Introductory Lectures on Psycho-Analysis

Part III General Theory of the Neuroses

Sixteenth Lecture — Psycho-Analysis and Psychiatry

It pleases me greatly to see you here again to continue our discussions after a year has passed. Last year the subject of my lectures was the application of psycho-analysis to errors and to dreams; I hope this year to lead you to some comprehension of neurotic phenomena which, as you will soon discover, have much in common with both our former subjects. I must tell you before I begin, however, that I cannot concede you the same attitude towards me now as I did last year. Then I endeavoured to make no step without being in agreement with your judgement; I debated a great deal with you, submitted to your objections, in fact, recognized you and your “healthy common-sense” as the deciding factor. That is no longer possible and for a very simple reason. Errors and dreams are phenomena which were familiar to you; one might say you had as much experience of them as I, or could easily have obtained it. The manifestations of neurosis, however, are an unknown region to you; those of you who are not yourselves medical men have no access there except through the accounts I give you; and of what use is the most excellent judgement where there is no knowledge of the subject under debate?

However, do not receive this announcement as though I were going to give these lectures ex cathedra or to demand unconditional acceptance from you. Any such misconception would do me a gross injustice. I do not aim at producing conviction,—my aim is to stimulate enquiry and to destroy prejudices. If owing to ignorance of the subject you are not in a position to adjudicate, then you should neither believe nor reject. You should only listen and allow what I tell you to make its own effect upon you. Convictions are not so easily acquired, or, when they are achieved without much trouble, they soon prove worthless and unstable. No one has a right to conviction on these matters who has not worked at this subject for many years, as I have, and has not himself experienced the same new and astonishing discoveries. Then why these sudden convictions in intellectual matters, lightning conversions, and instantaneous repudiations? Do you not see that the coup de foudre, “love at first sight,” proceeds from a very different mental sphere, from the affective one? We do not require even our patients to bring with them any conviction in favour of psycho-analysis or any devotion to it. It would make us suspicious of them. Benevolent scepticism is the attitude in them which we like best. Therefore will you also try to let psycho-analytical conceptions develop quietly in your minds alongside the popular or the psychiatric view, until opportunities arise for them to influence each other and be united into a decisive opinion.

On the other hand, you are not for a moment to suppose that the psycho-analytic point of view which I shall lay before you is a speculative system of ideas. On the contrary, it is the result of experience, being founded either on direct observations or on conclusions drawn from observation. Whether these have been drawn in an adequate or a justifiable manner future advances in science will show; after nearly two and a half decades and now that I am fairly well advanced in years I may say, without boasting, that it was particularly difficult, intense, and all-absorbing work that yielded these observations. I have often had the impression that our opponents were unwilling to consider this source of our statements, as if they looked upon them as ideas derived subjectively which anyone could dispute at his own sweet will. This attitude on the part of my opponents is not quite comprehensible to me. Perhaps it comes from the circumstance that physicians pay so little attention to neurotics and listen so carelessly to what they say that it has become impossible for them to perceive anything in the patients’ communications or to make detailed observations from them. I will take this opportunity of assuring you that in these lectures I shall make few controversial references, least of all to individuals. I have never been able to convince myself of the truth of the saying that “strife is the father of all things.” I think the source of it was the philosophy of the Greek sophists and that it errs, as does the latter, through the over estimation of dialectics. It seems to me, on the contrary, that scientific controversy, so-called, is on the whole quite unfruitful, apart from the fact that it is almost always conducted in a highly personal manner. Until a few years ago I could boast that I had only once been engaged in a regular scientific dispute, and that with one single investigator, Löwenfeld of Munich. The end of it was that we became friends and have remained so to this day. But I did not repeat the experiment for a very long time because I was not certain that the outcome would be the same.

Now you will surely judge that a refusal of this kind to discuss matters publicly points to a high degree of inaccessibility to criticism, to obstinacy, or, in the polite colloquialism of the scientific world, to “pig-headedness.”43 My reply to you would be that, should you have arrived at a conviction by means of such hard work, you would also thereby derive a certain right to maintain it with some tenacity. Further, on my own behalf, I can say that in the course of my work I have modified my views on important points, changed them or replaced them by others, and have of course in each case published the fact. What has been the result of this frankness? Some people have ignored my corrections of myself altogether and still to-day criticize me in respect of views which no longer mean the same to me. Others positively reproach me for these changes and declare me to be unreliable on that account. No one who changes his views once or twice deserves to be believed, for it is only too likely that he will be mistaken again in his latest assertions; but anyone who sticks to anything he has once said, or refuses to give way upon it easily enough, is obstinate or pig-headed; is it not so? What is to be done in the face of these self-contradictory criticisms except to remain as one is and behave as seems best to one? This is what I decided to do; and I am not deterred from remodelling and improving my theories in accordance with later experience. I have so far found nothing to alter in my fundamental standpoint and I hope this will never be necessary.

So now I have to lay before you the psycho-analytic theory of neurotic manifestations. For this purpose it will be simplest, on account of both the analogy and the contrast, to take an example which links up with the phenomena we have already considered. I will take a ‘symptomatic act’ which I see many people commit in my own consulting-room. The analyst has little to offer to the people who come to a physician’s consulting-room for half-an-hour to recount the lifelong misery of their fate. His deeper comprehension makes it difficult for him to give, as another might, the opinion that there is nothing wrong with them and that they had better take a light course of hydrotherapy. One of our colleagues once replied, with a shrug, when asked how he dealt with consultation patients, that he “fined them so many crowns for ‘wasting the time of the court.’” You will therefore not be surprised to hear that even the busiest psycho-analysts are not much sought after for consultations. I have had the ordinary door between the waiting-room and my consulting-room supplemented by another door and covered with felt. The reason for this is obvious. Now it constantly happens when I admit people from the waiting-room that they omit to close these doors, leaving even both doors open behind them. When I see this happen, I at once, with some stiffness, request him or her to go back and make good the omission, no matter how fine a gentleman he may be nor how many hours she had spent on her toilet. My action gives the impression of being uncalled-for and pedantic; occasionally too I have found myself in the wrong, when the person turned out to be one of those who cannot themselves grasp a door-handle and are glad when those with them avoid it. But in the majority of cases I was right, for anyone who behaves in this way and leaves the door of a physician’s consulting-room open into the waiting-room belongs to the rabble and deserves to be received with coldness. Now don’t allow yourselves to be biassed before you have heard the rest. This omission on the part of a patient occurs only when he has been waiting alone in the outer room and thus leaves an empty room behind him, never when others, strangers to him, have also been waiting there. In the latter case he knows very well that it is to his own interest not to be overheard while he talks to the physician and he never neglects to close both doors carefully.

Occurring in this way, the patient’s omission is neither accidental nor meaningless, and not even unimportant, for it betrays the visitor’s attitude to the physician. He belongs to that large class who seek those in high places, and wish to be dazzled and intimidated. Perhaps he had made enquiries by telephone at what time he would be most likely to gain admittance and had been expecting to find a crowd of applicants in a queue, as if at the grocer’s in war-time. Then he is shown into an empty room which, moreover, is most modestly furnished, and he is dumbfounded. He must somehow make the physician atone for the superfluous respect he had been prepared to show him; and so he omits to close the doors between the waiting-and the consulting-rooms. He intends this to mean: “Pooh! there is no one here and I daresay there won’t be, however long I stay!” He would behave during the interview in an uncivil and supercilious manner, too, if his presumption were not curbed at the outset by a sharp reminder.

In the analysis of this little symptomatic act you find nothing that is not already known to you; namely, the conclusion that it is no accident but has in it motive, meaning, and intention; that it belongs to a mental context which can be specified; and that it provides a small indication of a more important mental process. But above all it implies that the process thus indicated is not known to the consciousness of the person who carries it out; for not one of the patients who left the two doors open would have admitted that he wished to show any depreciation of me by his neglect. Many of them could probably recall a sense of disappointment on entering the empty waiting-room, but the connection between this impression and the succeeding symptomatic act certainly remained outside their consciousness.

Now let us place this little analysis of a symptomatic act by the side of an observation made on a patient. I will choose one which is fresh in my memory, and also because it can be described in comparatively few words. A certain amount of detail is indispensable for any such account.

A young officer, home on short leave of absence, asked me to treat his mother-in-law, who was living in the happiest surroundings and yet was embittering her own and her family’s lives by a nonsensical idea. I found her a well-preserved lady, fifty-three years of age, of a friendly, simple disposition, who gave without hesitation the following account of herself. She is most happily married, and lives in the country with her husband who manages a large factory. She cannot say enough of her husband’s kindness and consideration; theirs had been a love-marriage thirty years ago, since when they had never had a cloud, a quarrel, or a moment’s jealousy. Her two children have both married well, but her husband’s sense of duty keeps him still at work. A year before, an incredible and, to her, incomprehensible thing happened. She received an anonymous letter telling her that her excellent husband was carrying on an intrigue with a young girl, and believed it on the spot—since then her happiness has been destroyed. The details were more or less as follows: she had a housemaid with whom she discussed confidential matters, perhaps rather too freely. This young woman cherished a positively venomous hatred for another girl who had succeeded better in life than herself, although of no better origin. Instead of going into service, the other young woman had had a commercial training, been taken into the factory and, owing to vacancies caused by the absence of staff on service in the field, had been promoted to a good position. She lived in the factory, knew all the gentlemen, and was even addressed as “Miss.” The other one who had been left behind in life was only too ready to accuse her former schoolmate of all possible evil. One day our patient and her housemaid were discussing an elderly gentleman who had visited the house and of whom it was said that he did not live with his wife but kept a mistress. Why, she did not know, but she suddenly said: “I cannot imagine anything more awful than to hear that my husband had a mistress.” The next day she received by post an anonymous letter in disguised handwriting which informed her of the very thing she had just imagined. She concluded—probably correctly—that the letter was the handiwork of her malicious housemaid, for the woman who was named as the mistress of her husband was the very girl who was the object of this housemaid’s hatred. Although she at once saw through the plot and had seen enough of such cowardly accusations in her own surroundings to place little credence in them, our patient was nevertheless prostrated by this letter. She became terribly excited and at once sent for her husband to overwhelm him with reproaches. The husband laughingly denied the accusation and did the best thing he could. He sent for the family physician (who also attended the factory), and he did his best to calm the unhappy lady. The next thing they did was also most reasonable. The housemaid was dismissed, but not the supposed mistress. From that time on the patient claims to have repeatedly brought herself to a calm view of the matter, so that she no longer believes the contents of the letter; but it has never gone very deep nor lasted very long. It was enough to hear the young woman’s name mentioned, or to meet her in the street, for a new attack of suspicion, agony, and reproaches to break out.

This is the clinical picture of this excellent woman’s case. It did not require much experience of psychiatry to perceive that, in contrast to other neurotics, she described her symptoms too mildly—as we say, dissimulated them—and that she had never really overcome her belief in the anonymous letter.

Now what attitude does a psychiatrist take up to such a case? We know already what he would say to the symptomatic act of a patient who does not close the waiting-room doors. He explains it as an accident, without interest psychologically, and no concern of his. But he cannot continue to take up this attitude in regard to the case of the jealous lady. The symptomatic action appears to be unimportant; the symptom calls for notice as a grave matter. Subjectively it involves intense suffering, and objectively it threatens to break up a family; its claim to psychiatric interest is therefore indisputable. First the psychiatrist tries to characterize the symptom by some essential attribute. The idea with which this lady torments herself cannot be called nonsensical in itself; it does happen that elderly husbands contract relationships with young women. But there is something else about it that is nonsensical and incomprehensible. The patient has absolutely no grounds, except the anonymous letter, for supposing that her loving and faithful husband belongs to this category of men, otherwise not so uncommon. She knows that this communication carries no proof, she can explain its origin satisfactorily; she ought therefore to be able to say to herself that she has no grounds for her jealousy and she does even say so, but she suffers just as much as if she regarded her jealousy as well-founded. Ideas of this kind that are inaccessible to logic and the arguments of reality are unanimously described as delusions. The good lady suffers therefore, from a delusion of jealousy. That is evidently the essential characteristic of the case.

Having established this first point, our psychiatric interest increases. When a delusion cannot be dissipated by the facts of reality, it probably does not spring from reality. Where else then does it spring from? Delusions can have the most various contents; why is the content of it in this case jealousy? What kind of people have delusions, and particularly delusions of jealousy? Now we should like to listen to the psychiatrist, but he leaves us in the lurch here. He considers only one of our questions. He will examine the family history of this woman and will perhaps bring us the answer that the kind of people who suffer from delusions are those in whose families similar or different disorders have occurred repeatedly. In other words, this lady has developed a delusion because she had an hereditary predisposition to do so. That is certainly something; but is it all that we want to know? Is it the sole cause of her disease? Does it satisfy us to assume that it is unimportant, arbitrary, or inexplicable that one kind of delusion should have been developed instead of another? And are we to understand the proposition—that the hereditary predisposition is decisive—also in a negative sense; that is, that no matter what experiences and emotions life had brought her she was destined some time or other to produce a delusion? You will want to know why scientific psychiatry gives no further explanation. And I reply: “Only a rogue gives more than he has.” The psychiatrist knows of no path leading to any further explanation in such a case. He has to content himself with a diagnosis and, in spite of wide experience, with a very uncertain prognosis of its future course.

Now can psycho-analysis do better than this? Yes, certainly I hope to show you that even in such an obscure case as this it is possible to discover something which makes closer comprehension possible. First, I shall ask you to notice this incomprehensible detail; that the anonymous letter on which her delusion is founded was positively provoked by the patient herself, by her saying to the scheming housemaid the day before that nothing could be more awful than to hear that her husband had an intrigue with a young woman. She first put the idea of sending the letter into the servant’s mind by this. So the delusion acquires a certain independence of the letter; it existed beforehand as a fear—or, as a wish?—in her mind. Besides this, the further small indications revealed in the bare two hours of analysis are noteworthy. The patient responded very coldly, it is true, to the request to tell me her further thoughts, ideas, and recollections, after she had finished her story. She declared that nothing came to her mind, she had told me everything; and after two hours the attempt had to be given up, because she announced that she felt quite well already and was certain that the morbid idea would not return. Her saying this was naturally due to resistance and to the fear of further analysis, In these two hours she had let fall some remarks, nevertheless, which made a certain interpretation not only possible but inevitable, and this interpretation threw a sharp light on the origin of the delusion of jealousy. There actually existed in her an infatuation for a young man, for the very son-in-law who had urged her to seek my assistance. Of this infatuation she herself knew nothing or only perhaps very little; in the circumstances of their relationship it was easily possible for it to disguise itself as harmless tenderness on her part. After what we have already learnt it is not difficult to see into the mind of this good woman and excellent mother. Such an infatuation, such a monstrous, impossible thing, could not come into her conscious mind; it persisted, nevertheless, and unconsciously exerted a heavy pressure. Something had to happen, some sort of relief had to be found; and the simplest alleviation lay in that mechanism of displacement which so regularly plays its part in the formation of delusional jealousy. If not merely she, old woman that she was, were in love with a young man, but if only her old husband too were in love with a young mistress, then her torturing conscience would be absolved from the infidelity. The phantasy of her husband’s infidelity was thus a cooling balm on her burning wound. Of her own love she never became conscious; but its reflection in the delusion, which brought such advantages, thus became compulsive, delusional and conscious. All arguments against it could naturally avail nothing; for they were directed only against the reflection, and not against the original to which its strength was due and which lay buried out of reach in the Unconscious.

Let us now piece together the results of this short, obstructed psycho-analytic attempt to understand this case. It is assumed of course that the information acquired was correct, a point which I cannot submit to your judgement here. First of all, the delusion is no longer senseless and incomprehensible; it is sensible, logically motivated, and has its place in connection with an affective experience of the patient’s. Secondly, it has arisen as a necessary reaction to another mental process which has itself been revealed by other indications; and it owes its delusional character, its quality of resisting real and logical objections, to this relation with this other mental process. It is something desired in itself, a kind of consolation. Thirdly, the fact that the delusion is one of jealousy and no other is unmistakably determined by the experience underlying the disease. You will also recognize the two important analogies with the symptomatic act we analysed; namely, the discovery of the sense or intention behind the symptom and the relation of it to something in the given situation which is unconscious.

This does not, of course, answer all the questions arising out of this case. On the contrary, it bristles with further problems, some of which have not yet proved soluble at all, while others cannot be solved owing to the unfavourable circumstances met with in this case. For instance, why does this happily-married lady fall in love with her son-in-law, and why does relief come to her in the form of this kind of reflection, this projection of her own state of mind on to her husband, when other forms of relief were also possible? Do not think that it is idle and uncalled-for to propound these questions. We have already a good deal of material at hand to provide possible answers. The patient had come to that critical time of life which brings a sudden and unwelcome increase of sexual desire to a woman; that may have been sufficient in itself. Or there may have been an additional reason, in that the sexual capacity of her excellent and faithful husband may have been for some years insufficient for the still vigorous woman’s needs. Observation has taught us that it is just such men, whose fidelity is thus a matter of course, who treat their wives with particular tenderness and are unusually considerate of their nervous ailments. Neither is it unimportant, moreover, that the object of this abnormal infatuation should be her daughter’s young husband. A strong erotic attachment to the daughter, with its roots in the individual sexual constitution of the mother, often manages to maintain itself in such a transformation. I may perhaps remind you in this connection that the relation between mother-in-law and son-in-law has from time immemorial been regarded by mankind as a particularly sensitive one, which among primitive races has given rise to very powerful taboos and precautions.44 On the positive as well as on the negative side it frequently exceeds the limits regarded as desirable in civilized society. Of these three possible factors, whether one of them has been at work in the case before us, or two of them, or whether all three together have taken part, I cannot tell you; though only because the analysis of the case could not be continued beyond the second hour.

I perceive now that I have been speaking entirely of things which you were not yet prepared to understand. I did so in order to carry out the comparison between psychiatry and psycho-analysis. But I may ask you one thing at this point: Have you observed anything in the nature of a contradiction between the two? Psychiatry does not employ the technical methods of psycho-analysis, neglects any consideration of the content of the delusion, and in pointing to heredity gives us but a general and remote ætiology instead of first disclosing the more specific and immediate one. But is any contradiction or opposition contained in this? Is not the one rather a supplement to the other? Is the hereditary factor inconsistent with the importance of experience and would they not both work together most effectively? You will admit that there is nothing essential in the work of psychiatry which could oppose psycho-analytic researches. It is therefore the psychiatrists who oppose it, and not psychiatry itself. Psycho-Analysis stands to psychiatry more or less as histology does to anatomy; in one, the outer forms of organs are studied, in the other, the construction of these out of the tissues and constituent elements. It is not easy to conceive of any contradiction between these two fields of study, in which the work of the one is continued in the other. You know that nowadays anatomy is the basis of the scientific study of medicine; but time was when dissecting human corpses in order to discover the internal structure of the body was as much a matter for severe prohibition as practising psycho-analysis in order to discover the internal workings of the human mind seems to-day to be a matter for condemnation. And, presumably at a not too distant date, we shall have perceived that there can be no psychiatry which is scientifically radical without a thorough knowledge of the deep-seated unconscious processes in mental life.

There may be some of you who perhaps are friendly enough towards psycho-analysis, often attacked as it is, to wish that it would justify itself in another direction also, that is, therapeutically. You know that psychiatric therapy has hitherto been unable to influence delusions. Can psycho-analysis do so perhaps, by reason of its insight into the mechanism of these symptoms? No, I have to tell you that it cannot; for the present, at any rate, it is just as powerless as any other therapy to heal these sufferers. It is true that we can understand what has happened to the patient; but we have no means by which we can make him understand it himself. You have heard that I could not continue the analysis of this delusion beyond the first preliminaries. Would you then maintain that analysis of such cases is undesirable because it remains fruitless? I do not think so. It is our right, yes, and our duty, to pursue our researches without respect to the immediate gain effected. The day will come, where and when we know not, when every little piece of knowledge will be converted into power, and into therapeutic power. Even if psycho-analysis showed itself as unsuccessful with all other forms of nervous and mental diseases as with delusions, it would still remain justified as an irreplaceable instrument of scientific research. It is true that we should not be in a position to practise it; the human material on which we learn lives, and has its own will, and must have its own motives in order to participate in the work; and it would then refuse to do so. I will therefore close my lecture for to-day by telling you that there are large groups of nervous disturbances for which this conversion of our own advance in knowledge into therapeutic power has actually been carried out; and that with these diseases, otherwise so refractory, our measures yield, under certain conditions, results which give place to none in the domain of medical therapy.

Seventeenth Lecture — The Meaning of Symptoms

In the last lecture I explained to you that clinical psychiatry troubles itself little about the actual form of the individual symptom or the content of it; but that psycho-analysis has made this its starting-point, and has ascertained that the symptom itself has a meaning and is connected with experiences in the life of the patient. The meaning of neurotic symptoms was first discovered by J. Breuer in the study and successful cure of a case of hysteria (1880–82), which has since then become famous. It is true that P. Janet independently reached the same result; in fact, priority in publication must be granted to the French investigator, for Breuer did not publish his observations until more than a decade later (1893–95), during the period of our work together. Incidentally, it is of no great importance to us who made the discovery, for you know that every discovery is made more than once, and none is made all at once, nor is success meted out according to deserts. America is not called after Columbus. Before Breuer and Janet, the great psychiatrist Leuret expressed the opinion that even the delusions of the insane would prove to have some meaning, if only we knew how to translate them. I confess that for a long time I was willing to accord Janet very high recognition for his explanation of neurotic symptoms, because he regarded them as expressions of “idées inconscientes” possessing the patient’s mind. Since then, however, Janet has taken up an attitude of undue reserve, as if he meant to imply that the Unconscious had been nothing more to him than a manner of speaking, a makeshift, une façon de parler, and that he had nothing “real” in mind. Since then I have not understood Janet’s views, but I believe that he has gratuitously deprived himself of great credit.

Neurotic symptoms then, just like errors and dreams, have their meaning and, like these, are related to the life of the person in whom they appear. This is an important matter which I should like to demonstrate to you by some examples. I can merely assert, I cannot prove, that it is so in every case; anyone observing for himself will be convinced of it. For certain reasons though, I shall not take these examples from cases of hysteria, but from another very remarkable form of neurosis, closely allied in origin to the latter, about which I must say a few preliminary words. This, which we call the obsessional neurosis, is not so popular as the widely-known hysteria; it is, if I may so express myself, not so noisily ostentatious, behaves more as if it were a private affair of the patient’s, dispenses almost entirely with bodily manifestations and creates all its symptoms in the mental sphere. The obsessional neurosis and hysteria are the two forms of neurotic disease upon the study of which psycho-analysis was first built up, and in the treatment of which also our therapy celebrates its triumphs. In the obsessional neurosis, however, that mysterious leap from the mental to the physical is absent, and it has really become more intimately comprehensible and transparent to us through psycho-analytic research than hysteria; we have come to understand that it displays far more markedly certain extreme features of the neurotic constitution.

The obsessional neurosis45 takes this form: the patient’s mind is occupied with thoughts that do not really interest him, he feels impulses which seem alien to him, and he is impelled to perform actions which not only afford him no pleasure but from which he is powerless to desist. The thoughts (obsessions) may be meaningless in themselves or only of no interest to the patient; they are often absolutely silly; in every case they are the starting-point of a strained concentration of thought which exhausts the patient and to which he yields most unwillingly. Against his will he has to worry and speculate as if it were a matter of life or death to him. The impulses which he perceives within him may seem to be of an equally childish and meaningless character; mostly, however, they consist of something terrifying, such as temptations to commit serious crimes, so that the patient not only repudiates them as alien, but flees from them in horror, and guards himself by prohibitions, precautions, and restrictions against the possibility of carrying them out. As a matter of fact he never, literally not even once, carries these impulses into effect; flight and precautions invariably win. What he does really commit are very harmless, certainly trivial acts—what are termed the obsessive actions—which are mostly repetitions and ceremonial elaborations of ordinary everyday performances, making these common necessary actions—going to bed, washing, dressing, going for walks, etc.—into highly laborious tasks of almost insuperable difficulty. The morbid ideas, impulses, and actions are not by any means combined in the same proportions in individual types and cases of the obsessional neurosis; on the contrary, the rule is that one or another of these manifestations dominates the picture and gives the disease its name; but what is common to all forms of it is unmistakable enough.

This is a mad disease, surely. I don’t think the wildest psychiatric phantasy could have invented anything like it, and if we did not see it every day with our own eyes we could hardly bring ourselves to believe in it. Now do not imagine that you can do anything for such a patient by advising him to distract himself, to pay no attention to these silly ideas, and to do something sensible instead of his nonsensical practices. This is what he would like himself; for he is perfectly aware of his condition, he shares your opinion about his obsessional symptoms, he even volunteers it quite readily. Only he simply cannot help himself; the actions performed in an obsessional condition are supported by a kind of energy which probably has no counterpart in normal mental life. Only one thing is open to him—he can displace and he can exchange; instead of one silly idea he can adopt another of a slightly milder character, from one precaution or prohibition he can proceed to another, instead of one ceremonial rite he can perform another. He can displace his sense of compulsion, but he cannot dispel it. This capacity for displacing all the symptoms, involving radical alteration of their original forms, is a main characteristic of the disease; it is, moreover, striking that in this condition the ‘opposite-values’ (polarities) pervading mental life appear to be exceptionally sharply differentiated. In addition to compulsions of both positive and negative character, doubt appears in the intellectual sphere, gradually spreading until it gnaws even at what is usually held to be certain. All these things combine to bring about an ever-increasing indecisiveness, loss of energy, and curtailment of freedom; and that although the obsessional neurotic is originally always a person of a very energetic disposition, often highly opinionated, and as a rule intellectually gifted above the average. He has usually attained to an agreeably high standard of ethical development, is over-conscientious, and more than usually correct. You may imagine that it is a sufficiently arduous task to find one’s bearings in this maze of contradictory character-traits and morbid manifestations. At the moment our aim is merely to interpret some symptoms of this disease.

Perhaps in view of our previous discussions you would like to know what present-day psychiatry has to offer concerning the obsessional neurosis; it is but a miserable contribution, however. Psychiatry has given names to the various compulsions; and has nothing more to say about them. It asserts instead that persons exhibiting these symptoms are “degenerate.” That is not much satisfaction to us; it is no more than an estimate of their value, a condemnation instead of an explanation. We are intended, I suppose, to conclude that deterioration from type would naturally produce all kinds of oddities in people. Now, we do believe that people who develop such symptoms must be somewhat different in type from other human beings; but we should like to know whether they are more “degenerate” than other nervous patients, than hysterical or insane people. The characterization is clearly again much too general. One may even doubt whether it is justified at all when one learns that such symptoms occur in men and women of exceptional ability who have left their mark on their generation. Thanks to their own discretion and the untruthfulness of biographers we usually learn very little of an intimate nature about our exemplary great men; but it does happen occasionally that one of them is a fanatic about truth like Émile Zola,46 and then we hear of the many extraordinary obsessive habits from which he suffered throughout life.

Psychiatry has got out of this difficulty by dubbing these people “dégénerés superieurs.” Very well; but psycho-analysis has shown that these extraordinary obsessional symptoms can be removed permanently, like the symptoms of other diseases, and as in other people who are not degenerate. I myself have frequently succeeded in doing so.

I shall only give you two examples of analysis of obsessional symptoms; one is an old one, but I have never found a better; and one is a recent one. I shall limit myself to these two because an account of this kind must be very explicit and go into great detail.

A lady of nearly thirty years of age suffered from very severe obsessional symptoms. I might perhaps have been able to help her if my work had not been destroyed by the caprice of fate—perhaps I shall tell you about it later. In the course of a day she would perform the following peculiar obsessive act, among others, several times over. She would run out of her room into the adjoining one, there take up a certain position at the table in the centre of the room, ring for her maid, give her a trivial order or send her away without, and then run back again. There was certainly nothing very dreadful about this, but it might well arouse curiosity. The explanation presented itself in the simplest and most unexceptionable manner, without any assistance on the part of the analyst. I cannot imagine how I could even have suspected the meaning of this obsession or could possibly have suggested an interpretation for it. Every time I had asked the patient, “Why do you do this? What is the meaning of it?” she had answered, “I don’t know.” But one day, after I had succeeded in overcoming a great hesitation on her part, involving a matter of principle, she suddenly did know, for she related the history of the obsessive act. More than ten years previously she had married a man very much older than herself, who had proved impotent on the wedding-night. Innumerable times on that night he had run out of his room into hers in order to make the attempt, but had failed every time. In the morning he had said angrily: “It’s enough to disgrace one in the eyes of the maid who does the beds,” and seizing a bottle of red ink which happened to be at hand he poured it on the sheet, but not exactly in the place where such a mark might have been. At first I did not understand what this recollection could have to do with the obsessive act in question; for I could see no similarity between the two situations, except in the running from one room into the other, and perhaps also in the appearance of the servant on the scene. The patient then led me to the table in the adjoining room, where I found a great mark on the table-cover. She explained further that she stood by the table in such a way that when the maid came in she could not miss seeing this mark. After this, there could no longer be any doubt about the connection between the current obsessive act and the scene of the wedding-night, though there was still a great deal to learn about it.

It was clear, first of all, that the patient identified herself with her husband; in imitating his running from one room into another she acted his part. To keep up the similarity we must assume that she has substituted the table and table-cover for the bed and sheet. This might seem too arbitrary; but then we have not studied dream-symbolism in vain. In dreams a table is very often found to represent a bed. “Bed and board” together mean marriage, so that the one easily stands for the other.

All this would be proof enough that the obsessive act is full of meaning; it seems to be a representation, a repetition of that all-important scene. But we are not bound to stop at this semblance; if we investigate more closely the relation between the two situations we shall probably find out something more, the purpose of the obsessive act. The kernel of it evidently lies in the calling of the maid, to whom she displays the mark, in contrast to her husband’s words: “It’s enough to disgrace one before the servant.” In this way he, whose part she is playing, is not ashamed before the servant, the stain is where it ought to be. We see therefore that she has not simply repeated the scene, she has continued it and corrected it, transformed it into what it ought to have been. This implies something else, too, a correction of the circumstance which made that night so distressing, and which made the red ink necessary: namely, the husband’s impotence. The obsessive act thus says: “No, it is not true, he was not disgraced before the servant, he was not impotent.” As in a dream she represents this wish as fulfilled, in a current obsessive act, which serves the purpose of restoring her husband’s credit after that unfortunate incident.

Everything else which I could tell you about this lady fits in with this, or, more correctly stated, everything else that we know about her points to this interpretation of the obsessive act, in itself so incomprehensible. She had been separated from her husband for years and was trying to make up her mind to divorce him legally. But there would have been no prospect of being free from him in her mind; she forced herself to be true to him. She withdrew from the world and from everyone so that she might not be tempted, and in her phantasies she excused and idealized him. The deepest secret of her illness was that it enabled her to shield him from malicious gossip, to justify her separation from him, and to make a comfortable existence apart from her possible for him. The analysis of a harmless obsessive act thus leads straight to the inmost core of the patient’s disease, and at the same time betrays a great deal of the secret of the obsessional neurosis in general. I am quite willing that you should spend some time over this example, for it unites conditions which cannot reasonably be expected in all cases. The interpretation of the symptom was discovered by the patient herself in a flash, without guidance or interference from the analyst, and it had arisen in connection with an event which did not belong, as it commonly does, to a forgotten period in childhood, but which had occurred in the patient’s adult life and was clear in her memory. All those objections which critics habitually raise against our interpretations of symptoms are quite out of place here. To be sure, we cannot always be so fortunate.

And one thing more! Has it not struck you that this innocent obsessive act leads directly to this lady’s most private affairs? A woman can hardly have anything more intimate to relate than the story of her wedding-night; and is it by chance and without special significance that we are led straight to the innermost secrets of her sexual life? It might certainly be due to the choice I made of this example. Let us not decide this point too quickly; but let us turn to the second example, which is of a totally different nature, and belongs to a very common type, that of rituals preparatory to sleep.

A well-grown clever girl of 19, the only child of her parents, superior to them in education and intellectual activity, was a wild, high-spirited child, but of late years had become very nervous without any apparent cause. She was very irritable, particularly with her mother, was discontented and depressed, inclined to indecision and doubt, finally confessing that she could no longer walk alone through squares and wide streets. We will not go very closely into her complicated condition, which requires at least two diagnoses: agoraphobia and obsessional neurosis; but will turn our attention to the ritual elaborated by this young girl preparatory to going to bed, as a result of which she caused her parents great distress. In a certain sense, every normal person may be said to carry out a ritual before going to sleep, or at least, he requires certain conditions without which he is hindered in going to sleep; the transition from waking life to sleep has been made into a regular formula which is repeated every night in the same manner. But everything that a healthy person requires as a condition of sleep can be rationally explained, and if the external circumstances make any alteration necessary he adapts himself easily to it without waste of time. The morbid ritual on the other hand is inexorable, it will be maintained at the greatest sacrifices; it is disguised, too, under rational motives and appears superficially to differ from the normal only in a certain exaggerated carefulness of execution. On a closer examination, however, it is clear that the disguise is insufficient, that the ritual includes observances which go far beyond what reason can justify and even some which directly contravene this. As the motive of her nightly precautions, our patient declares that she must have silence at night and must exclude all possibility of noise. She does two things for this purpose; she stops the large clock in her room and removes all other clocks out of the room, including even the tiny wrist-watch on her bed-table. Flower-pots and vases are placed carefully together on the writing-table, so that they cannot fall down in the night and break, and so disturb her sleep. She knows that these precautions have only an illusory justification in the demand for quiet; the ticking of the little watch could not be heard, even if it lay on the table by the bed; and we all know that the regular ticking of a pendulum-clock never disturbs sleep, but is more likely to induce it. She also admits that her fear that the flower-pots and vases, if left in their places at night, might fall down of themselves and break is utterly improbable. For some other practices in her ritual this insistence upon silence as a motive is dropped; indeed, by ordaining that the door between her bedroom and that of her parents shall remain half-open (a condition which she ensures by placing various objects in the doorway) she seems, on the contrary, to open the way to sources of noise. The most important observances are concerned with the bed itself, however. The bolster at the head of the bed must not touch the back of the wooden bedstead. The pillow must lie across the bolster exactly in a diagonal position and in no other; she then places her head exactly in the middle of this diamond, lengthways. The eiderdown must be shaken before she puts it over her, so that all the feathers sink to the foot-end; she never fails, however, to press this out and redistribute them all over it again.

I will pass over other trivial details of her ritual; they would teach us nothing new and lead us too far from our purpose. Do not suppose, though, that all this is carried out with perfect smoothness. Everything is accompanied by the anxiety that it has not all been done properly; it must be tested and repeated; her doubts fix first upon one, then another, of the precautions; and the result is that one or two hours elapse before the girl herself can sleep, or lets the intimidated parents sleep.

The analysis of these torments did not proceed so simply as that of the former patient’s obsessive act. I had to offer hints and suggestions of its interpretation which were invariably received by her with a positive denial or with scornful doubt. After this first reaction of rejection, however, there followed a period in which she herself took up the possibilities suggested to her, noted the associations they aroused, produced memories, and established connections until she herself had accepted all the interpretations in working them out for herself. In proportion as she did this she began to relax the performance of her obsessive precautions and before the end of the treatment she had given up the whole ritual. I must also tell you that analytic work, as we conduct it nowadays, definitely excludes any uninterrupted concentration on a single symptom until its meaning becomes fully clear. It is necessary, on the contrary, to abandon a given theme again and again, in the assurance that one will come upon it anew in another context. The interpretation of the symptom, which I am now going to tell you, is therefore a synthesis of the results which, amid the interruptions of work on other points, took weeks and months to procure.

The patient gradually learnt to understand that she banished clocks and watches from her room at night because they were symbols of the female genitals. Clocks, which we know may have other symbolic meanings besides this, acquire this significance of a genital organ by their relation to periodical processes and regular intervals. A woman may be heard to boast that menstruation occurs in her as regularly as clockwork. Now this patient’s special fear was that the ticking of the clocks would disturb her during sleep. The ticking of a clock is comparable to the throbbing of the clitoris in sexual excitation. This sensation, which was distressing to her, had actually on several occasions wakened her from sleep; and now her fear of an erection of the clitoris expressed itself by the imposition of a rule to remove all going clocks and watches far away from her during the night. Flower-pots and vases are, like all receptacles, also symbols of the female genitals. Precautions to prevent them from falling and breaking during the night are therefore not lacking in meaning. We know the very widespread custom of breaking a vessel or a plate on the occasion of a betrothal; everyone present possesses himself of a fragment in symbolic acceptance of the fact that he may no longer put forward any claims to the bride, presumably a custom which arose with monogamy. The patient also contributed a recollection and several associations to this part of her ritual. Once as a child she had fallen while carrying a glass or porcelain vessel, and had cut her finger which had bled badly. As she grew up and learnt the facts about sexual intercourse, she developed the apprehension that on her wedding-night she would not bleed and so would prove not to be a virgin. Her precautions against the vases breaking signified a rejection of the whole complex concerned with virginity and with the question of bleeding during the first act of intercourse; a rejection of the anxiety both that she would bleed and that she would not bleed. These precautions were in fact only remotely connected with the prevention of noise.

One day she divined the central idea of her ritual when she suddenly understood her rule not to let the bolster touch the back of the bed. The bolster had always seemed a woman to her, she said, and the upright back of the bedstead a man. She wished therefore, by a magic ceremony, as it were, to keep man and woman apart; that is to say, to separate the parents and prevent intercourse from occurring. Years before the institution of her ritual, she had attempted to achieve this end by a more direct method. She had simulated fear, or had exploited a tendency to fear, so that the door between her bedroom and that of her parents should not be closed. This regulation was still actually included in her present ritual; in this way she managed to make it possible to overhear her parents; a proceeding which at one time had caused her months of sleeplessness. Not content with disturbing her parents in this way, she at that time even succeeded occasionally in sleeping between the father and mother in their bed. “Bolster” and “bedstead” were then really prevented from coming together. As she finally grew too big to be comfortable in the same bed with the parents, she achieved the same thing by consciously simulating fear and getting her mother to change places with her and to give up to her her place by the father. This incident was undoubtedly the starting-point of phantasies, the effect of which was evident in the ritual.

If the bolster was a woman, then the shaking of the eiderdown till all the feathers were at the bottom, making a protuberance there, also had a meaning. It meant impregnating a woman; she did not neglect, though, to obliterate the pregnancy again, for she had for years been terrified that intercourse between her parents might result in another child and present her with a rival. On the other hand, if the large bolster meant the mother then the small pillow could only represent the daughter. Why had this pillow to be placed diamond-wise upon the bolster and her head be laid exactly in its middle lengthways? She was easily reminded that a diamond is repeatedly used in drawings on walls to signify the open female genitals. The part of the man (the father) she thus played herself and replaced the male organ by her own head. (Cf. Symbolism of beheading for castration.)

Horrible thoughts, you will say, to run in the mind of a virgin girl. I admit that; but do not forget that I have not invented these ideas, only exposed them. A ritual of this kind before sleep is also peculiar enough, and you cannot deny the correspondence, revealed by the interpretation, between the ceremonies and the phantasies. It is more important to me, however, that you should notice that the ritual was the outcome, not of one single phantasy, but of several together which of course must have had a nodal point somewhere. Note, too, that the details of the ritual reflect the sexual wishes both positively and negatively, and serve in part as expressions of them, in part as defences against them.

It would be possible to obtain much more out of the analysis of this ritual by bringing it into its place in connection with the patient’s other symptoms. But that is not our purpose at the moment. You must be content with a reference to an erotic attachment to the father, originating very early in childhood, which had enslaved this girl. It was perhaps for this reason that she was so unfriendly towards her mother. Also we cannot overlook the fact that the analysis of this symptom has again led to the patient’s sexual life. The more insight we gain into the meaning and purpose of neurotic symptoms, the less surprising will this seem.

From two selected examples I have now shown you that neurotic symptoms have meaning, like errors and like dreams, and that they are closely connected with the events of the patient’s life. Can I expect you to believe this exceptionally significant statement on the strength of two examples? No. But can you expect me to go on quoting examples to you until you declare yourselves convinced? Again, no; for in view of the explicit treatment given to each individual case I should have to devote five hours a week for a whole term to the consideration of this one point in the theory of the neuroses. I will content myself therefore with the samples given, as evidence of my statement; and will refer you for more to the literature on the subject, to the classical interpretation of symptoms in Breuer’s first case (hysteria), to the striking elucidations of very obscure symptoms in dementia præcox, so-called, made by C. G. Jung at a time when this investigator was a mere psycho-analyst and did not yet aspire to be a prophet, and to all the subsequent contributions with which our periodicals have been filled since then. Precisely this type of investigation is plentiful. Analysis, interpretation, and translation of neurotic symptoms has proved so attractive to psycho-analysts that in comparison they have temporarily neglected the other problems of the neuroses.

Anyone of you who makes the necessary effort to look up this question will certainly be strongly impressed by the wealth of evidential material. But he will also meet with a difficulty. The meaning of a symptom lies, as we have seen, in its connection with the life of the patient. The more individually the symptom has been formed, the more clearly may we expect to establish this connection. Then the task resolves itself specifically into a discovery, for every nonsensical idea and every useless action, of the past situation in which the idea was justified and the action served a useful purpose. The obsessive act of the patient who ran to the table and rang for the maid is a perfect model of this kind of symptom. But symptoms of quite a different type are very frequently seen. They are what we call typical symptoms of a disease, in each case they are practically identical, the individual differences in them vanish or at least fade away, so that it is difficult to connect them with the patient’s life or to relate them to special situations in his past. Let us consider the obsessional neurosis again. The second patient’s ceremonies preparatory to sleep are in many ways quite typical, although showing enough individual features as well to make an “historical” interpretation, so to speak, possible. But all obsessional patients are given to repetitions, to isolating certain of their actions and to rhythmic performances. Most of them wash too much. Those patients who suffer from agoraphobia (topophobia, fear of space), no longer reckoned as an obsessional neurosis but now classified as anxiety-hysteria, reproduce the same features of the pathological picture often with fatiguing monotony. They fear enclosed spaces, wide, open squares, long stretches of road, and avenues; they feel protected if accompanied, or if a vehicle drives behind them, and so on. Nevertheless, on this groundwork of similarity the various patients construct individual conditions of their own, moods, one might call them, which directly contrast with other cases. One fears narrow streets only, another wide streets only, one can walk only when few people are about, others only when surrounded with people. Similarly in hysteria, beside the wealth of individual features there are always plenty of common typical symptoms which appear to resist an easy interpretation on historical lines. Do not let us forget that it is these typical symptoms which enable us to take our bearings in forming a diagnosis. Supposing we do trace back a typical symptom in a case of hysteria to an experience or to a chain of similar experiences (for instance, an hysterical vomiting to a series of impressions of a disgusting nature), it will be confusing to discover in another case of vomiting an entirely dissimilar series of apparently causative experiences. It almost looks as though hysterical patients must vomit, for some unknown reason, and as though the historical factors revealed by analysis were but pretexts, seized upon by an inner necessity, when opportunity offered, to serve its purpose.

