
may be observed directly in day-dreams or revealed by an
interpretation of nocturnal dreams. A dream frequently takes the place
of an attack and still more frequently helps to explain one, since the
same phantasy finds different forms of expression both in dreams and
in attacks. One might expect by observing an attack to be able to
discover the phantasy it represents, but this is rarely possible. As a
rule the pantomimic representation of the phantasy undergoes
distortions, due to the influence of the censorship, analogous to the
hallucinatory ones of dreams, so that to begin with both these
manifestations are rendered unintelligible either to the patient's
conscious mind or to the observer's comprehension. An hysterical
attack, therefore, must be subjected to the same analytic procedure as
we use in dream-interpretation. Not only are the forces producing the
distortion and the purpose of this distortion the same as those we are
familiar with from the interpretation of dreams, but the technique of
the distortion is the same also.
{101}
1. The attack becomes unintelligible through its representing several
phantasies simultaneously by means of the same material, that is,
through _condensation_. Features common to two (or more) phantasies
form the nucleus of the representation, as in dreams. The phantasies
thus made to coincide are often of quite different kinds, for
instance, a recent wish and the re-activation of an infantile
impression; the same innervations are then made to serve both
purposes, often most cleverly. Hysterical patients who make use of
condensation to a considerable extent may find a single type of attack
sufficient; others express a multiplicity of pathogenic phantasies by
several types of attack.
2. The attack becomes obscured by the patient's undertaking the parts
played by both the persons appearing in the phantasy, that is, through
_multiple identification_. For instance, I have mentioned a case[45]
in which a patient tore off her dress with one hand (as the man) while
she pressed it to her body with the other (as the woman).
3. A particularly effective form of distortion is _antagonistic
inversion of the innervation_, which is analogous to the very usual
changing of an element into its opposite by dream-work. For instance,
in an hysterical attack an embrace may be represented by the arms
being drawn back convulsively until the hands meet above the spinal
column. Possibly the well-known _arc de cercle_ of major hysterical
attacks is nothing but an energetic disavowal of this kind, by
antagonistic innervation of the position suitable for sexual
intercourse.
4. Scarcely less confusing and misleading is the _reversal of the
sequence of events_ in the phantasy, which again has its complete
counterpart in some dreams which begin with the end of an action and
finish with its beginning. For instance, an hysterical patient may
{102} have a phantasy of seduction, the content of which is that she
is reading in a park, her dress being slightly raised so that one foot
is visible; a gentleman approaches and speaks to her; they then go to
some other place where a love-scene takes place. This phantasy may be
acted in the attack in such a way as to begin with a convulsive stage
corresponding to the act of intercourse; she may then get up, go to
another room, sit down to read and reply to the imaginary remark made
in accosting her.
The two last-mentioned forms of distortion give some indication of the
intensity of the resistance with which the repressed material has to
deal, even when it breaks through in an hysterical attack.
_B_. The outbreak of hysterical attacks follows laws that are readily
understood. Since the repressed complex consists of libidinal cathexis
and ideational content (phantasy), the attack may be aroused (1)
_associatively_, if the content of the complex (sufficiently charged)
is stirred by a conscious occurrence; (2) _organically_, if from some
internal somatic reasons or external influences on the mind the
libidinal cathexis exceeds a certain amount; (3) in the service of the
_primary tendency_ (paranosic gain) as an expression of 'flight into
illness' if reality becomes painful or frightening, therefore as a
_consolation_; (4) in the service of the _secondary tendencies_
(epinosic gain) with which the state of illness becomes connected as
soon as the patient can gain a useful purpose by the production of an
attack. In the last case the attack is aimed at particular people; it
may be put off until they are within reach, and gives an impression of
conscious simulation.
_C_. Investigation of the childhood history of hysterical patients
shows that the hysterical attack is a substitute for an _auto-erotic_
gratification previously practised and since given up. In a great
number of cases this gratification (masturbation by manipulation or
pressure of the thighs, movement of the tongue, etc.) {103} recurs
during the attack itself during the deflection of consciousness. The
outbreak of attacks due to an increase of libido and in the service of
the primary tendency, as a consolation, then exactly repeats the
conditions under which the patient at one time consciously employed
this auto-gratification. The anamnesis of the patient then gives the
following phases: (_a_) auto-erotic gratification without ideational
content, (_b_) the same in connection with a phantasy which culminates
in the act of gratification, (_c_) renunciation of the act with
retention of the phantasy, (_d_) repression of this phantasy, which
then breaks through in the hysterical attack either unchanged or else
modified and adapted to new experiences, and (_e_) which may even
restore the action producing gratification which belongs to the
phantasy and has apparently been given up. This is a typical cycle of
infantile sexual activity: repression, failure of the repression, and
return of the repressed.
The involuntary passing of urine can certainly not be considered
irreconcilable with the diagnosis of hysterical attacks; it merely
repeats the infantile form of a violent pollution. Moreover, biting
the tongue may be met with in undoubted cases of hysteria; it is no
more inconsistent with hysteria than with love-making. It occurs in
attacks more readily when the physician's questions have drawn the
patient's attention to the difficulties of a differential
diagnosis. Self-injury may occur in hysterical attacks (more
frequently in the case of men) and then repeats an accident that
happened during childhood (for instance, during a fight).
The loss of consciousness, the '_absence_' of the hysterical attack,
is derived from the fleeting but unmistakable loss of consciousness
which can be observed at the climax of every intensive (also
auto-erotic) sexual gratification. Where hysterical '_absences_' arise
from pollutions in young female persons this development can be most
clearly followed. The so-called {104} hypnoidal states, '_absences_'
during day-dreaming so frequent in hysterical cases, reveal the same
origin. The mechanism of these '_absences_' is comparatively
simple. In the first place all the attention is concentrated on the
course of the process of gratification and this whole cathexis of
attention is suddenly removed at the moment when gratification occurs,
so that a momentary void in consciousness takes place. This gap in
consciousness, which may be called a physiological one, is then
extended in the service of repression until it takes up everything
which the repressing faculty rejects.
_D_. It is that reflex mechanism of the coitus-action which we see
becoming manifest during unrestrained surrender to a sexual activity
and which is available to everybody, including women, that points the
way to the motor discharge of the repressed libido in attacks. Even
the ancients called coitus a 'minor epilepsy'. We may alter this
statement: the hysterical fit is an equivalent of coitus. The analogy
with the epileptic attack helps us little, since its genesis is even
less intelligible to us than that of hysterical attacks.
In general, the hysterical attack, like every form of hysteria, in
women recalls to action a form of sexual activity which existed during
childhood, and had at that time a pronounced masculine character. One
may often observe that it is just those girls who in the years before
puberty showed a boyish character and inclinations who tend to become
hysterical at puberty. In a whole series of cases the hysterical
neurosis is nothing but an excessive over-accentuation of the typical
wave of repression through which the masculine type of sexuality is
removed and the woman emerges.[46]
----------------------------------------------------------------------
IX {105}
PSYCHOGENIC VISUAL DISTURBANCE
ACCORDING TO PSYCHO-ANALYTICAL
CONCEPTIONS[47]
(1910)
By taking psychogenic visual disturbances as an example, I propose
to show you what alterations in our idea of the genesis of such
ailments have resulted from the psycho-analytic method of
investigation. You are aware that hysterical blindness is taken as the
type of a psychogenic visual disturbance. It is thought that the
researches of the French school of Charcot, Janet, Binet have enabled
us to apprehend the genesis of such a disturbance. Indeed, we are now
in a position to induce such blindness experimentally if we happen to
have at our disposal a somnambulistic subject. If such a person is put
into a deep hypnotic trance, and it is suggested to him or her that
nothing can be seen with one of the eyes, he or she will behave as if
blind of that eye, just as an hysterical subject does under
spontaneously developed visual disturbance. We may thus construct the
mechanism of the spontaneous hysterical visual disturbance after the
pattern of the suggested hypnotic variety. In hysteria the idea of
blindness does not arise from the suggestion of the hypnotist, but
spontaneously, so to speak, through auto-suggestion; and this idea is
in both cases so powerful that it transmutes itself into actuality,
precisely like a suggested hallucination, paralysis, and the like.
This sounds quite reasonable, and will doubtless {106} satisfy all who
are able to ignore the enigmas latent in those phenomena we term
hypnosis, suggestion, and auto-suggestion. Auto-suggestion, in
particular, gives rise to further conjectures. When, and under what
conditions, can an idea become so powerful as to reproduce the
phenomena of a suggestion and be directly transmuted into actuality?
On this point closer investigations have shown that the question is
unanswerable without recourse to the concept of 'the
unconscious'. Many philosophers refuse to accept the concept of an
unconscious part of the mind, because they have not concerned
themselves with the phenomena which necessitate its postulation.
Psycho-pathologists can no longer operate without the concept of
unconscious mental processes, unconscious ideas and the like.
Well-directed experiments have shown that the hysterical blind do in a
certain sense see, though not in the complete sense. Excitations of
the blind eye may thus have definite results of a mental kind---for
instance, may evoke affects---although these fail to be consciously
apprehended. The hysterical blind are therefore blind in consciousness
only, while in the unconscious they are sighted. It is precisely
experiences of this sort that compel us to make a distinction between
conscious and unconscious mental processes. How comes it that these
people develop an unconscious auto-suggestion to be blind, while in
the unconscious they can see?
French research replies to this further question by the assertion that
patients of hysterical disposition display an inherent proneness to
dissociation---to a dissolution of the nexus in the psychic field---as
a consequence of which many unconscious processes never reach
consciousness. Let us for the present leave entirely unconsidered the
value of this attempt at explanation for comprehension of the
phenomena we are studying, and let us turn to another point of
view. You will surely note that the identity of hysterical {107}
blindness with that produced by auto-suggestion, which I emphasized in
my opening words, is here abandoned. Hysterical patients are not blind
as a result of the auto-suggestive idea that they cannot see, but as a
result of a dissociation between unconscious and conscious processes
in the visual act; their idea that they cannot see is the logical
expression of a mental condition, and not the causation of it.
If you demur to the foregoing delineation on the ground of obscurity,
I shall not find it easy to defend myself. I have attempted to give
you a synthesis of the views of different investigators, and in doing
so have probably drawn the links too closely together. My desire was
to condense into a homogeneous whole the prevailing contributions
towards an understanding of psychogenic disturbances---their origin in
over-mastering ideas, the distinction between conscious and
unconscious mental processes, and the hypothesis of psychic
dissociation---and in this I was able to succeed no better than the
French writers, with Pierre Janet at their head. Pardon me therefore
not only the obscurity but also the inaccuracy of my delineation, and
let me tell you how psycho-analysis has led us to a more firmly based
and probably a more authentic view of psychogenic visual disturbances.
Psycho-analysis, too, accepts the hypothesis of dissociation and of
the unconscious, but sets them in a different relation to each other.
Psycho-analysis is a dynamic conception, which reduces mental life to
the interplay of reciprocally urging and checking forces. When it
happens that a group of ideas remains in the unconscious,
psycho-analysis sees in this no proof of a constitutional incapacity
for synthesis, exhibiting itself through this particular dissociation,
but maintains that an active antagonism of certain groups of ideas has
caused the isolation of another group in the unconscious. The process
which imposes such a fate upon a given group is termed by
psycho-analysis 'repression', and it recognizes in it something {108}
analogous to reasoned rejection in the sphere of
logic. Psycho-analysis can show that such repressions play an
extraordinary part in our mental life, that they may frequently
miscarry in individual cases, and that such miscarriages of repression
are the primary cause of symptom-formation.
If, then, psychogenic visual disturbance, as we have learnt, is based
on the segregation from consciousness of certain ideas connected with
seeing, the psycho-analytical mode of thought constrains us to assume
that these ideas have come into opposition with other more powerful
ideas (which we should ascribe to our conception of the ego, which has
had a varying significance) and have therefore become repressed. But
where can any such opposition, calling for such repression, arise
between the ego and single groups of ideas? You will observe that this
question could not have been posed before the advent of
psycho-analysis, for before that nothing was known about mental
conflict and repression. Our researches have now put us in a position
to give the required answer. Our attention has been drawn to the
significance of the instincts in the conceptual life; we have learnt
that every instinct seeks to come to expression by activating those
ideas which are in accordance with its aims. These instincts do not
always agree with one another, and this frequently results in a
conflict of interests; the contradictions in the ideas are merely the
expression of the battle between the various instincts. Of quite
peculiar significance for our efforts towards elucidation is the
undeniable opposition between the instincts which serve the purposes
of sexuality, of gaining sexual pleasure, and those others which aim
at the self-preservation of the individual, the
ego-instincts. Schiller said that we can classify under 'hunger' or
under 'love' every active organic instinct of our souls. We have
tracked the 'sexual instinct' from its earliest manifestations in the
child to its attainment of what is called the 'normal' final form of
it, and {109} have found that it is made up of numerous
component-instincts which are rooted in the excitations of certain
regions of the body; we have clearly seen that these single instincts
must go through a complex process of development before they can
co-operate, in any effective sense, with the aims of propagation. The
light thrown by psychology on our cultural development has shown us
that culture is acquired essentially at the cost of the sexual
component-instincts, and that these must be suppressed, restrained,
transmuted, directed towards loftier goals, for civilized psychical
achievements to take place. As a valuable result of these researches
we have been able to recognize, what our colleagues are not yet
prepared to grant us, that those sufferings we call the neuroses
derive from the manifold ways in which these processes of
transformation fail in regard to the sexual component-instincts. The
ego feels itself menaced by the claims of the sexual instinct and
defends itself from them by repressions, which, however, do not always
produce the desired effect, but result in dangerous
substitute-formations of the repressed instinct and burdensome
reaction-formations in the ego. From these two classes of phenomena
are formed what we term the symptoms of neurosis.
We have apparently wandered far from our theme, but in doing so have
touched on the connection of neurotic conditions with the whole mental
life of man. Let us now return to our more immediate problem. Speaking
generally, the various organs and systems of organs are at the
disposal of both sexual and ego-instincts. Sexual pleasure is not
connected only with the function of the genitals; the mouth serves for
kissing as well as for eating and speaking, the eyes perceive not only
those modifications in the external world which are of import for the
preservation of life, but also the attributes of objects by means of
which these may be exalted as objects of erotic selection, their
'charms'. We now perceive the truth of the saying that it is never
easy to serve two masters at the same {110} time. The more intimate
the relation of an organ possessing such a duality of function with
one of the great instincts, the more will it refuse itself to the
other. This principle necessarily leads to pathological consequences
when the two fundamental instincts are at variance, when a repression
is set up on the part of the ego against the sexual component-instinct
in question. It is easy to apply this to the eye and the faculty of
vision. If the sexual component-instinct which makes use of
sight---the sexual 'lust of the eye'---has drawn down upon itself,
through its exorbitant demands, some retaliatory measure from the side
of the ego-instincts, so that the ideas which represent the content of
its strivings are subjected to repression and withheld from
consciousness, the general relation of the eye and the faculty of
vision to the ego and to consciousness is radically disturbed. The ego
has lost control of the organ, which now becomes solely the instrument
of the repressed sexual impulse. It would appear as though repression
on the part of the ego had gone too far and poured away the baby with
the bath-water, for the ego now flatly refuses to see anything at all,
since the sexual interests in looking have so deeply involved the
faculty of vision. The other presentation of the situation, however,
is probably closer to the facts, the aspect in which we see the
_active_ part in the process played by the repressed scoptophilia. It
is the revenge, the indemnification of the repressed impulse, thus
withheld from further psychical development, that it can succeed in so
boldly asserting its mastery over the organ which serves it. The loss
of conscious control over the organ is a detrimental
substitute-formation for the miscarried repression, which was only
possible at this cost.
This relation of the dually functioning organs to the conscious ego
and the repressed sexuality is even clearer in the case of the motor
organs than in that of the eye; as, for example, when the hand which
had been desirous of making a sexual aggression becomes {111}
hysterically crippled, and after the inhibition of this desire can do
nothing else, exactly as if it insisted stubbornly on accomplishing
that repressed innervation, and that only; or again, when the fingers
of persons who have renounced masturbation refuse to acquire the
delicate mobility which the piano or violin exacts. In the case of the
eye we customarily translate the obscure psychical processes implicit
in the repression of scoptophilia and in the outbreak of psychogenic
visual disturbance as if an accusing voice had uplifted itself within
the person concerned, saying: 'Because you have chosen to use your
organ of sight for evil indulgence of the senses, it serves you quite
right if you can see nothing at all now', thus giving its sanction to
the outcome of the process. There is here, we perceive, the idea of
the talion, and our explanation of psychogenic visual disturbance is
at one with those laws prevailing in saga, myth, and legend. In the
beautiful saga of Lady Godiva all the inhabitants of the little town
retire behind their shuttered windows in order to make less painful to
the lady her ordeal of riding naked through the streets in broad
daylight. The one man who peeps through the shutters at her nude
beauty is punished by becoming blind. Nor is this the only instance
which leads us to suspect that concealed in the study of neurosis lies
the key to mythology.
Psycho-analysis is wrongly reproached with tending to purely
psychological theories of the processes of disease. Yet its
accentuation of the pathogenic part played by sexuality, which is
assuredly no exclusively psychical factor, ought to have protected it
from this reproach. Psycho-analysis never forgets that the mental is
based on the physical, although it can only carry its work back to
this foundation and no farther. Hence psycho-analysis is fully
prepared to grant, indeed to postulate, that not every functional
visual disturbance is necessarily psychogenic, like those resulting
from repression of the scoptophilia. When an organ which serves two
purposes overplays its {112} erotogenic part, it is in general to be
expected that this will not occur without alterations in its response
to stimulation and in innervation, which will be manifested as
disturbances of the organ in its function as servant of the ego. And
indeed, when we observe an organ which ordinarily serves the purpose
of sensorial perception presenting as a result of the exaggeration of
its erotogenic rôle precisely the behaviour of a genital, we shall
even suspect that there are toxic modifications as well in that
organ. For both kinds of functional disturbances resultant from the
exaggeration of the erotogenic office, for those of physiological no
less than for those of toxic causation, we are obliged to retain, for
want of a better, the time-honoured, inapposite name of 'neurotic'
disturbances. Neurotic disturbances of vision are related to
psychogenic as, in general, are the actual neuroses to the
psychoneuroses; psychogenic visual disturbances can hardly occur
without neurotic disturbances, though the latter surely can without
the former. Unfortunately, these 'neurotic' symptoms are as yet little
appreciated and understood, for they are not directly accessible to
psycho-analysis, and other modes of investigation have neglected the
sexual aspect.
From psycho-analysis there branches out another line of thought
conducting to organic research. We may ask ourselves whether the
suppression of the sexual component-instincts induced by environmental
influences suffices in itself to set up functional disturbances of the
organs, or whether there must not be some particular constitutional
conditions which predispose the organs to overdo their erotogenic
part, and thus provoke repression of the impulse. These conditions we
should necessarily regard as the part played by the constitution in
the tendency to disease when considering psychogenic and neurotic
disturbances. This would represent that factor which, in hysteria, I
have already designated as the 'somatic compliance' of the organs.
----------------------------------------------------------------------
X {113}
TYPES OF NEUROTIC NOSOGENESIS[48]
(1912)
In the ensuing remarks, which are based on impressions obtained
empirically, it is proposed to describe those changes of conditions
which operate to bring about the onset of neurotic illness in a person
predisposed to it. We are concerned, that is, with the exciting cause
of illness; scarcely at all with the form of it. The following view is
distinguishable from other formulations concerning the exciting causes
of illness in that it connects the changes to be described entirely
with the libido of the person concerned. Psycho-analysis has shown us
that the course taken by the libido is decisive for nervous health or
ill-health. The concept of predisposition needs no discussion in this
connection; for psycho-analytic research has made it possible for us
to trace back the predisposition to neurosis to its source in the
developmental history of the libido, and to reveal the factors
operative in this predisposition as inborn varieties of the sexual
constitution and the effects of external experiences in early
childhood.
(_a_) The most immediate, most easily discerned, and most
comprehensible exciting cause of the onset of neurotic illness lies in
that external factor which may generally be described as
_frustration_. The person was healthy as long as his erotic need was
satisfied by an actual object in the outer world; he becomes neurotic
as soon as he is deprived of this object and no substitute is
forthcoming. Happiness here coincides with health, unhappiness with
neurosis. By providing a {114} substitute for the lost source of
gratification, fate can effect a cure more easily than the physician.
For this type, which may be said to include the majority of mankind,
the possibility of an outbreak of illness begins only with
abstinence---which may give us some indication of the significance for
the causation of neuroses of cultural restrictions in facilities for
satisfaction. Frustration operates pathogenically in that it dams up
the libido, and thus puts to the test both the person's power of
tolerating the increase of mental tension, and his manner of taking
steps to release himself from it. There are only two possible methods
of retaining health in a continuous state of actual frustration of
satisfaction: first, that of transposing the mental tension into
active energy which remains directed towards the outer world and
finally wrests from that world an actual satisfaction for the libido;
and secondly, that of renouncing the libidinal satisfaction,
sublimating the stored-up libido and making use of it to ends which
are no longer erotic and thus elude the frustration. Both
possibilities can be realized in the destinies of mankind, which shows
that unhappiness does not necessarily coincide with neurosis, and
frustration is not alone decisive for the health or ill-health of the
person concerned. The effect of frustration lies principally in its
bringing into action dispositional factors which have hitherto
remained inoperative.
When these are present in sufficient strength there arises the danger
of the libido becoming _introverted_.1 It turns away from reality,
which on account of the unrelenting frustration experienced has lost
all its value for the person concerned, and takes refuge in the life
of phantasy where it creates new wish-formations and re-animates the
vestiges of earlier, forgotten ones. In consequence of the intimate
connection between phantasy-activity and the infantile, repressed, and
now unconscious material existing in every individual, {115} and
thanks to that attribute of the life of phantasy which exempts it from
the 'testing of reality',[49] the libido may now begin to flow
backward, may seek out infantile paths in the course of its
regression, and may strive after corresponding aims. When such
strivings, which are incompatible with the person's state of mind in
real life, have become sufficiently intensified, there must ensue a
conflict between them and the other part of the personality which has
remained in relation with reality. This conflict issues in
symptom-formations and ends in manifest illness. That the whole
process originates in the actual frustration may be clearly perceived
from the circumstance that the symptoms by means of which the sphere
of reality is regained represent substitutive gratifications.
(_b_) The second type of occasion for the outbreak of illness is by no
means so obvious as the first, and could not indeed be discerned
before the searching analytic studies stimulated by the complex-theory
of the Zürich School.[50] In these cases the person falls ill not as a
result of some alteration in the outer world which has replaced
gratification by frustration, but as a result of an inner effort to
seize a gratification which reality offers to him. He falls ill of the
attempt to adapt himself to reality and to fulfil the _requisitions of
reality_, for in doing so he is confronted with insurmountable inward
obstacles.
It will be convenient to set these two types of falling ill in sharp
antithesis to one another---sharper, indeed, than observation for the
most part warrants. In the first type an alteration in the external
world is prominent; in the second, the accent falls upon an internal
change. In the first type, the person falls ill from an event; in the
second, from a developmental process. In the first case the task is
one of renouncing {116} a gratification, and the person falls ill
because of his lack of resistance; in the second case the task is that
of exchanging one kind of gratification for another, and the person is
wrecked by his rigidity. In the second case the conflict between the
endeavour to keep as he is and the other endeavour to alter himself in
accordance with new aims and new demands in reality already exists in
him; in the first case, the conflict does not begin until the
dammed-up libido has chosen other and incompatible possibilities of
gratification. The part played by the conflict and the previous
fixation of the libido is in the second type incomparably more
striking than in the first, for in the first it may well be that
undesirable fixations of this kind only re-establish themselves in
consequence of the external frustration.
The young man who has hitherto gratified his libido by phantasies
issuing in masturbation and now desires to exchange this state of
affairs, so closely related to auto-erotism, for actual object-choice;
the girl who has given all her affection to her father or brother and
now would fain exchange the hitherto unconscious incestuous
libido-wishes for the conscious wish towards the man who is wooing
her; the wife who would be glad to abandon her polygamous inclinations
and phantasies of prostitution so as to be a faithful companion to her
husband and a blameless mother to her child---all these fall ill in
consequence of most laudable endeavours if the earlier fixations of
their libido are powerful enough to oppose themselves to the
displacement; for this again the factors of predisposition,
constitutional basis and infantile experiences prove to be of decisive
significance. They all, as it were, undergo the fate of the little
tree in Grimm's fairy-tale which wanted to have different
foliage. From the hygienic standpoint, which is certainly not the only
one to be considered, one could but desire for them that they might
have remained to the end as undeveloped, as inferior, and as
good-for-nothing as they were before they fell ill. The change for
which such {117} patients strive, but which they achieve only
imperfectly or not at all, is regularly equivalent to a step forward
for them in real life. It is otherwise if we reckon by ethical
standards; we as often see people fall ill when they divest themselves
of an ideal as when they strive to attain it.
Despite the very evident distinctions between the two types of falling
ill here described, they have essential points in common, and it is
not hard to find a formula which will apply to both. Falling ill of a
deprivation (frustration) likewise comes under the head of incapacity
for adaptation to reality, only that the incapacity is confined to
occasions when reality denies gratification to the libido. Falling ill
under the conditions belonging to the second type points merely to a
necessary peculiarity in the frustration. What is denied is not every
form of gratification in reality, but merely just the one which the
person declares to be the one and only form for him; further, the
frustration does not derive directly from the outer world but
primarily from certain trends within the ego. Yet the factor of
frustration remains common to both, and the most significant one for
both. As a result of the conflict which forthwith ensues in the second
type, both kinds of gratification, the customary as well as the
desired, become equally inhibited; damming-up of the libido and its
attendant results follow as they did in the first case. The mental
processes involved in the course of symptom-formation are in the
second type more easily discoverable than in the first, since the
pathogenic fixations of the libido had not first to be re-established
but had been potentially active during the healthy period. A certain
degree of introversion of the libido was mostly already existent; some
degree of the regression to the infantile is spared because the
development had never traversed its entire course.
(_c_) The next type seems an exaggeration of the second type, that of
succumbing before the requisitions {118} of reality; I shall describe
it as outbreak of illness through _inhibition of development_. There
would be no theoretical reason for distinguishing this from the rest,
but there is a practical need to do so; since here we have to deal
with those persons who fall ill as soon as they pass beyond the
irresponsible age of childhood, and thus never attain a phase of
health---that of unrestricted capacity in general for production and
enjoyment. The essential part played by the dispositional processes is
in these cases quite apparent. The libido has never forsaken its
infantile fixations; the demands of reality do not suddenly confront
an individuality which is wholly or partially matured, but arise out
of the bare fact of its having grown older, and are of course
continually changing with the age of the person concerned. The
conflict is subordinate in importance to the incapacity; but if we
take into account the other results of our researches, we must
postulate a striving to overcome the infantile fixations, for
otherwise the outcome of the process would never be neurosis but only
stationary infantilism.
(_d_) Just as the third type shows us the dispositional condition in
an almost isolated form, so the now following fourth one directs our
attention to another factor, the operation of which has to be reckoned
with in all cases, and for that very reason might easily be overlooked
in a theoretical discussion. That is to say, we see people fall ill
who have hitherto been healthy, to whom no new experience has
presented itself, whose relation to the outer world has undergone no
change, so that their falling ill makes an inevitable impression of
spontaneity. Closer scrutiny of such cases shows us, nevertheless,
that a change _has_ taken place in them which we cannot but regard as
highly significant in the causation of the illness. As a result of
reaching a certain period of life, and in accordance with regular
biological processes, the _quantity_ of libido in their mental economy
has increased to an extent which by itself suffices to upset the
balance of health and {119} establish the conditions for neurosis. As
is well known, such rather sudden intensifications in libido are
regularly connected with puberty and the menopause, with the reaching
of a certain age in women; in many people they may in addition
manifest themselves in periodicities as yet unrecognized. The
damming-up of the libido is here the primary factor; it becomes
pathogenic as a result of the _relative_ frustration coming from the
outer world, which would have afforded sufficient gratification to a
lesser need in the libido. The dissatisfied and dammed-up libido may
now open up the path to regression and excite the same conflicts as
those found in cases of absolute external frustration. This warns us
never to leave the quantitative factor out of consideration when we
are dealing with the outbreak of illness. All the other
factors---frustration, fixation, inhibition in development---remain
inoperative as long as they do not involve a certain amount of libido
and produce a definite degree of damming-up. We cannot, it is true,
measure the amount of libido essential to produce pathological
effects; we can only postulate it after the effects of the illness
have evinced themselves. In only one direction can we define it more
closely; we may assume that it is not a question of an absolute
quantity, but of the relation of this effective amount of libido to
that quantity of libido which the particular ego in question can
control, that is, can hold in suspension, sublimate, or make direct
use of. Therefore a relative increase in the quantity of libido may
have the same effects as one that is absolute. An enfeeblement of the
ego through organic illness or an unusual demand upon its energy will
be capable of producing neuroses which would otherwise have remained
latent in spite of all dispositional tendencies.
The significance which we must attribute to the quantity of libido in
the causation of illness is in satisfactory accord with two axioms of
the new theory of neurosis which have emerged from psycho-analysis:
{120} first, with the axiom that the neuroses have their source in a
conflict between the ego and the libido; secondly, with the view that
no qualitative distinction exists between the conditions of health and
those of neurosis, but rather that the healthy have to contend with
the same difficulties in controlling the libido---only they succeed
better in doing so.
There still remain a few words to be said about the relation of these
'types' to clinical experience. When I review the number of patients
with whose analysis I am at this moment occupied, I must admit that
none of them represents any of the four types in its pure
form. Instead, I find in each an element of frustration operating
along with a certain degree of incapacity for adaptation to reality;
the standpoint of inhibition in development, which of course coincides
with a tenacity of fixations, is to be reckoned with in all of them;
and the significance of the quantity of libido we can never, as was
set forth above, afford to overlook. Indeed, it is my experience that
in several of these patients the illness has been manifested in
accesses, between which there were intervals of health, and that every
one of these accesses was to be traced to a different type of exciting
cause. The formulation of these four types has therefore no great
theoretical value; they are merely different paths by which a definite
pathogenic constellation in the mental economy may be achieved---I
refer to a damming-up of the libido which the ego is not able to
master with the means at its disposal without some damage. The
situation itself, however, becomes pathogenic only as a result of a
quantitative factor; it is in no way a novelty in the mental economy,
nor is it created by the advent of a so-called 'cause of illness'.
A certain practical importance may readily be granted to these types
of falling ill. Indeed, in individual cases they may be observed in a
pure form; we should not have been made aware of the third and fourth
types if they did not comprise the sole exciting {121} causes of onset
in some persons. The first type reveals to us the extraordinarily
powerful influence of the outer world; the second that, no less
significant, of the peculiarities of the individual who opposes
himself to that influence. Pathology could never master the problem of
the outbreak of illness in the neurotic so long as it was occupied
merely with deciding whether these affections were of an endogenous or
an exogenous nature. To all the experience which points to the
significance of abstinence (in the broadest sense) as an exciting
cause, pathology then necessarily objected that other persons suffered
a similar fate without falling ill. But if it elected to lay emphasis
upon individual peculiarities as essential in sickness or health, it
was obliged to bow to the objection that persons with such
peculiarities could permanently retain their health provided only that
they could preserve their peculiarity. Psycho-analysis warns us to
abandon the unfruitful antithesis of external and internal factors, of
fate and constitution, and has taught us regularly to discover the
cause of an outbreak of neurosis in a definite mental situation, which
can be brought into being in different ways.
----------------------------------------------------------------------
XI {122}
THE PREDISPOSITION TO OBSESSIONAL
NEUROSIS[51]
(1913)
*A Contribution to the Problem
of the Option of Neurosis*
The problem of why and how a person may fall ill of a neurosis
assuredly belongs to those which psycho-analysis is called upon to
solve. It is, however, probable that the solution will be found by way
of the answer to another and more specific problem---that of why any
particular person is bound to succumb to one particular neurosis, and
no other. This is the problem of the option of neurosis.
What do we know so far about this problem? Strictly speaking, only one
general principle has been established. We divide the causes of
neurotic disease into those which the individual himself brings with
him into life, and those which life brings to him---that is to say,
into constitutional and accidental. It is the interaction of these
that as a rule first gives rise to illness. Now the general principle
just referred to implies that the basic factors which determine the
option of neurosis are entirely of the former kind, that is, are of
the nature of dispositions, and are independent of experiences that
operate pathogenically.
Where are we to look for the origin of these dispositions? We have
come to realize that the mental functions concerned---above all, the
sexual function, {123} but also various important ego-functions---have
to go through a long and complicated process of development before
they reach the state characteristic of a normal adult. We must further
assume that these developments are not always carried out without a
hitch, so that the function as a whole is not always subjected to
progressive modification. Should any component of it remain arrested
at an earlier phase there results what is known as a 'fixation-point',
to which the function can regress if external hardships give rise to
illness.
Our predispositions to various neuroses are thus seen to be
inhibitions in development. The analogy with the facts of the general
pathology of other diseases strengthens this view. The question of
what factors can induce such disturbances in development does not lie
within the boundaries of psycho-analytic investigations; we must leave
it to biological research.[52]
With the help of such hypotheses, we were emboldened some years ago to
attack the problem of the option of neurosis. The line taken by our
method of investigation, which consists in tracing out normal
conditions from a study of their disturbances, led us to choose a very
singular and unexpected point of attack. The order in which the
principal forms of neurosis are customarily ranked---namely, hysteria,
obsessional neurosis, paranoia, dementia præcox---corresponds (if not
quite exactly) to the order of incidence of these diseases from
childhood onward. Hysterical manifestations may be observed already
in early childhood; the first symptoms of obsessional neurosis usually
declare themselves in the second period of childhood (from six to
eight years of age); whilst the two other psychoneuroses, which I have
coupled under the joint designation paraphrenia, first appear after
puberty and during adult life. Although last in order of incidence,
{124} these two conditions were the first to yield results from
investigations regarding the predispositions determining the option of
neurosis. The peculiar characteristics of them both, _i.e._
megalomania, turning from objective reality and difficulty in
effecting transference, have forced us to the conclusion that the
predisposing fixation is to be sought in a stage of libido-development
prior to the establishment of object-choice, that is to say, in the
stage of auto-erotism and narcissism.[53] Paranoia and dementia præcox
then, although manifesting themselves so late in life, derive from
very early inhibitions and fixations.
As a result of this, it seemed reasonable to suppose that the
disposition to hysteria and obsessional neurosis, the two
transference-neuroses proper, both of which show early
symptom-formation, would be found at still earlier stages of
libido-development. But where could an arrest in development be found
before this, and above all, where could lie that difference between
two phases of development which would give rise in one case to an
obsessional disposition and in another to that of hysteria? For a long
time no light could be obtained on these points, and earlier surmises
of my own about the nature of these dispositions---_e.g._ the idea
that hysteria and the obsessional neurosis were conditioned
respectively by passivity and activity in infantile experiences---had
soon to be discarded as erroneous.
I will now return to individual clinical study, and will consider the
case of a woman patient who was under observation for a considerable
period, and whose neurosis underwent an unusual transformation. The
case was at first one of pure anxiety-hysteria, following on a
traumatic experience, and it preserved that character for some
years. One day, however, it suddenly changed into an exceedingly
severe obsessional neurosis. A case of this kind must be significant
from more than one point of view. On the one hand, it {125} might turn
out to have the value of a bilingual document, and show how the two
neuroses would express an identical content in different languages. On
the other hand, it threatened wholly to overthrow our theory of
disposition as a result of arrest in development; unless we were
prepared to assume that an individual could have more than one weak
spot in his libido-development. I told myself that one had no right to
reject the latter possibility, but I was nevertheless very eager to
arrive at an understanding of the case.
As this came to me in the course of the analysis, it became evident
that the state of affairs was quite otherwise than I had imagined
it. The obsessional neurosis was not a further reaction to the same
trauma which had originally called forth the anxiety-hysteria; it was
a reaction to a second experience which had entirely eclipsed the
first---it was therefore an exception, although, to be sure, a still
debateable one, to our proposition that the option of neurosis does
not depend upon experience.
Unfortunately I cannot---for the usual reasons---go into the
case-history as fully as I could wish, but must confine myself to the
following details. Before she fell ill the patient had been a happy
and almost entirely contented married woman. She wished to have
children, a wish itself determined by infantile fixation, and fell ill
when she realized that her husband, to whom she was entirely devoted,
could not satisfy this longing. The anxiety-hysteria with which she
reacted to this frustration corresponded to a rejection of
seduction-phantasies in which she achieved her enduring wish for a
child. She was not long in coming to realize this herself, and did her
utmost to prevent her husband guessing that her illness was due to a
privation for which he was responsible. It is not without good reason,
however, that I have maintained that every man possesses in his
unconscious an instrument by which he can interpret the expressions of
the unconscious of another; the husband understood, {126} without any
confession or explanation, what his wife's anxiety signified, was
deeply hurt by the discovery, though he made no sign, and then began
to react neurotically himself by becoming for the first time impotent
during sexual intercourse. Immediately after he went on a journey, and
his wife, believing him to be permanently impotent, produced her first
obsessional symptom on the day before his expected return.
The content of her obsessional neurosis consisted in a tormenting
obsession about washing and cleanliness and in exceedingly vigorous
protective measures against wicked injuries which others might have to
fear from her; that is to say, it consisted of reaction-formations
against anal-erotic and sadistic impulses. In such forms her sexual
need was driven to find expression, as a result of the entire
bankruptcy of her genital life brought about by the impotence of her
husband, who was the only man to whom she could look for satisfaction.
At this point I was able to fit in a fragment of a new theory which
had recently been shaping in my mind. Although seemingly based on the
present isolated observation, it is, as a matter of fact, the result
of numerous earlier impressions, the significance of which first
became clear at this stage of the case under discussion. I told myself
that my original sketch of the development of the libidinal function
required another amplification. Formerly I had simply distinguished a
phase of auto-erotism, in which the various component-impulses, each
for itself, seek independent gratification on the body itself, from a
phase when in the interests of reproduction they unite under the
primacy of the genital system to effect object-choice. As is already
known, the analysis of paraphrenics had obliged us to interpolate a
stage of narcissism during which object-choice is already effected but
in which the object is still the ego itself. Now we are faced with the
necessity of reckoning with yet another stage before the ultimate
condition, one in which, although the {127} component-impulses have
been co-ordinated for purposes of object-choice, and although the
object does present itself as one outside the self, nevertheless _the
primacy of the genital zone has not yet been established_. The
component-impulses which govern this _pregenital_ organization of the
sexual life are, moreover, the anal-erotic and sadistic impulses.
I know that general statements of this kind appear very startling at
first hearing. We become reconciled to them only after correlation
with our previous knowledge, and it often happens that in the long run
they come to be accepted as an insignificant innovation which had
already been long suspected. We may proceed therefore to consider this
'pregenital sexual organization' with somewhat similar anticipations.
(_a_) The all-important part played by hate impulses and anal erotism
in the symptomatology of the obsessional neurosis has impressed many
observers, and recently Ernest Jones has called attention to it in a
particularly penetrating study.[54] This observation would be
established as an immediate corollary to our own views should it prove
that the component-impulses referred to, which precede the genital
impulses in the process of development, can act for the latter in this
neurosis.
At this point we may appropriately refer to a detail in the patient's
history which has not so far been mentioned. The patient's sexual life
began with sadistic beating-phantasies in her earliest childhood.
Following on their suppression an unusually long latency period set
in, in the course of which the girl achieved a far-reaching moral
development without awakening to the womanly sexual sensations. With
her early marriage began a period of normal sexual activity as a happy
wife, which lasted for a number of years, until the first great
privation brought on the hysterical neurosis. With the ensuing
destitution of {128} her genital life, her sexual activity, as has
been said, relapsed to the infantile stage of sadism.
It is not difficult to define the characteristic distinguishing this
case of obsessional neurosis from those many others which begin in
early years and follow a chronic course with more or less notable
exacerbations. In these latter, when once the stage of sexual
organization which contains the predisposition to obsessional neurosis
is established, it is never really overcome; in our case this
organization is, to begin with, superseded by a higher stage of
development, then subsequently reactivated by regression from that
higher stage.
(_b_) When we attempt to correlate our views with biological
considerations, we must bear in mind that the antithesis of masculine
and feminine which is set up by the reproductive function cannot be
present at the stage of pregenital object-choice. Instead we find an
antithesis of trends with active and passive aims which ultimately
resolves into the antithesis of sex (male and female). The active
trend is supplied by that general instinct of mastery which when we
find it serving the sexual function we call sadism; in the fully
developed normal sexual life it has also important accessory services
to render. The passive trend is fed from anal erotism, the erotogenic
zone of which corresponds with the old, undifferentiated
cloaca. Accentuation of anal erotism at the stage of pregenital
organization gives rise in a man to a marked predisposition to
homosexuality, when the next stage of the sexual function, that of
genital primacy, is reached. The building up of this last phase on the
foundation of the previous phases, and the subsequent transformation
of the libidinal cathexes, provides us with some of the most
interesting openings for psycho-analytic research.
It may be thought that all such difficulties and complications could
be avoided by denying the pregenital organization of sexual life and
adopting the {129} view that sexual life coincides with the genital
and reproductive function, making its appearance at the same time as
this. If this course were followed and use were made of such
psycho-analytic findings as are beyond dispute, the theory might be
advanced that as a result of sexual repression the neuroses are
compelled to express sexual strivings by means of other non-sexual
instincts, _i.e._ by compensatory sexualization of the latter. Anyone
so doing, however, would find himself in complete retreat from the
position taken up by psycho-analysis. He would stand where he was
before the advent of psycho-analysis and must abandon all the
comprehension it affords of the inter-connection between health,
perversion and neurosis. Psycho-analysis stands or falls by the
recognition of the sexual component-impulses, of the erotogenic zones,
and by the consequent expansion of the idea of the 'sexual function'
as opposed to the narrower one of a 'genital function'. Moreover,
observation of the normal development of the child is in itself
sufficient to obviate any such temptation.
(_c_) In the sphere of character-development we again meet with the
same instinctual forces whose workings we have already discovered in
the neuroses. A sharp theoretical distinction between the two becomes,
however, necessary from the single circumstance that in
character-formation one feature is absent which is peculiar to the
mechanism of neurosis---namely, miscarriage of repression and the
return of the repressed. In the formation of character either
repression is not at work at all or it easily attains its aim, which
is to replace the repressed impulses by reaction-formations and
sublimations. The processes of character-formation are therefore less
transparent and less accessible to analysis than those of neurosis.
In this very sphere of character-formation, however, we do come upon a
good analogy to the case of illness described, one which confirms the
existence of the pregenital sadistic-anal-erotic sexual
organization. It {130} is well known, and has been a matter for much
complaint, that women often alter strangely in character after they
have abandoned their genital functions. They become quarrelsome,
peevish and argumentative, petty and miserly; in fact, they display
sadistic and anal-erotic traits which were not theirs in the era of
womanliness. Writers of comedy and satirists have in all ages
launched their invectives against the 'old termagant' into which the
sweet maiden, the loving woman, the tender mother, has
deteriorated. This metamorphosis corresponds, as can be seen, with a
regression of sexual life to the pregenital anal-sadistic level, the
one in which we have found the predisposition to obsessional
neurosis. It would thus be not only the precursor of the genital
phase, but often enough its successor and resolvent as well, after the
genital function has been fulfilled.
The comparison of this alteration of character with the obsessional
neurosis is very impressive. Both are the result of regression, but in
the first the regression is complete and follows a process of
repression (or suppression) which has been accomplished smoothly; in
neurosis we find conflict, followed by efforts to prevent regression,
reaction-formations against it and symptom-constructions representing
compromises between the opposing tendencies, also a cleavage of the
mental processes into those which are capable of reaching
consciousness and those which are unconscious.
(_d_) Our formulation of the pregenital sexual organization is
incomplete in two directions. First it takes no account of the
behaviour of other component-impulses and is content to single out the
very definite primacy of sadism and anal erotism. There are many
points concerning the other component-impulses which would repay
careful investigation and collation; the desire for knowledge, in
particular, often gives one the impression that it can actually take
the place of sadism in the mechanism of the obsessional
neurosis. After all, it is at bottom an off-shoot, sublimated and
{131} raised to the intellectual sphere, of the possessive instinct
and its rejection in the form of doubt bulks largely in the picture of
obsessional neurosis.
The other defect in our formulation is much more important. We know
that a full understanding of any neurotic predisposition from the
developmental point of view is never complete without taking into
account not merely the stage of libido-development at which fixation
occurs but also the stage of ego-development. Our concern has been
confined to libido-development, however, and consequently does not
afford all the information we are entitled to expect. At the present
time little is known of the developmental stages of the ego-instincts;
I know only of one highly promising attempt by Ferenczi[55] to
approach this problem. I do not know if it will seem too daring if I
assume from the clues at our disposal that a premature advance of the
ego-development ahead of the libido-development contributes to the
obsessional disposition. Precocious development of this kind on the
part of the ego-instincts would necessitate the formation of
object-choice before the sexual function had reached its final
configuration and would thus leave a legacy of fixation at the
pregenital stage of sexual organization. When we take into
consideration that, in order to protect object-love from the hostility
which lurks behind it, the obsessional neurotic is compelled to build
up an overconscientious system of ultra-morality, one feels inclined
to go a step further and regard a certain degree of precocious
ego-development as characteristic of human nature in general and to
trace the capacity for morality to the circumstance that,
developmentally, hate is the forerunner of love. Perhaps this is the
meaning of a statement made by W. Stekel, which seemed
incomprehensible to me at the time, that hate, not love, is the
primary state of feeling between human beings.[56]
{132}
(_e_) The above considerations have some bearing on the subject of
hysteria; they bring out the intimate relation between this condition
and the last phase of libido-development characterized by genital
primacy and the introduction of the reproductive function. These newly
acquired activities undergo repression in hysteria, but no regression
to the pregenital phase takes place. The inadequacy of this
description of an hysterical disposition, due to our incomplete
understanding of ego-development, makes itself felt more than in the
case of the obsessional neurosis.
Nevertheless it is not difficult to see that a different regression to
an earlier level occurs in hysteria too. As we know, the sexuality of
a female child is governed by an organ that is essentially male (the
clitoris) and the manifestations of this sexuality are in many ways
similar to those occurring in boys. A final thrust of development at
the period of puberty must eliminate this masculine sexuality and
promote the vagina, a derivative of the cloaca, to the position of
leading erotogenic zone. Hence it is very usual in women suffering
from hysteria for a reactivation of this repressed masculine sexuality
to take place, against which defensive measures are directed by the
ego-syntonic instincts. It seems to me, however, a little premature to
discuss the problems of hysterical predisposition at this point.
----------------------------------------------------------------------
XII {133}
A DREAM WHICH BORE TESTIMONY[57]
(1913)
A lady suffering from doubting mania and obsessive ceremonials made a
rule that her nurses should never let her out of sight for a single
moment: otherwise she would begin to brood about forbidden actions
that she might conceivably have committed during this relaxation of
vigilance. One evening whilst resting on the sofa she thought she saw
that the nurse on duty had fallen asleep. On calling out, 'Have you
seen me?', the latter started up and replied, 'Of course I have'. This
aroused a fresh doubt in the patient's mind, and after a time she
repeated her question, which the nurse met with renewed protestations;
just at that moment a maid-servant came in bringing the patient's
supper.
This incident occurred one Friday evening. Next morning the nurse
recounted a dream which had the effect of dispelling the patient's
doubt.
Dream: _Some one entrusted a child to her whilst the mother was absent
on a journey and she had lost it. Going along the street, she inquired
from various people whether they had seen the child. Then she came to
a large expanse of water and crossed a narrow bridge._ (Supplementing
this later: _Suddenly there appeared before her on this bridge, like
a_ fata Morgana, _the figure of another nurse._) _Then she found
herself in some familiar place where she met a woman she had known as
a girl: the latter had in those days been saleswoman in a
provision-shop and later had got married. She was standing in {134}
front of her door and the dreamer asked her, 'Have you seen the
child?' The woman paid no attention to the question but informed her
that she had been divorced, adding that even marriage is not always
happy. She woke up feeling reassured and thought: the child will turn
up in a neighbour's house._
Analysis: The patient concluded that this dream was connected with the
incident of falling asleep which the nurse had denied; from additional
information volunteered by the latter she was able to interpret the
dream in a fashion which, although incomplete in many respects, was
sufficient for all practical purposes. For myself, not having
interviewed the nurse, I have only the lady's report to go on; first
of all I shall quote the patient's interpretation, supplementing this
afterwards as far as possible from our general understanding of the
laws governing dream-formation.
'Nurse told me that the child in the dream reminded her of a case the
treatment of which had given her the most lively satisfaction. It was
that of a child who was unable to see on account of inflammation of
the eyes (blennorrhœa). The mother, however, was not away: she helped
to look after the child. On the other hand, I know that my husband
thinks highly of this nurse; when he went away he left me in her care
and she promised him to look after me---as she would a child!'
On the other hand, we know from the patient's analysis that by
insisting on being kept in sight she had put herself once again in the
position of a child.
'That she had lost the child', continued our patient, 'signified that
she had not watched me; she had lost sight of me. It was an admission
that she had actually gone to sleep for the time and had not told me
the truth later'.
She was quite in the dark about the meaning of that fragment of dream
where the nurse inquired from people in the street whether they had
seen the child: on the other hand she was able to elucidate subsequent
details of the manifest dream.
{135}
'The expanse of water made nurse think of the Rhine; she added,
however, that it was much larger. Then she remembered that on the
previous evening I had read her the story of Jonah and the whale, and
had told her that I once saw a whale in the English Channel. I fancy
that the water represents the sea and is an allusion to the story of
Jonah.
'I think, too, that the narrow bridge comes from the same story, which
is told wittily in dialect. A religious instructor describes to his
pupils the wonderful adventure of Jonah, whereupon a boy points out
that it cannot be true, since the teacher himself had told them before
that whales could swallow only the smallest creatures owing to the
narrowness of their throats. The teacher got out of the difficulty by
saying that Jonah was a Jew, and that Jews would squeeze themselves in
anywhere. My nurse is very religious but inclined to scepticism, and I
reproached myself that my story-telling might perhaps have stirred her
religious doubts.
'Now on this narrow bridge she saw the figure of another nurse whom
she knew. From what she said it appears that this nurse drowned
herself in the Rhine after being discharged from a case owing to some
neglect or other.[58] She herself had feared, therefore, that she
would be discharged for having fallen asleep. Moreover, on the day
following the incident and after relating the dream, nurse cried
bitterly, and when I asked why, {136} replied quite rudely: "You know
why as well as I do: you won't trust me any more"!'
Since the appearance of the drowned nurse was an after-thought and an
especially distinct item, we should have advised the patient to begin
her dream-interpretation at this point. According to the dreamer's
report, too, the first half of her dream was accompanied by acute
anxiety; the second part paved the way for that feeling of reassurance
with which she awoke.
'I regard the next part of the dream', said the lady, continuing her
analysis, 'as certain corroboration of my view that the dream had to
do with what happened on Friday evening, for the person who had
formerly been a saleswoman in a provision-shop can only have referred
to the servant who brought in the supper on that occasion. I noticed,
too, that nurse complained of nausea all day long. The question she
puts to this woman, "Have you seen the child?" is obviously traceable
to my question, "Have you seen me?" I put this question to her for the
second time, just as the servant came in with the dishes.'
In the dream, too, inquiry after the child is made on two
occasions. The fact that the woman does not reply and shows no sign of
interest we shall regard as an aspersion on this other servant made in
the dreamer's own interest: she represents herself in the dream as
being superior to the other, just because she herself has to face
reproach on account of her own lack of attention.
'The woman who appears in the dream is not in actual fact divorced
from her husband. The situation is taken from an incident in the life
of the other servant, who has been separated from her
lover---"separated", divorced---by her parent's veto. The remark that
even marriage is not always happy was in all probability a consoling
remark made in the course of conversation between the two servants. On
it is modelled the concluding sentence of the dream: the child will
turn up.
'I concluded from this dream, however, that on the {137} evening in
question nurse really did fall asleep and that she was afraid of being
dismissed for this reason. I had no more doubt about the accuracy of
my powers of perception. Moreover, after relating the dream, nurse
added that she was very sorry she had no dream-book at hand. To my
comment that such books were full of the most ignorant superstitions,
she replied that, although she was not at all superstitious, still all
the unpleasant happenings of her life had taken place on a Friday. I
must add that at the present moment her treatment of me is not at all
satisfactory; she is touchy and irritable and makes scenes about
nothing.'
I think we must credit the lady with having accurately interpreted and
appreciated her nurse's dream. As so often happens with
dream-interpretation during analysis, the translation of the dream
does not depend solely on associative material, but in addition on the
circumstances of its narration, the behaviour of the patient before
and after analysis, together with every remark or disclosure made by
the patient at the time---during the same analytic session. If we take
into account this nurse's touchiness, her attitude to unlucky Fridays,
etc., we should confirm the conclusion that the dream contained a
confession; in spite of her denial, she had actually fallen asleep and
was afraid she would be sent away from her 'foster-child'.[59]
This dream, however, which had a practical bearing for the lady,
stimulates our theoretical interest in two directions. It took the
form of a consolation, but essentially it represented a significant
_avowal_ in regard to the nurse's relation to her patient. How does it
come about that a dream, which should surely serve the purpose of a
wish-fulfilment, can represent a confession which is not even in any
way advantageous to the dreamer? Must we concede the existence of
confession-dreams as distinct from wish- (and anxiety-) {138} dreams,
or again of warning-dreams, reflection-dreams, adaptation-dreams, and
so on?
I must confess I still do not quite understand why the objections I
gave to any such course in my _Traumdeutung_ have given rise to
misgivings in the minds of so many psycho-analysts, among them some of
repute. It seems to me that the differentiation of wish-, avowal-,
warning- and adaptation-dreams, and so on, has not much greater value
than the differentiation, accepted perforce, of medical specialists
into gynecologists, children's specialists, dentists. Let me
recapitulate here as briefly as possible the discussion of this
question as set forth in my _Traumdeutung_.[60]
The so-called 'residues from the previous day' can act as disturbers
of sleep and dream-producers; they are thought-processes from the
previous day which have retained affective cathexis and to some extent
withstood the general lowering of energy through sleep. These residues
are discovered by tracing back the manifest dream to the latent
dream-thoughts; they constitute portions of the latter, belong, that
is to say, to the activities of waking life---whether they are
conscious or unconscious---which are able to persist during sleep. In
accordance with the multiformity of thought-processes in the conscious
and preconscious systems, these day-residues are present in numerous
forms with the most varying significance: they may be wishes or fears
that have not been disposed of, or resolutions, reflections, warnings,
attempts to adapt oneself to current situations, and so on. To this
extent the question of this particular characteristic of dreams would
seem to be confirmed by the content discovered on interpretation of
them. These residues from the previous day, however, are not the dream
itself: they even lack the most essential constituent of a dream. They
could not of themselves form a dream. They are, strictly speaking,
only the psychical material which the dream-work employs, just as
sensory and somatic {139} stimuli, either incidental or produced under
experimental conditions, constitute the somatic material for the
dream-work. To attribute to them the main part in dream-formation is
simply to repeat in a new guise the pre-analytical error by which
dreams were explained on the hypothesis of stomach trouble or
skin-pressure. Scientific errors indeed have many lives, and even when
refuted are ready to creep in again under new guises.
In so far as we comprehend the state of affairs, the conclusion has
been forced on us that the essential factor in dream-formation is an
unconscious wish---as a rule, an infantile wish---now in a state of
repression; this can come to expression through the somatic or psychic
material (therefore also through the day-residues), and thus it can
provide these with the energy by which they can force themselves
through to consciousness even during the nocturnal suspension of
thought. Whatever else it may contain, warning, reflection, or
avowal, whatever part of the rich content of preconscious waking life
remains unsatisfied and arises during the night, the dream is in every
case the fulfilment of _this_ unconscious wish. It is _this_
unconscious wish that gives the dream-work its peculiar characteristic
of an unconscious elaboration of preconscious material. For a
psycho-analyst dreams can only be characterized as productions of the
dream-work; in spite of the fact that the latent dream-thoughts may
only be found after dream-interpretation, he cannot reckon them as
part of the dream; they are a part of preconscious
thinking. (Secondary elaboration by the conscious system is reckoned
as part of the dream-work. Even if one were to regard it separately,
this would not involve any alteration in our conception. The
definition would then run: Dreams considered in the analytical sense
include the actual dream-work together with the secondary elaboration
of the product of this work.) The conclusion to be drawn from these
considerations is that one cannot put the dream-characteristic of
wish-fulfilment in the same category {140} with dream-characteristics
such as warnings, avowals, attempts at solution, etc., without denying
the concept of psychic dimensions of depth, that is to say, without
rejecting the psycho-analytical standpoint.