This brings us to the discouraging conclusion that although individual forms of neurotic symptoms can certainly be satisfactorily explained by their relation to the patient’s experiences, yet our science fails us for the far more frequent typical symptoms in the same cases. In addition to this, I have not nearly explained to you all the difficulties that arise during a resolute pursuit of the historical meaning of a symptom. Nor shall I do so; for although my intention is to conceal nothing from you and to gloss over nothing, I do not need to confuse you and stupefy you at the outset of our studies together. It is true that our understanding of symptom-interpretation has only just begun, but we will hold fast to the knowledge gained and proceed to overcome step by step the difficulties of the unknown. I will try to cheer you with the thought that it is hardly possible to presume a fundamental difference between the one kind of symptom and the other. If the individual form of symptom is so unmistakably connected with the patient’s experiences, it is possible that the typical symptom relates to an experience which is itself typical and common to all humanity. Other regularly recurring features of a neurosis, such as the repetition and doubt of the obsessional neurosis, may be universal reactions which the patient is compelled to exaggerate by the nature of the morbid change. In short, there is no reason to give up hastily in despair; let us see what more we can find out.

There is a very similar difficulty met with in the theory of dreams, one which I could not deal with in the course of our previous discussions of dreams. The manifest content of dreams is multifarious and highly differentiated individually, and we have shown exhaustively what can be obtained by analysis from this content. But there are also dreams which may in the same way be called typical and occur in everybody, dreams with an identical content, which present the same difficulties to analysis. These are the dreams of falling, flying, floating, swimming, of being hindered, of being naked, and certain other anxiety-dreams; which yield first this, then that, interpretation, according to the person concerned, without any explanation of their monotonous and typical recurrence. But we notice that in these dreams also the common groundwork is embroidered with additions of an individually varying character. Most probably they too will prove to fit in with other knowledge about the dream-life, gained from a study of other kinds of dreams—not by any forcible twist, but by a gradual widening of our comprehension of these things.

Eighteenth Lecture — Fixation Upon Traumata: The Unconscious

I said last time that we would take, as a starting-point for further work, the knowledge we have gained already, and not the doubts which it has roused in us. We have not yet even begun to discuss two of the most interesting conclusions arising from the analysis of the two examples.

First: both the patients give the impression that they are “fixed” to a particular point in their past, that they do not know how to release themselves from it, and are consequently alienated from both present and future. They are marooned in their illness, as it were; just as in former times people used to withdraw to the cloister to live out their unhappy fate there. In the case of the first patient, it was the marriage to the husband, which in reality had long ago come to an end, that had settled this doom upon her. Her symptoms enabled her to continue her relationship with him; we could perceive in them the voices which pleaded for him, excused him, exalted him, lamented his loss. Although she is young and could attract other men, she has seized upon every possible real and imaginary (magical) precaution that will preserve her fidelity to him. She will not meet strangers, she neglects her appearance; moreover, she cannot readily rise from any chair which she sits upon, and she refuses to sign her name and can give no presents, because no one must have anything which is hers.

With the second patient, the young girl, it is the erotic attachment to the father established in the years before puberty that plays this part in her life. She also has herself perceived that she cannot marry as long as she is so ill. We may suspect that she became so ill in order to be unable to marry and so to remain with her father.

We cannot avoid asking the question how, by what means, and impelled by what motives, anyone can take up such an extraordinary and unprofitable attitude towards life. Provided, that is, that this attitude is a universal character of neurosis and is not a special peculiarity of these two patients. As a matter of fact, this is so; it is a universal trait common to every neurosis, and one of great practical significance. Breuer’s first hysterical patient was fixated, in the same way, to the time when her father was seriously ill and she nursed him. In spite of her recovery, she has remained to some extent cut off from life since that time; for although she has remained healthy and active, she did not take up the normal career of a woman. In every one of our patients we learn through analysis that the symptoms and their effects have set the sufferer back into some past period of his life. In the majority of cases it is actually a very early phase of the life-history which has been thus selected, a period in childhood, even, absurd as it may sound, the period of existence as a suckling infant.

The closest analogy to this behaviour in our nervous patients is provided by the forms of illness recently made so common by the war—the so-called traumatic neuroses. Of course similar cases had occurred before the war, after railway accidents and other terrifying experiences involving danger to life. The traumatic neuroses are not fundamentally the same as those which occur spontaneously, which we investigate analytically and are accustomed to treat; neither have we been successful so far in correlating them with our views on other subjects; later on I hope to show you where this limitation lies. Yet there is a complete agreement between them on one point which may be emphasized. The traumatic neuroses demonstrate very clearly that a fixation to the moment of the traumatic occurrence lies at their root. These patients regularly reproduce the traumatic situation in their dreams; in cases showing attacks of an hysterical type in which analysis is possible, it appears that the attack constitutes a complete reproduction of this situation. It is as though these persons had not yet been able to deal adequately with the situation, as if this task were still actually before them unaccomplished. We take this attitude of theirs in all seriousness; it points the way to what we may call an economic conception of the mental processes. The term ‘traumatic’ has actually no other meaning but this economic one. An experience which we call traumatic is one which within a very short space of time subjects the mind to such a very high increase of stimulation that assimilation or elaboration of it can no longer be effected by normal means, so that lasting disturbances must result in the distribution of the available energy in the mind.

This analogy tempts us also to classify as traumatic those experiences to which our nervous patients seem to be fixated. In this way we should be provided with a simple condition for a neurotic illness; it would be comparable to a traumatic illness and would result from an incapacity to deal with an overpowering affective experience. Indeed, the first formula in which Breuer and I, in 1893–95, reduced our new observations to a theory was expressed very similarly. A case like that of the first patient described, the young woman separated from her husband, fits very well into this description; she had not been able to “get over” the impracticability of her marriage and was still attached to her trauma. But the second case of the young girl who was tied to her father shows us at once that the formula is not comprehensive enough. On the one hand, an infantile adoration of her father by a little girl is such a common experience and so frequently grown out of that the term ‘traumatic’ would lose all its meaning if applied to it; on the other hand, the history of the case shows that this first erotic fixation was gone through by the patient quite harmlessly at the time, to all appearances, and only several years later came to expression in the obsessional neurosis. So we see that there are complications ahead, a considerable variety and number of determining factors in neurosis; but we divine that the traumatic view will not necessarily be abandoned as false, and that it will fit in and have to be co-ordinated properly elsewhere.

Here again we must leave the path we have been following. At the moment it will take us no further, and we have much more to learn before we can find a satisfactory continuation of it. But before leaving the subject of fixation to traumata it should be noted that it is a phenomenon manifested extensively outside the neuroses; every neurosis contains such a fixation, but not every fixation leads to a neurosis, or is necessarily combined with a neurosis, or arises in the course of a neurosis. Grief is a prototype and perfect example of an affective fixation upon something that is past, and, like the neuroses, it also involves a state of complete alienation from the present and the future. But even the lay public distinguishes clearly between grief and neurosis. On the other hand, there are neuroses which may be described as morbid forms of grief.

It does also happen that persons may be brought to a complete standstill in life by a traumatic experience which has shaken the whole structure of their lives to the foundations, so that they give up all interest in the present and the future, and live permanently absorbed in their retrospections; but these unhappy persons do not necessarily become neurotic. Therefore this single feature must not be overestimated as a characteristic of neurosis, however invariable and significant it may be otherwise.

Now let us turn to the second conclusion to be drawn from our analyses; it is one upon which we shall not need to impose any subsequent limitation. With the first patient we have heard of the senseless obsessive act she performed and of the intimate memories she recalled in connection with it; we also considered the relation between the two, and deduced the purpose of the obsessive act from its connection with the memory. But there is one factor which we have entirely neglected, and yet it is one which deserves our fullest attention. As long as the patient continued this performance she did not know that it was in any way connected with the previous experience; the connection between the two things was hidden; she could quite truly answer that she did not know what impulse led her to do it. Then it happened suddenly that, under the influence of the treatment, she found this connection and was able to tell it. But even then she knew nothing of the purpose she had in performing the action, the purpose that was to correct a painful event of the past and to raise the husband she loved in her own estimation. It took a long time and much effort for her to grasp, and admit to me, that such a motive as this alone could have been the driving force behind the obsessive act.

The connection with the scene on the morning after the unhappy bridal-night, and the patient’s own tender feeling for her husband, together, make up what we have called the “meaning” of the obsessive act. But both sides of this meaning were hidden from her, she understood neither the whence nor the whither of her act, as long as she carried it on. Mental processes had been at work in her, therefore, of which the obsessive act was the effect; she was aware in a normal manner of their effect; but nothing of the mental antecedents of this effect had come to the knowledge of her consciousness. She was behaving exactly like a subject under hypnotism whom Bernheim had ordered to open an umbrella in the ward five minutes after he awoke, but who had no idea why he was doing it. This is the kind of occurrence we have in mind when we speak of the existence of unconscious mental processes; we may challenge anyone in the world to give a more correctly scientific explanation of this matter, and will then gladly withdraw our inference that unconscious mental processes exist. Until they do, however, we will adhere to this inference and, when anyone objects that in a scientific sense the Unconscious has no reality, that it is a mere makeshift, une façon de parler, we must resign ourselves with a shrug to rejecting his statement as incomprehensible. Something unreal, which can nevertheless produce something so real and palpable as an obsessive action!

In the second patient fundamentally the same thing is found. She has instituted a rule that the bolster must not touch the back of the bedstead, and she had to carry out this rule, but she does not know whence it comes, what it means, or to what it owes its strength. Whether she regards it indifferently, or struggles against it, or rages against it, or determines to overcome it, matters not; it will be followed. It must be followed; in vain she asks herself why. It is undeniable that these symptoms of the obsessional neurosis, these ideas and these impulses which arise no man knows where and which oppose such a powerful resistance against all the influences to which an otherwise normal mental life is susceptible, give the impression, even to the patients themselves, of being all-powerful visitants from another world, immortal beings mingling in the whirlpool of mortal things. In these symptoms lies the clearest indication of a special sphere of mental activity cut off from all the rest. They show the way unmistakably to conviction on the question of the unconscious in the mind; and for that very reason clinical psychiatry, which only recognizes a psychology of consciousness, can do nothing with these symptoms except to stigmatize them as signs of a special kind of degeneration. Naturally, the obsessive ideas and impulses are not themselves unconscious, any more than is the performance of the obsessive acts. They would not have become symptoms if they had not penetrated into consciousness. But the mental antecedents of them disclosed by analysis, the connections into which they fit after interpretation, are unconscious, at least until the time when we make the patient conscious of them by the work of the analysis.

Consider now, in addition, that the facts established in these two cases are confirmed in every symptom of every neurotic disease; that always and everywhere the meaning of the symptoms is unknown to the sufferer; that analysis invariably shows that these symptoms are derived from unconscious mental processes which can, however, under various favourable conditions, become conscious. You will then understand that we cannot dispense with the unconscious part of the mind in psycho-analysis, and that we are accustomed to deal with it as with something actual and tangible. Perhaps you will also be able to realize how unfitted all those who only know the Unconscious as a phrase, who have never analysed, never interpreted dreams, or translated neurotic symptoms into their meaning and intention, are to form an opinion on this matter. I will repeat the substance of it again in order to impress it upon you: The fact that it is possible to find meaning in neurotic symptoms by means of analytic interpretation is an irrefutable proof of the existence—or, if you prefer it, of the necessity for assuming the existence—of unconscious mental processes.

But that is not all. Thanks to a second discovery of Breuer’s, for which he alone deserves credit and which seems to me even more far-reaching in its significance than the first, more still has been learnt about the relation between the Unconscious and the symptoms of neurotics. Not merely is the meaning of the symptom invariably unconscious; there exists also a connection of a substitutive nature between the two; the existence of the symptom is only possible by reason of this unconscious activity. You will soon understand what I mean. With Breuer, I maintain the following: Every time we meet with a symptom we may conclude that definite unconscious activities which contain the meaning of the symptom are present in the patient’s mind. Conversely, this meaning must be unconscious before a symptom can arise from it. Symptoms are not produced by conscious processes; as soon as the unconscious processes involved are made conscious the symptom must vanish. You will perceive at once that here is an opening for therapy, a way by which symptoms can be made to disappear. It was by this means that Breuer actually achieved the recovery of his patient, that is, freed her from her symptoms; he found a method of bringing into her consciousness the unconscious processes which contained the meaning of her symptoms and the symptoms vanished.

This discovery of Breuer’s was not the result of any speculation but of a fortunate observation made possible by the co-operation of the patient. Now you must not rack your brains to try and understand this by seeking to compare it with something similar that is already familiar to you; but you must recognize in it a fundamentally new fact, by means of which much else becomes explicable. Allow me therefore to express it again to you in other words.

The symptom is formed as a substitute for something else which remains submerged. Certain mental processes would, under normal conditions, develop until the person became aware of them consciously. This has not happened; and, instead, the symptom has arisen out of these processes which have been interrupted and interfered with in some way and have had to remain unconscious. Thus something in the nature of an exchange has occurred; if we can succeed in reversing this process by our therapy we shall have performed our task of dispersing the symptom.

Breuer’s discovery still remains the foundation of psycho-analytic therapy. The proposition that symptoms vanish when their unconscious antecedents have been made conscious has been borne out by all subsequent research; although the most extraordinary and unexpected complications are met with in attempting to carry this proposition out in practice. Our therapy does its work by transforming something unconscious into something conscious, and only succeeds in its work in so far as it is able to effect this transformation.

Now for a rapid digression, lest you should run the risk of imagining that this therapeutic effect is achieved too easily. According to the conclusions we have reached so far, neurosis would be the result of a kind of ignorance, a not-knowing of mental processes which should be known. This would approach very closely to the well-known Socratic doctrine according to which even vice is the result of ignorance. Now it happens in analysis that an experienced practitioner can usually surmise very easily what those feelings are which have remained unconscious in each individual patient. It should not therefore be a matter of great difficulty to cure the patient by imparting this knowledge to him and so relieving his ignorance. At least, one side of the unconscious meaning of the symptom would be easily dealt with in this way, although it is true that the other side of it, the connection between the symptom and the previous experiences in the patient’s life, can hardly be divined thus; for the analyst does not know what the experiences have been, he has to wait till the patient remembers them and tells him. But one might find a substitute even for this in many cases. One might ask for information about his past life from the friends and relations; they are often in a position to know what events have been of a traumatic nature, perhaps they can even relate some of which the patient is ignorant because they took place at some very early period of childhood. By a combination of these two means it would seem that the pathogenic ignorance of the patients might be overcome in a short time without much trouble.

If only it were so! But we have made discoveries that we were quite unprepared for at first. There is knowing and knowing; they are not always the same thing. There are various kinds of knowing, which psychologically are not by any means of equal value. Il y a fagots et fagots, as Molière says. Knowing on the part of the physician is not the same thing as knowing on the part of the patient and does not have the same effect. When the physician conveys his knowledge to the patient by telling him what he knows, it has no effect. No, it would be incorrect to say that. It does not have the effect of dispersing the symptoms; but it has a different one, it sets the analysis in motion, and the first result of this is often an energetic denial. The patient has learned something that he did not know before—the meaning of his symptom—and yet he knows it as little as ever. Thus we discover that there is more than one kind of ignorance. It requires a considerable degree of insight and understanding of psychological matters in order to see in what the difference consists. But the proposition that symptoms vanish with the acquisition of knowledge of their meaning remains true, nevertheless. The necessary condition is that the knowledge must be founded upon an inner change in the patient which can only come about by a mental operation directed to that end. We are here confronted by problems which to us will soon develop into the dynamics of symptom-formation.

Now I must really stop and ask you whether all that I have been saying is not too obscure and complicated? Am I confusing you by so often qualifying and restricting, spinning out trains of thought and then letting them drop? I should be sorry if it were so. But I have a strong dislike of simplification at the expense of truth, I am not averse from giving you a full impression of the many-sidedness and intricacy of the subject, and also I believe that it does no harm to tell you more about each point than you can assimilate at the moment. I know that every listener and every reader arranges what is offered him as suits him in his own mind, shortens it, simplifies it, and extracts from it what he will retain. Within certain limits it is true that the more we begin with the more we shall have at the end. So let me hope that, in spite of the elaboration, you will have grasped the essential substance of my remarks concerning the meaning of symptoms, the Unconscious, and the connection between the two. You have probably understood also that our further efforts will proceed in two directions; first, towards discovering how people become ill, how they come to take up the characteristic neurotic attitude towards life, which is a clinical problem; and secondly, how they develop the morbid symptoms out of the conditions of a neurosis, which remains a problem of mental dynamics. The two problems must somewhere have a point of contact.

I shall not go further into this to-day; but as our time is not yet up I propose to draw your attention to another characteristic of our two analyses; namely, the memory gaps or amnesias, again a point which only later will appear in its full significance. You have heard that the task of the psycho-analytic treatment can be summed up in this formula: everything pathogenic in the Unconscious must be transferred into consciousness. Now you will be perhaps astonished to hear that another formula may be substituted for that one: all gaps in the patient’s memory must be filled in, his amnesias removed. It amounts to the same thing; which means that an important connection is to be recognized between the development of the symptoms and the amnesias. If you consider the case of the first patient analysed you will, however, not find this view of amnesia justified; the patient had not forgotten the scene from which the obsessive act is derived; on the contrary, it was vivid in her memory, nor is there any other forgotten factor involved in the formation of her symptom. The situation is quite analogous, although less clear, in the second case, the girl with the obsessional ceremonies. She, too, had not really forgotten her behaviour in former years, the fact that she had insisted upon the open door between her parents’ bedroom and her own, and that she had turned her mother out of her place in the parents’ bed; she remembered it quite clearly, although with hesitation and unwillingness. What is remarkable about it is that the first patient, although she had carried out her obsessive act such a countless number of times, had not once been reminded of its similarity to the scene after the wedding-night, nor did this recollection ever occur to her when she was directly asked to search for the origin of her obsessive act. The same thing is true in the case of the girl, where not merely the ritual, but the situation which gave rise to it, was repeated identically every evening. In neither case was there really an amnesia, a lapse of memory; but a connection, which should have existed intact and have led to the reproduction, the recollection, of the memory, had been broken. This kind of disturbance of memory suffices for the obsessional neurosis; in hysteria it is different. This latter neurosis is usually characterized by amnesias on a grand scale. As a rule the analysis of each single hysterical symptom leads to a whole chain of former impressions, which upon their return may be literally described as having been hitherto forgotten. This chain reaches, on the one hand, back to the earliest years of childhood, so that the hysterical amnesia is seen to be a direct continuation of the infantile amnesia which hides the earliest impressions of our mental life from all of us. On the other hand, we are astonished to find that the most recent experiences of the patient are liable to be forgotten also, and that in particular the provocations which induced the outbreak of the disease or aggravated it are at least partially obliterated, if not entirely wiped out, by amnesia. From the complete picture of any such recent recollection important details have invariably disappeared or been replaced by falsifications. It happens again and again, almost invariably, that not until shortly before the completion of an analysis do certain recollections of recent experiences come to the surface, which had managed to be withheld throughout it and had left noticeable gaps in the context.

These derangements in the capacity to recall memories are, as I have said, characteristic of hysteria, in which disease it also happens even that states occur as symptoms (the hysterical attacks) without necessarily leaving a trace of recollection behind them. Since it is otherwise in the obsessional neurosis, you may infer that these amnesias are part of the psychological character of the hysterical change and are not a universal trait of neurosis in general. The importance of this difference will be diminished by the following consideration. Two things are combined to constitute the meaning of a symptom; its whence and its whither or why; that is, the impressions and experiences from which it sprang, and the purpose which it serves. The whence of a symptom is resolved into impressions which have been received from without, which were necessarily at one time conscious, and which may have become unconscious by being forgotten since that time. The why of the symptom, its tendency, is however always an endo-psychic process, which may possibly have been conscious at first, but just as possibly may never have been conscious and may have remained in the Unconscious from its inception. Therefore it is not very important whether the amnesia has also infringed upon the whence, the impressions upon which the symptom is supported, as happens in hysteria; the whither, the tendency of the symptom, which may have been unconscious from the beginning, is what maintains the symptom’s dependence upon the Unconscious, in the obsessional neurosis no less strictly than in hysteria.

By thus emphasizing the unconscious in mental life we have called forth all the malevolence in humanity in opposition to psycho-analysis. Do not be astonished at this and do not suppose that this opposition relates to the obvious difficulty of conceiving the Unconscious or to the relative inaccessibility of the evidence which supports its existence. I believe it has a deeper source. Humanity has in the course of time had to endure from the hands of science two great outrages upon its naïve self-love. The first was when it realized that our earth was not the centre of the universe, but only a tiny speck in a world-system of a magnitude hardly conceivable; this is associated in our minds with the name of Copernicus, although Alexandrian doctrines taught something very similar. The second was when biological research robbed man of his peculiar privilege of having been specially created, and relegated him to a descent from the animal world, implying an ineradicable animal nature in him: this transvaluation has been accomplished in our own time upon the instigation of Charles Darwin, Wallace, and their predecessors, and not without the most violent opposition from their contemporaries. But man’s craving for grandiosity is now suffering the third and most bitter blow from present-day psychological research which is endeavouring to prove to the “ego” of each one of us that he is not even master in his own house, but that he must remain content with the veriest scraps of information about what is going on unconsciously in his own mind. We psycho-analysts were neither the first nor the only ones to propose to mankind that they should look inward; but it appears to be our lot to advocate it most insistently and to support it by empirical evidence which touches every man closely. This is the kernel of the universal revolt against our science, of the total disregard of academic courtesy in dispute, and the liberation of opposition from all the constraints of impartial logic. And besides this, we have been compelled to disturb the peace of the world in yet another way, as you will soon hear.

Nineteenth Lecture — Resistance and Repression

We now need more data before we can advance further in our understanding of the neuroses; two observations lie to hand for us. Both are very remarkable and at first were very surprising. You are of course prepared for both of them by the work we did last year.

First: when we undertake to cure a patient of his symptoms he opposes against us a vigorous and tenacious resistance throughout the entire course of the treatment. This is such an extraordinary thing that we cannot expect much belief in it. It is best to say nothing about it to the patient’s relations, for they invariably regard it as a pretext set up by us to excuse the length or the failure of the treatment. The patient, too, exhibits all the manifestations of this resistance without recognizing it as such, and it is a great step forward when we have brought him to realize this fact and to reckon with it. To think that the patient, whose symptoms cause him and those about him such suffering, who is willing to make such sacrifices in time, money, effort, and self-conquest in order to be freed from them,—that he should, in the interests of his illness, resist the help offered him. How improbable this statement must sound! And yet it is so, and if the improbability is made a reproach against us we need only reply that it is not without its analogies; for a man who has rushed off to a dentist with a frightful toothache may very well fend him off when he takes his forceps to the decayed tooth.

The resistance shown by patients is highly varied and exceedingly subtle, often hard to recognize and protean in the manifold forms it takes; the analyst needs to be continually suspicious and on his guard against it. In psycho-analytic therapy we employ the technique which is already familiar to you through dream-interpretation: we require the patient to put himself into a condition of calm self-observation, without trying to think of anything, and then to communicate everything which he becomes inwardly aware of, feelings, thoughts, remembrances, in the order in which they arise in his mind. We expressly warn him against giving way to any kind of motive which would cause him to select from or to exclude any of the ideas (associations), whether because they are too “disagreeable,” or too “indiscreet” to be mentioned, or too “unimportant” or “irrelevant” or “nonsensical” to be worth saying. We impress upon him that he has only to attend to what is on the surface consciously in his mind, and to abandon all objections to whatever he finds, no matter what form they take; and we inform him that the success of the treatment, and, above all, its duration, will depend upon his conscientious adherence to this fundamental technical rule. We know from the technique of dream-interpretation that it is precisely those associations against which innumerable doubts and objections are raised that invariably contain the material leading to the discovery of the unconscious.

The first thing that happens as a result of instituting this technical rule is that it becomes the first point of attack for the resistance. The patient attempts to escape from it by every possible means. First he says nothing comes into his head, then that so much comes into his head that he can’t grasp any of it. Then we observe with displeasure and astonishment that he is giving in to his critical objections, first to this, then to that; he betrays it by the long pauses which occur in his talk. At last he admits that he really cannot say something, he is ashamed to, and he lets this feeling get the better of his promise. Or else, he has thought of something but it concerns someone else and not himself, and is therefore to be made an exception to the rule. Or else, what he has just thought of is really too unimportant, too stupid and too absurd, I could never have meant that he should take account of such thoughts. So it goes on, with untold variations, to which one continually replies that telling everything really means telling everything.

One hardly ever meets with a patient who does not attempt to make a reservation in some department of his thoughts, in order to guard them against intrusion by the analysis. One patient, who in the ordinary way was remarkably intelligent, concealed a most intimate love-affair from me for weeks in this way; when accused of this violation of the sacred rule he defended himself with the argument that he considered this particular story his private affair. Naturally analytic treatment cannot countenance a right of sanctuary like this; one might as well try to allow an exception to be made in certain parts of a town like Vienna, and forbid that any arrests should be made in the market-place or in the square by St. Stephen’s church, and then attempt to take up a “wanted” man. Of course he would never be found anywhere but in those safe places. Once I decided to permit a man to make an exception of such a point; for a great deal depended on his recovering his capacity for work and he was bound by his oath as a civil servant not to communicate certain matters to any other person. He was content with the result, it is true, but I was not: I made up my mind never again to repeat the attempt under such conditions.

Obsessional patients are exceedingly clever at making the technical rule almost useless by bringing their over-conscientiousness and doubt to bear upon it. Patients with anxiety-hysteria sometimes succeed in reducing it to absurdity by only producing associations which are so far removed from what is wanted that they yield nothing for analysis. However, I do not intend to introduce you to these technical difficulties of the treatment. It is enough to know that finally, with resolution and perseverance, we do succeed in extracting from the patient a certain amount of obedience for the rule of the technique; and then the resistance takes another line altogether. It appears as intellectual opposition, employs arguments as weapons, and turns to its own use all the difficulties and improbabilities which normal but uninstructed reasoning finds in analytical doctrines. We then have to hear from the mouth of the individual patient all the criticisms and objections which thunder about us in chorus in scientific literature. What the critics outside shout at us is nothing new, therefore. It is indeed a storm in a teacup. Still, the patient can be argued with; he is very glad to get us to instruct him, teach him, defeat him, point out the literature to him so that he can learn more; he is perfectly ready to become a supporter of psycho-analysis on the condition that analysis shall spare him personally. We recognize resistance in this desire for knowledge, however; it is a digression from the particular task in hand and we refuse to allow it. In the obsessional neurosis the resistance makes use of special tactics which we are prepared for. It permits the analysis to proceed uninterruptedly along its course, so that more and more light is thrown upon the problems of the case, until we begin to wonder at last why these explanations have no practical effect and entail no corresponding improvement in the symptoms. Then we discover that the resistance has fallen back upon the doubt characteristic of the obsessional neurosis and is holding us successfully at bay from this vantage-point. The patient has said to himself something of this kind: “This is all very pretty and very interesting. I should like to go on with it. I am sure it would do me a lot of good if it were true. But I don’t believe it in the least, and as long as I don’t believe it, it doesn’t affect my illness.” So it goes on for a long time, until at last this reservation itself is reached and then the decisive battle begins.

The intellectual resistances are not the worst; one can always get the better of them. But the patient knows how to set up resistances within the boundaries of analysis proper, and the defeat of these is one of the most difficult tasks of the technique. Instead of remembering certain of the feelings and states of mind of his previous life, he reproduces them, lives through again such of them as, by means of what is called the ‘transference,’ may be made effective in opposition against the physician and the treatment. If the patient is a man, he usually takes this material from his relationship with his father, in whose place he has now put the physician; and in so doing he erects resistances out of his struggles to attain to personal independence and independence of judgement, out of his ambition, the earliest aim of which was to equal or to excel the father, out of his disinclination to take the burden of gratitude upon himself for the second time in his life. There are periods in which one feels that the patient’s desire to put the analyst in the wrong, to make him feel his impotence, to triumph over him, has completely ousted the worthier desire to bring the illness to an end. Women have a genius for exploiting in the interests of resistance a tender erotically-tinged transference to the analyst; when this attraction reaches a certain intensity all interest in the actual situation of treatment fades away, together with every obligation incurred upon undertaking it. The inevitable jealousy and the embitterment consequent upon the unavoidable rejection, however considerately it is handled, is bound to injure the personal relationship with the physician, and so to put out of action one of the most powerful propelling forces in the analysis.

Resistances of this kind must not be narrowly condemned. They contain so much of the most important material from the patient’s past life and bring it back in so convincing a fashion that they come to be of the greatest assistance to the analysis, if a skilful technique is employed correctly to turn them to the best use. What is noteworthy is that this material always serves at first as a resistance and comes forward in a guise which is inimical to the treatment. Again it may be said that they are character-traits, individual attitudes of the Ego, which are thus mobilized to oppose the attempted alterations. One learns then how these character-traits have been developed in connection with the conditions of the neurosis and in reaction against its demands, and observes features in this character which would not otherwise have appeared, at least, not so clearly: that is, which may be designated latent. Also you must not carry away the impression that we look upon the appearance of these resistances as an unforeseen danger threatening our analytic influence. No, we know that these resistances are bound to appear; we are dissatisfied only if we cannot rouse them definitely enough and make the patient perceive them as such. Indeed, we understand at last that the overcoming of these resistances is the essential work of the analysis, that part of the work which alone assures us that we have achieved something for the patient.

Besides this, you must take into account that all accidental occurrences arising during the treatment are made use of by the patient to interfere with it, anything which could distract him or deter him from it, every hostile expression of opinion from anyone in his circle whom he can regard as an authority, any chance organic illness or one complicating the neurosis; indeed, he even converts every improvement in his condition into a motive for slackening his efforts. Then you will have obtained an approximate, though still incomplete, picture of the forms and the measures taken by the resistances which must be met and overcome in the course of every analysis. I have given such a detailed consideration to this point because I am about to inform you that our dynamic conception of the neuroses is founded upon this experience of ours of the resistances that neurotic patients set up against the cure of their symptoms. Breuer and I both originally practised psycho-therapy by the hypnotic method. Breuer’s first patient was treated throughout in a state of hypnotic suggestibility; at first I followed his example. I admit that at that time my work went forward more easily and agreeably and also took much less time: but the results were capricious and not permanent; therefore I finally gave up hypnotism. And then I understood that no comprehension of the dynamics of these affections was possible as long as hypnosis was employed. In this condition the very existence of resistances is concealed from the physician’s observation. Hypnosis drives back the resistances and frees a certain field for the work of the analysis, but dams them up at the boundaries of this field so that they are insurmountable; it is similar in effect to the doubt of the obsessional neurosis. Therefore I may say that true psycho-analysis only began when the help of hypnosis was discarded.

If it is a matter of such importance to establish these resistances then surely it would be wise to allow caution and doubt full play, in case we have been too ready with our assumption that they exist. Perhaps cases of neurosis may be found in which the associations really fail for other reasons, perhaps the arguments against our theories really deserve serious attention, and we may be wrong in so conveniently disposing of the patient’s intellectual objections by stigmatizing them as resistance. Well, I can only assure you that our judgement in this matter has not been formed hastily; we have had opportunity to observe these critical patients both before the resistance comes to the surface and after it disappears. In the course of the treatment the resistance varies in intensity continually; it always increases as a new topic is approached, it is at its height during the work upon it, and dies down again when this theme has been dealt with. Unless certain technical errors have been committed we never have to meet the full measure of resistance, of which any patient is capable, at once. Thus we could definitely ascertain that the same man would take up and then abandon his critical objections over and over again in the course of the analysis. Whenever we are on the point of bringing to his consciousness some piece of unconscious material which is particularly painful to him, then he is critical in the extreme; even though he may have previously understood and accepted a great deal, yet now all these gains seem to be obliterated; in his struggles to oppose at all costs he can behave just as though he were mentally deficient, a form of ‘emotional stupidity.’ If he can be successfully helped to overcome this new resistance he regains his insight and comprehension. His critical faculty is not functioning independently, and therefore is not to be respected as if it were; it is merely a maid-of-all-work for his affective attitudes and is directed by his resistance. When he dislikes anything he can defend himself against it most ingeniously; but when anything suits his book he can be credulous enough. We are perhaps all much the same; a person being analysed shows this dependence of the intellect upon the affective life so clearly because in the analysis he is so hard-pressed.

In what way can we now account for this fact observed, that the patient struggles so energetically against the relief of his symptoms and the restoration of his mental processes to normal functioning? We say that we have come upon the traces of powerful forces at work here opposing any change in the condition; they must be the same forces that originally induced the condition. In the formation of symptoms some process must have been gone through, which our experience in dispersing them makes us able to reconstruct. As we already know from Breuer’s observations, it follows from the existence of a symptom that some mental process has not been carried through to an end in a normal manner so that it could become conscious; the symptom is a substitute for that which has not come through. Now we know where to place the forces which we suspect to be at work. A vehement effort must have been exercised to prevent the mental process in question from penetrating into consciousness and as a result it has remained unconscious; being unconscious it had the power to construct a symptom. The same vehement effort is again at work during analytic treatment, opposing the attempt to bring the unconscious into consciousness. This we perceive in the form of resistances. The pathogenic process which is demonstrated by the resistances we call Repression.

It will now be necessary to make our conception of this process of repression more precise. It is the essential preliminary condition for the development of symptoms, but it is also something else, a thing to which we have no parallel. Let us take as a model an impulse, a mental process seeking to convert itself into action: we know that it can suffer rejection, by virtue of what we call “repudiation” or “condemnation”; whereupon the energy at its disposal is withdrawn, it becomes powerless, but it can continue to exist as a memory. The whole process of decision on the point takes place with the full cognizance of the Ego. It is very different when we imagine the same impulse subject to repression: it would then retain its energy and no memory of it would be left behind; the process of repression, too, would be accomplished without the cognizance of the Ego. This comparison therefore brings us no nearer to the nature of repression.

I will expound to you those theoretical conceptions which alone have proved useful in giving greater definiteness to the term repression. For this purpose it is first necessary that we should proceed from the purely descriptive meaning of the word “unconscious” to its systematic meaning; that is, we resolve to think of the consciousness or unconsciousness of a mental process as merely one of its qualities and not necessarily definitive. Suppose that a process of this kind has remained unconscious, its being withheld from consciousness may be merely a sign of the fate it has undergone, not necessarily the fate itself. Let us suppose, in order to gain a more concrete notion of this fate, that every mental process—there is one exception, which I will go into later—first exists in an unconscious state or phase, and only develops out of this into a conscious phase, much as a photograph is first a negative and then becomes a picture through the printing of the positive. But not every negative is made into a positive, and it is just as little necessary that every unconscious mental process should convert itself into a conscious one. It may be best expressed as follows: Each single process belongs in the first place to the unconscious psychical system; from this system it can under certain conditions proceed further into the conscious system.

The crudest conception of these systems is the one we shall find most convenient, a spatial one. The unconscious system may therefore be compared to a large ante-room, in which the various mental excitations are crowding upon one another, like individual beings. Adjoining this is a second, smaller apartment, a sort of reception-room, in which, too, consciousness resides. But on the threshold between the two there stands a personage with the office of door-keeper, who examines the various mental excitations, censors them, and denies them admittance to the reception-room when he disapproves of them. You will see at once that it does not make much difference whether the door-keeper turns any one impulse back at the threshold, or drives it out again once it has entered the reception-room; that is merely a matter of the degree of his vigilance and promptness in recognition. Now this metaphor may be employed to widen our terminology. The excitations in the unconscious, in the antechamber, are not visible to consciousness, which is of course in the other room, so to begin with they remain unconscious. When they have pressed forward to the threshold and been turned back by the door-keeper, they are ‘incapable of becoming conscious’; we call them then repressed. But even those excitations which are allowed over the threshold do not necessarily become conscious; they can only become so if they succeed in attracting the eye of consciousness. This second chamber therefore may be suitably called the preconscious system. In this way the process of becoming conscious retains its purely descriptive sense. Being repressed, when applied to any single impulse, means being unable to pass out of the unconscious system because of the door-keeper’s refusal of admittance into the preconscious. The door-keeper is what we have learnt to know as resistance in our attempts in analytic treatment to loosen the repressions.

Now I know very well that you will say that these conceptions are as crude as they are fantastic and not at all permissible in a scientific presentation. I know they are crude; further indeed, we even know that they are incorrect, and unless I am mistaken, we have something better ready as a substitute for them; whether you will then continue to think them so fantastic, I do not know. At the moment they are useful aids to understanding, like Ampère’s manikin swimming in the electric current, and, in so far as they do assist comprehension, are not to be despised. Still, I should like to assure you that these crude hypotheses, the two chambers, the door-keeper on the threshold between the two, and consciousness as a spectator at the end of the second room, must indicate an extensive approximation to the actual reality. I should also like to hear you admit that our designations, unconscious, preconscious, and conscious, are less prejudicial and more easily defensible than some others which have been suggested or have come into use, e.g. sub-conscious, inter-conscious, co-conscious, etc.

If so, I should think it more significant if you then went on to point out that any such constitution of the mental apparatus as I have assumed in order to account for neurotic symptoms can only be of universal validity and must throw light on normal functioning. In this, of course, you are perfectly right. We cannot follow up this conclusion at the moment; but our interest in the psychology of symptom-development would certainly be enormously increased if we could see any prospect of obtaining, by the study of pathological conditions, an insight into normal mental functioning, hitherto such a mystery.

Do you not recognize, moreover, what it is that supports these conceptions of the two systems and the relationship between them and consciousness? The door-keeper between the unconscious and the preconscious is nothing else than the censorship to which we found the form of the manifest dream subjected. The residue of the day’s experiences, which we found to be the stimuli exciting the dream, was preconscious material which at night during sleep had been influenced by unconscious and repressed wishes and excitations; and had thus by association with them been able to form the latent dream, by means of their energy. Under the dominion of the unconscious system this material had been elaborated (worked over)—by condensation and displacement—in a way which in normal mental life, i.e. in the preconscious system, is unknown or admissible very rarely. This difference in their manner of functioning is what distinguishes the two systems for us; the relationship to consciousness, which is a permanent feature of the preconscious, indicates to which of the two systems any given process belongs. Neither is dreaming a pathological phenomenon; every healthy person may dream while asleep. Every inference concerning the constitution of the mental apparatus which comprises an understanding of both dreams and neurotic symptoms has an irrefutable claim to be regarded as applying also to normal mental life.

This is as much as we will say about repression for the present. Moreover, it is but a necessary preliminary condition, a prerequisite, of symptom-formation. We know that the symptom is a substitute for some other process which was held back by repression; but even given repression we have still a long way to go before we can obtain comprehension of this substitute-formation. There are other sides to the problem of repression itself which present questions to be answered: What kind of mental excitations suffer repression? What forces effect it? and from what motives? On one point only, so far, have we gained any knowledge relevant to these questions. While investigating the problem of resistance we learned that the forces behind it proceed from the Ego, from character-traits, recognizable or latent: it is these forces therefore which have also effected the repression, or at least they have taken a part in it. We know nothing more than this at present.

The second observation for which I prepared you will help us now. By means of analysis we can always discover the purpose behind the neurotic symptom. This is of course nothing new to you: I have already pointed it out in two cases of neurosis. But, to be sure, what do two cases signify? You have a right to demand two hundred cases, innumerable cases, in demonstration of it. But then, I cannot comply with that. So you must fall back on personal experience, or upon belief, which in this matter can rely upon the unanimous testimony of all psycho-analysts.

You will remember that in the two cases in which we submitted the symptoms to detailed investigation analysis led to the innermost secrets of the patient’s sexual life. In the first case, moreover, the purpose or tendency of the symptom under examination was particularly evident; in the second case, it was perhaps to some extent veiled by another factor to be mentioned later. Well now, what we found in these two examples we should find in every case we submitted to analysis. Every time we should be led by analysis to the sexual experiences and desires of the patient, and every time we should have to affirm that the symptom served the same purpose. This purpose shows itself to be the gratification of sexual wishes; the symptoms serve the purpose of sexual gratification for the patient; they are a substitute for satisfactions which he does not obtain in reality.

Think of the obsessive act of our first patient. This woman has to do without the husband she loved so intensely; on account of his deficiencies and short-comings she could not share his life. She had to be faithful to him; she could not put anyone else in his place. Her obsessional symptom gives her what she so much desires; it exalts her husband, denies and corrects his deficiencies, above all, his impotence. This symptom is fundamentally a wish-fulfilment, in that respect exactly like a dream; it is, moreover, what a dream is not always, an erotic wish-fulfilment. In the case of the second patient you could see that her ritual aims at preventing intercourse between the parents or at hindering the procreation of another child; you have probably also divined that fundamentally it seeks to set her in her mother’s place. It again therefore constitutes a removal of hindrances to sexual satisfaction and the fulfilment of the subject’s own sexual wishes. Of the complications referred to in the second case I shall speak shortly.

I wish to avoid making reservations later on about the universal applicability of these statements, and therefore I will ask you to notice that all I have just been saying about repression, symptom-formation and symptom-interpretation has been obtained from the study of three types of neurosis, and for the present is only applicable to these three types—namely, anxiety-hysteria, conversion-hysteria, and the obsessional neurosis. These three disorders, which we are accustomed to combine together in a group as the TRANSFERENCE NEUROSES, constitute the field open to psycho-analytic therapy. The other neuroses have been far less closely studied psycho-analytically; in one group of them the impossibility of therapeutic influence has no doubt been one reason for this neglect. You must not forget that psycho-analysis is still a very young science, that much time and trouble are required for the study of it, and that not so very long ago there was only one man practising it: yet we are approaching from all directions to a nearer comprehension of these other conditions which are not transference neuroses. I hope I shall still be able to tell you of the developments that our hypotheses and conclusions have undergone in the course of adaptation to this new material, and to show you that these further studies have not yielded contradictions but have led to a higher degree of unification in our knowledge. Everything that has been said, then, applies only to the three transference neuroses and I will now add another piece of information which throws further light upon the significance of the symptoms. A comparative examination of the situations out of which the disease arose yields the following result, which may be reduced to a formula—namely, that these persons have fallen ill owing to some kind of PRIVATION which they suffer when reality withholds from them gratification of their sexual wishes. You will perceive how beautifully these two conclusions supplement one another. The symptoms are now explicable as substitute-gratifications for desires which are unsatisfied in life.

It is certainly possible to make all kinds of objections to the proposition that neurotic symptoms are substitutes for sexual gratifications. I will discuss two of them to-day. If any one of you has himself undertaken the analysis of a large number of neurotics, he will perhaps shake his head and say: “In certain cases this is not at all applicable, in them the symptoms seem rather to contain the opposite purpose, of excluding or of discontinuing sexual gratification.” I shall not dispute your interpretation. In psycho-analysis things are often a good deal more complicated than we could wish: if they had been simpler psycho-analysis would perhaps not have been required to bring them to light. Certain features of the ritual of our second patient are distinctly recognizable as being of this ascetic character, inimical to sexual satisfaction; e.g., her removing the clocks for the magic purpose of preventing erections at night, or her trying to prevent the falling and breaking of vessels, which amounts to a protection of her virginity. In other cases of ceremonials on going to bed which I have analysed this negative character was far more marked; the whole ritual could consist of defensive regulations against sexual recollections and temptations. But we have long ago learnt from psycho-analysis that opposites do not constitute a contradiction. We might extend our proposition and say that the purpose of the symptom is either a sexual gratification or a defence against it; in hysteria the positive, wish-fulfilling character predominates on the whole, and in the obsessional neurosis the negative ascetic character. The symptoms can serve the purpose both of sexual gratification and of its opposite so well because this double-sidedness, or polarity, has a most suitable foundation in one element of their mechanism which we have not yet had an opportunity to mention. They are in fact, as we shall see, the effects of compromises between two opposed tendencies, acting on one another; they represent both that which is repressed, and also that which has effected the repression and has co-operated in bringing them about. The representation of either one or another of these two factors may predominate in the symptom, but it happens very rarely that one of them is absent altogether. In hysteria a collaboration of the two tendencies in one symptom is usually achieved. In the obsessional neurosis the two parts are often distinct: the symptom is then a double one and consists of two successive actions which cancel each other.

It will not be so easy to dispose of a second difficulty. When you consider a whole series of symptom-interpretations your first opinion would probably be that the conception of a sexual substitute-gratification has to be stretched to its widest limits in order to include them. You will not neglect to point out that these symptoms offer nothing real in the way of gratification, that often enough they are confined to re-animating a sensation, or to enacting a phantasy arising from some sexual complex. Further, that the ostensible sexual gratification is very often of an infantile and unworthy character, perhaps approximating to a masturbatory act, or is reminiscent of dirty habits which long ago in childhood had been forbidden and abandoned. And further still, you will express your astonishment that anyone should reckon among sexual gratifications those which can only be described as gratifications of cruel or horrible appetites, or which may be termed unnatural. Indeed, we shall come to no agreement on these latter points until we have submitted human sexuality to a thorough investigation and have thus established what we are justified in calling sexual.

Twentieth Lecture — The Sexual Life of Man

One would certainly think that there could be no doubt about what is to be understood by the term “sexual.” First and foremost, of course, it means the “improper,” that which must not be mentioned. I have been told a story about some pupils of a famous psychiatrist, who once endeavoured to convince their master that the symptoms of an hysteric are frequently representations of sexual things. With this object, they took him to the bedside of an hysterical woman whose attacks were unmistakable imitations of childbirth. He objected, however: “Well, there is nothing sexual about childbirth.” To be sure, childbirth is not necessarily always improper.

I perceive that you don’t approve of my joking about such serious matters. It is not altogether a joke, however. Seriously, it is not so easy to define what the term sexual includes. Everything connected with the difference between the two sexes is perhaps the only way of hitting the mark; but you will find that too general and indefinite. If you take the sexual act itself as the central point, you will perhaps declare sexual to mean everything which is concerned with obtaining pleasurable gratification from the body (and particularly the sexual organs) of the opposite sex; in the narrowest sense, everything which is directed to the union of the genital organs and the performance of the sexual act. In doing so, however, you come very near to reckoning the sexual and the improper as identical, and childbirth would really have nothing to do with sex. If then you make the function of reproduction the kernel of sexuality you run the risk of excluding from it a whole host of things like masturbation, or even kissing, which are not directed towards reproduction, but which are nevertheless undoubtedly sexual. However, we have already found that attempts at definition always lead to difficulties; let us give up trying to do any better in this particular case. We may suspect that in the development of the concept “sexual” something has happened which has resulted in what H. Silberer has aptly called a ‘covering error.’ On the whole, indeed, we know pretty well what is meant by sexual.

In the popular view, which is sufficient for all practical purposes in ordinary life, sexual is something which combines references to the difference between the sexes, to pleasurable excitement and gratification, to the reproductive function, and to the idea of impropriety and the necessity for concealment. But this is no longer sufficient for science. For painstaking researches (only possible, of course, in a spirit of self-command maintained by self-sacrifice) have revealed that classes of human beings exist whose sexual life deviates from the usual one in the most striking manner. One group among these “perverts” has, as it were, expunged the difference between the sexes from its scheme of life. In these people, only the same sex as their own can rouse sexual desire; the other sex (especially the genital organ of the other sex) has absolutely no sexual attraction for them, can even in extreme cases be an object of abhorrence to them. They have thus of course foregone all participation in the process of reproduction. Such persons are called homosexuals or inverts. Often, though not always, they are men and women who otherwise have reached an irreproachably high standard of mental growth and development, intellectually and ethically, and are only afflicted with this one fateful peculiarity. Through the mouths of their scientific spokesmen they lay claim to be a special variety of the human race, a “third sex,” as they call it, standing with equal rights alongside the other two. We may perhaps have an opportunity of critically examining these claims. They are not, of course, as they would gladly maintain, the “elect” of mankind; they contain in their ranks at least as many inferior and worthless individuals as are to be found amongst those differently constituted sexually.

These perverts do at least seek to achieve very much the same ends with the objects of their desires as normal people do with theirs. But after them comes a long series of abnormal types, in whom the sexual activities become increasingly further removed from anything which appears attractive to a reasonable being. In their manifold variety and their strangeness these types may be compared to the grotesque monstrosities painted by P. Breughel to represent the temptations of St. Anthony, or to the long procession of effete gods and worshippers which G. Flaubert shows us passing before his pious penitent, and to nothing else. The chaotic assembly calls out for classification if it is not to bewilder us completely. We divide them into those in whom the sexual object has been altered, as with the homosexuals, and those in whom, first and foremost, the sexual aim has been altered. In the first group belong those who have dispensed with the mutual union of the genital organs and who have substituted for the genitals, in one of the partners in the act, another organ or part of the body (mouth or anus, in place of the vagina) making light of both the anatomical difficulties and the suppression of disgust involved. There follow others who, it is true, still retain the genital organs as object; not, however, by virtue of their sexual function, but on account of other functions in which they take part anatomically or by reason of their proximity. These people demonstrate that the excretory functions, which in the course of the child’s upbringing are relegated to a limbo as indecent, remain capable of attracting the entire sexual interest. There are others who have given up altogether the genital organs as object; and, instead, have exalted some other part of the body to serve as the object of desire, a woman’s breast, foot, or plait of hair. There are others yet to whom even a part of the body is meaningless, while a particle of clothing, a shoe or a piece of underclothing, will gratify all their desires; these are the fetichists. Farther on in the scale come those who indeed demand the object as a whole: but whose requirements in regard to it take specific forms, of an extraordinary or horrible nature—even to the point of seeking it as a defenceless corpse and, urged on by their criminal obsessions, of making it one in order so to enjoy it. But enough of these horrors!

Foremost in the second group are those perverts whose sexual desires aim at the performance of an act which normally is but an introductory or preparatory one. They are those who seek gratification in looking and touching, or in watching the other person’s most intimate doings; or those who expose parts of their own bodies which should be concealed, in the vague expectation of being rewarded by a similar action on the part of the other. Then come the incomprehensible sadists, in whom all affectionate feeling strains towards the one goal of causing their object pain and torture, ranging in degree from mere indications of a tendency to humiliate the other up to the infliction of severe bodily injuries. Then, as though complementary to these, come the masochists whose only longing is to suffer, in real or in symbolic form, humiliations and tortures at the hands of the loved object. There are others yet, in whom several abnormal characteristics of this kind are combined and interwoven with one another. Finally, we learn that the persons belonging to each of these groups may be divided again: into those who seek their particular form of sexual satisfaction in reality and those who are satisfied merely to imagine it in their own minds, needing no real object at all but being able to substitute for it a creation of phantasy.

There is not the slightest possible doubt that these mad, extraordinary and horrible things do actually constitute the sexual activities of these people. Not merely do they themselves so regard them, recognizing their substitutive character; but we also have to acknowledge that they play the same part in their lives as normal sexual satisfaction plays in ours, exacting the same, often excessive, sacrifices. It is possible to trace out, both broadly and in great detail, where these abnormalities merge into the normal and where they diverge from it. Nor will it escape you that that quality of impropriety which adheres inevitably to a sexual activity is not absent from these forms of it: in most of them it is intensified to the point of odium.

Well, now, what attitude are we to take up to these unusual forms of sexual satisfaction? Indignation and expressions of our personal disgust, together with assurances that we do not share these appetites, will obviously not carry us very far. That is not the point at issue. After all, this is a field of phenomena like any other; attempts to turn away and flee from it, on the pretext that these are but rarities and curiosities, could easily be rebutted. On the contrary, the phenomena are common enough and widely distributed. But if it is objected that our views on the sexual life of mankind require no revision on this account, since these things are one and all aberrations and divagations of the sexual instinct, a serious reply will be necessary. If we do not understand these morbid forms of sexuality and cannot relate them to what is normal in sexual life, then neither can we understand normal sexuality. It remains, in short, our undeniable duty to account satisfactorily in theory for the existence of all the perversions described and to explain their relation to normal sexuality, so-called.

In this task we can be helped by a point of view, and by two new evidential observations. The first we owe to Ivan Bloch; according to him, the view that all the perversions are “signs of degeneration” is incorrect; because of the evidence existing that such aberrations from the sexual aim, such erratic relationships to the sexual object, have been manifested since the beginning of time through every age of which we have knowledge, in every race from the most primitive to the most highly civilized, and at times have succeeded in attaining to toleration and general prevalence. The two evidential observations have been made in the course of psycho-analytic investigations of neurotic patients; they must undoubtedly influence our conception of sexual perversions in a decisive manner.

We have said that neurotic symptoms are substitutes for sexual satisfactions and I have already indicated that many difficulties will be met with in proving this statement from the analysis of symptoms. It is, indeed, only accurate if the “perverse” sexual needs, so-called, are included under the sexual satisfactions; for an interpretation of the symptoms on this basis is forced upon us with astonishing frequency. The claim made by homosexuals or inverts, that they constitute a select class of mankind, falls at once to the ground when we discover that in every single neurotic evidence of homosexual tendencies is forthcoming and that a large proportion of the symptoms are expressions of this latent inversion. Those who openly call themselves homosexuals are merely those in whom the inversion is conscious and manifest; their number is negligible compared with those in whom it is latent. We are bound, in fact, to regard the choice of an object of the same sex as a regular type of offshoot of the capacity to love, and are learning every day more and more to recognize it as especially important. The differences between manifest homosexuality and the normal attitude are certainly not thereby abrogated; they have their practical importance, which remains, but theoretically their value is very considerably diminished. In fact, we have even come to the conclusion that one particular mental disorder, paranoia, no longer to be reckoned among the transference neuroses, invariably arises from an attempt to subdue unduly powerful homosexual tendencies. Perhaps you will remember that one of our patients,47 in her obsessive act, played the part of a man—of her own husband, that is, whom she had left; such symptoms, representing the impersonation of a man, are very commonly produced by neurotic women. If this is not actually attributable to homosexuality, it is certainly very closely connected with its origins.

As you probably know, the neurosis of hysteria can create its symptoms in all systems of the body (circulatory, respiratory, etc.) and may thus disturb all the functions. Analysis shows that all those impulses, described as perverse, which aim at replacing the genital organ by another come to expression in these symptoms. These organs thus behave as substitutes for the genital organs: it is precisely from the study of hysterical symptoms that we have arrived at the view that, besides their functional rôle, a sexual—erotogenic—significance must be ascribed to the bodily organs; and that the needs of the former will be interfered with if the demands of the latter upon them are too great. Countless sensations and innervations, which we meet as hysterical symptoms, in organs apparently not concerned with sexuality, are thus discovered to be essentially fulfilments of perverse sexual desires, by the other organs having usurped the function of the genitalia. In this way also the very great extent to which the organs of nutrition and of excretion, in particular, may serve in yielding sexual excitement is brought home to us. It is indeed the same thing as is manifested in the perversions; except that in the latter it is unmistakable and recognizable without any difficulty, whereas in hysteria we have to make the détour of interpreting the symptom, and then do not impute the perverse sexual impulse in question to the person’s consciousness, but account it to the unconscious part of his personality.

Of the many types of symptom characteristic of the obsessional neurosis the most important are found to be brought about by the undue strength of one group of sexual tendencies with a perverted aim, i.e. the sadistic group. These symptoms, in accordance with the structure of the obsessional neurosis, serve mainly as a defence against these wishes or else they express the conflict between satisfaction and rejection. Satisfaction does not find short shrift, however; it knows how to get its own way by a roundabout route in the patient’s behaviour, by preference turning against him in self-inflicted torment. Other forms of this neurosis are seen in excessive “worry” and brooding; these are the expressions of an exaggerated sexualization of acts which are normally only preparatory to sexual satisfaction: the desire to see, to touch and to investigate. In this lies the explanation of the very great importance dread of contact and obsessive washing attains to in this disease. An unsuspectedly large proportion of obsessive actions are found to be disguised repetitions and modifications of masturbation, admittedly the only uniform act which accompanies all the varied flights of sexual phantasy.

It would not be difficult to show you the connections between perversion and neurosis in a much more detailed manner, but I believe that I have said enough for our purposes. We must beware, however, of overestimating the frequency and intensity of the perverse tendencies in mankind, after these revelations of their importance in the interpretation of symptoms. You have heard that privation in normal sexual satisfactions may lead to the development of neurosis. In consequence of this privation in reality the need is forced into the abnormal paths of sexual excitation. Later you will be able to understand how this happens. You will at any rate understand that a “collateral” damming-up of this kind must swell the force of the perverse impulses, so that they become more powerful than they would have been had no hindrance to normal sexual satisfaction been present in reality. Incidentally, a similar factor may be recognized also in the manifest perversions. In many cases they are provoked or activated by the unduly great difficulties in the way of normal satisfaction of the sexual instinct which are produced either by temporary conditions or by permanent social institutions. In other cases, certainly, perverse tendencies are quite independent of such conditions; they are, as it were, the natural kind of sexual life for the individual concerned.

Perhaps you are momentarily under the impression that all this tends to confuse rather than to explain the relations between normal and perverted sexuality. But keep in mind this consideration. If it is correct that real obstacles to sexual satisfaction or privation in regard to it bring to the surface perverse tendencies in people who would otherwise have shown none, we must conclude that something in these people is ready to embrace the perversions; or, if you prefer it, the tendencies must have been present in them in a latent form. Thus we come to the second of the new evidential observations of which I spoke. Psycho-Analytic investigation has found it necessary also to concern itself with the sexual life of children, for the reason that in the analysis of symptoms the forthcoming reminiscences and associations invariably lead back to the earliest years of childhood. That which we discovered in this way has since been corroborated point by point by the direct observation of children. In this way it has been found that all the perverse tendencies have their roots in childhood, that children are disposed towards them all and practise them all to a degree conforming with their immaturity; in short, perverted sexuality is nothing else but infantile sexuality, magnified and separated into its component parts.

Now you will see the perversions in an altogether different light and no longer ignore their connection with the sexual life of mankind; but what distressing emotions these astonishing and grotesque revelations will provoke in you! At first you will certainly be tempted to deny everything—the fact that there is anything in children which can be termed sexual life, the accuracy of our observations, and the justification of our claim to see in the behaviour of children any connection with that which in later years is condemned as perverted. Permit me first to explain to you the motives of your antagonism and then to put before you a summary of our observations. That children should have no sexual life—sexual excitement, needs, and gratification of a sort—but that they suddenly acquire these things in the years between twelve and fourteen would be, apart from any observations at all, biologically just as improbable, indeed, nonsensical, as to suppose that they are born without genital organs which first begin to sprout at the age of puberty. What does actually awake in them at this period is the reproductive function, which then makes use for its own purposes of material lying to hand in body and mind. You are making the mistake of confounding sexuality and reproduction with each other and thus you obstruct your own way to the comprehension of sexuality, the perversions, and the neuroses. This mistake, moreover, has a meaning in it. Strange to say, its origin lies in the fact that you yourselves have all been children and as children were subject to the influences of education. For it is indeed one of the most important social tasks of education to restrain, confine, and subject to an individual control (itself identical with the demands of society) the sexual instinct when it breaks forth in the form of the reproductive function. In its own interests, accordingly, society would postpone the child’s full development until it has attained a certain stage of intellectual maturity, since educability practically ceases with the full onset of the sexual instinct. Without this the instinct would break all bounds and the laboriously erected structure of civilization would be swept away. Nor is the task of restraining it ever an easy one; success in this direction is often poor and, sometimes, only too great. At bottom society’s motive is economic; since it has not means enough to support life for its members without work on their part, it must see to it that the number of these members is restricted and their energies directed away from sexual activities on to their work—the eternal primordial struggle for existence, therefore, persisting to the present day.

Experience must have taught educators that the task of moulding the sexual will of the next generation can only be carried out by beginning to impose their influence very early, and intervening in the sexual Life of children before puberty, instead of waiting till the storm bursts. Consequently almost all infantile sexual activities are forbidden or made disagreeable to the child; the ideal has been to make the child’s life asexual, and in course of time it has come to this that it is really believed to be asexual, and is given out as such, even at the hands of science. In order then to avoid any contradiction with established beliefs and aims, the sexual activity of children is overlooked—no small achievement, by the way—while science contents itself with otherwise explaining it away. The little child is supposed to be pure and innocent; he who says otherwise shall be condemned as a hardened blasphemer against humanity’s tenderest and most sacred feelings.

The children alone take no part in this convention; they assert their animal nature naïvely enough and demonstrate persistently that they have yet to learn their “purity.” Strange to say, those who deny sexuality in children are the last to relax educative measures against it; they follow up with the greatest severity every manifestation of the “childish tricks” the existence of which they deny. Moreover, it is theoretically of great interest that the time of life which most flagrantly contradicts the prejudice about asexual childhood, the years of infancy up to five or six, is precisely the period which is veiled by oblivion in most people’s memories; an oblivion which can only be dispelled completely by analytic investigation but which is nevertheless sufficiently penetrable to allow of the formation of single dreams.

I will now tell you the most clearly recognizable of the child’s sexual activities. It will be expedient if I first introduce you to the term Libido. In every way analogous to hunger, Libido is the force by means of which the instinct, in this case the sexual instinct, as, with hunger, the nutritional instinct, achieves expression. Other terms, such as sexual excitation and satisfaction, require no definition. Interpretation finds most to do in regard to the sexual activities of the infant, as you will easily perceive; and no doubt you will find it a reason for objections. This interpretation is formed on the basis of analytic investigation, working backwards from a given symptom. The infant’s first sexual excitations appear in connection with the other functions important for life. Its chief interest, as you know, is concerned with taking nourishment; as it sinks asleep at the breast, utterly satisfied, it bears a look of perfect content which will come back again later in life after the experience of the sexual orgasm. This would not be enough to found a conclusion upon. However, we perceive that infants wish to repeat, without really getting any nourishment, the action necessary to taking nourishment; they are therefore not impelled to this by hunger. We call this action “lutschen” or “ludeln” (German words signifying the enjoyment of sucking for its own sake—as with a rubber “comforter”); and as when it does this the infant again falls asleep with a blissful expression we see that the action of sucking is sufficient in itself to give it satisfaction. Admittedly, it very soon contrives not to go to sleep without having sucked in this way. An old physician for children in Budapest, Dr. Lindner, was the first to maintain the sexual nature of this procedure. Nurses and people who look after children appear to take the same view of this kind of sucking (lutschen), though without taking up any theoretic attitude about it. They have no doubt that its only purpose is in the pleasure derived; they account it one of the child’s “naughty tricks”; and take severe measures to force it to give it up, if it will not do so of its own accord. And so we learn that an infant performs actions with no other object but that of obtaining pleasure. We believe that this pleasure is first of all experienced while nourishment is being taken, but that the infant learns rapidly to enjoy it apart from this condition. The gratification obtained can only relate to the region of the mouth and lips; we therefore call these areas of the body erotogenic zones and describe the pleasure derived from sucking (lutschen) as a sexual one. To be sure, we have yet to discuss the justification for the use of this term.

If the infant could express itself it would undoubtedly acknowledge that the act of sucking at its mother’s breast is far and away the most important thing in life. It would not be wrong in this, for by this act it gratifies at the same moment the two greatest needs in life. Then we learn from psycho-analysis, not without astonishment, how much of the mental significance of this act is retained throughout life. Sucking at the mother’s breast (saugen) becomes the point of departure from which the whole sexual life develops, the unattainable prototype of every later sexual satisfaction, to which in times of need phantasy often enough reverts. The desire to suck includes within it the desire for the mother’s breast, which is therefore the first object of sexual desire; I cannot convey to you any adequate idea of the importance of this first object in determining every later object adopted, of the profound influence it exerts, through transformation and substitution, upon the most distant fields of mental life. First of all, however, as the infant takes to sucking for its own sake (lutschen) this object is given up and is replaced by a part of its own body; it sucks its thumb or its own tongue. For purposes of obtaining pleasure it thus makes itself independent of the concurrence of the outer world and, in addition, it extends the region of excitation to a second area of the body, thus intensifying it. The erotogenic zones are not all equally capable of yielding enjoyment; it is therefore an important experience when, as Dr. Lindner says, the infant in feeling about on its own body discovers the particularly excitable region of its genitalia, and so finds the way from sucking (lutschen) to onanism.

This assessment of the nature of sucking (lutschen) has now brought to our notice two of the decisive characteristics of infantile sexuality. It appears in connection with the satisfaction of the great organic needs, and it behaves auto-erotically, that is to say, it seeks and finds its objects in its own person. What is most clearly discernible in regard to the taking of nourishment is to some extent repeated with the process of excretion. We conclude that infants experience pleasure in the evacuation of urine and the contents of the bowels, and that they very soon endeavour to contrive these actions so that the accompanying excitation of the membranes in these erotogenic zones may secure them the maximum possible gratification. As Lou Andreas has pointed out, with fine intuition, the outer world first steps in as a hindrance at this point, a hostile force opposed to the child’s desire for pleasure—the first hint he receives of external and internal conflicts to be experienced later on. He is not to pass his excretions whenever he likes but at times appointed by other people. To induce him to give up these sources of pleasure he is told that everything connected with these functions is “improper,” and must be kept concealed. In this way he is first required to exchange pleasure for value in the eyes of others. His own attitude to the excretions is at the outset very different. His own fæces produce no disgust in him; he values them as part of his own body and is unwilling to part with them, he uses them as the first “present” by which he can mark out those people whom he values especially. Even after education has succeeded in alienating him from these tendencies, he continues to feel the same high regard for his “presents” and his “money”; while his achievements in the way of urination appear to be the subject of particular pride.

I know that for some time you have been longing to interrupt me with cries of: “Enough of these monstrosities! The motions of the bowels a source of pleasurable sexual satisfaction exploited even by infants! Fæces a substance of great value and the anus a kind of genital organ! We do not believe it; but we understand why children’s physicians and educationists have emphatically rejected psycho-analysis and its conclusions!” Not at all; you have merely forgotten for the moment that I have been endeavouring to show you the connection between the actual facts of infantile sexual life and the actual facts of the sexual perversions. Why should you not know that in many adults, both homosexual and heterosexual, the anus actually takes over the part played by the vagina in sexual intercourse? And that there are many persons who retain the pleasurable sensations accompanying evacuations of the bowels throughout life and describe them as far from insignificant? You may hear from children themselves, when they are a little older and able to talk about these things, what an interest they take in the act of defæcation and what pleasure they find in watching others in the act. Of course if you have previously systematically intimidated these children they will understand very well that they are not to speak of such things. And for all else that you refuse to believe I refer you to the evidence brought out in analysis and to the direct observation of children and I tell you that it will require the exercise of considerable ingenuity to avoid seeing all this or to see it in a different light. Nor am I at all averse from your thinking the relationship between childish sexual activities and the sexual perversions positively striking. It is a matter of course that there should be this relationship; for if a child has a sexual life at all it must be of a perverted order, since apart from a few obscure indications he is lacking in all that transforms sexuality into the reproductive function. Moreover, it is a characteristic common to all the perversions that in them reproduction as an aim is put aside. This is actually the criterion by which we judge whether a sexual activity is perverse—if it departs from reproduction in its aims and pursues the attainment of gratification independently. You will understand therefore that the gulf and turning-point in the development of the sexual life lies at the point of its subordination to the purposes of reproduction. Everything that occurs before this conversion takes place, and everything which refuses to conform to it and serves the pursuit of gratification alone, is called by the unhonoured title of “perversion” and as such is despised.

So let me continue my brief account of infantile sexuality. I could supplement what I have told you concerning two of the bodily systems by extending the same scrutiny to the others. The sexual life of the child consists entirely in the activities of a series of component-instincts which seek for gratification independently of one another, some in his own body and others already in an external object. Among the organs of these bodily systems the genitalia rapidly take the first place; there are people in whom pleasurable gratification in their own genital organ, without the aid of any other genital organ or object, is continued without interruption from the onanism habitual in the suckling period of infancy to the onanism of necessity occurring in the years of puberty, and then maintained indefinitely beyond that. Incidentally, the subject of onanism is not so easily exhausted; it contains material for consideration from various angles.

In spite of my wish to limit the extent of this discussion I must still say something about sexual curiosity in children. It is too characteristic of childish sexuality and too important for the symptom-formation of the neuroses to be omitted. Infantile sexual curiosity begins very early, sometimes before the third year. It is not connected with the difference between the sexes, which is nothing to children, since they—boys, at least—ascribe the same male genital organ to both sexes. If then a boy discovers the vagina in a little sister or play-mate he at once tries to deny the evidence of his senses; for he cannot conceive of a human being like himself without his most important attribute. Later, he is horrified at the possibilities it reveals to him; the influence of previous threats occasioned by too great a preoccupation with his own little member now begins to be felt. He comes under the dominion of the castration complex, which will play such a large part in the formation of his character if he remains healthy, and of his neurosis if he falls ill, and of his resistances if he comes under analytic treatment. Of little girls we know that they feel themselves heavily handicapped by the absence of a large visible penis and envy the boy’s possession of it; from this source primarily springs the wish to be a man which is resumed again later in the neurosis, owing to some mal-adjustment to a female development. The clitoris in the girl, moreover, is in every way equivalent during childhood to the penis; it is a region of especial excitability in which auto-erotic satisfaction is achieved. In the transition to womanhood very much depends upon the early and complete relegation of this sensitivity from the clitoris over to the vaginal orifice. In those women who are sexually anæsthetic, as it is called, the clitoris has stubbornly retained this sensitivity.

The sexual interest of children is primarily directed to the problem of birth—the same problem that lies behind the riddle of the Theban Sphinx. This curiosity is for the most part aroused by egoistic dread of the arrival of another child. The answer which the nursery has ready for the child, that the stork brings the babies, meets with incredulity even in little children much more often than we imagine. The feeling of having been deceived by grown-up people, and put off with lies, contributes greatly to a sense of isolation and to the development of independence. But the child is not able to solve this problem on his own account. His undeveloped sexual constitution sets definite limits to his capacity to understand it. He first supposes that children are made by mixing some special thing with the food taken; nor does he know that only women can have children. Later, he learns of this limitation and gives up the idea of children being made by food, though it is retained in fairy tales. A little later he soon sees that the father must have something to do with making babies, but he cannot discover what it is. If by chance he is witness of the sexual act he conceives it as an attempt to overpower the woman, as a combat, the sadistic misconception of coitus; at first, however, he does not connect this act with the creation of children; if he discovers blood on the mother’s bed or underlinen he takes it as evidence of injury inflicted by the father. In still later years of childhood he probably guesses that the male organ of the man plays an essential part in the procreation of children, but cannot ascribe to this part of the body any function but that of urination.

Children are all united from the outset in the belief that the birth of a child takes place by the bowel; that is to say, that the baby is produced like a piece of fæces. Not until all interest has been weaned from the anal region is this theory abandoned and replaced by the supposition that the navel opens, or that the area between the two nipples is the birthplace of the child. In some such manner as this the enquiring child approaches some knowledge of the facts of sex, unless, misled by his ignorance, he overlooks them until he receives an imperfect and discrediting account of them, usually in the period before puberty, which not infrequently affects him traumatically.

Now you will probably have heard that the term “sexual” has suffered an unwarrantable expansion of meaning at the hands of psycho-analysis, in order that its assertions regarding the sexual origin of the neuroses and the sexual significance of the symptoms may be maintained. You can now judge for yourselves whether this amplification is justified or not. We have extended the meaning of the concept “sexuality” only so far as to include the sexual life of perverted persons and also of children; that is to say, we have restored to it its true breadth of meaning. What is called sexuality outside psycho-analysis applies only to the restricted sexual life that is subordinated to the reproductive function and is called normal.

Twenty-First Lecture — Development of the Libido and Sexual Organizations

It is my impression that I have not succeeded in bringing home to you with complete conviction the importance of the perversions for our conception of sexuality. I wish therefore, as far as I am able, to review and improve upon what I have already said on this subject.

Now I do not wish you to think that it was the perversions alone that required us to make the alteration in the meaning of the term sexuality which has aroused such vehement opposition. The study of infantile sexuality has contributed even more to it, and the unanimity between the two was decisive. But, however unmistakable they may be in the later years of childhood, the manifestations of infantile sexuality in its earliest forms do seem to fade away indefinably. Those who do not wish to pay attention to evolution and to the connections brought out by analysis will dispute the sexual nature of them, and will ascribe in consequence some other, undifferentiated character to them. You must not forget that as yet we have no generally acknowledged criterion for the sexual nature of a phenomenon, unless it is some connection with the reproductive function—a definition which we have had to reject as too narrow. The biological criteria, such as the periodicities of twenty-three and twenty-eight days, suggested by W. Fliess, are exceedingly debatable; the peculiar chemical features which we may perhaps assume for sexual processes are yet to be discovered. The sexual perversions in adults, on the other hand, are something definite and unambiguous. As their generally accepted description implies, they are unquestionably of a sexual nature; whether you call them marks of degeneration or anything else, no one has yet been so bold as to rank them anywhere but among the phenomena of sexual life. In view of them alone we are justified in maintaining that sexuality and the reproductive function are not identical, for they one and all abjure the aim of reproduction.

I notice a not uninteresting parallel here. Whereas, for most people, the word ‘mental’ means ‘conscious,’ we found ourselves obliged to widen the application of the term ‘mental’ to include a part of the mind that is not conscious. In a precisely similar way, most people declare ‘sexual’ identical with ‘pertaining to reproduction’—or, if you like it expressed more concisely, with ‘genital’; whereas we cannot avoid admitting things as ‘sexual’ that are not ‘genital’ and have nothing to do with reproduction. It is only a formal analogy, but it is not without deeper significance.

However, if the existence of sexual perversions is such a forcible argument on this point, why has it not long ago done its work and settled the question? I really am unable to say. It seems to me that the sexual perversions have come under a very special ban, which insinuates itself into the theory, and interferes even with scientific judgement on the subject. It seems as if no one could forget, not merely that they are detestable, but that they are also something monstrous and terrifying; as if they exerted a seductive influence; as if at bottom a secret envy of those who enjoy them had to be strangled—the same sort of feeling that is confessed by the count who sits in judgement in the famous parody of Tannhäuser:

So in the Mount of Venus conscience, duty, are forgot!
—Remarkable that such a thing has never been my lot!

In reality, perverts are more likely to be poor devils who have to pay most bitterly for the satisfactions they manage to procure with such difficulty.

That which makes perverse activities so unmistakably sexual, in spite of all that seems unnatural in their objects or their aims, is the fact that in perverse satisfaction the act still terminates usually in a complete orgasm with evacuation of the genital product. This is of course only the consequence of adult development in the persons concerned; in children, orgasm and genital excretion are not very well possible; as substitutes they have approximations to them which are again not recognized definitely as sexual.

I must still add something more in order to complete our assessment of the sexual perversions. Abominated as they are, sharply distinguished from normal sexual activity as they may be, simple observation will show that very rarely is one feature or another of them absent from the sexual life of a normal person. The kiss to begin with has some claim to be called a perverse act, for it consists of the union of the two erotogenic mouth zones instead of the two genital organs. But no one condemns it as perverse; on the contrary, in the theatre it is permitted as a refined indication of the sexual act. Nevertheless, kissing is a thing that can easily become an absolute perversion—namely, when it occurs in such intensity that orgasm and emission directly accompany it, which happens not at all uncommonly. Further, it will be found that gazing at and handling the object are in one person an indispensable condition of sexual enjoyment, while another at the height of sexual excitement pinches or bites; that in another lover not always the genital region, but some other bodily region in the object, provokes the greatest excitement, and so on in endless variety. It would be absurd to exclude people with single idiosyncrasies of this kind from the ranks of the normal and place them among perverts; rather, it becomes more and more clear that what is essential to the perversions lies, not in the overstepping of the sexual aim, not in the replacement of the genitalia, not always even in the variations in the object, but solely in the exclusiveness with which these deviations are maintained, so that the sexual act which serves the reproductive process is rejected altogether. In so far as perverse performances are included in order to intensify or to lead up to the performance of the normal sexual act, they are no longer actually perverse. Facts of the kind just described naturally tend to diminish the gulf between normal and perverse sexuality very considerably. The obvious inference is that normal sexuality has arisen, out of something existing prior to it, by a process of discarding some components of this material as useless, and by combining the others so as to subordinate them to a new aim, that of reproduction.

The point of view thus gained in regard to the perversions can now be employed by us in penetrating more deeply, with a clearer perspective, into the problem of infantile sexuality; but before doing this I must draw your attention to an important difference between the two. Perverse sexuality is as a rule exceedingly concentrated, its whole activity is directed to one—and mostly to only one—aim; one particular component-impulse is supreme; it is either the only one discernible or it has subjected the others to its own purposes. In this respect there is no difference between perverse and normal sexuality, except that the dominating component-impulse, and therefore the sexual aim, is a different one. Both of them constitute a well-organized tyranny; only that in one case one ruling family has usurped all the power, and in the other, another. This concentration and organization, on the other hand, is in the main absent from infantile sexuality; its component-impulses are equally valid, each of them strives independently after its own pleasure. Both the lack of this concentration (in childhood) and the presence of it (in the adult) correspond well with the fact that both normal and perverse sexuality are derived from the same source, namely, infantile sexuality. There are indeed also cases of perversion which correspond even more closely to infantile sexuality in that numerous component-instincts, independently of one another, with their aims, are developed or, better, perpetuated in them. With these cases it is more correct to speak of infantilism than of perversion of the sexual life.

Thus prepared we may now go on to consider a suggestion which we shall certainly not be spared. It will be said: “Why are you so set upon declaring as already belonging to sexuality those indefinite manifestations of childhood out of which what is sexual later develops, and which you yourself admit to be indefinite? Why are you not content rather to describe them physiologically and simply to say that activities, such as sucking for its own sake and the retaining of excreta, may be observed already in young infants, showing that they seek pleasure in their organs? In that way you would have avoided the conception of a sexual life even in babies which is so repugnant to all our feelings.” Well, I can only answer that I have nothing against pleasure derived from the organs of the body; I know indeed that the supreme pleasure of the sexual union is also only a bodily pleasure, derived from the activity of the genital organ. But can you tell me when this originally indifferent bodily pleasure acquires the sexual character that it undoubtedly possesses in later phases of development? Do we know any more about this ‘organ-pleasure’ than we know about sexuality? You will answer that the sexual character is added to it when the genitalia begin to play their part; sexuality simply means genital. You will even evade the obstacle of the perversions by pointing out that after all with most of them a genital orgasm occurs, although brought about by other means than the union of the genitalia. If you were to eliminate the relation to reproduction from the essential characteristics of sexuality since this view is untenable in consequence of the existence of the perversions, and were to emphasize instead activity of the genital organs, you would actually take up a much better position. But then we should no longer differ very widely; it would be a case of the genital organs versus the other organs. What do you now make of the abundant evidence that the genital organs may be replaced by other organs for the purpose of gratification, as in the normal kiss, or the perverse practices of loose living, or in the symptomatology of hysteria? In this neurosis it is quite usual for stimulation phenomena, sensations, innervations, and even the processes of erection, which properly belong to the genitalia to be displaced on to other distant areas of the body (e.g. the displacement from below upwards to the head and face). Thus you will find that nothing is left of all that you cling to as essentially characteristic of sexuality; and you will have to make up your minds to follow my example and extend the designation ‘sexual’ to include those activities of early infancy which aim at ‘organ-pleasure.’

And now will you permit me to bring forward two further considerations in support of my view. As you know, we call the doubtful and indefinable activities of earliest infancy towards pleasure ‘sexual,’ because in the course of analysing symptoms we reach them by way of material that is undeniably sexual. They would not thereby necessarily be sexual themselves, let us grant; but let us take an analogous case. Suppose that there were no way to observe the development from seed of two dicotyledonous plants—the apple-tree and the bean; but imagine that in both it was possible to follow back its development from the fully-developed plant to the first seedling with two cotyledons. The two cotyledons are indistinguishable in each; they look exactly alike in both plants. Shall I conclude from this that they actually are exactly alike and that the specific differences between apple-tree and bean-plant arise later in the plant’s development? Or is it not more correct biologically to believe that this difference exists already in the seedlings, although I cannot see any in the cotyledons? This is what we do when we call infantile pleasurable activities sexual. Whether each and every organ-pleasure may be called sexual or whether there exists, besides the sexual, another kind of pleasure that does not deserve this name is a matter I cannot discuss here. I know too little about organ-pleasure and its conditions; and I am not at all surprised that in consequence of the retrogressive character of analysis I arrive finally at factors which at the present time do not permit of definite classification.

One thing more. You have on the whole gained very little for what you are so eager to maintain, the sexual ‘purity’ of children, even if you can convince me that the infant’s activities had better not be regarded as sexual. For from the third year onwards there is no longer any doubt about sexual life in the child; at this period the genital organs begin already to show signs of excitation; there is a perhaps regular period of infantile masturbation, that is, of gratification in the genital organs. The mental and social sides of sexual life need no longer be overlooked: choice of object, distinguishing of particular persons with affection, even decision in favour of one sex or the other, and jealousy, were conclusively established independently by impartial observation before the time of psycho-analysis; they may be confirmed by any observer who will use his eyes. You will object that you never doubted the early awakening of affection but only that this affection was of a ‘sexual’ quality. Children between the ages of three and eight have certainly learnt to conceal this element in it; but nevertheless if you look attentively you will collect enough evidence of the ‘sensual’ nature of this affection, and whatever still escapes your notice will be amply and readily supplied by analytic investigation. The sexual aims in this period of life are in closest connection with the sexual curiosity arising at the same time, of which I have given you some description. The perverse character of some of these aims is a natural result of the immature constitution of the child who has not yet discovered the aim of the act of intercourse.

From about the sixth or eighth year onwards a standstill or retrogression is observed in the sexual development, which in those cases reaching a high cultural standard deserves to be called a latency period. This latency period, however, may be absent; nor does it necessarily entail an interruption of sexual activities and sexual interests over the whole field. Most of the mental experiences and excitations occurring before the latency period then succumb to the infantile amnesia, already discussed, which veils our earliest childhood from us and estranges us from it. It is the task of every psycho-analysis to bring this forgotten period of life back into recollection; one cannot resist the supposition that the beginnings of sexual life belonging to this period are the motive for this forgetting, that is, that this oblivion is an effect of repression.

From the third year onwards the sexual life of children shows much in common with that of adults; it is differentiated from the latter, as we already know, by the absence of a stable organization under the primacy of the genital organs, by inevitable traits of a perverse order, and of course also by far less intensity in the whole impulse. But those phases of the sexual development, or as we will call it, of the Libido-development, which are of greatest interest theoretically lie before this period. This development is gone through so rapidly that direct observation alone would perhaps never have succeeded in determining its fleeting forms. Only by the help of psycho-analytic investigation of the neuroses has it become possible to penetrate so far back and to discover these still earlier phases of Libido-development. These phases are certainly only theoretic constructions, but in the practice of psycho-analysis you will find them necessary and valuable constructions. You will soon understand how it happens that a pathological condition enables us to discover phenomena which we should certainly overlook in normal conditions.

Thus we can now define the forms taken by the sexual life of the child before the primacy of the genital zone is reached; this primacy is prepared for in the early infantile period, before the latent period, and is permanently organized from puberty onwards. In this early period a loose sort of organization exists which we shall call pre-genital; for during this phase it is not the genital component-instincts, but the sadistic and anal, which are most prominent. The contrast between masculine and feminine plays no part as yet; instead of it there is the contrast between active and passive, which may be described as the forerunner of the sexual polarity with which it also links up later. That which in this period seems masculine to us, regarded from the standpoint of the genital phase, proves to be the expression of an impulse to mastery, which easily passes over into cruelty. Impulses with a passive aim are connected with the erotogenic zone of the rectal orifice, at this period very important; the impulses of skoptophilia (gazing) and curiosity are powerfully active; the function of excreting urine is the only part actually taken by the genital organ in the sexual life. Objects are not wanting to the component-instincts in this period, but these objects are not necessarily all comprised in one object. The sadistic-anal organization is the stage immediately preceding the phase of primacy of the genital zone. Closer study reveals how much of it is retained intact in the later final structure, and what are the paths by which these component-instincts are forced into the service of the new genital organization. Behind the sadistic-anal phase of the Libido-development we obtain a glimpse of an even more primitive stage of development, in which the erotogenic mouth zone plays the chief part. You can guess that the sexual activity of sucking (for its own sake) belongs to this stage; and you may admire the understanding of the ancient Egyptians in whose art a child, even the divine Horus, was represented with a finger in the mouth. Abraham has quite recently published work showing that traces of this primitive oral phase of development survive in the sexual life of later years.

I can indeed imagine that you will have found this last information about the sexual organizations less of an enlightenment than an infliction. Perhaps I have again gone too much into detail; but have patience! what you have just heard will be of more use when we employ it later. Keep in view at the moment the idea that the sexual life—the Libido-function, as we call it—does not first spring up in its final form, does not even expand along the lines of its earliest forms, but goes through a series of successive phases unlike one another; in short, that many changes occur in it, like those in the development of the caterpillar into the butterfly. The turning-point of this development is the subordination of all the sexual component-instincts under the primacy of the genital zone and, together with this, the enrolment of sexuality in the service of the reproductive function. Before this happens the sexual life is, so to say, disparate—independent activities of single component-impulses each seeking organ-pleasure (pleasure in a bodily organ). This anarchy is modified by attempts at pre-genital ‘organizations,’ of which the chief is the sadistic-anal phase, behind which is the oral, perhaps the most primitive. In addition there are the various processes, about which little is known as yet, which effect the transition from one stage of organization to the next above it. Of what significance this long journey over so many stages in the development of the Libido is for comprehension of the neuroses we shall learn later on.

To-day we will follow up another aspect of this development—namely, the relation of the sexual component-impulses to an object; or, rather, we will take a fleeting glimpse over this development so that we may spend more time upon a comparatively late result of it. Certain of the component-impulses of the sexual instinct have an object from the very beginning and hold fast to it: such are the impulse to mastery (sadism), to gazing (skoptophilia) and curiosity. Others, more plainly connected with particular erotogenic areas in the body, only have an object in the beginning, so long as they are still dependent upon the non-sexual functions, and give it up when they become detached from these latter. Thus the first object of the oral component of the sexual instinct is the mother’s breast which satisfies the infant’s need for nutrition. In the act of sucking for its own sake (lutschen) the erotic component, also gratified in sucking for nutrition (saugen), makes itself independent, gives up the object in an external person, and replaces it by a part of the child’s own person. The oral impulse becomes auto-erotic, as the anal and other erotogenic impulses are from the beginning. Further development has, to put it as concisely as possible, two aims: first, to renounce auto-erotism, to give up again the object found in the child’s own body in exchange again for an external one; and secondly, to combine the various objects of the separate impulses and replace them by one single one. This naturally can only be done if the single object is again itself complete, with a body like that of the subject; nor can it be accomplished without some part of the auto-erotic impulse-excitations being abandoned as useless.