At this point we may revert to the dream related by the nurse, in
order to demonstrate the dimensional character of the wish-fulfilment
contained therein. We already know that the lady's interpretation of
this dream was by no means complete; there were portions of the
day-content which she was unable to appraise accurately. Moreover she
suffered from an obsessional neurosis, a condition which seems to me
to make it harder for the patient to understand dream-symbols, in
contrast with dementia præcox in which the reverse is true.
Nevertheless our knowledge of dream-symbolism enables us to understand
uninterpreted portions of this dream and to perceive a deeper
significance behind the interpretations already given. We cannot but
observe how some of the material employed by the nurse comes from the
complex of giving birth, of having children. The expanse of water (the
Rhine, the Channel where the whale was seen) is certainly the water
out of which children come. She too comes to the water 'in search of a
child'. The Jonah legend behind this determination of the water, the
question how Jonah (the child) could get through such a narrow
passage, belong to the same association. The nurse, too, who out of
mortification threw herself into the Rhine, found some comfort in her
despair of life by the sexual-symbolic mode of her death---by going
into water. The narrow bridge on which the nurse makes her appearance
is in all probability also a genital symbol, although I must admit
that here we lack more precise knowledge.
The wish to have a child seems therefore to be the unconscious creator
of the dream in this instance; no other would be better calculated to
comfort the nurse for the painful state of affairs in real life. 'I
{141} shall be discharged: I shall lose my foster-child. What matter?
I shall get a real child of my own instead'. That uninterpreted
portion of the dream where she questions everyone in the street about
the child perhaps belongs here; the interpretation would then run,
'and even if I have to offer myself on the streets I know how to get a
child for myself'. A strain of defiance in the dreamer hitherto
disguised suddenly declares itself here: her avowal fits in here for
the first time. 'What if I have shut my eyes and compromised my
professional reputation for conscientiousness and lost my post? Shall
I be such a fool as to drown myself like Nurse X? Not I: I'll give up
nursing altogether and get married: I'll be a woman and have a real
child; nothing shall prevent me.' This interpretation is justified by
the consideration that 'having children' is really the infantile
expression of a desire for sexual intercourse: indeed it can be
consciously chosen as an euphemistic expression of this shocking wish.
In her waking life itself the dreamer showed some tendency to confess;
in the dream a confession which would be detrimental to her interests
is made possible; one of the nurse's latent character-traits makes use
of the confession to bring about an infantile wish-fulfilment. We may
surmise that this character has a close connection---in regard both to
time and to content---with the wish for a child and for sexual
enjoyment.
Subsequent inquiry of the lady to whom I owe the first part of this
interpretation afforded some unexpected information about the previous
career of the nurse. Before she took up nursing she had wished to
marry a man who had courted her assiduously; she had then abandoned
this projected marriage on account of the opposition of an aunt
towards whom her relations were a curious mixture of dependence and
defiance. This aunt who prevented the marriage was the superintendent
of a nursing association, and was regarded by the nurse as the pattern
on which she {142} modelled her life. The latter expected to be her
aunt's heir, and was dependent on her in this way; nevertheless she
thwarted the aunt by not entering the particular branch of nursing the
latter had destined her for. The defiance shown in the dream was
therefore directed against the aunt. We have ascribed an anal-erotic
origin to this character-trait, and may take into consideration that
the interests binding her to the aunt are of a financial nature; we
are also reminded that children favour the anal theory of birth.
This factor of infantile defiance may perhaps allow us to assume a
closer relation between the first and last scenes in the dream. The
former saleswoman in a provision-shop represents in the dream the
servant who brought the lady's supper into the room just when she was
asking the question, 'Have you seen me?' It appears, however, that she
is intended in every way to play the part of hostile
rival. Depreciation of her nursing capacity is indicated by the fact
that she takes not the slightest interest in the lost child, her
answer dealing with her own private affairs. The dreamer had thus
displaced on to this figure the indifference about her patient which
applied to herself. The unhappy marriage and divorce which the former
dreaded in connection with her most secret wishes are attributed to
the same person. We know, however, that it was the aunt who had
separated the nurse and her fiancé. Hence the 'provision-seller' (a
figure not lacking in infantile symbolic significance) may represent
the aunt-superintendent, who was in fact not much older than the nurse
and who had played the necessary part of mother-rival in the nurse's
life. A satisfactory confirmation of this interpretation is to be
found in the fact that the 'familiar' district where she comes upon
this person standing in front of her door was the place where her aunt
carried out her official duties.
Owing to the lack of contact between the analyst {143} and the object
of the analysis, it is scarcely advisable to penetrate deeper into the
structure of the dream. It may perhaps be stated that even in the
slight degree to which interpretation was possible the dream showed
itself rich in corroborative material and in new problems.
----------------------------------------------------------------------
XIII {144}
INFANTILE MENTAL LIFE
*Two Lies told by Children*[61]
(1913)
It is comprehensible that children should tell lies when in doing so
they mimic the lies of grown-up people. But a number of the lies of
well-brought-up children have a peculiar significance, and should
cause their instructors to reflect rather than to be angry. These lies
proceed from the influence of an excessive love motive, and become
momentous if they lead to a misunderstanding between the child and the
person whom it loves.
I
A girl of seven (in her second year at school) had asked her father
for money to buy colours for painting Easter eggs. The father had
refused, saying he had no money. Shortly afterwards the girl again
asked for some money for a contribution towards a wreath for the
funeral of the late reigning princess. Each of the school-children was
to bring fifty pfennigs. The father gave her ten marks; she paid her
contribution, put nine marks on her father's writing-table, and with
the remaining fifty pfennigs bought paints, which she hid in her
toy-cupboard.
At dinner the father asked suspiciously what she had done with the
missing pfennigs, and whether she had not bought the colours with
them. She denied it; but her brother, who was two years older, and
together {145} with whom she had planned to paint the eggs, betrayed
her; the colours were found in the cupboard. The father, very angry,
handed the culprit over to her mother for punishment, which was
severely administered. Afterwards the mother herself was overwhelmed
when she saw the child's extreme despair. She caressed the little girl
after punishing her, and took her for a walk to console her. But the
effects of this experience, described by the patient herself as the
'turning-point' of her life, proved to be immitigable. She had
hitherto been a wild, self-confident child; thenceforth she became
timid and vacillating. During her engagement she flew into a rage that
was incomprehensible even to herself, when her mother was buying
furniture and trousseau-garments for her. She had the feeling that
after all it was _her_ money, and no one else ought to buy anything
with it. As a young wife she was shy of asking her husband for any
expenditure for her personal needs, and made an unnecessary
distinction between 'her' money and his. During the course of her
treatment it happened now and again that her husband's remittances to
her were delayed, so that she was resourceless in the foreign
city. After she had once told me this, I made her promise that if it
happened again she would borrow the small necessary sum from me. She
gave the promise, but on the next occasion of embarrassment she did
not keep it and preferred to pawn her jewellery. She explained that
she could not take money from me.
The appropriation of the fifty pfennigs in her childhood had a
significance which the father could not divine. Some time before she
began going to school, she had played a singular little prank with
money. A neighbour with whom she was friendly had sent the girl with a
small sum of money, as companion for her own still younger little boy,
to make some purchase in a shop. As the elder of the two, she was
bringing the change from the purchase back to the house. But when she
met the neighbour's servant-maid in the {146} street,
she flung the money down on the pavement. In the analysis of this
action, even to herself inexplicable, the thought of Judas occurred to
her, when he flung away the silver pieces gained by him through the
betrayal of his Master. She declared that she was certainly acquainted
with the story of the Passion before she went to school. But in what
manner could she have identified herself with Judas?
At the age of three and a half she had a nursemaid of whom she was
extremely fond. This girl had a love-affair with a doctor, and visited
his surgery with the child. It appears that the child was the witness
of various sexual proceedings. Whether she saw the doctor give money
to the nursemaid is not certainly established; there is, however, no
doubt that the girl gave the child little presents of money to ensure
her silence, and that purchases (probably sweets) were made with these
on the way home. It is possible, too, that the doctor himself
occasionally gave money to the child. Nevertheless, the child betrayed
the girl to her mother out of jealousy. She played so ostentatiously
with the pfennigs she had brought home that the mother could not but
ask: 'Where did you get that money?' The maid was dismissed.
To take money from anyone had thus early come to mean for her the
yielding of the body, the erotic relation. To take money from her
father was equivalent to a declaration of love. The phantasy that her
father was her lover was so seductive that the childish desire for
colours for the Easter eggs was easily, by its aid, indulged in spite
of the prohibition. But she could not confess to the appropriation of
the money; she was obliged to disavow it, because the motive of the
deed, unknown to herself, could not be confessed. The father's
chastisement was thus a refusal of the tenderness offered him, a
humiliation, and so it broke her spirit. During the treatment a period
of severe depression ensued, the explanation of which led to her
remembering the events described, when I was once {147} obliged to
copy that humiliation by asking her not to bring me any more flowers.
It will scarcely be necessary, for the psycho-analyst, to insist upon
the fact that in this child's little experience we are confronted with
one of those extremely common cases of persistence of early anal
erotism in the later erotic life. Even the desire to paint the eggs
with colours derives from the same source.
II
A woman, now very ill as the consequence of a disappointment in life,
was in earlier years a particularly healthy, truth-loving, earnest and
admirable girl, and became a tender-natured woman. But still earlier,
in the first years of her life, she had been a wilful and discontented
child, and though she developed fairly early into an excessively good
and conscientious one, there were occurrences in her schooldays which,
when she fell ill, caused her deep remorse and were regarded by her as
proofs of fundamental depravity. Memory told her that she had
frequently in those days bragged and lied. Once, on the way home, a
schoolfellow boasted: 'Yesterday we had ice at dinner.' She answered:
'Oh, we have ice every day.' In reality she did not know what ice at
dinner could mean; she knew ice only in the long blocks in which it is
carted about, but she perceived that there was something grand in
having it for dinner, and so she would not be excelled by her
schoolfellow.
When she was ten years old they were given in their drawing-lesson the
task of drawing a circle in free-hand. But she made use of the
compasses, thus easily producing a perfect circle, and showed her
achievement triumphantly to her neighbour in class. The teacher came
up, heard her boasting, discovered the marks of the compasses in the
delineation of the circle, and took the girl to task. But she
stubbornly denied it, would not be abashed by any proofs, and took
{148} refuge in sullen silence. The teacher conferred with her father;
both were influenced by the girl's usual good behaviour to decide
against any further notice of the occurrence.
This child's two lies were instigated by the same complex. As the
eldest of five children, the little girl early manifested an unusually
strong attachment to her father, which was destined in later years to
wreck her happiness in life. But she could not long escape the
discovery that her beloved father was not so great a personage as she
was inclined to think him. He had to struggle against
money-difficulties; he was not so powerful nor so distinguished as she
had imagined. This departure from her ideal she could not put up
with. Since, as women do, she based all her ambition upon the beloved
man, it became a dominating idea with her that she must support her
father against the world. So she boasted to her schoolfellows, in
order not to have to belittle her father. When, later on, she learnt
to translate ice for dinner by '_glace_', the path lay open for her
remorse about this reminiscence to take its course as a dread of
pieces or splinters of glass.
The father was an excellent draughtsman, and had often enough called
forth the delight and wonderment of the children by exhibitions of his
skill. In her identification of herself with her father, she had in
school drawn that circle which she could produce successfully only by
underhand means. It was as though she wanted to boast: 'Look
here---see what my father can do'! The consciousness of guilt that
hung round her excessive fondness for her father found its outlet in
the attempted deception; a confession was impossible for the same
reason that was given in the earlier observation---it could not but
have been the confession of the hidden incestuous love.
We should not think lightly of such episodes in child-life. It would
be a grave misconception to read into such childish errors the
prognosis of a developing {149} immoral character. Nevertheless, they
are intimately connected with the most powerful motivations of the
childish soul, and are prophetic of tendencies which will take shape
either in the later destiny or in a future neurosis.
----------------------------------------------------------------------
XIV {150}
A CASE OF PARANOIA RUNNING COUNTER
TO THE PSYCHO-ANALYTICAL THEORY
OF THE DISEASE[62]
(1915)
Some years ago a well-known lawyer consulted me about a case which had
raised some doubts in his mind. A young woman had asked him to protect
her from the molestations of a man who had drawn her into a
love-affair. She declared that this man had abused her confidence by
getting invisible witnesses to photograph them in the act of
love-making, and that by exhibiting these pictures he could bring
shame upon her and force her to resign her position. Her legal adviser
was experienced enough to recognize the pathological stamp of this
accusation; he remarked, however, that, as what appears to be
incredible often actually happens, he would appreciate the opinion of
a psychiatrist in this matter. He promised to call on me again,
accompanied by the plaintiff.
Before I continue the account, I will say that I have altered the
_milieu_ of this case in order to preserve the incognito of those
concerned, but that I have altered nothing else. I consider it an
undesirable practice, however excellent the motive may be, to alter
any detail in the presentation of a case. One can never tell which
aspect of a case may be picked out by a reader of independent
judgement, and one runs the risk of giving the latter a false
impression.
Shortly afterwards I met the patient in person. She was thirty years
old, a singularly attractive and {151} handsome girl,
who looked much younger than her age and was of a distinctly feminine
type. She obviously resented the interference of a doctor and took no
trouble to hide her distrust. It was clear that only the influence of
her legal adviser, who was present, induced her to tell the following
story, one which set me a problem to be referred to later. Neither in
her manner nor by any kind of expression of emotion did she betray the
slightest shame or shyness, although some such state of mind would
naturally arise on such an occasion in the presence of a stranger. She
was completely under the spell of the apprehension that her experience
had induced in her.
For many years she had been on the staff of a big institution, where
she held a responsible post. Her work had given her satisfaction and
had been appreciated by her employers. She had never sought any
love-affairs with men, but had lived quietly with her old mother whose
only support she was. She had no brothers or sisters; her father had
died many years before. Recently an official in the same institution,
a cultured and attractive man, had paid her attentions and she had
inevitably been drawn towards him. For external reasons, marriage was
out of the question, but the man would not hear of giving up their
relationship on that account. He had pleaded that it was senseless to
sacrifice to social convention all that they longed for, that they had
an indisputable right to enjoy and that could enrich their life as
nothing else could. As he had promised not to expose her to any risk,
she had at last consented to go to his bachelor rooms in the
daytime. There they kissed and embraced as they lay side by side, and
he began to admire the charms which were now partly revealed. In the
midst of their love-making she was suddenly frightened by a noise, a
kind of knock or tick. It came from the direction of the writing-desk,
which was standing sideways in front of the window; the space between
desk and window was partly filled up by a heavy {152} curtain. She had
at once asked her friend what this noise meant, and was told, so she
said, that it probably came from the small clock on the
writing-desk. I shall take the liberty, however, of commenting below
on this part of her narrative.
As she left the house she had met two men on the staircase who
whispered to each other as she passed. One of the strangers was
carrying something which was wrapped up and looked rather like a
box. She was much exercised over this meeting, and even on the way
home her thoughts had already taken the following shape: the box could
easily have been a camera, and the man a photographer who had been
hidden behind the curtain while she was in the room; the tick had been
the noise of the shutter; the photograph had been taken as soon as he
saw her in a particularly compromising position of which he had wished
to obtain pictorial evidence. From that moment nothing could abate her
suspicion. She pursued her lover with reproaches and pestered him for
explanations and reassurances, not only when they met but also by
letter. In vain did he try to convince her that his feelings were
sincere and that her suspicions were entirely without foundation. At
last she called on the lawyer, told him of her experience and handed
over the letters which the accused had written to her about the
incident. Later I had an opportunity of seeing some of these
letters. They made a very favourable impression on me, and contained
mainly expressions of regret that such an unspoilt and tender
understanding should have been destroyed by this 'unfortunate morbid
idea'.
I need hardly justify my agreement with this view. But the case had a
special interest for me other than a merely diagnostic one. The view
had already been put forward in psycho-analytical literature that
patients suffering from paranoia are struggling against an
intensification of their homosexual trends, this pointing back to a
narcissistic object-choice. And a further interpretation had been
made: that the persecutor is {153} in reality the loved person, past
or present. A synthesis of the two propositions would lead us to
expect that the persecutor must be of the same sex as the
persecuted. We had not, it is true, asserted that paranoia is always
without exception conditioned by homosexuality; but only because our
observations were not sufficiently numerous. It was one of those
conceptions which in view of certain connections become important only
when universal application can be claimed for them. In psychiatric
literature there is certainly no lack of cases in which the patient
imagines himself persecuted by a person of the opposite sex. It is one
thing, however, to read of such cases, and quite a different thing to
come into personal contact with one. The relation between paranoia and
homosexuality had so far been easily confirmed by my own observations
and analyses and by those of my friends. But the present case
emphatically contradicted it. The girl seemed to defend herself
against love for a man by transforming the lover straightaway into a
persecutor: there was no sign of the influence of a woman, no trace of
a struggle against a homosexual attachment.
In these circumstances the simplest thing to do would have been to
abandon the theory that the delusion of persecution invariably depends
on homosexuality, and with it everything based on this view. Either
that theory must be given up or else, in view of this lack of
conformation to rule, one must side with the lawyer and assume that
this was no paranoiac combination but an actual experience which had
been accurately interpreted. But I saw another way out, by which a
final verdict could for the moment be postponed. I recollected how
often wrong views were taken about psychotic patients simply because
they had not been studied carefully enough and had not told enough
about themselves. I therefore said that I could not form an immediate
opinion, and asked the lady to call on me a second time, when she
could relate her story again and add any details that had {154}
perhaps been omitted. Thanks to the lawyer's influence I secured this
promise from the reluctant patient; while the former aided me in
another way by saying that at our second meeting his presence would be
superfluous.
The story told on this second occasion did not conflict with the
previous narrative, but the additional details supplied resolved all
doubts and difficulties. To begin with, she had visited the young man
not once but twice. It was on the second occasion that she had been
disturbed by the suspicious noise: she had suppressed, or omitted to
mention, the first visit because it had no longer seemed of importance
to her. On the first day nothing had happened, but something did
happen on the day following. Her department in the business concern
was under the direction of an elderly lady whom she described as
follows: 'She has white hair like my mother'. This elderly
superintendent had a great liking for her and treated her with
affection, though sometimes she teased her; the girl regarded herself
as her particular favourite. On the day after her first visit to the
young man's rooms he appeared in the office to discuss some business
matter with this elderly woman. During their whispered conversation
the patient suddenly felt convinced that he was telling her about
their adventure of the previous day, and even concluded that there had
been for some time a love-relationship between the two which she had
overlooked. The white-haired motherly old lady now knew everything,
and her speech and conduct throughout the rest of the day seemed to
confirm the patient's suspicion. At the first opportunity she took her
lover to task about his treachery. He naturally raised a vigorous
protest against what he called a senseless accusation. This time he
succeeded in freeing her from her delusion and she regained enough
confidence to repeat her visit to his room a short time, I believe a
few weeks, afterwards. The rest we know from her first narrative.
{155}
These new details remove first of all any doubts as to the
pathological nature of her suspicion. It is easy to see that the
white-haired elderly manageress is a mother-substitute, that in spite
of his youth the lover has been put in the place of the father, and
that the strength of the mother-complex has driven the patient to
suspect a love-relationship between these ill-matched partners,
however unlikely such a relation might be. Moreover, this fresh
information resolves the apparent contradiction with the view
maintained by psycho-analysis, that the development of a delusion of
persecution is conditioned by an over-powerful homosexual bond. The
_original_ persecutor---the agency whose influence the patient wishes
to escape---is here again not a man but a woman. The manageress knows
about the girl's love-affairs, disapproves of them, and shows her
disapproval by mysterious allusions. The woman's attachment to her
own sex hinders her attempts to adopt a person of the other sex as a
love-object. Love for the mother becomes the protagonist of all those
tendencies which, acting as her 'conscience', would arrest the girl's
first step along the new road to normal sexual satisfaction, in many
respects a dangerous one; and indeed it succeeds in destroying her
relation with the man.
When the mother hinders or arrests a daughter's sexual activity she
fulfils a normal function. This function is outlined in the early
relationship between mother and infant; it is based on powerful,
unconscious motivations, and has the sanction of society. It is the
daughter's business to emancipate herself from this influence and to
decide for herself on broad and rational grounds what her share of
enjoyment or denial of sexual pleasure shall be. If in the attempt to
emancipate herself she falls a victim to a neurosis there is present a
mother-complex, which is as a rule over-powerful, and is certainly
unmastered. This conflicts with the new direction taken by the libido,
and the conflict is disposed of in the form of this or that
{156} neurosis, according to the disposition present.
The manifestations of the neurotic reaction will always be determined,
however, not by the actual relation to the actual mother, but by the
infantile relation to the original mother-imago.
We know that our patient had been fatherless for many years: we may
also assume that she would not have kept away from men up to the age
of thirty if she had not been sustained by a powerful emotional
attachment to her mother. This supporting tie becomes a burdensome
obstacle when her libido begins to respond to the call of a man's
insistent wooing. She tries to free herself, to throw off her
homosexual bond; and her disposition, which need not be discussed
here, enables her to achieve this by the formation of a paranoiac
delusion. The mother thus becomes the hostile and jealous watcher and
persecutor. As such she could be overcome, were it not that the
mother-complex retained power enough to carry out its purpose of
keeping her at a distance from men. At the end of the first phase of
the conflict the patient has thus become estranged from the mother
without having definitely gone over to the man. Indeed, both of them
are plotting against her. Then with a vigorous effort the man draws
her to himself. She conquers the mother's opposition in her mind and
is willing to grant her lover a second meeting. In the later
developments the mother does not reappear, but we may rightly assume
that in this earlier phase the lover was not a persecutor directly;
his character as such was acquired, as it were, through the mother and
in virtue of his relationship to the mother, a factor which played the
chief part in the formation of the first delusion.
One would think that the resistance was now definitely overcome, that
the girl who had until now been bound to her mother had succeeded in
coming to love a man. But after the second visit a new delusion
appears, which, by making ingenious use of accidental circumstances,
destroys this love and thus successfully {157} carries through the
purpose of the mother-complex. It still seems strange that a woman
should protect herself against the love of a man by means of a
paranoiac delusion; but before examining this state of things more
closely, let us glance at the accidental circumstances that form the
basis of this second delusion, the one aimed exclusively against the
man.
Lying partly undressed on the sofa alongside her lover, she hears some
noise, a tick, knock, or tap. She does not know its cause but she
arrives at an interpretation of it after meeting on the staircase two
men, one of whom carries something that looks like a covered box. She
is convinced that someone acting on instructions from her lover has
watched and photographed her during their intimate tête-à-tête. We, of
course, are far from thinking that had the fatal noise not occurred
the delusion would not have been formed; on the contrary, we see
behind this accidental circumstance something compulsive, asserting
itself again as inevitably as when the patient divined a
love-relationship between her lover and the elderly manageress, her
mother-substitute. Among the wealth of unconscious phantasies of
neurotics, and probably of all human beings, there is one which is
seldom absent and can be disclosed by analysis, concerning the
watching of sexual intercourse between the parents. I call these
phantasies, together with those of seduction, castration, and others,
_primal phantasies_; and I shall discuss more fully elsewhere their
origin and the relation of them to individual experience. The
accidental noise is merely a stimulus which activates the typical
phantasy of eavesdropping, itself a component of the parental
complex. Indeed, it is doubtful whether we can rightly call it
'accidental'. As O. Rank has remarked to me, it is an essential part
of the phantasy of listening, and it reproduces either the sounds
which betray parental intercourse or those by which the listening
child fears to betray itself. But now we know at once where we
stand. The lover is still the {158} father, but the patient herself
has taken the mother's place. The part of the listener must then be
allotted to a third person. We can see by what means the girl has
freed herself from her homosexual dependence on the mother. A partial
regression has taken place; instead of choosing her mother as a
love-object, she has identified herself with her, she herself has
become the mother. The possibility of this regression points to the
narcissistic origin of her homosexual object-choice and with that to
the paranoiac disposition in her. One might sketch a train of thought
which would bring about a similar result: 'If mother does it, I can do
it too; I've just as good a right as she'.
One can go a step further in disproving the accidental nature of the
noise. We do not, however, ask our readers to follow us, since the
absence of thorough analytic investigation makes it impossible in this
case to go beyond a certain probability. The patient mentioned in her
first interview with me that she had immediately demanded an
explanation of the noise, and had been told that it was probably the
ticking of the little clock on the table. I take the liberty of
assuming that this piece of information was a mistaken memory. It
seems to me much more likely that at first she did not react to the
noise at all, and that it became significant only after she met the
two men on the staircase. Her friend, who had probably not even heard
the noise, ventured the explanation, perhaps on some later occasion
when she assailed him with her suspicions, 'I don't know what noise
you can have heard. Perhaps it was the little clock; it sometimes
ticks like that.' A subsequent use of impressions and displacement of
recollections such as this occurs frequently in paranoia and is
characteristic of it. But as I never met the man and did not continue
the analysis of the woman, my hypothesis cannot be proved.
I might go still further in the analysis of this apparently real
'accident'. I do not believe that the clock ever ticked or that any
noise was to be heard at {159} all. The woman's situation justified a
sensation of throbbing in the clitoris. This was what she subsequently
projected as a perception of an external object. Similar things occur
in dreams. An hysterical patient of mine once related to me a short
'awakening' dream to which she could bring no spontaneous
associations. She dreamt simply that someone knocked and then she
awoke. Nobody had knocked, but during the previous nights she had been
awakened by unpleasant sensations of pollutions: she had thus a motive
for awakening as soon as she felt the first sign of genital
excitation. There had been a 'knocking' of the clitoris. In the case
of our paranoiac patient, I should substitute for the accidental noise
a similar process of projection. I certainly cannot guarantee that
during our short acquaintance the patient, who was reluctantly
yielding to necessity, gave me a truthful account of all that had
taken place during the two meetings. But an isolated
clitoris-contraction would be in keeping with her statement that no
contact of the genitals had taken place. In her subsequent rejection
of the man, lack of satisfaction undoubtedly played a part as well as
'conscience'.
Let us consider again the outstanding fact that the patient protects
herself against her love for a man by means of a paranoiac
delusion. The key to the understanding of this is to be found in the
evolution of the delusion. As we might have expected, the latter was
at first aimed against the woman; _the subsequent progression from a
female to a male object_ was, however, made on a _paranoiac
basis_. Such a progression is unusual in paranoia; as a rule we find
that the victim of persecution remains fixated to the same persons and
therefore to the same sex as before the paranoiac transformation set
in. But neurotic disorder does not preclude a progression of this
kind, and our observation may be the prototype of many others. There
are many similar processes beside that in paranoia which have never
yet been classified under this heading, {160} amongst them some which
are very familiar. The so-called neurasthenic, for example, is
prevented by his unconscious incestuous fixation from choosing a
strange woman as a love-object; his sexual activity must remain within
the limits of phantasy. But within the limits of this phantasy he
achieves the progress denied him in reality and he succeeds in
replacing mother and sister by new objects. Since the veto of the
censorship does not then come into action, he can become conscious of
his choice of these substitute-figures.
Alongside the phenomena of attempted progression from a position
recently achieved, as a rule by regression, we may group the efforts
made in some neuroses to regain a libido-position once held and
subsequently lost. Indeed we can hardly draw any abstract distinction
between these two categories. We are too apt to think that the
conflict underlying a neurosis is removed when the symptom has been
formed. In reality the struggle often goes on after this. Fresh
instinctual components arise on both sides, and these continue it. The
symptom itself becomes an object of this struggle; certain trends
anxious to preserve it conflict with others which strive to remove it
and to re-establish the _status quo_. In the attempt to render the
symptom nugatory the expedient is often adopted of trying to regain
through new channels what has been lost and is now frustrated by the
symptom. These facts throw much light on a statement made by
C. G. Jung to the effect that a peculiar psychic inertia, hostile to
change and progress, is the fundamental condition of neurosis. This
inertia is in fact most peculiar; it is not a general one, but is
highly specialized; it is not even all-powerful within its own scope,
but fights against tendencies towards progress and reconstruction
which remain active even after the formation of neurotic symptoms. If
we search for the starting-point of this specialized inertia, we
discover that it is the expression of a conjunction of {161} instincts
with impressions and with the objects connected with these
impressions. This conjunction has been effected very early, is very
hard to resolve, and has the effect of bringing the development of the
instincts concerned to a standstill. Or in other words, this
specialized 'psychic inertia' is only a different term, though hardly
a better one, for what in psycho-analysis we are accustomed to call a
_fixation_.
----------------------------------------------------------------------
XV {162}
A CONNECTION BETWEEN A SYMBOL
AND A SYMPTOM[63]
(1916)
The hat has been adequately established as a symbol of the genital
organ, most frequently the male, through analyses of dreams. It cannot
be said, however, that this symbol is at all an intelligible one. In
phantasies and in numerous symptoms the head also appears as a symbol
of the male genitals, or, if one prefers to put it so, as a
representation of them. Many analysts will have noticed that certain
patients suffering from obsessions express an abhorrence of and
indignation against the penalty of beheading, feelings which are far
more pronounced as regards this than any other form of capital
punishment, and will in consequence have had to explain to them that
they treat being beheaded as a substitute for being castrated. Dreams
of young people or dreams occurring during the period of youth which
concern the subject of castration, and in which there was mention of a
ball which could only be interpreted as the head of the dreamer's
father, have been often analysed and frequently published. I have
recently been able to solve a ceremonial carried out by a patient
before going to sleep, which consisted in laying a small pillow
diamond-wise on a larger one so that the sleeper's head would rest
exactly in the long diameter of the diamond. The diamond had the
meaning that is familiar to us from drawings on walls, the head was to
represent the male organ.
{163}
It may be that the symbolic meaning of the hat is derived from that of
the head, in so far as the hat can be considered as a continuation of
the head, though detachable. In this connection I call to mind a
symptom of obsessional neurotics by means of which they manage to
ensure themselves continual torment. When they are in the street they
are constantly watching to see whether some acquaintance will salute
them first, by taking off his hat, or whether he seems to wait for
their salute; and they give up a number of their acquaintances who
they imagine no longer salute them or do not return their salute
properly. There is no end to their perplexities on the point; they
find them everywhere as their mood and fancy dictate. It makes no
difference to their behaviour when we tell them, what they all know
already, that the salute by taking off the hat signifies an abasement
before the saluted person, that a Spanish grandee, for example,
enjoyed the privilege of being in the presence of the king with his
head covered, and that their sensitiveness to saluting has therefore
the meaning of not being willing to show themselves as of less
importance than the other person thinks himself to be. The resistance
of their sensitiveness to such an explanation suggests the activity of
a motive less present to consciousness, and the source of this excess
of feeling can easily be found in relation to the castration complex.
----------------------------------------------------------------------
XVI {164}
ON THE TRANSFORMATION OF INSTINCTS
WITH SPECIAL REFERENCE TO ANAL
EROTISM[64]
(1916)
Many years ago, observations made during psycho-analysis led me to
surmise that the constant co-existence in any person of the three
character-traits of _orderliness_, _parsimony_ and _obstinacy_
indicated an intensification of the anal-erotic components in the
sexual constitution of that person, and that these were modes of
reaction specially favoured by his ego which had been established
during his development in the course of the absorption of his anal
erotism.[65]
In that publication my main object was to make known the fact of this
definite relation: I was little concerned about its theoretical
significance. Since then a general consensus of opinion has arisen
that each one of the three qualities, avarice, pedantry and
stubbornness, springs from anal-erotic sources---or, to express it
more cautiously and more completely---draws powerful contributions
from these sources. The cases in which these defects of character were
combined and which in consequence bore a special stamp (the 'anal
character') were merely extreme instances, which even to superficial
observation afforded illustration of the particular connection which
concerns us here.
As a result of numerous impressions, and in particular of one
specially cogent analytical experience, {165} I came to the conclusion
a few years later that in the development of the libido in man the
phase of genital primacy must be preceded by a 'pregenital
organization' in which sadism and anal erotism play the leading
parts.[66]
From that moment we had to face the following question: what becomes
of anal-erotic impulses subsequently when, after the establishment of
complete genital primacy, they have lost their importance in sexual
life? Do they preserve their original nature, but in a state of
repression? Are they sublimated and absorbed by transformation into
character-traits? Or do they find a place and function within the new
organization of sexuality characterized by genital primacy? Or, to put
the question more accurately, since none of these three possibilities
is likely to be the exclusive fate of the anal erotism, to what extent
and in what way does each of them share in deciding that fate? For the
organic sources of anal erotism cannot be exhausted by the
establishment of the genital organization.
One would think that there could be no lack of material from which to
provide an answer, since the processes of instinctual transformation
in question must have taken place in all persons undergoing
analysis. Yet the material is so obscure, the abundance of
ever-recurring impressions so confusing, that even now I am unable to
solve the problem fully and can only contribute in part towards its
solution. In this paper I shall also not neglect the opportunity to
refer where connections arise to transformations of other impulses
besides the anal-erotic. I need not emphasize the fact that the
processes of development here described---just as the others found in
psycho-analysis---have been inferred from the regressions into which
they had been forced by neurotic processes.
To begin with, it would appear that in the products {166} of the
unconscious---spontaneous ideas, phantasies, symptoms---the
conceptions _fæces_ (money, gift), _child_ and _penis_ are seldom
distinguished and are easily interchangeable. We realize, of course,
that to express oneself in this way is incorrectly to apply to the
sphere of the unconscious terms which belong properly to other regions
of mental life; in fact, that we have been tempted by the advantages
offered by an analogy. To put the matter in a form less open to
objection, these elements in the unconscious are often treated as if
they were equivalent and could replace one another.
The most evident connection is that between 'child' and 'penis'. It
cannot be without significance that in the symbolic language of
dreams, as well as of everyday speech, both are replaced by a single
symbol; both child and penis are called 'little one' (_das
Kleine_). It is a well-known fact that symbolic speech often ignores
the difference of sex. The 'little one', which originally meant the
male genital organ, may have achieved a secondary application to the
female genitals.
If we penetrate deeply into the neuroses of women, we not infrequently
meet with the repressed wish to possess a penis. We call this
infantile wish 'penis-envy' and include it within the castration
complex. Chance mishaps in a woman's life, mishaps which are
themselves frequently the result of a very masculine disposition, have
re-activated this infantile wish and, through the backward flow of
libido, made it the chief vehicle of the neurotic symptoms. In other
women we find no evidence of the penis-wish; it is replaced by the
wish for a child, the frustration of which in real life can lead to
outbreak of a neurosis. It looks as if such women had understood
(although this could not possibly have acted as a motive) that nature
has given children to women as a substitute for the penis that has
been denied them. From other women, again, we learn that both wishes
co-existed in infancy, and that one had replaced the other. At first
they had wanted a penis like a man; then at a later, though still
infantile, {167} stage there appeared instead the wish for a
child. The impression is forced upon us that this variety is caused by
accidental factors during childhood, _e.g._ the presence or absence of
brothers, the birth of another child at some critical time of life, so
that the penis-wish and the child-wish were fundamentally identical.
We can indicate the ultimate outcome of the infantile penis-wish in
those persons in whom the conditions for a neurosis in later life are
absent: it changes into the wish for a _man_, accepting the man as an
appendage, as it were, of the penis. A tendency hostile to the female
sexual function is thus transformed into one favourable to it. Such
women are capable of a love based on the masculine type of
object-love, which can exist alongside the feminine one proper, which
is derived from narcissism. We have already seen that in other cases
the child is the first link in the transition from narcissistic
self-love to object-love. In this way also, then, a child can be
represented by the penis.
I have occasionally had the opportunity of hearing some dreams of
women occurring after the first act of intercourse. They revealed an
unmistakable wish in the woman to keep for herself the penis with
which she had come in contact. Apart from their libidinal origin these
dreams indicated a temporary regression from the man to the penis as
an object of desire. One would certainly be inclined to trace back the
wish for a man in a purely rationalistic way to the wish for a child,
since a woman is bound to understand sooner or later that there can be
no child without the agency of a man. It is, however, more likely that
the wish for a man arises independently of the wish for a child, and
that when---from obvious motives derived exclusively from
ego-psychology---it does arise an unconscious reinforcement of libido
from the original penis-wish becomes attached to it.
The importance of the process described lies in the fact that a part
of the young woman's narcissistic masculinity is thus changed into
femininity, and so can {168} no longer operate in a way harmful to the
female sexual function. By yet another process a part of the erotism
of the pregenital phase becomes available for use in the phase of
genital primacy. The child is regarded as 'lumf'[67] (_Lumpf_), _i.e._
as something which becomes detached from the body by passing through
the bowel. A certain amount of libidinal cathexis which originally
attached to the contents of the bowel can thus be extended to the
child born through it. Linguistic evidence of this identity of child
and fæces is contained in the expression 'to _give_ some one a child'.
For its fæces are the infant's first gift, a part of his body which he
will give up only on persuasion by a loved person, to whom, indeed, he
will make a spontaneous gift of it as a token of affection, since as a
rule infants do not soil strangers. (There are similar if less
intensive reactions with urine.) The process of defæcation affords the
first occasion on which the child must decide between a narcissistic
and an object-loving attitude. He either parts obediently with his
fæces, 'offers them up' to his love, or else retains them for purposes
of auto-erotic gratification and later as a means of asserting his own
will. The latter choice constitutes the development of defiance
(obstinacy), a quality which springs, therefore, from a narcissistic
clinging to the pleasure of anal erotism.
It is probable that the first significance which fæcal interest
develops is not 'gold---money', but 'gift'. The child has no knowledge
of money other than that received as a gift, no idea of money earned
or belonging to it, inherited. Since its fæces constitute its first
gift, the child easily transfers interest from this substance to the
new one that meets it as the most valuable form of gift in life. Those
who question this derivation of gifts should review their experience
of psycho-analytic treatment, study the gifts they receive as doctors
from their patients, and watch the storms of {169} transference which
a gift from them can rouse in their patients.
Thus the interest in fæces is carried on partly as interest in money,
partly as a wish for a child, in which latter an anal-erotic and a
genital impulse ('penis-envy') coincide. But the penis has another
anal-erotic significance apart from its relation to the interest in a
child. The relationship between the penis and the passage lined with
mucous membrane which it fills and excites has already its prototype
in the pregenital, anal-sadistic phase. The fæcal mass, or as one
patient called it, the fæcal 'stick', represents as it were the first
penis, and the stimulated mucous membrane of the rectum represents
that of the vagina. There are persons whose anal erotism remains
vigorous and unmodified up to the age preceding puberty (ten to twelve
years); we learn from them that already during the pregenital phase
such persons had developed in phantasy and in perverse activity an
organization analogous to the genital one, in which penis and vagina
were represented by the fæcal stick and the rectum. In other cases
(obsessional neurotics) we can observe the result of a regressive
deterioration of the genital organization: all the phantasies
originally conceived on the genital level are set back on to the anal
level; the penis is replaced by the fæcal mass, the vagina by the
rectum.
Normally, when the interest in fæces recedes, the structural analogy
we have described here effects a transference of the interest to the
penis. Then if later inquiry yields the discovery that babies are
born from the bowel, the greater part of the anal erotism becomes
transferred to the baby, as chief heir, so to speak, of the anal
erotism; the penis, however, has been its predecessor in this as well
as in another sense.
I feel sure that by this time the manifold inter-relations of the
series, fæces, penis, child, have become utterly confused; so I will
attempt to remedy this defect by presenting them diagramatically, and
in {170} considering the diagram we can review the same material in a
different order. Unfortunately, this technical device is not
sufficiently plastic for our purpose, or possibly we have not yet
learned to use it with effect. In any case we ask the reader not to
expect too much from it.
[Illustration: Diagram --- see images/diagram.png]
Defiance springs from anal erotism and serves narcissistic purposes,
forming an important ego-reaction against demands made by others.
Interest in fæces is carried over first to interest in gifts, then to
interest in money. In girls, the discovery of the penis gives rise to
penis-envy, which later changes into the wish for a man as the
possessor of a penis. At an earlier stage the wish for a penis was
changed into the wish for a child, or the latter replaced the
former. An organic analogy between penis and child (dotted line) is
expressed by the existence of a symbol ('little one') common to
both. A rational wish (double line) leads from the wish for a child to
the wish for a man: we have already appreciated the importance of this
instinctual transformation.
A different series of relations can be observed much {171} more
distinctly in the male. It is formed when the boy's sexual curiosity
leads him to discover the absence of a penis in women. He concludes
that the penis must be a detachable part of the body, something
analogous to fæces, the first bodily substance the child had to part
with. Thus the original anal defiance enters into the composition of
the castration complex. The structural analogy which enabled the
intestinal contents to be the forerunner of the penis during the
pregenital phase cannot come into account as a motive, but a
substitute in the mind for it is provided by sexual investigation.
When a baby appears on the scene it is labelled 'lumf', in accordance
with the conclusions arrived at by sexual investigation, and becomes
invested with powerful anal-erotic interest. When social experiences
teach that a baby is to be regarded as a love-token, a gift, the wish
for a child is reinforced from the same source. Fæces, penis and child
are all three solid bodies: they all three, by forcible entry or
expulsion, stimulate a membranous passage, _i.e._ the rectum and the
vagina, the latter being as it were 'rented' from the rectum, as Lou
Andreas-Salome aptly remarks.[68] Infantile inquiry into sexual
matters can only lead to the conclusion that the child comes down by
the same route as the fæcal mass: the function of the penis is not
usually discovered by it. But it is interesting to note that after so
many vicissitudes an organic correspondence re-appears in the mental
sphere as an unconscious identity.
----------------------------------------------------------------------
XVII {172}
'A CHILD IS BEING BEATEN'[69]
*A Contribution to the Study of the Origin
of Sexual Perversions*
(1919)
I
It is surprising how frequently people who come to be analysed for
hysteria or an obsessional neurosis confess to having indulged in the
phantasy: 'A child is being beaten'. Very probably it occurs even more
often with other people who have not been obliged to come to this
decision by manifest illness.
The phantasy has feelings of pleasure attached to it, and on their
account it has been reproduced on innumerable occasions in the past or
is even being reproduced still. At the climax of the imaginary
situation there is almost invariably an onanistic gratification, that
is to say, a gratification in the genitals. At first this takes place
in accordance with the will of the person in question, but later on it
does so in spite of his efforts, and with the characteristics of an
obsession.
It is only with hesitation that this phantasy is confessed to. Its
first appearance is recollected with uncertainty. The analytic
treatment of the subject is met by unmistakable resistance. Shame and
a sense of guilt are perhaps more strongly excited in this connection
than when similar accounts are given of memories of the beginnings of
sexual life.
Eventually it becomes possible to establish that the first phantasies
of the kind were entertained very early {173} in life: certainly
before school age, and not later than in the fifth or sixth year. When
the child was at school and saw other children being beaten by the
teacher, then, if the phantasies had become dormant, this experience
called them up again, or, if they were still present, it reinforced
them, and noticeably modified their content. From that time forward it
was 'an indefinite number' of children that were being beaten. The
influence of the school was so clear that the patients concerned were
at first tempted to trace back their beating-phantasies exclusively to
these impressions of school life, which dated from later than their
sixth year. But it was never possible for them to maintain this
position; the phantasies had already been in existence before.
Though the children were no longer beaten in the higher forms at
school, the influence of such occasions was replaced and more than
replaced by the effects of reading, of which the importance was soon
to be felt. In my patient's _milieu_ it was almost always the same
books whose contents gave a new stimulus to the beating-phantasies:
those accessible to young people, such as the so-called '_Bibliothèque
rose_', _Uncle Tom's Cabin_, etc. The child began to compete with
these works of fiction by producing its own phantasies and by
constructing a wealth of situations, and even whole institutions, in
which children were beaten or were punished and disciplined in some
other way because of their naughtiness and bad behaviour.
This phantasy---'a child is being beaten'---was invariably charged
with a high degree of pleasure and had its issue in an act of
pleasurable, auto-erotic gratification; it might therefore be expected
that the sight of another child being beaten at school would also be a
source of similar enjoyment. But as a matter of fact this was never
so. The experience of real scenes of beating at school produced in the
child who witnessed them a peculiarly excited feeling which was
probably of a mixed character and in which repugnance had a {174}
large share. In a few cases the real experience of the scenes of
beating was felt to be intolerable. Moreover, it was always a
condition even of the elaborated phantasies of later years that the
punishment should do the children no serious injury.
The question was bound to arise of what relation there might be
between the importance of the beating-phantasies and the part that
real corporal punishment might have played in the education of the
child at home. It was impossible, on account of the one-sidedness of
the material, to confirm the first suspicion that the relation was an
inverse one. The individuals from whom the data for these analyses
were derived were very seldom beaten in their childhood, or were at
all events not brought up by the help of the rod. Naturally, however,
each of these children was bound to have become aware at one time or
another of the superior physical strength of its parents or educators;
the fact that in every nursery the children themselves at times come
to blows requires no special emphasis.
As regards the early and simple phantasies which could not obviously
be traced to the influence of school impressions or of scenes taken
from books, further information would have been welcome. Who was the
child that was being beaten? The one who was himself producing the
phantasy or another? Was it always the same child or as often as not a
different one? Who was it that was beating the child? A grown-up
person? And if so, who? Or did the child imagine that he himself was
beating another one? Nothing could be ascertained that threw any light
upon all these questions---only the one timid reply: 'I know nothing
more about it: a child is being beaten'.
Inquiries as to the sex of the child that was being beaten met with
more success, but none the less brought no enlightenment. Sometimes
the answer was: 'Always boys', or 'Only girls'; more often it was: 'I
don't know', or 'It doesn't matter which'. But the point to which the
questions were directed, the {175} discovery of some constant relation
between the sex of the child producing the phantasy and that of the
child that was being beaten, was never established. Now and again
another characteristic detail of the content of the phantasy came to
light: 'A little child is being beaten on its naked bottom'.
In these circumstances it was impossible at first even to decide
whether the pleasure attaching to the beating-phantasy was to be
described as sadistic or masochistic.
II
A phantasy of this kind, arising, perhaps from some accidental cause,
in early childhood and retained for the purpose of auto-erotic
gratification, can, in the light of our present knowledge, only be
regarded as a primary trait of perversion. One of the components of
the sexual function has, it seems, developed in advance of the rest,
has made itself prematurely independent, has undergone fixation and in
consequence been withdrawn from the later processes of development,
and has in this way given evidence of a peculiar and anomalous
constitution in the individual. We know that an infantile perversion
of this sort need not persist for a whole life-time; later on it can
be subjected to repression, be replaced by a reaction-formation, or be
transformed by sublimation. (It is possible, however, that sublimation
arises out of some special process which would be kept in the
background by repression.) But if these events do not take place, then
the perversion persists to maturity; and whenever we find a sexual
aberration in adults---perversion, fetishism, inversion---we are
justified in expecting that anamnestic investigation will reveal some
experience in the nature of a fixation in childhood. Indeed, long
before the days of psycho-analysis, observers like Binet were able to
trace the strange sexual aberrations of maturity back to similar
impressions and to precisely the same period of childhood, namely, the
fifth or {176} sixth year. But at this point the inquiry was brought
up against the limitations of our knowledge; for the impressions that
brought about the fixation were without any traumatic force. They were
for the most part commonplace and unexciting to other people. It was
impossible to say why the sexual impulse had undergone fixation
particularly upon them. It was possible, however, to look for their
significance in the fact that they provided an opportunity of fixation
(even though it was an accidental one) for precisely that sexual
component which was prematurely developed and was ready to spring
forward. We had in any case to be prepared to find a provisional end
somewhere or other to the chain of causal connection; and the
congenital constitution seemed exactly to correspond with what was
required for a stopping-place of that kind.
If the sexual component which has broken loose prematurely is the
sadistic one, then we may expect, on the basis of knowledge derived
from other sources, that a disposition to an obsessional neurosis will
result from its subsequent repression. This expectation cannot be said
to be contradicted by the results of inquiry. The present short paper
is based upon the exhaustive study of six cases (four female and two
male). Of these, two were cases of obsessional neurosis; one extremely
severe and incapacitating, the other of moderate severity and quite
well accessible to influence. There was also a third case which at all
events exhibited clearly marked individual traits of obsessional
neurosis. The fourth case, it must be admitted, was one of
straightforward hysteria, with pains and inhibitions; and the fifth
patient, who had come to be analysed merely on account of lack of
decision in life, would not have been classified at all by coarse
clinical diagnosis, or would have been dismissed as
'psychasthenic'. There is no need for feeling disappointed over these
statistics. In the first place, we know that not every disposition is
necessarily {177} developed into a disorder; in the second place, we
ought to be content to explain the facts before us, and ought as a
rule to avoid the additional task of making it clear why something has
_not_ taken place.
The present state of our knowledge would allow us to make our way so
far and no farther towards the comprehension of
beating-phantasies. But in the mind of the analytical physician there
remains an uneasy suspicion that this is not a final solution of the
problem. He is obliged to admit to himself that to a great extent
these phantasies subsist apart from the rest of the content of the
neurosis, and find no proper place in its structure. But impressions
of this kind, as I know from my own experience, are only too easily
put on one side.
III
Strictly considered---and why should this question not be considered
with all possible strictness?---analytic work deserves to be
recognized as genuine psycho-analysis only when it has succeeded in
removing the amnesia which conceals from the adult his knowledge of
his childhood from its beginning (that is, from about the second to
the fifth year). This cannot be said among analysts too emphatically
or repeated too often. The motives for disregarding this reminder are,
indeed, intelligible. It would be desirable to obtain practical
results in a shorter time and with less trouble. But at the present
time theoretical knowledge is still far more important to all of us
than therapeutic success, and anyone who neglects childhood analysis
is bound to fall into the most disastrous errors. The emphasis which
is laid here upon the importance of the earliest experiences does not
imply any underestimation of the influence of later ones. But the
later impressions of life speak loudly enough through the mouth of the
patient, while it is the physician who has to raise his voice on
behalf of the claims of childhood.
It is in the years of childhood between the ages of {178} two and four
or five that the congenital libidinal factors are first awakened by
actual experiences and become attached to certain complexes. The
beating-phantasies which are now under discussion show themselves only
towards the end of this period or after its termination. So it may
quite well be that they have an earlier history, that they go through
a process of development, that they represent an end-product and not
an initial manifestation.
This suspicion is confirmed by analysis. A systematic application of
it shows that beating-phantasies have an historical development which
is by no means simple, and in the course of which they are changed in
most respects more than once---as regards their relation to the author
of the phantasy, and as regards their object, their content, and their
significance.
In order to make it easier to follow these transformations in
beating-phantasies I shall venture to confine my descriptions to the
female cases, who, since they are four as against two, in any case
constitute the greater part of my material. Moreover,
beating-phantasies among men are connected with another subject, which
I shall leave on one side in this paper. In my description I shall be
careful to avoid being more schematic than is inevitable in presenting
an average case. If then upon further observation a greater complexity
of circumstances should come to light, I shall nevertheless be sure of
having secured a typical occurrence and not one of an uncommon kind.
The first phase of beating-phantasies among girls must therefore
belong to a very early period of childhood. Some features remain
curiously indefinite, as though they were a matter of
indifference. The scanty information given by the patients in their
first statement, 'a child is being beaten', seems to be justified in
respect to this phase. But another of their features can be
established with certainty, and to the same effect in every case. The
child being beaten is never the one producing the phantasy, but is
invariably {179} another child, most often a brother or a sister if
there is any. Since this other child may be a boy or a girl, there is
no constant relation between the sex of the child producing the
phantasy and that of the child being beaten. The phantasy, then, is
certainly not masochistic. It would be tempting to call it sadistic,
but one cannot neglect the fact that the child producing the phantasy
is never doing the beating himself. The actual identity of the person
beating remains obscure at first. Only this much can be established:
it is not a child but an adult. Later on this indeterminate grown-up
person becomes recognizable clearly and unambiguously as the (girl's)
_father_.
This first phase of the beating-phantasy is therefore completely
represented by the phrase: '_My father is beating the child_'. I am
betraying a great deal of what is to be brought forward later when
instead of this I say: 'My father is beating the child _whom I hate_'.
Moreover, one may hesitate to say whether the characteristics of a
'phantasy' can yet be ascribed to this first step towards the later
beating-phantasy. It is perhaps rather a question of recollections of
events which have been witnessed, or of desires which have arisen on
various occasions. But these doubts are of no importance.
Profound transformations have taken place between this first phase and
the next. It is true that the person beating remains the same (that
is, the father); but the child who is beaten has been changed into
another one and is now invariably the child producing the
phantasy. The phantasy is accompanied by a high degree of pleasure,
and has now acquired a significant content, with the origin of which
we shall be concerned later. Now, therefore, the wording runs: '_I am
being beaten by my father_'. It is of an unmistakably masochistic
character.
This second phase is the most important and the most momentous of all.
But we may say of it in a certain sense that it has never had a real
existence. {180} It is never remembered, it has never
succeeded in becoming conscious. It is a construction of analysis, but
it is no less a necessity on that account.
The third phase once more resembles the first. It has the wording
which is familiar to us from the patient's statement. The person
beating is never the father, but is either left undetermined just as
in the first phase, or turns in a characteristic way into a
representative of the father, such as a teacher. The figure of the
child who is producing the beating-phantasy no longer itself appears
in it. In reply to pressing inquiries the patients only declare: 'I am
probably looking on'. Instead of the one child that is being beaten,
there are now a number of children present as a rule. Most frequently
it is boys who are being beaten (in girls' phantasies), but none of
them is personally known to the subject. The situation of being
beaten, which was originally simple and monotonous, may go through the
most complicated alterations and elaborations; and punishments and
humiliations of another kind may be substituted for the beating
itself. But the essential characteristic which distinguishes even the
simplest phantasies of this phase from those of the first, and which
establishes the connection with the intermediate phase, is this: the
phantasy now has strong and unambiguous sexual excitement attached to
it, and so provides a means for onanistic gratification. But this is
precisely what is puzzling. By what path has the phantasy of strange
and unknown boys being beaten (a phantasy which has by this time
become sadistic) found its way into the permanent possession of the
little girl's libidinal tendencies?
Nor can we conceal from ourselves that the inter-relations and
sequence of the three phases of the beating-phantasy, as well as all
its other peculiarities, have so far remained quite
unintelligible.
IV {181}
If the analysis is traced through the early period to which the
beating-phantasies are referred and from which they are recollected,
it shows us the child involved in the agitations of its parental
complex.
The affections of the little girl are fixed upon her father, who has
probably done all he could to win her love, and in this way has sown
the seeds of an attitude of hatred and rivalry towards her
mother. This attitude exists side by side with a current of
affectionate dependence upon her, and as years go on it may be
destined to come into consciousness more and more clearly and
forcibly, or to give an impetus to an excessive reaction of devotion
to her. But it is not with the girl's relation to her mother that the
beating-phantasy is connected. There are other children in the
nursery, only a few years older or younger, who are disliked on all
sorts of other grounds, but chiefly because the parents' love has to
be shared with them, and for this reason they are repulsed with all
the wild energy characteristic of the emotional life of those
years. If it is a younger brother or sister (as in three of my four
cases) it is despised as well as hated; yet it attracts to itself the
share of affection which the blinded parents are always ready to give
to the youngest child, and this is a spectacle the sight of which
cannot be avoided. One soon learns that being beaten, even if it does
not hurt very much, signifies a deprivation of love and a
humiliation. And many children who believed themselves securely
enthroned in the unshakable affection of their parents have by a
single blow been cast down from all the heavens of their imaginary
omnipotence. The idea of the father beating this hateful child is
therefore an agreeable one, quite apart from whether he has actually
been seen doing it. It means: 'My father does not love this other
child, _he loves only me_'.