The processes by which an object is found are rather involved, and have not so far received comprehensive exposition. For our purposes it may be emphasized that, when the process has reached a certain point in the years of childhood before the latency period, the object adopted proves almost identical with the first object of the oral pleasure impulse, adopted by reason of the child’s dependent relationship to it; it is, namely, the mother, although not the mother’s breast. We call the mother the first love-object. We speak of ‘love’ when we lay the accent upon the mental side of the sexual impulses and disregard, or wish to forget for a moment, the demands of the fundamental physical or ‘sensual’ side of the impulses. At about the time when the mother becomes the love-object, the mental operation of repression has already begun in the child and has withdrawn from him the knowledge of some part of his sexual aims. Now with this choice of the mother as love-object is connected all that which, under the name of ‘the Oedipus complex,’ has become of such great importance in the psycho-analytic explanation of the neuroses, and which has had a perhaps equally important share in causing the opposition against psycho-analysis.

Here is a little incident which occurred during the present war. One of the staunch adherents of psycho-analysis was stationed in his medical capacity on the German front in Poland; he attracted the attention of his colleagues by the fact that he occasionally effected an unexpected influence upon a patient. On being questioned, he admitted that he worked with psycho-analytic methods and with readiness agreed to impart his knowledge to his colleagues. So every evening the medical men of the corps, his colleagues and superiors, met to be initiated into the mysteries of psycho-analysis. For a time all went well; but when he had introduced his audience to the Oedipus complex a superior officer rose and announced that he did not believe this, it was the behaviour of a cad for the lecturer to relate such things to brave men, fathers of families, who were fighting for their country, and he forbade the continuation of the lectures. This was the end; the analyst got himself transferred to another part of the front. In my opinion, however, it is a bad outlook if a victory for German arms depends upon an ‘organization’ of science such as this, and German science will not prosper under any such organization.

Now you will be impatiently waiting to hear what this terrible Oedipus complex comprises. The name tells you: you all know the Greek myth of King Oedipus, whose destiny it was to slay his father and to wed his mother, who did all in his power to avoid the fate prophesied by the oracle, and who in self-punishment blinded himself when he discovered that in ignorance he had committed both these crimes. I trust that many of you have yourselves experienced the profound effect of the tragic drama fashioned by Sophocles from this story. The Attic poet’s work portrays the gradual discovery of the deed of Oedipus, long since accomplished, and brings it slowly to light by skilfully prolonged enquiry, constantly fed by new evidence; it has thus a certain resemblance to the course of a psycho-analysis. In the dialogue the deluded mother-wife, Jocasta, resists the continuation of the enquiry; she points out that many people in their dreams have mated with their mothers, but that dreams are of no account. To us dreams are of much account, especially typical dreams which occur in many people; we have no doubt that the dream Jocasta speaks of is intimately related to the shocking and terrible story of the myth.

It is surprising that Sophocles’ tragedy does not call forth indignant remonstrance in its audience; this reaction would be much better justified in them than it was in the blunt army doctor. For at bottom it is an immoral play; it sets aside the individual’s responsibility to social law, and displays divine forces ordaining the crime and rendering powerless the moral instincts of the human being which would guard him against the crime. It would be easy to believe that an accusation against destiny and the gods was intended in the story of the myth; in the hands of the critical Euripides, at variance with the gods, it would probably have become such an accusation. But with the reverent Sophocles there is no question of such an intention; the pious subtlety which declares it the highest morality to bow to the will of the gods, even when they ordain a crime, helps him out of the difficulty. I do not believe that this moral is one of the virtues of the drama, but neither does it detract from its effect; it leaves the hearer indifferent; he does not react to this, but to the secret meaning and content of the myth itself. He reacts as though by self-analysis he had detected the Oedipus complex in himself, and had recognized the will of the gods and the oracle as glorified disguises of his own Unconscious; as though he remembered in himself the wish to do away with his father and in his place to wed his mother, and must abhor the thought. The poet’s words seem to him to mean: “In vain do you deny that you are accountable, in vain do you proclaim how you have striven against these evil designs. You are guilty, nevertheless; for you could not stifle them; they still survive unconsciously in you.” And psychological truth is contained in this; even though man has repressed his evil desires into his Unconscious and would then gladly say to himself that he is no longer answerable for them, he is yet compelled to feel his responsibility in the form of a sense of guilt for which he can discern no foundation.

There is no possible doubt that one of the most important sources of the sense of guilt which so often torments neurotic people is to be found in the Oedipus complex. More than this: in 1913, under the title of Totem und Tabu, I published a study of the earliest forms of religion and morality in which I expressed a suspicion that perhaps the sense of guilt of mankind as a whole, which is the ultimate source of religion and morality, was acquired in the beginnings of history through the Oedipus complex. I should much like to tell you more of this, but I had better not; it is difficult to leave this subject when once one begins upon it, and we must return to individual psychology.

Now what does direct observation of children, at the period of object-choice before the latency period, show us in regard to the Oedipus complex? Well, it is easy to see that the little man wants his mother all to himself, finds his father in the way, becomes restive when the latter takes upon himself to caress her, and shows his satisfaction when the father goes away or is absent. He often expresses his feelings directly in words and promises his mother to marry her; this may not seem much in comparison with the deeds of Oedipus, but it is enough in fact; the kernel of each is the same. Observation is often rendered puzzling by the circumstance that the same child on other occasions at this period will display great affection for the father; but such contrasting—or, better, ambivalent—states of feeling, which in adults would lead to conflicts, can be tolerated alongside one another in the child for a long time, just as later on they dwell together permanently in the Unconscious. One might try to object that the little boy’s behaviour is due to egoistic motives and does not justify the conception of an erotic complex; the mother looks after all the child’s needs and consequently it is to the child’s interest that she should trouble herself about no one else. This too is quite correct; but it is soon clear that in this, as in similar dependent situations, egoistic interests only provide the occasion on which the erotic impulses seize. When the little boy shows the most open sexual curiosity about his mother, wants to sleep with her at night, insists on being in the room while she is dressing, or even attempts physical acts of seduction, as the mother so often observes and laughingly relates, the erotic nature of this attachment to her is established without a doubt. Moreover, it should not be forgotten that a mother looks after a little daughter’s needs in the same way without producing this effect; and that often enough a father eagerly vies with her in trouble for the boy without succeeding in winning the same importance in his eyes as the mother. In short, the factor of sex preference is not to be eliminated from the situation by any criticisms. From the point of view of the boy’s egoistic interests it would merely be foolish if he did not tolerate two people in his service rather than only one of them.

As you see, I have only described the relationship of a boy to his father and mother; things proceed in just the same way, with the necessary reversal, in little girls. The loving devotion to the father, the need to do away with the superfluous mother and to take her place, the early display of coquetry and the arts of later womanhood, make up a particularly charming picture in a little girl, and may cause us to forget its seriousness and the grave consequences which may later result from this situation. Let us not fail to add that frequently the parents themselves exert a decisive influence upon the awakening of the Oedipus complex in a child, by themselves following the sex attraction where there is more than one child; the father in an unmistakable manner prefers his little daughter with marks of tenderness, and the mother, the son: but even this factor does not seriously impugn the spontaneous nature of the infantile Oedipus complex. When other children appear, the Oedipus complex expands and becomes a family complex. Reinforced anew by the injury resulting to the egoistic interests, it actuates a feeling of aversion towards these new arrivals and an unhesitating wish to get rid of them again. These feelings of hatred are as a rule much more often openly expressed than those connected with the parental complex. If such a wish is fulfilled and after a short time death removes the unwanted addition to the family, later analysis can show what a significant event this death is for the child, although it does not necessarily remain in memory. Forced into the second place by the birth of another child and for the first time almost entirely parted from the mother, the child finds it very hard to forgive her for this exclusion of him; feelings which in adults we should describe as profound embitterment are roused in him, and often become the groundwork of a lasting estrangement. That sexual curiosity and all its consequences is usually connected with these experiences has already been mentioned. As these new brothers and sisters grow up the child’s attitude to them undergoes the most important transformations. A boy may take his sister as love-object in place of his faithless mother; where there are several brothers to win the favour of a little sister hostile rivalry, of great importance in after life, shows itself already in the nursery. A little girl takes an older brother as a substitute for the father who no longer treats her with the same tenderness as in her earliest years; or she takes a little sister as a substitute for the child that she vainly wished for from her father.

So much and a great deal more of a similar kind is shown by direct observation of children, and by consideration of clear memories of childhood, uninfluenced by any analysis. Among other things you will infer from this that a child’s position in the sequence of brothers and sisters is of very great significance for the course of his later life, a factor to be considered in every biography. What is even more important, however, is that in the face of these enlightening considerations, so easily to be obtained, you will hardly recall without smiling the scientific theories accounting for the prohibition of incest. What has not been invented for this purpose! We are told that sexual attraction is diverted from the members of the opposite sex in one family owing to their living together from early childhood; or that a biological tendency against in-breeding has a mental equivalent in the horror of incest! Whereby it is entirely overlooked that no such rigorous prohibitions in law and custom would be required if any trustworthy natural barriers against the temptation to incest existed. The opposite is the truth. The first choice of object in mankind is regularly an incestuous one, directed to the mother and sister of men, and the most stringent prohibitions are required to prevent this sustained infantile tendency from being carried into effect. In the savage and primitive peoples surviving to-day the incest prohibitions are a great deal stricter than with us; Theodor Reik has recently shown in a brilliant work that the meaning of the savage rites of puberty which represent rebirth is the loosening of the boy’s incestuous attachment to the mother and his reconciliation with the father.

Mythology will show you that incest, ostensibly so much abhorred by men, is permitted to their gods without a thought; and from ancient history you may learn that incestuous marriage with a sister was prescribed as a sacred duty for kings (the Pharaohs of Egypt and the Incas of Peru); it was therefore in the nature of a privilege denied to the common herd.

Incest with the mother is one of the crimes of Oedipus and parricide the other. Incidentally, these are the two great offences condemned by totemism, the first social-religious institution of mankind. Now let us turn from the direct observation of children to the analytic investigation of adults who have become neurotic; what does analysis yield in further knowledge of the Oedipus complex? Well, this is soon told. The complex is revealed just as the myth relates it; it will be seen that every one of these neurotics was himself an Oedipus or, what amounts to the same thing, has become a Hamlet in his reaction to the complex. To be sure, the analytic picture of the Oedipus complex is an enlarged and accentuated edition of the infantile sketch; the hatred of the father and the death-wishes against him are no longer vague hints, the affection for the mother declares itself with the aim of possessing her as a woman. Are we really to accredit such grossness and intensity of the feelings to the tender age of childhood; or does the analysis deceive us by introducing another factor? It is not difficult to find one. Every time anyone describes anything past, even if he be a historian, we have to take into account all that he unintentionally imports into that past period from present and intermediate times, thereby falsifying it. With the neurotic it is even doubtful whether this retroversion is altogether unintentional; we shall hear later on that there are motives for it and we must explore the whole subject of the ‘retrogressive phantasy-making’ which goes back to the remote past. We soon discover, too, that the hatred against the father has been strengthened by a number of motives arising in later periods and other relationships in life, and that the sexual desires towards the mother have been moulded into forms which would have been as yet foreign to the child. But it would be a vain attempt if we endeavoured to explain the whole of the Oedipus complex by ‘retrogressive phantasy-making,’ and by motives originating in later periods of life. The infantile nucleus, with more or less of the accretions to it, remains intact, as is confirmed by direct observation of children.

The clinical fact which confronts us behind the form of the Oedipus complex as established by analysis now becomes of the greatest practical importance. We learn that at the time of puberty, when the sexual instinct first asserts its demands in full strength, the old familiar incestuous objects are taken up again and again invested by the Libido. The infantile object-choice was but a feeble venture in play, as it were, but it laid down the direction for the object-choice of puberty. At this time a very intense flow of feeling towards the Oedipus complex or in reaction to it comes into force; since their mental antecedents have become intolerable, however, these feelings must remain for the most part outside consciousness. From the time of puberty onward the human individual must devote himself to the great task of freeing himself from the parents; and only after this detachment is accomplished can he cease to be a child and so become a member of the social community. For a son, the task consists in releasing his libidinal desires from his mother, in order to employ them in the quest of an external love-object in reality; and in reconciling himself with his father if he has remained antagonistic to him, or in freeing himself from his domination if, in the reaction to the infantile revolt, he has lapsed into subservience to him. These tasks are laid down for every man; it is noteworthy how seldom they are carried through ideally, that is, how seldom they are solved in a manner psychologically as well as socially satisfactory. In neurotics, however, this detachment from the parents is not accomplished at all; the son remains all his life in subjection to his father, and incapable of transferring his Libido to a new sexual object. In the reversed relationship the daughter’s fate may be the same. In this sense the Oedipus complex is justifiably regarded as the kernel of the neuroses.

You will imagine how incompletely I am sketching a large number of the connections bound up with the Oedipus complex which practically and theoretically are of great importance. I shall not go into the variations and possible inversions of it at all. Of its less immediate effects I should like to allude to one only, which proves it to have influenced literary production in a far-reaching manner. Otto Rank has shown in a very valuable work that dramatists throughout the ages have drawn their material principally from the Oedipus and incest complex and its variations and masked forms. It should also be remarked that long before the time of psycho-analysis the two criminal offences of Oedipus were recognized as the true expressions of unbridled instinct. Among the works of the Encyclopædist Diderot you will find the famous dialogue, Le neveu de Rameau, which was translated into German by no less a person than Goethe. There you may read these remarkable words: Si le petit sauvage était abandonné à lui-même, qu’il conserva toute son imbecillité et qu’il réunit au peu de raison de l’enfant au berceau la violence des passions de l’homme de trente ans, il tordrait le cou à son père et coucherait avec sa mère.

There is yet one thing more which I cannot pass over. The mother-wife of Oedipus must not remind us of dreams in vain. Do you still remember the results of our dream-analyses, how so often the dream-forming wishes proved perverse and incestuous in their nature, or betrayed an unsuspected enmity to near and beloved relatives? We then left the source of these evil strivings of feeling unexplained. Now you can answer this question yourselves. They are dispositions of the Libido, and investments of objects by Libido, belonging to early infancy and long since given up in conscious life, but which at night prove to be still present and in a certain sense capable of activity. But, since all men and not only neurotic persons have perverse, incestuous, and murderous dreams of this kind, we may infer that those who are normal to-day have also made the passage through the perversions and the object-investments of the Oedipus complex; and that this is the path of normal development; only that neurotics show in a magnified and exaggerated form what we also find revealed in the dream-analyses of normal people. And this is one of the reasons why we chose the study of dreams to lead up to that of neurotic symptoms.

Twenty-Second Lecture — Aspects of Development and Regression. Ætiology

As we have heard, the Libido-function goes through an extensive development before it can enter the service of reproduction in the way that is called normal. Now I wish to show you the significance of this fact for the causation of the neuroses.

I think that it will be in agreement with the doctrines of general pathology to assume that such a development involves two dangers; first, that of inhibition, and secondly, that of regression. That is to say, owing to the general tendency to variation in biological processes it must necessarily happen that not all these preparatory phases will be passed through and completely outgrown with the same degree of success; some parts of the function will be permanently arrested at these early stages, with the result that with the general development there goes a certain amount of inhibited development.

Let us seek analogies to these processes in other fields. When a whole people leaves its dwellings in order to seek a new country, as often happened in earlier periods of human history, their entire number certainly did not reach the new destination. Apart from losses due to other causes, it must invariably have happened that small groups or bands of the migrating people halted on the way, and settled down in these stopping-places, while the main body went further. Or, to take a nearer comparison, you know that in the higher mammals the seminal glands, which are originally located deep in the abdominal cavity, begin a movement at a certain period of intra-uterine development which brings them almost under the skin of the pelvic extremity. In a number of males it is found that one of this pair of organs has remained in the pelvic cavity, or else that it has taken up a permanent position in the inguinal canal which both of them had to pass through on the journey, or at least that this canal has not closed as it normally should after the passage of the seminal glands through it. When as a young student I was doing my first piece of scientific research under v. Brücke, I was working on the origin of the dorsal nerve-roots in the spinal cord of a small fish, still very archaic in form. I found that the nerve-fibres of these roots grew out of large cells in the posterior horn of the grey matter, a condition which is no longer found in other vertebrates. But soon after I discovered that similar nerve-cells were to be found outside the grey matter along the whole length to the so-called spinal ganglion of the posterior roots, from which I concluded that the cells of this ganglion had moved out of the spinal cord along the nerve-roots. Evolutionary development shows this too; in this little fish, however, the whole route of this passage was marked by cells arrested on the way. Closer consideration will soon show you the weak points of these comparisons. Therefore let me simply say that we consider it possible that single portions of every separate sexual impulse may remain in an early stage of development, although at the same time other portions of it may have reached their final goal. You will see from this that we conceive each such impulse as a current continuously flowing from the beginning of life, and that we have divided its flow to some extent artificially into separate successive forward movements. Your impression that these conceptions require further elucidation is correct, but the attempt would lead us too far afield. We will, however, decide at this point to call this arrest in a component-impulse at an early stage a FIXATION (of the impulse).

The second danger in a development by stages such as this we call REGRESSION; it also happens that those portions which have proceeded further may easily revert in a backward direction to these earlier stages. The impulse will find occasion to regress in this way when the exercise of its function in a later and more developed form meets with powerful external obstacles, which thus prevent it from attaining the goal of satisfaction. It is a short step to assume that fixation and regression are not independent of each other; the stronger the fixations in the path of development the more easily will the function yield before the external obstacles, by regressing on to those fixations; that is, the less capable of resistance against the external difficulties in its path will the developed function be. If you think of a migrating people who have left large numbers at the stopping-places on their way, you will see that the foremost will naturally fall back upon these positions when they are defeated or when they meet with an enemy too strong for them. And again, the more of their number they leave behind in their progress, the sooner will they be in danger of defeat.

It is important for comprehension of the neuroses that you should keep in mind this relation between fixation and regression. You will thus acquire a secure foothold from which to investigate the causation of the neuroses—their ætiology—which we shall soon consider.

For the present we will keep to the question of regression. After what you have heard about the development of the Libido you may anticipate two kinds of regression; a return to the first objects invested with Libido, which we know to be incestuous in character, and a return of the whole sexual organization to earlier stages. Both kinds occur in the transference neuroses, and play a great part in their mechanism. In particular, the return to the first incestuous objects of the Libido is a feature found with quite fatiguing regularity in neurotics. There is much more to be said about the regressions of Libido if another group of neuroses, called the narcissistic, is taken into account; but this is not our intention at the moment. These affections yield conclusions about other developmental processes of the Libido-function, not yet mentioned, and also show us new types of regression corresponding with them. I think, however, that I had better warn you now above all not to confound Regression with Repression and that I must assist you to clear your minds about the relation between the two processes. Repression, as you will remember, is the process by which a mental act capable of becoming conscious (that is, one which belongs to the preconscious system) is made unconscious and forced back into the unconscious system. And we also call it repression when the unconscious mental act is not permitted to enter the adjacent preconscious system at all, but is turned back upon the threshold by the censorship. There is therefore no connection with sexuality in the concept ‘repression’; please mark this very carefully. It denotes a purely psychological process; and would be even better described as topographical, by which we mean that it has to do with the spatial relationships we assume within the mind, or, if we again abandon these crude aids to the formulation of theory, with the structure of the mental apparatus out of separate psychical systems.

The comparisons just now instituted showed us that hitherto we have not been using the word ‘regression’ in its general sense but in a quite specific one. If you give it its general sense, that of a reversion from a higher to a lower stage of development in general, then repression also ranges itself under regression; for repression can also be described as reversion to an earlier and lower stage in the development of a mental act. Only, in repression this retrogressive direction is not a point of any moment to us; for we also call it repression in a dynamic sense when a mental process is arrested before it leaves the lower stage of the Unconscious. Repression is thus a topographic-dynamic conception, while regression is a purely descriptive one. But what we have hitherto called ‘regression’ and considered in its relation to fixation signified exclusively the return of the Libido to its former halting-places in development, that is, something which is essentially quite different from repression and quite independent of it. Nor can we call regression of the Libido a purely psychical process; neither do we know where to localize it in the mental apparatus; for though it may exert the most powerful influence upon mental life, the organic factor in it is nevertheless the most prominent.

Discussions of this sort tend to be rather dry; therefore let us turn to clinical illustrations of them in order to get a more vivid impression of them. You know that the group of the transference neuroses consists principally of hysteria and the obsessional neurosis. Now in hysteria, a regression of the Libido to the primary incestuous sexual objects is without doubt quite regular, but there is little or no regression to an earlier stage of sexual organization. Consequently the principal part in the mechanism of hysteria is played by repression. If I may be allowed to supplement by a construction the certain knowledge of this neurosis acquired up to the present I might describe the situation as follows: The fusion of the component-impulses under the primacy of the genital zone has been accomplished; but the results of this union meet with resistance from the direction of the preconscious system with which consciousness is connected. The genital organization therefore holds good for the Unconscious, but not also for the preconscious, and this rejection on the part of the preconscious results in a picture which has a certain likeness to the state prior to the primacy of the genital zone. It is nevertheless actually quite different. Of the two kinds of regression of the Libido, that on to an earlier phase of sexual organization is much the more striking. Since it is absent in hysteria and our whole conception of the neuroses is still far too much dominated by the study of hysteria which came first in point of time, the significance of Libido-regression was recognized much later than that of repression. We may be sure that our points of view will undergo still further extensions and alterations when we include consideration of still other neuroses (the narcissistic) in addition to hysteria and the obsessional neurosis.

In the obsessional neurosis, on the other hand, regression of the Libido to the antecedent stage of the sadistic-anal organization is the most conspicuous factor and determines the form taken by the symptoms. The impulse to love must then mask itself under the sadistic impulse. The obsessive thought, “I should like to murder you,” means (when it has been detached from certain superimposed elements that are not, however, accidental but indispensable to it) nothing else but “I should like to enjoy love of you.” When you consider in addition that regression to the primary objects has also set in at the same time, so that this impulse concerns only the nearest and most beloved persons, you can gain some idea of the horror roused in the patient by these obsessive ideas and at the same time how unaccountable they appear to his conscious perception. But repression also has its share, a great one, in the mechanism of this neurosis, and one which is not easy to expound in a rapid survey such as this. Regression of Libido without repression would never give rise to a neurosis, but would result in a perversion. You will see from this that repression is the process which distinguishes the neuroses particularly and by which they are best characterized. Perhaps, however, I may have an opportunity at some time of expounding to you what we know of the mechanism of the perversions, and you will then see that there again nothing proceeds so simply as we should like to imagine in our constructions.

I think that you will be soonest reconciled to this exposition of fixation and regression of the Libido if you will regard it as preparatory to a study of the ætiology of the neuroses. So far I have only given you one piece of information on this subject, namely, that people fall ill of a neurosis when the possibility of satisfaction for the Libido is removed from them—they fall ill in consequence of a ‘privation,’ as I called it, therefore—and that their symptoms are actually substitutes for the missing satisfaction. This of course does not mean that every privation in regard to libidinal satisfaction makes everyone who meets with it neurotic, but merely that in all cases of neurosis investigated the factor of privation was demonstrable. The statement therefore cannot be reversed. You will no doubt have understood that this statement was not intended to reveal the whole secret of the ætiology of the neuroses, but that it merely emphasized an important and indispensable condition.

Now in order to consider this proposition further we do not know whether to begin upon the nature of the privation or the particular character of the person affected by it. The privation is very rarely a comprehensive and absolute one; in order to have a pathogenic effect it would probably have to strike at the only form of satisfaction which that person desires, the only form of which he is capable. In general, there are very many ways by which it is possible to endure lack of libidinal satisfaction without falling ill. Above all we know of people who are able to take such abstinence upon themselves without injury; they are then not happy, they suffer from unsatisfied longing, but they do not become ill. We therefore have to conclude that the sexual impulse-excitations are exceptionally ‘plastic,’ if I may use the word. One of them can step in in place of another; if satisfaction of one is denied in reality, satisfaction of another can offer full recompense. They are related to one another like a network of communicating canals filled with fluid, and this in spite of their subordination to the genital primacy, a condition which is not at all easily reduced to an image. Further, the component-instincts of sexuality, as well as the united sexual impulse which comprises them, show a great capacity to change their object, to exchange it for another—i.e. for one more easily attainable; this capacity for displacement and readiness to accept surrogates must produce a powerful counter-effect to the effect of a privation. One amongst these processes serving as protection against illness arising from want has reached a particular significance in the development of culture. It consists in the abandonment, on the part of the sexual impulse, of an aim previously found either in the gratification of a component-impulse or in the gratification incidental to reproduction, and the adoption of a new aim—which new aim, though genetically related to the first, can no longer be regarded as sexual, but must be called social in character. We call this process SUBLIMATION, by which we subscribe to the general standard which estimates social aims above sexual (ultimately selfish) aims. Incidentally, sublimation is merely a special case of the connections existing between sexual impulses and other, asexual ones. We shall have occasion to discuss this again in another context.

Your impression now will be that we have reduced want of satisfaction to a factor of negligible proportions by the recognition of so many means of enduring it. But no; this is not so: it retains its pathogenic power. The means of dealing with it are not always sufficient. The measure of unsatisfied Libido that the average human being can take upon himself is limited. The plasticity and free mobility of the Libido is not by any means retained to the full in all of us; and sublimation can never discharge more than a certain proportion of Libido, apart from the fact that many people possess the capacity for sublimation only in a slight degree. The most important of these limitations is clearly that referring to the mobility of the Libido, since it confines the individual to the attaining of aims and objects which are very few in number. Just remember that incomplete development of the Libido leaves behind it very extensive (and sometimes also numerous) Libido-fixations upon earlier phases of organization and types of object-choice, mostly incapable of satisfaction in reality; you will then recognize fixation of Libido as the second powerful factor working together with privation in the causation of illness. We may condense this schematically and say that Libido-fixation represents the internal, predisposing factor, while privation represents the external, accidental factor, in the ætiology of the neuroses.

I will take this opportunity to warn you against taking sides in a quite superfluous dispute. It is a popular habit in scientific matters to seize upon one side of the truth and set it up as the whole truth, and then in favour of that element of truth to dispute all the rest which is equally true. More than one faction has already split off in this way from the psycho-analytic movement; one of them recognizes only the egoistic impulses and denies the sexual; another perceives only the influence of real tasks in life but overlooks that of the individual’s past life, and so on. Now here is occasion for another of these antitheses and moot-points: Are the neuroses exogenous or endogenous diseases—the inevitable result of a certain type of constitution or the product of certain injurious (traumatic) events in the person’s life? In particular, are they brought about by the fixation of Libido and the rest of the sexual constitution, or by the pressure of privation? This dilemma seems to me about as sensible as another I could point to: Is the child created by the father’s act of generation or by the conception in the mother? You will properly reply: Both conditions are alike indispensable. The conditions underlying the neuroses are very similar, if not exactly the same. From the point of view of causation, cases of neurotic illness fall into a series, within which the two factors—sexual constitution and events experienced, or, if you wish, fixation of Libido and privation—are represented in such a way that where one of them predominates the other is proportionately less pronounced. At one end of the series stand those extreme cases of whom one can say: These people would have fallen ill whatever happened, whatever they experienced, however merciful life had been to them, because of their anomalous Libido-development. At the other end stand cases which call forth the opposite verdict—they would undoubtedly have escaped illness if life had not put such and such burdens upon them. In the intermediate cases in the series, more or less of the disposing factor (the sexual constitution) is combined with less or more of the injurious impositions of life. Their sexual constitution would not have brought about their neurosis if they had not gone through such and such experiences, and life’s vicissitudes would not have worked traumatically upon them if the Libido had been otherwise constituted. In this series I can perhaps admit a certain preponderance in the effect of the predisposing factor, but this admission again depends upon where you draw the line in marking the boundaries of nervousness.

I shall now suggest to you that we should call series such as these complemental series, and will inform you beforehand that we shall find occasion to establish others of this kind.

The tenacity with which the Libido holds to particular channels and particular objects, the ‘adhesiveness’ of the Libido, so to say, seems to be an independent factor, varying in individuals, the determining conditions of which are completely unknown to us, but the importance of which in the ætiology of the neuroses we shall certainly no longer underestimate. At the same time we should not overestimate the close relation between the two things. A similar ‘adhesiveness’ of the Libido occurs—from unknown causes—in normal people under numerous conditions, and is found as a decisive factor in those persons who in a certain sense are the extreme opposite of neurotics—namely, perverted persons. It was known before the time of psycho-analysis that in the anamnesis of such persons a very early impression, relating to an abnormal instinct-tendency or object-choice, is frequently discovered, to which the Libido of that person henceforth remains attached for life (Binet). It is often hard to say what has enabled this impression to exert such an intense power of attraction upon the Libido. I will describe a case of this kind observed by myself. A man to whom the genitals and all the other attractions in a woman now mean nothing can be roused to irresistible sexual excitation only by a shoe-clad foot of a certain shape; he can remember an event in his sixth year which determined this fixation of Libido. He was sitting upon a stool by the side of his governess who was to give him an English lesson. She was a plain, elderly, shrivelled old maid, with watery blue eyes and a snub nose, and on this day she had hurt her foot and had it therefore stretched out on a cushion in a velvet slipper, with the leg itself most decorously concealed. Later on, after a timid attempt at normal sexual activity during puberty, a thin sinewy foot like that of the governess became his only sexual object; and if still other features in the person reminded him of the type of woman represented by the English governess the man was helplessly attracted. This fixation of the Libido, however, rendered him not neurotic but perverse; he became, as we say, a foot-fetichist. So you see that although an excessive and, in addition, premature fixation of Libido is an indispensable condition in the causation of neurosis, the extent of its influence far exceeds the boundaries of the neuroses. This condition by itself is also as little decisive as the privation mentioned previously.

So the problem of the causation of the neuroses seems to become more complicated. In fact, psycho-analytic investigation acquaints us with yet a new factor, not considered in our ætiological series, and best observed in someone whose previous good health is suddenly disturbed by falling ill of a neurosis. In these people signs of contradictory and opposed wishes, or, as we say, of mental conflict, are regularly found. One side of the personality stands for certain wishes, while another part struggles against them and fends them off. There is no neurosis without such a CONFLICT. There might seem to be nothing very special in this; you know that mental life in all of us is perpetually engaged with conflicts that have to be decided. Therefore it would seem that special conditions must be fulfilled before such a conflict can become pathogenic; we may ask what these conditions are, what forces in the mind take part in these pathogenic conflicts, and what relation conflict bears to the other causative factors.

I hope to be able to give you answers to these questions which will be satisfactory although perhaps schematically condensed. Conflict is produced by privation, in that the Libido which lacks satisfaction is urged to seek other paths and other objects. A condition of it then is that these other paths and objects arouse disfavour in one side of the personality, so that a veto ensues, which at first makes the new way of satisfaction impossible. This is the point of departure for the formation of symptoms, which we shall follow up later. The rejected libidinal longings manage to pursue their course by circuitous paths, though not indeed without paying toll to the prohibition in the form of certain disguises and modifications. The circuitous paths are the ways of symptom-formation; the symptoms are the new or substitutive satisfactions necessitated by the fact of the privation.

The significance of the mental conflict can be defined in another way, thus: in order to become pathogenic external privation must be supplemented by internal privation. When this is so, the external and the internal privation relate of course to different paths and different objects; external privation removes one possibility of satisfaction, internal privation tries to exclude another possibility, and it is this second possibility which becomes the debatable ground of the conflict. I choose this form of presentation because it contains a certain implication; it implies that the internal impediment arose originally, in primitive phases of human development, out of real external obstacles.

But what are these forces out of which the prohibition against the libidinal longings proceeds, the other parties in the pathogenic conflict? Speaking very broadly, we may say that they are the non-sexual instincts. We include them all under the name ‘Ego-instincts’; analysis of the transference neuroses offers no adequate opportunity for further investigation of them; at most we learn something of them from the resistances opposed to the analysis. The pathogenic conflict is, therefore, one between the Ego-instincts and the sexual instincts. In a whole series of cases it looks as though there might also be conflict between various purely sexual impulses; at bottom, however, this is the same thing, because of the two sexual impulses engaged in a conflict one will always be found ‘consistent with the Ego’ (ichgerecht) while the other calls forth a protest from the Ego. It remains, therefore, a conflict between Ego and sexuality.

Over and over again when psycho-analysis has regarded something happening in the mind as an expression of the sexual instincts indignant protests have been raised to the effect that other instincts and other interests exist in mental life besides the sexual, that one should not derive “everything” from sexuality, and so on. Well, it is a real pleasure for once to be in agreement with one’s opponents. Psycho-analysis has never forgotten that non-sexual instincts also exist; it has been built upon a sharp distinction between sexual instincts and Ego-instincts; and in the face of all opposition it has insisted, not that they arise from sexuality, but that the neuroses owe their origin to a conflict between Ego and sexuality. It has no conceivable motive in denying the existence or the significance of the Ego-instincts while it investigates the part played by sexual instincts in disease and in life generally. Only, psycho-analysis has been destined to concern itself first and foremost with the sexual instincts, because in the transference neuroses these are the most accessible to investigation, and because it was obliged to study what others had neglected.

It is not any more accurate to say that psycho-analysis has not occupied itself at all with the non-sexual side of the personality. The very distinction between the Ego and sexuality has shown us with particular clearness that the Ego-instincts also undergo an important development which is neither entirely independent of the development of the Libido nor without influence upon the latter. We certainly understand the development of the Ego much less well than the development of the Libido, because it is only by the study of the narcissistic neuroses that we have just reached some hope of insight into the structure of the Ego. Nevertheless, we have already a notable attempt on the part of Ferenczi48 to reconstruct theoretically the developmental stages of the Ego; and there are at least two points at which we have a secure foothold from which to examine this development further. We are not at all disposed to think that the libidinal interests of a human being are from the outset in opposition to the interests of self-preservation; the Ego is rather impelled at every stage to attempt to remain in harmony with the corresponding stage of sexual organization and to accommodate itself to that. The succession of the separate phases in the development of the Libido probably follows a prescribed course; it is undeniable, however, that this course may be influenced from the direction of the Ego. A certain parallelism, a definite correspondence between the phases in the two developments (of the Ego and of the Libido) may also be assumed; indeed, a disturbance in this correspondence may become a pathogenic factor. More important to us is the question how the Ego behaves when the Libido has undergone a powerful fixation at an earlier point in its development. The Ego may countenance the fixation and will then be perverse to that extent, or, what is the same thing, infantile; it may, however, hold itself averse from this attachment of Libido, the result of which is that where the Libido undergoes a fixation there the Ego institutes an act of repression.

In this way we arrive at the conclusion that the third factor in the ætiology of the neuroses, the susceptibility to conflict, is as much connected with the development of the Ego as with the development of the Libido; our insight into the causation of the neuroses is thus enlarged. First, there is the most general condition of privation, then the fixation of Libido (forcing it into particular channels), and thirdly, the susceptibility to conflict produced by the development of the Ego having repudiated libidinal excitations of that particular kind. The thing is therefore not so very obscure and intricate—as you probably thought it during the course of my exposition. To be sure, though, after all, we have not done with it yet; there is still something new to add and something we already know to dissect further.

In order to demonstrate the effect of the development of the Ego upon the tendency to conflict and therewith upon the causation of the neurosis, I will quote an example which, although entirely imaginary, is not at all improbable in any respect. I will give it the title of Nestroy’s farce: On the Ground-Floor and in the Mansion. Suppose that a caretaker is living on the ground-floor of a house, while the owner, a rich and well-connected man, lives above. They both have children, and we will assume that the owner’s little girl is permitted to play freely without supervision with the child of lower social standing. It may then very easily happen that their games become “naughty,” that is, take on a sexual character: that they play “father and mother,” watch each other in the performance of intimate acts, and stimulate each other’s genital parts. The caretaker’s daughter may have played the temptress in this, since in spite of her five or six years she has been able to learn a great deal about sexual matters. These occurrences, even though they are only kept up for a short period, will be enough to rouse certain sexual excitations in both children which will come to expression in the practice of masturbation for a few years, after the games have been discontinued. There is common ground so far, but the final result will be very different in the two children. The caretaker’s daughter will continue masturbation, perhaps up to the onset of menstruation, and then give it up without difficulty; a few years later will find a lover, perhaps bear a child; choose this or that path in life, perhaps become a popular actress and end as an aristocrat. Probably her career will turn out less brilliantly, but in any case she will be unharmed by the premature sexual activity, free from neurosis, and able to live her life. Very different is the result in the other child. She will very soon, while yet a child, acquire a sense of having done wrong; after a fairly short time she will give up the masturbatory satisfaction, though perhaps only with a tremendous struggle, but will nevertheless retain an inner feeling of subdued depression. When later on as a young girl she comes to learn something of sexual intercourse, she will turn from it with inexplicable horror and wish to remain ignorant. Probably she will then again suffer a fresh irresistible impulse to masturbation about which she will not dare to unburden herself to anyone. When the time comes for a man to choose her as a wife the neurosis will break out and cheat her out of marriage and the joy of life. If analysis makes it possible to obtain an insight into this neurosis, it will be found that this well-broughtup, intelligent and idealistic girl has completely repressed her sexual desires; but that they are, unconsciously, attached to the few little experiences she had with the childish play-mate.

The differences which ensue in these two destinies in spite of the common experiences undergone, arise because in one girl the Ego has sustained a development absent in the other. To the caretaker’s daughter sexual activity seemed as natural and harmless in later years as in childhood. The gentleman’s daughter had been “well-brought-up” and had adopted the standards of her education. Thus stimulated, her Ego had formed ideals of womanly purity and absence of desire that were incompatible with sexual acts; her intellectual training had caused her to depreciate the feminine rôle for which she is intended. This higher moral and intellectual development in her Ego has brought her into conflict with the claims of her sexuality.

I will explore one more aspect of the development of the Libido to-day, both because it leads out upon certain wide prospects, and also because it is well-suited to justify the sharp, and not immediately obvious, line of demarcation we are wont to draw between Ego-instincts and sexual instincts. In considering the two developments undergone by the Ego and by the Libido we must emphasize an aspect which hitherto has received little attention. Both of them are at bottom inheritances, abbreviated repetitions of the evolution undergone by the whole human race through long-drawn-out periods and from prehistoric ages. In the development of the Libido this phylogenetic origin is readily apparent, I should suppose. Think how in one class of animals the genital apparatus is in closest relation with the mouth, in another it is indistinguishable from the excretory mechanism, in another it is part of the organs of motility; you will find a delightful description of these facts in W. Bölsche’s valuable book. One sees in animals all the various perversions, ingrained, so to speak, in the form taken by their sexual organizations. Now the phylogenetic aspect is to some extent obscured in man by the circumstance that what is fundamentally inherited is nevertheless individually acquired anew, probably because the same conditions that originally induced its acquisition still prevail and exert their influence upon each individual. I would say, where they originally created a new response they now stimulate a predisposition. Apart from this, it is unquestionable that the course of the prescribed development in each individual can be disturbed and altered by current impressions from without. But the power which has enforced this development upon mankind, and still to-day maintains its pressure in the same course, is known to us; it is, again, the privation exacted by reality; or, if we give it its great real name, it is Necessity, the struggle for life, ’ANATKH. Necessity has been a severe task-mistress, and she has taught us a great deal. Neurotics are those of her children upon whom this severity has had evil effects, but that risk is inevitable in any education. Incidentally, this view of the struggle for existence as the motive force in evolution need not detract from the significance of “inner evolutionary tendencies,” if such are found to exist.

Now it is very noteworthy that sexual instincts and self-preservative instincts do not behave alike when confronted with the necessity of real life. The self-preservative instincts and all that hangs together with them are more easily moulded; they learn early to conform to necessity and to adapt their development according to the mandates of reality. This is comprehensible, for they cannot obtain the objects they require by any other means, and without these objects the individual must perish. The sexual instincts are less easily moulded; for in the beginning they do not know any lack of objects. Since they are connected parasitically, as it were, with the other physical functions and at the same time can be auto-erotically gratified on their own body, they are at first isolated from the educative influence of real necessity; and in most people they retain throughout life, in some respect or other, this character of obstinacy and inaccessibility to influence which we call “unreasonableness.” Moreover, the educability of a young person as a rule comes to an end when sexual desire breaks out in its final strength. Educators know this and act accordingly; but perhaps they will yet allow themselves to be influenced by the results of psycho-analysis so that they will transfer the main emphasis in education to the earliest years of childhood, from the suckling period onward. The little human being is frequently a finished product in his fourth or fifth year, and only gradually reveals in later years what lies buried in him.

To appreciate the full significance of this difference between the two groups of instincts we must digress some distance, and include one of those aspects which deserve to be called economic; we enter here upon one of the most important, but unfortunately one of the most obscure, territories of psycho-analysis. We may put the question whether a main purpose is discernible in the operation of the mental apparatus; and our first approach to an answer is that this purpose is directed to the attainment of pleasure. It seems that our entire psychical activity is bent upon procuring pleasure and avoiding pain, that it is automatically regulated by the Pleasure-principle. Now of all things in the world we should like to know what are the conditions giving rise to pleasure and pain, but that is just where we fall short. We may only venture to say that pleasure is in some way connected with lessening, lowering, or extinguishing the amount of stimulation present in the mental apparatus; and that pain involves a heightening of the latter. Consideration of the most intense pleasure of which man is capable, the pleasure in the performance of the sexual act, leaves little doubt upon this point. Since pleasurable processes of this kind are bound up with the distribution of quantities of mental excitation and energy, we term considerations of this kind economic ones. It appears that we can describe the tasks and performances of the mental apparatus in another way and more generally than by emphasizing the attainment of pleasure. We can say that the mental apparatus serves the purpose of mastering and discharging the masses of supervening stimuli, the quantities of energy. It is quite plain that the sexual instincts pursue the aim of gratification from the beginning to the end of their development; throughout they keep up this primary function without alteration. At first the other group, the Ego-instincts, do the same; but under the influence of necessity, their mistress, they soon learn to replace the pleasure-principle by a modification of it. The task of avoiding pain becomes for them almost equal in importance to that of gaining pleasure; the Ego learns that it must inevitably go without immediate satisfaction, postpone gratification, learn to endure a degree of pain, and altogether renounce certain sources of pleasure. Thus trained, the Ego becomes “reasonable,” is no longer controlled by the pleasure-principle, but follows the Reality-principle, which at bottom also seeks pleasure—although a delayed and diminished pleasure, one which is assured by its realization of fact, its relation to reality.

The transition from the pleasure-principle to the reality-principle is one of the most important advances in the development of the Ego. We already know that the sexual instincts follow late and unwillingly through this stage; presently we shall learn what the consequences are to man that his sexuality is satisfied with such a slight hold upon external reality. And now in conclusion one more observation relevant in this connection. If the Ego in mankind has its evolution like the Libido, you will not be surprised to hear that there exist ‘Ego-regressions’ too, and will wish to know the part this reversion of the Ego to earlier stages in development can play in neurotic disease.

Twenty-Third Lecture — The Paths of Symptom-Formation

In the eyes of the general public the symptoms are the essence of a disease, and to them a cure means the removal of the symptoms. In medicine, however, we find it important to differentiate between symptoms and disease, and state that the disappearance of the symptoms is by no means the same as the cure of the disease. The only tangible element of the disease that remains after the removal of the symptoms, however, is the capacity to form new symptoms. Therefore for the moment let us adopt the lay point of view and regard a knowledge of the foundation of the symptoms as equivalent to understanding the disease.