This then is the content and meaning of the {182} beating-phantasy in
its first phase. The phantasy obviously gratifies the child's jealousy
and is dependent upon the erotic side of its life, but it is also
powerfully reinforced by its egoistic interests. It remains doubtful,
therefore, whether it ought to be described as purely 'sexual', nor
can one venture to call it 'sadistic'. As is well known, all the
signs upon which we are accustomed to base our distinctions tend to
melt as we come nearer to the source. So perhaps we may say in words
like those of the promise given by the three Witches to Banquo: 'Not
clearly sexual, not in itself sadistic, but yet the stuff from which
both will later come'. In any case, however, there is no ground for
suspecting that in this first phase the phantasy is already at the
service of an excitement which involves the genitals and finds its
outlet in an onanistic act.
It is clear that the sexual life of the child has reached the stage of
genital organization, now that its incestuous love has achieved this
premature object-choice. This can be demonstrated more easily in the
case of boys, but is also indisputable in the case of girls. Something
like a premonition of what are later to be the final and normal sexual
aims governs the libidinal tendencies of a child; we may justly wonder
why this should be so, but we may regard it as a proof of the fact
that the genitals have already taken on their share in the process of
excitation. With boys the wish to beget a child from their mother is
never absent, with girls the wish to have a child by their father is
equally constant; and this in spite of their being completely
incapable of forming any clear idea of the means for fulfilling these
wishes. The child seems to be convinced that the genitals have
something to do with the matter, even though in its constant brooding
it may look for the essence of the presumed intimacy between its
parents in relations of another sort, such as in their sleeping
together, micturating in each other's presence, etc.; and material of
the latter kind {183} can be more easily apprehended in verbal images
than the mystery that is connected with the genitals.
But the time comes when this early blossoming is nipped by the frost.
None of these incestuous loves can avoid the fate of repression. They
may succumb to it on the occasion of some discoverable external event
which leads to disillusionment---such as unexpected slights, the
unwelcome birth of a new brother or sister (which is felt as
faithlessness), etc.; or the same thing may happen owing to internal
conditions apart from any such events, perhaps simply because their
yearning remains unsatisfied too long. It is unquestionably true that
the events are not the effective causes, but that these love-affairs
are bound to be wrecked sooner or later, though we cannot say upon
what. Most probably they pass because their time is over, because the
children have entered upon a new phase of development in which they
are compelled to recapitulate from the history of mankind the
repression of an incestuous object-choice, just as at an earlier stage
they were obliged to effect an object-choice of that very sort.[70]
Nothing that is unconsciously present as a mental product of the
incestuous love-impulses is taken over by consciousness in the new
phase; and whatever has already come into consciousness is expelled
from it. At the same time as this process of repression takes place, a
sense of guilt appears. This is also of unknown origin, but there is
no doubt whatever that it is connected with the incestuous wishes, and
that it is justified by the persistence of those wishes in the
unconscious.
The phantasy of the period of incestuous love had said: 'He (my
father) loves only me, and not the other child, for he is beating
it'. The sense of guilt can discover no punishment more severe than
the reversal of this triumph: 'No, he does not love you, for he is
beating you'. In this way the phantasy of the second phase, that of
being beaten by the father, is a {184} direct expression of the sense
of guilt, to which the love for the father is now subordinated. The
phantasy, therefore, has become masochistic. So far as I know, this is
always so; a sense of guilt is invariably the factor that transforms
sadism into masochism. But this is certainly not the whole content of
masochism. The sense of guilt cannot have won the field alone; a share
must also fall to the love-impulse. We must remember that we are
dealing with children in whom the sadistic component was able for
constitutional reasons to develop prematurely and in isolation. We
need not abandon this point of view. It is precisely such children who
find it particularly easy to hark back to the pregenital,
sadistic-anal organization of their sexual life. If the genital
organization, when it has scarcely been effected, is met by
repression, it not only follows that every mental counterpart of the
incestuous love becomes unconscious, or remains so, but there is
another result as well: a regressive debasement of the genital
organization itself to a lower level. 'My father loves me' was meant
in a genital sense; owing to the regression it is turned into 'My
father is beating me (I am being beaten by my father)'. This being
beaten is now a meeting-place between the sense of guilt and sexual
love. _It is not only the punishment for the forbidden genital
relation, but also the regressive substitute for it_, and from this
latter source it derives the libidinal excitation which is from this
time forward attached to it, and which finds its outlet in onanistic
acts. Here for the first time we have the essence of masochism.
This second phase---the child's phantasy of being itself beaten by its
father---remains as a rule unconscious, probably in consequence of the
intensity of the repression. I cannot explain why nevertheless in one
of my six cases, that of a male, it was consciously remembered. This
man, now grown up, had preserved the fact clearly in his memory that
he used to employ the idea of being beaten by his mother for the
purpose of onanism, though to be sure he soon substituted for his own
mother the {185} mothers of his school-fellows or other women who in
some way resembled her. It must not be forgotten that when a boy's
incestuous phantasy is transformed into the corresponding masochistic
one, one more reversal has to take place than in the case of a girl,
namely the substitution of passivity for activity; and this additional
degree of distortion may save the phantasy from having to remain
unconscious as a result of repression. In this way the sense of guilt
would be satisfied by regression instead of by repression. In the
female cases the sense of guilt, in itself perhaps more exacting,
could be appeased only by a combination of the two.
In two of my four female cases an artistic superstructure of
day-dreams, which was of great significance for the life of the person
concerned, had grown up over the masochistic beating-phantasy. The
function of this superstructure was to make possible a feeling of
gratified excitation, even though the onanistic act was abstained
from. In one of these cases the content---being beaten by the
father---was allowed to venture again into consciousness, so long as
the subject's own ego was made unrecognizable by a thin disguise. The
hero of these stories was invariably beaten (or later only punished,
humiliated, etc.) by his father.
I repeat, however, that as a rule the phantasy remains unconscious,
and can only be reconstructed in the course of the analysis. This fact
perhaps vindicates patients who say they remember that with them
onanism made its appearance before the third phase of the
beating-phantasy (shortly to be discussed), and that this phase was
only a later addition, made perhaps under the impression of scenes at
school. Every time we have given credit to these statements we have
felt inclined to assume that the onanism was at first under the
dominion of unconscious phantasies and that conscious ones were
substituted for them later.
We look upon the beating-phantasy in its familiar third phase, which
is its final form, as a substitute of this {186} sort. Here the child
who produces the phantasy appears at most as a spectator, while the
father persists in the shape of a teacher or some other person in
authority. The phantasy, which now resembles that of the first phase,
seems to have become sadistic once more. It appears as though in the
phrase, 'My father is beating the other child, he loves only me', the
stress has been shifted back on to the first part after the second
part has undergone repression. But only the form of this phantasy is
sadistic; the gratification which is derived from it is
masochistic. Its significance lies in the fact that it has taken over
the libidinal cathexis of the repressed portion and at the same time
the sense of guilt which is attached to its content. All of the many
indeterminate children who are being beaten by the teacher are, after
all, nothing more than substitutes for the child itself.
We find here for the first time too something like a constant relation
of sex among the persons who play a part in the phantasy. The children
who are being beaten are almost invariably boys, in the phantasies of
boys just as much as in those of girls. This characteristic is
naturally not to be explained by any rivalry between the sexes, as
otherwise of course in the phantasies of boys it would be girls who
were being beaten; and it has nothing to do with the sex of the child
who was hated in the first phase; but it points to a complication in
the case of girls. When they turn away from their incestuous love for
their father, with its genital significance, they easily abandon their
feminine rôle. They spur their 'masculinity complex' (v. Ophuijsen)
into activity, and from that time forward only want to be boys. For
that reason the whipping-boys who represent them are boys too. In both
the cases of day-dreaming---one of which almost rose to the level of a
work of art---the heroes were always young men; indeed women used not
to come into these creations at all, and only made their first
appearance after many years, and then in minor parts.
V {187}
I hope I have brought forward my analytic observations in sufficient
detail, and I should only like to add that the six cases I have
mentioned so often do not exhaust my material. Like other analysts, I
have at my disposal a far larger number of cases which have been
investigated less thoroughly. These observations can be made use of
along various lines: for elucidating the genesis of the perversions in
general and of masochism in particular, and for estimating the part
played by difference of sex in the dynamics of neurosis.
The most obvious result of such a discussion is its application to the
origin of the perversions. The view which brought into the foreground
in this connection the constitutional reinforcement or premature
growth of a single sexual component is not shaken, indeed; but it is
seen not to comprise the whole truth. The perversion is no longer an
isolated fact in the child's sexual life; but falls into its place
among the typical, not to say normal, processes of development which
are familiar to us. It is brought into relation with the child's
incestuous object-love, with its Oedipus-complex. It first comes into
prominence in the sphere of this complex, and after the complex has
broken down it remains over, often quite by itself, the inheritor of
its charge of libido, and weighed down by the sense of guilt that was
attached to it. The abnormal sexual constitution, finally, has shown
its strength by forcing the Oedipus-complex into a particular
direction, and by compelling it to leave an unusual residue behind.
A perversion in childhood, as is well known, can become the basis for
the construction of a perversion having a similar sense and persisting
throughout life, one which consumes the subject's whole sexual
life. On the other hand the perversion can be broken off and remain in
the background of a normal sexual development, from which, however, it
continues to withdraw a certain amount of energy. The former case is
the one {188} which was already known before the days of analysis, but
the gulf between the two is almost filled up by the analytic
investigation of fully developed perversions of this sort. For we find
often enough with these perverts that they too made an attempt at
developing normal sexual activity, usually at the age of puberty. But
their attempt had not enough force in it and was abandoned in the face
of the first obstacles which inevitably arise, whereupon they fell
back upon their infantile fixation once and for all.
It would naturally be important to know whether the origin of
infantile perversions from the Oedipus-complex can be asserted as a
general principle. While this cannot be decided without further
investigation, it does not seem impossible. When we recall the
anamneses which have been obtained in adult cases of perversion we
cannot fail to notice that the decisive impression, the 'first
experience', of all these perverts, fetishists, etc., is scarcely ever
referred back to a time earlier than the sixth year. At this time,
however, the supremacy of the Oedipus-complex is already over; the
experience which is recalled, and which has been effective in such a
puzzling way, may very well have represented the legacy of that
complex. The connections between the experience and the complex which
is by this time repressed are bound to remain obscure so long as
analysis has not thrown any light on the time before the first
'pathogenic' impression. So it may be imagined how little value is to
be attached, for instance, to an assertion that a case of
homosexuality is congenital, when the ground given for this belief is
that ever since his eighth or sixth year the person in question has
felt inclinations only towards his own sex.
If, however, the derivation of perversions from the Oedipus-complex
can be generally established, our estimate of its importance will have
gained added strength. For in our opinion the Oedipus-complex is the
actual nucleus of neuroses, and the infantile sexuality which
culminates in this complex is the true determinant of {189}
neuroses. What remains of the complex in the unconscious represents
the disposition to the later development of neuroses in the adult. In
this way the beating-phantasy and other analogous perverse fixations
would also only be precipitates of the Oedipus-complex, scars, so to
say, after the process is completed, just as the notorious 'sense of
inferiority' corresponds to a narcissistic scar of the same sort. In
taking this view of the matter I must express my unreserved agreement
with Marcinowski, who has recently put it forward most happily.[71] As
is well known, this neurotic delusion of inferiority is only a partial
one, and is completely compatible with the existence of a
self-overestimation derived from other sources. The origin of the
Oedipus-complex itself, and the destiny which compels man, probably
alone among all animals, to begin his sexual life twice over, first
like all other creatures in his early childhood, and then after a long
interruption once more at the age of puberty---all the problems that
are connected with man's 'archaic inheritance'---have been discussed
by me elsewhere, and I have no intention of going into them in this
place.
Little light is thrown upon the genesis of masochism by our discussion
of the beating-phantasy. To begin with, there seems to be a
confirmation of the view that masochism is not the manifestation of a
primary instinct, but originates from sadism which has been turned
round and directed upon the self, that is to say, by means of
regression from an object to the ego.[72] Instincts with a passive aim
must be taken for granted as existing, especially among women. But
passivity is not the whole of masochism. The characteristic of 'pain'
[_Unlust_] belongs to it as well,---a bewildering accompaniment to the
gratification of an instinct. The transformation of sadism into
masochism appears to be due to the influence of the sense of guilt
concerned in {190} the act of repression. Repression, therefore, is
operative here in three ways: it renders the consequences of the
genital organization unconscious, it compels that organization itself
to regress to the earlier sadistic-anal stage, and it transforms the
sadism of this stage into masochism, which is passive and again in a
certain sense narcissistic. The second of these three effects is made
possible by the weakness of the genital organization, which must be
presupposed in these cases. The third becomes necessary because the
sense of guilt takes as much objection to sadism as to incestuous
object-choice genitally conceived. Again, the analyses do not tell us
the origin of the sense of guilt itself. It seems to be brought along
by the new phase upon which the child is entering, and if it
afterwards persists it seems to correspond to a scar-like formation
similar to the sense of inferiority. According to our present
orientation in the structure of the ego, which is as yet uncertain, we
should assign it to that institution in the mind which sets itself up
as a critical conscience over against the rest of the ego, which
produces Silberer's functional phenomenon in dreams, and which cuts
itself loose from the ego in delusions of observation.
We may note too in passing that the analysis of the infantile
perversion dealt with here is also of help in solving an old
riddle---one which, it is true, has always troubled those who have not
accepted psycho-analysis more than analysts themselves. Yet quite
recently even E. Bleuler regarded it as a remarkable and inexplicable
fact that neurotics make onanism the central point of their sense of
guilt. We have long assumed that this sense of guilt relates to the
onanism of early childhood and not to that of puberty, and that in the
main it is to be connected not with the act of onanism but with the
phantasy which, although unconscious, lies at its root---that is to
say, with the Oedipus-complex.
As regards the third and apparently sadistic phase of the
beating-phantasy, I have already discussed the {191} significance that
it gains from carrying with it an excitation impelling towards
onanism; and I have shown how it arouses activities of phantasy which
on the one hand continue the phantasy along the same line, and on the
other hand neutralize it by way of compensation. Nevertheless the
second phase, the unconscious and masochistic one, in which the child
itself is being beaten by its father, is incomparably the more
important. Not only because it continues to operate through the agency
of the phase that takes its place; but we can also detect effects upon
the character which are directly derived from its unconscious
setting. People who harbour phantasies of this kind develop a special
sensitiveness and irritability towards anyone whom they can put among
the class of fathers. They allow themselves to be easily offended by a
person of this kind, and in that way (to their own sorrow and cost)
bring about the realization of the imagined situation of being beaten
by their father. I should not be surprised if it were one day possible
to prove that the same phantasy is the basis of the delusional
litigiousness of paranoia.
VI
It would have been quite impossible to give a clear survey of
infantile beating-phantasies if I had not limited it, except in one or
two connections, to the state of things in women. I will briefly
recapitulate the conclusions. The little girl's beating-phantasy goes
through three phases, of which the first and third are consciously
remembered, the middle one remaining unconscious. The two conscious
phases appear to be sadistic, whereas the middle and unconscious one
is undoubtedly of a masochistic nature; its content consists in being
beaten by the father, and it carries with it the libidinal cathexis
and the sense of guilt. In the first and third phantasies the child
who is being beaten is always someone else; in the middle phase it is
only the child itself; in the third phase it is almost {192}
invariably only boys who are being beaten. The person beating is from
the first the father, but is later on a substitute taken from the
class of fathers. The unconscious phantasy of the middle phase had
primarily a genital significance and developed by means of repression
and regression out of an incestuous wish to be loved by the father.
Another fact, though its connection with the rest does not appear to
be close, is that between the second and third phases the girls change
their sex, for in the phantasies of the latter phase they turn into
boys.
I have not been able to get so far in my knowledge of
beating-phantasies among boys, perhaps because my material was
unfavourable. I naturally expected to find a complete analogy between
the state of things in the case of boys and in that of girls, the
mother taking the father's place in the phantasy. This expectation
seemed to be fulfilled; for the content of the boy's phantasy which
was taken to be the corresponding one was actually his being beaten by
his mother (or later on by a substitute for her). But this phantasy,
in which the boy's own self was retained as the object, differed from
the second phase in girls in that it was able to become conscious. If
on this account, however, an attempt was made to draw a parallel
between it and the third phase of the girl's phantasy, a new
difference was found, for the boy's own person was not replaced by
many, unknown, and undetermined children, least of all by many
girls. Therefore the expectation of a complete parallelism was
mistaken.
My male cases with an infantile beating-phantasy comprised only a few
who did not exhibit some other gross injury to their sexual
activities, but on the other hand they included a fairly large number
of persons who would have to be described as true masochists in the
sense of being sexual perverts. They were either people who obtained
their sexual satisfaction exclusively from onanism accompanied by
masochistic phantasies; or they were people who had succeeded in
combining {193} masochism with their genital activity in such a way as
to bring about erection and emission, or to carry out normal coitus
with the help of masochistic contrivances and under similar
conditions. In addition to this there was the rarer case in which a
masochist is interfered with in his perverse activities by the
appearance of obsessional ideas of unbearable intensity. Now perverts
who can obtain satisfaction rarely have occasion to come in search of
analysis. But as regards the three classes of masochists that have
been mentioned there may be strong motives to induce them to go to an
analyst. The masochistic onanist finds that he is absolutely impotent
if after all he does attempt coitus with a woman; and the man who has
hitherto effected coitus with the help of a masochistic idea or
contrivance may suddenly make the discovery that the alliance which
was so convenient for him has broken down, his genital organs no
longer reacting to the masochistic stimulus. We are accustomed
confidently to promise recovery to psychically impotent patients who
come to us for treatment; but we ought to be more guarded in making
this prognosis so long as the dynamics of the disturbance are unknown
to us. It comes as a disagreeable surprise if the analysis reveals the
cause of the 'merely psychical' impotence to be a typically
masochistic attitude, perhaps deeply embedded since infancy.
As regards these masochistic men, however, a discovery is made at this
point which warns us not to pursue the analogy between their case and
that of women any further at present, but to judge the matter
independently. For the fact emerges that in their masochistic
phantasies, as well as in the contrivances they adopt for their
realization, they invariably transfer themselves into the part of a
woman; that is to say, their masochistic attitude coincides with a
_feminine_ one. This can easily be demonstrated from details of the
phantasies; but many patients are even aware of it themselves, and
give expression to it as a subjective {194} conviction. It makes no
difference if in a fanciful embellishment of the masochistic scene
they keep up the fiction that a mischievous boy, or page, or
apprentice is going to be punished. On the other hand the persons who
administer chastisement are always women, both in the phantasies and
in the contrivances. This is confusing enough; and the further
question must be asked whether this feminine attitude already forms
the basis of the masochistic element in the infantile
beating-phantasy.
Let us therefore leave aside consideration of the state of things in
cases of adult masochism, which it is so hard to clear up, and turn to
the infantile beating-phantasy in the male sex. Analysis of the
earliest years of childhood once more allows us to make a surprising
discovery in this field. The phantasy which has as its content being
beaten by the mother, and which is conscious or can become so, is not
a primary one. It possesses a preceding stage which is invariably
unconscious and has as its content: '_I am being beaten by my
father_'. This preliminary stage, then, really corresponds to the
second phase of the phantasy in the girl. The familiar and conscious
phantasy: 'I am being beaten by my mother', takes the place of the
third phase in the girl, in which, as has been mentioned already,
unknown boys are the objects that are being beaten. I was not able to
demonstrate among boys a preliminary stage of a sadistic nature that
could be set beside the first phase of the phantasy in girls, but I
will not now express any final disbelief in its existence, for I can
readily see the possibility of meeting with more complicated types.
In the male phantasy---as I shall call it briefly, and, I hope,
without any risk of being misunderstood---the being beaten also stands
for being loved (in a genital sense), though this has been debased to
a lower level owing to regression. So the original form of the
unconscious male phantasy was not the provisional one that we have
hitherto given: 'I am being beaten by my {195} father', but rather:
'_I am loved by my father_'. The phantasy has been transformed by the
processes with which we are familiar into the conscious phantasy: '_I
am being beaten by my mother_'. The boy's beating-phantasy is
therefore passive from the very beginning, and is derived from a
feminine attitude towards his father. It corresponds with the
Oedipus-complex just as the feminine one (that of the girl) does; only
the parallel relation which we expected to find between the two must
be given up in favour of a common character of another kind. _In both
cases the beating-phantasy has its origin in an incestuous attachment
to the father_.
It will help to make matters clearer if at this point I enumerate the
other similarities and differences between beating-phantasies in the
two sexes. In the case of the girl the unconscious masochistic
phantasy starts from the normal Oedipus attitude; in that of the boy
it starts from the inverted attitude, in which the father is taken as
the object of love. In the case of the girl there is a first step
towards the phantasy (the first phase), in which the beating bears no
special significance and is performed upon a person who is viewed with
jealous hatred. Both of these features are absent in the case of the
boy, but this is precisely a difference which might be removed by more
fortunate observation. In her transition to the conscious phantasy
which takes the place of the unconscious one the girl retains the
figure of her father, and in that way keeps unchanged the sex of the
person beating; but she changes the figure and sex of the person being
beaten, so that eventually a man is beating male children. The boy, on
the contrary, changes the figure and sex of the person beating, by
putting his mother in the place of his father; but he retains his own
figure, with the result that the person beating and the person being
beaten are of opposite sexes. In the case of the girl the situation,
which was originally masochistic (passive), is transformed into a
sadistic one by means of repression, and its sexual quality is
effaced. In the case of the boy the situation {196} remains
masochistic, and shows a greater resemblance to the original phantasy
with its genital significance, since there is a difference of sex
between the person beating and the person being beaten. The boy evades
his homosexuality by repressing and remodelling his unconscious
phantasy; and the remarkable thing about his later conscious phantasy
is that it has for its content a feminine attitude without a
homosexual object-choice. By the same process, on the other hand, the
girl escapes from the demands of the erotic side of her life
altogether. She turns herself in phantasy into a man, without herself
becoming active in a masculine way, and is no longer anything but a
spectator of the event which takes the place of a sexual act.
We are justified in assuming that no great change is effected by the
_repression_ of the original unconscious phantasy. Whatever is
repressed from consciousness or replaced in it by something else
remains intact and potentially operative in the unconscious. The
effect of _regression_ to an earlier stage of the sexual organization
is quite another matter. As regards this we are led to believe that
the state of things changes in the unconscious as well: so that in
both sexes the masochistic phantasy of being beaten by the father,
though not the passive phantasy of being loved by him, lives on in the
unconscious after repression has taken place. There are, besides,
plenty of indications that the repression has only very incompletely
attained its object. The boy, who has tried to escape from a
homosexual object-choice, and who has not changed his sex,
nevertheless feels like a woman in his conscious phantasies, and
endows the women who are beating him with masculine attributes and
characteristics. The girl, who has even renounced her sex, and who has
upon the whole accomplished a more thoroughgoing work of repression,
nevertheless does not become freed from her father; she does not
venture to do the beating herself; and since she has herself become a
boy, it is principally boys whom she causes to be beaten.
{197}
I am aware that the differences that I have here described between the
two sexes in regard to the nature of the beating-phantasy have not
been cleared up sufficiently. But I shall not make the attempt to
unravel these complications by tracing out their dependence upon other
factors, as I do not consider that the material for observation is
exhaustive. So far as it goes, however, I should like to make use of
it as a test for two theories. These theories stand in opposition to
each other, though both of them deal with the relation between
repression and sexual character, and each, according to its own view,
represents the relation as a very intimate one. I may say at once that
I have always regarded both theories as incorrect and misleading.
The first of these theories is anonymous. It was brought to my notice
many years ago by a colleague with whom I was at that time on friendly
terms. The theory is so attractive on account of its simplicity and
comprehensiveness that the only wonder is that it should not hitherto
have found its way into the literature of the subject except in a few
scattered allusions. It is based upon the fact of the bisexual
constitution of human beings, and asserts that the motive force of
repression in each individual is a struggle between the two sexual
characters. The dominant sex of the person, that which is the more
strongly developed, has repressed the mental representation of the
subordinated sex into the unconscious. Therefore the nucleus of the
unconscious (that is to say, the repressed) is in each human being
that side of him which belongs to the opposite sex. Such a theory as
this can only have an intelligible meaning if we assume that a
person's sex is to be determined by the formation of his genitals; for
otherwise it would not be certain which is the stronger sex of a
person, and we should run the risk of reaching from the results of our
inquiry the very fact which has to serve as its point of departure. To
put the theory briefly: with men, what is unconscious and repressed
can be reduced {198} to feminine instinctual impulses; and conversely
with women.
The second theory is of more recent origin. It is in agreement with
the first one in so far as it too represents the struggle between the
two sexes as being the decisive cause of repression. In other respects
it comes into conflict with the former theory; moreover, it looks for
support to sociological rather than biological sources. According to
this theory of the 'masculine protest', formulated by Alfred Adler,
every individual makes efforts not to remain on the inferior 'feminine
line of development' and struggles towards the masculine line of
development, from which gratification can alone be derived. Adler
makes the masculine protest responsible for the whole formation both
of character and of neuroses. Unfortunately he makes so little
distinction between the two processes, which certainly have to be kept
separate, and sets altogether so little store in general by the fact
of repression, that to attempt to apply the doctrine of the masculine
protest to repression brings with it the risk of being
misunderstood. In my opinion such an attempt could only lead us to
infer that the masculine protest, the desire to break away from the
feminine line of development, was in every case the motive force of
repression. The repressing agency, therefore, would always be a
masculine instinctual impulse, and the repressed would be a feminine
one. But symptoms would also be the result of a feminine impulse, for
we cannot discard the characteristic feature of symptoms---that they
are substitutes for the repressed, substitutes that have made their
way out in spite of repression.
Now let us take these two theories, which may be said to have in
common a sexualization of the process of repression, and test them by
applying them to the example of the beating-phantasies which we have
been studying. The original phantasy, 'I am being beaten by my
father', corresponds, in the case of the boy, to a feminine attitude,
and is therefore an expression of {199} that part of his disposition
which belongs to the opposite sex. If this part of him undergoes
repression, the first theory seems shown to be correct; for this
theory set it up as a rule that what belongs to the opposite sex is
identical with the repressed. It scarcely answers to our expectations,
it is true, when we find that the conscious phantasy, which arises
after repression has been accomplished, nevertheless exhibits the
feminine attitude once more, though this time directed towards the
mother. But we will not go into these doubtful points, when the whole
question can be so quickly decided. There can be no doubt that the
original phantasy in the case of the girl, 'I am being beaten (_i.e._
I am loved) by my father', represents a feminine attitude, and
corresponds to her dominant and manifest sex; according to the theory,
therefore, it ought to escape repression, and there would be no need
for its becoming unconscious. But as a matter of fact it does become
unconscious, and is replaced by a conscious phantasy which disavows
the girl's manifest sexual character. The theory is therefore useless
as an explanation of beating-phantasies, and is contradicted by the
facts. It might be objected that it is precisely in unmanly boys and
unwomanly girls that these beating-phantasies appeared and went
through these vicissitudes; or that it was a trait of femininity in
the boy and of masculinity in the girl which must be made
responsible---that is, for the production of a passive phantasy in the
boy, and its repression in the girl. We should be inclined to agree
with this view, but it would be none the less impossible to defend the
supposed relation between manifest sexual character and the choice of
what is destined for repression. In the last resort we can only see
that both in male and female individuals masculine as well as feminine
instinctual impulses are found, and that each can equally well undergo
repression and so become unconscious.
The theory of the masculine protest seems to {200} maintain its ground
very much better on being tested in regard to the
beating-phantasies. In the case of both boys and girls the
beating-phantasy corresponds with a feminine attitude---one, that is,
in which the individual is lingering upon the feminine line of
development---and both sexes hasten to get free from this attitude by
repressing the phantasy. Nevertheless, it seems to be only with the
girl that the masculine protest is attended with complete success, and
in that instance, indeed, an ideal example is to be found of the
operation of the masculine protest. With the boy the result is not
entirely satisfactory; the feminine line of development is not given
up, and the boy is certainly not 'on the top' in his conscious
masochistic phantasy. It would therefore agree with the expectations
derived from the theory if we were to recognize that this phantasy was
a symptom which had come into existence through the failure of the
masculine protest. It is a disturbing fact, to be sure, that the
girl's phantasy, which owes its origin to the forces of repression,
should also have the value and meaning of a symptom. In this instance,
where the masculine protest has completely achieved its object, surely
the determining condition for the formation of a symptom must be
absent.
Before we are led by this difficulty to a suspicion that the whole
conception of the masculine protest is inadequate to meet the problem
of neuroses and perversions, and that its application to them is
unfruitful, we will for a moment leave the passive beating-phantasies
and turn our attention to other instinctual manifestations of
infantile sexual life---manifestations which have equally undergone
repression. No one can doubt that there are also wishes and phantasies
which keep to the masculine line of development from their very
nature, and which are the expression of masculine instinctual
impulses---sadistic tendencies, for instance, or a boy's lustful
feelings towards his mother arising out of the normal
Oedipus-complex. {201} It is no less certain that these impulses are
also overtaken by repression. If the masculine protest is to be taken
as having satisfactorily explained the repression of passive
phantasies (which later become masochistic), then it becomes for that
very reason totally inapplicable to the opposite case of active
phantasies. That is to say, the doctrine of the masculine protest is
altogether incompatible with the fact of repression. Unless we are
prepared to throw away all that has been acquired in psychology since
Breuer's first cathartic treatment and through its agency, we cannot
expect that the principle of the masculine protest will acquire any
significance in the elucidation of the neuroses and perversions.
The theory of psycho-analysis (a theory based upon observation) holds
firmly to the view that the motive forces of repression must not be
sexualized. Man's archaic inheritance forms the nucleus of the
unconscious mind; and whatever part of that inheritance has to be left
behind in the advance to later phases of development, because it is
useless or incompatible with what is new and harmful to it, falls a
victim to the process of repression. This selection is made more
successfully with one group of instincts than with the other. In
virtue of special circumstances which have often been pointed out
already, the latter group, that of the sexual instincts, are able to
defeat the intentions of repression, and to enforce their
representation by substitute-formations of a disturbing kind. For this
reason infantile sexuality, which is held under repression, acts as
the chief motive force in the formation of symptoms; and the essential
part of its content, the Oedipus-complex, is the nuclear complex of
neuroses. I hope that in this paper I have raised an expectation that
the sexual aberrations of childhood, as well as those of mature life,
are ramifications of the same complex.
----------------------------------------------------------------------
XVIII {202}
THE PSYCHOGENESIS OF A CASE OF
HOMOSEXUALITY IN A WOMAN[73]
(1920)
I
Homosexuality in women, which is certainly not less common than in
men, although much less glaring, has not only been ignored by the law,
but has also been neglected by psycho-analytic research. The narration
of a single case, not too pronounced in type, in which it was possible
to trace its origin and development in the mind with complete
certainty and almost without a gap may, therefore, have a certain
claim to attention. If this presentation of it furnishes only the
most general outlines of the various events concerned and of the
conclusions reached from a study of the case, while suppressing all
the characteristic details on which the interpretation is founded,
this limitation is easily to be explained by the medical discretion
necessary in discussing a recent case.
A beautiful and clever girl of eighteen, belonging to a family of good
standing, had aroused displeasure and concern in her parents by the
devoted adoration with which she pursued a certain lady 'in society'
who was about ten years older than herself. The parents asserted that,
in spite of her distinguished name, this lady was nothing but a
_cocotte_. It was said to be well known that she lived with a married
woman as her friend, having intimate relations with her, while at the
same time she carried on promiscuous affairs with a number of men. The
girl did not contradict {203} these evil reports, but neither did she
allow them to interfere with her worship of the lady, although she
herself was by no means lacking in a sense of decency and
propriety. No prohibitions and no supervision hindered the girl from
seizing every one of her rare opportunities of being together with her
beloved, of ascertaining all her habits, of waiting for her for hours
outside her door or at a tram-halt, of sending her gifts of flowers,
and so on. It was evident that this one interest had swallowed up all
others in the girl's mind. She did not trouble herself any further
with educational studies, thought nothing of social functions or
girlish pleasures, and kept up relations only with a few girl friends
who could help her in the matter or serve as confidantes. The parents
could not say to what lengths their daughter had gone in her relations
with the questionable lady, whether the limits of devoted admiration
had already been exceeded or not. They had never remarked in their
daughter any interest in young men, nor pleasure in their attentions,
while, on the other hand, they were sure that her present attachment
to a woman was only a continuation, in a more marked degree, of a
feeling she had displayed of recent years for other members of her own
sex which had already aroused her father's suspicion and anger.
There were two details of her behaviour, in apparent contrast with
each other, that most especially vexed her parents. On the one hand,
she did not scruple to appear in the most frequented streets in the
company of her questionable friend, being thus quite neglectful of her
own reputation; while, on the other hand, she disdained no means of
deception, no excuses and no lies that would make meetings with her
possible and cover them. She thus showed herself too brazen in one
respect and full of deceitfulness in the other. One day it happened,
indeed, as was sooner or later inevitable in the circumstances, that
the father met his daughter in the company of the lady. He passed them
by with an angry glance which boded no good. {204} Immediately after,
the girl rushed off and flung herself over a wall down the side of a
cutting on to a railway line. She paid for this undoubtedly serious
attempt at suicide with a considerable time on her back in bed, though
fortunately little permanent damage was done. After her recovery she
found it easier to get her own way than before. The parents did not
dare to oppose her with so much determination, and the lady, who up
till then had received her advances coldly, was moved by such an
unmistakable proof of serious passion and began to treat her in a more
friendly manner.
About six months after this episode the parents sought medical advice
and entrusted the physician with the task of bringing their daughter
back to a normal state of mind. The girl's attempted suicide had
evidently shown them that the instruments of domestic discipline were
powerless to overcome the existing disorder. Before going further it
will be desirable, however, to deal separately with the attitude of
her father and of her mother to the matter. The father was an earnest,
worthy man, at bottom very tender-hearted, but he had to some extent
estranged his children by the sternness he had adopted towards
them. His treatment of his only daughter was too much influenced by
consideration for his wife. When he first came to know of his
daughter's homosexual tendencies he flared up in rage and tried to
suppress them by threatening her; at that time perhaps he hesitated
between different, though equally painful, views---regarding her
either as vicious, as degenerate, or as mentally afflicted. Even after
the attempted suicide he did not achieve the lofty resignation shown
by one of our medical colleagues who remarked of a similar
irregularity in his own family, 'It is just a misfortune like any
other'. There was something about his daughter's homosexuality that
aroused the deepest bitterness in him, and he was determined to combat
it with all the means in his power; the low estimation in which
psycho-analysis is so generally held in Vienna {205} did not prevent
him from turning to it for help. If this way failed he still had in
reserve his strongest countermeasure; a speedy marriage was to awaken
the natural instincts of the girl and stifle her unnatural tendencies.
The mother's attitude towards the girl was not so easy to grasp. She
was still a youngish woman, who was evidently unwilling to relinquish
her own claim to find favour by means of her beauty. All that was
clear was that she did not take her daughter's passion so tragically
as did the father, nor was she so incensed at it. She had even for a
long time enjoyed her daughter's confidence concerning the
love-affair, and her opposition to it seemed to have been aroused
mainly by the harmful publicity with which the girl displayed her
feelings. She had herself suffered for some years from neurotic
troubles and enjoyed a great deal of consideration from her husband;
she was quite unfair in her treatment of her children, decidedly harsh
towards her daughter and over-indulgent to her three sons, the
youngest of whom had been born after a long interval and was then not
yet three years old. It was not easy to ascertain anything more
definite about her character, for, owing to motives that will only
later become intelligible, the patient was always reserved in what she
said about her mother, whereas in regard to her father she showed no
feeling of the kind.
To a physician who was to undertake psycho-analytic treatment of the
girl there were many grounds for a feeling of discomfort. The
situation he had to deal with was not the one that analysis demands,
in which alone it can demonstrate its effectiveness. As is well known,
the ideal situation for analysis is when someone who is otherwise
master of himself is suffering from an inner conflict which he is
unable to resolve alone, so that he brings his trouble to the analyst
and begs for his help. The physician then works hand in hand with one
part of the personality which is divided against itself, against the
other partner in the conflict. Any situation but this is more or less
unfavourable for {206} psycho-analysis and adds fresh difficulties to
those already present. Situations like that of a proprietor who orders
an architect to build him a villa according to his own tastes and
desires, or of a pious donor who commissions an artist to paint a
picture of saints, in the corner of which is to be a portrait of
himself worshipping, are fundamentally incompatible with the
conditions of psycho-analysis. It constantly happens, to be sure, that
a husband informs the physician as follows, 'My wife suffers from
nerves, so that she gets on badly with me; please cure her, so that we
may lead a happy married life again'. But often enough it turns out
that such a request is impossible to fulfil, _i.e._ that the physician
cannot bring about the result for which the husband sought the
treatment. As soon as the wife is freed from her neurotic inhibitions
she sets about dissolving the marriage, for her neurosis was the sole
condition under which maintenance of the marriage was possible. Or
else parents expect one to cure their nervous and unruly child. By a
healthy child they mean one who never places his parents in
difficulties, but only gives them pleasure. The physician may succeed
in curing the child, but after that it goes its own way all the more
decidedly, and the parents are now far more dissatisfied than
before. In short, it is not a matter of indifference whether someone
comes to analysis of his own accord or because he is brought to it,
whether he himself desires to be changed, or only his relatives, who
love him (or who might be expected to love him), desire this for him.
Further unfavourable features in the present case were the facts that
the girl was not in any way ill---she did not suffer from anything in
herself, nor did she complain of her condition---and that the task to
be carried out did not consist in resolving a neurotic conflict but in
converting one variety of the genital organization of sexuality into
the other. The removal of genital inversion or homosexuality is in my
experience never an easy matter. On the contrary, I have found {207}
success possible only under specially favourable circumstances, and
even then the success essentially consisted in being able to open to
those who are restricted homosexually the way to the opposite sex,
which had been till then barred, thus restoring to them full bisexual
functions. After that it lay with themselves to choose whether they
wished to abandon the other way that is banned by society, and in
individual cases they have done so. One must remember that normal
sexuality also depends upon a restriction in the choice of object; in
general, to undertake to convert a fully developed homosexual into a
heterosexual is not much more promising than to do the reverse, only
that for good practical reasons the latter is never attempted.
In actual numbers the successes achieved by psycho-analytic treatment
of the various forms of homosexuality, which, to be sure, are
manifold, are not very striking. As a rule the homosexual is not able
to give up the object of his pleasure, and one cannot convince him
that if he changed to the other object he would find again the
pleasure that he has renounced. If he comes to be treated at all, it
is mostly through the pressure of external motives, such as the social
disadvantages and dangers attaching to his choice of object, and such
components of the instinct of self-preservation prove themselves too
weak in the struggle against the sexual impulses. One then soon
discovers his secret plan, namely, to obtain from the striking failure
of his attempt the feeling of satisfaction that he has done everything
possible against his abnormality, to which he can now resign himself
with an easy conscience. The case is somewhat different when
consideration for beloved parents and relatives has been the motive
for his attempt to be cured. Then there really are libidinal
tendencies present which may put forth energies opposed to the
homosexual choice of object, though their strength is rarely
sufficient. It is only where the homosexual fixation has not yet
become strong enough, or where there are considerable {208} rudiments
and vestiges of a heterosexual choice of object, _i.e._ in a still
oscillating or in a definitely bisexual organization, that one may
make a more favourable prognosis for psycho-analytic therapy.
For these reasons I declined altogether holding out to the parents any
prospect of their wish being fulfilled. I merely said I was prepared
to study the girl carefully for a few weeks or months, so as then to
be able to pronounce how far a continuation of the analysis might
influence her. In quite a number of cases, indeed, the analysis
divides itself into two clearly distinguishable stages: in the first,
the physician procures from the patient the necessary information,
makes him familiar with the premises and postulates of
psycho-analysis, and unfolds to him the reconstruction of the genesis
of his disorder as deduced from the material brought up in the
analysis. In the second stage the patient himself lays hold of the
material put before him, works on it, recollects what he can of the
apparently repressed memories, and behaves as if he were living the
rest over again. In this way he can confirm, supplement, and correct
the inferences made by the physician. It is only during this work that
he experiences, through overcoming resistances, the inner change aimed
at, and acquires for himself the convictions that make him independent
of the physician's authority. These two stages in the course of the
analytic treatment are not always sharply divided from each other;
this can only happen when the resistance maintains certain
conditions. But when this is so, one may institute a comparison with
two stages of a journey. The first comprises all the necessary
preparations, to-day so complicated and hard to effect, before, ticket
in hand, one can at last go on to the platform and secure a seat in
the train. One then has the right, and the possibility, of travelling
into a distant country, but after all these preliminary exertions one
is not yet there---indeed, one is not a single mile nearer to one's
goal. For this to happen one has to make the journey itself from one
station to {209} the other, and this part of the performance may well
be compared with the second stage in the analysis.
The analysis of the patient I am discussing took this course of two
stages, but it was not continued beyond the beginning of the second
stage. A special constellation of the resistance made it possible,
nevertheless, to gain full confirmation of my inferences, and to
obtain an adequate insight on broad lines into the way in which her
inversion had developed. But before relating the findings of the
analysis I must deal with a few points which have either been touched
upon already by myself or which will have roused special interest in
the reader.
I had made the prognosis partly dependent on how far the girl had
succeeded in satisfying her passion. The information I gleaned during
the analysis seemed favourable in this respect. With none of the
objects of her adoration had the patient enjoyed anything beyond a few
kisses and embraces; her genital chastity, if one may use such a
phrase, had remained intact. As for the lady who led a double life,
and who had roused the girl's most recent and by far her strongest
emotions, she had always treated her coldly and had never allowed any
greater favour than kissing her hand. Probably the girl was making a
virtue of necessity when she kept insisting on the purity of her love
and her physical repulsion against the idea of any sexual
intercourse. But perhaps she was not altogether wrong when she vaunted
of her wonderful beloved that, aristocrat as she was, forced into her
present position only by adverse family circumstances, she had
preserved, in spite of her situation, a great deal of nobility. For
the lady used to recommend the girl every time they met to withdraw
her affection from herself and from women in general, and she had
persistently rejected the girl's advances up to the time of the
attempted suicide.
A second point, which I at once tried to investigate, concerned any
possible motives in the girl herself {210} which might serve to
support a psycho-analytic treatment. She did not try to deceive me by
saying that she felt any urgent need to be freed from her
homosexuality. On the contrary, she said she could not conceive of any
other way of being in love, but she added that for her parents' sake
she would honestly help in the therapeutic endeavour, for it pained
her very much to be the cause of so much grief to them. I had to take
this as a propitious sign to begin with; I could not divine the
unconscious affective attitude that lay behind it. What came to light
later in this connection decisively influenced the course taken by the
analysis and determined its premature conclusion.
Readers unversed in psycho-analysis will long have been awaiting an
answer to two other questions. Did this homosexual girl show physical
characteristics plainly belonging to the opposite sex, and did the
case prove to be one of congenital or acquired (later developed)
homosexuality?
I am aware of the importance attaching to the first of these
questions. Only one should not exaggerate it and obscure in its
favour the fact that sporadic secondary characteristics of the
opposite sex are very often present in normal individuals, and that
well-marked physical characteristics of the opposite sex may be found
in persons whose choice of object has undergone no change in the
direction of inversion; in other words, that in both sexes _the degree
of physical hermaphroditism is to a great extent independent of the
psychical hermaphroditism_. In modification of this statement it must
be added that this independence is more evident in men than women,
where bodily and mental traits belonging to the opposite sex are apt
to coincide in their incidence. Still I am not in a position to give
a satisfactory answer to the first of our questions about my patient;
the psycho-analyst customarily forgoes thorough bodily examination of
his patients in certain cases. Certainly there was no obvious
deviation from the feminine physical type, nor any {211} menstrual
disturbance. The beautiful and well-developed girl had, it is true,
her father's tall figure, and her facial features were sharp rather
than soft and girlish, traits which might be regarded as indicating a
physical masculinity. Some of her intellectual attributes also could
be connected with masculinity: for instance, her acuteness of
comprehension and her lucid objectivity, in so far as she was not
dominated by her passion; though these distinctions are conventional
rather than scientific. What is certainly of greater importance is
that in her behaviour towards her love-object she had throughout
assumed the masculine part: that is to say, she displayed the humility
and the sublime over-estimation of the sexual object so characteristic
of the male lover, the renunciation of all narcissistic satisfaction,
and the preference for being lover rather than beloved. She had thus
not only chosen a feminine love-object, but had also developed a
masculine attitude towards this object.
The second question, whether this was a case of inherited or acquired
homosexuality, will be answered by the whole history of the patient's
abnormality and its development. The study of this will show how
fruitless and inappropriate this question is.
II
After an introduction which digresses in so many directions, the
sexual history of the case under consideration can be presented quite
concisely. In childhood the girl had passed through the normal
attitude characteristic of the feminine Oedipus-complex[74] in a way
that was not at all remarkable, and had later also begun to substitute
for her father a brother slightly older than herself. She did not
remember any sexual traumata in early life, nor were any discovered by
{212} the analysis. Comparison of her brother's genital organs and her
own, which took place about the beginning of the latency period (at
five years old or perhaps a little earlier), left a strong impression
on her and had far-reaching after-effects. There were only slight
hints pointing to infantile onanism, or else the analysis did not go
deep enough to throw light on this point. The birth of a second
brother when she was between five and six years old left no special
influence upon her development. During the pre-pubertal years at
school she gradually became acquainted with the facts of sex, and she
received this knowledge with mixed feelings of fascination and
frightened aversion, in a way which may be called normal and was not
exaggerated in degree. This amount of information about her seems
meagre enough, nor can I guarantee that it is complete. It may be that
the history of her youth was much richer in experiences; I do not
know. As I have already said, the analysis was broken off after a
short time, and therefore yielded an anamnesis not much more reliable
than the other anamneses of homosexuals, which there is good cause to
question. Further, the girl had never been neurotic, and came to the
analysis without even one hysterical symptom, so that opportunities
for investigating the history of her childhood did not present
themselves so readily as usual.
At the age of thirteen to fourteen she displayed a tender and,
according to general opinion, exaggeratedly strong affection for a
small boy, not quite three years old, whom she used to see regularly
in a playground in one of the parks. She took to the child so warmly
that in consequence a permanent friendship grew up between herself and
his parents. One may infer from this episode that at that time she was
possessed of a strong desire to be a mother herself and to have a
child. However, after a short time she grew indifferent to the boy,
and began to take an interest in mature, but still youthful, women;
the manifestations of this {213} in her soon led her father to
administer a mortifying chastisement to her.
It was established beyond all doubt that this change occurred
simultaneously with a certain event in the family, and one may
therefore look to this for some explanation of the change. Before it
happened, her libido was focussed on motherhood, while afterwards she
became a homosexual attracted to mature women, and has remained so
ever since. The event which is so significant for our understanding
of the case was a new pregnancy of her mother's, and the birth of a
third brother when she was about sixteen.
The network of causes and effects that I shall now proceed to lay bare
is not a product of my gift for combination; it is based on such
trustworthy analytic evidence that I can claim objective validity for
it; it was in particular a series of inter-related dreams, easy of
interpretation, that proved decisive in this respect.
The analysis revealed beyond all shadow of doubt that the beloved lady
was a substitute for---the mother. It is true that she herself was not
a mother, but then she was not the girl's first love. The first
objects of her affection after the birth of her youngest brother were
really mothers, women between thirty and thirty-five whom she had met
with their children during summer holidays or in the family circle of
acquaintances in town. Motherhood as a 'condition of love' was later
on given up, because it was difficult to combine in real life with
another one, which grew more and more important. The specially
intensive bond with her latest love, the 'Lady', had still another
basis which the girl discovered quite easily one day. On account of
her slender figure, regular beauty, and off-hand manner, the lady
reminded her of her own brother, a little older than herself. Her
latest choice corresponded, therefore, not only with her feminine but
also with her masculine ideal; it combined gratification of the
homosexual tendency with that of the heterosexual one. It is well
known that analysis of male {214} homosexuals has in numerous cases
revealed the same combination, which should warn us not to form too
simple a conception of the nature and genesis of inversion, and to
keep in mind the extensive influence of the bisexuality of
mankind.[75]
But how are we to understand the fact that it was just the birth of a
child who came late in the family, at a time when the girl herself was
already mature and had strong wishes of her own, that moved her to
bestow her passionate tenderness upon her who gave birth to this
child, _i.e._ her own mother, and to express that feeling towards a
substitute for her mother? From all that we know we should have
expected just the opposite. In such circumstances mothers with
daughters of about a marriageable age usually feel embarrassed in
regard to them, while the daughters are apt to feel for their mothers
a mixture of compassion, contempt and envy which does nothing to
increase their tenderness for them. The girl we are considering,
however, had altogether little cause to feel affection for her
mother. The latter, still youthful herself, saw in her rapidly
developing daughter an inconvenient competitor; she favoured the sons
at her expense, limited her independence as much as possible, and kept
an especially strict watch against any close relation between the girl
and her father. A yearning from the beginning for a kinder mother
would, therefore, have been quite intelligible, but why it should have
flamed up just then, and in the form of a consuming passion, is not
comprehensible.
The explanation is as follows: The girl was just experiencing the
revival of the infantile Oedipus-complex at puberty when she suffered
a great disappointment. She became keenly conscious of the wish to
have a child, and a male one; that it was her father's child and his
image that she desired, her consciousness was not allowed to know. And
then---it was not she who bore the child, but the unconsciously {215}
hated rival, her mother. Furiously resentful and embittered, she
turned away from her father, and from men altogether. After this first
great reverse she forswore her womanhood and sought another goal for
her libido.
In doing so she behaved just as many men do who after a first painful
experience turn their backs for ever upon the faithless female sex and
become woman-haters. It is related of one of the most attractive and
unfortunate princes of our time that he became a homosexual because
the lady he was engaged to marry betrayed him with a stranger. I do
not know whether this is true historically, but much psychological
truth lies behind the rumour. In all of us, throughout life, the
libido normally oscillates between male and female objects; the
bachelor gives up his men friends when he marries, and returns to
club-life when married life has lost its savour. Naturally, when the
swing-over is fundamental and final, we suspect some special factor
which has definitely favoured one side or the other, and which perhaps
only waited for the appropriate moment in order to turn the choice of
object finally in its direction.
After her disappointment, therefore, this girl had entirely repudiated
her wish for a child, the love of a man, and womanhood altogether. Now
it is evident that at this point the developments open to her were
very manifold; what actually happened was the most extreme one
possible. She changed into a man, and took her mother in place of her
father as her love-object.[76] Her relation to her mother had
certainly been ambivalent from the beginning, and it proved easy to
revive her earlier love for her mother and with its help to bring
about an over-compensation for her current hostility towards
her. Since there was little to be done with the {216} real mother,
there arose from the conversion of feeling described the search for a
mother-substitute to whom she could become passionately attached.[77]
In her actual relations with her mother there was a practical motive
furthering the change of feeling which might be called an 'advantage
through illness'. The mother herself still attached great value to the
attentions and the admiration of men. If, then, the girl became
homosexual and left men to her mother (in other words, 'retired in
favour of' the mother), she removed something which had hitherto been
partly responsible for her mother's disfavour.[78]
{217}
The attitude of the libido thus adopted was greatly reinforced as soon
as the girl perceived how much it displeased her father. Once she had
been punished for an over-affectionate overture made to a woman she
realized how she could wound her father and take revenge on him.
Henceforth she remained homosexual out of defiance against her father.
Nor did she scruple to lie to him and to deceive him in every way.
Towards her mother, indeed, she was only so far deceitful as was
necessary to prevent her father from knowing things. I had the
impression that her behaviour followed the principle of the talion:
'Since you have betrayed me, you must put up with my betraying
you'. Nor can I come to any other conclusion about the striking lack
of caution displayed by this otherwise ingenious and clever girl. She
_wanted_ her father to know occasionally of her intercourse with the
lady, otherwise she would be deprived of satisfaction of her keenest
desire---namely, revenge. So she saw to this by showing herself openly
in the company of her adored one, by walking with her in the streets
near her father's place of business, and the like. This maladroitness
was by no means unintentional. It was remarkable, by the way, that
both parents behaved as though they understood the secret psychology
of their daughter. The mother was tolerant, as though she appreciated
the favour of her daughter's 'retirement' from the arena; the father
was furious, as though he realized the deliberate revenge directed
against himself.
The girl's inversion, however, received its final reinforcement when
she found in her 'Lady' an object which promised to satisfy not only
her homosexual tendency, but also that part of her heterosexual libido
still attached to her brother.
III
Consecutive presentation is not a very adequate means of describing
complicated mental processes going on in different layers of the
mind. I am therefore {218} obliged to pause in the discussion of the
case and treat more fully and deeply some of the points brought
forward above.
I mentioned the fact that in her behaviour to her adored lady the girl
had adopted the characteristic masculine type of love. Her humility
and her tender lack of pretensions, '_che poco spera e nulla chiede_',
her bliss when she was allowed to accompany the lady a little way and
to kiss her hand on parting, her joy when she heard her praised as
beautiful---while any recognition of her own beauty by another person
meant nothing at all to her---her pilgrimages to places once visited
by the loved one, the oblivion of all more sensual wishes: all these
little traits in her resembled the first passionate adoration of a
youth for a celebrated actress whom he regards as far above him, to
whom he scarcely dares lift his bashful eyes. The correspondence with
the 'type of object-choice in men' that I have described elsewhere,
whose special features I traced to the attachment to the mother,[79]
held good even to the smallest details. It may seem remarkable that
she was not in the least repelled by the evil reputation of her
beloved, although her own observations sufficiently confirmed the
truth of such rumours. She was after all a well-brought-up and modest
girl, who had avoided sexual adventures for herself, and who regarded
coarsely sensual gratification as unæsthetic. But already her first
passions had been for women who were not celebrated for specially
strict propriety. The first protest her father made against her
love-choice had been evoked by the pertinacity with which she sought
the company of a cinematograph actress at a summer resort. Moreover,
in all these affairs it had never been a question of women who had any
reputation for homosexuality, and who might, therefore, have offered
her some prospect of homosexual gratification; on the contrary, she
illogically courted women who were coquettes in the ordinary sense of
the word, and she rejected without hesitation the willing {219}
advances made by a homosexual friend of her own age. The bad
reputation of her 'Lady', however, was positively a 'condition of
love' for her, and all that is enigmatical in this attitude vanishes
when we remember that in the case of the masculine type of
object-choice derived from the mother it is also an essential
condition that the loved object should be in some way or other 'of bad
repute' sexually, one who really may be called a 'light woman'. When
the girl learnt later on how far her adored lady deserved to be called
by this title and that she lived simply by giving her bodily favours,
her reaction took the form of great compassion and of phantasies and
plans for 'rescuing' her beloved from these ignoble circumstances. We
have been struck by the same endeavours to 'rescue' in the men of the
type referred to above, and in my description of it I have tried to
give the analytical derivation of this tendency.
We are led into quite another realm of explanation by the analysis of
the attempt at suicide, which I must regard as seriously intended, and
which, by the way, considerably improved her position both with her
parents and with the lady she loved. She went for a walk with her one
day in a part of the town and at an hour at which she was not unlikely
to meet her father on his way from his office. So it turned out. Her
father passed them in the street and cast a furious look at her and
her companion, whom he had by that time come to know. A few moments
later she flung herself on to the railway cutting. Now the explanation
she gave of the immediate reasons determining her resolution sounded
quite plausible. She had confessed to the lady that the man who had
given them such an irate glance was her father, and that he had
absolutely forbidden their friendship. The lady became incensed at
this and ordered the girl to leave her then and there, and never again
to wait for her or to address her---the affair must now come to an
end. In her despair at having thus lost her loved one for ever, she
wanted to put an end to {220} herself. The analysis, however, was able
to disclose another and deeper interpretation behind the one she gave,
which was confirmed by the evidence of her own dreams. The attempted
suicide was, as might have been expected, determined by two other
motives besides the one she gave: it was a 'punishment fulfilment'
(self-punishment), and a wish-fulfilment. As a wish-fulfilment it
signified the attainment of the very wish which, when frustrated, had
driven her into homosexuality---namely, the wish to have a child by
her father, for now she 'fell'[80] through her father's fault.[81] The
fact that at this moment the lady had spoken to the same effect as the
father, and had uttered the same prohibition, forms the connecting
link between this deeper interpretation and the superficial one of
which the girl herself was conscious. From the point of view of
self-punishment the girl's action shows us that she had developed in
her unconscious strong death-wishes against one or other of her
parents: perhaps against her father, out of revenge for impeding her
love, but, more likely, also against her mother when she was pregnant
with the little brother. For analysis has explained the enigma of
suicide in the following way: probably no one finds the mental energy
required to kill himself unless, in the first place, he is in doing
this at the same time killing an object with whom he has identified
himself, and, in the second place, is turning against himself a
death-wish which had been directed against someone else. Nor need the
regular discovery of these unconscious death-wishes in those who have
attempted suicide surprise us as strange (any more than it need make
an impression as confirming our deductions), since the unconscious of
all human beings is full enough of such {221} death-wishes, even
against those we love.[82] The girl's identification of herself with
her mother, who ought to have died at the birth of the child denied to
herself, makes this 'punishment-fulfilment' itself again into a
'wish-fulfilment'. Lastly, a discovery that several quite different
motives, all of great strength, must have co-operated to make such a
deed possible is only in accord with what we should expect.
In the girl's account of her conscious motives the father did not
figure at all; there was not even any mention of fear of his anger. In
the motivation laid bare by the analysis he played the principal
part. Her relation to her father had this same decisive importance for
the course and outcome of the analytic treatment, or rather, analytic
exploration. Behind her pretended consideration for her parents, for
whose sake she had been willing to make the attempt to be transformed,
lay concealed her attitude of defiance and revenge against her father
which held her fast to her homosexuality. Secure under this cover, the
resistance allowed a considerable degree of freedom to the analytic
investigation. The analysis went forward almost without any signs of
resistance, the patient participating actively with her intellect,
though absolutely tranquil emotionally. Once when I expounded to her a
specially important part of the theory, one touching her nearly, she
replied in an inimitable tone, 'How very interesting', as though she
were a _grande dame_ being taken over a museum and glancing through
her lorgnon at objects to which she was completely indifferent. The
impression one had of her analysis was not unlike that of an hypnotic
treatment, where the resistance has in the same way withdrawn to a
certain limit, beyond which it then proves to be unconquerable. The
resistance very often pursues similar tactics---Russian tactics, as
they might be called[83]---in cases of the obsessional neurosis, {222}
which for this reason yield the clearest results for a time and permit
of a penetrating inspection of the causation of the symptoms. One
begins to wonder how it is that such marked progress in analytic
understanding can be unaccompanied by even the slightest change in the
patient's compulsions and inhibitions, until at last one perceives
that everything accomplished had been admitted only under the mental
reservation of doubt,[84] and behind this protective barrier the
neurosis may feel secure. 'It would be all very fine', thinks the
patient, often quite consciously, 'if I were obliged to believe what
the man says, but there is no question of that, and so long as that is
not so I need change nothing.' Then, when one comes to close quarters
with the motivation of this doubt, the fight with the resistances
breaks forth in earnest.
In the case of our patient, it was not doubt, but the affective factor
of revenge against her father that made her cool reserve possible,
that divided the analysis into two distinct stages, and rendered the
results of the first stage so complete and perspicuous. It seemed,
further, as though nothing resembling a transference to the physician
had been effected. That, however, is of course absurd, or, at least,
is a loose way of expressing it; for some kind of relation to the
analyst must come about, and this is usually transferred from an
infantile one. In reality she transferred to me the deep antipathy to
men which had dominated her ever since the disappointment she had
suffered from her father. Bitterness against men is as a rule easy to
gratify upon the analyst; it need not evoke any violent emotional
manifestations, it simply expresses itself in rendering futile all his
endeavours and in clinging to the neurosis. I know from experience how
difficult it is to make the patient understand just this mute kind of
symptomatic behaviour and to make him aware of this latent, and often
exceedingly strong, hostility without endangering {223} the
treatment. So as soon as I recognized the girl's attitude to her
father, I broke off the treatment and gave the advice that, if it was
thought worth while to continue the therapeutic efforts, it should be
done by a woman. The girl had in the meanwhile promised her father
that at any rate she would not communicate with the 'Lady', and I do
not know whether my advice, the motive for which is evident, will be
followed.
Only once in the course of this analysis did anything appear which I
could regard as a positive transference, a greatly weakened revival of
the original passionate love for the father. Even this manifestation
was not quite free from other motives, but I mention it because it
brings up, in another direction, an interesting problem of analytic
technique. At a certain period, not long after the treatment had
begun, the girl brought a series of dreams which, distorted as is
customary and couched in the usual dream-language, could nevertheless
be easily translated with certainty. Their content, when interpreted,
was, however, remarkable. They anticipated the cure of the inversion
through the treatment, expressed her joy over the prospects in life
then opened before her, confessed her longing for a man's love and for
children, and so might have been welcomed as a gratifying preparation
for the desired change. The contradiction between them and the girl's
utterances in waking life at the time was very great. She did not
conceal from me that she meant to marry, but only in order to escape
from her father's tyranny and to follow her true inclinations
undisturbed. As for the husband, she remarked rather contemptuously,
she would easily deal with him, and besides, one could have sexual
relations with a man and a woman at one and the same time, as the
example of the adored lady showed. Warned through some slight
impression or other, I told her one day that I did not believe these
dreams, that I regarded them as false or hypocritical, and that she
intended to deceive me just as she habitually deceived her father. I
was right; after {224} this exposition this kind of dream ceased. But
I still believe that, beside the intention to mislead me, the dreams
partly expressed the wish to win my favour; they were also an attempt
to gain my interest and my good opinion---perhaps in order to
disappoint me all the more thoroughly later on.
I can imagine that to point out the existence of lying dreams of this
kind, destined to please the analyst, will arouse in some readers who
call themselves analysts a real storm of helpless indignation. 'What!'
they will exclaim, 'so the unconscious, the real centre of our mental
life, the part of us that is so much nearer the divine than our poor
consciousness, so that too can lie! Then how can we still build on the
interpretations of analysis and the accuracy of our findings?' To
which one must reply that the recognition of these lying dreams does
not constitute an astounding novelty. I know, indeed, that the craving
of mankind for mysticism is ineradicable, and that it makes ceaseless
efforts to win back for mysticism the playground it has been deprived
of by the _Traumdeutung_, but in the case under consideration surely
everything is simple enough. A dream is not the 'unconscious' itself;
it is the form into which a thought from the preconscious, or even
from waking conscious life, can, thanks to the favouring conditions of
sleep, be recast. During sleep this thought has been reinforced by
unconscious wish-excitations and thus has experienced distortion
through the 'dream-work', which is determined by the mechanisms valid
for the unconscious. With our dreamer, the intention to mislead me,
just as she did her father, certainly emanated from the preconscious,
or perhaps even from consciousness; it could come to expression by
entering into connection with the unconscious wish-impulse to please
the father (or father-substitute), and in this way it created a lying
dream. The two intentions, to betray and to please the father,
originate in the same complex; the former resulted from the repression
of the latter, and {225} the later one was reduced by the dream-work
to the earlier one. There can therefore be no question of any
devaluation of the unconscious, nor of a shaking of our confidence in
the results of our analysis.
I will not miss this opportunity of expressing for once my
astonishment that human beings can go through such great and momentous
phases of their love-life without heeding them much, sometimes even,
indeed, without having the faintest suspicion of them: or else that,
when they do become aware of these phases, they deceive themselves so
thoroughly in their judgement of them. This happens not only with
neurotics, where we are familiar with the phenomenon, but seems also
to be common enough in ordinary life. In the present case, for
example, a girl develops a devotion for women, which her parents at
first find merely vexatious and hardly take seriously; she herself
knows quite well that her feelings are greatly engaged, but still she
is only slightly aware of the sensations of intense love until a
certain disappointment is followed by an absolutely excessive
reaction, which shows everyone concerned that they have to do with a
consuming passion of elemental strength. Even the girl herself had
never perceived anything of the conditions necessary for the outbreak
of such a mental upheaval. In other cases we come across girls or
women in a state of severe depression, who on being asked for a
possible cause of their condition tell us that they have, it is true,
had a little feeling for a certain person, but that it was nothing
deep and that they soon got over it when they had to give up hope. And
yet it was this renunciation, apparently so easily borne, that became
the cause of serious mental disturbance. Again, we have to do with men
who have passed through casual love-affairs and then realize only from
the subsequent effects that they had been passionately in love with
someone whom they had apparently regarded lightly. One is also amazed
at the unexpected results that may follow an artificial abortion which
{226} had been decided upon without remorse and without
hesitation. One must agree that the poets are right who are so fond of
portraying people in love without knowing it, or uncertain whether
they do love, or who think that they hate when in reality they
love. It would seem that the knowledge received by our consciousness
of what is happening to our love-instincts is especially liable to be
incomplete, full of gaps, or falsified. Needless to say, in this
discussion I have not omitted to allow for the part played by
subsequent failures of memory.
IV
I now come back, after this digression, to the consideration of my
patient's case. We have made a survey of the forces which led the
girl's libido from the normal Oedipus attitude into that of
homosexuality, and of the paths thus traversed by it in the mind. Most
important in this respect was the impression made by the birth of her
little brother, and we might from this be inclined to classify the
case as one of late acquired inversion.
But at this point we become aware of a state of things which also
confronts us in many other instances in which light has been thrown by
psycho-analysis on a mental process. So long as we trace the
development from its final stage backwards, the connection appears
continuous, and we feel we have gained an insight which is completely
satisfactory or even exhaustive. But if we proceed the reverse way, if
we start from the premises inferred from the analysis and try to
follow these up to the final result, then we no longer get the
impression of an inevitable sequence of events which could not be
otherwise determined. We notice at once that there might have been
another result, and that we might have been just as well able to
understand and explain the latter. The synthesis is thus not so
satisfactory as the analysis; in other words, from a {227} knowledge
of the premises we could not have foretold the nature of the result.
It is very easy to account for this disturbing state of affairs. Even
supposing that we thoroughly know the ætiological factors that decide
a given result, still we know them only qualitatively, and not in
their relative strength. Some of them are so weak as to become
suppressed by others, and therefore do not affect the final
result. But we never know beforehand which of the determining factors
will prove the weaker or the stronger. We only say at the end that
those which succeeded must have been the stronger. Hence it is always
possible by analysis to recognize the causation with certainty,
whereas a prediction of it by synthesis is impossible.
We do not, therefore, mean to maintain that every girl who experiences
a disappointment of this kind, of the longing for love that springs
from the Oedipus attitude during puberty, will necessarily on that
account fall a victim to homosexuality. On the contrary, other kinds
of reaction to this trauma are probably commoner. Then, however, there
must have been present in this girl special factors that turned the
scale, factors outside the trauma, probably of an internal nature. Nor
is there any difficulty in pointing them out.
It is well known that even in the normal person it takes a certain
time before a decision in regard to the sex of the love-object is
finally achieved. Homosexual enthusiasms, unduly strong friendships
tinged with sensuality, are common enough in both sexes during the
first years after puberty. This was also so with our patient, but in
her these tendencies undoubtedly showed themselves to be stronger, and
lasted longer, than with others. In addition, these presages of later
homosexuality had always occupied her conscious life, while the
attitude arising from the Oedipus-complex had remained unconscious and
had appeared only in such signs as her tender fondling of the little
boy. As a school-girl she was for a long time {228} in love with a
strict and unapproachable mistress, obviously a mother-substitute. A
long time before the birth of her brother and still longer before the
first reprimand at the hands of her father, she had taken a specially
keen interest in various young mothers. From very early years,
therefore, her libido had flowed in two streams, the one on the
surface being one that we may unhesitatingly designate
homosexual. This latter was probably a direct and unchanged
continuation of an infantile mother-fixation. Possibly the analysis
described here actually revealed nothing more than the process by
which, on an appropriate occasion, the deeper heterosexual
libido-stream was also deflected into the manifest homosexual one.
The analysis showed, further, that the girl had suffered from
childhood from a strongly marked 'masculinity complex'. A spirited
girl, always ready to fight, she was not at all prepared to be second
to her slightly older brother; after inspecting his genital organs she
had developed a pronounced envy of the penis, and the thoughts derived
from this envy still continued to fill her mind. She was in fact a
feminist; she felt it to be unjust that girls should not enjoy the
same freedom as boys, and rebelled against the lot of woman in
general. At the time of the analysis the idea of pregnancy and
child-birth was disagreeable to her, partly, I surmise, on account of
the bodily disfigurement connected with them. Her girlish narcissism
had betaken itself to this refuge,[85] and ceased to express itself as
pride in her good looks. Various clues indicated that she must
formerly have taken great pleasure in exhibitionism and
scoptophilia. Anyone who is anxious that the claims of environment in
ætiology should not come short, as opposed to those of heredity, will
call attention to the fact that the girl's behaviour, as described
above, was exactly what would follow from the combined effect in a
person with a strong mother-fixation of the two influences of her
mother's indifference and of her {229} comparison of her genital
organs with her brother's. It is possible here to trace back to the
impression of an effective external influence in early life something
which one would have been ready to regard as a constitutional
peculiarity. But a part even of this acquired disposition, if it has
really been acquired, has to be ascribed to the inborn
constitution. So we see in practice a continual mingling and blending
of what in theory we should try to separate into a pair of
opposites---namely, inherited and acquired factors.
An earlier, more tentative conclusion of the analysis might have led
to the view that this was a case of late-acquired homosexuality, but
deeper consideration of the material undertaken later impels us to
conclude that it is rather a case of inborn homosexuality which, as
usual, became fixed and unmistakably manifest only in the period
following puberty. Each of these classifications does justice only to
one part of the state of affairs ascertainable by observation, but
neglects the other. It would be best not to attach too much value to
this way of stating the problem.
Publications on homosexuality usually do not distinguish clearly
enough between the questions of the choice of object, on the one hand,
and of the sexual characteristics and sexual attitude of the subject,
on the other, as though the answer to the former necessarily involved
the answers to the latter. Experience, however, proves the contrary: a
man with predominantly male characteristics and also masculine in his
love-life may still be inverted in respect to his object, loving only
men instead of women. A man in whose character feminine attributes
evidently predominate, who may, indeed, behave in love like a woman,
might be expected, from this feminine attitude, to choose a man for
his love-object; but he may nevertheless be heterosexual, and show no
more inversion in respect of his object than an average normal
man. The same is true of women; here also mental sexual character and
object-choice do not necessarily coincide. The mystery of
homosexuality {230} is therefore by no means so simple as it is
commonly depicted in popular expositions, _e.g._ a feminine
personality, which therefore has to love a man, is unhappily attached
to a male body; or a masculine personality, irresistibly attracted by
women, is unfortunately cemented to a female body. It is instead a
question of three series of characteristics, namely---
Physical sexual characteristics --- Mental sexual characteristics
(physical hermaphroditism) (masculine, or feminine, attitude)
Kind of object-choice
which, up to a certain point, vary independently of one another, and
are met with in different individuals in manifold
permutations. Tendencious publications have obscured our view of this
inter-relationship by putting into the foreground, for practical
reasons, the third feature (the kind of object-choice), which is the
only one that strikes the layman, and in addition by exaggerating the
closeness of the association between this and the first
feature. Moreover, they block the way leading to a deeper insight into
all that is uniformly designated homosexuality by rejecting two
fundamental facts which have been revealed by psycho-analytic
investigation. The first of these is that homosexual men have
experienced a specially strong fixation in regard to the mother; the
second, that, in addition to their manifest heterosexuality, a very
considerable measure of latent or unconscious homosexuality can be
detected in all normal people. If these findings are taken into
account, then, to be sure, the supposition that nature in a freakish
mood created a 'third sex' falls to the ground.
It is not for psycho-analysis to solve the problem of
homosexuality. It must rest content with disclosing the psychical
mechanisms that resulted in determination of the object-choice, and
with tracing the paths leading from them to the instinctual basis of
the disposition. There its work ends, and it leaves the rest to
biological research, which has recently brought to light, through
{231} Steinach's[86] experiments, such very important results
concerning the influence exerted by the first factor mentioned above
on the second and third. Psycho-analysis has a common basis with
biology, in that it presupposes an original bisexuality in human
beings (as in animals). But psycho-analysis cannot elucidate the
intrinsic nature of what in conventional or in biological phraseology
is termed 'masculine' and 'feminine': it simply takes over the two
concepts and makes them the foundation of its work. When we attempt to
reduce them further, we find masculinity vanishing into activity and
femininity into passivity, and that does not tell us enough. In what
has gone before I have tried to explain how far we may reasonably
expect, or how far experience has already proved, that the
elucidations yielded by analysis furnish us with the means for
altering inversion. When one compares the extent to which we can
influence it with the remarkable transformations that Steinach has
effected in some cases by his operations, it does not make a very
imposing impression. Thus it would be premature, or a harmful
exaggeration, if at this stage we were to indulge in hopes of a
'therapy' of inversion that could be generally used. The cases of male
homosexuality in which Steinach has been successful fulfilled the
condition, which is not always present, of a very patent physical
'hermaphroditism'. Any analogous treatment of female homosexuality is
at present quite obscure. If it were to consist in removing the
probably hermaphroditic ovaries, and in implanting others, which
would, it is hoped, be of a single sex, there would be little prospect
of its being applied in practice. A woman who has felt herself to be a
man, and has loved in masculine fashion, will hardly let herself be
forced into playing the part of a woman when she must pay for this
transformation, which is not in every way advantageous, by renouncing
all hope of motherhood.
----------------------------------------------------------------------
XIX {232}
CERTAIN NEUROTIC MECHANISMS IN
JEALOUSY, PARANOIA AND
HOMOSEXUALITY[87]
(1922)
_A_. Jealousy is one of those affective states, like grief, that may
be described as normal. If anyone appears to be without it, the
inference is justified that it has undergone severe repression and
consequently plays all the greater part in his unconscious mental
life. The instances of abnormally intense jealousy met with in
analytic work reveal themselves as constructed of three layers. The
three layers or stages of jealousy may be described as (1)
_competitive_ or normal, (2) _projected_, and (3) _delusional_
jealousy.
There is not much to be said from the analytic point of view about
normal jealousy. It is easy to see that essentially it is compounded
of grief, the pain caused by the thought of losing the loved object,
and of the narcissistic wound, in so far as this is distinguishable
from the other wound; further, of feelings of enmity against the
successful rival, and of a greater or lesser amount of self-criticism
which tries to hold the person himself accountable for his
loss. Although we may call it normal, this jealousy is by no means
completely rational, that is, derived from the actual situation,
proportionate to the real circumstances and under the complete control
of the conscious ego; for it is rooted deep in the unconscious, it is
a continuation of the earliest stirrings of the child's affective
life, and it originates in the Oedipus or family complex of the first
sexual period. Moreover, it is noteworthy that in many {233} persons
it is experienced bisexually; that is to say, in a man, beside the
suffering in regard to the loved woman and the hatred against the male
rival, grief in regard to the unconsciously loved man and hatred of
the woman as a rival will add to its intensity. I even know of a man
who suffered exceedingly during his attacks of jealousy and who,
according to his own account, went through unendurable torments by
consciously imagining himself in the position of the faithless
woman. The sensation of helplessness which then came over him, the
images he used to describe his condition---exposed to the vulture's
beak like Prometheus, or cast fettered into a serpent's den---he
himself referred to the impressions received during several homosexual
aggressions to which he had been subjected as a boy.
The jealousy of the second layer, the _projected_, is derived in both
men and women either from their own actual unfaithfulness in real life
or from impulses towards it which have succumbed to repression. It is
a matter of everyday experience that fidelity, especially that degree
of it required in marriage, is only maintained in the face of
continual temptation. Anyone who denies this in himself will
nevertheless be impelled so strongly in the direction of infidelity
that he will be glad enough to make use of an unconscious mechanism as
an alleviation. This relief---more, absolution by his conscience---he
achieves when he projects his own impulses to infidelity on to the
partner to whom he owes faith. This weighty motive can then make use
of the material at hand (perception-material) by which the unconscious
impulses of the partner are likewise betrayed, and the person can
justify himself with the reflection that the other is probably not
much better than he is himself.[88]
Social conventions have taken this universal state of things into
account very adroitly, by granting a {234} certain amount of latitude
to the married woman's thirst to find favour in men's eyes and the
married man's thirst to capture and possess, in the expectation that
this inevitable tendency to unfaithfulness will thus find a
safety-valve and be rendered innocuous. Convention has laid down that
neither partner is to hold the other accountable for these little
excursions in the direction of unfaithfulness, and it achieves the
result on the whole that the desire awakened by the new love-object is
gratified by a kind of turning-back to the object already
possessed. The jealous person, however, does not recognize this
convention of tolerance; he does not believe in any such thing as a
halt or a turning-back once the path has been trod, nor that a social
'flirtation' may be a safeguard against actual infidelity. In the
treatment of a jealous person like this one must refrain from
disputing with him the material on which he bases his suspicions; one
can only aim at bringing him to regard the matter in a different
light.
The jealousy that arises from this projection has, it is true, an
almost delusional character; it is, however, amenable to the analytic
work of exposing the unconscious phantasies of personal
infidelity. The jealousy of the third layer, the true _delusional_
type, is worse. It also has its origin in repressed impulses towards
unfaithfulness---the object, however, in these cases is of the same
sex as the subject. Delusional jealousy represents an acidulated
homosexuality, and rightly takes its position among the classical
forms of paranoia. As an attempt at defence against an unduly strong
homosexual impulse it may, in a man, be described in the formula:
'Indeed I do not love him, _she_ loves him!'[89] In a delusional case
one will be prepared to find the jealousy arising in all three layers,
never in the third alone.
_B_. _Paranoia_.---Cases of paranoia are for well-known reasons not
usually amenable to analytic investigation. {235} I
have recently been able, nevertheless, by an intensive study of two
paranoiacs, to discover something new to me.
The first case was that of a youngish man with a fully developed
paranoia of jealousy, the object of which was his impeccably faithful
wife. A stormy period in which the delusion had possessed him
uninterruptedly already lay behind him. When I saw him he was still
subject only to clearly defined attacks, which lasted for several days
and, curiously enough, regularly appeared on the day following an act
of intercourse, which was, incidentally, satisfying to both of
them. The inference is justified that after every satiation of the
heterosexual libido the homosexual component, likewise stimulated by
the act, forced for itself an outlet in the attack of jealousy.
The jealousy of the attack drew its material from his observation of
the smallest possible indications, in which the utterly unconscious
coquetry of the wife, unnoticeable to any other person, had betrayed
itself to him. She had unintentionally touched the man sitting next
her with her hand; she had turned too much towards him, or she had
smiled more pleasantly than when alone with her husband. To all these
manifestations of her unconscious feelings he paid extraordinary
attention, and always knew how to interpret them correctly, so that he
really was always in the right about it, and could justify his
jealousy still more by analytic interpretation. His abnormality really
reduced itself to this, that he watched his wife's unconscious mind
much more closely and then regarded it as far more important than
anyone else would have thought of doing.
We are reminded that sufferers from persecutory paranoia act in just
the same way. They, too, cannot regard anything in others as
indifferent, and into their 'delusions of reference' they, too, take
up the smallest possible indications which these others, strangers,
offer them. The meaning of their delusion of reference is that they
expect from every stranger {236} something like love; these 'others'
show them nothing of the kind, however---they laugh to themselves,
fiddle with their sticks, even spit on the ground as they go by---and
one really does not do these things while anyone in whom one takes a
friendly interest is near. One does them only when one is quite
indifferent to the passer-by, when one can treat him like air; and
when we consider the fundamental kinship of the words 'stranger' and
'enemy', the paranoiac is not so far wrong in regarding this
indifference as hate, in comparison with his claim for love.
We begin to see that we describe the behaviour of both jealous and
persecuted paranoiacs very inadequately by saying that they project
outwards on to others what they do not wish to recognize in
themselves.
Certainly they do this; but they do not project it into the sky, so to
speak, where there is nothing of the sort already. They let themselves
be guided by their knowledge of the unconscious, and displace to the
unconscious minds of others the attention which they have withdrawn
from their own. Our jealous husband perceives his wife's
unfaithfulness instead of his own; by becoming conscious of hers and
magnifying it enormously he succeeds in keeping unconscious his
own. If we accept his example as typical, we may infer that the enmity
which the persecuted paranoiac sees in others is the reflection of his
own hostile impulses against them. Since we know that with the
paranoiac it is precisely the most loved person of his own sex that
becomes his persecutor, the question arises where this reversal of
affect takes its origin; the answer is not far to seek---the
ever-present ambivalence of the feelings provides its source and the
unfulfilment of his claim for love strengthens it. This ambivalence
thus serves the same purpose for the persecuted paranoiac as jealousy
serves for our patient---that of a defence against homosexuality.
The dreams of my jealous patient contained a great surprise for
me. They were not simultaneous with the {237} outbreaks of the
attacks, though they occurred within the period influenced by the
delusion; they were completely free from the delusion and showed
themselves based on homosexual tendencies which were disguised no more
strictly than usual. In view of my slight knowledge of the dreams of
paranoiacs I was inclined to suppose at that time that the disease did
not penetrate into dreams.
The homosexuality of this patient was easily surveyed. He had made no
friendships and developed no social interests; one had the impression
that the delusion had constituted the first actual development of his
relations with men, as if it had taken over a piece of work that had
been neglected. The fact that his father was of no great importance in
the family life, combined with a humiliating homosexual trauma in
early childhood, had forced his homosexuality into repression and
barred the way to its sublimation. The whole of his youth was governed
by a strong attachment to his mother. Of all her many sons he was her
declared favourite, and he developed marked jealousy of the normal
type in regard to her. When later he made his choice of a
wife---mainly prompted by the impulse to enrich his mother---his
longing for a virgin mother expressed itself in obsessive doubts about
his wife's virginity. The first years of his marriage were free from
jealousy. Then he became unfaithful to his wife and entered upon an
intimate relationship with another woman that lasted for a
considerable time. Startled by a certain suspicion, he at length made
an end of this love affair, and not until then did the jealousy of the
second, projected type break out, by means of which he was able to
assuage his self-reproaches about his own unfaithfulness. It was soon
complicated by an accession of homosexual impulses, of which his
father-in-law was the object, and became a fully formed jealousy
paranoia.
My second case would probably not have been classified as persecutory
paranoia without analysis; {238} but I had to recognize the young man
as a candidate for this termination of the illness. In his attitude to
his father there existed an ambivalence which in its range was quite
extraordinary. On the one hand, he was the most pronounced rebel
imaginable, and had developed manifestly in every direction in
opposition to his father's wishes and ideals; on the other hand, at a
deeper level he was still the most utterly abject son, in loving
remorse after his father's death denying himself all enjoyment of
women. His actual relations with men were clearly dominated by
suspiciousness; his keen intellect easily rationalized this attitude;
and he knew how to bring it about that both friends and acquaintances
deceived and exploited him. The new thing I learned from studying him
was that classical persecution-ideas may be present without finding
belief or acceptance. They flashed up occasionally during the
analysis, but he regarded them as unimportant and invariably scoffed
at them. This may occur in many cases of paranoia; it may be that the
delusions which we regard as new formations when the disease breaks
out have already long been in existence.
It seems to me that this is an important recognition---namely, that
the qualitative factor, the presence of certain neurotic formations,
has less practical significance than the quantitative factor, the
degree of attention, or more correctly, the measure of cathexis that
these formations engage. Our consideration of the first case, the
jealousy paranoia, led to a similar estimate of the importance of the
quantitative factor, by showing that there also the abnormality
essentially consisted in the hyper-cathexis of the interpretations of
another's unconscious behaviour. We have long known of an analogous
fact in the analysis of hysteria. The pathogenic phantasies,
derivatives of repressed instinctual trends, are for a long time
tolerated alongside the normal life of the mind, and have no
pathogenic effect until by a revolution {239} in the libido-economy
they undergo hyper-cathexis; not till then does the conflict which
leads to symptom-formation break out. Thus as our knowledge increases
we are ever being impelled to bring the _economic_ point of view into
the foreground. I should also like to throw out the question whether
this quantitative factor that I am now dwelling on does not suffice to
cover the phenomena for which Bleuler and others have lately wished to
introduce the term 'switching'. One need only assume that increased
resistance in one direction of the psychical currents results in
hyper-cathexis along some other path and thus causes the whole current
to be switched into this path.
The dreams of my two cases of paranoia showed an instructive contrast.
Whereas those of the first case were free from delusion, as has
already been said, the other patient produced great numbers of
persecution-dreams, which may be regarded as forerunners or
substitutive formations of the delusional ideas. The pursuer, from
whom he managed to escape only in terror, was usually a powerful bull
or some other male symbol which even in the dream itself he sometimes
recognized as representing his father. One day he produced a very
characteristic paranoiac transference-dream. He saw me shaving in
front of him, and from the scent of the soap he realized that I was
using the same soap as his father had used. I was doing this in order
to induce in him a father-transference on to myself. The choice of
this incident out of which the dream was formed unmistakably betrays
the patient's depreciatory attitude to his paranoiac phantasies and
his disbelief in them; for his own eyes could tell him every day that
I never require to avail myself of shaving-soap and that therefore
there was in this respect nothing to which a father-transference could
attach itself.
A comparison of the dreams of the two patients shows, however, that
the question whether or not paranoia (or any other psychoneurosis) can
penetrate {240} into dreams is based on a false conception of
dreams. Dreams are distinguishable from waking thought in that for
their content they can draw from material (belonging to the region of
the unconscious) which cannot emerge in waking thought. Apart from
this, dreams are merely a _form of thinking_, a transformation of
preconscious thought-material by the dream-work and its
conditions. Our terminology of the neuroses is not applicable to
repressed material; this cannot be called hysterical, nor obsessional,
nor paranoiac. The other part of the material which is woven into the
structure of a dream, the preconscious thoughts, may be normal or may
bear the character of any neurosis; they may be the effects of all
those pathogenic processes in which the essence of neurosis lies. It
is not evident why any such morbid idea should not become woven into
dreams. A dream may therefore quite simply represent an hysterical
phantasy, an obsessional idea, or a delusion, that is, may reveal it
upon interpretation. Observation of the two paranoiacs shows that the
dreams of the one were quite normal while he was subject to his
delusion, and that those of the other were paranoiac in content while
he treated his delusional ideas with contempt. In both cases,
therefore, the dream took up the material that was at the time being
forced into the background in waking life. This too, however, need not
necessarily be an invariable rule.
_C_. _Homosexuality_.---Recognition of the organic factor in
homosexuality does not relieve us of the obligation of studying the
psychical processes of its origin. The typical process, already
established in innumerable cases, is that a few years after the
termination of puberty the young man, who until this time has been
strongly fixated to his mother, turns in his course, identifies
himself with his mother, and looks about for love-objects in whom he
can re-discover himself, and whom he wishes to love as his mother
loved him. The characteristic mark of this process is that usually
for several years one of the 'conditions of love' is that the {241}
male object shall be of the same age as he himself was when the change
took place. We know of various factors contributing to this result,
probably in different degrees. First there is the fixation on the
mother, which renders passing on to another woman difficult. The
identification with the mother is an outcome of this attachment, and
at the same time in a certain sense it enables the son to keep true to
her, his first object. Then there is the inclination towards a
narcissistic object-choice, which lies in every way nearer and is
easier to put into effect than the move towards the other sex. Behind
this factor there lies concealed another of quite exceptional
strength, or perhaps it coincides with it: the high value set upon the
male organ and the inability to tolerate its absence in a
love-object. Depreciation of women, and aversion from them, even
horror of them, are generally derived from the early discovery that
women have no penis. We subsequently discovered, as another powerful
motive urging towards the homosexual object-choice, regard for the
father or fear of him; for the renunciation of women means that all
rivalry with him (or with all men who may take his place) is
avoided. The two last motives, the clinging to the condition of a
penis in the object as well as the retiring in favour of the father,
may be ascribed to the castration complex. Attachment to the mother,
narcissism, fear of castration---these are the factors (which by the
way have nothing specific about them) that we have hitherto found in
the psychical ætiology of homosexuality; and on them is superimposed
the effect of any seduction bringing about a premature fixation of the
libido, as well as the influence of the organic factor favouring the
passive rôle in love.
We have, however, never regarded this analysis of the origin of
homosexuality as complete; and I can now point to a new mechanism
leading to homosexual object-choice, although I cannot say how large a
part it plays in the formation of the extreme, manifest and {242}
exclusive type of homosexuality. Observation has directed my attention
to several cases in which during early childhood feelings of jealousy
derived from the mother-complex and of very great intensity arose
against rivals, usually older brothers. This jealousy led to an
exceedingly hostile aggressive attitude against brothers (or sisters)
which might culminate in actual death-wishes, but which could not
survive further development. Under the influences of training---and
certainly not uninfluenced also by their own constant
powerlessness---these feelings yielded to repression and to a
transformation, so that the rivals of the earlier period became the
first homosexual love-objects. Such an outcome of the attachment to
the mother shows various interesting relations with other processes
known to us. First of all it is a complete contrast to the development
of persecutory paranoia, in which the person who has before been loved
becomes the hated persecutor, whereas here the hated rivals are
transformed into love-objects. It represents, too, an exaggeration of
the process which, according to my view, leads to the birth of social
instincts in the individual.[90] In both processes there is first the
presence of jealous and hostile feelings which cannot achieve
gratification; and then both the personal affectionate and the social
identification feelings arise as reaction-formations against the
repressed aggressive impulses.
This new mechanism in the homosexual object-choice, its origin in
rivalry which has been overcome and in aggressive impulses which have
become repressed, is often combined with the typical conditions known
to us. In the history of homosexuals one often hears that the change
in them took place after the mother had praised another boy and set
him up as a model. The tendency to a narcissistic object-choice was
thus stimulated, and after a short phase of keen jealousy the rival
became a love-object. Otherwise, however, the new mechanism is a
separate one, in that the change {243} takes place at a much earlier
period, and the identification with the mother recedes into the
background. Moreover, in the cases I have observed, it led only to
homosexual attitudes, which did not exclude heterosexuality and did
not involve a horror of women.
It is well known that a good number of homosexual persons is
distinguished by a special development of the social instincts and by
a devotion to the interests of the community. It would be tempting, as
a theoretical explanation of this, to say that the behaviour towards
men in general of a man who sees in other men potential love-objects
must be different from that of a man who looks upon other men first as
rivals in regard to women. Against this there is only the objection
that jealousy and rivalry play their part in homosexual love also, and
that the community of men also includes these potential rivals. Apart
from this speculative explanation, however, the fact that the
homosexual object-choice not rarely proceeds from an early conquest of
the rivalry in regard to men cannot be unimportant for the connection
between homosexuality and social feeling.
In the light of psycho-analysis we are accustomed to regard social
feeling as a sublimation of homosexual attitudes towards objects. In
the homosexual person with marked social interests, the detachment of
social feeling from object-choice has not been fully carried through.
----------------------------------------------------------------------
XX {244}
THE INFANTILE GENITAL ORGANIZATION
OF THE LIBIDO
*A Supplement to the Theory of Sexuality*[91]
(1923)
It is indicative of the difficulties which beset the work of
psycho-analytic research that it is possible, in spite of unremitting
observation extending over periods of years, to overlook quite broad
general features and typical situations, until at last they confront
one in a completely unmistakable guise. The remarks that follow are
intended to retrieve a lapse of this sort in the field of infantile
sexuality.
Readers of my _Drei Abhandlungen zur Sexualtheorie_ (1905) will be
aware that I have never undertaken any thorough alteration of this
work for later editions, but have preserved the original arrangement
and have fulfilled the claims of later advances in our knowledge by
supplementing and correcting the text. Thus it may well be that the
old and the new do not admit of fusion without indications of
contradiction. In the beginning, for instance, the emphasis fell upon
pointing out the fundamental difference between the sexual life of
children and of adults; later on the pregenital organizations of the
libido swung into the foreground, together with the remarkable and
significant fact of the double thrust of sexual development, twice
making a start at separate periods. Finally, the curiosity of the
child engaged our interest; and from this proceeded the recognition of
the far-reaching similarity between the last stages of infantile
sexuality (about the fifth {245} year) and the final form to which it
develops in the adult. In the last edition of the _Sexualtheorie_
(1922) I left things at this point.
I stated there (on p. 63) that 'often, or perhaps regularly, complete
object-choice is established in early childhood, of the kind that we
have inferred to be characteristic of the pubertal phase of
development, namely, such as occurs when all the sexual trends become
directed towards one single person, and in that person seek to reach
their aims. This constitutes the most complete approximation possible
in childhood to the definitive form taken by sexual life after
puberty. The sole difference from the latter is that the coalescence
of the component-impulses and their concentration under the primacy of
the genital organs is not effected in childhood, or only very
imperfectly. The institution of this primacy is, therefore, the last
phase which the sexual organization undergoes.'
I am to-day no longer satisfied with the statement that the primacy of
the genitals is not effected in the early period of childhood, or only
very imperfectly. The approximation of childhood-sexuality to that of
the adult goes much farther and is not limited solely to the
establishment of an object-attachment. Even if perfect concentration
of the component-impulses under the primacy of the genitals is not
attained, at any rate at the height of the development of
childhood-sexuality the functioning of the genitals and the interest
in them reaches predominant significance, which comes little short of
that reached in maturity. The _difference_ between the two---the
'infantile genital organization' and the final genital organization of
the adult---constitutes at the same time the main characteristic of
the infantile form, namely, that for both sexes in childhood only one
kind of genital organ comes into account---the male. The primacy
reached is, therefore, not a primacy of the _genital_, but of the
_phallus_.
Unfortunately we can describe this state of things only as it concerns
the male child; the corresponding {246} processes in the little girl
are not sufficiently known to us. The little boy undoubtedly perceives
the distinction between men and women, but to begin with he has no
occasion to connect it with any difference in the genitals. It is
natural for him to assume that all living beings, persons and animals,
possess a genital organ like his own; indeed we know that he
investigates inanimate objects with a view to discovering something
like his member in them.[92] This part of the body, so easily
excitable and changeable, and so rich in sensation, occupies the boy's
interest to a high degree, and never ceases to provide new problems
for his epistemophilic impulse. He wants to see the same thing in
other people, so as to compare it with his own; he behaves as if he
had a dim idea that this member might be and should be larger. The
driving force which this male portion of his body will generate later
at puberty expresses itself in childhood essentially as an impulsion
to inquire into things---as sexual curiosity. Many of those deeds of
exhibitionism and aggression which children commit, and which in later
years would be judged without hesitation to be manifestations of
sensual passion, prove on analysis to be experiments undertaken in the
search for sexual knowledge.
In the course of these investigations the child makes the discovery
that the penis is not one of the possessions common to all creatures
who are like himself. The accidental sight of the genitals of a little
sister or a little playmate is the occasion of this. In unusually
intelligent children the sight of girls urinating arouses the
suspicion even earlier that something is different here; for they will
have noticed the different position adopted and the different sound
heard, and have taken steps to repeat their observations in such a way
as to find out the truth. We know how they react to their {247} first
perception of the absence of the penis. They deny its absence, and
believe they do see a penis all the same; the discrepancy between what
they see and what they imagine is glossed over by the idea that the
penis is still small and will grow; gradually they come to the
conclusion, so fraught with emotion, that at least it had been there
and had at some time been taken away. The absence of the penis is
thought to be the result of a castration, and then the child is faced
with the task of dealing with the thought of a castration in relation
to himself. Subsequent developments are too well known for it to be
necessary to recapitulate them here. It seems to me, however, that the
significance of the castration complex can only be rightly appreciated
when its origin in the phase of _primacy of the phallus_ is also taken
into account.[93]
We know, too, to what a degree depreciation of women, loathing of
women, and a disposition to homosexuality are derived from a final
conviction of women's lack of a penis. Ferenczi has recently, with
complete justification, traced back the mythological symbol of
loathing---the head of Medusa---to the impression made by the female
genitals devoid of a penis.[94]
It should not be presumed, however, that the child instantly and
readily makes a generalization of its perception that many women
possess no penis; in the way of this there lies the assumption that
the absence {248} of the penis is due to a castration performed as a
punishment. On the contrary, the child imagines that only unworthy
female persons have thus sacrificed their genital organ, such persons
as have probably been guilty of the same forbidden impulses as he
himself. Women who are regarded with respect, such as the mother,
retain the penis long after this date. Not yet is being a woman the
same thing to the child as having no penis.[95] Not till later, when
the child takes up the problems of the origin and birth of children,
and divines that only women can bear children, does the mother, too,
become deprived of a penis; and along with this quite complicated
theories are constructed, so as to account for the exchange of a penis
in return for a child. At the same time the real female genitals never
seem to be discovered. As we know, the baby is supposed to live in the
mother's body (bowels) and to be born through the bowel passage. These
last theories take us up to the end of the period of infantile
sexuality or beyond.
It is well, further, to bear in mind the transformations which the
familiar polarity of the sexes goes through in the course of the
sexual development of childhood. A first contrast is introduced with
object-choice, which of course presupposes a subject and an object. At
the level of the pregenital sadistic-anal organization nothing is yet
heard of any maleness and femaleness; the dominant antithesis is that
between active and passive.[96] In the following stage of the
infantile genital organization _maleness_ has come to life, but no
femaleness. The antithesis runs: a male genital organ or a castrated
condition. Not until completion of development at the time of puberty
does the polarity of sexuality coincide with _male_ and
_female_. {249} In maleness is concentrated subject, activity, and the
possession of a penis; femaleness carries on the object, and
passivity. The vagina becomes valued henceforth as an asylum for the
penis; it comes into the inheritance of the mother's womb.
----------------------------------------------------------------------
XXI {250}
NEUROSIS AND PSYCHOSIS[97]
(1924)
In my booklet _Das Ich und das Es_,[98] which appeared recently, I
suggested that the mental apparatus should be subdivided in such a way
as to allow of a series of relationships being represented in a simple
and synoptic fashion. In other matters---for instance, concerning the
origin and function of the super-ego---a good deal remained
insufficiently elucidated. Now one may reasonably expect that a
proposition of the kind should prove itself useful and helpful in
other directions as well, even if it only enables us to see from
another angle what we already know, to group it differently and to
describe it more convincingly. By applying it in this way we might
also reap the advantage of turning away from the greyness of theory
back to the ever-green realm of observation.
The essay referred to describes the various allegiances the ego owes,
its mediate position between the outer world and the _id_, and its
struggles to serve all its masters at one and the same time. Now it so
happened that a train of thought suggested elsewhere, which had to do
with the causes giving rise to the psychoses and with prevention of
them, furnished me with a simple formula concerning what is perhaps
the most important genetic difference between neurosis and psychosis:
_Neurosis is the result of a conflict between {251} the ego and its
_id_, whereas psychosis is the analogous outcome of a similar
disturbance in the relation between the ego and its environment_
(_outer world_).
To be suspicious of such simple solutions of problems is undoubtedly a
piece of justifiable caution. Moreover, the most that we should expect
from it would not be more than that this formula should prove itself
correct in rough outline. But even that would be something. Also one
recalls immediately a whole series of conclusions and discoveries
which seem to support our proposition. All our analyses go to show
that the transference neuroses originate from the ego's refusing to
accept a powerful instinctual impulse existing in its _id_ and denying
it motor discharge, or disputing the object towards which it is
aimed. The ego then defends itself against the impulse by the
mechanism of repression; the repressed impulse struggles against this
fate, and finds ways which the ego cannot control to create for itself
substitutive gratification (a symptom), which is forced upon the ego
in the form of a compromise; the ego finds its unity menaced and
injured by this interloper, pursues against the symptom the struggle
it had formerly maintained against the original impulse, and all this
together produces the clinical picture of a neurosis. It is no matter
that in undertaking the repression the ego is at bottom following the
dictates of its super-ego, which dictates originated in influences of
the same kind from the real environment that subsequently found
representation in the super-ego. The fact remains that the ego takes
sides with these powers that be, that their demands are stronger in it
than the claims of instinct from the _id_, and that the force which
sets repression to work against that part of the _id_ and fortifies it
by the anti-cathexis of resistance is the ego. In the service of its
super-ego and of reality the ego has come into conflict with its _id_,
and this state of affairs is found in all the transference neuroses.
It is just as easy, on the other hand, from what we {252} already know
of the mechanism of the psychoses, to quote examples from them
pointing to a disturbance in the relation between the ego and its
environment. In Meynert's amentia,[99] the acute hallucinatory
confusion which is perhaps the most extreme and striking form of
psychosis, the outer world is either not perceived in the very least
or else any perception of it remains absolutely without effect.
Normally, indeed, the outer world commands the ego in two ways: first,
by current perceptions which it is constantly able to engender afresh,
and secondly, by the store of memories of former perceptions which, as
its 'inner world', has become the possession and a constituent part of
the ego. Now in amentia not only is acceptance denied to fresh
perceptions, but the importance (cathexis) of the inner world---that
inner world which formerly reflected the outer world as an image of
it---is withdrawn too; the ego creates for itself in a lordly manner a
new outer and inner world; and there is no doubt about two facts, that
this new world is constructed after the pattern of the impulses in the
_id_, and that the motive of this collapse of the ego's relation with
the outer world is a severe frustration by reality of a wish, a
frustration which seemed too unendurable to be borne. The close
affinity of this psychosis with normal dreams is unmistakable. A
pre-condition of dreaming, however, is a state of sleep, and complete
abandonment of perceptive capacity and of the outer world is one of
the features of sleep.
We know that other forms of psychosis, the schizophrenias, incline to
end in affective hebetude, that is, to lose all interest in the outer
world. In regard to the genesis of delusions, a number of analyses
have taught us that the delusion is found like a patch on the spot
where originally there was a rent in the relation between ego and
outer world. If the condition of a conflict with the outer world is
not still more striking {253} than it seems to us now, this is due to
the fact that in the clinical picture of the psychoses manifestations
of the pathogenic process are often overlaid by those resulting from
an attempt at cure or at reconstruction.
There always remains as a common feature in the ætiology both of the
psychoneuroses and the psychoses the factor of frustration---the lack
of fulfilment of one of those eternal uncontrollable childhood's
wishes that are so deeply rooted in our composition, phylogenetically
fore-ordained as it is. In the last resort this frustration is always
an outer one; in the individual case it may proceed from that internal
institution (in the super-ego) which has taken over the part played by
the demands of reality. Now the pathogenic effect depends on whether,
in the tension of such a conflict, the ego remains true in its
allegiance to the outer world and endeavours to subjugate the _id_, or
whether it allows itself to be overwhelmed by the _id_ and thus torn
away from reality. In this apparently simple situation, however, a
complication is introduced by the existence of the super-ego, which,
in some connection not yet clear to us, combines in itself influences
from the _id_ as well as from the outer world, and is to some extent
an ideal prototype of that state towards which all the ego's
endeavours are bending, a reconciliation of its manifold
allegiances. The attitude of the super-ego should be taken into
account, as has not hitherto been done, in all forms of mental
disorder. For the moment, however, we can postulate that there must be
diseases founded on a conflict between ego and super-ego. Analysis
gives us the right to infer that melancholia is the model of this
group, and then we should put in a claim for the name of 'narcissistic
psychoneuroses' for these disorders. It does not fit in badly with our
impressions if we find reasons for distinguishing conditions such as
melancholia from the other psychoses. We then observe, however, that
we were able to complete our simple genetic formula without abandoning
{254} it. A transference neurosis corresponds to a conflict between
ego and _id_, a narcissistic neurosis to that between ego and
super-ego, and a psychosis to that between ego and outer world. To be
sure, we can hardly say at a glance whether this really represents new
knowledge or is merely an addition to our list of formulas; but I
think that after all its capacity for application must give us courage
to keep in mind this dissection of the mental apparatus that I have
proposed, namely, into ego, super-ego and _id_.
The proposition that neuroses and psychoses originate in the ego's
conflicts with the various powers ruling it, that is, that they
correspond with a failure in the function of the ego, which after all
is straining to reconcile all these different claims with one another,
requires supplementing in a further point. One would like to know in
what circumstances and by what means the ego succeeds in surviving
such conflicts, which are undoubtedly always present, without falling
ill. Now this is a new field for research in which the most various
factors will certainly demand consideration. Two of them, however, can
be indicated at once. The outcome of such situations will assuredly
depend upon economic conditions, upon the relative strength of the
forces striving with one another. And further, it is always possible
for the ego to avoid a rupture in any of its relations by deforming
itself, submitting to forfeit something of its unity, or in the long
run even to being gashed and rent. Thus the illogicalities,
eccentricities and follies of mankind would fall into a category
similar to their sexual perversions, for by accepting them they spare
themselves repressions.
In conclusion there remains to be considered the question what that
mechanism analogous to repression may be by which the ego severs
itself from the outer world. This is not to be answered, in my
opinion, without fresh investigations, but, like repression, the
content of this mechanism must include a withdrawal of the cathexes
emanating from the ego.
----------------------------------------------------------------------
XXII {255}
THE ECONOMIC PROBLEM IN MASOCHISM[100]
(1924)
We have a right to describe the existence of the masochistic trend
in the life of the human instincts as from the economic point of view
mysterious. For if mental processes are governed by the
pleasure-principle, so that avoidance of 'pain' and obtaining pleasure
is their first aim, masochism is incomprehensible. If physical pain
and feelings of distress[101] can cease to be signals of danger and be
ends in themselves, the pleasure-principle is paralysed, the watchman
of our mental life is to all intents and purposes himself drugged and
asleep.
In this light, masochism appears to us as a great danger, which is in
no way true of sadism, its counterpart. We feel tempted to call the
pleasure-principle the watchman of our lives, instead of only the
watchman of our mental life. But then the question of the relation of
the pleasure-principle to the two varieties of instincts that we have
distinguished, the death-instincts and the erotic (libidinal)
life-instincts, demands investigation, and we can reach no further
conclusion about the problem of masochism till we have answered this
call.
As will be remembered,[102] we have conceived the principle which
governs all mental processes as a special case of Fechner's _tendency
to stability_, and consequently have ascribed to the mental apparatus
the aim of extinguishing, or at least of maintaining at as low a level
as possible, the quantities of excitation flowing {256} into it. For
this tendency that has been presumed by us Barbara Low has suggested
the name Nirvana-principle, which we accept. But we have
unquestioningly identified the pleasure-pain-principle with this
Nirvana-principle. From this it would follow that every 'pain'
coincides with a heightening, every pleasure with a lowering, of the
stimulus-tension existing in the mind; the Nirvana-principle (and the
pleasure-principle which is assumed to be identical with it) would be
entirely in the service of the death-instincts (the aim of which is to
lead our throbbing existence into the stability of an inorganic state)
and would have the function of warning us against the claims of the
life-instinct, of the libido, which tries to disturb the course life
endeavours to take. Unfortunately, this view cannot be correct. It
seems that we experience the ebb and flow of quantities of stimuli
directly in perceptions of tension which form a series, and it cannot
be doubted that there is such a thing as both pleasurable tension and
'painful' lowering of tension. The condition of sexual excitement is
the most striking example of a pleasurable increase in tension of this
kind, but it is certainly not the only one. Pleasure and 'pain'
cannot, therefore, be referred to a quantitative increase or decrease
of something which we call stimulus-tension, although they clearly
have a great deal to do with this factor. It seems as though they do
not depend on this quantitative factor, but on some peculiarity in it
which we can only describe as qualitative. We should be much farther
on with psychology if we knew what this qualitative peculiarity
was. Perhaps it is something rhythmic, the periodical duration of the
changes, the risings and fallings of the volume of stimuli; we do not
know.
Whatever it is, we must perceive that the Nirvana-principle, which
belongs to the death-instincts, underwent a modification in the living
organism through which it became the pleasure-principle, and
henceforth we shall avoid regarding the two principles as one. It
{257} is not difficult to infer what force it was that effected this
modification, that is, if one has any interest at all in following
this argument. It can only be the life-instinct, the libido, which has
thus wrested a place for itself alongside the death-instinct in
regulating the processes of life. In this way we obtain a series, a
small but an interesting one: the _Nirvana_-principle expresses the
tendency of the death-instincts, the _pleasure_-principle represents
the claims of the libido and that modification of it, the
_reality_-principle, the influence of the outer world.
None of these three principles can actually be put out of action by
another. As a rule they know how to tolerate one another, although
conflicts must occasionally arise from the various aims towards which
each strives---a quantitative reduction of the stimulus-pressure on
one side, on another side some qualitative feature in it, and lastly a
postponement of the discharge of tension and a temporary acquiescence
in 'painful' tension.
The conclusion to be derived from these considerations is that a
description of the pleasure-principle as the watchman over our lives
cannot be altogether put aside.
Let us return to masochism. It comes under our observation in three
shapes: as a condition under which sexual excitation may be roused; as
an expression of feminine nature; and as a norm of behaviour.
According to this one may distinguish an _erotogenic_, a _feminine_,
and a _moral_ type of masochism. The first, the erotogenic masochism,
the lust of pain, is also to be found at bottom in the other forms;
the concept of it can be supported on biological and constitutional
grounds; it remains incomprehensible unless one can bring oneself to
make certain assumptions about matters that are wrapt in
obscurity. The third, in certain respects the most important form in
which masochism appears, has only lately, as a sense of guilt that is
for the most part unconscious, been properly {258} appreciated by
psycho-analysis; it already admits, however, of full explanation and
of co-ordination into our previous knowledge. Feminine masochism, on
the other hand, is the form most accessible to observation, least
mysterious, and is comprehensible in all its relations. We may begin
our discussion with it.
In men (to whom for reasons connected with the material I shall limit
my remarks) we know this kind of masochism sufficiently well from the
phantasies of masochistic persons, who are often in consequence
impotent; their phantasies either terminate in an onanistic act or
else themselves constitute the sexual gratification. These phantasies
are in complete accord with the real conditions sought by masochistic
perverts, whether these situations are enacted as an end in themselves
or serve to induce potency and lead up to sexual intercourse. In both
cases---for the real situations are in fact only a kind of
make-believe performance of the phantasies---the manifest content is
of being pinioned, bound, beaten painfully, whipped, in some way
mishandled, forced to obey unconditionally, defiled, degraded. Far
more rarely some kind of mutilation is also included in their content,
but then only in a very restricted manner. The obvious interpretation,
which is easily arrived at, is that the masochist wants to be treated
like a little, helpless, dependent child, but especially like a
naughty child. It is unnecessary to adduce case-material in this
connection, for it is all so very much alike and is accessible to any
observer, even to non-analysts. But if one has an opportunity of
studying cases in which the masochistic phantasies have undergone
specially rich elaboration, one easily discovers that in them the
subject is placed in a situation characteristic of womanhood, _i.e._
they mean that he is being castrated, is playing the passive part in
coitus, or is giving birth. For this reason I have called this form
of masochism _a potiori_ feminine, although so many of its features
point to childish life. This stratification in superimposed layers
{259} of the infantile and the feminine will later find a simple
explanation. Castration, or the blinding which represents it, often
leaves a negative trace in these phantasies by the condition that just
the genitals or the eyes are not to be injured in any way.
(Incidentally, masochistic tortures seldom convey an impression of
such seriousness as the brutalities---phantasied or actual---of
sadists.) Moreover, in the manifest content of the masochistic
phantasies a feeling of guilt comes to expression, it being assumed
that the subject has committed some crime (the nature of which is left
uncertain) which is to be expiated by his undergoing the pain and
torture. This looks like a superficial rationalization of the
masochistic content of the phantasy, but behind it there lies a
relation to infantile masturbation. On the other hand, this element of
guilt takes us to the third, the moral type of masochism.
The feminine type of masochism described is based entirely on the
primary erotogenic type, on the 'lust of pain', which cannot be
explained without going very far back.
In my _Drei Abhandlungen zur Sexualtheorie_, in the section on the
sources of infantile sexuality, I put forward the proposition that
sexual excitation arises as an accessory effect of a large series of
internal processes as soon as the intensity of these processes has
exceeded certain quantitative limits; indeed, that perhaps nothing
very important takes place within the organism without contributing a
component to the excitation of the sexual instinct. According to this,
an excitation of physical pain and feelings of distress would surely
also have this effect. This libidinal sympathetic excitation
accompanying the tension of physical pain and feelings of distress
would be an infantile physiological mechanism which ceases to operate
later on. It would reach a varying degree of development in different
sexual constitutions; in any case it would provide the physiological
foundation {260} on which the structure of erotogenic masochism is
subsequently erected in the mind.