The symptoms—of course we are here dealing with mental (or psychogenic) symptoms, and mental disease—are activities which are detrimental, or at least useless, to life as a whole; the person concerned frequently complains of them as obnoxious to him or they involve distress and suffering for him. The principal injury they inflict lies in the expense of mental energy they entail and, besides this, in the energy needed to combat them. Where the symptoms are extensively developed, these two kinds of effort may exact such a price that the person suffers a very serious impoverishment in available mental energy, which consequently disables him for all the important tasks of life. This result depends principally upon the amount of energy taken up in this way, therefore you will see that “illness” is essentially a practical conception. But if you look at the matter from a theoretical point of view and ignore this question of degree you can very well say that we are all ill, i.e. neurotic; for the conditions required for symptom-formation are demonstrable also in normal persons.

Of neurotic symptoms we already know that they are the result of a conflict arising when a new form of satisfaction of Libido is sought. The two powers which have entered into opposition meet together again in the symptom and become reconciled by means of the compromise contained in symptom-formation. That is why the symptom is capable of such resistance; it is sustained from both sides. We also know that one of the two partners to the conflict is the unsatisfied Libido, frustrated by reality and now forced to seek other paths to satisfaction. If reality remains inexorable, even when the Libido is prepared to take another object in place of that denied, the Libido will then finally be compelled to resort to regression, and to seek satisfaction in one of the organizations it had already surmounted or in one of the objects it had relinquished earlier. The Libido is drawn into the path of regression by the fixations it has left behind it at these places in its development.

Now the path of perversion branches off sharply from that of neurosis. If these regressions do not call forth a prohibition on the part of the Ego, no neurosis results; the Libido succeeds in obtaining a real, although not a normal, satisfaction. But if the Ego, which controls not merely consciousness but also the approaches to motor innervation and hence the realization in actuality of mental impulses, is not in agreement with these regressions, conflict ensues. The Libido is turned off, blocked, as it were, and must seek an escape by which it can find an outlet for its ‘charge of energy’ in conformity with the demands of the pleasure-principle: it must elude, eschew the Ego. The fixations upon the path of development now regressively traversed—fixations against which the Ego had previously guarded itself by repressions—offer just such an escape. In streaming backward and re-‘investing’ these repressed ‘positions,’ the Libido withdraws itself from the Ego and its laws; but it also abandons all the training acquired under the influence of the Ego. It was docile as long as satisfaction was in sight; under the double pressure of external and internal privation it becomes intractable and harks back to former happier days. That is its essential unchangeable character. The ideas to which the Libido now transfers its ‘charge of energy’ belong to the unconscious system and are subject to the special processes characteristic of that system—namely, condensation and displacement. Conditions are thus set up which correspond exactly with those of dream-formation. Just as the latent dream, first formed in the Unconscious out of the thoughts proper, and constituting the fulfilment of an unconscious wish-phantasy, meets with some (pre)conscious activity which exerts a censorship upon it and permits, according to its verdict, the formation of a compromise in the manifest dream, so the ideas to which the Libido is attached (‘libido-representatives’) in the Unconscious have still to contend with the power of the preconscious Ego. The opposition that has arisen against it in the Ego follows it as a ‘countercharge’ and forces it to adopt a form of expression by which the opposing forces also can at the same time express themselves. In this way the symptom then comes into being, as a derivative, distorted in manifold ways, of the unconscious libidinal wish-fulfilment, as a cleverly chosen ambiguity with two completely contradictory significations. In this last point alone is there a difference between dream-formation and symptom-formation; for the preconscious purpose in dream-formation is merely to preserve sleep and to allow nothing that would disturb it to penetrate consciousness; it does not insist upon confronting the unconscious wish-impulse with a sharp prohibiting “No, on the contrary.” It can be more tolerant because a sleeping person is in a less dangerous position; the condition of sleep is enough in itself to prevent the wish from being realized in actuality.

You see that this escape of the Libido under the conditions of conflict is rendered possible by the existence of fixations. The regressive investment (with Libido) of these fixations leads to a circumventing of the repressions and to a discharge—or a satisfaction—of the Libido, in which the conditions of a compromise have nevertheless to be maintained. By this détour through the Unconscious and the old fixations the Libido finally succeeds in attaining to a real satisfaction, though the satisfaction is certainly of an exceedingly restricted kind and hardly recognizable as such. Let me add two remarks on this outcome. First, will you notice how closely connected the Libido and the Unconscious, on the one hand, and the Ego, consciousness, and reality, on the other, show themselves to be, although there were no such connections between them originally; and secondly, let me tell you that all I have said and have still to say on this point concerns the neurosis of hysteria only.

Where does the Libido find the fixations it needs in order to break through the repressions? In the activities and experiences of infantile sexuality, in the component-tendencies and the objects of childhood which have been relinquished and abandoned. It is to them, therefore, that the Libido turns back. The significance of childhood is a double one; on the one hand the congenitally-determined instinct-dispositions are first shown at that time, and secondly, other instincts are then first awakened and activated by external influences and accidental events experienced. In my opinion we are quite justified in laying down this dichotomy. That the innate predisposition comes to expression will certainly not be disputed; but analytic observation even requires us to assume that purely accidental experiences in childhood are capable of inducing fixations of Libido. Nor do I see any theoretical difficulty in this. Constitutional predispositions are undoubtedly the after-effects of the experiences of an earlier ancestry; they also have been at one time acquired; without such acquired characters there would be no heredity. And is it conceivable that the acquisition of characters which will be transmitted further should suddenly cease in the generation which is being observed to-day? The importance of the infantile experiences should not, however, be entirely overlooked, as so often happens, in favour of ancestral experiences or of experiences in adult life; but on the contrary they should be particularly appreciated. They are all the more pregnant with consequences because they occur at a time of uncompleted development, and for this very reason are likely to have a traumatic effect. The work done by Roux and others on the mechanism of development has shown that a needle pricked into an embryonic cell-mass undergoing division results in serious disturbances of the development; the same injury to a larva or a full-grown animal would be innocuous.

The Libido-fixation of an adult, which we have referred to as representing the constitutional factor in the ætiology of the neuroses, may therefore now be divided into two further elements: the inherited predisposition and the predisposition acquired in early childhood. Since a schematic mode of presentation is always acceptable to a student, let us formulate these relations as follows:

Causation of Neurosis =		Predisposition resulting from Libido-fixation		+ Accidental (traumatic) Experiences
	↙		↘
	———		———
	↓		↓
	Sexual Constitution (Ancestral experiences)		Infantile Experiences

The hereditary sexual constitution provides a great variety of predispositions, according as this or that component-impulse, alone or in combination with others, is specially strongly accentuated. Together with the infantile experiences the sexual constitution forms another ‘complemental series,’ quite similar to that already described as being formed out of the predisposition and accidental experiences of an adult. In each series similar extreme cases are met with, and also similar degrees and relationships between the factors concerned. It would be appropriate at this point to consider whether the most striking of the two kinds of Libido-regression (that which reverts to earlier stages of sexual organization) is not predominantly conditioned by the hereditary constitutional factor; but the answer to this question is best postponed until a wider range of forms of neurotic disease can be considered.

Now let us devote attention to the fact that analytic investigation shows the Libido of neurotics to be attached to their infantile sexual experiences. In this light these experiences seem to be of enormous importance in the lives and illnesses of mankind. This importance remains undiminished in so far as the therapeutic work of analysis is concerned; but regarded from another point of view it is easy to see that there is a danger of a misunderstanding here, one which might delude us into regarding life too exclusively from the angle of the situation in neurotics. The importance of the infantile experiences is after all diminished by the reflection that the Libido reverts regressively to them after it has been driven from its later positions. This would lead us towards the opposite conclusion, that the Libido-experiences had no importance at the time of their occurrence, but only acquired it later by regression. You will remember that we discussed a similar alternative before, in dealing with the Oedipus complex.

To decide this point is again not difficult. The statement is undoubtedly correct that regression greatly augments the investment of the infantile experiences with Libido—and with that their pathogenic significance; but it would be misleading to allow this alone to become decisive. Other considerations must be taken into account as well. To begin with, observation shows in a manner excluding all doubt that infantile experiences have their own importance which is demonstrated already during childhood. There are, indeed, neuroses in children too; in their neuroses the factor of displacement backwards in time is necessarily much diminished, or quite absent, the outbreak of illness following immediately upon a traumatic experience. The study of infantile neuroses guards us from many risks of misunderstanding the neuroses of adults, just as children’s dreams gave us the key to comprehension of the dreams of adults. Neurosis in children is very common, far more common than is usually supposed. It is often overlooked, regarded as a manifestation of bad behaviour or naughtiness, and often subdued by the authorities in the nursery; but in retrospect it is always easily recognizable. It appears most often in the form of anxiety-hysteria; we shall learn what that means on another occasion. When a neurosis breaks out in later life analysis invariably reveals it to be a direct continuation of that infantile neurosis, which had perhaps been expressed in a veiled and incipient form only; as has been said, however, there are cases in which the childish nervousness is carried on into lifelong illness without a break. In a few instances we have been able to analyse a child actually in a condition of neurosis; far more often we have had to be satisfied with the retrospective insight into a childhood-neurosis that can be gained through someone who has fallen ill in mature years, a situation in which due corrections and precautions must not be neglected.

In the second place, it would certainly be inexplicable that the Libido should regress so regularly to the time of childhood if there had been nothing there which could exert an attraction upon it. The fixation upon certain stages of development, which we assume, only has meaning if we regard it as attaching to itself a definite amount of libidinal energy. Finally, I may point out that a complemental relationship exists here between the intensity and pathogenic importance of the infantile and of the later experiences, again a similar relationship to that found in the other two series we have already studied. There are cases in which the whole accent of causation falls on the sexual experiences in childhood; cases in which these impressions undoubtedly had a traumatic effect, nothing more than the average sexual constitution and its immaturity being required to supplement them. Then there are others in which all the accent lies on the later conflicts, and the analytic emphasis upon the childhood-impressions seems to be the effect of regression alone. There exist, therefore, the two extremes—‘inhibited development’ and ‘regression’—and between them every degree of combination of the two factors.

This state of things has a certain interest for those looking to pedagogy for the prevention of neuroses by early intervention in the matter of the child’s sexual development. As long as attention is directed mainly to the infantile sexual experiences one would think everything in the way of prophylaxis of later neurosis could be done by ensuring that this development should be retarded and the child secured against this kind of experience. But we know that the conditions causing neurosis are more complicated than this and that they cannot be influenced in a general way by attending to one factor only. Strict supervision in childhood loses value because it is helpless against the constitutional factor; more than this, it is less easy to carry out than specialists in education imagine; and it entails two new risks, which are not to be lightly disregarded. It may accomplish too much; in that it favours an exaggerated degree of sexual repression which is harmful in its effects, and it sends the child into life without power to resist the urgent demands of his sexuality that must be expected at puberty. It therefore remains most doubtful how far prophylaxis in childhood can go with advantage, and whether a changed attitude to actuality would not constitute a better point of departure for attempts to forestall the neuroses.

Let us return to consideration of the symptoms. They yield a satisfaction in place of one lacking in reality; they achieve this by means of a regression of the Libido to a previous time of life, with which regression is indissolubly connected, a reversion to earlier phases in the object-choice or in the organization. We learned some time ago that the neurotic is in some way tied to a period in his past life; we know now that this period in the past is one in which his Libido could attain satisfaction, one in which he was happy. He looks back on his life-story, seeking some such period, and goes on seeking it, even if he must go back to the time when he was a suckling infant to find it according to his recollection or his imagination of it under later influences. In some way the symptom reproduces that early infantile way of satisfaction, disguised though it is by the censorship implicit in the conflict, converted as it usually is into a sensation of suffering, and mingled with elements drawn from the experiences leading up to the outbreak of the illness. The kind of satisfaction which the symptom brings has much about it which estranges us, quite apart from the fact that the person concerned is unaware of the satisfaction and perceives this that we call satisfaction much more as suffering, and complains of it. This transformation belongs to the mental conflict, by the pressure of which the symptom had to be formed; what was at one time a satisfaction must to-day arouse resistance or horror in him. We are familiar with a simple but instructive instance of such a change of feeling: the same child that sucked milk with voracity from its mother’s breast often shows, some years later, a strong dislike of milk which can with difficulty be overcome by training; this dislike is intensified to the point of horror if the milk or any other kind of liquid containing it has a skin formed upon it. It is possible that this skin calls up reverberations of a memory of the mother’s breast, once so ardently desired; it is true that the traumatic experience of weaning has intervened meanwhile.

There is still something else which makes the symptoms seem remarkable and inexplicable as a means of libidinal satisfaction. They so entirely fail to remind us of all that we are accustomed normally to connect with satisfaction. They are mostly quite independent of an object and thus have given up a relation to external reality. We understand this as a consequence of the rejection of the reality-principle and the return to the pleasure-principle; it is also, however, a return to a kind of amplified auto-erotism, the kind which offered the sexual instinct its first gratifications. In the place of effecting a change in the outer world they set up a change in the body itself; that is, an internal action instead of an external one, an adaptation instead of an activity—from a phylogenetic point of view again a very significant regression. We shall understand this better when we consider it in connection with a new factor yet to be learnt from among those which analytic research has yielded in regard to symptom-formation. Further, we remember that in symptom-formation the same unconscious processes are at work as in dream-formation, namely, condensation and displacement. Like the dream, the symptom represents something as fulfilled, a satisfaction infantile in character; but by the utmost condensation this satisfaction can be compressed into a single sensation or innervation, or by farthest displacement can be whittled away to a tiny detail out of the entire libidinal complex. It is no wonder that we often find it difficult to recognize in the symptom the libidinal satisfaction which we suspect and can always verify in it.

I have indicated that we have still to learn of a new element; it is really something most surprising and bewildering. You know that from analysis of symptoms we arrive at a knowledge of the infantile experiences to which the Libido is fixated and out of which the symptoms are made up. Now the astonishing thing is that these scenes of infancy are not always true. Indeed, in the majority of cases they are untrue, and in some cases they are in direct opposition to historical truth. You will see that this discovery is more likely than any other to discredit either the analysis which leads to such results, or the patient, upon whose testimony the analysis and comprehension of the neuroses as a whole is built up. There is besides this still something utterly bewildering about it. If the infantile experiences brought to light by the analysis were in every case real we should have the feeling that we were on firm ground; if they were invariably falsified and found to be inventions and phantasies of the patient’s we should have to forsake this insecure foothold and save ourselves some other way. But it is neither one thing nor the other; for what we find is that the childhood-experiences reconstructed or recollected in analysis are on some occasions undeniably false, while others are just as certainly quite true, and that in most cases truth and falsehood are mixed up. So the symptoms are thus at one minute reproductions of experiences which actually took place and which one can credit with an influence on the fixation of the Libido; and at the next a reproduction of phantasies of the patient’s to which, of course, it is difficult to ascribe any ætiological significance. It is hard to find one’s way here. We may perhaps find our first clue in a discovery of a similar kind, namely, that the meagre childish recollections which people have always, long before analysis, consciously preserved can be falsified in the same way, or at least can contain a generous admixture of truth and falsehood; evidence of error in them is nearly always plainly visible, and so we have at least the reassurance that not the analysis, but the patient in some way, must bear the responsibility for this unexpected disappointment.

After a little reflection we can easily understand what it is that is so bewildering in this matter. It is the depreciation of reality, the neglect of the difference between reality and phantasy; we are tempted to be offended with the patient for taking up our time with invented stories. According to our way of thinking heaven and earth are not farther apart than fiction from reality, and we value the two quite differently. The patient himself, incidentally, takes the same attitude when he is thinking normally. When he brings forward the material that leads us to the wished-for situations (which underlie the symptoms and are formed upon the childhood-experiences), we are certainly in doubt at first whether we have to deal with reality or with phantasies. Decision on this point becomes possible later by means of certain indications, and we are then confronted with the task of making this result known to the patient. This is never accomplished without difficulty. If we tell him at the outset that he is now about to bring to light the phantasies in which he has shrouded the history of his childhood, just as every race weaves myths about its forgotten early history, we observe to our dissatisfaction that his interest in pursuing the subject further suddenly declines—he also wishes to find out facts and despises what is called “imagination.” But if we leave him to believe until this part of the work has been carried through that we are investigating the real events of his early years, we run the risk of being charged with the mistake later and of being laughed at for our apparent gullibility. It takes him a long time to understand the proposal that phantasy and reality are to be treated alike and that it is to begin with of no account whether the childhood-experiences under consideration belong to the one class or to the other. And yet this is obviously the only correct attitude towards these products of his mind. They have indeed also a kind of reality; it is a fact that the patient has created these phantasies, and for the neurosis this fact is hardly less important than the other—if he had really experienced what they contain. In contrast to material reality these phantasies possess psychical reality, and we gradually come to understand that in the world of neurosis PSYCHICAL REALITY is the determining factor.

Among the occurrences which continually recur in the story of a neurotic’s childhood, and seem hardly ever absent, are some of particular significance which I therefore consider worthy of special attention. As models of this type I will enumerate: observation of parental intercourse, seduction by an adult, and the threat of castration. It would be a great mistake to suppose that they never occur in reality; on the contrary, they are often confirmed beyond doubt by the testimony of older relatives. Thus, for example, it is not at all uncommon for a little boy, who is beginning to play with his penis and has not yet learnt that he must conceal such activities, to be threatened by parents or nurses that his member or his offending hand will be cut off. Parents will often admit the fact on being questioned, since they imagine that such intimidation was the right course to take; many people have a clear conscious recollection of this threat, especially if it took place in later childhood. If the mother or some other woman makes the threat she usually shifts the execution of it to someone else, indicating that the father or the doctor will perform the deed. In the famous Struwelpeter by the Frankfort physician for children, Hoffmann, which owes its popularity precisely to his understanding of the sexual and other complexes of children, you will find the castration idea modified and replaced by cutting off the thumbs as a punishment for stubborn sucking of them. It is, however, highly improbable that the threat of castration has been delivered as often as would appear from the analysis of a neurotic. We are content to understand that the child concocts a threat of this kind out of its knowledge that auto-erotic satisfactions are forbidden, on the basis of hints and allusions, and influenced by the impression received on discovering the female genital organ. Similarly, it is not at all impossible that a small child, credited as he is with no understanding and no memory, may be witness of the sexual act on the part of his parents or other adults in other families besides those of the proletariat; and there is reason to think that the child can subsequently understand the impression received and react to it. But when this act of intercourse is described with minute details which can hardly have been observed, or when it appears, as it most frequently does, to have been performed from behind, more ferarum, there can be little doubt that this phantasy has grown out of the observation of copulating animals (dogs) and that its motive force lies in the unsatisfied skoptophilia (gazing-impulse) of the child during puberty. The greatest feat achieved by this kind of phantasy is that of observing parental intercourse while still unborn in the mother’s womb.

The phantasy of seduction has special interest, because only too often it is no phantasy but a real remembrance; fortunately, however, it is still not as often real as it seemed at first from the results of analysis. Seduction by children of the same age or older is more frequent than by adults; and when girls who bring forward this event in the story of their childhood fairly regularly introduce the father as the seducer, neither the phantastic character of this accusation nor the motive actuating it can be doubted. When no seduction has occurred, the phantasy is usually employed to cover the childhood period of auto-erotic sexual activity; the child evades feelings of shame about onanism by retrospectively attributing in phantasy a desired object to the earliest period. Do not suppose, however, that sexual misuse of children by the nearest male relatives is entirely derived from the world of phantasy; most analysts will have treated cases in which such occurrences actually took place and could be established beyond doubt; only even then they belonged to later years of childhood and had been transposed to an earlier time.

All this seems to lead to but one impression, that childhood experiences of this kind are in some way necessarily required by the neurosis, that they belong to its unvarying inventory. If they can be found in real events, well and good; but if reality has not supplied them they will be evolved out of hints and elaborated by phantasy. The effect is the same, and even to-day we have not succeeded in tracing any variation in the results according as phantasy or reality plays the greater part in these experiences. Here again is one of those complemental series so often referred to already; it is certainly the strangest of all those we have encountered. Whence comes the necessity for these phantasies, and the material for them? There can be no doubt about the instinctive sources; but how is it to be explained that the same phantasies are always formed with the same content? I have an answer to this which I know will seem to you very daring. I believe that these primal phantasies (as I should like to name these, and certainly some others also) are a phylogenetic possession. In them the individual, wherever his own experience has become insufficient, stretches out beyond it to the experience of past ages. It seems to me quite possible that all that to-day is narrated in analysis in the form of phantasy, seduction in childhood, stimulation of sexual excitement upon observation of parental coitus, the threat of castration—or rather, castration itself—was in prehistoric periods of the human family a reality; and that the child in its phantasy simply fills out the gaps in its true individual experiences with true prehistoric experiences. We have again and again been led to suspect that more knowledge of the primordial forms of human development is stored up for us in the psychology of the neuroses than in any other field we may explore.

Now these things that we have been discussing require us to consider more closely the origin and meaning of that mental activity called “phantasy-making.” In general, as you know, it enjoys high esteem, although its place in mental life has not been clearly understood. I can tell you as much as this about it. You know that the Ego in man is gradually trained by the influence of external necessity to appreciate reality and to pursue the reality-principle, and that in so doing it must renounce temporarily or permanently various of the objects and aims—not only sexual—of its desire for pleasure. But renunciation of pleasure has always been very hard to man; he cannot accomplish it without some kind of compensation. Accordingly he has evolved for himself a mental activity in which all these relinquished sources of pleasure and abandoned paths of gratification are permitted to continue their existence, a form of existence in which they are free from the demands of reality and from what we call the exercise of ‘testing reality.’ Every longing is soon transformed into the idea of its fulfilment; there is no doubt that dwelling upon a wish-fulfilment in phantasy brings satisfaction, although the knowledge that it is not reality remains thereby unobscured. In phantasy, therefore, man can continue to enjoy a freedom from the grip of the external world, one which he has long relinquished in actuality. He has contrived to be alternately a pleasure-seeking animal and a reasonable being; for the meagre satisfaction that he can extract from reality leaves him starving. “There is no doing without accessory constructions,” said Fontane. The creation of the mental domain of phantasy has a complete counterpart in the establishment of “reservations” and “nature-parks” in places where the inroads of agriculture, traffic, or industry threaten to change the original face of the earth rapidly into something unrecognizable. The “reservation” is to maintain the old condition of things which has been regretfully sacrificed to necessity everywhere else; there everything may grow and spread as it pleases, including what is useless and even what is harmful. The mental realm of phantasy is also such a reservation reclaimed from the encroaches of the reality-principle.

The best-known productions of phantasy have already been met by us; they are called day-dreams, and are imaginary gratifications of ambitious, grandiose, erotic wishes, dilating the more extravagantly the more reality admonishes humility and patience. In them is shown unmistakably the essence of imaginary happiness, the return of gratification to a condition in which it is independent of reality’s sanction. We know that these day-dreams are the kernels and models of night-dreams; fundamentally the night-dream is nothing but a day-dream distorted by the nocturnal form of mental activity and made possible by the nocturnal freedom of instinctive excitations. We are already familiar with the idea that a day-dream is not necessarily conscious, that unconscious day-dreams also exist; such unconscious day-dreams are therefore just as much the source of night-dreams as of neurotic symptoms.

The significance of phantasy for symptom-formation will become clear to you in what follows. We said that under privation the Libido regressively invests the positions it had left, but to which nevertheless some portions of its energy had remained attached. We shall not retract or correct this statement, but we shall have to interpolate a connecting-link in it. How does the Libido find its way back to these fixation-points? Now the objects and channels which have been forsaken by the Libido have not been forsaken in every sense; they, or their derivatives, are still retained to some degree of intensity in the conceptions of phantasy. The Libido has only to withdraw on to the phantasies in order to find the way open to it back to all the repressed fixations. These phantasies had enjoyed a certain sort of toleration; no conflict between them and the Ego had developed, however sharp an opposition there was between them, as long as a certain condition was preserved—a condition of a quantitative nature, now disturbed by the return of the Libido-stream on to the phantasies. By this accession, the investment of the phantasies with energy becomes so much augmented that they become assertive and begin to press towards realization; then, however, conflict between them and the Ego becomes unavoidable. Although previously they were preconscious or conscious, now they are subject to repression from the side of the Ego and are exposed to the attraction exerted from the side of the Unconscious. The Libido travels from the phantasies, now unconscious, to their sources in the Unconscious—back to its own fixation-points again.

The return of the Libido on to phantasy is an intermediate step on the way to symptom-formation which well deserves a special designation. C. G. Jung has coined for it the very appropriate name of INTROVERSION, but inappropriately he uses it also to describe other things. We will adhere to the position that introversion describes the deflection of the Libido away from the possibilities of real satisfaction and its excessive accumulation upon phantasies previously tolerated as harmless. An introverted person is not yet neurotic, but he is in an unstable condition; the next disturbance of the shifting forces will cause symptoms to develop, unless he can yet find other outlets for his pent-up Libido. The unreal character of neurotic satisfaction and the disregard of the difference between phantasy and reality are already determined by the delay at this stage of introversion.

You will doubtless have noticed that in these last remarks I have introduced a new factor into the concatenation of the ætiological chain—namely, the quantity, the magnitude of the energies concerned; we must always take this factor into account as well. A purely qualitative analysis of the ætiological conditions does not suffice; or, to put it in another way, a purely dynamic conception of these processes is insufficient, the economic aspect is also required. We have to realize that the conflict between the two forces in opposition does not break out until a certain intensity in the degree of investment is reached, even though the substantive conditions have long been in existence. In the same way, the pathogenic significance of the constitutional factor is determined by the preponderance of one of the component-instincts in excess over another in the disposition; it is even possible to conceive disposition as qualitatively the same in all men and only differentiated by this quantitative factor. No less important is this quantitative factor for the capacity to withstand neurotic illness; it depends upon the amount of undischarged Libido that a person can hold freely suspended, and upon how large a portion of it he can deflect from the sexual to a non-sexual goal in sublimation. The final aim of mental activity, which can be qualitatively described as a striving towards pleasure and avoidance of pain, is represented economically in the task of mastering the distribution of the quantities of excitation (stimulus-masses) present in the mental apparatus, and in preventing the accumulation of them which gives rise to pain.

I set out to tell you as much as this about symptom-formation in the neuroses. Yes, but I must not neglect to mention once more that everything said to-day relates only to symptom-formation in hysteria. Even the obsessional neurosis shows great differences, although the essentials are the same. The ‘counter-charges’ from the Ego against the demands made by instincts for satisfaction, mentioned already in connection with hysteria, are more strongly marked in the obsessional neurosis and govern the clinical picture in the form of what we call ‘reaction-formations.’ Similar and more extensive deviations still are found in the other neuroses, in which field researches into the mechanisms of symptom-formation are not yet complete in any direction.

Before you leave to-day I should like to direct your attention for a moment to a side of phantasy-life of very general interest. There is, in fact, a path from phantasy back again to reality, and that is—art. The artist has also an introverted disposition and has not far to go to become neurotic. He is one who is urged on by instinctive needs which are too clamorous; he longs to attain to honour, power, riches, fame, and the love of women; but he lacks the means of achieving these gratifications. So, like any other with an unsatisfied longing, he turns away from reality and transfers all his interest, and all his Libido too, on to the creation of his wishes in the life of phantasy, from which the way might readily lead to neurosis. There must be many factors in combination to prevent this becoming the whole outcome of his development; it is well known how often artists in particular suffer from partial inhibition of their capacities through neurosis. Probably their constitution is endowed with a powerful capacity for sublimation and with a certain flexibility in the repressions determining the conflict. But the way back to reality is found by the artist thus: He is not the only one who has a life of phantasy; the intermediate world of phantasy is sanctioned by general human consent, and every hungry soul looks to it for comfort and consolation. But to those who are not artists the gratification that can be drawn from the springs of phantasy is very limited; their inexorable repressions prevent the enjoyment of all but the meagre day-dreams which can become conscious. A true artist has more at his disposal. First of all he understands how to elaborate his day-dreams, so that they lose that personal note which grates upon strange ears and become enjoyable to others; he knows too how to modify them sufficiently so that their origin in prohibited sources is not easily detected. Further, he possesses the mysterious ability to mould his particular material until it expresses the ideas of his phantasy faithfully; and then he knows how to attach to this reflection of his phantasy-life so strong a stream of pleasure that, for a time at least, the repressions are out-balanced and dispelled by it. When he can do all this, he opens out to others the way back to the comfort and consolation of their own unconscious sources of pleasure, and so reaps their gratitude and admiration; then he has won—through his phantasy—what before he could only win in phantasy: honour, power, and the love of women.

Twenty-Fourth Lecture — Ordinary Nervousness

After such a difficult piece of work as we got through in our last lecture I shall leave the subject for a time and turn to my audience.

For I know that you are dissatisfied. You imagined that Introductory Lectures on Psycho-Analysis would be something quite different. You expected illustrations from life instead of theories; you will tell me that the story of the two children, on the ground-floor and in the mansion, revealed something of the causation of neurosis to you, except that it ought to have been an actual fact instead of an invention of my own. Or you will say that, when at the beginning I described two symptoms to you (not also imaginary, let us hope), and unfolded the solution of them and their connection with the lives of the patients, it threw some light on the meaning of symptoms, and you had hoped I would continue in the same way. Instead of doing so I gave you long-drawn-out and very obscure theories which were never complete, and to which I was constantly adding something; I dealt with conceptions which I had not yet introduced to you; I let go of descriptive explanation and took up the dynamic aspect and dropped this again for a so-called economic one; made it difficult for you to understand how many of these technical terms mean the same thing and are only exchanged for one another on account of euphony; I let vast conceptions, such as those of the pleasure and reality principles, and the inherited residue of phylogenetic development, appear, and then instead of explaining anything to you I let them drift away before your eyes out of sight.

Why did I not begin the introduction to the study of the neuroses with what you all know of nervousness, a thing that has long roused your interest, or with the peculiar nature of nervous persons, their incomprehensible reactions to human intercourse and external influences, their excitability, their unreliability, and their inability to do well in anything? Why not lead you step by step from an explanation of the simple everyday forms of nervousness to the problems of the enigmatic extreme manifestations?

Indeed, I cannot deny any of this or say that you are wrong. I am not so much in love with my powers of presentation as to imagine that every blemish in it is a peculiar charm. I think myself that I might with advantage to you have proceeded differently, and, indeed, such was my intention. But one cannot always carry through a reasoned scheme; something in the material itself often intervenes and takes possession of one and turns one from one’s first intentions. Even such an ordinary task as the arrangement of familiar material is not entirely subject to the author’s will; it comes out in its own way and one can but wonder afterwards why it happened so and not otherwise.

One of the reasons probably is that my theme, an introduction to psycho-analysis, no longer covers this section dealing with the subject of the neuroses. The introduction to psycho-analysis lies in the study of errors and of dreams; the theory of neurosis is psycho-analysis itself. I do not think that in such a short time I could have given you any knowledge of the material contained in the theory of the neuroses except in this very concentrated form. It was a matter of presenting to you in their proper context the sense and meaning of symptoms, together with the external and internal conditions and mechanisms of symptom-formation. This I attempted to do; it is more or less the core of what psycho-analysis is able to offer to-day. In conjunction with it there was much to be said about the Libido and its development, and something about that of the Ego. You were already prepared by the preliminary lectures for the main principles of our method and for the broad aspects involved in the conceptions of the Unconscious and of repression (resistance). In one of the following lectures you will learn at what point the work of psycho-analysis finds its organic continuation. So far I have not concealed from you that all our results proceed from the study of one single group only of nervous disorders—namely, the transference neuroses; and even so I have traced out the mechanism of symptom-formation only in the hysterical neurosis. Though you will probably have gained no very thorough knowledge and have not retained every detail, yet I hope that you have acquired a general idea of the means with which psycho-analysis works, the problems it has to deal with, and the results it has to offer.

I have ascribed to you a wish that I had begun the subject of the neuroses with a description of the neurotic’s behaviour, and of the ways in which he suffers from his disorder, protects himself against it, and adapts himself to it. This is certainly a very interesting subject, well worth studying, and not difficult to treat; nevertheless there are reasons against beginning with this aspect. The danger is that the Unconscious will be overlooked, the great importance of the Libido ignored, and that everything will be judged as it appears to the patient’s own Ego. Now it is obvious that his Ego is not a reliable and impartial authority. The Ego is after all the force which denies the existence of the Unconscious and has subjected it to repressions; how then can we trust its good faith where the Unconscious is concerned? That which has been repressed consists first and foremost of the repudiated claims of the sexuality; it is perfectly self-evident that we shall never learn their extent and their significance from the Ego’s view of the matter. As soon as the nature of repression begins to dawn upon us we are advised not to allow one of the two contending parties, and certainly not the victorious one, to be judge in the dispute. We are forewarned against being misled by what the Ego tells us. According to its evidence it would appear to have been the active force throughout, so that the symptoms arise by its will and agency; we know that to a large extent it has played a passive part, a fact which it then endeavours to conceal and to gloss over. It is true that it cannot always keep up this pretence—in the symptoms of the obsessional neurosis it has to confess to being confronted by something alien which it must strenuously resist.

It is certainly plain sailing enough for anyone who does not heed these warnings against taking the falsifications of the Ego at their face-value; he will escape all the opposition which psycho-analysis has to encounter in accentuating the Unconscious, sexuality, and the passivity of the Ego. He can agree with Alfred Adler that the “nervous character” is the cause of the neurosis, instead of the result; but he will not be in a position to account for a single detail of symptom-formation or a single dream.

You will ask: May it not be possible to do justice to the part played by the Ego in nervousness and in symptom-formation without absolutely glaring neglect of the other factors discovered by psycho-analysis? I reply: Certainly it must be possible, and some time or other it will be done; but the work which lies at hand for psycho-analysis is not suited for a beginning at this end. One can, no doubt, predict the point at which this task also will be included. There are neuroses, called by us the narcissistic neuroses, in which the Ego is far more deeply involved than in those we have studied; analytic investigation of these disorders will enable us to estimate impartially and reliably the share taken by the Ego in neurotic disease.

One of the relations the Ego bears to its neurosis is, however, so conspicuous that it was quite appreciable from the beginning. It never seems to be absent; but it is most clearly discernible in a form of disorder which we are far from understanding, the traumatic neurosis. You must know that in the causation and mechanism of all the various different forms of neurosis the same factors are found at work over and over again, only that in one type this factor and in another type that factor is of greatest significance in symptom-formation. It is just the same as with the personnel of a theatrical company, where every member plays a special type of part—hero, confidant, villain, etc; each of them will choose a different piece for his own benefit-performance. Hence, the phantasies which are transformed into the symptoms are nowhere so manifest as in hysteria; the ‘counter-charges’ or reaction-formations of the Ego dominate the picture in the obsessional neurosis; the mechanism which in dreams we called ‘secondary elaboration’ is the prominent feature in the delusions of paranoia, and so on.

In the traumatic neuroses, especially in those arising from the terrors of war, we are particularly impressed by a self-seeking, egoistic motive, a straining towards protection and self-interest; this alone perhaps could not produce the disease, but it gives its support to the latter and maintains it once it has been formed. This tendency aims at protecting the Ego from the dangers which led by their imminence to the outbreak of illness; nor does it permit of recovery until a repetition of the dangers appear to be no longer possible, or until some gain in compensation for the danger undergone has been received.

The Ego takes a similar interest in the origin and maintenance of all the other forms of neurosis; we have said already that the symptom is supported by the Ego because one side of it offers a satisfaction to the repressing Ego-tendency. More than this, a solution of the conflict by a symptom-formation is the most convenient one, most in accordance with the pleasure-principle; for it undoubtedly spares the Ego a severe and painful piece of internal labour. There are indeed cases in which the physician himself must admit that the solution of a conflict by a neurosis is the one most harmless and most tolerable socially. Do not be astonished to hear then that the physician himself occasionally takes sides with the illness which he is attacking. It is not for him to confine himself in all situations in life to the part of fanatic about health; he knows that there is other misery in the world besides neurotic misery—real unavoidable suffering—that necessity may even demand of a man that he sacrifice his health to it, and he learns that such suffering in one individual may often avert incalculable hardship for many others. Therefore, although it may be said of every neurotic that he has taken ‘flight into illness,’ it must be admitted that in many cases this flight is fully justified, and the physician who has perceived this state of things will silently and considerately retire.

But let us continue our discussion without regard to these exceptional cases. In the ordinary way it is apparent that by flight into neurosis the Ego gains a certain internal ‘advantage through illness,’ as we call it; under certain conditions a tangible external advantage, more or less valuable in reality, may be combined with this. To take the commonest case of this kind: a woman who is brutally treated and mercilessly exploited by her husband fairly regularly takes refuge in a neurosis, if her disposition admits of it. This will happen if she is too cowardly or too conventional to console herself secretly with another man, if she is not strong enough to defy all external reasons against it and separate from her husband, if she has no prospect of being able to maintain herself or of finding a better husband, and last of all, if she is still strongly attached sexually to this brutal man. Her illness becomes her weapon in the struggle against him, one that she can use for her protection, or misuse for purposes of revenge. She can complain of her illness, though she probably dare not complain of her marriage; her doctor is her ally; the husband who is otherwise so ruthless is required to spare her, to spend money on her, to grant her absence from home and thus some freedom from marital oppression. Whenever this external or ‘accidental’ advantage through illness is at all pronounced, and no substitute for it can be found in reality, you need not look forward very hopefully to influencing the neurosis by your therapy.

You will now say that what I have just told you about the ‘advantage through illness’ is all in favour of the view I have rejected, namely, that the Ego itself desires the neurosis and creates it. But just a moment! Perhaps it means merely this: that the Ego is pleased to accept the neurosis which it is in any case unable to prevent, and that if there is anything at all to be made out of it it makes the best of it. This is only one side of the matter. In so far as there is advantage in it the Ego is quite happy to be on good terms with a neurosis, but there are also disadvantages to be considered. As a rule it is soon apparent that by accepting a neurosis the Ego has made a bad bargain. It has paid too heavily for the solution of the conflict; the sufferings entailed by the symptoms are perhaps as bad as those of the conflict they replace, and they may quite probably be very much worse. The Ego wishes to be rid of the pain of the symptoms, but not to give up its advantage through illness; and that is just what it cannot succeed in doing. It appears therefore that the Ego was not quite so actively concerned in the matter throughout as it had thought, and we will keep this well in mind.

If, as physicians, you have much to do with neurotics, you will soon cease to expect that those who complain most bitterly of their illness will be most ready to accept your help and make least difficulty—quite the contrary. You will at all events easily understand that everything which contributes to the advantage through illness reinforces the resistance arising from the repressions, and increases the therapeutic difficulties. And there is yet another kind of advantage through illness, one which supervenes later than that born with the symptom, so to speak. When such a mental organization as the disease has persisted for a considerable time it seems finally to acquire the character of an independent entity; it displays something like a self-preservative instinct; it forms a kind of pact, a modus vivendi, with the other forces in mental life, even with those fundamentally hostile to it, and opportunities can hardly fail to arise in which it once more manifests itself as useful and expedient, thus acquiring a secondary function which again strengthens its position. Instead of taking an example from pathology let us consider a striking illustration in everyday life. A capable working-man earning his living is crippled by an accident in the course of his employment; he can work no more, but he gets a small periodical dole in compensation and learns how to exploit his mutilation as a beggar. His new life, although so inferior, nevertheless is supported by the very thing which destroyed his old life; if you were to remove his disability you would deprive him for a time of his means of subsistence, for the question would arise whether he would still be capable of resuming his former work. When a secondary exploitation of the illness such as this is formed in a neurosis we can range it alongside the first and call it a ‘secondary advantage through illness.’

I should like to advise you in a general way not to underestimate the practical importance of the advantage through illness, and yet not to be too much impressed by its theoretical significance. Apart from the exceptions previously recognized, this factor always reminds one of the illustrations of “Intelligence in Animals” by Oberländer in Fliegende Blätter. An Arab is riding a camel along a narrow path cut in the side of a steep mountain. At a turn in the path he suddenly finds himself confronted by a lion ready to spring at him. There is no escape; on one side the abyss, on the other the precipice; retreat and flight are impossible; he gives himself up for lost. Not so the camel. He takes one leap with his rider into the abyss—and the lion is left a spectator. The remedies provided by neurosis avail the patient no better as a rule; perhaps because the solution of the conflict by a symptom-formation is after all an automatic process which may show itself inadequate to meet the demands of life, and involves man in a renunciation of his best and highest powers. The more honourable choice, if there be a choice, is to go down in fair fight with destiny.

I still owe you a further explanation of my motive in not taking ordinary nervousness as my starting-point. Perhaps you think I avoided doing so because it would have been more difficult to bring in evidence of the sexual origin of the neuroses in that way; but in this you would be mistaken. In the transference neuroses the symptoms have to be submitted to interpretation before we arrive at this; but in the ordinary forms of what are called the ACTUAL NEUROSES the ætiological significance of the sexual life is a crudely obvious fact which courts notice. I became aware of it more than twenty years ago, as one day I began to wonder why, when we examine nervous patients, we so invariably exclude from consideration all matters concerning their sexual life. Investigations on this point led to the sacrifice of my popularity with my patients, but in a very short time my efforts had brought me to this conclusion: that no neurosis—actual neurosis, I meant—is present where sexual life is normal. It is true that this statement ignores the individual differences in people rather too much, and it also suffers from the indefinite connotation inseparable from the word “normal”; but as a broad outline it has retained its value to this day. At that time I got so far as to be able to establish particular connections between certain forms of nervousness and certain injurious sexual conditions; I do not doubt that I could repeat these observations to-day if I still had similar material for investigation. I noticed often enough that a man who contented himself with some kind of incomplete sexual satisfaction, e.g. with manual masturbation, would suffer from a definite type of actual neurosis, and that this neurosis would promptly give way to another form if he adopted some other equally unsatisfactory form of sexual life. I was then in a position to infer the change in his mode of sexual life from the alteration in the patient’s condition; and I learnt to abide stubbornly by my conclusions until I had overcome the prevarications of my patients and had compelled them to give me confirmation. It is true that they then thought it advisable to seek other physicians who would not take so much interest in their sexual life.

It did not escape me at that time either that sexuality was not always indicated as the cause of a neurosis; one person certainly would fall ill because of some injurious sexual condition, but another because he had lost his fortune or recently sustained a severe organic illness. The explanation of these variations was revealed later, when insight was obtained into the interrelationships suspected between the Ego and the Libido; and the further this subject was explored the more satisfactory became our insight into it. A person only falls ill of a neurosis when the Ego loses its capacity to deal in some way or other with the Libido. The stronger the Ego the more easily can it accomplish this task; every weakening of the Ego, from whatever cause, must have the same effect as an increase in the demands of the Libido; that is, make a neurosis possible. There are yet other and more intimate relations between the Ego and the Libido, which I shall not go into now as we have not yet come to them in the course of our discussions. The most essential and most instructive point for us is that the fund of energy supporting the symptoms of a neurosis, in every case and regardless of the circumstances inducing their outbreak, is provided by the Libido, which is thus put to an abnormal use.