The inadequacy of this explanation is seen, however, in that it throws
no light on the regular and close connection of masochism with sadism,
its counterpart in the life of the instincts. If we go a step further
back to our hypothesis of the two varieties of instincts which we
believe to be active in animate beings, we come to another conclusion
which, however, does not contradict the one just mentioned. In the
multicellular living organism the libido meets the death or
destruction instinct which holds sway there, and which tries to
disintegrate this cellular being and bring each elemental primary
organism into a condition of inorganic stability (though this again
may be but relative). To the libido falls the task of making this
destructive instinct harmless, and it manages to dispose of it by
directing it to a great extent and early in life---with the help of a
special organic system, the musculature---towards the objects of the
outer world. It is then called the instinct of destruction, of
mastery, the will to power. A section of this instinct is placed
directly in the service of the sexual function, where it has an
important part to play: this is true sadism. Another part is not
included in this displacement outwards; it remains within the organism
and is 'bound' there libidinally with the help of the accompanying
sexual excitation mentioned above: this we must recognize as the
original erotogenic masochism.
We are entirely without any understanding of the physiological ways
and means by which this subjugation of the death-instinct by the
libido can be achieved. In the psycho-analytical world of ideas we can
only assume that a very extensive coalescence and fusion, varying
according to conditions, of the two instincts takes place, so that we
never have to deal with pure life-instincts and death-instincts at
all, but only with combinations of them in different
degrees. Corresponding with the fusion of instincts there may under
certain {261} influences occur a '_de_fusion' of them. How large a
part of the death-instincts may refuse to be subjugated in this way by
becoming attached to libidinal quantities is at present not possible
to ascertain.
If one is willing to disregard a certain amount of inexactitude, it
might be said that the death-instinct active in the organism---the
primal sadism---is identical with masochism. After the chief part of
it has been directed outwards towards objects, there remains as a
residuum within the organism the true erotogenic masochism, which on
the one hand becomes a component of the libido and on the other still
has the subject itself for an object. So that this masochism would be
a witness and a survival of that phase of development in which the
amalgamation, so important for life afterwards, of death-instinct and
Eros took place. We should not be astonished to hear that under
certain conditions the sadism or destruction instinct which has been
directed outwards can be introjected, turned inward again, regressing
in this way to its earlier condition. It then provides that secondary
masochism which supplements the original one.
The erotogenic type of masochism passes through all the developmental
stages of the libido, and from them it takes the changing shapes it
wears in the life of the mind. The fear of being devoured by the
totem-animal (father) is derived from the primitive oral stage of
libido-organization; the desire to be beaten by the father from the
next-following sadistic-anal stage; castration, although it is
subsequently denied, enters into the content of masochistic phantasies
as a residue from the phallic stage[103]; and from the final genital
stage are derived of course the situations characteristic of
womanhood, namely, the passive part in coitus and the act of giving
birth. The part played by the nates in masochism is also easily
intelligible, apart from its obvious foundation in reality. The {262}
nates are the special erotogenic bodily regions which have preference
in the sadistic-anal stage, as the nipple in the oral stage and the
penis in the genital stage.
The third form of masochism, the moral type, is chiefly remarkable for
having loosened its connection with what we recognize to be sexuality.
To all other masochistic sufferings there still clings the condition
that it should be administered by the loved person; it is endured at
his command; in the moral type of masochism this limitation has been
dropped. It is the suffering itself that matters; whether the sentence
is cast by a loved or by an indifferent person is of no importance; it
may even be caused by impersonal forces or circumstances, but the true
masochist always holds out his cheek wherever he sees a chance of
receiving a blow. One is much tempted, in explaining this attitude, to
leave the libido out of account and to confine oneself to an
assumption that here the instinct of destruction is again turned
inwards and is now raging against the self; yet there should be some
meaning in the usage of speech, which has not ceased to connect this
norm of behaviour in life with erotism and calls these maimers of
themselves masochists too.
True to a habit which has grown out of our technique, let us first
consider the extreme, undeniably pathological form of this
masochism. I have described elsewhere[104] how in analytic treatment
we come across patients whose behaviour in regard to the effects of
the analysis compels us to ascribe to them an 'unconscious' feeling of
guilt. I there mentioned the trait by which these people are
recognized (the 'negative therapeutic reaction'), and I did not
conceal the fact that a strong feeling of this kind amounts to one of
the most difficult resistances and the greatest menace to the success
of our medical or educative aims. The gratification of this
unconscious sense of guilt is perhaps {263} the strongest item in the
whole 'advantage through illness' (which is as a rule composed of many
different gains), _i.e._ in the sum-total of the forces which oppose
the cure and struggle against relinquishing the neurosis; the
suffering that the neurosis involves is the very element which makes
it of value to the masochistic trend. It is instructive, too, to find,
against all theory and expectation, that a neurosis which has defied
every therapeutic effort may vanish when the person has become
involved in the misery of an unhappy marriage, has lost his fortune,
or has developed a dangerous organic disease. The one form of
suffering has then given way to another, and all that mattered, as we
see, was that a certain level of suffering should be maintained.
Patients do not easily believe what we tell them about an unconscious
sense of guilt. They know well enough by what torments (pangs of
conscience) a conscious feeling of guilt, the consciousness of guilt,
can express itself, and so they cannot admit that they could harbour
entirely analogous feelings in themselves without observing a trace of
them. I think we may meet their objection by abandoning the term
'unconscious feeling of guilt', which is in any case an incorrect one
psychologically, and substitute for it a 'need for punishment' which
describes the state of things observed just as aptly. We cannot,
however, let ourselves be prevented from judging and localizing this
unconscious feeling of guilt in the same way as we do the conscious
variety.
We have ascribed to the super-ego the function of the conscience and
have recognized the consciousness of guilt as an expression of a
tension between ego and super-ego. The ego reacts with feelings of
anxiety (pangs of conscience) to the perception that it has failed to
perform the behests of its ideal, the super-ego. Now we want to know
how the super-ego came to play this exacting part and why the ego has
to fear a difference of opinion with its ideal.
{264}
We have said that the function of the ego consists in uniting with one
another the claims of the three powers it serves, in reconciling them;
and we can add that it has in the super-ego a model for this which it
can strive to emulate. This super-ego is in fact just as much a
representative of the _id_ as of the outer world. It originated
through the introjection into the ego of the first objects of the
libidinal impulses in the _id_, namely, the two parents, by which
process the relation to them was desexualized, that is, underwent a
deflection from direct sexual aims. Only in this way was it possible
for the child to overcome the Oedipus-complex. Now the super-ego has
retained essential features of the introjected persons, namely, their
power, their severity, their tendency to watch over and to punish. As
has been set forth elsewhere,[105] it is quite conceivable that this
severity becomes intensified through the 'defusion' of the instincts
which takes place along with this incorporation into the ego. The
super-ego, the conscience at work in it, can then become harsh, cruel
and inexorable against the ego which is in its charge. The categorical
imperative of Kant is thus a direct inheritance from the
Oedipus-complex.
These same persons, however, whose effect persists as the power of
conscience after they have ceased to be objects of libidinal impulses
in the _id_, belong also to the real outer world. This is where they
came from; their power, behind which lie concealed all the influences
of the past and of tradition, was one of the most acutely-felt
manifestations of reality. In virtue of their coincidence the
super-ego, which replaces the Oedipus-complex, becomes also a
representative of the real outer world and is thus a model for the
ego's endeavours.
In this way the Oedipus-complex proves itself, as has already been
suggested on an historical basis,[106] to {265} be the origin of
morality in each one of us. In the course of development through
childhood which brings about an ever-increasing severance from the
parents, their personal significance for the super-ego recedes. To the
imagos they leave behind are then linked on the influences of
teachers, authorities, of self-chosen models and heroes venerated by
society; these persons need no longer be introjected by the ego, which
has now become much more resistant. The last figure in the series
beginning with the parents is that dark supremacy of Fate, which only
the fewest among us are able to conceive of impersonally. Little can
be said against the Dutch writer, Multatuli,[107] when he substitutes
the divine pair _Λόγος καὶ Ἀνάγκη_ for the _Μοῖρα_ of the Greeks; but
all those who transfer the guidance of the world to Providence, to
God, or to God and Nature, rouse a suspicion that they still look upon
these farthest and remotest powers as a
parent-couple---mythologically---and imagine themselves linked to them
by libidinal bonds. In _Das Ich und das Es_ I have made an attempt to
derive the objective fear of death in mankind also from the same sort
of parental conception of Fate. It seems to be very difficult to free
oneself from it.
After these preliminaries we can return to our consideration of the
moral type of masochism. We said that the persons in question, by
their behaviour---in the treatment and in their lives---make the
impression of being morally inhibited to an excessive degree, of being
dominated by an especially sensitive conscience, although they are not
at all conscious of any such ultra-morality. On close inspection we
can surely see the distinction which divides this kind of unconscious
development of morality from the moral type of masochism. In the
first, the accent falls on the heightened sadism of the super-ego to
which the ego subjects itself; in the last, it falls instead on the
masochism in the ego itself, which seeks punishment, whether from
{266} the super-ego within or from parental authorities without. It
may be excused us that we confounded them to begin with, for in both
cases it is a question of a relation between the ego and the super-ego
or the powers equivalent to it; in both cases there is a craving which
is satisfied by punishment and suffering. It is hardly an
insignificant detail then that the sadism of the super-ego is for the
most part acutely perceived consciously, while the masochistic impulse
of the ego as a rule remains hidden from the person and must be
inferred from his behaviour.
The unconsciousness of the moral form of masochism guides us to a near
clue. We have translated the words 'unconscious feeling of guilt' as
meaning a need for punishment by some parental authority. Now we know
that the wish to be beaten by the father, which is so common, is
closely connected with the other wish, to have some passive (feminine)
sexual relations with him, and is only a regressive distortion of the
latter. If we introduce this explanation into the content of moral
masochism, its hidden meaning becomes clear to us. Conscience and
morality arose through overcoming, desexualizing, the Oedipus-complex;
in moral masochism morality becomes sexualized afresh, the
Oedipus-complex is reactivated, a regression from morality back to the
Oedipus-complex is under way. This is to the advantage neither of the
person concerned nor of morality. An individual may, it is true,
preserve the whole or a certain amount of his morality alongside his
masochism, but, on the other hand, a good part of his conscience may
become swallowed up by his masochism. Further, the masochism in him
creates a temptation to 'sinful acts' which must then be expiated by
the reproaches of the sadistic conscience (as in so many Russian
character-types) or by chastisement from the great parental authority
of Fate. In order to provoke punishment from this last
parent-substitute the masochist must do something inexpedient, act
against his own interests, ruin the prospects {267} which the real
world offers him, and possibly destroy his own existence in the world
of reality.
The revulsion of sadism against the self regularly occurs under the
condition of civilized suppression of the instincts, which withholds a
great part of the destructive instinctual components from being
exercised in life. One can imagine that this backward-flowing part of
the instinct of destruction comes to expression in the ego as an
intensified masochism. The manifestations of conscience allow us to
infer, however, that the destructiveness rebounding from the outer
world is also absorbed by the super-ego without any such
transformation and increases its sadism against the ego. The sadism of
the super-ego and the masochism of the ego supplement each other and
combine to produce the same effects. In my opinion it is only in this
way possible to understand how it is that a feeling of guilt
ensues---frequently or even quite generally---from a suppression of
instinct and how it is that the more anyone refrains from
aggressiveness towards others the more strict and sensitive his
conscience becomes. One might expect that a person who knows himself
to be in the habit of avoiding aggressions that are regarded as
undesirable by civilization would have a good conscience as a result
and would therefore watch over his ego less suspiciously. The
situation is generally represented as though the requirements of
social life came first and the instinctual renunciation were its
consequence. The origin of morality remains then unexplained. The
actual state of things seems to be a reversal of this: the first
renunciation of instinctual gratification is enforced by external
powers, and it is this that creates morality, which expresses itself
in conscience and exacts a further renunciation of instinct.
Moral masochism thus becomes the classical piece of evidence for the
existence of 'instinctual fusion'. Its dangerousness lies in its
origin in the death-instinct and represents that part of the latter
which escaped {268} deflection on to the outer world in the form of an
instinct of destruction. But since, on the other hand, it has the
value of an erotic component, even the destruction of anyone by
himself cannot occur without gratification of the libido.
----------------------------------------------------------------------
XXIII {269}
THE PASSING OF THE OEDIPUS-COMPLEX[108]
(1924)
The significance of the Oedipus-complex as the central phenomenon of
the sexual period in early childhood reveals itself more and
more. After this it disappears; it succumbs to repression, as we say,
and is followed by the latency period. But it is not yet clear to us
what occasions its decay; analyses seem to show that the painful
disappointments experienced bring this about. The little girl who
wants to believe herself her father's beloved and partner in love must
one day endure a harsh punishment at his hands, and finds herself
hurled to earth from her cloud-castles. The boy who regards his mother
as his own property finds that her love and care for him are
transferred to a new arrival. Reflection deepens the effect of these
impressions by insisting that painful experiences of this kind,
antagonistic to the content of the complex, are inevitable. Even when
no special events such as those mentioned occur, the absence of the
hoped-for gratification, the continual frustration of the wish for a
child, causes the love-lorn little one to turn from its hopeless
longing. According to this, the Oedipus-complex becomes extinguished
by its lack of success, the result of its inherent impossibility.
Another view would put it that the Oedipus-complex must come to an end
because the time has come for its dissolution, just as the milk-teeth
fall out when the permanent ones begin to press forward. Although the
majority of human children individually pass through {270} the
Oedipus-complex, yet after all it is a phenomenon determined and laid
down for him by heredity, and must decline according to schedule when
the next pre-ordained stage of development arrives. It is therefore
not very important what the occasions are through which this happens,
or whether any such occasions are discoverable at all.
One cannot dispute the justice of both these views. They are
compatible with each other, moreover; there is room for the
ontogenetic alongside the more far-reaching phylogenetic one. Even at
birth, indeed, the whole organism is destined to die, and an
indication of what will eventually cause its death may possibly
already be contained in its organic disposition. Yet after all it is
of interest to follow up the way in which the innate schedule is
worked out, the way in which accidental noxiæ exploit the disposition.
We have lately recognized more clearly than before that the sexual
development of a child advances up to a certain point, and that when
it reaches this point the genital organ has already taken over the
leading part. The genital organ in question, however, is the male
alone, or, more exactly, the penis; the female organ is still
undiscovered. This phallic phase, which is contemporaneous with the
Oedipus-complex, does not develop further into the final stage of
genital organization, but becomes submerged, and is succeeded by the
latency period. Its conclusion, however, is effected in a typical
manner and in conjunction with happenings that recur regularly.
When the (male) child's interest turns to his genital organ, he
betrays this by handling it frequently, and then he is bound to
discover that grown-up people do not approve of this activity. More or
less plainly and more or less brutally the threat is uttered that this
highly valued part of him will be taken away. Usually it is from women
that the threat emanates; very often they seek to strengthen their
authority by referring to the father or the doctor, who, as they
assure the {271} child, will carry out the punishment. In a number of
cases women will themselves modify the threat in a symbolic manner by
warning the child that his actively sinning hand will be removed,
instead of his genital, which is after all passive. It happens
particularly often that the little boy is threatened in this way not
because he plays with his penis with his hand, but because he wets his
bed every night and is not to be induced to learn cleanliness.
Children's attendants behave as if this nocturnal incontinence were a
result and a proof of undue preoccupation with the penis, and are
probably right in their inference. In any case long-continued
bed-wetting is comparable to pollutions in adults---an expression of
the same excitation in the genitals that impels the child to
masturbate at this period.
Now the view we hold is that the phallic stage of the genital
organization succumbs to this threat of castration. But not
immediately, and not without the assistance of further influences. For
to begin with the boy does not believe in the threat, nor obey it in
the least. Psycho-analysis has recently laid fresh emphasis on two
experiences which all children go through, by which it is thought that
they become prepared for the loss of a valued part of the body---the
withdrawal from them of the mother's breast, at first intermittently
and later finally, and the daily demand made on them to give up the
contents of the bowel. But if these experiences have an effect when
the threat of castration takes place, one sees nothing of it. Not
until yet another experience comes its way does the child begin to
reckon with the possibility of being castrated, and then only
hesitatingly, unwillingly, and not without efforts to depreciate the
significance of what it has itself observed.
The observation that finally breaks down the child's unbelief is the
sight of the female genitalia. Some day or other it happens that the
child whose own penis is such a proud possession obtains a sight of
the genital parts of a little girl; he must then become convinced
{272} of the absence of a penis in a creature so like himself. With
this, however, the loss of his own penis becomes imaginable, and the
threat of castration achieves its delayed effect.
We must not be so short-sighted as the child's attendant who threatens
it with castration; we cannot overlook the fact that the child's
sexual life at this time is by no means exhausted by masturbation. The
child is demonstrably under the influence of the Oedipus-attitude to
its parents; masturbation is only the discharge in the genital of the
excitation belonging to the complex, and to this connection between
the two masturbation will owe its significance to him for ever
after. The Oedipus-complex offered the child two possibilities of
satisfaction, an active and a passive one. It could have put itself in
its father's place and had intercourse with the mother as he did, so
that the father was soon felt to be an obstacle; or else it had wanted
to supplant the mother and be loved by the father, whereupon the
mother became superfluous. The child may have had only the vaguest
notions of what constituted the love-intercourse which serves as a
gratification, but that the penis played a part in it was certain, for
the feelings in his own organ were evidence of that. So far there had
been no occasion for doubt about a penis in women. But now the
acceptance of the possibility of castration, the recognition that
women are castrated, makes an end of both the possibilities of
satisfaction in the Oedipus-complex. For both of them---the male as a
consequence, a punishment, and the other, the female, as a
prerequisite---would indeed be accompanied by a loss of the penis. If
the gratification desired in consequence of the love is to cost the
child his penis, a conflict must arise between the narcissistic
interest in this part of the body and the libidinal cathexis of the
parent-objects. Normally, in this conflict the first of these forces
triumphs; the child's ego turns away from the Oedipus-complex.
{273}
I have described elsewhere the way by which this aversion is
accomplished. The object-cathexes are given up and replaced by
identification. The authority of the father or the parents is
introjected into the ego and there forms the kernel of the super-ego,
which takes its severity from the father, perpetuates his prohibition
against incest, and so insures the ego against a recurrence of the
libidinal object-cathexis. The libidinal trends belonging to the
Oedipus-complex are in part desexualized and sublimated, which
probably happens with every transformation into identification; in
part they are inhibited in their aim and changed into affectionate
feelings. The whole process, on the one hand, preserves the genital
organ, wards off the danger of losing it; on the other hand, it
paralyses it, takes away its function from it. This process introduces
the latency period which now interrupts the child's sexual
development.
I see no reason to deny the name of 'repression' to the ego's turning
from the Oedipus-complex, although later repressions are for the most
part effected with the participation of the super-ego, which is only
built up during this process. But the process described is more than a
repression; when carried out in the ideal way it is equivalent to a
destruction and abrogation of the complex. It is not a great step to
assume that here we have come upon the borderland between normal and
pathological which is never very sharply defined. If the ego has
really not achieved much more than a repression of the complex, then
this latter persists unconsciously in the _id_, and will express
itself later on in some pathogenic effect.
Analytic observation enables us to perceive or to infer these
connections between the phallic organization, the Oedipus-complex, the
threat of castration, the formation of the super-ego and the latency
period. They justify the statement that the Oedipus-complex succumbs
to the threat of castration. But this does not dispose of the problem;
there is room for a {274} theoretical speculation which may overthrow
the results obtained or set them in a new light. Before we traverse
this path, however, we must attend to a question which was already
roused during this discussion and has long been left on one side. The
process described relates, as we expressly stated, only to the male
child. How is the corresponding development effected in a little girl?
Here our material---for some reason we do not understand---becomes far
more shadowy and incomplete. The female sex develops an
Oedipus-complex, too, a super-ego and a latency period. May one
ascribe to it also a phallic organization and a castration complex?
The answer is in the affirmative, but it cannot be the same as in the
boy. The feministic demand for equal rights between the sexes does not
carry far here; the morphological difference must express itself in
differences in the development of the mind. 'Anatomy is Destiny', to
vary a saying of Napoleon's. The little girl's clitoris behaves at
first just like a penis, but by comparing herself with a boy
playfellow the child perceives that she has 'come off short', and
takes this fact as ill-treatment and as a reason for feeling
inferior. For a time she still consoles herself with the expectation
that later, when she grows up, she will acquire just as big an
appendage as a boy. Here the woman's 'masculine complex' branches
off. The female child does not understand her actual loss as a sex
characteristic, but explains it by assuming that at some earlier date
she had possessed a member which was just as big and which had later
been lost by castration. She does not seem to extend this conclusion
about herself to other grown women, but in complete accordance with
the phallic phase she ascribes to them large and complete, that is,
male, genitalia. The result is an essential difference between her and
the boy, namely, that she accepts castration as an established fact,
an operation already performed, whereas the boy dreads the possibility
of its being performed.
{275}
The castration-dread being thus excluded in her case, there falls away
a powerful motive towards forming the super-ego and breaking up the
infantile genital organization. These changes seem to be due in the
girl far more than in the boy to the results of educative influences,
of external intimidation threatening the loss of love. The
Oedipus-complex in the girl is far simpler, less equivocal, than that
of the little possessor of a penis; in my experience it seldom goes
beyond the wish to take the mother's place, the feminine attitude
towards the father. Acceptance of the loss of a penis is not endured
without some attempt at compensation. The girl passes over---by way of
a symbolic analogy, one may say---from the penis to a child; her
Oedipus-complex culminates in the desire, which is long cherished, to
be given a child by her father as a present, to bear him a child. One
has the impression that the Oedipus-complex is later gradually
abandoned because this wish is never fulfilled. The two desires, to
possess a penis and to bear a child, remain powerfully charged with
libido in the unconscious and help to prepare the woman's nature for
its subsequent sex rôle. The comparative weakness of the sadistic
component of the sexual instinct, which may probably be related to the
penis-deficiency, facilitates the transformation of directly sexual
trends into those inhibited in aim, feelings of tenderness. It must be
confessed, however, that on the whole our insight into these processes
of development in the girl is unsatisfying, shadowy and incomplete.
I have no doubt that the temporal and causal relations described
between Oedipus-complex, sexual intimidation (the threat of
castration), formation of the super-ego and advent of the latency
period are of a typical kind; but I do not maintain that this type is
the only possible one. Variations in the sequence and the linking up
of these processes must be very significant in the development of the
individual.
Since the publication of Otto Rank's interesting {276} study on the
trauma of birth, the conclusion of the present modest
communication---that the boy's Oedipus-complex succumbs to the dread
of castration---cannot be accepted without further discussion. It
seems to me premature, however, to enter upon this discussion at the
present time, and perhaps also inadvisable to begin to criticize or to
assess the value of Rank's view in the present connection.
----------------------------------------------------------------------
XXIV {277}
THE LOSS OF REALITY IN NEUROSIS
AND PSYCHOSIS[109]
(1924)
I have recently[110] defined as follows one of the features
distinguishing the neuroses from the psychoses: in the former the ego,
in virtue of its allegiance to reality, suppresses a part of the _id_
(the life of instinct), whereas in the psychoses the same ego, in the
service of the _id_, withdraws itself from a part of
reality. According to this, the excessive power of the influence of
reality is decisive for neurosis, and for psychosis that of the
_id_. A loss of reality must be an inherent element in psychosis;
while in neurosis, one would suppose, it would be avoided.
But now, this does not at all agree with experience, which shows us
all that every neurosis in some way interferes with the patient's
situation in life, that it serves him as a means whereby he can
withdraw from his real situation and that in its severe forms it
signifies directly a flight from real life. This contradiction appears
to give grounds for thought; it is, however, easily removed, and an
explanation of it will but advance our comprehension of neurosis.
The contradiction exists only so long as we keep in mind merely the
situation at the outbreak of the neurosis, when the ego undertakes, in
the service of reality, to repress an instinctual impulse. This is not
yet the neurosis itself, however. The latter consists much more in
those processes which render compensation for the damage done to a
part of the _id_, _i.e._ in the {278} reaction to the repression and
in a miscarriage of it. The loosening of the relation to reality is
then a consequence of this second step in the formation of a neurosis,
and we should not be surprised if close investigation showed that the
loss of reality concerned precisely that very part of reality which
demanded the instinctual repression.
It is nothing new to characterize neurosis as the outcome of a
repression which has miscarried. We have always said this, and only
because of the new connection it has come into was it necessary to
repeat it.
Incidentally, the same doubts arise again in a specially impressive
manner when the neurosis in question is a case in which the exciting
cause ('the traumatic scene') is known, and in which one can see how
the person averts himself from the experience and consigns it to an
amnesia. I will take, for instance, a case analysed many years
ago,[111] in which a young woman who was in love with her
brother-in-law, and whose sister lay dying, was horrified at the
thought, 'Now he is free and can marry me'! This scene was instantly
forgotten, and thus the process of repression which led to the
hysterical pains was set in motion. It is instructive to see precisely
in such a case, however, the way in which a neurosis attempts to solve
the conflict. It discounts the change in reality, by repressing the
claim of the instinct in question, the love for the
brother-in-law. The psychotic reaction would have been a denial of the
fact of the sister's death.
Now one might expect that when a psychosis breaks out something
analogous to the process in a neurosis happens, though of course
between different institutions in the mind; that is, that two steps
may be discernible in a psychosis also, the first of which tears the
ego away from reality, while the second tries to make good the damage
done and re-establish the relation to reality at the expense of the
_id_. And {279} something of the kind can really be observed in a
psychosis; there are indeed two stages in it, the second of which
bears the character of a reparation---but then the analogy gives way
to a far more extensive similarity in the two processes. The second
step in a psychosis is also an attempt to make good the loss of
reality, not, however, at the expense of a restriction laid on the
_id_---as in neurosis at the expense of the relation with
reality---but in another, a more lordly manner, by creating a new
reality which is no longer open to objections like that which has been
forsaken. The second step, therefore, in both neurosis and psychosis
is induced by the same tendencies; in both it serves the struggle for
power on the part of the _id_ which will not allow reality to dictate
to it. Neurosis and psychosis are both of them an expression of the
rebellion of the _id_ against the outer world, of its 'pain',
unwillingness to adapt itself to necessity---to _ἀνάγκη_, or, if one
prefers, of its incapacity to do so. They are far more
distinguishable from each other in the reaction at the outbreak than
in the attempt at reparation which follows it.
The difference at the beginning comes to expression at the end in this
way: in neurosis a part of reality is avoided by a sort of flight, but
in psychosis it is remodelled. Or one may say that in psychosis flight
at the beginning is succeeded by an active phase of reconstruction,
while in neurosis obedience at the beginning is followed by a
subsequent attempt at flight. Or, to express it in yet another way,
neurosis does not deny the existence of reality, it merely tries to
ignore it; psychosis denies it and tries to substitute something else
for it. A reaction which combines features of both these is the one we
call normal or 'healthy'; it denies reality as little as neurosis, but
then, like a psychosis, is concerned with effecting a change in
it. This expedient normal attitude leads naturally to some active
achievement in the outer world and is not content, like a psychosis,
with {280} establishing the alteration within itself; it is no longer
_auto-plastic_ but _allo-plastic_.
In a psychosis the remodelling of reality is effected by means of the
residues in the mind of former relations with reality; that is, it
concerns the memory-traces, ideas and judgements which have previously
been formed about reality and by which reality was represented in the
life of the mind. But this relation was never a final and complete
one; it was perpetually being enriched and altered by new
perceptions. Thus to a psychosis also there falls the task of creating
perceptions of a kind corresponding with the new reality, which is
accomplished most effectually by way of hallucinations. Now the
falsifications of memory, the delusional systems and hallucinations in
so many cases and forms of psychosis are of a most distressing
character and are bound up with a development of dread, which is
surely a sign that the whole process of remodelling reality is
conducted in the face of most strenuous opposition. We may, for our
own purposes, reconstruct the process on the model of a neurosis,
which is more familiar to us. Here we see that a reaction of anxiety
takes place every time the repressed instinct makes a move forward,
and that the result of the conflict is after all but a compromise and
as a satisfaction is incomplete. Probably in a psychosis the rejected
part of reality re-asserts its claim, just as in neurosis the
repressed instinct does; hence the consequences in both are the
same. Elucidation of the various mechanisms in the psychoses by which
the turning from reality and reconstruction of it is effected, and
also of the degree of success they are able to achieve, is a task for
special psychiatry which has not yet been undertaken.
There exists, therefore, a further analogy between neurosis and
psychosis in that the task undertaken in the second step of each to
some extent miscarries; for the repressed instinct (in neurosis)
cannot create for itself a completely satisfying substitute, and the
{281} presentations of reality do not permit of being re-casted into
entirely satisfying moulds (not, at least, in all forms of mental
disorder). But the accent falls differently in the two cases. In a
psychosis it falls exclusively on the first step, which is
pathological in itself and can only lead to disease; in neurosis, on
the contrary, it falls on the second step, the miscarriage of
repression, whereas the first step may succeed and does succeed on
innumerable occasions within the bounds of health---even though it is
not achieved free of cost and without leaving traces of the necessary
expenditure of mental energy. These differences, and perhaps many
others too, are the consequence of the topographical difference in the
original situation at the outbreak of the pathogenic
conflict---whether in this conflict the ego surrenders to its
dependence on the real world or to its allegiance to the _id_.
A neurosis usually contents itself with avoiding the part of reality
in question and protecting itself against coming into contact with
it. The sharp distinction between neurosis and psychosis is modified,
however, by the circumstance that neurosis, too, does not fail to make
attempts to substitute a reality more in accord with its desires for
the unsatisfactory real one. The way in which this becomes possible is
through the _world of phantasy_, a realm that, at the time when the
activity of the reality-principle first set in, became distinguished
from the real outer world, and later on was excluded from the demands
of necessity, like a kind of 'reservation', and which, though not
inaccessible to the ego, is only loosely attached to it. It is from
this world of phantasy that neurosis draws the material for
re-creating the world afresh according to its desires, and it finds
this material there, as a rule, by way of a regression to an earlier
period in real life.
It is hardly possible to doubt that the world of phantasy plays the
same part in a psychosis, that for it, too, this world represents the
store-chamber from which the materials or the design for constructing
a {282} new reality are obtained. But the new phantastic outer world
of a psychosis attempts to set itself in place of external
reality. That of neurosis, on the contrary, is glad to attach itself,
like a children's game, to a part of reality---some other part than
the one against which it must protect itself; it endows it with a
special meaning and a secret significance which we, not always quite
correctly, call _symbolical_. Thus we see that there arises both in
neurosis and in psychosis the question not only of the _loss of
reality_, but of a _substitute for reality_ too.
----------------------------------------------------------------------
PAPERS ON TECHNIQUE {283}
----------------------------------------------------------------------
XXV {285}
THE FUTURE PROSPECTS OF
PSYCHO-ANALYTIC THERAPY[112]
*An Address Delivered before the Second
International Psycho-analytical Congress
at Nuremberg in 1910*
(1910)
Since the objects for which we are assembled here to-day are mainly
practical, I shall choose a practical theme for my introductory
address and appeal to your interest in medical, not in scientific,
matters. I can imagine what your opinion about the success of our
therapy probably is, and I assume that most of you have already passed
through the two stages which all beginners go through, that of
enthusiasm at the unexpected increase in our therapeutic achievements,
and that of depression at the magnitude of the difficulties which
stand in the way of our efforts. Whichever of these stages in
development, however, each of you may happen to be going through at
the moment, my intention to-day is to show you that we have by no
means come to the end of our resources for combating the neuroses, and
that we may expect a substantial improvement in our therapeutic
prospects before very long.
This improvement will come, I think, from three sources:
1. From internal progress.
2. From increased prestige.
3. From the general effect of our work.
{286}
1. Under 'internal progress' I understand advances (_a_) in our
analytical knowledge, (_b_) in our technique.
(_a_) Advances in our knowledge. We are, of course, still a long way
from knowing all that is required for an understanding of the
unconscious minds of our patients. Now it is clear that every advance
in our knowledge means an increase in the power of our therapy. As
long as we understood nothing, we accomplished nothing; the more we
understand the more we shall achieve. At its beginning psycho-analytic
treatment was inexorable and exhaustive. The patient had to say
everything himself, and the physician's part consisted of urging him
on incessantly. To-day things have a more friendly air. The treatment
is made up of two parts, out of what the physician infers and tells
the patient, and out of the patient's work of assimilation, of
'working through', what he hears. The mechanism of our curative method
is indeed quite easy to understand; we give the patient the conscious
idea of what he may expect to find (_bewusste Erwartungsvorstellung_),
and the similarity of this with the repressed unconscious one leads
him to come upon the latter himself. This is the intellectual help
which makes it easier for him to overcome the resistances between
conscious and unconscious. Incidentally, I may remark that it is not
the only mechanism made use of by the analytic method; you all know
that far more powerful one which lies in the use of the
'transference'. I intend soon to undertake an exposition of these
various factors, which are so important for an understanding of the
cure, in a Practice of Psycho-Analysis. And, further, in speaking to
you I need not rebut the objection that the way in which we practise
the method to-day obscures its testimony to the correctness of our
hypotheses; you will not forget that this evidence is to be found
elsewhere, and that a therapeutic procedure cannot be performed in the
same way as a theoretical investigation.
Now let me refer briefly to various fields in which {287} we both have
much to learn that is new and do actually make new discoveries
daily. First of all, there is the matter of symbolism in dreams and in
the unconscious---a fiercely contested subject, as you know! It is no
small credit to our colleague, W. Stekel, that, indifferent to all the
objections of our opponents, he has undertaken a study of
dream-symbols. In this there is indeed much still to learn; my
_Traumdeutung_, which was written in 1899, awaits important
amplification from researches into symbolism.
I will say a few words about one of the symbols that has lately been
recognized. Not long ago it came to my knowledge that a psychologist
whose views are not too distant from ours had remarked to one of us
that we undoubtedly overestimate the hidden sexual significance of
dreams; his most frequent dream was of going upstairs, and there could
certainly be nothing sexual about that. Our attention being thus drawn
to it, we began to study the incidence of stairs, steps and ladders in
dreams, and soon could establish the fact that stairs and such things
are certainly a symbol of coitus. The underlying element which the two
things have in common is not difficult to discover; one climbs an
acclivity in rhythmic movements, accompanied by increasing
breathlessness, and in a few rapid leaps can be down below again. Thus
the rhythm of coitus reappears in climbing steps. We will not forget
to adduce the usages of speech in this connection. It shows us that
'mounting' is used quite simply as a symbol for the sexual act. In
German one says 'the man is a _Steiger_, _nachsteigen_'. In French the
steps of a stair are called '_marches_'; '_un vieux marcheur_', _ein
alter Steiger_ both mean an old profligate. The dream-material from
which these newly recognized symbols are derived will in due time be
put before you by the committee we are about to form for collecting
and studying symbols. An account of another interesting symbol, of the
idea of 'rescue' and its changes in significance, will appear in the
second volume of our {288}_Jahrbuch_. However, I must break off here
or I shall not reach my other points.
Every one of you will know from his own experience the total change in
one's attitude to a new case when once one has thoroughly mastered the
structure of some typical cases of illness. Assuming now that we had
narrowly defined the regular elements in the composition of the
various forms of neurosis, just as we have already succeeded in doing
for hysterical symptom-formation, how much more assured we should be
in our prognoses! Just as an obstetrician knows by examining the
placenta whether it has been completely expelled or whether noxious
fragments of it still remain, so we should be able, independently of
the success of the cure and the patient's present condition, to say
whether the work had been completely carried to an end or whether we
had to expect relapses and fresh onsets of illness.
(_b_) I will hasten on to the innovations in the field of technique,
where indeed nearly everything still awaits definitive settlement, and
much is only now beginning to come clear. There are now two aims in
psycho-analytic technique: to save the physician effort and to open up
for the patient the freest access to his unconscious. You know that
our technique has been transformed in important respects. At the time
of the cathartic treatment we set ourselves the aim of elucidating the
symptoms, then we turned away from the symptoms to discovering the
'complexes', to use Jung's indispensable word; now, however, our work
is aimed directly at finding out and overcoming the 'resistances', and
we can with justification rely on the complexes coming to light as
soon as the resistances have been recognized and removed. Some of you
have since shown a desire to formulate and classify these
resistances. Now I beg you to examine your material and see whether
you can confirm the following statement: In male patients the most
important resistances to the treatment seem to be {289} derived from
the father-complex and to express themselves in fear of the father,
and in defiance and incredulity towards him.
Other innovations in technique relate to the physician himself. We
have begun to consider the 'counter-transference', which arises in the
physician as a result of the patient's influence on his unconscious
feelings, and have nearly come to the point of requiring the physician
to recognize and overcome this counter-transference in himself. Now
that a larger number of people have come to practise psycho-analysis
and mutually exchange their experiences, we have noticed that every
analyst's achievement is limited by what his own complexes and
resistances permit, and consequently we require that he should begin
his practice with a self-analysis and should extend and deepen this
constantly while making his observations on his patients. Anyone who
cannot succeed in this self-analysis may without more ado regard
himself as unable to treat neurotics by analysis.
We are also now coming to the opinion that the analytic technique must
undergo certain modifications according to the nature of the disease
and the dominating instinctual trends in the patient. Our therapy was,
in fact, first designed for conversion-hysteria; in anxiety-hysteria
(phobias) we must alter our procedure to some extent. The fact is that
these patients cannot bring out the material necessary for resolving
the phobia so long as they feel protected by retaining their phobic
condition. One cannot, of course, induce them to give up their
protective measures and work under the influence of anxiety from the
beginning of the treatment. One must therefore help them by
interpreting their unconscious to them until they can make up their
minds to do without the protection of their phobia and expose
themselves to a now comparatively moderate degree of anxiety. Only
when they have done so does the material necessary for achieving
solution of the phobia become accessible. {290} Other modifications of
technique which seem to me not yet ready for discussion will be
required in the treatment of obsessional neurosis. In this connection
very important questions arise, which are not yet elucidated: how far
the instincts involved in the conflict in the patient are to be
allowed some gratification during the treatment, and what difference
it then makes whether these impulses are active (sadistic) or passive
(masochistic) in nature.
I hope you have received the impression that, when all that can at
present be merely glimpsed is known and when we have established all
the improvements in technique to which deeper experience with our
patients must lead us, then our medical practice will reach a degree
of precision and certainty of success which is not to be had in all
medical specialities.
2. I said that we had much to expect from the increase in prestige
which must accrue to us as time goes on. I need hardly say much to you
about the importance of authority. Only very few civilized persons are
capable of existing without reliance on others or are even capable of
coming to an independent opinion. You cannot exaggerate the intensity
of man's inner irresolution and craving for authority. The
extraordinary increase in the neuroses since the power of religion has
waned may give you some indication of it. The impoverishment of the
ego due to the tremendous effort in repression demanded of every
individual by culture may be one of the principal causes of this state
of things.
Hitherto the weight of authority with its enormous 'suggestive' force
has been against us. All our therapeutic successes have been achieved
in spite of this suggestion; it is surprising that any success was to
be had at all in the circumstances. I will not let myself go to the
extent of describing to you the agreeable things that happened during
the time when I alone represented psycho-analysis. I know that when I
assured my patients that I knew how to relieve them {291} permanently
of their sufferings they looked round my modest abode, thought of my
want of fame and honours, and regarded me like a man who possesses an
infallible system in a gambling-place, of whom people say that if he
could do what he professes he would look very different. Nor was it
really at all pleasant to operate on people's minds while colleagues
whose duty it was to assist took a pleasure in spitting into the field
of operation, and while at the first signs of blood or restlessness in
him the patient's relatives threatened one. An operation may surely
cause reactions; in surgery we became used to that long ago. Nobody
believed in me, in fact, just as even to-day very few believe in us;
under such conditions many an attempt was bound to fail. To estimate
the increase in our therapeutic capacities that will ensue when
general recognition is accorded us, you should think of the different
positions of gynæcologists in Turkey and in the West. All that a
woman's physician may do there is to feel the pulse of an arm which is
stretched out to him through a hole in the wall. And his curative
results are in proportion to the inaccessibility of their object; our
opponents in the West wish to restrict our access over our patients'
minds to something very similar. But now that the force of public
opinion drives sick women to the gynæcologist, he has become their
helper and saviour. Now do not say that, even if the weight of public
opinion comes to our aid and so much increases our successes, that
will in no way prove the validity of our hypotheses. Suggestion is
supposed to be able to do anything, and our successes would then be
results of suggestion and not of psycho-analysis. Public opinion is at
present suggesting hydropathic cures, diet cures, electricity cures
for nervous persons, but that does not enable these measures to remove
the neuroses. It will be seen whether psycho-analytic treatment can
accomplish more than they.
But now, to be sure, I must damp the ardour of your expectations. The
community will not hasten {292} to grant authority to us. It is bound
to offer resistance to us, for we adopt a critical attitude towards
it; we accuse it of playing a great part itself in causing the
neuroses. Just as we make any single person our enemy by discovering
what is repressed in him, so the community cannot respond with
sympathy to a relentless exposure of its injurious effects and
deficiencies; because we destroy illusions we are accused of
endangering ideals. It seems, therefore, that the state of things from
which I expect such great advantages for our therapeutic results will
never arrive. And yet the situation is not so hopeless as one might
think at the present time. Powerful though the feelings and the
self-interest of men may be, yet intellect is a power too. It has not,
perhaps, the power that makes itself felt immediately, but one that is
all the more certain in the end. The most mordant verities are heard
at last, after the interests they injure and the emotions they rouse
have exhausted their frenzy. It has always been so, and the unwelcome
truths which we psycho-analysts have to tell the world will undergo
the same fate. Only it will not come very quickly; we must be able to
wait.
3. Finally, I have to explain to you what I mean by the 'general
effect' of our work, and how I come to set my hopes on it. This
consists in a very remarkable therapeutic constellation which could
perhaps not be repeated anywhere else and which will appear strange to
you too at first, until you recognize in it something you have long
been familiar with. You know, of course, that the psychoneuroses are
substitutive gratifications of instincts the existence of which one is
forced to deny to oneself and others. Their capacity to exist depends
on this distortion and disguise. When the riddle they hold is solved
and the solution accepted by the sufferers these diseases will no
longer be able to exist. There is hardly anything quite like it in
medicine; in fairy-tales you hear of evil spirits whose power is
broken when you can tell them their name which they have kept
secret.
{293}
Now in place of a single sick person put the whole community of
persons liable to neuroses, persons ill and persons well; in place of
the acceptance of the solution in the first put a general recognition
in the second; and a little reflection will show you that this
substitution cannot alter the result at all. The success which the
therapy has with individuals must appear in the many too. Diseased
people cannot let their various neuroses become known---their
apprehensive over-anxiousness which is to conceal their hatred, their
agoraphobia which betrays disappointed ambition, their obsessive
actions which represent self-reproaches for evil intentions and
precautions against them---when all their relatives and every stranger
from whom they wish to conceal their thoughts and feelings know the
general meaning of these symptoms, and when they know themselves that
the manifestations of their disease produce nothing which others
cannot instantly understand. The effect, however, will not be merely
that they will conceal their symptoms---a design, by the way, which
would be impossible to execute; for this concealment will destroy the
purpose of the illness. Disclosure of the secret will have attacked,
at its most sensitive point, the 'ætiological equation' from which the
neuroses descend, will have made the 'advantage through illness'
illusory, and consequently in the end nothing can come of the changed
situation brought about by the indiscretions of physicians but an end
of producing these illnesses.
If this hope seems utopian to you, you may remember that certain
neurotic phenomena have already been dispelled by this means, although
only in quite isolated instances. Think how common hallucinations of
the Virgin Mary were in peasant-girls in former times. So long as such
a phenomenon brought a flock of believers and resulted perhaps in a
chapel being built on the sacred spot, the visionary state of these
maidens was inaccessible to influence. To-day even the priesthood has
changed its attitude to such {294} things; it allows police and
medical men to visit the seer, and since then the Virgin appears very
seldom. Or allow me to study the same processes, that I have been
describing as taking place in the future, in an analogous situation
which is on a smaller scale and consequently more easily appreciated.
Suppose that a number of ladies and gentlemen in good society had
planned a picnic at an inn in the forest one day. The ladies make up
their minds that if one of them wants to relieve a natural need she
will say aloud that she is going to pick flowers; but a wicked fellow
hears of this secret and has printed on the programme which is sent
round to the whole party---'If the ladies wish to retire they are
requested to say that they are going to pick flowers'. Of course after
this no lady will think of availing herself of this flowery pretext,
and other freshly devised formulas of the same kind will be seriously
compromised by it. What will be the result? The ladies will own up to
their natural needs without shame and none of the men will take
exception to it. Let us return to the serious aspect of our problem. A
number of people who find life's conflicts too difficult to solve have
taken flight into neurosis and in this way won an unmistakable,
although in the end too costly, advantage through illness. What would
these people have to do if their flight into illness were barred by
the indiscreet revelations of psycho-analysis? They would have to be
honest, own up to the instincts that are at work in them, face the
conflict, fight for what they want or go without, and the tolerance
from the community which is bound to ensue as a result of
psycho-analytical knowledge would help them in their task.
Let us remember, however, that it is not for us to advance upon life
as fanatical hygienists or therapeutists. We must admit that this
ideal prevention of all neurotic illness would not be advantageous to
every individual. A good number of those who now take flight into
illness would not support the conflict under the conditions we have
assumed, but would {295} rapidly succumb or would commit some outrage
which would be worse than if they themselves fell ill of a
neurosis. The neuroses have in fact their biological function as
defensive measures and their social justification; the 'advantage
through illness' that they provide is not always a purely subjective
one. Is there one of you who has not at some time caught a glimpse
behind the scenes in the causation of a neurosis and had to allow that
it was the least of the evils possible in the circumstances? And
should one really require such sacrifices in order to exterminate the
neuroses, while the world is all the same full of other
inextinguishable miseries?
Should we therefore abandon our efforts to explain the hidden meaning
of neurotic manifestations, regarding it as dangerous to the
individual and harmful to the interests of society; should we give up
drawing the practical conclusion from a piece of scientific insight?
No; I think that nevertheless our duty lies in the other
direction. The 'advantage through illness' provided by the neuroses is
indeed on the whole and in the end detrimental to the individual as
well as to society. The distress that our work of revelation may cause
will but affect a few. The change to a more honest and honourable
attitude in the world in general will not be bought too dearly by
these sacrifices. But above all, all the energies which are to-day
consumed in the production of neurotic symptoms, to serve the purposes
of a world of phantasy out of touch with reality, will, even if they
cannot at once be put to uses in life, help to strengthen the outcry
for those changes in our civilization from which alone we can hope for
better things for our descendants.
I will let you go, therefore, with the assurance that you do your duty
in more than one sense by treating your patients psycho-analytically.
You are not merely working in the service of science, by using the
only and irreplaceable opportunity for discovering the secrets of the
neuroses; you are not only giving your {296} patients the most
efficacious remedy for their sufferings available at the present time
; but you are contributing your share to that enlightenment of the
many from which we expect to gain the authority of the community in
general and thus to achieve the most far-reaching prophylaxis against
neurotic disorders.
----------------------------------------------------------------------
XXVI {297}
OBSERVATIONS ON 'WILD' PSYCHO-ANALYSIS[113]
(1910)
A few days ago an elderly lady, under the protection of a female
friend, called upon me for a consultation, complaining of
anxiety-states. She was in the second half of the forties, fairly well
preserved, and had obviously not yet finished with her womanhood. A
divorce from her last husband had been the occasion exciting the
anxiety-states; but the anxiety had become greatly intensified,
according to her account, since she had consulted a young physician in
the suburb she lived in, for he had informed her that her sexual
desires were the cause of her anxiety. He said that she could not
tolerate the loss of intercourse with her husband, and so there were
only three ways by which she could recover her health---she must
either return to her husband, or take a lover, or satisfy
herself. Since then she had been convinced that she was incurable, for
she would not return to her husband, and the other two alternatives
were repugnant to her moral and religious feelings. She had come to
me, however, because the doctor had said that I was responsible for
this new opinion, and that she had only to come and ask me to confirm
what he said, and I should tell her that this and nothing else was the
truth. The friend who was with her, a still older, pinched and
unhealthy-looking woman, then implored me to assure the patient that
the doctor was mistaken. It could not possibly be true, for she
herself had been {298} a widow for many years, and had remained
respectable without suffering from anxiety.
I will not dwell on the awkward predicament in which I was placed by
this visit, but instead will consider the conduct of the practitioner
who sent this lady to me. First, however, it will be as well to adopt
a cautious attitude, which may possibly not be superfluous---indeed we
will hope so. Long experience has taught me---as it may others---not
to accept straight away as true what patients, especially nervous
patients, relate about their physician. A neurologist not only easily
becomes the object of many of the patient's hostile feelings, whatever
method of treatment he employs; he must also sometimes resign himself
to accepting responsibility, by a kind of projection, for the buried
repressed wishes of his nervous patients. That such accusations then
nowhere find more credence than among other physicians is a melancholy
but a significant circumstance.
I have some grounds, therefore, for hoping that this lady gave me a
tendenciously distorted account of what her physician had said, and
that I do a man who is unknown to me an injustice by connecting my
remarks about 'wild' psycho-analysis with this incident. But all the
same, by doing so I may perhaps prevent others from acting wrongly
towards their patients.
Let us suppose, therefore, that her medical practitioner spoke to the
patient exactly as she reported of him. Everyone will at once
vouchsafe the criticism that if a physician holds it necessary to
discuss the question of sexuality with a woman he must do so with tact
and consideration. Compliance with this demand, however, coincides
with carrying out certain of the _technical_ regulations of
psycho-analysis; moreover, the physician in question was ignorant of a
number of the _scientific_ principles of psycho-analysis or had
misapprehended them, and thus showed how little understanding of its
nature and purposes he had in fact acquired.
{299}
We will begin with the second of these, with his scientific
errors. His advice to the lady shows clearly in what sense he
understands the expression 'sexual life'---in the popular sense,
namely, in which by sexual needs nothing is meant but the need for
coitus or analogous acts producing orgasm and emission of sexual
secretions. The physician cannot have been unaware, however, that
psycho-analysis is commonly reproached with having extended the
connotation of the term 'sexual' far beyond its usual range. The fact
is undisputed; whether it may justly be used as a reproach shall not
be discussed here. In psycho-analysis the term 'sexuality' comprises
far more; it goes lower and also higher than the popular sense of the
word. This extension is justified genetically; we reckon as belonging
to 'sexual life' all expressions of tender feeling, which spring from
the source of primitive sexual feelings, even when those feelings have
become inhibited in regard to their original sexual aim or have
exchanged this aim for another which is no longer sexual. For this
reason we prefer to speak of _psycho-sexuality_, thus laying stress on
the point that the mental factor should not be overlooked or
underestimated. We use the word sexuality in the same comprehensive
sense as that in which the German language uses the word _lieben_ (to
love). And we have long known that a mental lack of satisfaction with
all its consequences can exist where there is no lack of normal sexual
intercourse; as therapeutists, too, we have constantly to remember
that the unsatisfied sexual trends (the substitutive satisfactions of
which in the form of nervous symptoms we have to combat) can often
find only very inadequate outlet in coitus or other sexual acts.
Anyone not sharing this psycho-analytical point of view has no right
to call to his aid psycho-analytical theories concerned with the
ætiological significance of sexuality. By emphasizing exclusively the
somatic factor in sexuality he certainly simplifies the problem {300}
greatly, but he alone must bear the responsibility for what he does.
A second and equally gross misunderstanding is discernible behind the
physician's advice.
It is true that psycho-analysis puts forward lack of sexual
satisfaction as the cause of nervous disorders. But does it not also
go much further than this? Is its teaching to be ignored as too
complicated when it declares that nervous symptoms arise from a
conflict between two forces---on the one hand, the libido (which is
for the most part excessive), and on the other, a too severe aversion
from sexuality or a repression? No one who remembers this second
factor, which is by no means secondary in importance, can ever believe
that sexual satisfaction in itself constitutes a remedy of general
reliability for the sufferings of neurotics. A good number of nervous
persons are, indeed, either in the actual circumstances or altogether
incapable of satisfaction. If they were capable of it, if they were
without their inner resistances, the strength of the instinct itself
would point the way to satisfaction for them even though no physician
recommended it. What is the good, therefore, of advice such as that
supposed to have been given to this lady by her physician?
Even if it could be justified scientifically, it is not advice that
she can carry out. If she had had no inner resistances against onanism
or against a liaison she would of course have adopted one of these
measures long before. Or does the physician think that a woman of over
forty has never heard of such a thing as taking a lover, or does he
overestimate his influence so much as to think that she could never
decide upon such a step without medical recommendation?
All this seems very simple, and yet it must be admitted that there is
one factor which often complicates the issue in forming a judgement.
Some nervous states which we call the _actual_ neuroses, such as
typical neurasthenia and pure forms of anxiety-neurosis, {301}
obviously depend on the physical factor in sexual life, and we have no
certain knowledge of the part played in them by the mental factor and
by repression. In such cases it is natural that the physician should
first consider some 'actual' therapy, some alteration in the physical
sexual way of life, and he does so with perfect justification if his
diagnosis is correct. The lady who consulted the young physician
complained chiefly of anxiety-states, and so he probably assumed that
she was suffering from an _anxiety-neurosis_, and felt justified in
recommending an actual therapy to her. Again a convenient
misapprehension! A person suffering from anxiety is not for that
reason necessarily suffering from anxiety-neurosis; a diagnosis of it
cannot be based on its name; one has to know what manifestations are
comprised in an anxiety-neurosis, and be able to distinguish it from
other pathological states in which anxiety appears. My impression was
that the lady in question was suffering from anxiety-hysteria, and the
whole value of such nosographical distinctions, one which quite
justifies them, lies in the fact that they indicate a different
ætiology and a different therapy. No one who took into consideration
the possibility of anxiety-hysteria in this case would have fallen
into the error of neglecting the mental factors, as this physician did
with his three alternatives.
Oddly enough, the three therapeutic alternatives of this would-be
psycho-analyst leave no room for---psycho-analysis! This woman can
only be cured of her anxiety by returning to her husband, or by
satisfying her needs by onanism or with a lover. And where does
analytic treatment come in, the treatment which we regard as the first
remedy in anxiety-states?
This brings us to the _technical_ errors to be remarked in the way
that, according to our assumption, this physician proceeded. The idea
that a neurotic is suffering from a sort of ignorance, and that if one
removes this ignorance by telling him facts (about the {302} causal
connection of his illness with his life, about his experiences in
childhood, and so on) he must recover, is an idea that has long been
superseded, and one derived from superficial appearances. The
pathological factor is not his ignorance in itself, but the root of
this ignorance in his _inner resistances_; it was they that first
called this ignorance into being, and they still maintain it now. In
combating these resistances lies the task of the therapy. Telling the
patient what he does not know because he has repressed it, is only one
of the necessary preliminaries in the therapy. If knowledge about his
unconscious were as important for the patient as the inexperienced in
psycho-analysis imagine, it would be sufficient to cure him for him to
go to lectures or read books. Such measures, however, have as little
effect on the symptoms of nervous disease as distributing menu-cards
in time of famine has on people's hunger. The analogy goes even
further than its obvious application, too; for describing his
unconscious to the patient is regularly followed by intensification of
the conflict in him and exacerbation of his symptoms.
Since, however, psycho-analysis cannot dispense with making this
disclosure to patients, it prescribes that two conditions are to be
fulfilled before it is done. First, by preparatory work, the repressed
material must have come very near to the patient's thoughts, and
secondly, he must be sufficiently firmly attached by an affective
relationship to the physician (transference) to make it impossible for
him to take fresh flight again.
Only when these two conditions are fulfilled is it possible to
recognize and to overcome the resistances which have led to the
repression and the ignorance. Psycho-analytic measures, therefore,
cannot possibly dispense with a fairly long period of contact with the
patient, and attempts to bully the patient during his first
consultation by brusquely telling him the hidden things one infers
behind his story are technically {303} reprehensible; they mostly lead
to their own doom, too, by inspiring a hearty dislike for the
physician in the patient and putting an end to any further influence.
Besides all this, one may sometimes make a false inference, and one is
never in a position to discover the whole truth. In psycho-analysis
these exact technical precautions take the place of a vague demand,
implying a peculiar talent, for 'medical tact'.
It is not enough, therefore, for a physician to know a little of what
psycho-analysis has discovered; he must also have familiarized himself
with its technique if he wishes his medical practice to be guided by a
psycho-analytic point of view. This technique is even to-day not to be
learnt from books, and it is certainly not to be discovered
independently without great sacrifices of time, labour and success. It
is to be learnt, like other medical measures, from those who are
already proficient in it. In forming a judgement on the incident that
I took as a starting-point for these remarks, therefore, it is a
matter of some significance that I do not know the physician who is
said to have given the lady such advice and have never before heard
his name.
Neither for myself nor for my friends and co-workers is it pleasant to
claim in this way a monopoly in the use of psycho-analytic technique.
But in face of the danger to patients and to the cause of
psycho-analysis which one foresees in this 'wild' psycho-analysis, we
have no other choice. In the spring of 1910 we founded an
International Psycho-Analytical Association, in which the members
admit their participation by allowing publication of their names, in
order to be able to repudiate responsibility for what is done by those
who do not belong to us and yet call their methods
'psycho-analysis'. For as a matter of fact 'wild' analysts of this
kind do more harm to the cause of psycho-analysis than to individual
patients. I have often found that a clumsy feat of a similar kind led
to good results in the end, although it first produced an {304}
exacerbation of the patient's condition. Not always, but still
often. When he has abused the physician enough and feels impervious
enough to any further influence of the kind, his symptoms give way, or
he decides to take some step leading to recovery. The final
improvement then 'comes of itself,' or is ascribed to some entirely
harmless treatment by another physician to whom the patient turned
afterwards. In the case of the lady whose complaint against her doctor
we have heard, I should say that, in spite of all, the wild
psycho-analyst did more for her than some highly respected authority
who might have told her she was suffering from a 'vasomotor
neurosis'. He did force her attention to the real cause of her
trouble, or in that direction, and in spite of all her struggles that
cannot be without some favourable results. But he has done himself
harm and helped to intensify the prejudices which patients feel, owing
to their natural resistances, against the ways of psycho-analysts. And
this can be avoided.
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XXVII {305}
THE EMPLOYMENT OF DREAM-INTERPRETATION
IN PSYCHO-ANALYSIS[114]
(1912)
The _Zentralblatt für Psychoanalyse_ was not designed solely to keep
its readers informed of the advances made in psycho-analytical
knowledge, and itself to publish lesser contributions to the subject;
but it aims also at presenting to the student a clear outline of what
is already known, so that by means of suitable directions the beginner
in analytical practice should be saved waste of time and effort.
Henceforward, therefore, articles of a didactic nature and a technical
content, not necessarily containing new matter, will appear in this
Journal.
The question with which I now intend to deal is not that of the
technique of dream-interpretation; neither the methods by which dreams
may be interpreted nor the use of such interpretations when made will
be considered, but merely the way in which the analyst should employ
the art of dream-interpretation in the psycho-analytic treatment of
patients. There are undoubtedly different ways of going to work in the
matter, but then the answer to questions of technique in analysis is
never a matter of course. Although there may perhaps be more than one
good road to follow, still there are very many bad ones, and a
comparison of the various methods can only be illuminating, even if it
should not lead to a decision in favour of any particular one.
{306}
Anyone coming from the study of dream-interpretation to analytic
practice will retain his interest in the content of dreams, and his
inclination will be to interpret as fully as possible every dream
related by the patient. But he will soon remark that he is now working
under very different conditions, and that in attempting to carry out
such an intention he will come into conflict with the most immediate
aims of the treatment. Even if a patient's first dream proves to be
admirably suited for the introduction of the first explanations to be
given, other dreams will straightway appear, so long and so obscure
that the full meaning cannot be extracted from them in the limited
hour of one day's work. If the physician pursues the work of
interpretation throughout the next few days, fresh dreams which have
been produced in the meantime will have to be put aside until he can
regard the first dream as finally resolved. The supply of dreams is at
times so copious, and the patient's progress towards comprehension of
them so slow, that a suspicion will force itself upon the analyst that
the appearance of the material in this form may be simply a
manifestation of the patient's resistance perceiving and taking
advantage of the inability of the method to master adequately what is
so presented. Moreover, the treatment will meanwhile have fallen some
way behind the present and quite lost touch with actuality. In
opposition to this method stands the rule that it is of the greatest
importance for the cure that the analyst should always be aware of
what is chiefly occupying the surface of the patient's mind at the
moment, that he should know just what complexes and resistances are
active and what conscious reaction to them will govern the patient's
behaviour. It is seldom if ever advisable to sacrifice this
therapeutic aim to an interest in dream-interpretation.
Then if we take account of this rule how are we to proceed with
interpreting dreams in analysis? More or less as follows: The
interpretation which can be {307} obtained in an hour should be taken
as sufficient and it is not to be counted a loss if the content of a
dream is not fully revealed. On the following day, the thread of the
dream is not to be taken up again as a matter of course, unless it is
first evident that nothing has happened meanwhile to come more into
the foreground of the patient's thoughts. Therefore no exception in
favour of uninterrupted dream-interpretation is to be made to the rule
that what first comes to the patient's mind is first to be dealt
with. If fresh dreams occur before the others are disposed of, they
must be attended to, and no uneasiness need be felt about neglecting
the others. If the dreams become altogether too diffuse and
voluminous, all hope of completely unravelling them should tacitly be
given up at the start. One must generally guard against displaying
special interest in the meaning of dreams, or arousing the idea that
the work would come to a standstill if no dreams were forthcoming;
otherwise there is a danger of resistance being directed against the
production of dreams and a risk of bringing about a cessation of
them. The patient must be brought to believe, on the contrary, that
material is always at hand for analysis, regardless of whether or no
he has dreams to report or what measure of attention is bestowed upon
them.
It will now be asked: If dreams are in practice only to be interpreted
in this restricted way, will not too much valuable material which
might throw light on the unconscious be lost? The answer to this is as
follows: The loss is by no means so great as might appear from a
superficial view of the matter. To begin with, the analyst should
recognize that in cases of severe neurosis any elaborate
dream-productions are to be regarded as, theoretically and in the
nature of the case, incapable of complete solution. A dream of this
kind is often based on the entire pathogenic material of the case, as
yet unknown to both analyst and patient (so-called descriptive and
biographical dreams, etc.), and is sometimes equivalent to a
translation into {308} dream-language of the whole content of the
neurosis. In the attempt to find the meaning of such a dream all the
latent, as yet untouched resistances will be roused to activity and
soon make it impossible to penetrate very far. The full interpretation
of such a dream will coincide with the completion of the whole
analysis; if a note is made of it at the beginning, it may be possible
to understand it at the end, after many months. In the same way as
with the elucidation of a single symptom (the main symptom, perhaps),
the explanation will depend upon the whole analysis, during which one
must endeavour to lay hold of first this, then that, fragment of its
meaning, one after another, until one can finally piece them all
together. Similarly, no more can be expected of a dream in the early
stages of the analysis; one must be content with bringing a single
pathogenic wish-motive to light in the attempt at interpretation.
Thus nothing that could have been attained is abandoned by
relinquishing the idea of a perfect dream-interpretation; neither is
anything lost, as a rule, by breaking off from one dream to another
more recent one. We have found from fine examples of fully analysed
dreams that the several successive scenes of one dream may contain the
same idea running through them all, perhaps with gathering
distinctness, and likewise we have learnt that several dreams
occurring on the same night are generally nothing more than attempts,
expressed in various forms, to represent one meaning. In general, we
can rest assured that every wish-impulse which creates a dream to-day
will re-appear in other dreams as long as it has not been understood
and withdrawn from the control of the unconscious. It often happens,
therefore, that the best way to complete the interpretation of a dream
is to dismiss it and to devote attention to a new dream, which may
contain the same material in perhaps a more accessible form. I know
that it is making a great demand, not only on the patient but also on
the {309} physician, to expect them both to put aside all thought of
the conscious aim of the treatment, and to abandon themselves to
promptings which, in spite of all, still seem to us so accidental. But
I can answer for it that one is rewarded every time that one resolves
to have faith in one's theoretical principles, and prevails upon
oneself not to compete with the guidance of the unconscious towards
the establishment of the connection.
I submit, therefore, that dream-interpretation should not be pursued
in analytic treatment as an art for its own sake, but that its use
should be subject to those technical rules that govern the conduct of
the analysis throughout. Naturally, one can at times adopt the other
course and give way a little to theoretical interest; but one should
always be well aware of what one is doing. Another situation to be
considered is that which has arisen since we have acquired more
confidence in our understanding of dream-symbolism, and in this way
know ourselves to be more independent of the patient's
associations. An unusually skilful interpreter will sometimes be able
to see through every dream a patient brings without requiring him to
go through the tedious and time-absorbing process of dissection. Such
an analyst does not experience these conflicts between the demands of
the cure and those of dream-interpretation. And then he will be
tempted to make full use every time of his interpretations, by telling
the patient all that he has seen in the dream. In so doing, however,
he will be conducting the analysis in a way which departs considerably
from the established method, as I shall point out in another
connection. Beginners in analytic practice, at any rate, are urged
against taking this exceptional case as a model.
Every analyst will be in the position of this supposed expert of ours
in regard to the first dreams that his patients bring on beginning the
treatment, before they have learnt anything of the process of
dream-interpretation. {310} These initial dreams are, so to speak,
naïve; they betray a great deal to the auditor, like the dreams of
so-called healthy people. The question then arises whether the analyst
is promptly to translate and communicate to the patient all that he
himself sees in them. However, this question will not be answered
here, for it obviously forms part of the wider question: at what stage
in the treatment and how rapidly should the analyst guide him to the
knowledge of that which lies veiled in the patient's mind? The more
the patient has learnt of the method of dream-interpretation the more
obscure do his later dreams become, as a rule. All the acquired
knowledge about dreams serves also as a warning to the dream-work.
In the 'scientific' works about dreams, which in spite of their
repudiation of dream-interpretation have received a new stimulus from
psycho-analysis, one repeatedly finds a very superfluous care
exercised about the accurate preservation of the text of the
dream. This is thought necessary in order to guard it against the
distortions and accretions supervening in the hours immediately after
waking. Even many psycho-analysts, in giving the patient instructions
to write down the dream immediately upon waking, seem not to rely
consistently enough upon their knowledge of the conditions of
dream-making. This direction is superfluous in the treatment; and the
patients are glad enough to make use of it to disturb their slumbers
and to display eager obedience where it cannot serve any useful
purpose. Even if the substance of a dream is in this way laboriously
rescued from oblivion, it is easy enough to convince oneself that
nothing has thereby been achieved for the patient. The associations
will not come to the text, and the result is the same as if the dream
had not been preserved. The physician certainly has acquired some
knowledge which he would not have done otherwise. But it is by no
means the same thing whether the analyst knows something or the
patient knows it; later on the {311} importance of this distinction in
the technique of psycho-analysis will be more fully considered.
In conclusion, I will mention a particular type of dream which, in the
nature of the case, occurs only in the course of psycho-analytic
treatment, and may bewilder or deceive beginners in practice. These
are the corroborating dreams which follow, as one may say, like
'hangers-on'; they are easily translated, and contain merely what has
been arrived at by analysis of the previous few days' material. It
looks as though the patient had had the amiability to reproduce for us
in dream-form exactly what we had been 'suggesting' to him immediately
beforehand in the treatment. The more experienced analyst will
certainly have some difficulty in attributing any such graciousness to
the patient; he accepts such dreams as hoped-for confirmations, and
recognizes that they are only to be observed under certain conditions
brought about under the influence of the treatment. The great majority
of the dreams forge ahead of the analysis, so that, after subtraction
of all that in them which is already known and understood, there still
remains a more or less clear indication of something hitherto deeply
hidden.
----------------------------------------------------------------------
XXVIII {312}
THE DYNAMICS OF THE TRANSFERENCE[115]
(1912)
The almost inexhaustible subject of 'transference' has recently been
dealt with in this Journal by W. Stekel in a descriptive manner.[116]
I wish to add a few remarks in order to make clear how it happens that
the transference inevitably arises during the analysis and comes to
play its well-known part in the treatment.
Let us bear clearly in mind that every human being has acquired, by
the combined operation of inherent disposition and of external
influences in childhood, a special individuality in the exercise of
his capacity to love---that is, in the conditions which he sets up for
loving, in the impulses he gratifies by it, and in the aims he sets
out to achieve in it.[117] This {313} forms a _cliché_ or stereotype
in him, so to speak (or even several), which perpetually repeats and
reproduces itself as life goes on, in so far as external circumstances
and the nature of the accessible love-objects permit, and is indeed
itself to some extent modifiable by later impressions. Now our
experience has shown that of these feelings which determine the
capacity to love only a part has undergone full psychical development;
this part is directed towards reality, and can be made use of by the
conscious personality, of which it forms part. The other part of these
libidinal impulses has been held up in development, withheld from the
conscious personality and from reality, and may either expend itself
only in phantasy, or may remain completely buried in the unconscious
so that the conscious personality is unaware of its
existence. Expectant libidinal impulses will inevitably be roused, in
anyone whose need for love is not being satisfactorily gratified in
reality, by each new person coming upon the scene, and it is more than
probable that both parts of the libido, the conscious and the
unconscious, will participate in this attitude.
It is therefore entirely normal and comprehensible that the
libido-cathexes, expectant and in readiness as they are in those who
have not adequate gratification, should be turned also towards the
person of the physician. As we should expect, this accumulation of
libido will be attached to prototypes, bound up with one of the
_clichés_ already established in the mind of the person concerned, or,
to put it in another way, the patient will weave the figure of the
physician into one of the 'series' already constructed in his mind. If
the physician should be specially connected in this way with the
father-imago (as Jung has happily named[118] it) it is quite in
accordance with his actual {314} relationship to the patient; but the
transference is not bound to this prototype; it can also proceed from
the mother- or brother-imago and so on. The peculiarity of the
transference to the physician lies in its excess, in both character
and degree, over what is rational and justifiable---a peculiarity
which becomes comprehensible when we consider that in this situation
the transference is effected not merely by the conscious ideas and
expectations of the patient, but also by those that are under
suppression, or unconscious.
Nothing more would need to be said or would perplex us concerning this
characteristic of the transference, if it were not that two points
which are of particular interest to psycho-analysts still remain
unexplained by it. First, it is not clear why neurotic subjects under
analysis develop the transference so much more intensely than those
who are not being analysed; and secondly, it remains a mystery why in
analysis the transference provides the _strongest resistance_ to the
cure, whereas in other forms of treatment we recognize it as the
vehicle of the healing process, the necessary condition for
success. Experience shows, and a test will always confirm it, that
when the patient's free associations fail[119] the obstacle can be
removed every time by an assurance that he is now possessed by a
thought which concerns the person of the physician or something
relating to him. No sooner is this explanation given than the obstacle
is removed, or at least the absence of thoughts has been transformed
into a refusal to speak.
It appears at the first glance to be an enormous disadvantage in
psycho-analysis as compared with other methods that in it the
transference, elsewhere such a powerful instrument for success, should
become here the most formidable ally of the resistance. On closer
consideration, however, the first of these difficulties at least will
disappear. It is not the fact that the {315} transference in
psycho-analysis develops more intensely and immoderately than outside
it. Institutions and homes for the treatment of nervous patients by
methods other than analysis provide instances of transference in its
most excessive and unworthy forms, extending even to complete
subjection, which also show its erotic character unmistakably. A
sensitive observer, Gabriele Reuter, depicted these facts at a time
when psycho-analysis hardly existed, in a remarkable book[120] which
altogether reveals great insight into the nature and causes of the
neuroses. This peculiarity of the transference is not, therefore, to
be placed to the account of psycho-analysis but is to be ascribed to
the neurosis itself. The second problem still remains unexplained.
This problem must now be tackled at close quarters: Why does the
transference in analysis confront us as resistance? Let us call to
mind the psychological situation in the treatment. One of the
invariable and indispensable preliminary conditions in _every_ case of
psychoneurosis is the process which Jung has aptly named
_introversion_ of the libido.[121] This means that the quantity of
libido which is capable of becoming conscious, and is directed towards
reality, has become diminished, while the part which is unconscious
and turned away from reality (and, although it may still nourish
phantasies in the person concerned, belongs to the unconscious) is by
so much increased. The libido (entirely or in part) has found its way
back into regression and has re-animated the infantile imagos[122];
{316} and thither we pursue it in the analytic treatment, aiming
always at unearthing it, making it accessible to consciousness and at
last serviceable to reality. Wherever in our analytic delving we come
upon one of the hiding-places of the withdrawn libido, there ensues a
battle; all the forces which have brought about the regression of the
libido will rise up as 'resistances' against our efforts in order to
maintain the new condition. For if the introversion or regression of
the libido had not been justified by some relation to the outer world
(in the broadest terms, by a frustration of some desired
gratification) and at the time been even expedient, it would never
have taken place at all. Yet the resistances which have this origin
are not the only ones, nor even the most powerful. The libido at the
disposal of the personality had always been exposed to the attraction
of unconscious complexes (strictly speaking, of that part of those
complexes which belongs to the unconscious), and underwent regression
because the attraction of reality had weakened. In order to free it,
this attraction of the unconscious must now be overcome; that is, the
repression of the unconscious impulses and their derivatives, which
has subsequently developed in the mind of the person concerned, must
be lifted. Here arises by far the greater part of the resistances,
which so often succeed in upholding the illness, even though the
original grounds for the recoil from reality have now
disappeared. From both these sources come the resistances with which
the analysis has to struggle. Every step of the treatment is
accompanied by resistance; every single thought, every mental act of
the patient's, must pay toll to the resistance, and represents a
compromise between the forces urging towards the cure and those
gathered to oppose it.
Now as we follow a pathogenic complex from its {317} representative in
consciousness (whether this be a conspicuous symptom or something
apparently quite harmless) back to its root in the unconscious, we
soon come to a place where the resistance makes itself felt so
strongly that it affects the next association, which has to appear as
a compromise between the demands of this resistance and those of the
work of exploration. Experience shows that this is where the
transference enters on the scene. When there is anything in the
complex-material (the content of the complex) which can at all
suitably be transferred on to the person of the physician such a
transference will be effected, and from it will arise the next
association; it will then manifest itself by the signs of
resistance---for instance, a cessation in the flow of associations. We
conclude from such experiences that this transferred idea is able to
force itself through to consciousness in preference to all other
possible associations, just _because_ it also satisfies
resistance. This type of incident is repeated innumerable times during
an analysis. Over and over again, when one draws near to a pathogenic
complex, that part of it which is first thrust forward into
consciousness will be some aspect of it which can be transferred;
having been so, it will then be defended with the utmost obstinacy by
the patient.[123]
Once this point is won, the elements of that complex which are still
unresolved cause little further difficulty. The longer the analysis
lasts, and the more clearly the patient has recognized that
distortions of the pathogenic material in themselves offer no
protection against disclosure, the more consistently he makes use of
that variety of distortion which obviously brings him the greatest
advantage, the distortion by transference. {318} These incidents all
converge towards a situation in which eventually all the conflicts
must be fought out on the field of transference.
Transference in analysis thus always seems at first to be only the
strongest weapon of the resistance, and we are entitled to draw the
inference that the intensity and duration of the transference are an
effect and expression of the resistance. The mechanism of transference
is indeed explained by the state of readiness in which the libido that
has remained accumulated about the infantile imagos exists, but the
part played by it in the process of cure is only intelligible in the
light of its relation to the resistance.
How does it come about that the transference is so pre-eminently
suitable as a weapon of resistance? One might think that this could
easily be answered. It is surely clear enough that it must become
peculiarly difficult to own up to any particular reprehended wish when
the confession must be made to the very person with whom that feeling
is most concerned. To proceed at all in such situations as this
necessity produces would appear hardly possible in real life. This
impossibility is precisely what the patient is aiming at when he
merges the physician with the object of his emotions. Yet on closer
consideration we see that this apparent gain cannot supply the answer
to the riddle, for, on the contrary, an attitude of affectionate and
devoted attachment can surmount any difficulty in confession; in
analogous situations in real life we say: 'I don't feel ashamed with
you; I can tell you everything'. The transference to the physician
might quite as well relieve the difficulties of confession, and we
still do not understand why it aggravates them.
The answer to this reiterated problem will not be found by pondering
it any further, but must be sought in the experience gained by
examination of individual instances of transference-resistance
occurring in the course of an analysis. From these one perceives
eventually that the use of the transference for resistance {319}
cannot be understood so long as one thinks simply of
'transference'. One is forced to distinguish 'positive' transference
from 'negative' transference, the transference of affectionate feeling
from that of hostile feeling, and to deal separately with the two
varieties of the transference to the physician. Positive transference
can then be divided further into such friendly or affectionate
feelings as are capable of becoming conscious and the extensions of
these in the unconscious. Of these last, analysis shows that they
invariably rest ultimately on an erotic basis; so that we have to
conclude that all the feelings of sympathy, friendship, trust and so
forth which we expend in life are genetically connected with sexuality
and have developed out of purely sexual desires by an enfeebling of
their sexual aim, however pure and non-sensual they may appear in the
forms they take on to our conscious self-perception. To begin with we
knew none but sexual objects; psycho-analysis shows us that those
persons whom in real life we merely respect or are fond of may be
sexual objects to us in our unconscious minds still.
So the answer to the riddle is this, that the transference to the
physician is only suited for resistance in so far as it consists in
_negative_ feeling or in the repressed _erotic_ elements of positive
feeling. As we 'raise' the transference by making it conscious we
detach only these two components of the emotional relationship from
the person of the physician; the conscious and unobjectionable
component of it remains, and brings about the successful result in
psycho-analysis as in all other remedial methods. In so far we readily
admit that the results of psycho-analysis rest upon a basis of
suggestion; only by suggestion we must be understood to mean that
which we, with Ferenczi,[124] find that it consists of---influence on
a person through and by means of the transference-manifestations of
which he is capable. The eventual independence of the patient is our
ultimate object when we use suggestion to bring {320} him to carry out
a mental operation that will necessarily result in a lasting
improvement in his mental condition.
The next question is, Why do these manifestations of
transference-resistance appear only in psycho-analysis and not in
other forms of treatment, in institutions, for example? The answer is
that they do appear there also, but they need to be recognized for
what they are. The outbreak of negative transference is a very common
occurrence in institutions; as soon as he is seized by it the patient
leaves, uncured or worse. The erotic transference has not such an
inhibitory effect in institutions, since there, as otherwise in life,
it is decorously glossed over, instead of being exposed; nevertheless,
it betrays itself unequivocally as resistance to the cure, not,
indeed, by driving the patient out of the place---on the contrary, it
binds him to the spot---but just as certainly by keeping him away from
real life. Actually it is quite unimportant for his cure whether or
not the patient can overcome this or that anxiety or inhibition in the
institution; what is of importance, on the contrary, is whether or not
he will be free from them in real life.
The negative transference requires a more thorough elucidation than is
possible within the limits of this paper. It is found in the curable
forms of the psychoneuroses alongside the affectionate transference,
often both directed on to the same person at the same time, a
condition for which Bleuler has coined the useful term
ambivalence.[125] This ambivalence of the feelings appears to be
normal up to a point, but a high degree of it is certainly a special
peculiarity of neurotics. In the obsessional neurosis an early
'splitting of the pairs of opposites' seems to characterize the
instinctual life and to form one of the constitutional conditions of
{321} this disease. The ability of neurotics to make the transference
a form of resistance is most easily accounted for by ambivalence in
the flow of feelings. Where the capacity to transfer feeling has come
to be of an essentially negative order, as with paranoids, the
possibility of influence or cure ceases.
After all this investigation we have so far considered one aspect only
of transference-phenomena; some attention must be given to another
side of this question. Those who have formed a true impression of the
effect of an extreme transference-resistance on the patient, of the
way in which as soon as he comes under its influence he is hurled out
of all reality in his relation to the physician---how he then
arrogates to himself freedom to ignore the psycho-analytic rule (to
communicate without reserve whatever goes through his mind), how all
the resolutions with which he entered upon the analysis then become
obliterated, and how the logical connections and conclusions which
just before had impressed him deeply then become matters of
indifference to him---will need some further explanation than that
supplied by the factors mentioned above to account for this effect,
and these other factors are, indeed, not far to seek; they lie again
in the psychological situation in which the analysis has placed the
patient.
In following up the libido that is withdrawn from consciousness we
penetrate into the region of the unconscious, and this provokes
reactions which bring with them to light many of the characteristics
of unconscious processes as we have learnt to know them from the study
of dreams. The unconscious feelings strive to avoid the recognition
which the cure demands; they seek instead for reproduction, with all
the power of hallucination and the inappreciation of time
characteristic of the unconscious. The patient ascribes, just as in
dreams, currency and reality to what results from the awakening of his
unconscious feelings; he seeks to discharge his emotions, regardless
of the reality {322} of the situation. The physician requires of him
that he shall fit these emotions into their place in the treatment and
in his life-history, subject them to rational consideration, and
appraise them at their true psychical value. This struggle between
physician and patient, between intellect and the forces of instinct,
between recognition and the striving for discharge, is fought out
almost entirely over the transference-manifestations. This is the
ground on which the victory must be won, the final expression of which
is lasting recovery from the neurosis. It is undeniable that the
subjugation of the transference-manifestations provides the greatest
difficulties for the psycho-analyst; but it must not be forgotten that
they, and they only, render the invaluable service of making the
patient's buried and forgotten love-emotions actual and manifest; for
in the last resort no one can be slain _in absentia_ or _in effigie_.
----------------------------------------------------------------------
XXIX {323}
RECOMMENDATIONS FOR PHYSICIANS ON
THE PSYCHO-ANALYTIC METHOD OF
TREATMENT[126]
(1912)
The technical rules which I bring forward here have been evolved out
of my own experience in the course of many years, after I had
renounced other methods which had cost me dear. It will easily be seen
that they may be summed up, or at least many of them, in one single
injunction. My hope is that compliance with them will spare physicians
practising analysis much unavailing effort and warn them of various
possibilities which they might otherwise overlook. I must, however,
expressly state that this technique has proved to be the only method
suited to my individuality; I do not venture to deny that a physician
quite differently constituted might feel impelled to adopt a different
attitude to his patients and to the task before him.
(_a_) To the analyst who is treating more than one patient in the day,
the first necessity with which he is faced will seem the hardest. It
is, of course, that of keeping in mind all the innumerable names,
dates, detailed reminiscences, associations, and effects of the
disease which each patient communicates during the treatment in the
course of months or years, and not confounding them with similar
material proceeding from other patients treated simultaneously or
previously. When one is required to analyse six, eight, or even more
patients daily, the effort of memory {324} necessary to achieve this
evokes incredulity, astonishment, or even pity in the
uninformed. Curiosity is inevitably aroused about the technique which
makes it possible to deal with such abundance of material, and the
expectation is that some special means are required for the purpose.
The technique, however, is a very simple one. It disclaims the use of
any special aids, even of note-taking, as we shall see, and simply
consists in making no effort to concentrate the attention on anything
in particular, and in maintaining in regard to all that one hears the
same measure of calm, quiet attentiveness---of 'evenly-hovering
attention', as I once before described it. In this way a strain which
could not be kept up for several hours daily and a danger inseparable
from deliberate attentiveness are avoided. For as soon as attention is
deliberately concentrated in a certain degree, one begins to select
from the material before one; one point will be fixed in the mind with
particular clearness and some other consequently disregarded, and in
this selection one's expectations or one's inclinations will be
followed. This is just what must not be done, however; if one's
expectations are followed in this selection there is the danger of
never finding anything but what is already known, and if one follows
one's inclinations anything which is to be perceived will most
certainly be falsified. It must not be forgotten that the meaning of
the things one hears is, at all events for the most part, only
recognizable later on.
It will be seen, therefore, that the principle of evenly-distributed
attention is the necessary corollary to the demand on the patient to
communicate everything that occurs to him without criticism or
selection. If the physician behaves otherwise he is throwing aside
most of the advantage to be gained by the patient's obedience to the
'fundamental rule of psycho-analysis'. For the physician the rule may
be expressed thus: All conscious exertion is to be withheld from the
capacity for attention, and one's 'unconscious {325} memory' is to be
given full play; or to express it in terms of technique, pure and
simple: One has simply to listen and not to trouble to keep in mind
anything in particular.
What one achieves in this way will be sufficient for all requirements
during the treatment. Those elements of the material which have a
connection with one another will be at the conscious disposal of the
physician; the rest, as yet unconnected, chaotic and
indistinguishable, seems at first to disappear, but rises readily into
recollection as soon as the patient brings something further to which
it is related, and by which it can be developed. The undeserved
compliment of a 'remarkably good memory' which the patient pays when
one reproduces some detail after a year and a day is then accepted
with a smile, whereas a conscious effort to retain a recollection of
the point would probably have resulted in nothing.
Mistakes in recollection occur only at times and in places where some
personal consideration has intervened (see below); that is, where
there is a notable failure to reach the ideal set up for the analyst.
Confusion with the communications of other patients arises very
rarely. In a disagreement with the patient whether he said some
particular thing, or how he said it, the physician is usually
right.[127]
(_b_) I do not recommend that during the sitting, in the patient's
presence, full notes should be made or a shorthand record kept, and so
on. Apart from the unfavourable impression which this makes on many
patients, the same considerations as have been advanced in regard to
attention also apply here. A prejudicial selection will of necessity
be made in taking down {326} notes or shorthand, and part of one's own
mental activity is occupied in this way which would be better employed
in interpreting what one hears. Exceptions may be made to this rule
without reproach in the case of dates, the text of dreams, or single
incidents of a noteworthy kind which can easily be detached from their
context to serve an independent purpose as examples. I am not in the
habit of doing this either, however. I write down examples from memory
in the evening after work is over; the text of a dream in which I find
something useful I ask the patient to write down for me after he has
related it.
(_c_) Note-taking during the sitting with the patient might be
supported on the ground of an intention to publish a scientific study
of the case. In theory this can hardly be denied. But in practice it
must not be forgotten that exact reports of an analytic history of a
case are less valuable than might be expected. Strictly speaking, they
only convey that appearance of exactness which 'modern' psychiatry
presents in many conspicuous instances. They are wearisome to the
reader as a rule, and yet they do not go far enough as a substitute
for actual presence at the analysis. Altogether, experience shows that
a reader who is willing to believe an analyst at all will give him
credit for the touch of revision to which he has subjected his
material; but if the reader is unwilling to take analysis or the
analyst seriously, the most faithful shorthand reports of the
treatment of cases will not influence him. This does not seem to be
the way to make up for the deficiency in evidence found in
psycho-analytical descriptions of cases.
(_d_) It is indeed one of the distinctions of psycho-analysis that
research and treatment proceed hand in hand, but still the technique
required for the one begins at a certain point to diverge from that of
the other. It is not a good thing to formulate a case scientifically
while treatment is proceeding, to reconstruct its development,
anticipate its progress, and take notes {327} from time to time of the
condition at the moment, as scientific interests would require. Cases
which are thus destined at the start to scientific purposes and
treated accordingly suffer in consequence; while the most successful
cases are those in which one proceeds, as it were, aimlessly, and
allows oneself to be overtaken by any surprises, always presenting to
them an open mind, free from any expectations. To swing over as
required from one mental attitude to another, to avoid speculation or
brooding over cases while the analysis proceeds, and to submit the
material gained to the synthetic process only after the analysis is
concluded, is the right course for the analyst. The distinction here
drawn between the two different attitudes would have no significance
if we already possessed all the knowledge (or even the essential
knowledge) about the unconscious and the structure of the neuroses
which is obtained by means of the analytic work. At the present time
we are still far from this goal and must not cut ourselves off from
the means by which we can test what we already know and learn more.
(_e_) I cannot recommend my colleagues emphatically enough to take as
a model in psycho-analytic treatment the surgeon who puts aside all
his own feelings, including that of human sympathy, and concentrates
his mind on one single purpose, that of performing the operation as
skilfully as possible. Under present conditions the affective impulse
of greatest danger to the psycho-analyst will be the therapeutic
ambition to achieve by this novel and disputed method something which
will impress and convince others. This will not only cause a state of
mind unfavourable for the work in him personally, but he will find
himself in consequence helpless against certain of the patient's
resistances, upon the struggle with which the cure primarily
depends. The justification for this coldness in feeling in the analyst
is that it is the condition which brings the greatest advantage to
both persons involved, ensuring a needful protection for the
physician's {328} emotional life and the greatest measure of aid for
the patient that is possible at the present time. An old surgeon once
took for his motto the words: _Je le pansai_, _Dieu le guérit_. The
analyst should content himself with a similar thought.
(_f_) All these rules which I have brought forward coincide at one
point which is easily discernible. They all aim at creating for the
physician a complement to the 'fundamental rule of psycho-analysis'
for the patient. Just as the patient must relate all that
self-observation can detect, and must restrain all the logical and
affective objections which would urge him to select, so the physician
must put himself in a position to use all that is told him for the
purposes of interpretation and recognition of what is hidden in the
unconscious, without substituting a censorship of his own for the
selection which the patient forgoes. Expressed in a formula, he must
bend his own unconscious like a receptive organ towards the emerging
unconscious of the patient, be as the receiver of the telephone to the
disc. As the receiver transmutes the electric vibrations induced by
the sound-waves back again into sound-waves, so is the physician's
unconscious mind able to reconstruct the patient's unconscious, which
has directed his associations, from the communications derived from
it.
But if the physician is to be able to use his own unconscious in this
way as an instrument in the analysis, he must himself fulfil one
psychological condition in a high degree. He may tolerate no
resistances in himself which withhold from his consciousness what is
perceived by his unconscious, otherwise he would introduce into the
analysis a new form of selection and distortion which would be far
more injurious than that resulting from the concentration of conscious
attention. It does not suffice for this that the physician should be
of approximate normality himself; it is a justifiable requisition that
he should further submit himself to a psycho-analytic purification and
become {329} aware of those complexes in himself which would be apt to
affect his comprehension of the patient's disclosures. There can be no
reasonable doubt about the disqualifying effect of such personal
defects; every unresolved repression in the physician constitutes what
W. Stekel has well named a 'blind spot' in his capacity for analytic
perception.
Years ago I replied to the question how one becomes an analyst with
the answer: By the analysis of one's own dreams. This training
certainly suffices for many people, but not for all those who wish to
learn to analyse. Moreover, not everyone is able to interpret his own
dreams without the help of another. I count it one of the valuable
services of the Zürich school of analysis that they have emphasized
this necessity and laid it down as a requisition that anyone who
wishes to practise analysis of others should first submit to be
analysed himself by a competent person. Anyone taking up the work
seriously should choose this course, which offers more than one
advantage; the sacrifice involved in laying oneself bare to a stranger
without the necessity incurred by illness is amply rewarded. Not only
is the purpose of learning to know what is hidden in one's own mind
far more quickly attained and with less expense of affect, but
impressions and convictions are received in one's own person which may
be sought in vain by studying books and attending lectures. In
addition, the gain resulting from the lasting personal relationship
which usually springs up between the learner and his guide is not to
be estimated lightly.
Such analysis of a person who is for all practical purposes healthy
will naturally remain uncompleted. Whoever knows how to appreciate the
high value of the self-knowledge and increase in self-control so
acquired will afterwards continue the analytic examination of his own
personality by a self-analysis, and willingly recognize that, in
himself as in others, he must always expect to find something
new. That analyst, however, who has despised the provision of analysis
for {330} himself will be penalized, not merely by an incapacity to
learn more than a certain amount from his patient, but by risking a
more serious danger, one which may become a danger for others. He will
easily yield to the temptation of projecting as a scientific theory of
general applicability some of the peculiarities of his own personality
which he has dimly perceived; he will bring the psycho-analytic method
into discredit, and lead the inexperienced astray.
(_g_) I will now add a few other rules which will make a transition
from the attitude of the physician to the treatment of the patient.
The young and eager psycho-analyst will certainly be tempted to bring
his own individuality freely into the discussion, in order to draw out
the patient and help him over the confines of his narrow personality.
One would expect it to be entirely permissible, and even desirable,
for the overcoming of the patient's resistances, that the physician
should afford him a glimpse into his own mental defects and conflicts
and lead him to form comparisons by making intimate disclosures from
his own life. One confidence repays another, and anyone demanding
intimate revelations from another must be prepared to make them
himself.
But the psycho-analytic relationship is a thing apart; much of it
takes a different course from that which the psychology of
consciousness would lead us to expect. Experience does not bear
witness to the excellence of an affective technique of this
kind. Further, it is not difficult to see that it involves a departure
from psycho-analytic principles and verges upon treatment by
suggestion. It will induce the patient to bring forward sooner and
with less difficulty what he already knows and would otherwise have
kept back for a time on account of conventional objections. But this
technique achieves nothing towards the discovery of the patient's
unconscious; it makes him less able than ever to overcome the deeper
resistances, and in the more severe cases it invariably fails on {331}
account of the insatiability it rouses in the patient, who then tries
to reverse the situation, finding the analysis of the physician more
interesting than his own. The loosening of the transference, too---one
of the main tasks of the cure---is made more difficult by too intimate
an attitude on the part of the doctor, so that a doubtful gain in the
beginning is more than cancelled in the end. Therefore I do not
hesitate to condemn this kind of technique as incorrect. The physician
should be impenetrable to the patient, and, like a mirror, reflect
nothing but what is shown to him. In practice, it is true, one cannot
object to a psychotherapeutist combining a certain amount of analysis
with some suggestive treatment in order to achieve a perceptible
result in a shorter time---as is necessary, for instance, in
institutions; but one may demand that he himself should be in no doubt
about what he is doing and should know that his method is not that of
true psycho-analysis.
(_h_) Another temptation arises out of the educative function which in
a psycho-analytic treatment falls to the physician without any special
intention on his part. As the inhibitions in development are undone it
inevitably happens that the physician finds himself in a position to
point out new aims for the impulses which have been set free. It is
but a natural ambition for him then to endeavour to make something
specially excellent out of the person whose neurosis has cost so much
labour, and to set up high aims for these impulses. But here again the
physician should restrain himself and take the patient's capacities
rather than his own wishes as his standard. Talent for a high degree
of sublimation is not found in all neurotics; of many of them one can
believe that they would never have fallen ill had they possessed the
art of sublimating their impulses. In pressing them unduly towards
sublimation, and cutting them off from the easier and simpler
gratifications, life may often be made even harder for them than they
feel it otherwise. A physician must always {332} be tolerant of a
patient's weakness, and must be content to win back a part of the
capacity for work and enjoyment even for a person of but moderate
worth. Ambitiousness in the educative direction is as undesirable as
in the therapeutic. Moreover, it must not be forgotten that many
people succumb to illness in the very effort towards sublimation
beyond the limit of their capacity, and that in those who are capable
of it the process usually takes place from within as soon as their
inhibitions have been removed by the analysis. In my opinion,
therefore, efforts to bring about sublimations of the impulses in the
course of psycho-analytic treatment are no doubt always praiseworthy
but most certainly not in all cases advisable.
(_i_) To what extent should the intellectual co-operation of the
patient be called for in the treatment? It is difficult to say
anything of general applicability on this point; the personality of
the patient is here the principal deciding factor. In any case caution
and self-restraint are to be observed in this matter. It is incorrect
to set the patient tasks, such as collecting his memories, thinking
over a certain period of his life, and so on. On the contrary, the
patient has above all to learn, what never comes easily to anyone,
that such mental activities as thinking over a matter, or
concentrating the will and attention, avail nothing in solving the
riddles of the neurosis; but that this can only be done by patiently
adhering to the psycho-analytic rule demanding the exclusion of all
criticism of the unconscious or of its derivatives. One must
especially insist upon the following of the rule most rigidly with
those patients whose habitual manoeuvre it is to shirk analysis by
sheering off into the intellectual, and who speculate much and often
with great wisdom over their condition, thereby sparing themselves
from taking steps to overcome it. For this reason I dislike resorting
to analytical writings as an aid to patients; I require them to learn
by personal experience, and I assure them that in this way they will
acquire wider {333} and more valuable knowledge than the whole
literature of psycho-analysis could afford them. I recognize, however,
that under the conditions of institution treatment it may be very
advantageous to employ reading as a preparation for patients in
analysis and as a means of creating an atmosphere favourable to
influence.
The most urgent warning I have to express is against any attempt to
engage the confidence or support of parents or relatives by giving
them psycho-analytical books to read---either of an introductory or of
an advanced kind. This well-meant step usually has the effect of
evoking prematurely the natural and inevitable opposition of the
relatives to the treatment, which in consequence is never even begun.
I will here express the hope that advances in the experience of
psycho-analysts will soon lead to agreement upon the most expedient
technique for the treatment of neurotic persons. As for treatment of
the 'relatives', I must confess myself utterly at a loss, and I have
altogether little faith in any individual treatment of them.
----------------------------------------------------------------------
XXX {334}
FAUSSE RECONNAISSANCE ('DÉJÀ RACONTÉ')
IN PSYCHO-ANALYTIC TREATMENT[128]
(1913)
It not infrequently happens in the course of an analytic treatment
that the patient, after reporting some fact that he has remembered,
will go on to say: '_But I've told you that already_'---while the
analyst himself feels sure that this is the first time he has heard
the story. If the patient is contradicted upon the point, he will
often protest with energy that he is perfectly certain he is right,
that he is ready to swear to it, and so on; while the analyst's own
conviction that what he has heard is new to him will become
correspondingly stronger. To try to decide the dispute by shouting the
patient down or by outvying him in protestations would be a most
unpsychological proceeding. It is familiar ground that a sense of
conviction of the accuracy of one's memory has no objective value;
and, since one of the two persons concerned must necessarily be in the
wrong, it may just as well be the physician as the patient who has
fallen a victim to a paramnesia. The analyst will admit as much to the
patient, will break off the argument, and will postpone a settlement
of the point until some later occasion.
In a minority of cases the analyst himself will then recollect that he
has already heard the piece of information under dispute, and will at
the same time discover the subjective, and often far-fetched, reason
which led to this temporary forgetfulness. But in the great {335}
majority of cases it is the patient who turns out to have been
mistaken; and he can be brought to recognize the fact. The
explanation of this frequent occurrence appears to be that the patient
really did on some previous occasion have the intention of giving this
information, that once or even several times he actually made some
remark leading up to it, but that he was then prevented by resistance
from carrying out his purpose, and afterwards confounded a
recollection of his intention with a recollection of its performance.
Leaving on one side any cases in which there may still be some element
of doubt, I will now bring forward a few others which are of special
theoretical interest. With certain people it happens, and may even
happen repeatedly, that they cling with particular obstinacy to the
assertion that they have already told the analyst this or that, when
the nature of the circumstances and of the information in question
makes it quite impossible that they can be right. For what they claim
to have told already once before and what they claim to recognize as
something old, which must also be familiar to the physician, turn out
to be memories of the greatest importance to the
analysis---confirmatory facts for which the analyst has long been
waiting, or solutions which wind up a whole section of the work and
which he would certainly have made the basis of an exhaustive
discussion. In the face of these considerations the patient himself
soon admits that his recollection must have deceived him, though he is
unable to account for its definite character.
The phenomenon presented by the patient in cases like this deserves to
be called a '_fausse reconnaissance_', and is completely analogous to
what occurs in certain other cases and has been described as a '_déjà
vu_'. In these other cases the subject has a spontaneous feeling such
as 'I've been in this situation before', or 'I've been through all
this already', without ever being in a position to confirm his
conviction by discovering an actual recollection of the previous
occasion. {336} This latter phenomenon, as is well known, has
provoked a large number of attempts at explanation, which can be
divided roughly into two groups.[129] One class of explanation looks
upon the feeling which constitutes the phenomenon as deserving of
credence, and assumes that something really has been remembered---the
only question being what. The second and far larger class of
explanation includes those which maintain, on the contrary, that what
we have to deal with is an illusory memory, and that the problem is to
discover how this paramnestic error can have arisen. This latter group
comprises many widely different hypotheses. There is, for instance,
the ancient view, ascribed to Pythagoras, that the phenomenon of the
_déjà vu_ is evidence of the individual having had a former life;
again, there is the hypothesis based upon anatomy (put forward by
Wigan in 1860) to the effect that the phenomenon is based upon an
absence of simultaneity in the functioning of the two cerebral
hemispheres; and finally there are the purely psychological theories,
supported by the majority of more recent authorities, which regard the
_déjà vu_ as an indication of an apperceptive weakness, and assign the
responsibility for its occurrence to such causes as fatigue,
exhaustion and distraction.
In 1904 Grasset[130] put forward an explanation of the _déjà vu_ which
must be reckoned as one of the group which 'believes' in the
phenomenon. He was of opinion that the phenomenon indicates that at
some earlier time there has been an _unconscious_ perception, which
only now makes its way into consciousness under the influence of a new
and similar impression. Several other authorities have agreed with
this view, and have maintained that the basis of the phenomenon is the
recollection of something that has been dreamed and then forgotten. In
both cases it would {337} be a question of the activation of an
unconscious impression.
In 1907, in the second edition of my _Psychopathologie des
Alltagslebens_, I proposed an exactly similar explanation for this
form of apparent paramnesia without mentioning Grasset's paper or
knowing of its existence. By way of excuse I may remark that I arrived
at my conclusion as the result of a psycho-analytic investigation
which I was able to make of an example of _déjà vu_ in a female
patient; it was extremely clear, though it had occurred twenty-eight
years earlier. I shall not reproduce the little analysis in this
place. It showed that the situation in which the _déjà vu_ occurred
was really calculated to revive the memory of an earlier experience of
the patient's. The patient, who was at that time a twelve-year-old
child, was visiting a family in which there was a brother who was
seriously ill and at the point of death; while her own brother had
been in a similarly dangerous condition a few months earlier. But with
the earlier of these two similar events there had been associated a
phantasy that was incapable of entering consciousness---namely, a wish
that her brother should die. Consequently, the analogy between the
two cases could not become conscious. And the perception of it was
replaced by the phenomenon of 'having been through it all before', the
identity being displaced from the really common element on to the
locality.
The name '_déjà vu_' is, as we know, applied to a whole class of
analogous phenomena, such as the '_déjà entendu_', the '_déjà
éprouvé_' and the '_déjà senti_'. The case which I am now about to
report, as a single instance out of many similar ones, consists of a
'_déjà raconté_'; and it could be traced back to an unconscious
resolution which was never carried out.
A patient[131] said to me in the course of his associations: {338}
'When I was playing in the garden with a knife (that was when I was
five years old) and cut through my little finger---oh, I only
_thought_ it was cut through---but I've told you about that already'.
I assured him that I had no recollection of anything of the kind. He
insisted with increasing conviction that it was impossible he could be
mistaken. I finally put an end to the argument in the manner I have
described above and asked him in any case to repeat the story. Then we
should see where we were.
'When I was five years old, I was playing in the garden near my nurse,
and was carving with my pocket-knife in the bark of one of the
walnut-trees that also come into my dream.[132] Suddenly, to my
unspeakable terror, I noticed that I had cut through the little finger
of my (right or left?) hand, so that it was only hanging on by its
skin. I felt no pain, but great fear. I did not venture to say
anything to my nurse, who was only a few paces distant, but I sank
down on the nearest seat and sat there incapable of casting another
glance at my finger. At last I grew calm, took a look at the finger,
and saw that it was entirely uninjured.'
We soon agreed that, in spite of what he had thought, he could not
have told me the story of this vision or hallucination before. He was
very well aware that I could not have failed to exploit such evidence
as this of his having had a _fear of castration_ at the age of
five. The episode broke down his resistance against assuming the
existence of a castration complex; but he raised the question: 'Why
did I feel so certain of having told you this recollection before?'
It then occurred to both of us that repeatedly and {339} in various
connections he had brought out the following trivial recollection, and
each time without our deriving any profit from it:
'Once when my uncle went away on a journey he asked me and my sister
what we should like him to bring us back. My sister asked for a book,
and I asked for a pocket-knife.' We now understood that this
association which had emerged months before had in reality been a
screen-memory for the repressed recollection, and had been an attempt
(rendered abortive by the resistance) at telling the story of his
imagined loss of his little finger---an unmistakable
penis-equivalent. The knife which his uncle did in fact bring him back
was, as he clearly remembered, the same one that made its appearance
in the episode which had been suppressed for so long.
It seems unnecessary to add anything in the way of an interpretation
of this little occurrence, so far as it throws light upon the
phenomenon of '_fausse reconnaissance_'. As regards the subject-matter
of the patient's vision, I may remark that, particularly in relation
to the castration complex, similar hallucinatory falsifications are of
not infrequent occurrence, and that they can just as easily serve the
purpose of correcting unwelcome perceptions.
The following notes upon their author's childhood were put at my
disposal in 1911. The writer, with whom I am unacquainted and whose
age is unknown to me, is a man of university education residing in a
university town in Germany:
'In the course of reading your _Kindheitserinnerung des Leonardo da
Vinci_, I was moved to internal dissent by the observations contained
upon pages 29 to 31. Your assertion that male children are dominated
by an interest in their own genitals provoked me to make a
counter-assertion to the effect that "if that is the general rule, I
at all events am an exception to it". I then went on to read the
passage that follows (page 31 to the top of page 32) with the utmost
amazement, such {340} amazement as one feels when one comes across a
fact of an entirely novel character. In the midst of my amazement a
recollection occurred to me which showed me, to my own surprise, that
the fact could not be by any means so novel as it had seemed. For, at
the time at which I was passing through the period of "infantile
sexual inquiry", a lucky chance gave me the opportunity of inspecting
the female genitals in a little girl of my own age, and in doing so _I
quite clearly observed a penis of the same kind as my own_. Soon
afterwards I was plunged into fresh confusion by the sight of some
female statues and nudes; and in order to get over this "scientific"
discrepancy I devised the following experiment. By pressing my thighs
together I succeeded in making my genitals disappear between them; and
I was glad to find that in that way all differences between my own
appearance and that of a female nude could be got rid of. Evidently, I
thought to myself, the genitals have been made to disappear in a
similar way in female nudes.
'At this point another recollection occurred to me, which has always
been of the greatest importance to me, in so far as it is _one_ of the
three recollections which constitute all that I can remember of my
mother, who died when I was very young. My mother is standing in front
of the wash-hand-stand and cleaning the glasses and washing-basin,
while I am playing in the same room and committing some
misdemeanour. As a punishment my hand is soundly slapped. Then to my
very great terror I see that my little finger is falling off; and in
fact it falls into the pail. Knowing that my mother is angry, I do not
venture to say anything; but my terror grows still more intense when I
see the pail carried off soon afterwards by the servant-maid. For a
long time I was convinced that I had lost a finger---up to the time, I
believe, at which I learnt to count.
'I have often tried to interpret this recollection, which, as I have
already mentioned, has always been of the greatest importance to me on
account of its {341} connection with my mother; but
none of my interpretations has satisfied me. It is only now, after
reading your book, that I begin to have a suspicion of a simple and
satisfying answer to the conundrum.'
There is another kind of _fausse reconnaissance_ which not
infrequently makes its appearance at the close of a treatment, much to
the physician's satisfaction. After he has succeeded in forcing the
repressed event (whether it was of a real or of a psychical nature)
upon the patient's acceptance in the teeth of all resistances, and has
succeeded, as it were, in rehabilitating it---the patient may say:
'_Now I feel as though I had known it all the time_'. With this the
problem of the analysis has been solved.
----------------------------------------------------------------------
XXXI {342}
FURTHER RECOMMENDATIONS IN THE
TECHNIQUE OF PSYCHO-ANALYSIS[133]
*On Beginning the Treatment. The Question of
the First Communications. The Dynamics of
the Cure.*
(1913)
He who hopes to learn the fine art of the game of chess from books
will soon discover that only the opening and closing moves of the game
admit of exhaustive systematic description, and that the endless
variety of the moves which develop from the opening defies
description; the gap left in the instructions can only be filled in by
the zealous study of games fought out by master-hands. The rules which
can be laid down for the practical application of psycho-analysis in
treatment are subject to similar limitations.
I intend now to try to collect together for the use of practising
analysts some of the rules for the opening of the treatment. Among
them there are some which may seem to be mere details, as indeed they
are. Their justification is that they are simply rules of the game,
acquiring their importance by their connection with the whole plan of
the game. I do well, however, to bring them forward as
'recommendations' without claiming any unconditional acceptance for
them. The exceptional diversity in the mental constellations
concerned, the plasticity of all mental processes, and the great
number of the determining factors involved prevent the formulation of
a stereotyped technique, and also bring it about that a course of
action, ordinarily {343} legitimate, may be at times ineffective,
while one which is usually erroneous may occasionally lead to the
desired end. These circumstances do not prevent us from establishing a
procedure for the physician which will be found most generally
efficient.
Some years ago I set forth the considerations of chief importance in
the selection of patients, which I shall therefore not repeat
here[134]; since that time other psycho-analysts have confirmed their
validity. I will add, though, that since then, when I know little of a
case, I have formed the practice of first undertaking it only
provisionally for one or two weeks. If one breaks off within this
period the patient is spared the distress of an unsuccessful attempt
at cure; it was only 'taking a sounding' in order to learn more about
the case and to decide whether it was a suitable one for
psycho-analysis. No other kind of preliminary examination is possible;
the most lengthy discussions and questionings in ordinary consultation
are no substitute. This experiment, however, is in itself the
beginning of an analysis, and must conform to its rules; there may
perhaps be this difference in that on the whole one lets the patient
talk, and explains nothing more than is absolutely necessary to keep
him talking.
For the purposes of diagnosis, also, it is an advantage to begin with
a period of a few weeks designed as an experiment. Often enough, when
one sees a case of neurosis with hysterical or obsessional symptoms,
mild in character and of short duration (just the type of case, that
is, which one would regard as suitable for the treatment), a doubt
which must not be overlooked arises whether the case may not be one of
incipient dementia præcox, so called (schizophrenia, according to
Bleuler; paraphrenia, as I prefer to call it), and may not sooner or
later develop well-marked signs of this disease. I do not agree that
it is always possible to effect the distinction so easily. I know that
there are psychiatrists who hesitate less often in their {344}
differential diagnosis, but I have been convinced that they are just
as often mistaken. For the psycho-analyst, however, the mistake is
more serious than for so-called clinical psychiatrists. The latter has
little of value to offer either to the one type of case or to the
other; he merely runs the risk of a theoretical mistake, and his
diagnosis has but an academic interest. In an unsuitable case,
however, the psycho-analyst has committed a practical error; he has
occasioned useless expense and discredited his method of treatment; he
cannot fulfil his promise of cure if the patient is suffering from
paraphrenia instead of from hysteria or obsessional neurosis, and
therefore he has particularly strong motives for avoiding mistakes in
diagnosis. In an experimental course of a few weeks suspicious signs
will often be observed which will decide him not to pursue the attempt
further. Unfortunately I cannot assert that an attempt of this kind
will invariably ensure certainty; it is but one more useful
precaution.[135]
Lengthy preliminary discussions before the beginning of the treatment,
previous treatment by another method, and also previous acquaintance
between physician and patient, have certain disadvantageous
consequences for which one must be prepared. They result in the
patient entering upon the analysis with a transference already
effected, which must then be slowly uncovered by the physician;
whereas otherwise he is in a position to observe the growth and
development of it from the outset. By this means the patient gains a
start upon us which we do not willingly grant him in the
treatment.
{345}
One must distrust all those who wish to put off beginning the
treatment. Experience shows that at the appointed time they fail to
return, even though their motive for the delay (that is, their
rationalization of the intention) appears to the novice to be above
suspicion.
Special difficulties arise when friendship or acquaintance already
exists between the physician and the patient, or their families. The
psycho-analyst who is asked to undertake treatment of the wife or
child of a friend must be prepared for it to cost him the friendship,
no matter what the outcome of the treatment; nevertheless he must make
the sacrifice unless he can propose a trustworthy substitute.