Now I must point out to you the decisive difference between the symptoms of the actual neuroses and those of the psychoneuroses, with the first group of which (the transference neuroses) we have hitherto been so much occupied. In both the actual neuroses and the psychoneuroses the symptoms proceed from the Libido; that is, they are abnormal ways of using it, substitutes for satisfaction of it. But the symptoms of an actual neurosis—headache, sensation of pain, an irritable condition of some organ, the weakening or inhibition of some function—have no ‘meaning,’ no signification in the mind. Not merely are they manifested principally in the body, as also happens, for instance with hysterical symptoms, but they are in themselves purely and simply physical processes; they arise without any of the complicated mental mechanisms we have been learning about. They really are, therefore, what psychoneurotic symptoms were for so long held to be. But then, how can they be expressions of the Libido which we have come to know as a force at work in the mind? Now, really, the answer to that is very simple. Let me resurrect one of the very first objections ever made against psycho-analysis. It was said that the theories were an attempt to account for neurotic symptoms by psychology alone and that the outlook was consequently hopeless, since no illness could ever be accounted for by psychological theories. These critics were pleased to forget that the sexual function is not a purely mental thing, any more than it is merely a physical thing. It affects bodily life as well as mental life. Having learnt that the symptoms of the psychoneuroses express the mental consequences of some disturbance in this function, we shall not be surprised to find that the actual neuroses represent the direct somatic consequences of sexual disturbances.

Clinical medicine gives us a useful hint (recognized by many different investigators) towards comprehension of the actual neuroses. In the details of their symptomatology, and also in the peculiarity by which all the bodily systems and functions are affected together, they exhibit an unmistakable similarity with pathological conditions resulting from the chronic effect or the sudden removal of foreign toxins—i.e. with states of intoxication or of abstinence. The two groups of affections are brought still closer together by comparison with conditions like Basedow’s disease49 that have also been found to result from poisoning, not, however, from poisons derived externally, but from such as arise in the internal metabolism. In my opinion these analogies necessitate our regarding the neuroses as the effects of disturbances in the sexual metabolism, due either to more of these sexual toxins being produced than the person can dispose of, or else to internal and even mental conditions which interfere with the proper disposal of these substances. Assumptions of this kind about the nature of sexual desire have found acceptance in the mind of the people since the beginning of time; love is called an “intoxication,” it can be induced by “potions”—in these ideas the agency at work is to some extent projected on to the outer world. We find occasion at this point to remember the erotogenic zones, and to reflect upon the proposition that sexual excitation may arise in the most various organs. Beyond this the subject of ‘sexual metabolism’ or the ‘chemistry of sexuality’ is an empty chapter: we know nothing about it, and cannot even determine whether to assume two kinds of sexual substances, to be called ‘male’ and ‘female,’ or to content ourselves with one sexual toxin as the agent of all the stimuli effected by the Libido. The edifice of psycho-analytic doctrine which we have erected is in reality but a superstructure, which will have to be set on its organic foundation at some time or other; but this foundation is still unknown to us.

As a science psycho-analysis is characterized by the methods with which it works, not by the subject-matter with which it deals. These methods can be applied without violating their essential nature to the history of civilization, to the science of religion, and to mythology as well as to the study of the neuroses. Psycho-Analysis aims at and achieves nothing more than the discovery of the unconscious in mental life. The problems of the actual neuroses, in which the symptoms probably arise through direct toxic injury, offer no point of attack for psycho-analysis; it can supply little towards elucidation of them and must leave this task to biological and medical research. Now perhaps you understand better why I chose this arrangement of my material. If I had intended an Introduction to the Study of the Neuroses it would undoubtedly have been correct to begin with the simple forms of (actual) neuroses and proceed from them to the more complicated psychical disorders resulting from disturbances of the Libido. I should have had to collect from various quarters what we know or think we know about the former, and about the latter psycho-analysis would have been introduced as the most important technical means of obtaining insight into these conditions. An Introduction to Psycho-Analysis was what I had undertaken and announced, however; I thought it more important to give you an idea of psycho-analysis than to teach you something about the neuroses; and therefore the actual neuroses which yield nothing towards the study of psycho-analysis could not suitably be put in the foreground. I think too that my choice was the wiser for you, since the radical axioms and far-reaching connections of psycho-analysis make it worthy of every educated person’s interest; the theory of the neuroses, however, is a chapter of medicine like any other.

However, you are justified in expecting that we should take some interest in the actual neuroses; their close clinical connection with the psychoneuroses even necessitates this. I will tell you then that we distinguish three pure forms of actual neurosis: neurasthenia, anxiety-neurosis and hypochondria. Even this classification has been disputed; the terms are certainly all in use, but their connotation is vague and unsettled. There are some medical men who are opposed to all discrimination in the confusing world of neurotic manifestations, who object to any distinguishing of clinical entities or types of disease, and do not even recognize the difference between actual neuroses and psychoneuroses; in my opinion they go too far, and the direction they have chosen does not lead to progress. The three kinds of neurosis named above are occasionally found in a pure form; more frequently, it is true, they are combined with one another and with a psychoneurotic affection. This fact need not make us abandon the distinctions between them. Think of the difference between the science of minerals and that of ores in mineralogy: the minerals are classified individually, in part no doubt because they are frequently found as crystals, sharply differentiated from their surroundings; the ores consist of mixtures of minerals which have indeed coalesced, not accidentally, but according to the conditions at their formation. In the theory of the neuroses we still understand too little of the process of their development to formulate anything similar to our knowledge of ores; but we are certainly working in the right direction in first isolating from the mass the recognizable clinical elements, which are comparable to the individual minerals.

A noteworthy connection between the symptoms of the actual neuroses and the psychoneuroses adds a valuable contribution to our knowledge of symptom-formation in the latter; the symptom of the actual neurosis is frequently the nucleus and incipient stage of the psychoneurotic symptom. A connection of this kind is most clearly observable between neurasthenia and the transference neurosis known as conversion-hysteria, between the anxiety-neurosis and anxiety-hysteria, but also between hypochondria and forms of a neurosis which we shall deal with later on, namely, paraphrenia (dementia præcox and paranoia). As an example, let us take an hysterical headache or backache. Analysis shows that by means of condensation and displacement it has become a substitutive satisfaction for a whole series of libidinal phantasies or memories; at one time, however, this pain was real, a direct symptom of a sexual toxin, the bodily expression of a sexual excitation. We do not by any means maintain that all hysterical symptoms have a nucleus of this kind, but it remains true that this very often is so, and that all effects (whether normal or pathological) of the libidinal excitation upon the body are specially adapted to serve the purposes of hysterical symptom-formation. They play the part of the grain of sand which the oyster envelopes in mother-of-pearl. The temporary signs of sexual excitation accompanying the sexual act serve the psychoneurosis in the same way, as the most suitable and convenient material for symptom-formation.

There is a similar process of special diagnostic and therapeutic interest. In persons who are disposed to be neurotic without having yet developed a neurosis on a grand scale, some morbid organic condition—perhaps an inflammation, or an injury—very commonly sets the work of symptom-formation in motion; so that the latter process swiftly seizes upon the symptom supplied by reality, and uses it to represent those unconscious phantasies that have only been lying in wait for some means of expression. In such a case the physician will try first one therapy and then the other; will either endeavour to abolish the organic foundation on which the symptom rests, without troubling about the clamorous neurotic elaboration of it; or will attack the neurosis which this opportunity has brought to birth, while leaving on one side the organic stimulus which incited it. Sometimes one and sometimes the other procedure will be found justified by success; no general rules can be prescribed for mixed cases of this kind.

Twenty-Fifth Lecture — Anxiety

You will certainly have judged the information that I gave you in the last lecture about ordinary nervousness as the most fragmentary and most inadequate of all my accounts. I know that it was; and I expect that nothing surprised you more than that I made no mention of the ‘anxiety’ which most nervous people complain of and themselves describe as their most terrible burden. Anxiety or dread can really develop tremendous intensity and in consequence be the cause of the maddest precautions. But in this matter at least I wished not to cut you short; on the contrary, I had determined to put the problem of nervous anxiety to you as clearly as possible and to discuss it at some length.

Anxiety (or dread)50 itself needs no description; everyone has personally experienced this sensation, or to speak more correctly this affective condition, at some time or other. But in my opinion not enough serious consideration has been given to the question why nervous persons in particular suffer from anxiety so much more intensely, and so much more altogether, than others. Perhaps it has been taken for granted that they should; indeed, the words “nervous” and “anxious” are used interchangeably, as if they meant the same thing. This is not justifiable, however; there are anxious people who are otherwise not in any way nervous and there are, besides, neurotics with numerous symptoms who exhibit no tendency to dread.

However this may be, one thing is certain, that the problem of anxiety is a nodal point, linking up all kinds of most important questions; a riddle, of which the solution must cast a flood of light upon our whole mental life. I do not claim that I can give you a complete solution; but you will certainly expect psycho-analysis to have attacked this problem too in a different manner from that adopted by academic medicine. Interest there centres upon the anatomical processes by which the anxiety condition comes about. We learn that the medulla oblongata is stimulated, and the patient is told that he is suffering from a neurosis in the vagal nerve. The medulla oblongata is a wondrous and beauteous object; I well remember how much time and labour I devoted to the study of it years ago. But to-day I must say I know of nothing less important for the psychological comprehension of anxiety than a knowledge of the nerve-paths by which the excitations travel.

One may consider anxiety for a long time without giving a thought to nervousness. You will understand me at once when I describe this form of anxiety as Real Anxiety, in contrast to neurotic anxiety. Now real anxiety or dread appears to us a very natural and rational thing; we should call it a reaction to the perception of an external danger, of an injury which is expected and foreseen; it is bound up with the reflex of flight, and may be regarded as an expression of the instinct of self-preservation. The occasions of it, i.e. the objects and situations about which anxiety is felt, will obviously depend to a great extent upon the state of the person’s knowledge and feeling of power regarding the outer world. It seems to us quite natural that a savage should be afraid of a cannon or of an eclipse of the sun, while a white man who can handle the weapon and foretell the phenomenon remains unafraid in the same situation. At other times it is knowledge itself which inspires fear, because it reveals the danger sooner; thus a savage will recoil with terror at the sight of a track in the jungle which conveys nothing to an ignorant white man, but means that some wild beast is near at hand; and an experienced sailor will perceive with dread a little cloud on the horizon because it means an approaching hurricane, while to a passenger it looks quite insignificant.

The view that real anxiety is rational and expedient, however, will on deeper consideration be admitted to need thorough revision. In face of imminent danger the only expedient behaviour, actually, would be first a cool appraisement of the forces at disposal as compared with the magnitude of the danger at hand, and then a decision whether flight or defence, or possibly attack, offered the best prospect of a successful outcome. Dread, however, has no place in this scheme; everything to be done will be accomplished as well and probably better if dread does not develop. You will see too that when dread is excessive it becomes in the highest degree inexpedient; it paralyses every action, even that of flight. The reaction to danger usually consists in a combination of the two things, the fear-affect and the defensive action; the frightened animal is afraid and flees, but the expedient element in this is the ‘flight,’ not the ‘being afraid.’

One is tempted therefore to assert that the development of anxiety is never expedient; perhaps a closer dissection of the situation in dread will give us a better insight into it. The first thing about it is the ‘readiness’ for danger, which expresses itself in heightened sensorial perception and in motor tension. This expectant readiness is obviously advantageous; indeed, absence of it may be responsible for grave results. It is then followed on the one hand by a motor action, taking the form primarily of flight and, on a higher level, of defensive action; and on the other hand by the condition we call a sensation of ‘anxiety’ or dread. The more the development of dread is limited to a flash, to a mere signal, the less does it hinder the transition from the state of anxious readiness to that of action, and the more expediently does the whole course of events proceed. The anxious readiness therefore seems to me the expedient element, and the development of anxiety the inexpedient element, in what we call anxiety or dread.

I shall not enter upon a discussion whether the words anxiety, fear, fright, mean the same or different things in common usage. In my opinion, anxiety relates to the condition and ignores the object, whereas in the word fear attention is directed to the object; fright does actually seem to possess a special meaning—namely, it relates specifically to the condition induced when danger is unexpectedly encountered without previous anxious readiness. It might be said then that anxiety is a protection against fright.

It will not have escaped you that a certain ambiguity and indefiniteness exists in the use of the word ‘anxiety.’ It is generally understood to mean the subjective condition arising upon the perception of what we have called ‘developed’ anxiety; such a condition is called an affect. Now what is an affect, in a dynamic sense? It is certainly something very complex. An affect comprises first of all certain motor innervations or discharges; and, secondly, certain sensations, which moreover are of two kinds—namely, the perceptions of the motor actions which have been performed, and the directly pleasurable or painful sensations which give the affect what we call its dominant note. But I do not think that this description penetrates to the essence of an affect. With certain affects one seems to be able to see deeper, and to recognize that the core of it, binding the whole complex structure together, is of the nature of a repetition of some particular very significant previous experience. This experience could only have been an exceedingly early impression of a universal type, to be found in the previous history of the species rather than of the individual. In order to be better understood I might say that an affective state is constructed like an hysterical attack, i.e. is the precipitate of a reminiscence. An hysterical attack is therefore comparable to a newly-formed individual affect, and the normal affect to a universal hysteria which has become a heritage.

Do not imagine that what I am telling you now about affects is the common property of normal psychology. On the contrary, these conceptions have grown on the soil of psycho-analysis and are only indigenous there. What psychology has to say about affects—the James-Lange theory, for instance—is utterly incomprehensible to us psycho-analysts and impossible for us to discuss. We do not however regard what we know of affects as at all final; it is a first attempt to take our bearings in this obscure region. To continue, then: we believe we know what this early impression is which is reproduced as a repetition in the anxiety-affect. We think it is the experience of birth—an experience which involves just such a concatenation of painful feelings, of discharges of excitation, and of bodily sensations, as to have become a prototype for all occasions on which life is endangered, ever after to be reproduced again in us as the dread or ‘anxiety’ condition. The enormous increase in stimulation effected by the interruption of the renewal of blood (the internal respiration) was the cause of the anxiety experience at birth—the first anxiety was therefore toxically induced. The name Angst (anxiety)—angustiæ, Enge, a narrow place, a strait—accentuates the characteristic tightening in the breathing which was then the consequence of a real situation and is subsequently repeated almost invariably with an affect. It is very suggestive too that the first anxiety state arose on the occasion of the separation from the mother. We naturally believe that the disposition to reproduce this first anxiety condition has become so deeply ingrained in the organism, through countless generations, that no single individual can escape the anxiety affect; even though, like the legendary Macduff, he ‘was from his mother’s womb untimely ripped’ and so did not himself experience the act of birth. What the prototype of the anxiety condition may be for other animals than mammals we cannot say; neither do we know what the complex of sensations in them is which is equivalent to fear in us.

It may perhaps interest you to know how it was possible to arrive at such an idea as this—that birth is the source and prototype of the anxiety affect. Speculation had least of all to do with it; on the contrary, I borrowed a thought from the naïve intuitive mind of the people. Many years ago a number of young house-physicians, including myself, were sitting round a dinner-table, and one of the assistants at the obstetrical clinic was telling us all the funny stories of the last midwives’ examination. One of the candidates was asked what it meant when the meconium (child’s excreta) was present in the waters at birth, and promptly replied: “That the child is frightened.” She was ridiculed and failed. But I silently took her part and began to suspect that the poor unsophisticated woman’s unerring perception had revealed a very important connection.

Now let us turn to neurotic anxiety; what are the special manifestations and conditions found in the anxiety of nervous persons? There is a great deal to be described here. First of all, we find a general apprehensiveness in them, a ‘free-floating’ anxiety, as we call it, ready to attach itself to any thought which is at all appropriate, affecting judgements, inducing expectations, lying in wait for any opportunity to find a justification for itself. We call this condition ‘expectant dread’ or ‘anxious expectation.’ People who are tormented with this kind of anxiety always anticipate the worst of all possible outcomes, interpret every chance happening as an evil omen, and exploit every uncertainty to mean the worst. The tendency to this kind of expectation of evil is found as a character-trait in many people who cannot be described as ill in any other way, and we call them ‘overanxious’ or pessimistic; but a marked degree of expectant dread is an invariable accompaniment of the nervous disorder which I have called anxiety-neurosis and include among the actual neuroses.

In contrast to this type of anxiety, a second form of it is found to be much more circumscribed in the mind, and attached to definite objects and situations. This is the anxiety of the extraordinarily various and often very peculiar phobias. Stanley Hall, the distinguished American psychologist, has recently taken the trouble to designate a whole series of these phobias by gorgeous Greek titles; they sound like the ten plagues of Egypt, except that there are far more than ten of them. Just listen to the things that can become the object or content of a phobia: darkness, open air, open spaces, cats, spiders, caterpillars, snakes, mice, thunder, sharp points, blood, enclosed places, crowds, loneliness, crossing bridges, travelling by land or sea, and so on. As a first attempt to take one’s bearings in this chaos we may divide them into three groups. Many of the objects and situations feared are rather sinister, even to us normal people, they have some connection with danger; and these phobias are not entirely incomprehensible to us, although their intensity seems very much exaggerated. Most of us, for instance, have a feeling of repulsion upon encountering a snake. It may be said that the snake-phobia is universal in mankind. Charles Darwin has described most vividly how he could not control his dread of a snake that darted at him, although he knew that he was protected from it by a thick plate of glass. The second group consists of situations that still have some relation to danger, but to one that is usually belittled or not emphasized by us; most situation-phobias belong to this group. We know that there is more chance of meeting with a disaster in a railway train than at home—namely, a collision; we also know that a ship may sink, whereupon it is usual to be drowned; but we do not brood upon these dangers and we travel without anxiety by train and boat. Nor can it be denied that if a bridge were to break at the moment we were crossing it we should be hurled into the torrent, but that only happens so very occasionally that it is not a danger worth considering. Solitude too has its dangers, which in certain circumstances we avoid, but there is no question of never being able to endure it for a moment under any conditions. The same thing applies to crowds, enclosed spaces, thunderstorms, and so on. What is foreign to us in these phobias is not so much their content as their intensity. The anxiety accompanying a phobia is positively indescribable! And we sometimes get the impression that neurotics are not really at all fearful of those things which can, under certain conditions, arouse anxiety in us and which they call by the same names.

There remains a third group which is entirely unintelligible to us. When a strong full-grown man is afraid to cross a street or square in his own so familiar town, or when a healthy well-developed woman becomes almost senseless with fear because a cat has brushed against her dress or a mouse has scurried through the room, how can we see the connection with danger which is obviously present to these people? With this kind of animal-phobia it is no question of an increased intensity of common human antipathies; to prove the contrary, there are numbers of people who, for instance, cannot pass a cat without attracting and petting it. A mouse is a thing that so many women are afraid of, and yet it is at the same time a very favourite pet name;51 many a girl who is delighted to be called so by her lover will scream with terror at the sight of the dainty little creature itself. The behaviour of the man who is afraid to cross streets and squares only suggests one thing to us—that he behaves like a little child. A child is directly taught that such situations are dangerous, and the man’s anxiety too is allayed when he is led by someone across the open space.

The two forms of anxiety described, the ‘free-floating’ expectant dread and that attached to phobias, are independent of each other. The one is not the other at a further stage; they are only rarely combined, and then as if fortuitously. The most intense general apprehensiveness does not necessarily lead to a phobia; people who have been hampered all their lives by agoraphobia may be quite free from pessimistic expectant dread. Many phobias, e.g. fear of open spaces, of railway travelling, are demonstrably acquired first in later life; others, such as fear of darkness, thunder, animals, seem to have existed from the beginning. The former signify serious illness, the latter are more of the nature of idiosyncrasies, peculiarities; anyone exhibiting one of these latter may be suspected of harbouring others similar to it. I must add that we group all these phobias under anxiety-hysteria, that is, we regard them as closely allied to the well-known disorder called conversion-hysteria.

The third form taken by neurotic anxiety brings us to an enigma; there is no visible connection at all between the anxiety and the danger dreaded. This anxiety occurs in hysteria, for instance, accompanying the hysterical symptoms; or under various conditions of excitement in which, it is true, we should expect some affect to be displayed, but least of all an anxiety-affect; or without reference to any conditions, incomprehensible both to us and to the patient, an unrelated anxiety-attack. We may look far and wide without discovering a danger or an occasion which could even be exaggerated to account for it. These spontaneous attacks show therefore that the complex condition which we describe as anxiety can be split up into components. The whole attack can be represented (as a substitute) by a single intensively developed symptom—shuddering, faintness, palpitation of the heart, inability to breathe—and the general feeling which we recognize as anxiety may be absent or may have become unnoticeable. And yet these states which are termed ‘anxiety-equivalents’ have the same clinical and ætiological validity as anxiety itself.

Two questions arise now: Is it possible to bring neurotic anxiety, in which such a small part or none at all is played by danger, into relation with ‘real anxiety,’ which is essentially a reaction to danger? And, how is neurotic anxiety to be understood? We will at present hold fast to the expectation that where there is anxiety there must be something of which one is afraid.

Clinical observation yields various clues to the comprehension of neurotic anxiety, and I will now discuss their significance with you.

(a) It is not difficult to see that expectant dread or general apprehensiveness stands in intimate relation to certain processes in the sexual life—let us say, to certain modes of Libido-utilization. The simplest and most instructive case of this kind arises in people who expose themselves to what is called frustrated excitation, i.e. when a powerful sexual excitation experiences insufficient discharge and is not carried on to a satisfying termination. This occurs, for instance, in men during the time of an engagement to marry, and in women whose husbands are not sufficiently potent, or who perform the sexual act too rapidly or incompletely with a view to preventing conception. Under these conditions the libidinal excitation disappears and anxiety appears in place of it, both in the form of expectant dread and in that of attacks and anxiety-equivalents. The precautionary measure of coitus interruptus, when practised as a customary sexual régime, is so regularly the cause of anxiety-neurosis in men, and even more so in women, that medical practitioners would be wise to enquire first of all into the possibility of such an ætiology in all such cases. Innumerable examples show that the anxiety-neurosis vanishes when the sexual malpractice is given up.

So far as I know, the fact that a connection exists between sexual restraint and anxiety conditions is no longer disputed, even by physicians who hold aloof from psycho-analysis. Nevertheless I can well imagine that they do not neglect to invert the connection, and to put forward the view that such persons are predisposed to apprehensiveness and consequently practise caution in sexual matters. Against this, however, decisive evidence is found in the reactions in women, in whom the sexual function is essentially passive, so that its course is determined by the treatment accorded by the man. The more ‘temperament,’ i.e. the more inclination for sexual intercourse and capacity for satisfaction, a woman has, the more certainly will she react with anxiety manifestations to the man’s impotence or to coitus interruptus; whereas such abuse entails far less serious results with anæsthetic women or those in whom the sexual hunger is less strong.

Sexual abstinence, which is nowadays so warmly recommended by physicians, of course only has the same significance for anxiety conditions when the Libido which is denied a satisfactory outlet is correspondingly insistent, and is not being utilized to a large extent in sublimation. Whether or not illness will ensue is indeed always a matter of the quantitative factor. Even apart from illness, it is easy to see in the sphere of character-formation that sexual restraint goes hand in hand with a certain anxiousness and cautiousness, whereas fearlessness and a boldly adventurous spirit bring with them a free tolerance of sexual needs. However these relations may be altered and complicated by the manifold influences of civilization, it remains incontestible that for the average human being anxiety is closely connected with sexual limitation.

I have by no means told you all the observations which point to this genetic connection between Libido and anxiety. There is, for instance, the effect upon anxiety states of certain periods of life, such as puberty and the menopause, in which the production of Libido is considerably augmented. In many states of excitement too, the mingling of sexual excitation with anxiety may be directly observed, as well as the final replacement of the libidinal excitation by anxiety. The impression received from all this is a double one; first, that it is a matter of an accumulation of Libido, debarred from its normal utilization; and secondly, that the question is one of somatic processes only. How anxiety develops out of sexual desire is at present obscure; we can only ascertain that desire is lacking and anxiety is found in its place.

(b) A second clue is obtained from analysis of the psychoneuroses, in particular, of hysteria. We have heard that anxiety frequently accompanies the symptoms in this disease, and that unattached anxiety may also be chronically present or come to expression in attacks. The patients cannot say what it is they fear; they link it up by unmistakable secondary elaboration to the most convenient phobias: of dying, of going mad, of having a stroke, etc. When we subject to analysis the situation in which the anxiety, or the symptom accompanied by anxiety, arose, we can as a rule discover what normal mental process has been checked in its course and replaced by a manifestation of anxiety. To express it differently: we construe the unconscious process as though it had not undergone repression and had gone through unhindered into consciousness. This process would have been accompanied by a particular affect and now we discover, to our astonishment, that this affect, which would normally accompany the mental process through into consciousness, is in every case replaced by anxiety, no matter what particular type it had previously been. So that when we have a hysterical anxiety condition before us, its unconscious correlative may be an excitation of a similar character, such as apprehension, shame, embarrassment; or quite as possibly a ‘positive’ libidinal excitation; or an antagonistic, aggressive one, such as rage or anger. Anxiety is thus general current coin for which all the affects are exchanged, or can be exchanged, when the corresponding ideational content is under repression.

(c) A third observation is provided by patients whose symptoms take the form of obsessive acts, and who seem to be remarkably immune from anxiety. When we restrain them from carrying out their obsessive performances, their washing, their ceremonies, etc., or when they themselves venture an attempt to abandon one of their compulsions, they are forced by an appalling dread to yield to the compulsion and to carry out the act. We perceive that the anxiety was concealed under the obsessive act and that this is only performed to escape the feeling of dread. In the obsessional neurosis, therefore, the anxiety which would otherwise ensue is replaced by the symptom-formation; and when we turn to hysteria we find a similar relation existing—as a consequence of the process of repression either a pure developed anxiety, or anxiety with symptom-formation, or, symptom-formation without anxiety. In an abstract sense, therefore, it seems correct to say that symptoms altogether are formed purely for the purpose of escaping the otherwise inevitable development of anxiety. Thus anxiety comes to the forefront of our interest in the problems of the neuroses.

We concluded from our observations on the anxiety-neurosis that the diversion of the Libido away from its normal form of utilization, a diversion which releases anxiety, took place on the basis of somatic processes. The analyses of hysterical and obsessional neuroses furnish the additional conclusion that a similar diversion with a similar result can follow from opposition on the part of psychical agents (Instanzen). We know as much as this, therefore, about the origin of neurotic anxiety; it still sounds rather indefinite. But for the moment I know of no path which will take us further. The second task we undertook, that of establishing a connection between neurotic anxiety (abnormally utilized Libido) and ‘real anxiety’ (which corresponds with the reaction to danger), seems even more difficult to accomplish. One would think there could be no comparison between the two things, and yet there are no means by which the sensations of neurotic anxiety can be distinguished from those of real anxiety.

The desired connection may be found with the help of the antithesis, so often put forward, between the Ego and the Libido. As we know, the development of anxiety is the reaction of the Ego to danger and the signal preparatory to flight; it is then not a great step to imagine that in neurotic anxiety also the Ego is attempting a flight, from the demands of its Libido, and is treating this internal danger as if it were an external one. Then our expectation, that where anxiety is present there must be something of which one is afraid, would be fulfilled. The analogy goes further than this, however. Just as the tension prompting the attempt to flee from external danger is resolved into holding one’s ground and taking appropriate defensive measures, so the development of neurotic anxiety yields to a symptom-formation, which enables the anxiety to be ‘bound.’

Our difficulty in comprehension now lies elsewhere. The anxiety which signifies the flight of the Ego from its Libido is nevertheless supposed to have had its source in that Libido. This is obscure, and we are warned not to forget that the Libido of a given person is fundamentally part of that person and cannot be contrasted with him as if it were something external. It is the question of the topographical dynamics of anxiety-development that is still obscure to us—what kind of mental energies are being expended and to what systems do they belong? I cannot promise you to answer this question also; but we will not neglect to follow up two other clues, and in so doing will again summon direct observation and analytic investigation to aid our speculation. We will turn to the sources of anxiety in children, and to the origin of the neurotic anxiety which is attached to phobias.

Apprehensiveness is very common among children, and it is difficult enough to decide whether it is real or neurotic anxiety. Indeed the very value of this distinction is called in question by the attitude of children themselves. For on the one hand we are not surprised that children are afraid of strangers, of strange objects and situations, and we account for this reaction to ourselves very easily by reflecting on their weakness and ignorance. Thus we ascribe to the child a strong tendency to real anxiety and should regard it as only practical if this apprehensiveness had been transmitted by inheritance. The child would only be repeating the behaviour of prehistoric man and of primitive man to-day who, in consequence of his ignorance and helplessness, experiences a dread of anything new and strange, and of much that is familiar to him, none of which any longer inspires fear in us. It would also correspond to our expectations if the phobias of children were at least in part such as might be attributed to those primeval periods of human development.

On the other hand, it cannot be overlooked that children are not all equally apprehensive, and that the very children who are more than usually timid in the face of all kinds of objects and situations are just those who later on become neurotic. The neurotic disposition is therefore betrayed, amongst other signs, by a marked tendency to real anxiety; apprehensiveness rather than nervousness appears to be primary; and we arrive at the conclusion that the child, and later the adult, experiences a dread of the strength of his Libido, simply because he is afraid of everything. The derivation of anxiety from the Libido itself would then be discarded; and investigation of the conditions of real anxiety would logically lead to the view that the consciousness of personal weakness and helplessness—inferiority, as A. Adler calls it—when it is able to maintain itself into later life is the final cause of neurosis.

This sounds so simple and plausible that it has a claim on our attention. It is true that it would involve shifting the point of view from which we regard the problem of nervousness. That such feelings of inferiority do persist into later life—together with a disposition to anxiety and symptom-formation—seems so well established that much more explanation is required when, in an exceptional case, what we call ‘health’ is the outcome. But what can be learnt from the close observation of apprehensiveness in children? The small child is first of all afraid of strange people; situations become important only on account of the people concerned in them, and objects always much later. But the child is not afraid of these strange people because he attributes evil intentions to them, comparing their strength with his weakness, and thus recognizing in them a danger to his existence, his safety, and his freedom from pain. Such a conception of a child, so suspicious and terrified of an overpowering aggressivity in the world, is a very poor sort of theoretical construction. On the contrary, the child starts back in fright from a strange figure because he is used to—and therefore expects—a beloved and familiar figure, primarily his mother. It is his disappointment and longing which are transformed into dread—his Libido, unable to be expended, and at that time not to be held suspended, is discharged through being converted into dread. It can hardly be a coincidence too that in this situation, which is the prototype of childish anxiety, the condition of the primary anxiety state during birth, a separation from the mother, is again reproduced.

The first phobias of situations in children concern darkness and loneliness; the former is often retained throughout life; common to both is the desire for the absent attendant, for the mother, therefore. I once heard a child who was afraid of the darkness call out: “Auntie, talk to me, I’m frightened.” “But what good will that do? You can’t see me;” to which the child replied: “If someone talks, it gets lighter.” The longing felt in the darkness is thus transformed into fear of the darkness. Far from finding that neurotic anxiety is only secondary and a special case of real anxiety, we see on the contrary that there is something in the small child which behaves like real anxiety and has an essential feature in common with neurotic anxiety—namely, origin in undischarged Libido. Of genuine ‘real anxiety’ the child seems to bring very little into the world. In all those situations which can become the conditions of phobias later, on heights, on narrow bridges over water, in trains and boats, the small child shows no fear—the less it knows the less it fears. It is much to be wished that it had inherited more of these life-preserving instincts; the task of looking after it and preventing it from exposing itself to one danger after another would have been very much lightened. Actually, you see, a child overestimates his powers, to begin with, and behaves without fear because he does not recognize dangers. He will run along the edge of the water, climb upon the window-sill, play with sharp things and with fire, in short, do anything that injures him and alarms his attendants. Since he cannot be allowed to learn it himself through bitter experience, it is entirely due to training that real anxiety does eventually awake in him.

Now if some children embrace this training in apprehensiveness very readily, and then find for themselves dangers which they have not been warned against, it is explicable on the ground that these children have inherently a greater amount of libidinal need in their constitution than others, or else that they have been spoiled early with libidinal gratifications. It is no wonder if those who later become nervous also belong to this type as children; we know that the most favourable circumstance for the development of a neurosis lies in the inability to tolerate a considerable degree of pent-up Libido for any length of time. You will observe now that here the constitutional factor, which we have never denied, comes into its own. We protest only when others emphasize it to the exclusion of all other claims, and when they introduce the constitutional factor even where according to the unanimous findings both of observation and of analysis, it does not belong, or only plays a minor part.

Let us sum up the conclusions drawn from the observation of apprehensiveness in children: Infantile dread has very little to do with real anxiety (dread of real danger), but is, on the other hand, closely allied to the neurotic anxiety of adults. It is derived like the latter from undischarged Libido, and it substitutes some other external object or some situation for the love-object which it misses.

Now you will be glad to hear that the analysis of phobias has little more to teach us than we have learnt already. The same thing happens in them as in the anxiety of children; Libido that cannot be discharged is continuously being converted into an apparently ‘real’ anxiety, and so an insignificant external danger is taken as a representative of what the Libido desires. The agreement between the two forms of anxiety is not surprising; for infantile phobias are not merely prototypes of those which appear later in anxiety-hysteria, but they are a direct preliminary condition and prelude of them. Every hysterical phobia can be traced back to a childish dread, of which it is a continuation, even if it has a different content and must be called by a different name. The difference between the two conditions lies in their mechanism. In order that the Libido should be converted into anxiety in the adult it is no longer sufficient that the Libido should be momentarily unable to be utilized. The adult has long since learned to maintain such Libido suspended, or to apply it in different ways. But, when the Libido is attached to a mental excitation which has undergone repression, conditions similar to those in the child, in whom there is not yet any distinction between conscious and unconscious, are re-established; and by a regression to the infantile phobia a bridge, so to speak, is provided by which the conversion of Libido into anxiety can be conveniently effected. As you will remember, we have treated repression at some length, but in so doing we have been concerned exclusively with the fate of the idea to be repressed; naturally, because this was easier to recognize and to present. But we have so far ignored the question of what happened to the affect attached to this idea, and now we learn for the first time that it is the immediate fate of the affect to be converted into anxiety, no matter what quality of affect it would otherwise have been had it run a normal course. This transformation of affect is, moreover, by far the more important effect of the process of repression. It is not so easy to present to you; for we cannot maintain the existence of unconscious affects in the same sense as that of unconscious ideas. An idea remains up to a point the same, whether it is conscious or unconscious; we can indicate something that corresponds to an unconscious idea. But an affect is a process involving a discharge of energy, and it is to be regarded quite differently from an idea; without searching examination and clarification of our hypotheses concerning mental processes, we cannot tell what corresponds with it in the Unconscious—and that cannot be undertaken here. However, we will preserve the impression we have gained, that the development of anxiety is closely connected with the unconscious system.

I said that conversion into anxiety, or better, discharge in the form of anxiety, was the immediate fate of Libido which encounters repression; I must add that it is not the only or the final fate of it. In the neuroses, processes take place which are intended to prevent the development of anxiety, and which succeed in so doing by various means. In the phobias, for instance, two stages in the neurotic process are clearly discernible. The first effects the repressions and conversion of the Libido into anxiety, which is then attached to some external danger. The second consists in building up all those precautions and safeguards by which all contact with this externalized danger shall be avoided. Repression is an attempt at flight on the part of the Ego from the Libido which it feels to be dangerous; the phobia may be compared to a fortification against the outer danger which now stands for the dreaded Libido. The weakness of this defensive system in the phobias is of course that the fortress which is so well guarded from without remains exposed to danger from within; projection externally of danger from Libido can never be a very successful measure. In the other neuroses, therefore, other defensive systems are employed against the possibility of the development of anxiety; this is a very interesting part of the psychology of the neuroses. Unfortunately it would take us too far afield and also it would require a thorough grounding in special knowledge of the subject. I will merely add this. I have already spoken of the ‘counter-charges’ that are instituted by the Ego upon repression, which must be maintained so that the repression can persist. It is the task of this counter-charge to carry out the various forms of defence against the development of anxiety after repression.

To return to the phobias: I may now hope that you realize how inadequate it is to attempt merely to explain their content, and to take no interest in them apart from their derivation—this or that object or situation which has been made into a phobia. The content of the phobia has an importance comparable to that of the manifest dream—it is a façade. With all due modifications, it is to be admitted that among the contents of the various phobias many are found which, as Stanley Hall points out, are specially suited by phylogenetic inheritance to become objects of dread. It is even in agreement with this that many of these dreaded things have no connection with danger, except through a symbolic relation to it.

Thus we are convinced of the quite central position which the problem of anxiety fills in the psychology of the neuroses. We have received a strong impression of how the development of anxiety is bound up with the fate of the Libido and with the unconscious system. There is only one unconnected thread, only one gap in our structure, the fact, which after all can hardly be disputed, that ‘real anxiety’ must be regarded as an expression of the Ego’s instinct for self-preservation.

Twenty-Sixth Lecture — The Theory of the Libido: Narcissism

We have repeatedly, and again quite recently, referred to the distinction between the sexual and the Ego-instincts. First of all, repression showed how they can oppose each other, how the sexual instincts are then apparently brought to submission, and required to procure their satisfaction by circuitous regressive paths, where in their impregnability they obtain compensation for their defeat. Then it appeared that from the outset they each have a different relation to the task-mistress Necessity, so that their developments are different and they acquire different attitudes to the reality-principle. Finally we believe we can observe that the sexual instincts are connected by much closer ties with the affective state of anxiety than are the Ego-instincts—a conclusion which in one important point only still seems incomplete. In support of it we may bring forward the further remarkable fact that want of satisfaction of hunger or thirst, the two most elemental of the self-preservative instincts, never results in conversion of them into anxiety, whereas the conversion of unsatisfied Libido into anxiety is, as we have heard, a very well-known and frequently-observed phenomenon.

Our justification for distinguishing between sexual and Ego-instincts can surely not be contested; it is indeed assumed by the existence of the sexual instinct as a special activity in the individual. The only question is what significance is to be attached to this distinction, how radical and decisive we intend to consider it. The answer to this depends upon what we can ascertain about the extent to which the sexual instincts, both in their bodily and their mental manifestations, conduct themselves differently from the other instincts which we set against them; and how important the results arising from these differences are found to be. We have of course no motive for maintaining any difference in the fundamental nature of the two groups of instincts, and, by the way, it would be difficult to apprehend any. They both present themselves to us merely as descriptions of the sources of energy in the individual, and the discussion whether fundamentally they are one, or essentially different, and if one, when they became separated from each other, cannot be carried through on the basis of these concepts alone, but must be grounded on the biological facts underlying them. At present we know too little about this, and even if we knew more it would not be relevant to the task of psycho-analysis.

We should clearly also profit very little by emphasizing the primordial unity of all the instincts, as Jung has done, and describing all the energies which flow from them as ‘Libido.’ We should then be compelled to speak of sexual and asexual Libido, since the sexual function is not to be eliminated from the field of mental life by any such device. The name Libido, however, remains properly reserved for the instinctive forces of the sexual life, as we have hitherto employed it.

In my opinion, therefore, the question how far the quite justifiable distinction between sexual and self-preservative instincts is to be carried has not much importance for psycho-analysis, nor is psycho-analysis competent to deal with it. From the biological point of view there are certainly various indications that the distinction is important. For the sexual function is the only function of a living organism which extends beyond the individual and secures its connection with its species. It is undeniable that the exercise of this function does not always bring advantage to the individual, as do his other activities, but that for the sake of an exceptionally high degree of pleasure he is involved by this function in dangers which jeopardize his life and often enough exact it. Quite peculiar metabolic processes, different from all others, are probably required in order to preserve a portion of the individual’s life as a disposition for posterity. And finally, the individual organism that regards itself as first in importance and its sexuality as a means like any other to its own satisfaction is from a biological point of view only an episode in a series of generations, a short-lived appendage to a germplasm which is endowed with virtual immortality, comparable to the temporary holder of an entail that will survive his death.

We are not concerned with such far-reaching considerations, however, in the psycho-analytic elucidation of the neuroses. By means of following up the distinction between the sexual and the Ego-instincts we have gained the key to comprehension of the group of transference neuroses. We were able to trace back their origin to a fundamental situation in which the sexual instincts had come into conflict with the self-preservative instincts, or—to express it biologically, though at the same time less exactly—in which the Ego in its capacity of independent individual organism had entered into opposition with itself in its other capacity as a member of a series of generations. Such a dissociation perhaps only exists in man, so that, taken all in all, his superiority over the other animals may come down to his capacity for neurosis. The excessive development of his Libido and the rich elaboration of his mental life (perhaps directly made possible by it) seem to constitute the conditions which give rise to a conflict of this kind. It is at any rate clear that these are the conditions under which man has progressed so greatly beyond what he has in common with the animals, so that his capacity for neurosis would merely be the obverse of his capacity for cultural development. However, these again are but speculations which distract us from the task in hand.

Our work so far has been conducted on the assumption that the manifestations of the sexual and the Ego-instincts can be distinguished from one another. In the transference neuroses this is possible without any difficulty. We called the investments of energy directed by the Ego towards the object of its sexual desires ‘Libido,’ and all the other investments proceeding from the self-preservative instincts its ‘interest’; and by following up the investments with Libido, their transformations, and their final fates, we were able to acquire our first insight into the workings of the forces in mental life. The transference neuroses offered the best material for this exploration. The Ego, however,—its composition out of various organizations with their structure and mode of functioning—remained undiscovered; we were led to believe that analysis of other neurotic disturbances would be required before light could be gained on these matters.

The extension of psycho-analytic conceptions on to these other affections was begun in early days. Already in 1908 K. Abraham expressed the view after a discussion with me that the main characteristic of dementia præcox (reckoned as one of the psychoses) is that in this disease the investment of objects with Libido is lacking. (The Psycho-Sexual Differences between Hysteria and Dementia Præcox). But then the question arose: what happens to the Libido of dementia patients when it is diverted from its objects? Abraham did not hesitate to answer that it is turned back upon the Ego, and that this reflex reversion of it is the origin of the delusions of grandeur in dementia præcox. The delusion of grandeur is in every way comparable to the well-known overestimation of the object in a love-relationship. Thus we came for the first time to understand a feature of a psychotic affection by bringing it into relation to the normal mode of loving in life.

I will tell you at once that these early views of Abraham’s have been retained in psycho-analysis and have become the basis of our position regarding the psychoses. We became slowly accustomed to the conception that the Libido, which we find attached to certain objects and which is the expression of a desire to gain some satisfaction in these objects, can also abandon these objects and set the Ego itself in their place; and gradually this view developed itself more and more consistently. The name for this utilization of the Libido—Narcissism—we borrowed from a perversion described by P. Näcke, in which an adult individual lavishes upon his own body all the caresses usually expended only upon a sexual object other than himself.

Reflection then at once disclosed that if a fixation of this kind to the subject’s own body and his own person can occur it cannot be an entirely exceptional or meaningless phenomenon. On the contrary, it is probable that this narcissism is the universal original condition, out of which object-love develops later without thereby necessarily effecting a disappearance of the narcissism. One also had to remember the evolution of object-Libido, in which to begin with many of the sexual impulses are gratified on the child’s own body—as we say, auto-erotically—and that this capacity for auto-erotism accounts for the backwardness of sexuality in learning to conform to the reality-principle. Thus it appeared that auto-erotism was the sexual activity of the narcissistic phase of direction of the Libido.