Both the general public and medical men---still fain to confound
psycho-analytic with suggestive treatment---are inclined to attribute
great importance to the expectations which the patient brings to the
new treatment. They often believe that one patient will not give much
trouble because he has a great belief in psycho-analysis and is fully
convinced of its truth and curative power; and that another patient
will doubtless prove more difficult because he is of a sceptical
nature and will not believe until he has experienced good results in
his own person. Actually, however, this attitude on the part of the
patient has very little importance; his preliminary belief or
disbelief is almost negligible compared with the inner resistances
which hold the neurosis fast. A blissful trustfulness on the patient's
part makes the relationship at first a very pleasant one; one thanks
him for it, but warns him that this favourable prepossession will be
shattered by the first difficulty arising in the analysis. To the
sceptic one says that the analysis requires no faith; that he may be
as critical and suspicious as he pleases; that one does not regard his
attitude as the effect of his judgement at all, for he is not in a
position to form a reliable judgement on the matter; his distrust is
but a symptom like his other symptoms and will not {346} interfere if
he conscientiously carries out what the rule of the treatment requires
of him.
Whoever is familiar with the nature of neurosis will not be astonished
to hear that even a man who is very well able to carry out analysis
upon others can behave like any other mortal and be capable of
producing violent resistances as soon as he himself becomes the object
of analytic investigation. When this happens it serves to remind us
again of the dimensions which the mind has in regard to its depth, and
it does not surprise us to find that a neurosis is rooted in mental
strata that were never penetrated by an intellectual study of
analysis.
Points of importance for the beginning of the treatment are the
arrangements about time and money. In regard to time, I adhere rigidly
to the principle of leasing a definite hour. A certain hour of my
available working day is appointed to each patient; it is his, and he
is liable for it, even if he does not make use of it. This
arrangement, which is regarded as a matter of course for teachers of
music or languages among our upper classes, perhaps seems too rigorous
for a medical man, or even unworthy of the profession. All the many
accidents which may prevent the patient from attending every day at
the same hour will be referred to, and some allowance will be expected
for the numerous intercurrent ailments which may arise in the course
of a lengthy analytic treatment. My only answer is: No other way is
practicable. Under a less stringent régime the 'occasional'
non-attendances accumulate so greatly that the physician's material
existence is threatened; whereas strict adherence to the arrangement
has the effect that accidental hindrances do not arise at all and
intercurrent illnesses but seldom. One is hardly ever put in the
position of enjoying a leisure hour which one is paid for and would be
ashamed of; the work continues without interruptions, and one is
spared the disheartening and bewildering experience that an unexpected
pause in the work always occurs just when it promises to be especially
important and productive. {347} Nothing brings home to one with such
overwhelming conviction the significance of the psychogenic factor in
the daily life of mankind, the frequency of fictitious
'indispositions', and the non-existence of chance as the practice of
psycho-analysis for some years strictly on the principle of hire by
the hour. In cases of indubitable organic illness, the occurrence of
which cannot be excluded in spite of interest in the psychical work, I
break off the treatment, regard myself as entitled to dispose
otherwise of the hour which becomes free, and take the patient back
again when he has recovered and I again have a free hour.
I work with my patients every day, except Sundays and public holidays,
that is, usually six days a week. For slight cases, or the
continuation of a treatment already well advanced, three days in the
week will suffice. Otherwise, restriction of the time expended brings
no advantage to physician or patient; it is not to be thought of at
the beginning. Even short interruptions have a disconcerting effect
on the work; we used to speak jokingly of the 'Monday-crust' when we
began work again after the rest on Sunday; with more frequent
intervals the risk arises that one will not be able to keep pace with
the patient's real life, that the analysis will lose contact with the
present and be forced into by-paths. Occasionally one meets with
patients to whom one must give more than the average time of one hour
a day, because the best part of an hour is gone before they begin to
open out and to communicate anything at all.
An unwelcome question which the patient asks the physician at the
outset is: How long will the treatment last? What length of time will
you require to relieve me of my trouble? If one has proposed an
experimental course of a few weeks one can avoid a direct reply to
this question by undertaking to give a more trustworthy answer later
on. The answer is like that of Aesop in the fable of the Wanderer; on
being asked the length of the journey he answered 'Go', and gave {348}
the explanation that he must know the pilgrim's pace before he could
tell the time his journey would take him. This explanation helps one
over the difficulty at the start, but the comparison is not a good
one, for the neurotic can easily alter his pace and at times make but
very slow progress. The question of the probable duration of the
treatment is hardly to be answered at all, in fact.
As a result of the lack of insight on the part of patients combined
with the lack of straightforwardness on the part of physicians,
analysis is expected to realize the most boundless claims in the
shortest time. As an example I will give some details from a letter
which I received a few days ago from a lady in Russia. Her age is
fifty-three; her illness began twenty-three years ago; for the last
ten years she has been incapable of continued work; 'various cures in
homes' have not succeeded in making an 'active life' possible for
her. She hopes to be completely cured by psycho-analysis, of which she
has read, but her illness has already cost her family so much that she
cannot undertake a visit of more than six weeks or two months to
Vienna. In addition to this there is another difficulty: she wishes to
'explain herself' from the beginning in writing, since any discussion
of her complexes would excite an attack or render her 'temporarily
dumb'. No one would expect a man to lift a heavy table with two
fingers as if it were a little stool, or to build a large house in the
time it would take to put up a wooden hut, but as soon as it becomes a
question of the neuroses (which mankind seems not yet to have fitted
into the general scheme of his ideas) even intelligent people forget
the necessity for proportion between work, time and success---a
comprehensible result, too, of the deep ignorance which prevails
concerning the ætiology of neuroses. Thanks to this ignorance a
neurosis is generally regarded as a sort of 'maiden from afar'; the
world knows not whence it comes, and therefore expects it to vanish
away some day.
{349}
Medical men support this happy belief; even the experienced among them
often fail to estimate properly the severity of nervous disorders. A
friend and colleague of mine, to whose credit I account it that after
several decades of scientific work on other principles he has betaken
himself to the recognition of psycho-analysis, once wrote to me: What
we need is a short, convenient form of treatment for out-patients
suffering from obsessional neurosis. I could not supply him with it,
and felt ashamed; so I tried to excuse myself with the remark that
probably physicians would also be very glad of a treatment for
consumption or cancer which combined these advantages.
To speak more plainly, psycho-analysis is always a matter of long
periods of time, of six months or a year, or more---a longer time than
the patient expects. It is therefore a duty to explain this fact to
the patient before he finally resolves upon the treatment. I hold it
to be altogether more honourable, and also more expedient, to draw his
attention, without alarming him unduly but from the very beginning, to
the difficulties and sacrifices involved by analytic treatment;
thereby depriving him of the right to assert later on that he had been
inveigled into a treatment the implications and extent of which he did
not realize. The patient who lets himself be dissuaded by these
considerations would later on have shown himself unsuitable; it is a
good thing to institute a selection in this way before the beginning
of the treatment. With the progress of understanding among patients
the number of those who stand this first test increases.
I do not bind patients to continue the treatment for a certain length
of time; I permit each one to break off whenever he likes, though I do
not conceal from him that no success will result from a treatment
broken off after only a small amount of work, and that it may easily,
like an unfinished operation, leave him in an unsatisfactory
condition. In the early years of my practice of psycho-analysis I had
the greatest {350} difficulty in prevailing upon patients to continue;
this difficulty has long since altered; I must now anxiously exert
myself to induce them to give it up.
The shortening of the analytic treatment remains a reasonable wish,
the realization of which, as we shall hear, is being sought after in
various ways. Unfortunately, it is opposed by a very important element
in the situation---namely, the slowness with which profound changes in
the mind bring themselves about, fundamentally the same thing as the
'inappreciation of time' characteristic of our unconscious processes.
When the patients are confronted with the great expenditure of time
required for the analysis they often bethink themselves of suggesting
a makeshift way out of the difficulty. They divide up their complaints
and describe some as unendurable and others as secondary, saying, 'If
only you will relieve me of this (for instance, a headache or a
particular fear) I will manage by myself to endure life with the other
troubles'. They exaggerate the selective capacity of the analysis in
this. The analyst is certainly able to do a great deal, but he cannot
determine beforehand exactly what results he will effect. He sets in
operation a certain process, the 'loosening' of the existing
repressions: he can watch over it, further it, remove difficulties in
the way of it, and certainly do much also to vitiate it; but on the
whole, once begun, the process goes its own way and does not admit of
prescribed direction, either in the course it pursues or in the order
in which the various stages to be gone through are taken. The power of
the analyst over the symptoms of disease is comparable in a way to
sexual potency; the strongest man can beget a whole child, it is true,
but he cannot effect the production of a head alone, or an arm, or a
leg in the female organ, he cannot even prescribe the sex of the
child. He, too, only sets in operation a highly complicated process,
determined by foregone events, and ending with the severance of the
child from the mother. {351} Again, a neurosis has the character of
an organism; its component manifestations are not independent of one
another, they each condition and mutually support the others; a man
can only suffer from one neurosis, never from several accidentally
combined in his person. Suppose one had freed the patient, according
to his wish, from the one unendurable symptom, he might then have
discovered that a symptom which was previously negligible had
increased until it in turn had become intolerable. In general, the
analyst who wishes the results to be as independent as possible of the
influence of suggestion from himself (that is, of transference) will
do best to refrain from using even the fraction of selective influence
upon the results of the cure which is perhaps open to him. The
patients who are most welcome to the psycho-analyst will be those who
desire complete health so far as they are capable of it, and who will
place as much time at his disposal for the cure as the process
requires. Naturally, such favourable conditions are to be met with
only in the minority of cases.
The next point to be decided on beginning the treatment is the money
question, the physician's fee. The analyst does not dispute that money
is to be regarded first and foremost as the means by which life is
supported and power is obtained, but he maintains that, besides this,
powerful sexual factors are involved in the value set upon it; he may
expect, therefore, that money questions will be treated by cultured
people in the same manner as sexual matters, with the same
inconsistency, prudishness and hypocrisy. He is therefore determined
beforehand not to concur in this attitude, and in his dealings with
patients to treat of money matters with the same matter-of-course
frankness that he wishes to induce in them towards matters relating to
sexual life. By voluntarily introducing the subject of fees and
stating the price for which he gives his time, he shows the patient
that he himself has cast aside false shame in these matters. Ordinary
prudence {352} then demands that the sums to be paid should not be
allowed to accumulate until they are very large, but that payment
should be made at fairly short regular intervals (every month or so).
(It is well known that the value of the treatment is not enhanced in
the patient's eyes if a very low fee is asked.) This is of course not
the usual practice of neurologists or other physicians in our European
cities. But the psycho-analyst may put himself in the position of
surgeons, who are both honest and expensive because they deal in
measures which can be of aid. In my opinion it is more dignified and
ethically less open to objection to acknowledge one's actual claims
and needs rather than, as the practice is now among medical men, to
act the part of the disinterested philanthropist, while that enviable
situation is denied to one and one grumbles in secret, or animadverts
loudly, over the lack of consideration or the miserliness shown by
patients. In estimating his fee the analyst must allow for the fact
that, in spite of strenuous work, he can never earn as much as other
medical specialists.
For the same reasons he may refrain from giving treatment
gratuitously, making no exceptions to this in favour of his colleagues
or their relatives. This last requisition seems to conflict with the
claims of professional fellow-feeling; one must consider, however,
that gratuitous treatment means much more to a psycho-analyst than to
other medical men---namely, the dedication of a considerable portion
(an eighth or a seventh part, perhaps) of the time available for his
livelihood over a period of several months. Another treatment
conducted gratuitously at the same time would rob him of a quarter or
a third of his earning capacity, which would be comparable to the
effects of some serious accident.
Then the question arises whether the advantage to the patient would
not outweigh the physician's sacrifice. I may rely on my own judgement
in this matter, since I have given an hour daily, and sometimes {353}
two, for ten years to gratuitous treatment, because I wished, for the
purpose of studying the neuroses, to work with the fewest possible
hindrances. The advantages which I sought in this way were not
forthcoming. Gratuitous treatment enormously increases many neurotic
resistances, such as the temptations of the transference-relationship
for young women, or the opposition to the obligatory gratitude in
young men arising from the father-complex, which is one of the most
troublesome obstacles to the treatment. The absence of the corrective
influence in payment of the professional fee is felt as a serious
handicap; the whole relationship recedes into an unreal world; and the
patient is deprived of a useful incentive to exert himself to bring
the cure to an end.
One may stand quite aloof from the ascetic view of money as a curse
and yet regret that analytic therapy is almost unattainable for the
poor, both for external and for internal reasons. Little can be done
to remedy this. Perhaps there is some truth in the widespread belief
that those who are forced by necessity to a life of heavy labour
succumb less easily to neurosis. But at all events experience shows
without a doubt that, in this class, a neurosis once acquired is only
with very great difficulty eradicated. It renders the sufferer too
good service in the struggle for existence; the accompanying secondary
'epinosic gain' has here too much importance. The pity which the world
has refused to his material distress the sufferer now claims by right
of his neurosis and absolves himself from the obligation of combating
his poverty by work. Any one who tries to deal by psychotherapeutic
means with a neurosis in a poor person usually makes the discovery
that what is really required of him in such a case is a very
different, material kind of therapy---the sort of healing which,
according to tradition, Emperor Joseph II. used to
dispense. Naturally, one does occasionally meet with people of worth
who are helpless from no fault of their own, in whom unpaid treatment
{354} leads to excellent results without exciting any of the
difficulties mentioned.
For the middle classes the necessary expense of psycho-analysis is
only apparently excessive. Quite apart from the fact that restored
health and capacity for life on the one hand, and a moderate outlay in
money on the other, cannot be measured in the same category; if one
contrasts a computation of the never-ceasing costs of nursing homes
and medical treatment with the increase of capacity to live well and
earn well after a successful analytic treatment, one may say that the
patient has made a good bargain. Nothing in life is so expensive as
illness---and foolishness.
Before I conclude these remarks on beginning the analytic treatment a
word must be said about a certain ceremonial observance regarding the
position in which the treatment is carried out. I adhere firmly to the
plan of requiring the patient to recline upon a sofa, while one sits
behind him out of his sight. This arrangement has an historic meaning;
it is the last vestige of the hypnotic method out of which
psycho-analysis was evolved; but for many reasons it deserves to be
retained. The first is a personal motive, one that others may share
with me, however. I cannot bear to be gazed at for eight hours a day
(or more). Since, while I listen, I resign myself to the control of my
unconscious thoughts I do not wish my expression to give the patient
indications which he may interpret or which may influence him in his
communications. The patient usually regards being required to take up
this position as a hardship and objects to it, especially when
scoptophilia plays an important part in the neurosis. I persist in the
measure, however, for the intention and result of it are that all
imperceptible influence on the patient's associations by the
transference may be avoided, so that the transference may be isolated
and clearly outlined when it appears as a resistance. I know that many
analysts work in a different way, though I do not know whether the
main {355} motive of their departure is the ambition to work in a
different way or an advantage which they gain thereby.
The conditions of the treatment being now regulated in this manner,
the question arises at what point and with what material it shall
begin.
What subject-matter the treatment begins with is on the whole
immaterial, whether with the patient's life-story, with a history of
the illness or with recollections of childhood; but in any case the
patient must be left to talk, and the choice of subject left to
him. One says to him, therefore, 'Before I can say anything to you, I
must know a great deal about you; please tell me what you know about
yourself'.
The only exception to this concerns the fundamental rule of the
psycho-analytic technique which the patient must observe. This must be
imparted to him at the very beginning: 'One thing more, before you
begin. Your talk with me must differ in one respect from an ordinary
conversation. Whereas usually you rightly try to keep the threads of
your story together and to exclude all intruding associations and
side-issues, so as not to wander too far from the point, here you must
proceed differently. You will notice that as you relate things various
ideas will occur to you which you feel inclined to put aside with
certain criticisms and objections. You will be tempted to say to
yourself: "This or that has no connection here, or it is quite
unimportant, or it is nonsensical, so it cannot be necessary to
mention it". Never give in to these objections, but mention it even if
you feel a disinclination against it, or indeed just because of
this. Later on you will perceive and learn to understand the reason
for this injunction, which is really the only one that you have to
follow. So say whatever goes through your mind. Act as if you were
sitting at the window of a railway train and describing to some one
behind you the changing views you see outside. Finally, never forget
that you have promised absolute honesty, {356} and never leave
anything unsaid because for any reason it is unpleasant to say
it.'[136]
Patients who date their illness from a particular time usually
concentrate upon the events leading up to it; others who themselves
recognize the connection of their neurosis with their childhood often
begin with an account of their whole life-story. A consecutive
narrative should never be expected and nothing should be done to
encourage it. Every detail of the story will later have to be related
afresh, and only with this repetition will additional matter appear
enabling the significant connections which are unknown to the patient
to be traced.
There are patients who from the first hour carefully {357} prepare
their communications, ostensibly so as to make better use of the time
given to treatment. This appears to be eagerness on their part, but it
is resistance. One must disallow this preparation; it is employed to
guard against the appearance of unwelcome thoughts;[137] the patient
may believe ever so honestly in his praiseworthy intention, but
resistance will play its part in this kind of considered preparation
and will see to it that in this way the most valuable part of the
communication escapes. One will soon find that the patient invents yet
other methods by which the required material may be withheld from
analysis. He will perhaps talk over the treatment every day with some
intimate friend, and in this discussion bring out all the thoughts
which should occur to him in the presence of the physician. The
treatment then suffers from a leak which lets through just what is
most valuable. It will then soon be time to recommend the patient to
treat the analysis as a matter between himself and his physician, and
to exclude everyone else from sharing in it, no matter how closely
bound to him or how inquisitive they may be. In later stages of the
treatment the patient is not usually tempted in this way.
Certain patients wish their treatment kept secret, often because they
have kept their neurosis secret, and I put no obstacle in the way of
this. That in consequence the world hears nothing of some of the most
brilliantly successful cures is of course a consideration not to be
taken into account. Obviously the patient's decision in favour of
secrecy at once reveals one feature of his inner history.
In advising at the beginning of treatment that as few persons as
possible shall be informed of it, one protects patients to some extent
from the many hostile influences seeking to detach them from the
analysis. Such influences may be very mischievous at the outset of the
cure; later they are usually immaterial, or even {358} useful in
bringing into prominence resistances which are attempting concealment.
If during the course of the analysis the patient requires temporarily
some other medical or special treatment, it is far wiser to call in
some colleague outside analytic work than to administer this treatment
oneself. Analysis combined with other treatment, for neurotic maladies
with a strong organic connection, is nearly always impracticable; the
patients withdraw their interest from the analysis when there is more
than one way leading them to health. Preferably one postpones the
organic treatment until after the conclusion of the mental; if the
former were tried first, in most cases it would do no good.
To return to the beginning of the treatment. Patients are occasionally
met with who begin the treatment with an absolute disclaimer of the
existence of any thoughts in their minds which they could utter,
although the whole field of their life-history and their neurosis lies
before them untrodden. One must accede this first time as little as at
any other to their request that one should propose something for them
to speak of. One must bear in mind what it is that confronts one in
these cases. A formidable resistance has come out into the open in
order to defend the neurosis; one takes up its challenge then and
there, and grips it by the throat. Emphatic and repeated assurance
that the absence of all ideas at the beginning is an impossibility,
and that there is some resistance against the analysis, soon brings
the expected confessions from the patient or else leads to the first
discovery of some part of his complexes. It is ominous if he has to
confess that while listening to the rule of the analysis he formed a
determination in spite of it not to communicate this or that; not
quite so bad if he only has to declare the distrust he has of the
treatment or the appalling things he has heard about it. If he denies
these and similar possibilities when they are suggested to him,
further pressure will constrain him to acknowledge that he {359} has
neglected certain thoughts which are occupying his mind. He was
thinking of the treatment itself but not in a definite way, or else
the appearance of the room he is in occupied him, or he found himself
thinking of the objects round him in the consulting-room, or of the
fact that he is lying on a sofa; for all of which thoughts he has
substituted 'nothing'. These indications are surely intelligible;
everything connected with the situation of the moment represents a
transference to the physician which proves suitable for use as
resistance. It is necessary then to begin by uncovering this
transference; thence the way leads rapidly to penetration of the
pathogenic material in the case. Women who are prepared by events in
their past lives for a sexual overture, or men with unusually strong,
repressed homosexuality, are the most prone to exhibit this denial of
all ideas at the outset of the analysis.
The first symptoms or chance actions of the patient, like the first
resistance, have a special interest and will betray one of the
governing complexes of the neurosis. A clever young philosopher, with
leanings towards æsthetic exquisiteness, hastens to twitch the crease
in his trousers into place before lying down for the first sitting; he
reveals himself as an erstwhile coprophiliac of the highest
refinement, as was to be expected of the developed æsthete. A young
girl on the same occasion hurriedly pulls the hem of her skirt over
her exposed ankle; she has betrayed the kernel of what analysis will
discover later, her narcissistic pride in her bodily beauty and her
tendencies to exhibitionism.
Very many patients object especially to the arrangement of reclining
in a position where the physician sits out of sight behind them; they
beg to be allowed to undergo analysis in some other position, mostly
because they do not wish to be deprived of a view of the
physician. Permission is invariably refused; one cannot prevent them,
however, from contriving to say a few words before the beginning of
the 'sitting itself', {360} and after one has signified its
termination and they have risen from the sofa. In this way they make
in their own minds a division of the treatment into an official part,
in which they behave in a very inhibited manner, and an informal
'friendly' part, in which they really speak freely and say a good deal
that they do not themselves regard as belonging to the treatment. The
physician does not fall in for long with this division of the time, he
makes a note of what is said before or after the sitting, and in
bringing it up at the next opportunity he tears down the partition
which the patient has tried to erect. It again is a structure formed
from the material of a transference-resistance.
_So long as the patient continues to utter without obstruction the
thoughts and ideas rising to his mind, the theme of the transference
should be left untouched_. One must wait until the transference, which
is the most delicate matter of all to deal with, comes to be employed
as resistance.
The next question with which we are confronted is a main one. It runs:
When shall we begin our disclosures to the patient? When is it time to
unfold to him the hidden meaning of his thoughts and associations, to
initiate him into the postulates of analysis and its technical
devices?
The answer to this can only be: Not until a dependable transference, a
well-developed _rapport_, is established in the patient. The first aim
of the treatment consists in attaching him to the treatment and to the
person of the physician. To ensure this one need do nothing but allow
him time. If one devotes serious interest to him, clears away
carefully the first resistances that arise and avoids certain
mistakes, such an attachment develops in the patient of itself, and
the physician becomes linked up with one of the imagos of those
persons from whom he was used to receive kindness. It is certainly
possible to forfeit this primary success if one takes up from the
start any standpoint other than that of understanding, such as a
moralizing {361} attitude, perhaps, or if one behaves as the
representative or advocate of some third person, maybe the husband or
wife, and so on.
This answer of course involves a condemnation of that mode of
procedure which consists in communicating to the patient the
interpretation of the symptoms as soon as one perceives it oneself, or
of that attitude which would account it a special triumph to hurl
these 'solutions' in his face at the first interview. It is not
difficult for a skilled analyst to read the patient's hidden wishes
plainly between the lines of his complaints and the story of his
illness; but what a measure of self-complacency and thoughtlessness
must exist in one who can upon the shortest acquaintance inform a
stranger, who is entirely ignorant of analytical doctrines, that he is
bound by an incestuous love for his mother, that he harbours wishes
for the death of the wife he appears to love, that he conceals within
himself the intention to deceive his chief, and so forth! I have heard
that analysts exist who plume themselves upon these kinds of
lightning-diagnoses and 'express'-treatments, but I warn everyone
against following such examples. Such conduct brings both the man and
the treatment into discredit and arouses the most violent opposition,
whether the interpretations be correct or not; yes, and the truer they
are actually the more violent is the resistance they arouse. Usually
the therapeutic effect at the moment is nothing; the resulting horror
of analysis, however, is ineradicable. Even in later stages of the
analysis one must be careful not to communicate the meaning of a
symptom or the interpretation of a wish until the patient is already
close upon it, so that he has only a short step to take in order to
grasp the explanation himself. In former years I often found that
premature communication of interpretations brought the treatment to an
untimely end, both on account of the resistances suddenly aroused
thereby and also because of the relief resulting from the insight so
obtained.
{362}
The following objection will be raised here: Is it then our task to
lengthen the treatment, and not rather to bring it to an end as
rapidly as possible? Are not the patient's sufferings due to his lack
of knowledge and understanding, and is it not a duty to enlighten him
as soon as possible, that is, as soon as the physician himself knows
the explanations? The answer to this question requires a short
digression concerning the significance of knowledge and the mechanism
of the cure in psycho-analysis.
In the early days of analytic technique it is true that we regarded
the matter intellectually and set a high value on the patient's
knowledge of that which had been forgotten, so that we hardly made a
distinction between our knowledge and his in these matters. We
accounted it specially fortunate if it were possible to obtain
information of the forgotten traumas of childhood from external
sources, from parents or nurses, for instance, or from the seducer
himself, as occurred occasionally; and we hastened to convey the
information and proofs of its correctness to the patient, in the
certain expectation of bringing the neurosis and the treatment to a
rapid end by this means. It was a bitter disappointment when the
expected success was not forthcoming. How could it happen that the
patient, who now had the knowledge of his traumatic experience, still
behaved in spite of it as if he knew no more than before? Not even
would the recollection of the repressed trauma come to mind after it
had been told and described to him.
In one particular case the mother of an hysterical girl had confided
to me the homosexual experience which had greatly influenced the
fixation of the attacks. The mother herself had come suddenly upon the
scene and had been a witness of it; the girl, however, had totally
forgotten it, although it had occurred not long before
puberty. Thereupon I made a most instructive observation. Every time
that I repeated the mother's story to the girl she reacted to it with
an hysterical {363} attack, after which the story was again
forgotten. There was no doubt that the patient was expressing a
violent resistance against the knowledge which was being forced upon
her; at last she simulated imbecility and total loss of memory in
order to defend herself against what I told her. After this, there was
no alternative but to abandon the previous attribution of importance
to knowledge in itself, and to lay the stress upon the resistances
which had originally induced the condition of ignorance and were still
now prepared to defend it. Conscious knowledge, even if it were not
again expelled, was powerless against these resistances.
This disconcerting ability in patients to combine conscious knowledge
with ignorance remains unexplained by what is called normal
psychology. By reason of the recognition of the unconscious,
psycho-analysis finds no difficulty in it; the phenomenon described
is, however, one of the best confirmations of the conception by which
mental processes are approached as being differentiated
topographically. The patients are aware, in thought, of the repressed
experience, but the connection between the thought and the point where
the repressed recollection is in some way imprisoned is lacking. No
change is possible until the conscious thought-process has penetrated
to this point and has overcome the resistances of the repression
there. It is just as if a decree were promulgated by the Ministry of
Justice to the effect that juvenile misdemeanours should be dealt with
by certain lenient methods. As long as this concession has not come to
the knowledge of the individual magistrates, or in the event of their
not choosing to make use of it but preferring to deal justice
according to their own lights, nothing will be changed in the
treatment accorded to youthful delinquents. For the sake of complete
accuracy, though, it may be added that communicating to the patient's
consciousness information about what is repressed does not entirely
fail of any effect at all. It does not produce the hoped-for {364}
result of abolishing the symptoms, but it has other consequences. It
first arouses resistances, but when these are overcome it sets a
mental process in action, in the course of which the desired influence
upon the unconscious memory is eventually effected.
At this point we should review the play of forces brought into action
by the treatment. The primary motive-power used in therapy is the
patient's suffering and the wish to be cured which arises from it. The
volume of this motive-force is diminished in various ways,
discoverable only in the course of the analysis, above all by what we
call the 'epinosic gain'; the motive-power itself must be maintained
until the end of the treatment; every improvement effects a diminution
of it. Alone, however, the force of this motive is insufficient to
overcome the illness; two things are lacking in it, the knowledge of
the paths by which the desired end may be reached, and the amount of
energy needed to oppose the resistances. The analytic treatment helps
to supply both these deficiencies. The accumulation of energy
necessary to overcome the resistances is supplied by analytic
utilization of the energies which are always ready to be
'transferred'; and by timely communications to the patient at the
right moment analysis points out the direction in which these energies
should be employed. The transference alone frequently suffices to
bring about a disappearance of the symptoms of the disease, but this
is merely temporary and lasts only as long as the transference itself
is maintained. The treatment is then nothing more than suggestion, not
a psycho-analysis. It deserves the latter name only when the intensity
of the transference has been utilized to overcome the resistances;
only then does illness become impossible, even though the transference
is again dissolved as its function in the treatment requires.
In the course of the treatment another helpful agency is roused---the
patient's intellectual interest and understanding. But this alone is
hardly worth {365} consideration by the side of the other forces
engaged in the struggle, for it is always in danger of succumbing to
the clouding of reasoning power under the influence of
resistances. Hence it follows that the new sources of strength for
which the sufferer is indebted to the analyst resolve themselves into
transference, and instruction (by explanation). The patient only makes
use of the instruction, however, in so far as he is induced to do so
by the transference; and therefore until a powerful transference is
established the first explanation should be withheld; and likewise, we
may add, with each subsequent one, we must wait until each disturbance
of the transference by the transference-resistances arising in
succession has been removed.
----------------------------------------------------------------------
XXXII {366}
FURTHER RECOMMENDATIONS IN THE
TECHNIQUE OF PSYCHO-ANALYSIS[138]
*Recollection, Repetition and Working Through*
(1914)
It seems to me not unnecessary constantly to remind students of the
far-reaching changes which psycho-analytic technique has undergone
since its first beginnings. Its first phase was that of Breuer's
catharsis, direct concentration upon the events exciting
symptom-formation and persistent efforts on this principle to obtain
reproduction of the mental processes involved in that situation, in
order to bring about a release of them through conscious
operations. The aims pursued at that time, by the help of the hypnotic
condition, were 'recollection' and 'abreaction'. Next, after hypnosis
had been abandoned, the main task became that of divining from the
patient's free associations what he failed to remember. Resistances
were to be circumvented by the work of interpretation and by making
its results known to the patient; concentration on the situations
giving rise to symptom-formation and on those which lay behind the
outbreak of illness was retained, while abreaction receded and seemed
to be replaced by the work the patient had to do in overcoming his
critical objections to his associations, in accordance with the
fundamental psycho-analytic rule. Finally, the present-day technique
evolved itself, whereby the analyst abandons concentration on any
particular element or problem, contents himself with {367} studying
whatever is occupying the patient's mind at the moment, and employs
the art of interpretation mainly for the purpose of recognizing the
resistances which come up in regard to this material and making the
patient aware of them. A rearrangement of the division of labour
results from this; the physician discovers the resistances which are
unknown to the patient; when these are removed the patient often
relates the forgotten situations and connections without any
difficulty. The aim of these different procedures has of course
remained the same throughout: descriptively, to recover the lost
memories; dynamically, to conquer the resistances caused by
repression.
One is bound to be grateful still to the old hypnotic technique for
the way in which it unrolled before us certain of the mental processes
of analysis in an isolated and schematic form. Only this could have
given us the courage to create complicated situations ourselves in the
analytic process and to keep them perspicuous.
Now in those days of hypnotic treatment 'recollection' took a very
simple form. The patient put himself back into an earlier situation,
which he seemed never to confound with the present, gave an account of
the mental processes belonging to it, in so far as they were normal,
and appended to this whatever conclusions arose from making conscious
what had before been unconscious.
I will here interpolate a few observations which every analyst has
found confirmed in his experience. The forgetting of impressions,
scenes, events, nearly always reduces itself to 'dissociation' of
them. When the patient talks about these 'forgotten' matters he seldom
fails to add: 'In a way I have always known that, only I never thought
of it'. He often expresses himself as disappointed that not enough
things come into his mind which he can hail as 'forgotten', which he
has never thought of since they happened. Even this desire on his part
is fulfilled, however, particularly {368} in cases of
conversion-hysteria. The 'forgotten' material is still further
circumscribed when we estimate at their true value the screen-memories
which are so generally present. In many cases I have had the
impression that the familiar childhood-amnesia, which is theoretically
so important to us, is entirely outweighed by the screen-memories. Not
merely is much that is essential in childhood preserved in them, but
actually all that is essential. Only one must understand how to
extract it from them by analysis. They represent the forgotten years
of childhood just as adequately as the manifest content represents the
dream-thoughts.
The other group of mental processes, the purely internal mental
activities, such as phantasies, relations between ideas, impulses,
feelings, connections, may be contrasted with impressions and events
experienced, and must be considered apart from them in its relation to
forgetting and remembering. With these processes it particularly often
happens that something is 'remembered' which never could have been
'forgotten', because it was never at any time noticed, never was
conscious; as regards the fate of any such 'connection' in the mind,
moreover, it seems to make no difference whatever whether it was
conscious and then was forgotten or whether it never reached
consciousness at all. The conviction which a patient obtains in the
course of analysis is quite independent of remembering it in that way.
In the manifold forms of obsessional neurosis particularly,
'forgetting' consists mostly of a falling away of the links between
various ideas, a failure to draw conclusions, an isolating of certain
memories.
No memory of one special kind of highly important experience can
usually be recovered: these are experiences which took place in very
early childhood, before they could be comprehended, but which were
_subsequently_ interpreted and understood. One gains a knowledge of
them from dreams, and is compelled to believe in them on irresistible
evidence in the structure {369} of the neurosis; moreover, one can
convince oneself that after his resistances have been overcome the
patient no longer invokes the absence of any memory of them (sensation
of familiarity) as a ground for refusing to accept them. This matter,
however, is one demanding so much critical caution and introducing so
much that is novel and startling that I will reserve it for special
discussion in connection with suitable material.[139]
To return to the comparison between the old and the new techniques; in
the latter there remains very little, often nothing, of this smooth
and pleasing course of events belonging to the former. There are cases
which, under the new technique, conduct themselves up to a point like
those under the hypnotic technique and only later abandon this
behaviour; but others behave differently from the beginning. If we
examine the latter class in order to define this difference, we may
say that here the patient _remembers_ nothing of what is forgotten and
repressed, but that he expresses it in _action_. He reproduces it not
in his memory but in his behaviour; he _repeats_ it, without of course
knowing that he is repeating it.
For instance, the patient does not say that he remembers how defiant
and critical he used to be in regard to the authority of his parents,
but he behaves in that way towards the physician. He does not remember
how he came to a helpless and hopeless deadlock in his infantile
searchings after the truth of sexual matters, but he produces a mass
of confused dreams and associations, complains that he never succeeds
at anything, and describes it as his fate never to be able to carry
anything through. He does not remember that he was intensely ashamed
of certain sexual activities, but he makes it clear that he is ashamed
of the treatment to which he has submitted himself, and does his
utmost to keep it a secret; and so on.
{370}
Above all, the beginning of the treatment sets in with a repetition of
this kind. When one announces the fundamental psycho-analytical rule
to a patient with an eventful life-history and a long illness behind
him, and then waits for him to pour forth a flood of information, the
first thing that happens often is that he has nothing to say. He is
silent and declares that nothing comes into his mind. That is of
course nothing but the repetition of a homosexual attitude, which
comes up as a resistance against remembering anything. As long as he
is under treatment he never escapes from this compulsion to repeat; at
last one understands that it is his way of remembering.
The relation between this compulsion to repeat and the transference
and resistance is naturally what will interest us most of all. We soon
perceive that the transference is itself only a bit of repetition, and
that the repetition is the transference of the forgotten past not only
on to the physician, but also on to all the other aspects of the
current situation. We must be prepared to find, therefore, that the
patient abandons himself to the compulsion to repeat, which is now
replacing the impulse to remember, not only in his relation with the
analyst but also in all other matters occupying and interesting him at
the time, for instance, when he falls in love or sets about any
project during the treatment. Moreover, the part played by resistance
is easily recognized. The greater the resistance the more extensively
will expressing in action (repetition) be substituted for
recollecting. The ideal kind of recollection of the past which belongs
to hypnosis is indeed a condition in which resistance is completely
abrogated. If the treatment begins under the auspices of a mild and
unpronounced positive transference, it makes an unearthing of memories
like that in hypnosis possible to begin with, while the symptoms
themselves are for the time quiescent; if then, as the analysis
proceeds, this transference becomes hostile or unduly intense,
consequently necessitating repression, remembering {371} immediately
gives way to expression in action. From then onward the resistances
determine the succession of the various repetitions. The past is the
patient's armoury out of which he fetches his weapons for defending
himself against the progress of the analysis, weapons which we must
wrest from him one by one.
The patient reproduces instead of remembering, and he reproduces
according to the conditions of the resistance; we may now ask what it
is exactly that he reproduces or expresses in action. The answer is
that he reproduces everything in the reservoirs of repressed material
that has already permeated his general character---his inhibitions and
disadvantageous attitudes of mind, his pathological traits of
character. He also repeats during the treatment all his symptoms. And
now we can see that our special insistence upon the compulsion to
repeat has not yielded any new fact, but is only a more comprehensive
point of view. We are only making it clear to ourselves that the
patient's condition of illness does not cease when his analysis
begins, that we have to treat his illness as an actual force, active
at the moment, and not as an event in his past life. This condition of
present illness is shifted bit by bit within the range and field of
operation of the treatment, and while the patient lives it through as
something real and actual, we have to accomplish the therapeutic task,
which consists chiefly in translating it back again into terms of the
past.
Causing memories to be revived under hypnosis gives the impression of
an experiment in the laboratory. Allowing 'repetition' during analytic
treatment, which is the latest form of technique, constitutes a
conjuring into existence of a piece of real life, and can therefore
not always be harmless and indifferent in its effects on all
cases. The whole question of 'exacerbation of symptoms during
treatment', so often unavoidable, is linked up with this.
The very beginning of the treatment above all {372} brings about a
change in the patient's conscious attitude towards his illness. He has
contented himself usually with complaining of it, with regarding it as
nonsense, and with underestimating its importance; for the rest, he
has extended the ostrich-like conduct of repression which he adopted
towards the sources of his illness on to its manifestations. Thus it
happens that he does not rightly know what are the conditions under
which his phobia breaks out, has not properly heard the actual words
of his obsessive idea or not really grasped exactly what it is his
obsessive impulse is impelling him to do. The treatment of course
cannot allow this. He must find the courage to pay attention to the
details of his illness. His illness itself must no longer seem to him
contemptible, but must become an enemy worthy of his mettle, a part of
his personality, kept up by good motives, out of which things of value
for his future life have to be derived. The way to reconciliation with
the repressed part of himself which is coming to expression in his
symptoms is thus prepared from the beginning; yet a certain tolerance
towards the illness itself is induced. Now if this new attitude
towards the illness intensifies the conflicts and brings to the fore
symptoms which till then had been indistinct, one can easily console
the patient for this by pointing out that these are only necessary and
temporary aggravations, and that one cannot overcome an enemy who is
absent or not within range. The resistance, however, may try to
exploit the situation to its own ends, and abuse the permission to be
ill. It seems to say: 'See what happens when I really let myself go in
these things! Haven't I been right to relegate them all to
repression?' Young and childish persons in particular are inclined to
make the necessity for paying attention to their illness a welcome
excuse for luxuriating in their symptoms.
There is another danger, that in the course of the analysis, other,
deeper-lying instinctual trends which {373} had not yet become part of
the personality may come to be 'reproduced'. Finally, it is possible
that the patient's behaviour outside the transference may involve him
in temporary disasters in life, or even be so designed as permanently
to rob the health he is seeking of all its value.
The tactics adopted by the physician are easily justified. For him
recollection in the old style, reproduction in the mind, remains the
goal of his endeavours, even when he knows that it is not to be
obtained by the newer method. He sets about a perpetual struggle with
the patient to keep all the impulses which he would like to carry into
action within the boundaries of his mind, and when it is possible to
divert into the work of recollection any impulse which the patient
wants to discharge in action, he celebrates it as a special triumph
for the analysis. When the transference has developed to a
sufficiently strong attachment, the treatment is in a position to
prevent all the more important of the patient's repetition-actions and
to make use of his intentions alone, _in statu nascendi_, as material
for the therapeutic work. One best protects the patient from disasters
brought about by carrying his impulses into action by making him
promise to form no important decisions affecting his life during the
course of the treatment, for instance, choice of a profession or of a
permanent love-object, but to postpone all such projects until after
recovery.
At the same time one willingly accords the patient all the freedom
that is compatible with these restrictions, nor does one hinder him
from carrying out projects which, though foolish, are not of special
significance; one remembers that it is only by dire experience that
mankind ever learns sense. There are no doubt persons whom one cannot
prevent from plunging into some quite undesirable project during the
treatment and who become amenable and willing to submit the impulse to
analysis only afterwards. {374} Occasionally, too, it is bound to
happen that the untamed instincts assert themselves before there is
time for the curbing-rein of the transference to be placed on them, or
that an act of reproduction causes the patient to break the bond that
holds him to the treatment. As an extreme example of this, I might
take the case of an elderly lady who had repeatedly fled from her
house and her husband in a twilight state, and gone no one knew where,
without having any idea of a motive for this 'elopement'. Her
treatment with me began with a marked positive transference of
affectionate feeling, which intensified itself with uncanny rapidity
in the first few days, and by the end of a week she had 'eloped' again
from me, before I had time to say anything to her which might have
prevented this repetition.
The main instrument, however, for curbing the patient's compulsion to
repeat and for turning it into a motive for remembering consists in
the handling of the transference. We render it harmless, and even make
use of it, by according it the right to assert itself within certain
limits. We admit it into the transference as to a playground, in
which it is allowed to let itself go in almost complete freedom and is
required to display before us all the pathogenic impulses hidden in
the depths of the patient's mind. If the patient does but show
compliance enough to respect the necessary conditions of the analysis
we can regularly succeed in giving all the symptoms of the neurosis a
new transference-colouring, and in replacing his whole ordinary
neurosis by a 'transference-neurosis' of which he can be cured by the
therapeutic work. The transference thus forms a kind of intermediary
realm between illness and real life, through which the journey from
the one to the other must be made. The new state of mind has absorbed
all the features of the illness; it represents, however, an artificial
illness which is at every point accessible to our interventions. It is
at the same time a piece of real life, but adapted to our purposes by
{375} specially favourable conditions, and it is of a provisional
character. From the repetition-reactions which are exhibited in the
transference the familiar paths lead back to the awakening of the
memories, which yield themselves without difficulty after the
resistances have been overcome.
I might break off at this point but for the title of this paper, which
requires me to discuss a further point in analytic technique. The
first step in overcoming the resistance is made, as we know, by the
analyst's discovering the resistance, which is never recognized by the
patient, and acquainting him with it. Now it seems that beginners in
analytic practice are inclined to look upon this as the end of the
work. I have often been asked to advise upon cases in which the
physician complained that he had pointed out his resistance to the
patient and that all the same no change had set in; in fact, the
resistance had only then become really pronounced and the whole
situation had become more obscure than ever. The treatment seemed to
make no progress. This gloomy foreboding always proved mistaken. The
treatment was as a rule progressing quite satisfactorily; only the
analyst had forgotten that naming the resistance could not result in
its immediate suspension. One must allow the patient time to get to
know this resistance of which he is ignorant, to 'work through' it, to
overcome it, by continuing the work according to the analytic rule in
defiance of it. Only when it has come to its height can one, with the
patient's co-operation, discover the repressed instinctual trends
which are feeding the resistance; and only by living them through in
this way will the patient be convinced of their existence and their
power. The physician has nothing more to do than to wait and let
things take their course, a course which cannot be avoided nor always
be hastened. If he holds fast to this principle, he will often be
spared the disappointment of failure in cases where all the time he
has conducted the treatment quite correctly.
{376}
This 'working through' of the resistances may in practice amount to an
arduous task for the patient and a trial of patience for the analyst.
Nevertheless, it is the part of the work that effects the greatest
changes in the patient and that distinguishes analytic treatment from
every kind of suggestive treatment. Theoretically one may correlate it
with the 'abreaction' of quantities of affect pent-up by repression,
without which the hypnotic treatment remained ineffective.
----------------------------------------------------------------------
XXXIII {377}
FURTHER RECOMMENDATIONS IN THE
TECHNIQUE OF PSYCHO-ANALYSIS[140]
*Observations on Transference-Love*
(1915)
Every beginner in psycho-analysis probably feels alarmed at first at
the difficulties in store for him when he comes to interpret the
patient's associations and deal with the reproduction of repressed
material. When the time comes, however, he soon learns to look upon
these difficulties as insignificant and instead becomes convinced that
the only serious difficulties are encountered in handling the
transference.
Among the situations to which the transference gives rise, one is very
sharply outlined, and I will select this, partly because it occurs so
often and is so important in reality and partly because of its
theoretical interest. The case I mean is that in which a woman or girl
patient shows by unmistakable allusions or openly avows that she has
fallen in love, like any other mortal woman, with the physician who is
analysing her. This situation has its distressing and its comical
aspects as well as its serious ones; it is so complicated, and
conditioned by so many factors, so unavoidable and so difficult to
dissolve, that discussion of it has long been a pressing need of
analytic technique. But since those who mock at the failings of others
are not always themselves free from them, we have hardly been inclined
to rush in to the fulfilment of this task. The obligation of
professional discretion, which cannot be {378} disregarded in life but
which is useless in our science, makes itself felt here again and
again. In so far as psycho-analytical publications are a part of life,
we have here an insoluble conflict. I have recently disregarded this
matter of discretion for once[141] and shown how this same
transference situation at first retarded the development of
psycho-analytic therapy for ten years.
To a cultivated layman---and in their relation to psycho-analysis the
attitude of such men is the best we encounter---matters concerned with
love cannot be measured by the same standards as other things: it is
as though they were written on a page by themselves which would not
take any other script. If a patient falls in love with her doctor,
then, such a man will think only two outcomes are possible---one
comparatively rare, in which all the circumstances allow of a
permanent legal union between them, and the other much commoner, in
which physician and patient part, and abandon the work begun which
should have led to her recovery, as though it had been prevented by
some elemental phenomenon. There is certainly a third conceivable way
out, which even appears compatible with continuing the treatment, and
that is a love-relationship between them of an illicit character, not
intended to last permanently; but both conventional morality and
professional dignity surely make this impossible. In any event our
layman would beg the analyst to reassure him as unambiguously as
possible that this third alternative is out of the question.
It is clear that the analyst's point of view must be different from
this.
Let us take the case of the second possible alternative. After the
patient has fallen in love with the physician, they part; the
treatment is given up. But very soon the patient's condition
necessitates her making another attempt at cure with another
physician; {379} the next thing that happens is that she feels she has
fallen in love with the second physician, and just the same again when
she had broken off and begun again with a third, and so on. This
phenomenon, which occurs with such regularity and is one of the
foundations of psycho-analytical theory, may be regarded from two
points of view, that of the physician analysing and that of the
patient in need of analysis.
To the physician it represents an invaluable explanation and a useful
warning against any tendency to counter-transference which may be
lurking in his own mind. He must recognize that the patient's falling
in love is induced by the analytic situation and is not to be ascribed
to the charms of his person, that he has no reason whatever therefore
to be proud of such a 'conquest', as it would be called outside
analysis. And it is always well to be reminded of this. For the
patient, however, there are two alternatives: either she must abandon
her analytic treatment or she must make up her mind to being in love
with physicians as to an inevitable destiny.[142]
I have no doubt that the patient's relatives and friends would decide
as emphatically in favour of the first of the two alternatives as the
analyst would for the second. In my opinion, however, this is a case
in which the decision cannot be left to the tender---or rather, the
jealous egoistic---mercies of the relatives and friends. The patient's
welfare alone should decide. The love of her relatives cannot cure her
neurosis. It is not necessary for the psycho-analyst to force himself
upon anyone, but he may take up the stand that for certain purposes he
is indispensable. Anyone who takes up Tolstoy's attitude to this
problem can remain in undisputed possession of his wife or daughter,
but must try to put up with her retaining her neurosis and with the
disturbance it involves in her capacity for {380} love. After all, it
is the same situation as that of a gynecological treatment.
Incidentally, the jealous father or husband makes a great mistake if
he thinks the patient will escape falling in love with the physician
if he hands her over to some other kind of treatment than that of
analysis in order to get rid of her neurosis. The difference will be,
on the contrary, that her falling in love in a way which is bound to
remain unexpressed and unanalysed can never render that aid to her
recovery which analysis would have extracted from it.
It has come to my knowledge that certain physicians who practise
analysis frequently prepare their patients for the advent of a
love-transference or even instruct them to 'go ahead and fall in love
with the analyst so that the treatment may make progress'. I can
hardly imagine a more nonsensical proceeding. It robs the phenomenon
itself of the element of spontaneity which is so convincing and it
lays up obstacles ahead which are extremely difficult to overcome.
At the first glance it certainly does not look as if any advantage to
the treatment could result from the patient's falling in love in the
transference. No matter how amenable she has been up till then, she
now suddenly loses all understanding of and interest in the treatment,
and will not hear or speak of anything but her love, the return of
which she demands; she has either given up her symptoms or else she
ignores them; she even declares herself well. A complete
transformation ensues in the scene---it is as though some make-believe
had been interrupted by a real emergency, just as when the cry of fire
is raised in a theatre. Any physician experiencing this for the first
time will not find it easy to keep a grasp of the analytic situation
and not to succumb to the illusion that the treatment is really at an
end.
On reflection one realizes the true state of things. One remembers
above all the suspicion that everything impeding the progress of the
treatment may be an {381} expression of resistance. It certainly plays
a great part in the outbreak of passionate demands for love. One has
long noticed in the patient the signs of an affectionate transference
on to the physician and could with certainty ascribe to this attitude
her docility, her acceptance of the analytic explanations, her
remarkable comprehension and the high degree of intelligence which she
displayed during this period. This is now all swept away; she has
become completely lacking in understanding and seems to be swallowed
up in her love; and this change always came over her just as one had
to bring her to the point of confessing or remembering one of the
particularly painful or heavily repressed vicissitudes in her
life-history. She had been in love, that is to say, for a long time;
but now the resistance is beginning to make use of it in order to
hinder the progress of the treatment, to distract her interest from
the work and to put the analyst into a painful and embarrassing
position.
If one looks into the situation more closely one can recognize that
more complicated motives are also at work, of which some are connected
with the falling in love, and others are particular expressions of
resistance. To the first belong the patient's efforts to re-assure
herself of her irresistibility, to destroy the physician's authority
by bringing him down to the level of a lover, and to gain all the
other advantages which she foresees as incidental to gratification of
her love. With regard to the resistance, one may presume that at times
it uses the declarations of love as a test for the strait-laced
analyst, so that compliance on his part would call down on him a
reprimand. But above all one obtains the impression that the
resistance acts as an _agent provocateur_, intensifying the love of
the patient and exaggerating her readiness for the sexual surrender,
in order thereby to vindicate the action of her repression more
emphatically by pointing to the dangers of such licentiousness. All
this by-play, which in less complicated cases may not be present at
all, has {382} as we know been regarded by A. Adler as the essential
element in the whole process.
But how is the analyst to behave in this situation if he is not to
come to grief and yet believes that the treatment should be continued
through this love-transference and in spite of it?
It would be very simple for me now, on the score of conventional
morality, emphatically to insist that the analyst must never in any
circumstances accept or return the tender passion proffered him---that
instead he must watch for his chance to urge the infatuated woman to
take the moral path and see the necessity of renunciation, and induce
her to overcome the animal side of her nature and subdue her passion,
so as to continue the analytic work.
I shall not fulfil these expectations, however---neither the first nor
the second. Not the first, because I am writing not for patients, but
for physicians who have serious difficulties to contend with, and also
because in this instance I can go behind moral prescriptions to the
source of them, namely, to utility. I am on this occasion in the happy
position of being able to put the requirements of analytic technique
in the place of a moral decree without any alteration in the results.
Even more emphatically, however, do I decline to fulfil the second of
the expectations suggested above. To urge the patient to suppress, to
renounce and to sublimate the promptings of her instincts, as soon as
she has confessed her love-transference, would be not an analytic way
of dealing with them, but a senseless way. It would be the same thing
as to conjure up a spirit from the underworld by means of a crafty
spell and then to dispatch him back again without a question. One
would have brought the repressed impulses out into consciousness only
in terror to send them back into repression once more. Nor should one
deceive oneself about the success of any such proceeding. When
levelled at the passions, lofty language {383} achieves very little,
as we all know. The patient will only feel the humiliation, and will
not fail to revenge herself for it.
Just as little can I advocate a middle course which would recommend
itself to some as especially ingenious; this would consist in averring
one's response to the patient's feelings of affection, but in
refraining from all the physical accompaniments of these tender
feelings, until one could guide the situation along calmer channels
and raise it on to a higher level. Against this expedient I have to
object that the psycho-analytic treatment is founded on
truthfulness. A great part of its educative effect and its ethical
value lies in this very fact. It is dangerous to depart from this sure
foundation. When a man's life has become bound up with the analytic
technique, he finds himself at a loss altogether for the lies and the
guile which are otherwise so indispensable to a physician, and if for
once with the best intentions he attempts to use them he is likely to
betray himself. Since we demand strict truthfulness from our patients,
we jeopardize our whole authority if we let ourselves be caught by
them in a departure from the truth. And besides, this experimental
adoption of tender feeling for the patient is by no means without
danger. One cannot keep such complete control of oneself as not one
day suddenly to go further than was intended. In my opinion,
therefore, it is not permissible to disavow the indifference one has
developed by keeping the counter-transference in check.
I have already let it be seen that the analytic technique requires the
physician to deny the patient who is longing for love the satisfaction
she craves. The treatment must be carried through in a state of
abstinence; I do not mean merely corporal abstinence, nor yet
deprivation of everything desired, for this could perhaps not be
tolerated by any sick person. But I would state as a fundamental
principle that the patient's desire and longing are to be allowed to
{384} remain, to serve as driving forces for the work and for the
changes to be wrought, and that one must beware of granting this
source of strength some discharge by surrogates. Indeed, one could not
offer the patient anything but surrogates, for until the repressions
are lifted her condition makes her incapable of true satisfaction.
Let us admit that this principle---of carrying through the analytic
treatment in a state of renunciation---extends far beyond the case we
are discussing, and that it needs close consideration in order to
define the limits of its possible application. But we will refrain
from going into this question now and will keep as closely as possible
to the situation we started from. What would happen if the physician
were to behave differently, and avail himself of a freedom perhaps
available to them both to return the love of the patient and to
appease her longing for tenderness from him?
If he had been guided in his decision by the argument that compliance
on his part would strengthen his power over the patient so that he
could influence her to perform the tasks required by the treatment,
that is, could achieve a permanent cure of her neurosis by this means,
experience would teach him that he had miscalculated. The patient
would achieve her aim, but he would never achieve his. There is an
amusing story about a pastor and an insurance agent which describes
what would happen. An ungodly insurance agent lay at the point of
death and his relatives fetched the holy man to convert him before he
died. The interview lasted so long that those outside began to have
some hope. At last the door of the sick chamber opened. The
free-thinker had not been converted---but the pastor went away
insured.
If her advances were returned, it would be a great triumph for the
patient, but a complete overthrow for the cure. She would have
succeeded in what all patients struggle for, in expressing in action,
in reproducing in real life, what she ought only to remember, {385} to
reproduce as the content of her mind and to retain within the mental
sphere.[143] In the further course of the love-relationship all the
inhibitions and pathological reactions of her love-development would
come out, yet there would be no possibility of correcting them, and
the painful episode would end in remorse and a strengthening of her
tendency to repression. The love-relationship actually destroys the
influence of the analytic treatment on the patient; a combination of
the two would be an inconceivable thing.
It is therefore just as disastrous for the analysis if the patient's
craving for love prevails as if it is suppressed. The way the analyst
must take is neither of these; it is one for which there is no
prototype in real life. He must guard against ignoring the
transference-love, scaring it away or making the patient disgusted
with it; and just as resolutely must he withhold any response to
it. He must face the transference-love boldly but treat it like
something unreal, as a condition which must be gone through during the
treatment and traced back to its unconscious origins, so that it shall
assist in bringing to light all that is most hidden in the development
of the patient's erotic life, and help her to learn to control it. The
more plainly the analyst lets it be seen that he is proof against
every temptation, the sooner will the advantage from the situation
accrue to the analysis. The patient, whose sexual repressions are of
course not yet removed but merely pushed into the background, will
then feel safe enough to allow all her conditions for loving, all the
phantasies of her sexual desires, all the individual details of her
way of being in love to come to light, and then will herself open up
the way back from them to the infantile roots of her love.
With one type of woman, to be sure, this attempt to preserve the
love-transference for the purposes of analytic work without gratifying
it will not succeed. These are women of an elemental passionateness;
{386} they tolerate no surrogates; they are children of nature who
refuse to accept the spiritual instead of the material; to use the
poet's words, they are amenable only to the 'logic of gruel and the
argument of dumplings'. With such people one has the choice: either to
return their love or else to bring down upon oneself the full force of
the mortified woman's fury. In neither event can one safeguard the
interests of the treatment. One must acknowledge failure and withdraw;
and may at leisure study the problem how the capacity for neurosis can
be combined with such an intractable craving for love.
Many analysts must have discovered the way in which other women, less
violent in their love, can be brought round gradually to the analytic
point of view. Above all, the unmistakable element of resistance in
their 'love' must be insisted upon. Genuine love would make the
patient docile and intensify her readiness to solve the problems of
her case, simply because the man she loved expected it. A woman who
was really in love would gladly choose the road to completion of the
cure, in order to give herself a value in the physician's eyes and to
prepare herself for real life where her feelings of love could find
their proper outlet. Instead of this, she is showing a stubborn and
rebellious spirit, has thrown up all interest in her treatment, and
clearly too all respect for the physician's well-founded
judgement. She is bringing out a resistance, therefore, under the
guise of being in love; and in addition to this, she has no
compunction about trying to lead him into a cleft stick. For if he
refuses her love, as duty and his understanding compel him to do, she
can take up the attitude that she has been humiliated and, out of
revenge and resentment, make herself inaccessible to cure by him, just
as she is now doing ostensibly out of love.
As a second argument against the genuineness of this love one advances
the fact that it shows not a single new feature connecting it with the
present {387} situation, but is entirely composed of
repetitions and 'rechauffés' of earlier reactions, including childish
ones. One then sets about proving this by detailed analysis of the
patient's behaviour in love.
When the necessary amount of patience is added to these arguments it
is usually possible to overcome the difficult situation and to
continue the work, the patient having either moderated her love or
transformed it; the aim of the work then becomes the discovery of the
infantile object-choice and of the phantasies woven round it. I will
now, however, examine these arguments critically and put the question
whether they really represent the truth or whether by employing them
we are not in our desperation resorting to prevarication and
misrepresentation. In other words: can the love which is manifested in
analytic treatment not truly be called real?
I think that we have told the patient the truth, but not the whole
truth without regard for consequences. Of our two arguments the first
is the stronger. The part taken by resistance in the transference-love
is unquestionable and very considerable. But this love was not created
by the resistance; the latter finds it ready to hand, exploits it and
aggravates the manifestations of it. Nor is its genuineness impugned
by the resistance. The second argument is far weaker; it is true that
the love consists of new editions of old traces and that it repeats
infantile reactions. But this is the essential character of every
love. There is no love that does not reproduce infantile
prototypes. The infantile conditioning factor in it is just what gives
it its compulsive character which verges on the pathological. The
transference-love has perhaps a degree less of freedom than the love
which appears in ordinary life and is called normal; it displays its
dependence on the infantile pattern more clearly, is less adaptable
and capable of modification, but that is all and that is nothing
essential.
By what other signs can the genuineness of a love {388} be recognized?
By its power to achieve results, its capacity to accomplish its aim?
In this respect the transference-love seems to give place to none; one
has the impression that one could achieve anything by its means.
Let us resume, therefore: One has no right to dispute the 'genuine'
nature of the love which makes its appearance in the course of
analytic treatment. However lacking in normality it may seem to be,
this quality is sufficiently explained when we remember that the
condition of being in love in ordinary life outside analysis is also
more like abnormal than normal mental phenomena. The transference-love
is characterized, nevertheless, by certain features which ensure it a
special position. In the first place, it is provoked by the analytic
situation; secondly, it is greatly intensified by the resistance which
dominates this situation; and thirdly, it is to a high degree lacking
in regard for reality, is less sensible, less concerned about
consequences, more blind in its estimation of the person loved, than
we are willing to admit of normal love. We should not forget, however,
that it is precisely these departures from the norm that make up the
essential element in the condition of being in love.
The first of these three characteristics of the transference-love is
what determines the physician's course of action. He has evoked this
love by undertaking analytic treatment in order to cure the neurosis;
for him it is an unavoidable consequence of the medical situation, as
inevitable as the exposure of a patient's body or being told some
life-and-death secret. It is therefore plain to him that he is not to
derive any personal advantage from it. The patient's willingness makes
no difference whatever; it merely throws the whole responsibility on
him. Indeed, as he must know, the patient had from the beginning
entertained hopes of this way of being cured. After all the
difficulties are overcome she will often confess to a phantasy, an
expectation that she had had as she began the {389} treatment---'if
she behaved well, she would be rewarded in the end by the doctor's
love for her'.
For the physician there are ethical motives which combine with the
technical reasons to hinder him from according the patient his
love. The aim that he has to keep in view is that this woman, whose
capacity for love is disabled by infantile fixations, should attain
complete access over this function which is so inestimably important
for her in life, not that she should fritter it away in the treatment,
but preserve it for real life, if so be that after her cure life makes
that demand on her. He must not let the scene of the race between the
dogs be enacted, in which the prize was a chaplet of sausages and
which a funny fellow spoilt by throwing one sausage on to the course;
the dogs fell upon it and forgot about the race and the chaplet in the
distance luring them on to win. I do not mean to say that it is always
easy for the physician to keep within the bounds prescribed by
technique and ethics. Younger men especially, who are not yet bound by
a permanent tie, may find it a hard task. The love between the sexes
is undoubtedly one of the first things in life, and the combination of
mental and bodily satisfaction attained in the enjoyment of love is
literally one of life's culminations. Apart from a few perverse
fanatics, all the world knows this and conducts life accordingly; only
science is too refined to confess it. Again, when a woman sues for
love, to reject and refuse is a painful part for a man to play; and in
spite of neurosis and resistance there is an incomparable fascination
about a noble woman who confesses her passion. It is not the grossly
sensual desires of the patient that constitute the temptation. These
are more likely to repel and to demand the exercise of toleration in
order to regard them as a natural phenomenon. It is perhaps the finer
impulses, those 'inhibited in their aim', which lead a man into the
danger of forgetting the rules of technique and the physician's task
for the sake of a wonderful experience.
{390}
And yet the analyst is absolutely debarred from giving way. However
highly he may prize love, he must prize even more highly the
opportunity to help his patient over a decisive moment in her
life. She has to learn from him to overcome the pleasure-principle, to
give up a gratification which lies to hand but is not sanctioned by
the world she lives in, in favour of a distant and perhaps altogether
doubtful one, which is, however, socially and psychologically
unimpeachable. To achieve this mastery of herself she must be taken
through the primordial era of her mental development and in this way
reach that greater freedom within the mind which distinguishes
conscious mental activity---in the systematic sense---from
unconscious.
The analytic psychotherapist thus has a threefold battle to wage---in
his own mind against the forces which would draw him down below the
level of analysis; outside analysis against the opponents who dispute
the importance he attaches to the sexual instinctual forces and hinder
him from making use of them in his scientific method; and in the
analysis against his patients, who at first behave like his critics
but later on disclose the over-estimation of sexual life which has
them in thrall, and who try to take him captive in the net of their
socially ungovernable passions.
The lay public, of whose attitude to psycho-analysis I spoke at the
outset, will certainly seize the opportunity given it by this
discussion of the transference-love to direct the attention of the
world to the dangers of this therapeutic method. The psycho-analyst
knows that the forces he works with are of the most explosive kind and
that he needs as much caution and conscientiousness as a chemist. But
when has it ever been forbidden to a chemist, on account of its
danger, to occupy himself with the explosives which, just because of
their effectiveness, are so indispensable? It is remarkable that
psycho-analysis has to win for itself afresh all the liberties which
have long been accorded to other medical work. I certainly do not
advocate that the {391} harmless methods of treatment should be
abandoned. For many cases they suffice, and when all is said, the
_furor sanandi_ is no more use to human society than any other kind of
fanaticism. But it is grossly to undervalue both the origins and the
practical significance of the psychoneuroses to suppose that these
disorders are to be removed by pottering about with a few harmless
remedies. No; in medical practice there will always be room for the
'_ferrum_' and the '_ignis_' as well as for the '_medicina_', and
there a strictly regular, unmodified psycho-analysis, which is not
afraid to handle the most dangerous forces in the mind and set them to
work for the benefit of the patient, will be found indispensable.
----------------------------------------------------------------------
XXXIV {392}
TURNINGS IN THE WAYS OF PSYCHO-
ANALYTIC THERAPY[144]
(1919)
You know that we have never been proud of the fullness and finality of
our knowledge and our capacity; as at the beginning, we are ready now
to admit the incompleteness of our understanding, to learn new things
and to alter our methods in any way that yields better results.
Now that we are met together once more after the long and difficult
years of separation we have lived through, I feel drawn to review the
position of our therapy, for to it indeed we owe our position, and to
take a survey of the new directions in which it may develop.
We have formulated our therapeutic task as one of bringing to the
knowledge of the patient the unconscious, repressed impulses existing
in his mind and, to this end, of uncovering the resistances that
oppose themselves to this extension of his knowledge about
himself. Now when we speak of uncovering these resistances, do we also
mean that they are thereby overcome? Certainly not always; but our
hope is to achieve this by exploiting the patient's transference to
the person of the physician, so as to induce him to adopt our
conviction of the inexpediency of the repressive processes established
in childhood and of the impossibility of conducting life on the
pleasure-principle. {393} I have expounded elsewhere[145] the dynamic
conditions in the new conflict we lead the patient through, which we
have substituted in him for the previous conflict of his illness. I
know of nothing there to alter at present.
The work by which we bring the repressed material in his mind into the
patient's consciousness has been called by us psycho-analysis. Why
'analysis', which means divellication and dissection and, by analogy
with the work of chemists, suggests the substances they find existing
in nature and bring into their laboratories? Because in an important
respect there is really an analogy between the two. The patient's
symptoms and pathological manifestations, like all his mental
processes, are of a very elaborately organized nature; their elements
at bottom consist of motives, of instinctual impulses. But the patient
knows nothing of these elemental motives or not nearly enough. Now we
teach him to understand the structure of these highly complicated
formations in his mind; we trace the symptoms back to the instinctual
impulses which motivate them; we point out to the patient these
instinctual motives in his symptoms of which he has hitherto been
unaware---just as a chemist segregates the fundamental substance, the
chemical 'element', out of the salt in which it had been combined with
other elements and was thus unrecognizable. In the same way with
expressions of his personality that were not regarded as pathological,
we show the patient that he was only to a certain extent conscious of
their motivation, that other instinctual impulses of which he had
remained in ignorance had co-operated in forming them.
We have also thrown light on the sexual force in man, too, by
separating it into its component elements, and when we interpret a
dream we proceed by ignoring the dream as a whole and instituting
associations to its single elements.
{394}
Now this well-founded comparison of the psycho-analytic medical
procedure with a chemical procedure might suggest a new direction for
our therapy. We have _analysed_ the patient, _i.e._ separated his
mental processes into their constituent parts and demonstrated these
instinctual elements in him singly and in isolation; what could be
more natural than a request that we should also help him to make a new
and a better re-combination of them? You know that this demand has
actually been put forward. We have heard that after the analysis of
the diseased mental organism a synthesis of it must follow! And, close
upon this, concern was expressed that the patient might be given too
much analysis and too little synthesis; and then there followed a move
to put all the weight on this synthesis as the main factor in the
psychotherapeutic effect---seeing in it a kind of revivification of
something destroyed by vivisection.
I cannot imagine, however, that any new task for us is to be found in
this psycho-synthesis. If I were to permit myself to be honest and
uncivil I should say it was nothing but a meaningless phrase. I will
limit myself to remarking that it is only pushing a comparison so far
that it ceases to have any foundation, or, if you prefer, that it is
an unjustifiable exploitation of a name. A name, however, is only a
label applied to it to distinguish a thing from other similar things,
not a syllabus, a description of its content or a definition. And the
two objects in a comparison need only touch at a single point and may
be entirely different from each other in all else. The life of the
mind is a thing so unique and peculiar to itself that no one
comparison can reflect its nature. The work of psycho-analysis
suggests analogies with chemical analysis, but just as much with the
incursions of the surgeon or the manipulations of the orthopædist or
the influence of the pedagogue. The comparison with chemical analysis
has its limits, in this way: in mental life we have to deal with
forces that are under {395} a compulsion towards unification and
combination. When we succeed in dissolving a symptom into its
elements, in freeing an instinct from one concatenation, it does not
remain in isolation, but immediately enters into combination again
with something else.[146]
On the contrary, indeed! The neurotic human being brings us his mind
racked and rent by resistances; whilst we are working at analysis of
it and at removing the resistances, this mind of his begins to grow
together; that great unity which we call his ego fuses into one all
the instinctual trends which before had been split off and barred away
from it. The psycho-synthesis is thus achieved during analytic
treatment without our intervention, automatically and inevitably. We
have created the conditions for it by dissolving the symptoms into
their elements and by removing the resistances. There is no truth in
the idea that when the patient's mind is dissolved into its elements
it then quietly waits until somebody puts it together again.
Developments in our therapy will surely proceed in a different
direction, therefore; above all, in that which Ferenczi[147] has
lately characterized as 'activity' on the part of the analyst.
Let us hasten to agree upon what we mean by this activity. We defined
our therapeutic task as consisting of two things: making conscious the
repressed material and uncovering the resistances. In that we are
active enough, to be sure. But are we to leave it to the patient to
deal alone with the resistances we have pointed out to him? Can we
give him no other help in this besides the stimulus he gets from the
transference? Does it not seem natural that we should help him also
in another way, by putting him into the mental situation most
favourable to solution of the {396} conflict, which is our aim? After
all, what he can achieve depends partly on a number of external
circumstances which converge in their influence on him. Should we
hesitate to alter this combination by intervening in a suitable
manner? I think activity of such a kind on the part of the physician
analysing is unobjectionable and entirely justifiable.
You observe that this opens up a new vein in analytic technique, which
will require close application in order to work it out and which will
yield very definite rules. I shall not attempt to introduce you to-day
to this new technique which is still being evolved, but will content
myself with enunciating a fundamental principle which will probably be
the guiding force in our work on this new problem. It runs as follows:
_Analytic treatment should be carried through, as far as is possible,
under privation_---_in a state of abstinence_.
How far it is possible to determine this must be left for more
detailed discussion. By abstinence, however, is not to be understood
doing without any and every satisfaction---that would of course not be
practicable; nor do we mean what it popularly connotes, refraining
from sexual intercourse; it means something else which has far more to
do with the dynamics of illness and recovery.
You will remember that it was a _frustration_ that made the patient
ill, and that his symptoms serve him as substitutive
gratifications. It is possible to observe during the treatment that
every improvement in his condition reduces the rate at which he
recovers and diminishes the instinctual energy impelling him towards
cure. But this instinctual propelling force is indispensable for cure;
reduction of it endangers our aim, the patient's restoration to
health. What is the conclusion that forces itself inevitably upon us?
Harsh though it may sound, we must see to it that the patient's
sufferings, to a degree that is in some way or other effective, do not
prematurely come to an end. When the symptoms have been dissected and
the value {397} of them thus discounted, his sufferings become
moderated, and then we must set up a sufficiently distressing
privation again in some other sensitive spot, or else we run the risk
of never achieving any further improvement except quite insignificant
and transitory ones.
As far as I can see, danger threatens from two directions. On the one
hand, when the illness has been broken down by the analysis the
patient applies his most assiduous endeavours to creating for himself
in place of his symptoms new substitutive gratifications, now lacking
in the feature of suffering. He makes use of the colossal capacity for
displacement in the libido that is now partly liberated, in order to
invest with libido and promote to the position of substitutive
gratifications the most diverse kinds of activities, pleasures,
interests, habits, including those that he already possessed. He
continually finds new distractions of this kind, into which the energy
necessary to complete the cure escapes, and he knows how to keep them
secret for a time. It is the analyst's task to detect these by-paths
and to require him every time to abandon them, however harmless the
performance which leads to satisfaction may be in itself. The
half-cured person may also undertake escapades that are not so
harmless, as when, for instance, if he is a man, he seeks prematurely
to bind himself to a woman. It may be observed, incidentally, that
unhappy marriage and bodily infirmity are the two things that most
often dissolve a neurosis. They both gratify especially the sense of
guilt (need for punishment) which binds many neurotics so fast to
their neuroses. By a foolish choice in marriage they punish
themselves; a long organic illness they regard as a punishment by fate
and then often cease to keep up their neurosis.
In all such situations activity on the part of the physician must take
the form of energetic opposition to premature substitutive
gratifications. It is easier for him, however, to prevent the second
danger, one {398} not to be under-estimated, which jeopardizes the
propelling forces of the analysis. The patient looks for his
substitutive gratification above all in the treatment itself, in his
transference-relationship with the physician, and he may even strive
to compensate himself through this means for all the other privations
laid upon him. A certain amount must of course be permitted to him,
more or less according to the nature of the case and the patient's
individuality. But it is not good to let it become too much. Any
analyst who out of the fullness of his heart and his readiness to help
perhaps extends to the patient all that one human being may hope to
receive from another, commits the same economic error which our
non-analytic institutions for nervous patients are guilty of. They
exert themselves only to make everything as pleasant as possible for
the patient, so that he may feel well there and gladly take flight
back there again away from the trials of life. In so doing they
entirely forgo making him stronger for life and more capable of
carrying out the actual tasks of his life. In analytic treatment all
such cosseting must be avoided. As far as his relations with the
physician are concerned, the patient must have unfulfilled wishes in
abundance. It is expedient to deny him precisely those satisfactions
which he desires most intensely and expresses most importantly.
I do not think I have exhausted the range of useful activity on the
part of the physician with the statement that a condition of privation
is to be kept up during the treatment. Activity in another direction
during analytic treatment has already, as you will remember, been a
point at issue between us and the Swiss school. We rejected most
emphatically the view that we should convert into our own property the
patient who puts himself into our hands in seek of help, should carve
his destiny for him, force our own ideals upon him, and with the
arrogance of a Creator form him in our own image and see that it was
good. I still to-day maintain this attitude of rejection, and I think
that this is the {399} place for that medical discretion which we have
had to ignore in other connections; I have learnt, too, that such a
far-reaching activity towards patients is not at all requisite for
therapeutic aims. For I have been able, without affecting their
individuality, to help people with whom I had nothing in common,
neither nationality, education, social position nor outlook upon life
in general. At the time of the controversy I spoke of, I had the
impression, to be sure, that the objections of our spokesmen---I think
it was Ernest Jones who took the chief part---were too harsh and
uncompromising. We cannot avoid also taking for treatment patients who
are so helpless and incapable of ordinary life that for them one has
to combine analytic with educative influence; and even with the
majority now and then occasions arise in which the physician is bound
to take up the position of teacher and mentor. But it must always be
done with great caution, and the patient should be educated to
liberate and fulfil his own nature, and not to resemble ourselves.
Our honoured friend, J. J. Putnam, in the land of America which is now
so hostile to us, must forgive us if we cannot accept his proposal
either, namely, that psycho-analysis should place itself in the
service of a particular philosophical outlook on the world and should
urge this upon the patient in order to ennoble him. I would say that
after all this is only tyranny, even though disguised by the most
honourable motives.
Lastly, another quite different kind of activity is necessitated by
the gradually growing appreciation that the various forms of disease
treated by us cannot all be dealt with by the same technique. It would
be premature to discuss this in detail, but I can give two examples of
the way in which a new kind of activity comes into question. Our
technique grew up in the treatment of hysteria and is still directed
principally to the cure of this affection. But the phobias have
already made it necessary for us to go beyond our former limits. One
can hardly ever master a phobia if one {400} waits till the patient
lets the analysis influence him to give it up. He will never in that
case bring for the analysis the material indispensable for a
convincing solution of the phobia. One must proceed differently. Take
the example of agoraphobia; there are two classes of it, one slight
and the other severe. Patients belonging to the first indeed suffer
from anxiety when they go about alone, but they have not yet given up
going out alone on that account; the others protect themselves from
the anxiety by altogether giving up going about alone. With these last
one succeeds only when one can induce them through the influence of
the analysis to behave like the first class, that is, to go about
alone and to struggle with their anxiety while they make the
attempt. One first achieves, therefore, a considerable moderation of
the phobia, and it is only when this has been attained by the
physician's recommendation that the associations and memories come
into the patient's mind enabling the phobia to be solved.
In severe cases of obsessive acts a passive waiting attitude seems
even less well adapted; indeed in general these cases incline to
favour an asymptomatic process of cure, an interminable protraction of
the treatment; in their analysis there is always the danger of a great
deal coming to light without its effecting any change in them. I think
there is little doubt that here the correct technique can only be to
wait until the treatment itself has become a compulsion, and then with
this counter-compulsion forcibly to suppress the compulsion of the
disease. You will understand, however, that these two instances I
have given you are only samples of the new developments towards which
our therapy is tending.
And now in conclusion I will cast a glance at a situation which
belongs to the future---one that will seem fantastic to many of you,
but which I think, nevertheless, deserves that we should be prepared
for it in our minds. You know that the therapeutic effects {401} we
can achieve are very inconsiderable in number. We are but a handful of
people, and even by working hard each one of us can deal in a year
with only a small number of persons. Against the vast amount of
neurotic misery which is in the world, and perhaps need not be, the
quantity we can do away with is almost negligible. Besides this, the
necessities of our own existence limit our work to the well-to-do
classes, accustomed to choose their own physicians, whose choice is
diverted away from psycho-analysis by all kinds of prejudices. At
present we can do nothing in the crowded ranks of the people, who
suffer exceedingly from neuroses.
Now let us assume that by some kind of organization we were able to
increase our numbers to an extent sufficient for treating large masses
of people. Then on the other hand, one may reasonably expect that at
some time or other the conscience of the community will awake and
admonish it that the poor man has just as much right to help for his
mind as he now has to the surgeon's means of saving life; and that the
neuroses menace the health of a people no less than tuberculosis, and
can be left as little as the latter to the feeble handling of
individuals. Then clinics and consultation-departments will be built,
to which analytically trained physicians will be appointed, so that
the men who would otherwise give way to drink, the women who have
nearly succumbed under their burden of privations, the children for
whom there is no choice but running wild or neurosis, may be made by
analysis able to resist and able to do something in the world. This
treatment will be free. It may be a long time before the State regards
this as an urgent duty. Present conditions may delay its arrival even
longer; probably these institutions will first be started by private
beneficence; some time or other, however, it must come.
The task will then arise for us to adapt our technique to the new
conditions. I have no doubt that the validity of our psychological
assumptions will impress {402} the uneducated too, but we shall need
to find the simplest and most natural expression for our theoretical
doctrines. We shall probably discover that the poor are even less
ready to part with their neuroses than the rich, because the hard life
that awaits them when they recover has no attraction, and illness in
them gives them more claim to the help of others. Possibly we may
often only be able to achieve something if we combine aid for the mind
with some material support, in the manner of Emperor Joseph. It is
very probable, too, that the application of our therapy to numbers
will compel us to alloy the pure gold of analysis plentifully with the
copper of direct suggestion; and even hypnotic influence might find a
place in it again, as it has in the treatment of war-neuroses. But
whatever form this psychotherapy for the people may take, whatever the
elements out of which it is compounded, its most effective and most
important ingredients will assuredly remain those borrowed from strict
psycho-analysis which serves no ulterior purpose.
----------------------------------------------------------------------
LIST OF BOOKS AND PAPERS REFERRED
TO IN THE TEXT
- Adler,
- 'Drei Psychoanalysen von Zahleneinfällen und obsedierenden Zahlen',
_Psychiatrisch-neurologische Wochenschrift_, Nr. 28, 1905.
- Andreas-Salomé, Lou,
- '"Anal" und "Sexual"', _Imago_, Bd. IV., 1916.
- Binswanger,
- _Die Pathologie und Therapie der Neurasthenie_, 1896.
- Bleuler,
- 'Dementia Praecox oder Gruppe der Schizophrenien', Aschaffenburg's
_Handbuch der Psychiatrie_, 1911.
- Breuer und Freud,
- _Studien über Hysterie_, 1895. Vienna. Fourth Edition, 1922.
- Eckstein, Emma,
- _Die Sexualfrage in der Erziehung des Kindes_, 1904.
- v. Ehrenfels,
- _Sexualethik_, Grenzfragen des Nerven- und Seelenlebens, LVI.
Wiesbaden, 1907.
- Ellis, Havelock,
- _Studies in the Psychology of Sex_, vol. i., 'The Evolution of
Modesty', 1904.
- _The World of Dreams_, 1911.
- Erb, W.,
- _Über die wachsende Nervosität unserer Zeit_, 1893.
- Ferenczi,
- 'Introjection and Transference' (1909), _Contributions to
Psycho-Analysis_, translated by Ernest Jones, Boston, 1916. First
published in German, _Jahrbuch_, Bd. I., 1909.
- 'Stages in the Development of the Sense of Reality' (1913),
_Contributions to Psycho-Analysis_, translated by Ernest Jones,
Boston, 1916. First published in German, _Zeitschrift_, Bd. I.,
1913.
- 'Technische Schwierigkeiten einer Hysterieanalyse', _Zeitschrift_,
Bd. V., 1919.
- 'Zur Symbolik des Medusenhauptes', _Zeitschrift_, Bd. IX., 1923.
- Freud,
- _Beyond the Pleasure Principle_, London, 1922. Translated by C. M.
Hubback from _Jenseits des Lustprinzips_, Vienna, 1920.
- _Das Ich und das Es_, Vienna, 1923.
- _Die Traumdeutung_, Vienna, 1900. Seventh Edition, 1922.
- _Drei Abhandlungen zur Sexualtheorie_, 1905. Fifth Edition, 1922.
- _Group Psychology and the Analysis of the Ego_, London, 1922.
Translated by James Strachey from _Massenpsychologie und
Ichanalyse_, Vienna, 1921.
- _Totem und Tabu_, Vienna, 1913.
- _Zur Psychopathologie des Alltagslebens_, first published in the
_Monatsschrift für Psychiatrie und Neurologie_, Bd. X., 1901. Also
published in book form by the Internationaler Psychoanalytischer
Verlag, Vienna, 1904. Tenth Edition, 1924.
- Grasset,
- 'La sensation du "déjà vu",' _Journal de psychologie normale et
pathologique_, T. 1, 1904.
- Janet, Pierre,
- _Névroses et idées fixes_, 1898.
- Jeremias,
- _Babylonisches im neuen Testament_, 1906.
- _Das alte Testament im Lichte des alten Orients_, Zweite Auflage,
1906.
- Jones, Ernest,
- 'Hate and Anal Erotism in the Obsessional Neurosis' (1913), _Papers
on Psycho-Analysis_, Third Edition, 1923. First published in German,
_Zeitschrift_, Bd. I., 1913.
- Jung,
- 'Die Bedeutung des Vaters für den Schicksal des Einzelnen',
_Jahrbuch_, Bd. I., 1909.
- 'Die psychologische Diagnose des Tatbestandes',
_Juristischpsychiatrische Grenzfragen_, Bd. IV., 2, 1906.
- 'Symbole und Wandlungen der Libido', _Jahrbuch_, Bd. III., 1911.
- v. Krafft-Ebing,
- 'Nervosität und neurasthenische Zustände', Nothnagel's Handbuch der
speziellen Pathologie und Therapie.
- Lipschütz, A.,
- _Die Pubertätsdrüse und ihre Wirkungen_, Berne, 1919.
- Löwenfeld,
- _Die psychische Zwangserscheinungen_, 1904.
- Marcinowski,
- 'Die erotischen Quellen der Minderwertigkeitsgefühle', _Zeitschrift
für Sexualwissenschaft_, Bd. IV., 1918.
- Multatuli,
- _Briefe_, 1906.
- Pick, A.,
- 'Über pathologische Träumerei und ihre Beziehungen zur Hysterie',
_Jahrbuch für Psychiatrie und Neurologie_, Bd. XIV., 1896.
- Sadger, J.,
- 'Die Bedeutung der psychoanalytischen Methode nach Freud',
_Centralblatt für Nervenheilkunde und Psychiatrie_, Nr. 229, 1907.
- 'Jahresbericht über sexuelle Perversionen', _Jahrbuch_, Bd. VI.,
1914.
- Stekel, W.,
- _Die Sprache des Traumes_, Wiesbaden, 1911.
----------------------------------------------------------------------
NOTES
[1]: Lecture delivered to Prof. Löffler's Seminar in June 1906. First
published in the _Archiv für Kriminalanthropologie und
Kriminalistik_, von H. Gross, Bd. 26, 1906; reprinted in
_Sammlung_, Zweite Folge. [Translated by E. B. M. Herford.]
[2]: Jung, _Die psychologische Diagnose des Tatbestandes_, 1906.
[3]: Freud, _Zur Psychopathologie des Alltagslebens_.
[4]: Adler, _Drei Psychoanalysen von Zahleneinfällen und obsedierenden
Zahlen_, 1905.
[5]: According to Jung, _op. cit._
[6]: Breuer und Freud, _Studien über Hysterie_, 1895.
[7]: Cf. Freud, _Die Traumdeutung_.
[8]: First published in the _Zeitschrift für Religionspsychologie_,
Bd. I., 1907; reprinted in _Sammlung_, Zweite Folge. [Translated
by R. C. McWatters.]
[9]: Cf. Löwenfeld, _Die psychische Zwangserscheinungen_, 1904.
[10]: Cf. Freud, _Die Traumdeutung_.
[11]: First published in _Soziale Medizin und Hygiene_, Bd. II., 1907;
reprinted in _Sammlung_, Zweite Folge. [Translated by E. B. M.
Herford.]
[12]: Multatuli, _Briefe_, 1906, Bd. I. S. 26.
[13]: Emma Eckstein, _Die Sexualfrage in der Erziehung des Kindes_,
1904.
[14]: [The original has also: _am Schlusse des Volksschulunterrichtes
und vor Eintritt in die Mittelschule_.---Trans.]
[15]: First published in the _Psychiatrisch-Neurologische
Wochenschrift_, Bd. IX., 1908; reprinted in _Sammlung_, Zweite
Folge. [Translated by R. C. McWatters.]
[16]: Cf. Freud, _Drei Abhandlungen zur Sexualtheorie_, 1905.
[17]: Since it is just these remarks about the anal erotism of infants
in my three contributions to the sexual theory that have most
scandalized uncomprehending readers, I venture to insert here an
observation which I owe to a very intelligent patient. 'An
acquaintance of mine who has read the _Drei Abhandlungen zur
Sexualtheorie_ was talking about the book and said he fully
accepted it, but one passage---though naturally he also accepts
and understands it---appeared to him so grotesque and comic that
he sat down and laughed over it for a quarter of an hour. This
passage runs: "It is one of the best signs of later eccentricity
or nervousness if an infant obstinately refuses to empty its
bowel when placed on the chamber, that is, when the nurse
wishes, but withholds this function at his own
pleasure. Naturally it does not matter to the child if he soils
his bed; his only concern is not to lose the pleasure incidental
to the act of defæcation." The picture of this infant sitting on
the chamber and deliberating whether he should allow such a
limitation of his personal independence, and of his anxiety not
to lose the pleasure of defæcation, caused my friend the
greatest merriment. Some twenty minutes later, as we were
sitting at tea, my acquaintance suddenly remarked without any
preliminary, "Do you know, there just occurs to me, as I see the
cocoa in front of me, an idea that I always had as a child. I
then always pretended to myself that I was the cocoa
manufacturer Van Houten" (he pronounced it "Van Hauten"), "that
I possessed a great secret for the preparation of this cocoa,
and that all the world was trying to get this valuable secret
from me, but that I carefully kept it to myself. Why it was Van
Houten that I hit upon I do not know. Probably it was that his
advertisements made the greatest impression on me." Laughing,
and without thinking much about the meaning of my words, I
replied, "_Wann haut'n_ (Van Houten) _die Mutter_?" [When do
mothers smack?] It was only later that I realized that my pun
really contained the key to the whole of his sudden recollection
from childhood, which I now recognized as a striking example of
a screen-phantasy, setting at rest the sense of guilt by means
of a complete reversal of the value of its memory content, while
it retained its reference to actual experience (the nutritional
process) and was supported by a phonetic association:
"cocoa"---"_Wann haut'n_" (Van Houten). (Displacement from
behind forwards; excrement becomes aliment; the shameful
substance which has to be concealed turns into a secret which
enriches the world.) It was interesting to me how in this case,
after a defence-reaction, which to be sure took the
comparatively mild form of a merely formal objection, the most
striking evidence was supplied from the subject's own
unconscious after a quarter of an hour without any effort on his
part.'
[Besides the pun on the word Van Houten, there is probably a
further association between the German for cocoa (_Kakao_) and
for the nursery term for fæces in that language,
_Kakis_. Compare also the English _caca_ for fæces.---Trans.]
[18]: Compare hysterical possession and demoniac epidemics.
[19]: [Unfamiliar to English readers, but compare 'the goose which
lays golden eggs'.---Trans.]
[20]: Jeremias, _Das Alte Testament im Lichte des alten Orients_,
1906, p. 216, and _Babylonisches im Neuen Testament_, 1906,
p. 96. 'Mammon is Babylonian "Manman", another name of Nergal,
the god of the underworld. According to an Oriental myth which
has passed over into sagas and folk-tales, gold is the excrement
of hell; see _Monotheistische Strömungen innerhalb der
babylonischen Religion_, S. 16, Anmk. i.'
[21]: First published in the _Zeitschrift für Sexualwissenschaft_,
Bd. I., 1908; reprinted in _Sammlung_, Zweite Folge. [Translated
by Douglas Bryan.]
[22]: Cf. Breuer und Freud, _Studien über Hysterie_, 1895; Pierre
Janet, _Névroses et idées fixes_, I., 'Les rêveries
subconscientes,' 1898; Havelock Ellis, _Studies in the
Psychology of Sex_, vol. i., 'The Evolution of Modesty', 1904;
Freud, _Die Traumdeutung_, 1900; A. Pick, _Über pathologische
Träumerei und ihre Beziehungen zur Hysterie_, 1896.
[23]: Havelock Ellis is of the same opinion; _op. cit._
[24]: Cf. Freud, _Die Traumdeutung_, Dritte Auflage, p. 331 _et seq._
[25]: Cf. Freud, _Drei Abhandlungen zur Sexualtheorie_.
[26]: The same is true of the relation between the 'latent'
dream-thoughts and the elements of the 'manifest'
dream-content. See the section on dream-work in my
_Traumdeutung_.
[27]: J. Sadger has recently discovered this independently in his own
psycho-analyses, and even vouches for its general validity: _Die
Bedeutung der psychoanalytischen Methode nach Freud_.
[28]: _Drei Abhandlungen zur Sexualtheorie_.
[29]: First published in _Sexualprobleme_, new issue of the periodical
_Mutterschutz_, Bd. IV., 1908; reprinted in _Sammlung_, Zweite
Folge. [Translated by Douglas Bryan.]
[30]: Freud, 'Analysis of a Phobia in a Five-year-old Boy,' *Collected
Papers*, vol. iii.
[31]: Freud, _op. cit._
[32]: In his autobiographical book entitled _Monsieur Nicolas_,
published in 1794, this sadistic misconception of coitus is
confirmed by Restif de la Bretonne, who there relates an
experience from his fourth year.
[33]: The games that are significant in later neuroses are the
'doctor' game and the game of 'father and mother'.
[34]: First published in _Sexual Probleme_, new issue of the
periodical _Mutterschutz_, Bd. IV., 1908; reprinted in
_Sammlung_, Zweite Folge. [Translated by E. B. Herford and
E. Colburn Mayne.]
[35]: _Sexualethik_, Grenzfragen des Nerven- und Seelenlebens.
[36]: _Loc. cit._, p. 32 _et seq._
[37]: _Loc. cit._, p. 35. [The preceding paragraph is clearly an
abstract of v. Ehrenfels' views, and does not necessarily
represent Freud's own.---*Ed.*]
[38]: _Über die wachsende Nervosität unserer Zeit_, 1893.
[39]: _Die Pathologie und Therapie der Neurasthenie_, 1896.
[40]: _Nervosität und neurasthenische Zustände_, 1895, p. 11.
[41]: *Collected Papers*, vol. i.
[42]: Cf. my _Drei Abhandlungen zur Sexualtheorie_.
[43]: Cf. introductory remarks above.
[44]: First published in the _Zeitschrift für Psychotherapie und
medizinische Psychologie_, Bd. I., 1909; reprinted in
_Sammlung_, Zweite Folge. [Translated by Douglas Bryan.]
[45]: 'Hysterical Phantasies and their Relation to Bisexuality',
No. V. of this volume, p. 51.
[46]: Cf. Freud, _Drei Abhandlungen zur Sexualtheorie_.
[47]: First published in _Ärztliche Standeszeitung_, Vienna, 1910;
reprinted in _Sammlung_, Dritte Folge. [Translated by E. Colburn
Mayne.]
[48]: First published in _Zentralblatt_, Bd. II., 1912; reprinted in
_Sammlung_, Dritte Folge. [Translated by E. Colburn Mayne.]
[49]: Cf. Freud, 'Formulations regarding the two Principles in Mental
Functioning', *Collected Papers*, vol. iv.
[50]: Cf. Jung, _Die Bedeutung des Vaters für das Schicksal des
Einzelnen_, 1909.
[51]: Paper read before the International Psycho-Analytical Congress
at Munich in 1913; reprinted in _Sammlung_, Vierte
Folge. [Translated by Edward Glover and E. Colburn Mayne.]
[52]: Since the work of W. Fliess has revealed the biological
importance of periodicity, it has become conceivable that
developmental disturbances may be ascribed to modifications in
the duration of the various stages.
[53]: Cf. 'Account of a Case of Paranoia,' *Collected Papers*,
vol. iii.
[54]: Ernest Jones, _Hate and Anal Erotism in the Obsessional
Neurosis_, 1913.
[55]: Ferenczi, _Stages in the Development of the Sense of Reality_.
[56]: W. Stekel, _Die Sprache des Traumes_, 1911, S. 536.
[57]: First published in the _Zeitschrift_, Bd. I., 1913; reprinted in
_Sammlung_, Vierte Folge. [Translated by Edward Glover.]
[58]: I was here guilty of a condensation of the material, which I was
able to put right when I read my account to the patient. The
nurse who appeared on the bridge had not been discharged on
account of neglect. She was discharged because the child's
mother, who had to leave home at the time, wanted to leave her
child in charge of an older---_i.e._ after all, a more
trustworthy!---attendant. This was followed by a reference to
yet another nurse who had actually been discharged on account of
neglect, but who had not drowned herself. The material
necessary for interpretation of the dream element comes, as is
often the way, from two sources. My memory completed the
synthesis leading to interpretation. For the rest, this story of
the drowned nurse contains the element of a mother's departure,
which the patient connected with the departure of her
husband. We thus have here an overdetermination which detracts
somewhat from the elegance of the interpretation.
[59]: As a matter of fact, a few days later the nurse confessed to a
third person that she had fallen asleep, thus confirming the
lady's interpretation.
[60]: Dritte Auflage, p. 367 _et seq._
[61]: First published in _Zeitschrift_, Bd. I., 1913; reprinted in
_Sammlung_, Vierte Folge. [Translated by E. Colburn Mayne.]
[62]: First published in _Zeitschrift_, Bd. III., 1915; reprinted in
_Sammlung_, Vierte Folge. [Translated by Edward Glover.]
[63]: First published in _Zeitschrift_, Bd. IV., 1916; reprinted in
_Sammlung_, Vierte Folge. [Translated by Douglas Bryan.]
[64]: First published in _Zeitschrift_, Bd. IV., 1916; reprinted in
_Sammlung_, Vierte Folge. [Translated by Edward Glover.]
[65]: 'Character and Anal Erotism', 1908; see No. IV. of this volume,
p. 45.
[66]: 'The Predisposition to Obsessional Neurosis', 1913; see No. XI.
of this volume, p. 122.
[67]: [A child's word for fæces. Cf. 'Analysis of a Phobia in a
Five-year-old Boy', *Collected Papers*, vol. iii.---Trans.]
[68]: Lou Andreas-Salome, _'Anal' und 'Sexual'_.
[69]: First published in _Zeitschrift_, Bd. V., 1919; reprinted in
_Sammlung_, Fünfte Folge. [Translated by Alix and James
Strachey.]
[70]: Cf. the part played by Fate in the myth of Oedipus.
[71]: _Die erotischen Quellen der Minderwertigkeitsgefühle_, 1918.
[72]: Cf. 'Instincts and their Vicissitudes,' 1918, *Collected
Papers*, vol. iv.
[73]: First published in _Zeitschrift_, Bd. VI., 1920; reprinted in
_Sammlung_, Fünfte Folge. [Translated by Barbara Low and R.
Gabler.]
[74]: I do not see any progress or advantage in the introduction of
the term 'Electra-complex', and do not advocate its use.
[75]: Cf. J. Sadger, _Jahresbericht über sexuelle Perversionen_.
[76]: It is by no means rare for a love-relation to be broken off by
means of a process of identification on the part of the lover
with the loved object, a process equivalent to a kind of
regression to narcissism. After this has been accomplished, it
is easy in making a fresh choice of object to direct the libido
to a member of the sex opposite to that of the earlier choice.
[77]: The displacements of the libido here described are doubtless
familiar to every analyst from investigation of the anamneses of
neurotics. With the latter, however, they occur in early
childhood, at the beginning of the love-life; with our patient,
who was in no way neurotic, they took place in the first years
following puberty, though, by the way, they were just as
completely unconscious. Perhaps one day this temporal factor
may turn out to be of great importance.
[78]: As 'retiring in favour of someone else' has not previously been
mentioned among the causes of homosexuality, or in the mechanism
of libido-fixation in general, I will adduce here another
analytical observation of the same kind which has a special
feature of interest. I once knew two twin brothers, both of whom
were endowed with strong libidinal impulses. One of them was
very successful with women, and had innumerable affairs with
women and girls. The other went the same way at first, but it
became unpleasant for him to be trespassing on his brother's
beat, and, owing to the likeness between them, to be mistaken
for him on intimate occasions, so he got out of the difficulty
by becoming homosexual. He left the women to his brother, and
thus 'retired' in his favour. Another time I treated a young
man, an artist, unmistakably bisexual in disposition, in whom
the homosexual trend had come to the fore simultaneously with a
disturbance in his work. He fled from both women and work
together. The analysis, which was able to bring him back to
both, showed that the fear of the father was the most powerful
psychic motive for both the disturbances, which were really
renunciations. In his imagination all women belonged to the
father, and he sought refuge in men out of submission, so as to
'retire from' the conflict in favour of the father. Such a
motivation of the homosexual object-choice must be by no means
uncommon; in the primeval ages of the human race all women
presumably belonged to the father and head of the primal horde.
Among brothers and sisters who are not twins this 'retirement'
plays a great part in other spheres as well as in that of the
love-choice. For example, an elder brother studies music and is
admired for it; the younger, far more gifted musically, soon
gives up his own musical studies, in spite of his longing, and
cannot be persuaded to touch an instrument again. This is one
example of a very frequent occurrence, and investigation of the
motives leading to this 'retirement' rather than to open rivalry
discloses very complicated conditions in the mind.
[79]: *Collected Papers*, vol. iv.
[80]: [In the text there is a play on the word _niederkommen_, which
means both 'to fall' and 'to be delivered of a child'. There is
also in English a colloquial use of the verb 'to fall', meaning
pregnancy or childbirth.---Trans.]
[81]: That the various means of suicide can represent sexual
wish-fulfilments has long been known to all analysts. (To poison
oneself = to become pregnant; to drown = to bear a child; to
throw oneself from a height = to be delivered of a child.)
[82]: Cf. 'Reflections upon War and Death', *Collected Papers*,
vol. iv.
[83]: [A reference to the European War, 1914--18.---Trans.]
[84]: [_I.e._ believed on condition that it is regarded as not
certain.---Trans.]
[85]: Cf. Kriemhilde's confession in the _Nibelungenlied_.
[86]: Cf. A. Lipschütz, _Die Pubertätsdrüse und ihre Wirkungen_.
[87]: First published in _Zeitschrift_, Bd. VIII., 1922. [Translated
by Joan Riviere.]
[88]: Cf. Desdemona's song:
> 'I called my love false love; but what said he then?
> If I court moe women, you'll couch with moe men.'
[89]: Cf. Freud, 'Psycho-Analytic Notes upon an Autobiographical
Account of a Case of Paranoia', *Collected Papers*, vol. iii.
[90]: Cf. Freud, _Group Psychology and the Analysis of the Ego_.
[91]: First published in _Zeitschrift_, Bd. IX., 1923. [Translated by
Joan Riviere.]
[92]: It is remarkable, by the way, what a small degree of interest
the other part of the male genitals, the little sac with its
contents, arouses in the child. From all one hears in analyses
one could not guess that the male genitals consist of anything
more than the penis.
[93]: It has quite correctly been pointed out that the child acquires
the idea of a narcissistic wound or deprivation of a part of its
body by the experience of the loss of the nipple after suckling
and of the daily production of its fæces, even already by its
separation from the womb of the mother at birth. Nevertheless,
the castration complex should be a term reserved for the
occasion when the idea of such deprivations comes to be
associated with the loss of the male organ.
[94]: _Zur Symbolik des Medusenhauptes_. I will merely add that in the
myth it is the genital of the mother that is
represented. Athene, who carries the head of Medusa on her
armour, becomes by virtue of it the unapproachable, the woman at
sight of whom all thought of sexual desire is stifled.
[95]: From the analysis of a young woman I learnt that, having no
father and several aunts, until quite late in the latency-period
she clung to a belief that her mother and some of her aunts
possessed a penis. One of the aunts, however, was weak-minded,
and she was regarded by the child as castrated like herself.
[96]: Cf. _Drei Abhandlungen zur Sexualtheorie_. Fünfte Auflage,
S. 62.
[97]: First published in _Zeitschrift_, Bd. X., 1924. [Translated by
Joan Riviere.]
[98]: [_The Ego and the Id_, shortly to appear in translation. To
translate the German '_es_', which means '_it_' and thus implies
the _impersonality_ of the mind apart from its ego, the Latin
'_id_' has been selected.---*Ed.*]
[99]: [To be distinguished, of course, from the common English use of
the term, meaning feeble-mindedness.---*Ed.*]
[100]: First published in _Zeitschrift_, Bd. X., 1924. [Translated by
Joan Riviere.]
[101]: [_Unlust_, usually translated by 'pain'.---Trans.]
[102]: Freud, _Beyond the Pleasure-Principle_.
[103]: See No. XX. of this volume, p. 244.
[104]: _Das Ich und das Es_.
[105]: _Das Ich und das Es_.
[106]: Freud, _Totem und Tabu_, Abschnitt IV.
[107]: Ed. Douwes Dekker (1820--1887).
[108]: First published in _Zeitschrift_, Bd. X., 1924. [Translated by
Joan Riviere.]
[109]: Here first published. [Translated by Joan Riviere.]
[110]: 'Neurosis and Psychosis', No. XXI. of this volume, p. 250.
[111]: Breuer und Freud, _Studien über Hysterie_, 1895.
[112]: First published in _Zentralblatt_, Bd. I., 1910; reprinted in
_Sammlung_, Dritte Folge. [Translated by Joan Riviere.]
[113]: First published in _Zentralblatt_, Bd. I., 1910; reprinted in
_Sammlung_, Dritte Folge. [Translated by Joan Riviere.]
[114]: First published in the _Zentralblatt_, Bd. II., 1912; reprinted
in _Sammlung_, Vierte Folge. [Translated by Joan Riviere.] [The
following six papers (omitting No. XXX.) originally formed a
Series of Papers on Technique, and are reprinted together in
the _Sammlung_.---*Ed.*]
[115]: First published in the _Zentralblatt_, Bd. II., 1912; reprinted
in _Sammlung_, Vierte Folge. [Translated by Joan Riviere.]
[116]: _Zentralblatt_, Bd. II., Nr. II. S. 26.
[117]: We will here provide against misconceptions and reproaches to
the effect that we have denied the importance of the inborn
(constitutional) factor because we have emphasized the
importance of infantile impressions. Such an accusation arises
out of the narrowness with which mankind looks for causes,
inasmuch as one single causal factor satisfies him, in spite of
the many commonly underlying the face of reality.
Psycho-Analysis has said much about the 'accidental' component
in ætiology and little about the constitutional, but only
because it could throw new light upon the former, whereas of
the latter it knows no more so far than is already known. We
deprecate the assumption of an essential opposition between the
two series of ætiological factors; we presume rather a
perpetual interchange of both in producing the results
observed. _δαίμων καὶ τύχη_ determine the fate of man; seldom,
perhaps never, one of these powers alone. The relative
ætiological effectiveness of each is only to be measured
individually and in single instances. In a series comprising
varying degrees of both factors extreme cases will certainly
also be found. According to the knowledge we possess we shall
estimate the parts played by the forces of heredity and of
environment differently in each case, and retain the right to
modify our opinion in consequence of new knowledge. Further, we
may venture to regard the constitution itself as a residue from
the effects of accidental influences upon the endless
procession of our forefathers.
[118]: _Symbole und Wandlungen der Libido_.
[119]: I mean here, when really nothing comes to his mind, and not
when he keeps silence on account of some slight disagreeable
feeling.
[120]: _Aus guter Familie_, 1895.
[121]: Although many of Jung's utterances give the impression that he
sees introversion as something characteristic of dementia
præcox and not observable to the same extent in the other
neuroses.
[122]: It would be easy to say: the libido has re-invested the
infantile 'complexes'. But this would be erroneous; it would be
correct only if expressed thus: 'the unconscious part of these
complexes'. The exceptional intricacy of the theme dealt with
in this essay tempts one to discuss further a number of adjunct
problems, which require elucidation before one can speak
definitely enough about the psychical processes here
described. Such problems are: The definition of the boundary
between introversion and regression; the incorporation of the
complex-doctrine into the libido-theory; the relationship of
phantasy-creation to the conscious, the unconscious, and to
reality; etc. I need not apologize for having resisted these
temptations here.
[123]: From which, however, one need not infer in general any very
particular pathogenic importance in the point selected for
resistance by transference. In warfare, when a bitter fight is
raging over the possession of some little chapel or a single
farmhouse, we do not necessarily assume that the church is a
national monument, or that the barns contain the military
funds. Their value may be merely tactical; in the next
onslaught they will very likely be of no importance.
[124]: Ferenczi, _Introjection and Transference_.
[125]: E. Bleuler, _Dementia Praecox oder Gruppe der Schizophrenien_,
in Aschaffenburg's _Handbuch der Psychiatrie_, 1911; also a
Lecture on Ambivalence in Berne, 1910, abstracted in
_Zentralblatt für Psychoanalyse_, Bd. I., S. 266. W. Stekel had
previously suggested the term _bipolarity_ for the same
phenomenon.
[126]: First published in _Zentralblatt_, Bd. II., 1912; reprinted in
_Sammlung_, Vierte Folge. [Translated by Joan Riviere.]
[127]: The patient often asserts that he has previously mentioned some
particular thing, while one can assure him with calm authority
that he has now mentioned it for the first time. It then turns
out that the patient had previously had the intention to
mention it, but had been hindered in so doing by a resistance
which had not yet been overcome. The memory of his intention is
indistinguishable in his mind from the memory of the act
itself.
[128]: First published in _Zeitschrift_, Bd. I., 1913; reprinted in
_Sammlung_, Vierte Folge. [Translated by James Strachey.]
[129]: One of the most recent bibliographies of the subject is to be
found in Havelock Ellis, _The World of Dreams_, 1911.
[130]: _La sensation du déjà vu_.
[131]: [A detailed analysis of this patient's case will be found in
'From the History of an Infantile Neurosis', *Collected
Papers*, vol. iii.---Trans.]
[132]: Cf. 'The Occurrence in Dreams of Material from Fairy Tales'
(1913), *Collected Papers*, vol. iv. In telling the story again
on a later occasion he made the following correction: 'I don't
believe I was cutting the tree. That was a confusion with
another recollection, which must also have been hallucinatorily
falsified, of having made a cut upon a tree with my knife and
of _blood_ having come out of the tree.'
[133]: First published in _Zeitschrift_, Bd. I., 1913; reprinted in
_Sammlung_, Vierte Folge. [Translated by Joan Riviere.]
[134]: 'On Psychotherapy', *Collected Papers*, vol. i.
[135]: There is much to be said on the subject of this uncertainty in
diagnosis, on the prospects of analysis in the milder forms of
paraphrenia, and on the explanation of the similarity between
the two diseases, which I cannot bring forward in this
connection. I should be willing to contrast hysteria and the
obsessional neurosis, under the name of 'transference
neuroses', with the paraphrenic group, under the name of
'introversion neuroses', in accordance with Jung's formula, if
the term 'introversion' (of the libido) were not alienated by
such usage from its only legitimate meaning.
[136]: Much might be said about our experience with the fundamental
rule of psycho-analysis. One meets occasionally with people who
behave as if they had instituted this rule for themselves;
others offend against it from the beginning. It is
indispensable, and also advantageous, to mention it at the
first stage of the treatment; later, under the influence of
resistances, obedience to it weakens and there comes a time in
every analysis when the patient disregards it. One must
remember how irresistible was the temptation in one's
self-analysis to yield to those cavilling pretexts for
rejecting certain thoughts. The feeble effect of the patient's
agreement to the bargain made with him about the 'fundamental
rule' is regularly demonstrated when something of an intimate
nature about a third person rises to his mind for the first
time; the patient knows that he must say everything, but he
makes a new obstacle out of the discretion required on behalf
of others. 'Must I really say everything? I thought that only
applied to what concerns myself.' It is naturally impossible to
carry out an analysis if the patient's relations with other
people and his thoughts about them are excluded. _Pour faire
une omelette il faut casser des œufs_. An honourable man
readily forgets such of the private affairs of strangers as do
not seem important for him to know. Names, too, cannot be
excepted from communication; otherwise the patient's narratives
become rather shadowy, like the scenes of Goethe's _Natural
Daughter_, and do not remain in the physician's memory;
moreover, the names withheld cover the approach to all kinds of
important connections. One may perhaps leave names until the
patient has become more familiar with the physician and the
process of analysis. It is a most remarkable thing that the
whole undertaking becomes lost labour if a single concession is
made to secrecy. If at any one spot in a town the right of
sanctuary existed, one can well imagine that it would not be
long before all the riff-raff of the town would gather there. I
once treated a high official who was bound by oath not to
communicate certain State secrets, and the analysis came to
grief as a consequence of this restriction. The psycho-analytic
treatment must override everything which comes in its way,
because the neurosis and the resistances are equally
relentless.
[137]: Exceptions may be made only of such data as the family
relationships, visits, operations, and so on.
[138]: First published in _Zeitschrift_, Bd. II., 1914; reprinted in
_Sammlung_, Vierte Folge. [Translated by Joan Riviere.]
[139]: [Cf. Freud, 'From the History of an Infantile Neurosis',
*Collected Papers*, vol. iii.---Trans.]
[140]: First published in _Zeitschrift_, Bd. III., 1915; reprinted in
_Sammlung_, Vierte Folge. [Translated by Joan Riviere.]
[141]: 'On the History of the Psycho-Analytic Movement', 1914,
*Collected Papers*, vol. i.
[142]: We know that the transference can express itself by other less
tender feelings, but I do not propose to go into that side of
the matter here.
[143]: Cf. pp. 321 and 369 _et seq._
[144]: Address delivered before the Fifth International
Psycho-Analytical Congress, in Budapest, September 1918. First
published in _Zeitschrift_, Bd. V., 1919; reprinted in
_Sammlung_, Fünfte Folge. [Translated by Joan Riviere.]
[145]: [Cf. 'The Dynamics of the Transference', Section II. of the
Series of Papers on Technique, p. 312 of this volume.---Trans.]
[146]: Even in chemical analysis something very similar occurs.
Simultaneously with the isolation of the various elements,
which the chemist forces upon them, syntheses which are no part
of his intention come into existence, owing to the liberation
of the elective affinities in their substances.
[147]: Ferenczi, _Technische Schwierigkeiten einer Hysterieanalyse_.
------------------------------------------------------------------------
Transcriber’s Note
The following typos in the original text have been corrected.
p. 305
- good road to to follow
+ good road to follow
p. 314
- a pecularity which becomes comprehensible
+ a peculiarity which becomes comprehensible
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