To put it briefly, we formed an idea of the relation between the Ego-Libido and the object-Libido which I can illustrate to you by a comparison taken from zoology. Think of the simplest forms of life consisting of a little mass of only slightly differentiated protoplasmic substances. They extend protrusions which are called pseudopodia into which the protoplasm overflows. They can, however, again withdraw these extensions of themselves and reform themselves into a mass. We compare this extending of protrusions to the radiation of Libido on to the objects, while the greatest volume of Libido may yet remain within the Ego; we infer that under normal conditions Ego-Libido can transform itself into object-Libido without difficulty and that this can again subsequently be absorbed into the Ego.

With the help of these conceptions it is now possible to explain a whole series of mental states, or, to express it more modestly, to describe in terms of the Libido-theory conditions that belong to normal life; for instance, the mental attitude pertaining to the conditions of “being in love,” of organic illness, and of sleep. Of the condition of sleep we assumed that it is founded upon a withdrawal from the outer world and a concentration upon the wish to sleep. We found that the nocturnal mental activity which is expressed in dreams served the purpose of the wish to sleep, and, moreover, that it was governed exclusively by egoistic motives. In the light of the Libido-theory we may carry this further and say that sleep is a condition in which all investments of objects, the libidinal as well as the egoistic, are abandoned and withdrawn again into the Ego. Does not this shed a new light upon the recuperation afforded by sleep and upon the nature of fatigue in general? The likeness we see in the condition which the sleeper conjures up again every night to the blissful isolation of the intra-uterine existence is thus confirmed and amplified in its mental aspects. In the sleeper the primal state of the Libido-distribution is again reproduced, that of absolute narcissism, in which Libido and Ego-interests dwell together still, united and indistinguishable in the self-sufficient Self.

Two observations are in place here. First, how is the concept ‘narcissism’ distinguished from ‘egoism’? In my opinion, narcissism is the libidinal complement of egoism. When one speaks of egoism one is thinking only of the interests of the person concerned, narcissism relates also to the satisfaction of his libidinal needs. It is possible to follow up the two separately for a considerable distance as practical motives in life. A man may be absolutely egoistic and yet have strong libidinal attachments to objects, in so far as libidinal satisfaction in an object is a need of his Ego: his egoism will then see to it that his desires towards the object involve no injury to his Ego. A man may be egoistic and at the same time strongly narcissistic (i.e. feel very little need for objects), and this again either in the form taken by the need for direct sexual satisfaction, or in those higher forms of feeling derived from the sexual needs which are commonly called “love,” and as such are contrasted with “sensuality.” In all these situations egoism is the self-evident, the constant element, and narcissism the variable one. The antithesis of egoism, “altruism,” is not an alternative term for the investment of an object with Libido; it is distinct from the latter in its lack of the desire for sexual satisfaction in the object. But when the condition of love is developed to its fullest intensity altruism coincides with the investment of an object with Libido. As a rule the sexual object draws to itself a portion of the Ego’s narcissism, which becomes apparent in what is called the ‘sexual overestimation’ of the object. If to this is added an altruism directed towards the object and derived from the egoism of the lover, the sexual object becomes supreme; it has entirely swallowed up the Ego.

I think you will find it a relief if, after these scientific phantasies, which are after all very dry, I submit to you a poetic description of the ‘economic’ contrast between the condition of narcissism and that of love in full intensity. I take it from a dialogue between Zuleika and her lover in Goethe’s Westöstliche Divan:—

Zuleika:

The slave, the lord of victories,
The crowd, with single voice, confess
In sense of personal being lies
A child of earth’s true happiness.
There’s not a life he need refuse
If his true self he does not miss:
There’s not a thing he cannot lose
If he remains the man he is.

Hâtem:

So it is held! so well may be!
But down a different track I come
Of all the bliss earth holds for me
I in Zuleika find the sum.
Does she expend her being on me,
Myself grows to myself of cost;
Turns she away, then instantly
I to my very self am lost.
And then with Hâtem all were over;
Though yet I should but change my state;
Swift, should she grace some happy lover,
In him I were incorporate.52

The second observation is an amplification of the theory of dreams. The way in which a dream originates is not explicable unless we assume that what is repressed in the Unconscious has acquired a certain independence of the Ego, so that it does not subordinate itself to the wish for sleep and maintains its investments, although all the object-investments proceeding from the Ego have been withdrawn for the purpose of sleep. Only this makes it possible to understand how it is that this unconscious material can make use of the abrogation or diminution in the activities of the censorship which takes place at night, and that it knows how to mould the day’s residue so as to form a forbidden dream-wish from the material to hand in that residue. On the other hand, some of the resistance against the wish to sleep and the withdrawal of Libido thereby induced may have its origin in an association already in existence between this residue and the repressed unconscious material. This important dynamic factor must therefore now be incorporated into the conception of dream-formation which we formed in our earlier discussions.

Certain conditions—organic illness, painful accesses of stimulation, an inflammatory condition of an organ—have clearly the effect of loosening the Libido from its attachment to its objects. The Libido which has thus been withdrawn attaches itself again to the Ego in the form of a stronger investment of the diseased region of the body. Indeed, one may venture the assertion that in such conditions the withdrawal of the Libido from its objects is more striking than the withdrawal of egoistic interests from their concerns in the outer world. This seems to lead to a possibility of understanding hypochondria, in which some organ, without being perceptibly diseased, becomes in a very similar way the subject of a solicitude on the part of the Ego. I shall, however, resist the temptation to follow this up, or to discuss other situations which become explicable or capable of exposition on this assumption of a return of the object-Libido into the Ego; for I feel bound to meet two objections which I know have all your attention at the moment. First of all, you want to know why when I discuss sleep, illness, and similar conditions, I insist upon distinguishing between Libido and ‘interests,’ sexual instincts and Ego-instincts, while the observations are satisfactorily explained by assuming a single uniform energy which is freely mobile, can invest either object or Ego, and can serve the purposes of the one as well as of the other. Secondly, you will want to know how I can be so bold as to treat the detachment of the Libido from its objects as the origin of a pathological condition, if such a transformation of object-Libido into Ego-Libido—or into Ego-energy in general—is a normal mental process repeated every day and every night.

The answer is: Your first objection sounds a good one. Examination of the conditions of sleep, illness, and falling in love would probably never have led to a distinction between Ego-Libido and object-Libido, or between Libido and ‘interests.’ But in this you omit to take into account the investigations with which we started, in the light of which we now regard the mental situations under discussion. The necessity of distinguishing between Libido and ‘interests,’ between sexual and self-preservative instincts, has been forced upon us by our insight into the conflict from which the transference neuroses arise. We have to reckon with this distinction henceforward. The assumption that object-Libido can transform itself into Ego-Libido, in other words, that we shall also have to reckon with an Ego-Libido, appears to be the only one capable of solving the riddle of what are called the narcissistic neuroses, e.g. dementia præcox, or of giving any satisfactory explanation of their likeness to hysteria and obsessions and differences from them. We then apply what we have found undeniably proved in these cases to illness, sleep, and the condition of intense love. We are at liberty to apply them in any direction and see where they will take us. The single conclusion which is not directly based on analytical experience is that Libido is Libido and remains so, whether it is attached to objects or to the Ego itself, and is never transformed into egoistic ‘interests’ and vice versa. This statement, however, is another way of expressing the distinction between sexual instincts and Ego-instincts which we have already critically examined, and which we shall hold to from heuristic motives until such time as it may prove valueless.

Your second objection too raises a justifiable question, but it is directed to a false issue. The withdrawal of object-Libido into the Ego is certainly not pathogenic; it is true that it occurs every night before sleep can ensue, and that the process is reversed upon awakening. The protoplasmic animalcule draws in its protrusions and sends them out again at the next opportunity. But it is quite a different matter when a definite, very forcible process compels the withdrawal of the Libido from its objects. The Libido that has then become narcissistic can no longer find its way back to its objects, and this obstruction in the way of the free movement of the Libido certainly does prove pathogenic. It seems that an accumulation of narcissistic Libido over and above a certain level becomes intolerable. We might well imagine that it was this that first led to the investment of objects, that the Ego was obliged to send forth its Libido in order not to fall ill of an excessive accumulation of it. If it were part of our scheme to go more particularly into the disorder of dementia præcox I would show you that the process which detaches the Libido from its objects and blocks the way back to them again is closely allied to the process of repression, and is to be regarded as a counterpart of it. In any case you would recognize familiar ground under your feet when you found that the preliminary conditions giving rise to these processes are almost identical, so far as we know at present, with those of repression. The conflict seems to be the same and to be conducted between the same forces. Since the outcome is so different from that of hysteria, for instance, the reason can only lie in some difference in the disposition. The weak point in the Libido-development in these patients is found at a different phase of the development; the decisive fixation which, as you will remember, enables the process of symptom-formation to break out is at another point, probably at the stage of primary narcissism, to which dementia præcox finally returns. It is most remarkable that for all the narcissistic neuroses we have to assume fixation-points of the Libido at very much earlier phases of development than those found in hysteria or the obsessional neurosis. You have heard, however, that the concepts we have elicited from the study of the transference neuroses also suffice to show us our bearings in the narcissistic neuroses, which are in practice so much more severe. There is a very wide community between them; fundamentally they are phenomena of a single class. You may imagine how hopeless a task it is for anyone to attempt to explain these disorders (which properly belong to psychiatry) without being first equipped with the analytic knowledge of the transference neuroses.

The picture formed by the symptoms of dementia præcox, incidentally a very variable one, is not determined exclusively by the symptoms arising from the forcing of the Libido back from the objects and the accumulation of it as narcissism in the Ego. Other phenomena occupy a large part of the field, and may be traced to the efforts made by the Libido to reach its objects again, which correspond therefore to attempts at restitution and recovery. These are in fact the conspicuous, clamorous symptoms; they exhibit a marked similarity to those of hysteria, or more rarely of the obsessional neurosis; they are nevertheless different in every respect. It seems that in dementia præcox the efforts of the Libido to get back to its objects, that is, to the mental idea of its objects, do really succeed in conjuring up something of them, something that at the same time is only the shadow of them—namely, the verbal images, the words, attached to them. This is not the place to discuss this matter further, but in my opinion this reversed procedure on the part of the Libido gives us an insight into what constitutes the real difference between a conscious and an unconscious idea.

This has now brought us into the field where the next advances in analytic work are to be expected. Since the time when we resolved upon our formulation of the conception of Ego-Libido, the narcissistic neuroses have become accessible to us; the task before us was to find the dynamic factors in these disorders, and at the same time to amplify our knowledge of mental life by a comprehension of the Ego. The psychology of the Ego, at which we are aiming, cannot be founded upon data provided by our own self-perceptions; it must be based, as is that of the Libido, upon analysis of the disturbances and disintegrations of the Ego. We shall probably think very little of our present knowledge of the fate of the Libido, gained from the study of the transference neuroses, when that further, greater work has been achieved. But as yet we have not got very far towards it. The narcissistic neuroses can hardly be approached at all by the method which has availed for the transference neuroses; you shall soon hear why this is. With these patients it always happens that after one has penetrated a little way one comes up against a stone wall which cannot be surmounted. You know that in the transference neuroses, too, barriers of resistance of this kind are met with, but that it is possible bit by bit to pull them down. In the narcissistic neuroses the resistance is insuperable; at the most we can satisfy our curiosity by craning our necks for a glimpse or two at what is going on over the wall. Our technique will therefore have to be replaced by other methods; at present we do not know whether we shall succeed in finding a substitute. There is no lack of material with these patients; they bring forward a great deal, although not in answer to our questions; at present all we can do is to interpret what they say in the light of the understanding gained from the study of the transference neuroses. The agreement between the two forms of disease goes far enough to ensure us a satisfactory start with them. How much we shall be able to achieve by this method remains to be seen.

There are other difficulties, besides this, in the way of our progress. The narcissistic disorders and the psychoses related to them can only be unriddled by observers trained in the analytic study of the transference neuroses. But our psychiatrists do not study psycho-analysis and we psycho-analysts see too little of psychiatric cases. We shall have to develop a breed of psychiatrists who have gone through the training of psycho-analysis as a preparatory science. A beginning in this direction is being made in America, where several of the leading psychiatrists lecture on psycho-analytic doctrines to their students, and where medical superintendents of institutions and asylums endeavour to observe their patients in the light of this theory. But all the same it has sometimes been possible for us here to take a peep over the wall of narcissism, so I will now proceed to tell you what we think we have discovered in this way.

The disease of paranoia, a chronic form of systematic insanity, has a very uncertain position in the attempts at classification made by present-day psychiatry. There is no doubt, however, that it is closely related to dementia præcox; I have in fact proposed that they should both be included under the common designation of paraphrenia. The forms taken by paranoia are described according to the content of the delusion, e.g. delusions of grandeur, of persecution, of jealousy, of being loved (erotomania), etc. We do not expect attempts at explanation from psychiatry; as an example, an antiquated and not very fair example, I grant, I will tell you the attempt which was made to derive one of these symptoms from another, by means of a piece of intellectual rationalization: The patient who has a primary tendency to believe himself persecuted draws from this the conclusion that he must necessarily be a very important person and therefore develops a delusion of grandeur. According to our analytic conception, the delusion of grandeur is the direct consequence of the inflation of the Ego by the Libido withdrawn from the investment of objects, a secondary narcissism ensuing as a return of the original early infantile form. In the case of delusions of persecution, however, we observed things which led us to follow up a certain clue. In the first place we noticed that in the great majority of cases the persecuting person was of the same sex as the persecuted one; this was capable of a harmless explanation, it is true, but in certain cases which were closely studied it appeared that the person of the same sex who had been most beloved while the patient was normal became the persecutor after the disease broke out. A further development of this becomes possible through the well-known paths of association by which a loved person may be replaced by someone else, e.g. the father by masters or persons in authority. From these observations, which were continually corroborated, we drew the conclusion that persecutory paranoia is the means by which a person defends himself against a homosexual impulse which has become too powerful. The conversion of the affectionate feeling into the hate which, as is well-known, can seriously endanger the life of the loved and hated object then corresponds to the conversion of libidinal impulses into anxiety, which is a regular result of the process of repression. As an illustration I will quote the last case I had of this type. A young doctor had to be sent away from the place where he lived because he had threatened the life of the son of a university professor there who had previously been his greatest friend. He imputed superhuman power and the most devilish intentions to this friend; he was to blame for all the misfortunes which had occurred in recent years to the family of the patient and for all his ill-luck in public and in private. This was not enough, however; the wicked friend and his father, the professor, had caused the war and brought the Russians over the border; he had ruined his life in a thousand ways; our patient was convinced that the death of this criminal would be the end of all evil in the world. And yet his old love for him was still so strong that it had paralysed his hand when he had an opportunity of shooting his enemy at sight. In the short conversation which I had with the patient it came to light that this intimate friendship between the two men went right back to their school-days; on at least one occasion it had passed beyond the boundaries of friendship, a night spent together had been the occasion of complete sexual intercourse. The patient had never developed any of the feeling towards women that would have been natural at his age with his attractive personality. He had been engaged to a handsome, well-connected girl, but she had broken off the engagement because her lover was so cold. Years after, his disease broke out at the very moment when he had for the first time succeeded in giving full sexual gratification to a woman; as she encircled him in her arms in gratitude and devotion he suddenly felt a mysterious stab of pain running like a sharp knife round the crown of his head. Afterwards he described the sensation as being like that of the incision made at a post-mortem to bare the brain; and as his friend was a pathological anatomist he slowly came to the conclusion that he alone could have sent him this woman as a temptation. Then his eyes began to be opened about the other persecutions of which he had been the victim by the machinations of his former friend.

But how about those cases in which the persecutor is of a different sex from that of the persecuted one, and which appear therefore to contradict our explanation of this disease as a defence against homosexual Libido? Some time ago I had an opportunity of examining a case of the kind, and behind the apparent contradiction I was able to elicit a confirmation. A young girl imagined herself persecuted by a man with whom she had twice had intimate relations; actually she had first of all cherished the delusion against a woman who could be recognized to be a mother-substitute. Not until after the second meeting with him did she make the advance of transferring the delusional idea from the woman to the man; so that in this case also the condition that the sex of the persecutor is the same as that of the victim originally held good also. In her complaint to the lawyer and the doctor the patient had not mentioned the previous phase of her delusion and this gave rise to an apparent contradiction of our theory of paranoia.

The homosexual choice of object is originally more closely related to narcissism than the heterosexual; hence, when a strong unwelcome homosexual excitation suffers repudiation, the way back to narcissism is especially easy to find. I have so far had very little opportunity in these lectures of speaking about the fundamental plan on which the course of the love-impulse during life is based, so far as we know it; nor can I supplement it now. I will only select this to tell you: that the choice of object, the step forward in the development of the Libido which comes after the narcissistic stage, can proceed according to two types. These are: either the narcissistic type, according to which, in place of the Ego itself, someone as nearly as possible resembling it is adopted as an object; or the anaclitic type (Anlehnungstypus)53 in which those persons who became prized on account of the satisfactions they rendered to the primal needs in life are chosen as objects by the Libido also. A strong Libido-fixation on the narcissistic type of object-choice is also found as a trait in the disposition of manifest homosexuals.

You will remember that in the first lecture given this session I described to you a case of delusional jealousy in a woman. Now that we have so nearly reached the end you will certainly want to know how we account for a delusion psycho-analytically. I have less to say about it than you would expect, however. The inaccessibility of delusions to logical arguments and to actual experience is to be explained, as it is with obsessions, by the connection they bear to the unconscious material which is both expressed by, and held in check by, the delusion or the obsession. The differences between the two are based on the topographical and dynamic differences in the two affections.

As with paranoia, so also with melancholia (under which, by the way, very different clinical types are classified), it has been possible to obtain a glimpse into the inner structure of the disorder. We have perceived that the self-reproaches with which these sufferers torment themselves so mercilessly actually relate to another person, to the sexual object they have lost or whom they have ceased to value on account of some fault. From this we concluded that the melancholic has indeed withdrawn his Libido from the object, but that by a process which we must call ‘narcissistic identification’ he has set up the object within the Ego itself, projected it on to the Ego. I can only give you a descriptive representation of this process, and not one expressed in terms of topography and dynamics. The Ego itself is then treated as though it were the abandoned object; it suffers all the revengeful and aggressive treatment which is designed for the object. The suicidal impulses of melancholics also become more intelligible on the supposition that the bitterness felt by the diseased mind concerns the Ego itself at the same time as, and equally with, the loved and hated object. In melancholia, as in the other narcissistic disorders, a feature of the emotional life which, after Bleuler, we are accustomed to call ambivalence comes markedly to the fore; by this we mean a directing of antithetical feelings (affectionate and hostile) towards the same person. It is unfortunate that I have not been able to say more about ambivalence in these lectures.

There is also, besides the narcissistic, an hysterical form of identification which has long been known to us. I wish it were possible to make the differences between them clear to you in a few definite statements. I can tell you something of the periodic and cyclic forms of melancholia which will interest you. It is possible in favourable circumstances—I have twice achieved it—to prevent the recurrence of the condition, or of its antithesis, by analytic treatment during the lucid intervals between the attacks. One learns from this that in melancholia and mania as well as other conditions a special kind of solution of a conflict is going on, which in all its pre-requisites agrees with those of the other neuroses. You may imagine how much there remains for psycho-analysis to do in this field.

I also told you that by analysis of the narcissistic disorders we hoped to gain some knowledge of the composition of the Ego and of its structure out of various faculties and elements. We have made a beginning towards this at one point. From analysis of the delusion of observation we have come to the conclusion that in the Ego there exists a faculty that incessantly watches, criticizes, and compares, and in this way is set against the other part of the Ego. In our opinion, therefore, the patient reveals a truth which has not been appreciated as such when he complains that at every step he is spied upon and observed, that his every thought is known and examined. He has erred only in attributing this disagreeable power to something outside himself and foreign to him; he perceives within his Ego the rule of a faculty which measures his actual Ego and all his activities by an Ego-ideal, which he has created for himself in the course of his development. We also infer that he created this ideal for the purpose of recovering thereby the self-satisfaction bound up with the primary infantile narcissism, which since those days has suffered so many shocks and mortifications. We recognize in this self-criticizing faculty the Ego-censorship, the ‘conscience’; it is the same censorship as that exercised at night upon dreams, from which the repressions against inadmissible wish-excitations proceed. When this faculty disintegrates in the delusion of being observed, we are able to detect its origin and that it arose out of the influence of parents and those who trained the child, together with his social surroundings, by a process of identification with certain of these persons who were taken as a model.

These are some of the results yielded by the application of psycho-analysis to the narcissistic disorders. They are still not very numerous, and many of them still lack that sharpness of outline which cannot be achieved in a new field until some degree of familiarity has been attained. All of them have been made possible by employing the conception of Ego-Libido, or narcissistic Libido, by means of which we can extend the conclusions established for the transference neuroses on to the narcissistic neuroses. But now you will put the question whether it is possible for us to bring all the disorders of the narcissistic neuroses and of the psychoses into the range of the Libido-theory, for us to find the libidinal factor in mental life always and everywhere responsible for the development of disease, and for us never to have to attribute any part in the causation to the same alteration in the functions of the self-preservative instincts. Well now, it seems to me that decision on this point is not very urgent, and above all that the time is not yet ripe for us to make it; we may leave it calmly to be decided by advance in the work of science. I should not be astonished if it should prove that the capacity to induce a pathogenic effect were actually a prerogative of the libidinal impulses, so that the theory of the Libido would triumph all along the line from the actual neuroses to the severest psychotic form of individual derangement. For we know it to be characteristic of the Libido that it refuses to subordinate itself to reality in life, to Necessity. But I consider it extremely probable that the Ego-instincts are involved secondarily and that disturbances in their functions may be necessitated by the pathogenic affections of the Libido. Nor can I see that the direction taken by our investigations will be invalidated if we should have to recognize that in severe psychosis the Ego-instincts themselves are primarily deranged; the future will decide—for you, at least.

Let me return for a moment to anxiety, in order to throw light upon the one obscure point we left there. We said that the relation between anxiety and Libido, otherwise so well defined, is with difficulty harmonized with the almost indisputable assumption that real anxiety in the face of danger is the expression of the self-preservative instincts. But how if the anxiety-affect is provided, not by self-interest on the part of the Ego-instincts, but by the Ego-Libido? The condition of anxiety is after all invariably detrimental; its disadvantage becomes conspicuous when it reaches an intense degree. It then interferes with the action that alone would be expedient and would serve the purposes of self-preservation, whether it be flight or self-defence. Therefore if we ascribe the affective component of real anxiety to the Ego-Libido, and the action undertaken to the Ego-preservative instincts, every theoretical difficulty will be overcome. You will hardly maintain seriously that we run away because we perceive fear? No, we perceive fear and we take to flight, out of the common impulse that is roused by the perception of danger. Men who have survived experiences of imminent danger to life tell us that they did not perceive any fear, that they simply acted—for instance, pointed their gun at the oncoming beast—which was undoubtedly the best thing they could do.

Twenty-Seventh Lecture — Transference

Now that we are coming to the end of our discussions you will feel a certain expectation which must not be allowed to mislead you. You are probably thinking that I surely have not led you through all these complicated mazes of psycho-analysis only to dismiss you at the end without a word about the therapy, upon which after all the possibility of undertaking psycho-analytic work depends. As a matter of fact I could not possibly leave out this aspect of it; for some of the phenomena belonging to it will teach you a new fact, without knowledge of which you would be quite unable to assimilate properly your understanding of the diseases we have been studying.

I know you do not expect directions in the technique of practising analysis for therapeutic purposes; you only want to know in a general way by what means the psycho-analytic therapy works and to gain a general idea of what it accomplishes. And you have an undeniable right to learn this; nevertheless I am not going to tell you—I am going to insist upon your finding it out for yourselves.

Think for a moment! You have already learnt everything essential, from the conditions by which illness is provoked to all the factors which take effect within the diseased mind. Where is the opening in all this for therapeutic influence? First of all there is the hereditary disposition,—we do not often mention it because it is so strongly emphasized in other quarters and we have nothing new to say about it. But do not suppose that we underestimate it; as practitioners we are well aware of its power. In any event we can do nothing to change it; for us also it is a fixed datum in the problem, which sets a limit to our efforts. Next, there is the influence of the experiences of early childhood, which we are accustomed in analysis to rank as very important; they belong to the past, we cannot undo them. Then there is all that unhappiness in life which we have included under ‘privation in reality,’ from which all the absence of love in life proceeds—namely, poverty, family strife, mistaken choice in marriage, unfavourable social conditions, and the severity of the demands by which moral convention oppresses the individual. There is indeed a wide opening for a very effective treatment in all this; but it would have to follow the course of the dispensations of Kaiser Joseph in the Viennese legend—the benevolent despotism of a potentate before whose will men bow and difficulties disappear! But who are we that we can exert such beneficence as a therapeutic measure? Poor as we are and without influence socially, with our living to earn by our medical practice, we are not even in a position to extend our efforts to penniless folk, as other physicians with other methods can do; our treatment takes too much time and labour for that. But perhaps you are still clinging on to one of the factors put forward, and believe you see an opening for our influence there. If the conventional restrictions imposed by society have had a part in the privations forced upon the patient, the treatment could give him the courage and even directly advise him to defy these obstacles, and to seize satisfactions and health for himself at the cost of failing to achieve an ideal which, though highly esteemed, is after all often set at naught by the world. Health is to be won by “free living,” then. There would be this blot upon analysis, to be sure, that it would not be serving general morality; what it gave to the individual it would take from the rest of the world.

But now, who has given you such a false impression of analysis? It is out of the question that part of the analytic treatment should consist of advice to “live freely”—if for no other reason because we ourselves tell you that a stubborn conflict is going on in the patient between libidinal desires and sexual repression, between sensual and ascetic tendencies. This conflict is not resolved by helping one side to win a victory over the other. It is true we see that in neurotics asceticism has gained the day; the result of which is that the suppressed sexual impulses have found a vent for themselves in the symptoms. If we were to make victory possible to the sensual side instead, the disregarded forces repressing sexuality would have to indemnify themselves by symptoms. Neither of these measures will succeed in ending the inner conflict; one side in either event will remain unsatisfied. There are but few cases in which the conflict is so unstable that a factor like medical advice can have any effect upon it, and these cases do not really require analytic treatment. People who can be so easily influenced by physicians would have found their own way to that solution without this influence. After all, you know that a young man living in abstinence who makes up his mind to illicit sexual intercourse, or an unsatisfied wife who seeks compensation with a lover, does not as a rule wait for the permission of a physician, still less of an analyst, to do so.

In considering this question people usually overlook the essential point of the whole difficulty—namely, that the pathogenic conflict in a neurotic must not be confounded with a normal struggle between conflicting impulses all of which are in the same mental field. It is a battle between two forces of which one has succeeded in coming to the level of the preconscious and conscious part of the mind, while the other has been confined on the unconscious level. That is why the conflict can never have a final outcome one way or the other; the antagonists meet each other as little as the whale and the polar bear in the well-known story. An effective decision can be reached only when they confront each other on the same ground. And, in my opinion, to accomplish this is the sole task of the treatment.

Besides this, I can assure you that you are quite misinformed if you imagine that advice and guidance concerning conduct in life forms an integral part of the analytic method. On the contrary, so far as possible we refrain from playing the part of mentor; we want nothing better than that the patient should find his own solutions for himself. To this end we expect him to postpone all vital decisions affecting his life, such as choice of career, business enterprises, marriage or divorce, during treatment and to execute them only after it has been completed. Now confess that you had imagined something very different. Only with certain very young or quite helpless and defenceless persons is it impossible to keep within such strict limitations as we should wish. With them we have to combine the positions of physician and educator; we are then well aware of our responsibility and act with the necessary caution.

You must not be led away by my eagerness to defend myself against the accusation that in analytic treatment neurotics are encouraged to “live a free life” and conclude from it that we influence them in favour of conventional morality. That is at least as far removed from our purpose as the other. We are not reformers, it is true; we are merely observers; but we cannot avoid observing with critical eyes, and we have found it impossible to give our support to conventional sexual morality or to approve highly of the means by which society attempts to arrange the practical problems of sexuality in life. We can demonstrate with ease that what the world calls its code of morals demands more sacrifices than it is worth, and that its behaviour is neither dictated by honesty nor instituted with wisdom. We do not absolve our patients from listening to these criticisms; we accustom them to an unprejudiced consideration of sexual matters like all other matters; and if after they have become independent by the effect of the treatment they choose some intermediate course between unrestrained sexual licence and unconditional asceticism, our conscience is not burdened whatever the outcome. We say to ourselves that anyone who has successfully undergone the training of learning and recognizing the truth about himself is henceforth strengthened against the dangers of immorality, even if his standard of morality should in some respect deviate from the common one. Incidentally, we must beware of overestimating the importance of abstinence in affecting neurosis; only a minority of pathogenic situations due to privation and the subsequent accumulation of Libido thereby induced can be relieved by the kind of sexual intercourse that is procurable without any difficulty.

So you cannot explain the therapeutic effect of psycho-analysis by supposing that it permits patients free sexual indulgence; you must look round for something else. I think that one of the remarks I made while I was disposing of this conjecture on your part will have put you on the right track. Probably it is the substitution of something conscious for something unconscious, the transformation of the unconscious thoughts into conscious thoughts, that makes our work effective. You are right; that is exactly what it is. By extending the unconscious into consciousness the repressions are raised, the conditions of symptom-formation are abolished, and the pathogenic conflict exchanged for a normal one which must be decided one way or the other. We do nothing for our patients but enable this one mental change to take place in them; the extent to which it is achieved is the extent of the benefit we do them. Where there is no repression or mental process analogous to it to be undone there is nothing for our therapy to do.

The aim of our efforts may be expressed in various formulas—making conscious the unconscious, removing the repressions, filling in the gaps in memory; they all amount to the same thing. But perhaps you are dissatisfied with this declaration; you imagined the recovery of a nervous person rather differently, that after he had been subjected to the laborious process of psycho-analysis he would emerge a different person altogether, and then you hear that the whole thing only amounts to his having a little less that is unconscious and a little more that is conscious in him than before. Well, you probably do not appreciate the importance of an inner change of this kind. A neurotic who has been cured has really become a different person, although at bottom of course he remains the same—that is, he has become his best self, what he would have been under the most favourable conditions. That, however, is a great deal. Then when you hear of all that has to be done, of the tremendous exertion required to carry out this apparently trifling change in his mental life, the significance attached to these differences between the various mental levels will appear more comprehensible to you.

I will digress a moment to enquire whether you know what ‘a causal therapy’ means? This name is given to a procedure which puts aside the manifestations of a disease and looks for a point of attack in order to eradicate the cause of the illness. Now is psycho-analysis a causal therapy or not? The answer is not a simple one, but it may give us an opportunity to convince ourselves of the futility of such questions. In so far as psycho-analytic therapy does not aim immediately at removing the symptoms it is conducted like a causal therapy. In other respects you may say it is not, for we have followed the causal chain back far beyond the repressions to the instinctive predispositions, their relative intensity in the constitution, and the aberrations in the course of their development. Now suppose that it were possible by some chemical means to affect this mental machinery, to increase or decrease the amount of Libido available at any given moment, or to reinforce the strength of one impulse at the expense of another—that would be a causal therapy in the literal sense, and our analysis would be the indispensable preliminary work of reconnoitring the ground. As you know, there is at present no question of any such influence upon the processes of the Libido; our mental therapy makes its attack at another point in the concatenation, not quite at the place where we perceive the manifestations to be rooted, but yet comparatively far behind the symptoms themselves, at a place which becomes accessible to us in very remarkable circumstances.

What then have we to do in order to bring what is unconscious in the patient into consciousness? At one time we thought that would be very simple; all we need do would be to identify this unconscious matter and then tell the patient what it was. However, we know already that that was a short-sighted mistake. Our knowledge of what is unconscious in him is not equivalent to his knowledge of it; when we tell him what we know he does not assimilate it in place of his own unconscious thoughts, but alongside of them, and very little has been changed. We have rather to regard this unconscious material topographically; we have to look for it in his memory at the actual spot where the repression of it originally ensued. This repression must be removed, and then the substitution of conscious thought for unconscious thought can be effected straightaway. How is a repression such as this to be removed? Our work enters upon a second phase here; first, the discovery of the repression, and then the removal of the resistance which maintains this repression.

How can this resistance be got rid of? In the same way: by finding it out and telling the patient about it. The resistance too arises in a repression, either from the very one which we are endeavouring to dispel, or in one that occurred earlier. It is set up by the counter-charge which rose up to repress the repellent impulse. So that we now do just the same as we were trying to do before; we interpret, identify, and inform the patient; but this time we are doing it at the right spot. The counter-charge or the resistance is not part of the Unconscious, but of the Ego which co-operates with us, and this is so, even if it is not actually conscious. We know that a difficulty arises here in the ambiguity of the word ‘unconscious,’ on the one hand, as a phenomenon, on the other hand, as a system. That sounds very obscure and difficult; but after all it is only a repetition of what we have said before, is it not? We have come to this point already long ago.—Well then, we expect that this resistance will be abandoned, and the counter-charge withdrawn, when we have made the recognition of them possible by our work of interpretation. What are the instinctive propelling forces at our disposal to make this possible? First, the patient’s desire for recovery, which impelled him to submit himself to the work in co-operation with us, and secondly, the aid of his intelligence which we reinforce by our interpretation. There is no doubt that it is easier for the patient to recognize the resistance with his intelligence, and to identify the idea in his Unconscious which corresponds to it, if we have first given him an idea which rouses his expectations in regard to it. If I say to you: “Look up at the sky and you will see a balloon,” you will find it much more quickly than if I merely tell you to look up and see whether you can see anything; a student who looks through a microscope for the first time is told by the instructor what he is to see; otherwise he sees nothing, although it is there and quite visible.

And now for the fact! In quite a number of the various forms of nervous illness, in the hysterias, anxiety conditions, obsessional neuroses, our hypothesis proves sound. By seeking out the repression in this way, discovering the resistances, indicating the repressed, it is actually possible to accomplish the task, to overcome the resistances, to break down the repression, and to change something unconscious into something conscious. As we do this we get a vivid impression of how, as each individual resistance is being mastered, a violent battle goes on in the soul of the patient—a normal mental struggle between two tendencies on the same ground, between the motives striving to maintain the counter-charge and those which are ready to abolish it. The first of these are the old motives which originally erected the repression; among the second are found new ones more recently acquired, which it is hoped will decide the conflict in our favour. We have succeeded in revivifying the old battle of the repression again, in bringing the issue, so long ago decided, up for revision again. The new contribution we make to it lies, first of all, in demonstrating that the original solution led to illness and in promising that a different one would pave the way to health, and secondly, in pointing out that the circumstances have all changed immensely since the time of that original repudiation of these impulses. Then, the Ego was weak, infantile, and perhaps had reason to shrink with horror from the claims of the Libido as being dangerous to it. To-day it is strong and experienced and moreover has a helper at hand in the physician. So we may expect to lead the revived conflict through to a better outcome than repression; and, as has been said, in hysteria, anxiety-neurosis, and the obsessional neurosis success in the main justifies our claims.

There are other forms of illness, however, with which our therapeutic treatment never is successful, in spite of the similarity of the conditions. In them also there was originally a conflict between Ego and Libido, leading to repression—although this conflict may be characterized by topographical differences from the conflict of the transference neuroses; in them too it is possible to trace out the point in the patient’s life at which the repressions occurred; we apply the same method, are ready to make the same assurances, offer the same assistance by telling the patient what to look out for; and here also the interval in time between the present and the point at which the repressions were established is all in favour of a better outcome of the conflict. And yet we cannot succeed in overcoming one resistance or in removing one of the repressions. These patients, paranoiacs, melancholics, and those suffering from dementia præcox, remain on the whole unaffected, proof against psycho-analytic treatment. What can be the cause of this? It is not due to lack of intelligence; a certain degree of intellectual capacity must naturally be stipulated for analysis, but there is no deficiency in this respect in, for instance, the very quick-witted deductive paranoiac. Nor are any of the other propelling forces regularly absent: melancholics, for instance, in contrast to paranoiacs, experience a very high degree of realization that they are ill and that their sufferings are due to this; but they are not on that account any more accessible to influence. In this we are confronted with a fact that we do not understand, and are therefore called upon to doubt whether we have really understood all the conditions of the success possible with the other neuroses.

When we keep to consideration of hysterical and obsessional neurotics we are very soon confronted with a second fact, for which we were quite unprepared. After the treatment has proceeded for a while we notice that these patients behave in a quite peculiar manner towards ourselves. We thought indeed that we had taken into account all the motive forces affecting the treatment and had reasoned out the situation between ourselves and the patient fully, so that it balanced like a sum in arithmetic; and then after all something seems to slip in which was quite left out of our calculation. This new and unexpected feature is in itself many-sided and complex; I will first of all describe some of its more frequent and simpler forms to you.

We observe then that the patient, who ought to be thinking of nothing but the solution of his own distressing conflicts, begins to develop a particular interest in the person of the physician. Everything connected with this person seems to him more important than his own affairs and to distract him from his illness. Relations with the patient then become for a time very agreeable; he is particularly docile, endeavours to show his gratitude wherever he can, exhibits a fineness of character and other good qualities which we had perhaps not anticipated in him. The analyst thus forms a very good opinion of the patient and values his luck in being able to render assistance to such an admirable personality. If the physician has occasion to see the patient’s relatives he hears with satisfaction that this esteem is mutual. The patient at home is never tired of praising the analyst and attributing new virtues to him. “He has quite lost his head over you; he puts implicit trust in you; everything you say is like a revelation to him,” say the relatives. Here and there one among this chorus having sharper eyes will say: “It is positively boring the way he never speaks of anything but you: he quotes you all the time.”

We will hope that the physician is modest enough to ascribe the patient’s estimate of his value to the hopes of recovery which he has been able to offer to him, and to the widening in the patient’s intellectual horizon consequent upon the surprising revelations entailed by the treatment and their liberating influence. The analysis too makes splendid progress under these conditions, the patient understands the suggestions offered to him, concentrates upon the tasks appointed by the treatment, the material needed—his recollections and associations—is abundantly available; he astonishes the analyst by the sureness and accuracy of his interpretations, and the latter has only to observe with satisfaction how readily and willingly a sick man will accept all the new psychological ideas that are so hotly contested by the healthy in the world outside. A general improvement in the patient’s condition, objectively confirmed on all sides, also accompanies this harmonious relationship in the analysis.

But such fair weather cannot last for ever. There comes a day when it clouds over. There begin to be difficulties in the analysis; the patient says he cannot think of anything more to say. One has an unmistakable impression that he is no longer interested in the work, and that he is casually ignoring the injunction given him to say everything that comes into his mind and to yield to none of the critical objections that occur to him. His behaviour is not dictated by the situation of the treatment; it is as if he had not made an agreement to that effect with the physician; he is obviously preoccupied with something which at the same time he wishes to reserve to himself. This is a situation in which the treatment is in danger. Plainly a very powerful resistance has risen up. What can have happened?

If it is possible to clear up this state of things, the cause of the disturbance is found to consist in certain intense feelings of affection which the patient has transferred on to the physician, not accounted for by the latter’s behaviour nor by the relationship involved by the treatment. The form in which this affectionate feeling is expressed and the goal it seeks naturally depend upon the circumstances of the situation between the two persons. If one of them is a young girl and the other still a fairly young man, the impression received is that of normal love; it seems natural that a girl should fall in love with a man with whom she is much alone and can speak of very intimate things, and who is in the position of an adviser with authority—we shall probably overlook the fact that in a neurotic girl some disturbance of the capacity for love is rather to be expected. The farther removed the situation between the two persons is from this supposed example, the more unaccountable it is to find that nevertheless the same kind of feeling comes to light in other cases. It may be still comprehensible when a young woman who is unhappily married seems to be overwhelmed by a serious passion for her physician, if he is still unattached, and that she should be ready to seek a divorce and give herself to him, or, where circumstances would prevent this, to enter into a secret love-affair with him. That sort of thing, indeed, is known to occur outside psycho-analysis. But in this situation girls and women make the most astonishing confessions which reveal a quite peculiar attitude on their part to the therapeutic problem: they had always known that nothing but love would cure them, and from the beginning of the treatment they had expected that this relationship would at last yield them what life had so far denied them. It was only with this hope that they had taken such pains over the analysis and had conquered all their difficulties in disclosing their thoughts. We ourselves can add: ‘and had understood so easily all that is usually so hard to accept.’ But a confession of this kind astounds us; all our calculations are blown to the winds. Could it be that we have omitted the most important element in the whole problem?

And actually it is so; the more experience we gain the less possible does it become for us to contest this new factor, which alters the whole problem and puts our scientific calculations to shame. The first few times one might perhaps think that the analytic treatment had stumbled upon an obstruction in the shape of an accidental occurrence, extraneous to its purpose and unconnected with it in origin. But when it happens that this kind of attachment to the physician regularly evinces itself in every fresh case, under the most unfavourable conditions, and always appears in circumstances of a positively grotesque incongruity—in elderly women, in relation to grey-bearded men, even on occasions when our judgement assures us that no temptations exist—then we are compelled to give up the idea of a disturbing accident and to admit that we have to deal with a phenomenon in itself essentially bound up with the nature of the disease.

The new fact which we are thus unwillingly compelled to recognize we call Transference. By this we mean a transference of feelings on to the person of the physician, because we do not believe that the situation in the treatment can account for the origin of such feelings. We are much more disposed to suspect that the whole of this readiness to develop feeling originates in another source; that it was previously formed in the patient, and has seized the opportunity provided by the treatment to transfer itself on to the person of the physician. The transference can express itself as a passionate petitioning for love, or it can take less extreme forms; where a young girl and an elderly man are concerned, instead of the wish to be wife or mistress, a wish to be adopted as a favourite daughter may come to light, the libidinous desire can modify itself and propose itself as a wish for an everlasting, but ideally platonic friendship. Many women understand how to sublimate the transference and to mould it until it acquires a sort of justification for its existence; others have to express it in its crude, original, almost impossible form. But at bottom it is always the same, and its origin in the same source can never be mistaken.

Before we enquire where we are to range this new fact, we will amplify the description of it a little. How is it with our male patients? There at least we might hope to be spared the troublesome element of sex difference and sex attraction. Well, the answer is very much the same as with women. The same attachment to the physician, the same overestimation of his qualities, the same adoption of his interests, the same jealousy against all those connected with him. The sublimated kinds of transference are the forms more frequently met with between man and man, and the directly sexual declaration more rarely, in the same degree to which the manifest homosexuality of the patient is subordinated to the other ways by which this component-instinct can express itself. Also, it is in male patients that the analyst more frequently observes a manifestation of the transference which at the first glance seems to controvert the description of it just given—that is, the hostile or negative transference.

First of all, let us realize at once that the transference exists in the patient from the beginning of the treatment, and is for a time the strongest impetus in the work. Nothing is seen of it and one does not need to trouble about it as long as its effect is favourable to the work in which the two persons are co-operating. When it becomes transformed into a resistance, attention must be paid to it; and then it appears that two different and contrasting states of mind have supervened in it and have altered its attitude to the treatment: first, when the affectionate attraction has become so strong and betrays signs of its origin in sexual desire so clearly that it was bound to arouse an inner opposition against itself; and secondly, when it consists in antagonistic instead of affectionate feeling. The hostile feelings as a rule appear later than the affectionate and under cover of them; when both occur simultaneously they provide a very good exemplification of that ambivalence in feeling which governs most of our intimate relationships with other human beings. The hostile feelings therefore indicate an attachment of feeling quite similar to the affectionate, just as defiance indicates a similar dependence upon the other person to that belonging to obedience, though with a reversed prefix. There can be no doubt that the hostile feelings against the analyst deserve the name of ‘transference,’ for the situation in the treatment certainly gives no adequate occasion for them; the necessity for regarding the negative transference in this light is a confirmation of our previous similar view of the positive or affectionate variety.

Where the transference springs from, what difficulties it provides for us, how we can overcome them, and what advantage we can finally derive from it, are questions which can only be adequately dealt with in a technical exposition of the analytic method; I can merely touch upon them here. It is out of the question that we should yield to the demands made by the patient under the influence of his transference; it would be nonsensical to reject them unkindly, and still more so, indignantly. The transference is overcome by showing the patient that his feelings do not originate in the current situation, and do not really concern the person of the physician, but that he is reproducing something that had happened to him long ago. In this way we require him to transform his repetition into recollection. Then the transference which, whether affectionate or hostile, every time seemed the greatest menace to the cure becomes its best instrument, so that with its help we can unlock the closed doors in the soul. I should like, however, to say a few words to dispel the unpleasant effects of the shock that this unexpected phenomenon must have been to you. After all, we must not forget that this illness of the patient’s which we undertake to analyse is not a finally accomplished, and as it were consolidated thing; but that it is growing and continuing its development all the time like a living thing. The beginning of the treatment puts no stop to this development; but, as soon as the treatment has taken a hold upon the patient, it appears that the entire productivity of the illness henceforward becomes concentrated in one direction—namely, upon the relationship to the physician. The transference then becomes comparable to the cambium layer between the wood and the bark of a tree, from which proceeds the formation of new tissue and the growth of the trunk in diameter. As soon as the transference has taken on this significance the work upon the patient’s recollections recedes far into the background. It is then not incorrect to say that we no longer have to do with the previous illness, but with a newly-created and transformed neurosis which has replaced the earlier one. This new edition of the old disease has been followed from its inception, one sees it come to light and grow, and is particularly familiar with it since one is oneself its central object. All the patient’s symptoms have abandoned their original significance and have adapted themselves to a new meaning, which is contained in their relationship to the transference; or else only those symptoms remain which were capable of being adapted in this way. The conquest of this new artificially-acquired neurosis coincides with the removal of the illness which existed prior to the treatment, that is, with accomplishing the therapeutic task. The person who has become normal and free from the influence of repressed instinctive tendencies in his relationship to the physician remains so in his own life when the physician has again been removed from it.

The transference has this all-important, absolutely central significance for the cure in hysteria, anxiety-hysteria, and the obsessional neurosis, which are in consequence rightly grouped together as the ‘transference neuroses.’ Anyone who has grasped from analytic experience a true impression of the fact of transference can never again doubt the nature of the suppressed impulses which have manufactured an outlet for themselves in the symptoms; and he will require no stronger proof of their libidinal character. We may say that our conviction of the significance of the symptoms as a substitutive gratification of the Libido was only finally and definitely established by evaluating the phenomenon of transference.

Now, however, we are called upon to correct our former dynamic conception of the process of cure and to bring it into agreement with the new discovery. When the patient has to fight out the normal conflict with the resistances which we have discovered in him by analysis, he requires a powerful propelling force to influence him towards the decision we aim at, leading to recovery. Otherwise it might happen that he would decide for a repetition of the previous outcome, and allow that which had been raised into consciousness to slip back again under repression. The outcome in this struggle is not decided by his intellectual insight—it is neither strong enough nor free enough to accomplish such a thing—but solely by his relationship to the physician. In so far as his transference bears the positive sign, it clothes the physician with authority, transforms itself into faith in his findings and in his views. Without this kind of transference or with a negative one, the physician and his arguments would never even be listened to. Faith repeats the history of its own origin; it is a derivative of love and at first it needed no arguments. Not until later does it admit them so far as to take them into critical consideration if they have been offered by someone who is loved. Without this support arguments have no weight with the patient, never do have any with most people in life. A human being is therefore on the whole only accessible to influence, even on the intellectual side, in so far as he is capable of investing objects with Libido; and we have good cause to recognize, and to fear, in the measure of his narcissism a barrier to his susceptibility to influence, even by the best analytic technique.

The capacity for the radiation of Libido towards other persons in object investment must, of course, be ascribed to all normal people; the tendency to transference in neurotics, so-called, is only an exceptional intensification of a universal characteristic. Now it would be very remarkable if a human character-trait of this importance and universality had never been observed and made use of. And this has really been done. Bernheim, with unerring perspicacity, based the theory of hypnotic manifestations upon the proposition that all human beings are more or less open to suggestion, are ‘suggestible.’ What he called suggestibility is nothing else but the tendency to transference, rather too narrowly circumscribed so that the negative transference did not come within its scope. But Bernheim could never say what suggestion actually was nor how it arises; it was an axiomatic fact to him and he could give no explanation of its origin. He did not recognize the dependence of ‘suggestibility’ on sexuality, on the functioning of the Libido. And we have to admit that we have only abandoned hypnosis in our methods in order to discover suggestion again in the shape of transference.

But now I will pause and let you take up the thread. I observe that an objection is invading your thoughts with such violence that it would deprive you of all power of attention if it were not given expression. “So now at last you have confessed that you too work with the aid of suggestion like the hypnotists. We have been thinking so all along. But then, what is the use of all these roundabout routes by way of past experiences, discovering the unconscious material, interpreting and retranslating the distortions, and the enormous expenditure of time, trouble, and money, when after all the only effective agent is suggestion? Why do you not suggest directly against the symptoms, as others do who are honest hypnotists? And besides, if you are going to make out that by these roundabout routes you have made numerous important psychological discoveries, which are concealed in direct suggestion, who is to vouch for their validity? Are not they too the result of suggestion, of unintentional suggestion, that is? Cannot you impress upon the patient what you please and whatever seems good to you in this direction also?”

What you charge me with in this way is exceedingly interesting and must be answered. But I cannot do that to-day; our time is up. Till next time, then. You will see that I shall be answerable to you. To-day I must finish what I began. I promised to explain to you through the factor of the transference why it is that our therapeutic efforts have no success in the narcissistic neuroses.

I can do it in a few words, and you will see how simply the riddle is solved, and how well everything fits together. Experience shows that persons suffering from the narcissistic neuroses have no capacity for transference, or only insufficient remnants of it. They turn from the physician, not in hostility, but in indifference. Therefore they are not to be influenced by him; what he says leaves them cold, makes no impression on them, and therefore the process of cure which can be carried through with others, the revivification of the pathogenic conflict and the overcoming of the resistance due to the repressions, cannot be effected with them. They remain as they are. They have often enough undertaken attempts at recovery on their own account which have led to pathological results; we can do nothing to alter this.

On the basis of our clinical observations of these patients we stated that they must have abandoned the investment of objects with Libido and transformed object-Libido into Ego-Libido. By this we differentiated them from the first group of neurotics (hysteria, anxiety, and obsessional neurosis). Their behaviour during the attempt to cure them confirms this suspicion. They produce no transference, and are, therefore, inaccessible to our efforts, not to be cured by us.

Twenty-Eighth Lecture — The Analytic Therapy

You know what we are going to discuss to-day. When I admitted that the influence of the psycho-analytic therapy is essentially founded upon transference, i.e. upon suggestion, you asked me why we do not make use of direct suggestion, and you linked this up with a doubt whether, in view of the fact that suggestion plays such a large part, we can still vouch for the objectivity of our psychological discoveries. I promised to give you a comprehensive answer.

Direct suggestion is suggestion delivered directly against the forms taken by the symptoms, a struggle between your authority and the motives underlying the disease. In this struggle you do not trouble yourself about these motives, you only require the patient to suppress the manifestation of them in the form of symptoms. In the main it makes no difference whether you place the patient under hypnosis or not. Bernheim, with his characteristic acuteness, repeatedly stated that suggestion was the essence of the manifestations of hypnotism, and that hypnosis itself was already a result of suggestion, a suggested condition; he preferred to use suggestion in the waking state, which can achieve the same results as suggestion in hypnosis.

Now which shall I take first, the results of experience or theoretical considerations?

Let us begin with experience. I sought out Bernheim in Nancy in 1889 and became a pupil of his; I translated his book on suggestion into German. For years I made use of hypnotic treatment, first with prohibitory suggestions and later combined with Breuer’s system of the fullest enquiry into the patient’s life; I can therefore speak from wide experience about the results of the hypnotic or suggestive therapy. According to an old medical saying an ideal therapy should be rapid, reliable and not disagreeable to the patient; Bernheim’s method certainly fulfilled two of these requirements. It was much more rapid, that is, incomparably more rapid in its course than the analytic, and it involved the patient in no trouble or discomfort. For the physician it eventually became monotonous; it meant treating every case in the same way, always employing the same ritual to prohibit the existence of the most diverse symptoms, without being able to grasp anything of their meaning or significance. It was a sort of mechanical drudgery—hodman’s work—not scientific work; it was reminiscent of magic, conjuring, and hocus-pocus, yet in the patient’s interests one had to ignore that. In the third desideratum, however, it failed; it was not reliable in any respect. It could be employed in certain cases only and not in others; with some much could be achieved by it, and with others very little, one never knew why. But worse than its capricious nature was the lack of permanence in the results; after a time, if one heard from the patient again, the old malady had reappeared or had been replaced by another. Then one could begin to hypnotize again. In the background there was the warning of experienced men against robbing the patient of his independence by frequent repetitions of hypnosis, and against accustoming him to this treatment as though it were a narcotic. It is true, on the other hand, that at times everything fell out just as one could wish; one obtained complete and lasting success with little difficulty; but the conditions of this satisfactory outcome remained hidden. In one case, when I had completely removed a severe condition by a short hypnotic treatment, it recurred unchanged after the patient (a woman) had developed ill feeling against me without just cause; then after a reconciliation I was able to effect its disappearance again and this time far more thoroughly; but it reappeared again when she had a second time become hostile to me. Another time I had the following experience; during the treatment of an especially obstinate attack in a patient whom I had several times relieved of nervous symptoms, she suddenly threw her arms round my neck. Whether one wished to do so or not, this kind of thing finally made it imperative to enquire into the problem of the nature and source of one’s suggestive authority.

So much for experience; it shows that in abandoning direct suggestion we have given up nothing irreplaceable. Now let us link on to the facts a few comments. The exercise of the hypnotic method makes as little demand for effort on the part of the patient as it does on the physician. The method is in complete harmony with the view of the neuroses generally accepted by the majority of medical men. The practitioner says to the nervous person: “There is nothing the matter with you; it is merely nervousness, therefore a few words from me will scatter all your troubles to the winds in five minutes.” But it is contrary to all our beliefs about energy in general that a minimal exertion should be able to remove a heavy load by approaching it directly without the assistance of any suitably-devised appliance. In so far as the circumstances are at all comparable, experience shows that this trick cannot be performed successfully with the neuroses. I know, however, that this argument is not unassailable; there are such things as explosions.

In the light of the knowledge we have obtained through psycho-analysis, the difference between hypnotic and psycho-analytic suggestion may be described as follows: The hypnotic therapy endeavours to cover up and as it were to whitewash something going on in the mind, the analytic to lay bare and to remove something. The first works cosmetically, the second surgically. The first employs suggestion to interdict the symptoms; it reinforces the repressions, but otherwise it leaves unchanged all the processes that have led to symptom-formation. Analytic therapy takes hold deeper down nearer the roots of the disease, among the conflicts from which the symptoms proceed; it employs suggestion to change the outcome of these conflicts. Hypnotic therapy allows the patient to remain inactive and unchanged, consequently also helpless in the face of every new incitement to illness. Analytic treatment makes as great demands for efforts on the part of the patient as on the physician, efforts to abolish the inner resistances. The patient’s mental life is permanently changed by overcoming these resistances, is lifted to a higher level of development, and remains proof against fresh possibilities of illness. The labour of overcoming the resistances is the essential achievement of the analytic treatment; the patient has to accomplish it and the physician makes it possible for him to do this by suggestions which are in the nature of an education. It has been truly said therefore, that psycho-analytic treatment is a kind of re-education.

I hope I have now made clear to you the difference between our method of employing suggestion therapeutically and the method which is the only possible one in hypnotic therapy. Since we have traced the influence of suggestion back to the transference, you also understand the striking capriciousness of the effect in hypnotic therapy, and why analytic therapy is within its limits dependable. In employing hypnosis we are entirely dependent upon the condition of the patient’s transference and yet we are unable to exercise any influence upon this condition itself. The transference of a patient being hypnotized may be negative, or, as most commonly, ambivalent, or he may have guarded himself against his transference by adopting special attitudes; we gather nothing about all this. In psycho-analysis we work upon the transference itself, dissipate whatever stands in the way of it, and manipulate the instrument which is to do the work. Thus it becomes possible for us to derive entirely new benefits from the power of suggestion; we are able to control it; the patient alone no longer manages his suggestibility according to his own liking, but in so far as he is amenable to its influence at all, we guide his suggestibility.

Now you will say that, regardless of whether the driving force behind the analysis is called transference or suggestion, the danger still remains that our influence upon the patient may bring the objective certainty of our discoveries into doubt; and that what is an advantage in therapy is harmful in research. This is the objection that has most frequently been raised against psycho-analysis; and it must be admitted that, even though it is unjustified, it cannot be ignored as unreasonable. If it were justified, psycho-analysis after all would be nothing else but a specially well-disguised and particularly effective kind of suggestive treatment; and all its conclusions about the experiences of the patient’s past life, mental dynamics, the Unconscious, and so on, could be taken very lightly. So our opponents think; the significance of sexual experiences in particular, if not the experiences themselves, we are supposed to have “put into the patient’s mind,” after having first concocted these conglomerations in our own corrupt minds. These accusations are more satisfactorily refuted by the evidence of experience than by the aid of theory. Anyone who has himself conducted psycho-analyses has been able to convince himself numberless times that it is impossible to suggest things to a patient in this way. There is no difficulty, of course, in making him a disciple of a particular theory, and thus making it possible for him to share some mistaken belief possibly harboured by the physician. He behaves like anyone else in this, like a pupil; but by this one has only influenced his intellect, not his illness. The solving of his conflicts and the overcoming of his resistances succeeds only when what he is told to look for in himself corresponds with what actually does exist in him. Anything that has been inferred wrongly by the physician will disappear in the course of the analysis; it must be withdrawn and replaced by something more correct. One’s aim is, by a very careful technique, to prevent temporary successes arising through suggestion; but if they do arise no great harm is done, for we are not content with the first result. We do not consider the analysis completed unless all obscurities in the case are explained, the gaps in memory filled out, and the original occasions of the repressions discovered. When results appear prematurely, one regards them as obstacles rather than as furtherances of the analytic work, and one destroys them again by continually exposing the transference on which they are founded. Fundamentally it is this last feature which distinguishes analytic treatment from that of pure suggestion, and which clears the results of analysis from the suspicion of being the results of suggestion. In every other suggestive treatment the transference is carefully preserved and left intact; in analysis it is itself the object of the treatment and is continually being dissected in all its various forms. At the conclusion of the analysis the transference itself must be dissolved; if success then supervenes and is maintained it is not founded on suggestion, but on the overcoming of the inner resistances effected by the help of suggestion, on the inner change achieved within the patient.

That which probably prevents single effects of suggestion from arising during the treatment is the struggle that is incessantly being waged against the resistances, which know how to transform themselves into a negative (hostile) transference. Nor will we neglect to point to the evidence that a great many of the detailed findings of analysis, which would otherwise be suspected of being produced by suggestion, are confirmed from other, irreproachable sources. We have unimpeachable witnesses on these points, namely, dements and paranoiacs, who are of course quite above any suspicion of being influenced by suggestion. All that these patients relate in the way of phantasies and translations of symbols, which have penetrated through into their consciousness, corresponds faithfully with the results of our investigations into the Unconscious of transference neurotics, thus confirming the objective truth of the interpretations made by us which are so often doubted. I do not think you will find yourselves mistaken if you choose to trust analysis in these respects.

We now need to complete our description of the process of recovery by expressing it in terms of the Libido-theory. The neurotic is incapable of enjoyment or of achievement—the first because his Libido is attached to no real object, the last because so much of the energy which would otherwise be at his disposal is expended in maintaining the Libido under repression, and in warding off its attempts to assert itself. He would be well if the conflict between his Ego and his Libido came to an end, and if his Ego again had the Libido at its disposal. The task of the treatment, therefore, consists in the task of loosening the Libido from its previous attachments, which are beyond the reach of the Ego, and in making it again serviceable to the Ego. Now where is the Libido of a neurotic? Easily found: it is attached to the symptoms, which offer it the substitutive satisfaction that is all it can obtain as things are. We must master the symptoms then, dissolve them—just what the patient asks of us. In order to dissolve the symptoms it is necessary to go back to the point at which they originated, to review the conflict from which they proceeded, and with the help of propelling forces which at that time were not available to guide it towards a new solution. This revision of the process of repression can only partially be effected by means of the memory-traces of the processes which led up to repression. The decisive part of the work is carried through by creating—in the relationship to the physician, in “the transference”—new editions of those early conflicts, in which the patient strives to behave as he originally behaved, while one calls upon all the available forces in his soul to bring him to another decision. The transference is thus the battlefield where all the contending forces must meet.

All the Libido and the full strength of the opposition against it are concentrated upon the one thing, upon the relationship to the physician; thus it becomes inevitable that the symptoms should be deprived of their Libido; in place of the patient’s original illness appears the artificially-acquired transference, the transference-disorder; in place of a variety of unreal objects of his Libido appears the one object, also ‘phantastic,’ of the person of the physician. This new struggle which arises concerning this object is by means of the analyst’s suggestions lifted to the surface, to the higher mental levels, and is there worked out as a normal mental conflict. Since a new repression is thus avoided, the opposition between the Ego and the Libido comes to an end; unity is restored within the patient’s mind. When the Libido has been detached from its temporary object in the person of the physician it cannot return to its earlier objects, but is now at the disposal of the Ego. The forces opposing us in this struggle during the therapeutic treatment are on the one hand the Ego’s aversion against certain tendencies on the part of the Libido, which had expressed itself in repressing tendencies; and on the other hand the tenacity or ‘adhesiveness’ of the Libido, which does not readily detach itself from objects it has once invested.

The therapeutic work thus falls into two phases; in the first all the Libido is forced away from the symptoms into the transference and there concentrated, in the second the battle rages round this new object and the Libido is made free from it. The change that is decisive for a successful outcome of this renewed conflict lies in the preclusion of repression, so that the Libido cannot again withdraw itself from the Ego by a flight into the Unconscious. It is made possible by changes in the Ego ensuing as a consequence of the analyst’s suggestions. At the expense of the Unconscious the Ego becomes wider by the work of interpretation which brings the unconscious material into consciousness; through education it becomes reconciled to the Libido and is made willing to grant it a certain degree of satisfaction; and its horror of the claims of its Libido is lessened by the new capacity it acquires to expend a certain amount of the Libido in sublimation. The more nearly the course of the treatment corresponds with this ideal description the greater will be the success of the psycho-analytic therapy. Its barriers are found in the lack of mobility in the Libido, which resists being released from its objects, and in the rigidity of the patient’s narcissism, which will not allow more than a certain degree of object-transference to develop. Perhaps the dynamics of the process of recovery will become still clearer if we describe it by saying that, in attracting a part of it to ourselves through transference, we gather in the whole amount of the Libido which has been withdrawn from the Ego’s control.

It is as well here to make clear that the distributions of the Libido which ensue during and by means of the analysis afford no direct inference of the nature of its disposition during the previous illness. Given that a case can be successfully cured by establishing and then resolving a powerful father-transference to the person of the physician, it would not follow that the patient had previously suffered in this way from an unconscious attachment of the Libido to his father. The father-transference is only the battlefield on which we conquer and take the Libido prisoner; the patient’s Libido has been drawn hither away from other ‘positions.’ The battlefield does not necessarily constitute one of the enemy’s most important strongholds; the defence of the enemy’s capital city need not be conducted immediately before its gates. Not until after the transference has been again resolved can one begin to reconstruct in imagination the dispositions of the Libido that were represented by the illness.

In the light of the Libido-theory there is a final word to be said about dreams. The dreams of a neurotic, like his “errors” and his free associations, enable us to find the meaning of the symptoms and to discover the dispositions of the Libido. The forms taken by the wish-fulfilment in them show us what are the wish-impulses that have undergone repression, and what are the objects to which the Libido has attached itself after withdrawal from the Ego. The interpretation of dreams therefore plays a great part in psycho-analytic treatment, and in many cases it is for lengthy periods the most important instrument at work. We already know that the condition of sleep in itself produces a certain relaxation of the repressions. By this diminution in the heavy pressure upon it the repressed desire is able to create for itself a far clearer expression in a dream than can be permitted to it by day in the symptoms. Hence the study of dreams becomes the easiest approach to a knowledge of the repressed Unconscious, which is where the Libido which has withdrawn from the Ego belongs.

The dreams of neurotics, however, differ in no essential from those of normal people; they are indeed perhaps not in any way distinguishable from them. It would be illogical to account for the dreams of neurotics in a way that would not also hold good of the dreams of normal people. We have to conclude therefore that the difference between neurosis and health prevails only by day; it is not sustained in dream-life. It thus becomes necessary to transfer to healthy persons a number of conclusions arrived at as a result of the connections between the dreams and the symptoms of neurotics. We have to recognize that the healthy man as well possesses those factors in mental life which alone can bring about the formation of a dream or of a symptom, and we must conclude further that the healthy also have instituted repressions and have to expend a certain amount of energy to maintain them; that their unconscious minds too harbour repressed impulses which are still suffused with energy, and that a part of the Libido is in them also withdrawn from the disposal of the Ego. The healthy man too is therefore virtually a neurotic, but the only symptom that he seems capable of developing is a dream. To be sure when you subject his waking life also to a critical investigation you discover something that contradicts this specious conclusion; for this apparently healthy life is pervaded by innumerable trivial and practically unimportant symptom-formations.

The difference between nervous health and nervous illness (neurosis) is narrowed down therefore to a practical distinction, and is determined by the practical result—how far the person concerned remains capable of a sufficient degree of capacity for enjoyment and active achievement in life. The difference can probably be traced back to the proportion of the energy which has remained free relative to that of the energy which has been bound by repression, i.e. it is a quantitative and not a qualitative difference. I do not need to remind you that this view provides a theoretical basis for our conviction that the neuroses are essentially amenable to cure, in spite of their being based on a constitutional disposition.

So much, therefore, in the way of knowledge of the characteristics of health may be inferred from the identity of the dreams dreamt by neurotic and by healthy persons. Of dreams themselves, however, a further inference must be drawn—namely, that it is not possible to detach them from their connection with neurotic symptoms; that we are not at liberty to believe that their essential nature is exhausted by compressing them into the formula of ‘a translation of thoughts into archaic forms of expression’; and that we are bound to conclude that they disclose dispositions of the Libido and objects of desire which are actually in operation and valid at the moment.

We have now come very nearly to the end. Perhaps you are disappointed that under the heading of psycho-analytic therapy I have limited myself to theory, and have told you nothing of the conditions under which the cure is undertaken, or of the results it achieves. I omit both, however: the first, because in fact I never intended to give you a practical training in the exercise of the analytic method; and the last, because I have several motives against it. At the beginning of these discussions I said emphatically that under favourable conditions we achieve cures that are in no way inferior to the most brilliant in other fields of medical therapy; I may perhaps add that these results could be achieved by no other method. If I said more I should be suspected of wishing to drown the depreciatory voices of our opponents by self-advertisement. Medical “colleagues” have, even at public congresses, repeatedly held out a threat to psycho-analysts that by publishing a collection of the failures and harmful effects of analysis they will open the eyes of the injured public to the worthlessness of this method of treatment. Apart from the malicious, denunciatory character of such a measure, however, a collection of that kind would not even be valid evidence upon which a correct estimate of the therapeutic results of analysis might be formed. Analytic therapy, as you know, is still young; it needed many years to elaborate the technique, which could only be done in the course of the work under the influence of increasing experience. On account of the difficulties of imparting instruction in the methods the beginner is thrown much more upon his own resources for development of his capacity than any other kind of specialist, and the results of his early years can never be taken as indicating the full possible achievements of analytic therapy.

Many attempts at treatment made in the beginning of psycho-analysis were failures because they were undertaken with cases altogether unsuited to the procedure, which nowadays we should exclude by following certain indications. These indications, however, could only be discovered by trying. In the beginning we did not know that paranoia and dementia præcox, when fully developed, are not amenable to analysis; we were still justified in trying the method on all kinds of disorders. Most of the failures of those early years, however, were not due to the fault of the physician, or to the unsuitability in the choice of subject, but to unpropitious external conditions. I have spoken only of the inner resistances, those on the part of the patient, which are inevitable and can be overcome. The external resistances which the patient’s circumstances and surroundings set up against analysis have little theoretic interest but the greatest practical importance. Psycho-Analytic treatment is comparable to a surgical operation and, like that, for its success it has the right to expect to be carried out under the most favourable conditions. You know the preliminary arrangements a surgeon is accustomed to make—a suitable room, a good light, expert assistance, exclusion of the relatives, and so on. Now ask yourselves how many surgical operations would be successful if they had to be conducted in the presence of the patient’s entire family poking their noses into the scene of the operation and shrieking aloud at every cut. In psycho-analytic treatment the intervention of the relatives is a positive danger and, moreover, one which we do not know how to deal with. We are armed against the inner resistances of the patient, which we recognize as necessary, but how can we protect ourselves against these outer resistances? It is impossible to get round the relatives by any sort of explanation, nor can one induce them to hold aloof from the whole affair; one can never take them into one’s confidence because then we run the danger of losing the patient’s trust in us, for he—quite rightly, of course—demands that the man he confides in should take his part. Anyone who knows anything of the dissensions commonly splitting up family life will not be astonished in his capacity of analyst to find that those nearest to the patient frequently show less interest in his recovery than in keeping him as he is. When as so often occurs the neurosis is connected with conflicts between different members of a family, the healthy person does not make much of putting his own interest before the patient’s recovery. After all, it is not surprising that the husband does not favour a treatment in which, as he correctly supposes, his sins will all come to light; nor do we wonder at this, but then we cannot blame ourselves when our efforts remain fruitless and are prematurely broken off because the husband’s resistance is added to that of the sick wife. We had simply undertaken something which, under the existing conditions, it was impossible to carry out.

Instead of describing many cases to you I will tell you of one only, in which I had to suffer for the sake of professional conscientiousness. I took a young girl—many years ago—for analytic treatment; for a considerable time previously she had been unable to go out of doors on account of a dread, nor could she stay at home alone. After much hesitation the patient confessed that her thoughts had been a good deal occupied by some signs of affection that she had noticed by chance between her mother and a well-to-do friend of the family. Very tactlessly—or else very cleverly—she then gave the mother a hint of what had been discussed during the analysis; she did this by altering her behaviour to her mother, by insisting that no one but her mother could protect her against the dread of being alone, and by holding the door against her when she attempted to leave the house. The mother herself had formerly been very nervous, but had been cured years before by a visit to a hydropathic establishment—or, putting it otherwise, we may say she had there made the acquaintance of the man with whom she had established a relationship that had proved satisfying in more than one respect. Made suspicious by her daughter’s passionate demands the mother suddenly understood what the girl’s dread signified. She had become ill in order to make her mother a prisoner and rob her of the freedom necessary for her to maintain her relations with her lover. The mother’s decision was instantly taken; she put an end to the harmful treatment. The girl was sent to a home for nervous patients, and for many years was there pointed out as an “unhappy victim of psycho-analysis”; for just as long I was pursued by damaging rumours about the unfortunate results of the treatment. I maintained silence because I supposed myself bound by the rules of professional secrecy. Years later I learned from a colleague who had visited the home and there seen the girl with agoraphobia that the intimacy between the mother and the wealthy man was common knowledge, and that in all probability it was connived at by the husband and father. To this “secret” the girl’s cure had been sacrificed.

In the years before the war, when the influx of patients from many countries made me independent of the goodwill or disfavour of my native city, I made it a rule never to take for treatment anyone who was not sui juris, independent of others in all the essential relations of life. Every psycho-analyst cannot make these stipulations. Perhaps you will conclude from my warnings about relatives that one should take the patient out of his family circle in the interests of analysis, and restrict this therapy to those living in private institutions. I could not support this suggestion, however; it is far more advantageous for the patients—those who are not in a condition of severe prostration, at least—to remain during the treatment in those circumstances in which they have to struggle with the demands that their ordinary life makes on them. But the relatives ought not to counteract this advantage by their behaviour, and above all should not oppose their hostility to one’s professional efforts. But how are you going to induce people who are inaccessible to you to take up this attitude? You will naturally also conclude that the social atmosphere and degree of cultivation of the patient’s immediate surroundings have considerable influence upon the prospects of the treatment.

This is a gloomy outlook for the efficacy of psycho-analysis as a therapy, even if we may explain the overwhelming majority of our failures by taking into account these disturbing external factors! Friends of analysis have advised us to counterbalance a collection of failures by drawing up a statistical enumeration of our successes. I have not taken up this suggestion either. I brought forward the argument that statistics would be valueless if the units collated were not alike, and the cases which had been treated were in fact not equivalent in many respects. Further, the period of time that could be reviewed was too short for one to be able to judge of the permanence of the cures; and of many cases it would be impossible to give any account. They were persons who had kept both their illness and their treatment secret, and whose recovery in consequence had similarly to be kept secret. The strongest reason against it, however, lay in the recognition of the fact that in matters of therapy humanity is in the highest degree irrational, so that there is no prospect of influencing it by reasonable arguments. A novelty in therapeutics is either taken up with frenzied enthusiasm, as for instance when Koch first published his results with tuberculin; or else it is regarded with abysmal distrust, as happened for instance with Jenner’s vaccination, actually a heaven-sent blessing, but one which still has its implacable opponents. A very evident prejudice against psycho-analysis made itself apparent. When one had cured a very difficult case one would hear: “That is no proof of anything; he would have got well of himself after all this time.” And when a patient who had already gone through four cycles of depression and mania came to me in an interval after the melancholia and three weeks later again began to develop an attack of mania, all the members of the family, and also all the high medical authorities who were called in, were convinced that the fresh attack could be nothing but a consequence of the attempted analysis. Against prejudice one can do nothing, as you can now see once more in the prejudices that each group of the nations at war has developed against the other. The most sensible thing to do is to wait and allow them to wear off with the passage of time. A day comes when the same people regard the same things in quite a different light from what they did before; why they thought differently before remains a dark secret.

It is possible that the prejudice against the analytic therapy has already begun to relax. The continual spread of analytic doctrine and the numbers of medical men taking up analytic treatment in many countries seem to point in that direction. As a young man I was caught in just such a storm of indignation roused in the medical profession by the hypnotic suggestion-treatment, which nowadays is held up in opposition to psycho-analysis by the “sober-minded.” As a therapeutic instrument, however, hypnotism did not bear out the hopes placed in it; we psycho-analysts may claim to be its rightful heirs and should not forget how much encouragement and theoretic enlightenment we owe to it. The harmful effects reported of psycho-analysis are essentially confined to transitory manifestations of an exacerbation of the conflict, which may occur when the analysis is clumsily handled, or when it is broken off suddenly. You have heard an account of what we do with our patients, and you can form your own judgement whether our efforts are likely to lead to lasting injury. Misuse of analysis is possible in various ways: the transference especially, in the hands of an unscrupulous physician, is a dangerous instrument. But no medical remedy is proof against misuse; if a knife will not cut, neither will it serve a surgeon.

I have now reached the end. It is more than a conventional formality when I say that I myself am heavily oppressed by the many defects of the lectures I have delivered before you. I regret most of all that I have so often promised to return again in another place to a subject that I had just touched upon shortly, and that then the context in which I could keep my word did not offer itself. I undertook to give you an account of a thing that is still unfinished, still developing, and now my short summary itself has become an incomplete one. In many places I laid everything ready for drawing a conclusion, and then I did not draw it. But I could not aim at making you experts in psycho-analysis; I only wished to put you in the way of some understanding of it, and to arouse your interest in it.

Notes

1. [Literally: “that wishes to build in the dark and fish in murky waters.”—Tr.]

2. In German—Versprechen.

3. Verschreiben.

4. Verlesen.

5. Verhören.

6. Vergessen.

7. Verlegen.

8. [The equivalent English prefix is “mis-,” but is not so widely employed.—Tr.]

9. In German—Vergreifen.

10. [English example.—Tr.]

11. [Komfortabel is a slang Viennese expression for a one-horse cab. An English example of this is as follows: In a play during a scene of a funeral procession the actor was made to say, “Stand back, my Lord, and let the parson cough!” instead of “the coffin pass.”—Tr.]

12. [English examples.—Tr.]

13. [English examples.—Tr.]

14. “Ja, das draut” = das dauert... eine traurige Geschichte.

15. “Dann aber sind Tatsachen zum Vorschwein gekommen” = Vorschein... Schweinerei.

16. [The two words “begleiten” and “beleidigen” are a good deal more obvious in the German “begleidigen” than in the translation.—Tr.]

17. [Two untranslatable examples are given in the text, apopos for apropos and Eischeissweibchen for Eiweisscheibchen. (Meringer and Mayer.)—Tr.]

18. Vorschussmitglieder instead of Ausschussmitglieder.

19. From C. G. Jung.

20. From A. A. Brill.

21. From B. Dattner.

22. Also in the writings of A. Maeder (French), A. A. Brill and Ernest Jones (English), and J. Stärcke (Dutch) and others.

23. From R. Reitler.

24. [German: Zurückdrängen = to force back. This word is stronger than unterdrücken = to press under, which we translate by suppress (not a technical term); zurückdrängen contains already the drängen of verdrängen, the technical word used by Freud to denote the strongest pressure of all, repression. In the examples discussed here, the agency withholding the intention from expression may be either conscious or unconscious (groups one, two, and three, according to the degree of unconsciousness); Freud does not use verdrängen = “repression,” the technical word for unconscious agency only, here, but one very near to it in sense.—Tr.]

25. Joseph Breuer, in the years 1880–1882. Cf. my Lectures on Psycho-Analysis, delivered in the United States in 1909.

26. [It should be noted that in using the word “unconscious” to translate the German “unbewusst” we are deflecting it from its customary English sense, which is “absence of unawareness,” such as in the phrases “he lay unconscious,” “a stone is unconscious,” etc. Unbewusst is rather “unconscious’d,” i.e. something of which the subject is not aware. Of it two statements may therefore be predicated, not only that it is not conscious in itself or of itself, but also that the subject is not conscious of its existence.—Tr.]

27. [Lit.: “Tablers”—Tr.]

28. [This example has been altered in translation to bring in the play upon words in English.—Tr.]

29. [See note on preceding example.—Tr.]

30. See Frontispiece.

31. Frau Dr. von Hug-Hellmuth.

32. [Liebesdienst = “love service,” a popular expression adapted from “military service.”—Tr.]

33. [Cf. sweetheart, sweetest.—Tr.]

34. [In German, an old acquaintance is often addressed as “old house” (altes Haus); the expression “giving him one on the roof” (einem eins aufs Dachl geben) corresponds to “hitting him over the head.”]

35. [The portal vein carries nourishment from the bowels to the body via the liver. The pylorus (from πύλη = gate) is the entrance to the small intestine. In German, the apertures of the body are called Leibespforten (gates of the body).—Tr.]

36. [Cf. the Russian expression, “Little father.”—Tr.]

37. [Cf. “I am a wall and my breasts like towers: then was I in his eyes as one that found favour.” Cant. viii. 10.—Tr.]

38. [This is certainly so with English patients.—Tr.]

39. Whilst correcting these pages, my eye happened to fall upon a newspaper paragraph which I reproduce here as affording unexpected confirmation of the above words.

DIVINE RETRIBUTION

A Broken Arm for a Broken Marriage-Vow.

Frau Anna M., the wife of a soldier in the reserve, accused Frau Clementine K. of unfaithfulness to her husband. In her accusation she stated that Frau K. had had an illicit relationship with Karl M. during her husband’s absence at the front, and while he was sending her as much as 70 crowns a month. Besides this, she had already received a large sum of money from her (Frau M.’s) husband, while his wife and children had to live in hunger and misery. Some of her husband’s comrades had informed her that he and Frau K. had visited public-houses together and remained there drinking late into the night. The accused woman had once actually asked the husband of the accuser, in the presence of several soldiers, whether he would not soon leave his “old woman” and come to her, and the caretaker of the house where Frau K. lived had repeatedly seen the plaintiff’s husband in Frau K.’s room, in a state of complete undress.

Yesterday, before a magistrate in the Leopoldstadt, Frau K. denied knowing M. at all: any intimate relations between them were out of the question, she said.

Albertine M., a witness, however, gave evidence of having surprised Frau K. in the act of kissing the accuser’s husband.

M., who had been called as a witness in some earlier proceedings, had then denied any intimate relations with the accused. Yesterday, a letter was handed to the magistrate, in which the witness retracted his former denial and confessed that up to the previous June he had carried on illicit relations with Frau K. In the earlier proceedings he had denied his relations with the accused only because she had come to him before the action came into court and begged him on her knees to save her and say nothing. “To-day,” wrote the witness, “I feel compelled to lay a full confession before the court, for I have broken my left arm and regard this as God’s punishment for my offence.”

The judge decided that the penal offence had been committed too long ago for the action to stand, whereupon the accuser withdrew her accusation and the accused was discharged.

40. [Both senses of cleave are still alive in English: to cleave (= separate) and to cleave to (= adhere).—Tr.]

41. [The principal park of Vienna.—Tr.]

42. Another interpretation of the number three, occurring in the dream of this childless woman, lies very close; but I will not mention it here, because this analysis did not furnish any material illustrating it.

43. Verranntheit.

44. Cf. Totem und Tabu, 1913.

45. [Zwangsneurose, sometimes called in English compulsion-neurosis.—Tr.]

46. E. Toulouse, Émile Zola. Enquête medico-psychologique. Paris, 1896.

47. See p. 222.

48. Ferenczi, Contributions to Psycho-Analysis. English translation by Ernest Jones, 1916. Chap. viii, p. 181.

49. [I.e. Grave’s disease, exophthalmic goitre.—Tr.]

50. [Angst. The German word denotes a more intense feeling than the English ‘anxiety’; the latter however, derived from the same root, has become established as the technical English term.—Tr.]

51. [In Germany it replaces the use of “duck” for this purpose in English.—Tr.]

52. [Taken, with very slight modifications, from Ernest Dowden’s translation.—Tr.]

53. [This name is based on a reference to a relationship with an older person in early life.—Tr.]

“In this remarkable book there lies at least a double interest. There is, in the first place, a longish short story of unusual merit and charm; and, in the second, Professor Freud’s commentary on it from the psycho-analytic standpoint—a brilliant and ingenious treatment of the story as a narrative of real happenings.”—Manchester Guardian.

“A wholly charming fantasy.... Professor Freud treats Jensen’s very delicate and finely spun story with artistic respect, and presents it in full as an artistic delight.”—Westminster Gazette.

The Psychology of Day Dreams

By DR. J. VARENDONCK

“A genuine, well documented first-hand study of an important psychological phenomenon.”—Times.

Delusion and Dream

By Dr. SIGMUND FREUD

Translated by HELEN M. DOWNEY

Introduction by Dr. G. STANLEY HALL

“In this remarkable book there lies at least a double interest. In the first place a longish short story of unusual merit and in the second Professor Freud’s commentary on it from the psycho-analytic standpoint, a brilliant and ingenious treatment of the story as a narrative of real happenings.”—Manchester Guardian.

A Young Girl’s Diary

Prefaced with a Letter by SIGMUND FREUD

Translated from the German by EDEN AND CEDAR PAUL

“All educationists—and, indeed, many others—should welcome this book; it will provide amazing food for thought.... Every page bears upon it the mark of absolute genuineness, and this alone makes the book of exceeding value.... A book of deep interest and significance.”—Education.

The sale of this book is rigidly restricted to members of the medical, educational and legal professions.

The Interpretation of Dreams

By Professor SIGM. FREUD

Translated by A. A. BRILL, Ph.D.

“This is certainly the author’s greatest and most important work. To psychologist and physician the work is indispensable.”—Lancet

Fundamental Conceptions of Psycho-Analysis

An authoritative statement of the Freudian doctrine of psycho-analysis, written by Freud’s chief American disciple and translator, done in a lively and coherent fashion, and with unusual delicacy in the choice of illustrative material.

Some Applications of Psycho-Analysis

This is a collection of essays dealing with the nature and application of psycho-analysis in various mental and spiritual domains. The author treats of psychology, philosophy, the psychology of the sources of artistic inspiration, of war and peace, of religion, of science and pedagogics, particularly of psychic inhibitions and abnormalities in children.

The Evolution of the Conscious Faculties

This book, which is the sequel of the author’s “Psychology of Day-dreams,” is mainly devoted to the study of the two different aspects of the faculty of retention: duplicative and synthetical memory.

Psycho-Analysis

By BARBARA LOW, B.A., Ex-Training College Lecturer

“An admirable little outline of the theory and application of psycho-analysis... as a primer in the first elements of the subject, it could hardly be improved upon.”—Westminster Gazette.

Psychoanalysis and Sociology

By AUREL KOLNAI

Translated by EDEN AND CEDAR PAUL

“A book of bold and ponderable ideas about the progress of humanity.”—Daily News.

Studies in Psychoanalysis

An account of 27 concrete cases preceded by a Theoretical Exposition

By Prof. C. BAUDOUIN

Author of Suggestion and Autosuggestion, etc.

The New Psychology: and its Relation to Life

By A. G. TANSLEY

The issue of the Fifth Impression of this book—originally published in June 1920—has given the opportunity of a fairly thorough revision. Advantage has been taken of criticisms to make various statements more explicit, and a few fresh topics have been dealt with; for instance, Dr. Varendonck’s recent work on Day-dreaming and Adler’s views on the importance of the feeling of inferiority in moulding the character. A new preface and a glossary have been added.

Suggestion & Autosuggestion

A Study of the Work of M. Emile Coué based upon Investigations made by the New Nancy School

By Professor CHARLES BAUDOUIN

Translated by EDEN AND CEDAR PAUL

“The most exciting book published since ‘The Origin of Species.’”—Nation.

“It is full of thought in itself. It is bound to be a cause of thought.... We very strongly advise our readers to read and study M. Baudouin’s book.”—Spectator.

Hypnotism and Suggestion

By LOUIS SATOW

Translated by BERNARD MIALL

This volume, which contains a glossary of technical terms, should fill a long-felt want, as supplying a foundation of accurate knowledge which will enable the reader to follow and understand the recent developments of psycho-analysis. An exact knowledge of the various phases of hypnosis is equally essential for a true understanding of the phenomena of religion, politics, education, herd-psychology, minority rule and war.

History of Psychology

By G. S. BRETT, M.A.

“The value of a work at once impartial and scholarly, scientific and comprehensive, which, of matter all compact, surveys more than six hundred of the greatest thinkers, needs no emphasis.”—Holborn Review.

Abnormal Psychology and Education

“This is a very clear and admirable study... his handling of the problem of repression in education seems to us excellent. We hope this book may find its way into the studies of our teachers.”—Challenge.

The Psychological Problems of Industry

By FRANK WATTS

“An interesting book which Trade Unionists should study.”—Daily Herald.

RUSKIN HOUSE, 40 MUSEUM STREET, W.C. 1.

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Used numbers for footnotes, placing them all at the end of the last chapter.