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Articles- Part XXII
INHIBITIONS, SYMPTOMS AND ANXIETY
Sigmund Freud (1926)
Parts I-VII
IN the description of pathological phenomena, linguistic
usage enables us to distinguish symptoms from inhibitions, without,
however, attaching much importance to the distinction. Indeed, we
might hardly think it worth while to differentiate exactly between
the two, were it not for the fact that we meet with illnesses in which
we observe the presence of inhibitions but not of symptoms and are
curious to know the reason for this.
The two concepts are not upon the same
plane. Inhibition has a special relation to function. It does not
necessarily have a pathological implication. One can quite well call
a normal restriction of a function an inhibition of it. A symptom,
on the other hand, actually denotes the presence of some pathological
process. Thus, an inhibition may be a symptom as well. Linguistic
usage, then, employs the word inhibition when there is a simple
lowering of function, and symptom when a function has undergone
some unusual change or when a new phenomenon has arisen out of it.
Very often it seems to be quite an arbitrary matter whether we emphasize
the positive side of a pathological process and call its outcome a
symptom, or its negative side and call its outcome an inhibition.
But all this is really of little interest; and the problem as we have
stated it does not carry us very far.
Since the concept of inhibition is so
intimately associated with that of function, it might be helpful to
examine the various functions of the ego with a view to discovering
the forms which any disturbance of those functions assumes in each
of the different neurotic affections. Let us pick out for a comparative
study of this kind the sexual function and those of eating, of locomotion
and of professional work.
(a) The sexual function is liable to a great number of disturbances,
most of which exhibit the characteristics of simple inhibitions. These
are classed together as psychical impotence. The normal performance of the sexual function can only come about
as the result of a very complicated process, and disturbances may
appear at any point in it. In men the chief stages at which inhibition
occurs are shown by: a turning away of the libido at the very beginning
of the process (psychical unpleasure); an absence of the physical
preparation for it (lack of erection); an abridgement of the sexual
act (ejaculatiopraecox), an occurrence which might equally
well be regarded as a symptom; an arrest of the act before it has
reached its natural conclusion (absence of ejaculation); or a non-appearance
of the psychical outcome (lack of the feeling of pleasure in orgasm).
Other disturbances arise from the sexual function becoming dependent
on special conditions of a perverse or fetishist nature.
That there is a relationship between
inhibition and anxiety is pretty evident. Some inhibitions obviously
represent a relinquishment of a function because its exercise would
produce anxiety. Many women are openly afraid of the sexual function.
We class this anxiety under hysteria, just as we do the defensive
symptom of disgust which, arising originally as a deferred reaction
to the experiencing of a passive sexual act, appears later whenever
the idea of such an act is presented. Furthermore, many obsessional
acts turn out to be measures of precaution and security against sexual
experiences and are thus of a phobic character.
This is not very illuminating. We can
only note that disturbances of the sexual function are brought about
by a great variety of means. (1) The libido may simply be turned away
(this seems most readily to produce what we regard as an inhibition
pure and simple); (2) the function may be less well carried out; (3)
it may be hampered by having conditions attached to it, or modified
by being diverted to other aims; (4) it may be prevented by security
measures; (5) if it cannot be prevented from starting, it may be immediately
interrupted by the appearance of anxiety; and (6), if it is nevertheless
carried out, there may be a subsequent reaction of protest against
it and an attempt to undo what has been done.
(b) The function of nutrition is most
frequently disturbed by a disinclination to eat, brought about by
a withdrawal of libido. An increase in the desire to eat is also a
not uncommon thing. The compulsion to eat is attributed to a fear
of starving; but this is a subject which has been but little studied.
The symptom of vomiting is known to us as a hysterical defence against
eating. Refusal to eat owing to anxiety is a concomitant of psychotic
states (delusions of being poisoned).
(c) In some neurotic conditions locomotion
is inhibited by a disinclination to walk or a weakness in walking.
In hysteria there will be a paralysis of the motor apparatus, or this
one special function of the apparatus will be abolished (abasia).
Especially characteristic are the increased difficulties that appear
in locomotion owing to the introduction of certain stipulations whose
non-observance results in anxiety (phobia).
(d] In inhibition in work--a thing which
we so often have to deal with as an isolated symptom in our therapeutic
work--the subject feels a decrease in his pleasure in it or becomes
less able to do it well; or he has certain reactions to it, like fatigue,
giddiness or sickness, if he is obliged to go on with it. If he is
a hysteric he will have to give up his work owing to the appearance
of organic and functional paralyses which make it impossible for him
to carry it on. If he is an obsessional neurotic he will be perpetually
being distracted from his work or losing time over it through the
introduction of delays and repetitions.
Our survey might be extended to other
functions as well; but there would be nothing more to be learnt by
doing so. For we should not penetrate below the surface of the phenomena
presented to us. Let us then proceed to describe inhibition in such
a way as to leave very little doubt about what is meant by it, and
say that inhibition is the expression of a restriction of an ego-function.
A restriction of this kind can itself have very different causes.
Some of the mechanisms involved in this renunciation of function are
well known to us, as is a certain general purpose which governs it.
This purpose is more easily recognizable
in the specific inhibitions. Analysis shows that when activities
like playing the piano, writing or even walking are subjected to neurotic
inhibitions it is because the physical organs brought into play--the
fingers or the legs--have become too strongly erotized. It has been
discovered as a general fact that the ego-function of an organ is
impaired if its erotogenicity--its sexual significance--is increased.
It behaves, if I may be allowed a rather absurd analogy, like a maid-servant
who refuses to go on cooking because her master has started a love-affair
with her. As soon as writing, which entails making a liquid flow out
of a tube on to a piece of white paper, assumes the significance of
copulation, or as soon as walking becomes a symbolic substitute for
treading upon the body of mother earth, both writing and walking are
stopped because they represent the performance of a forbidden sexual
act. The ego renounces these functions, which are within its sphere,
in order not to have to undertake fresh measures of repression--in
order to avoid a conflict with the id.
There are clearly also inhibitions which
serve the purpose of self-punishment. This is often the case in inhibitions
of professional activities. The ego is not allowed to carry on those
activities, because they would bring success and gain, and these are
things which the severe super-ego has forbidden. So the ego gives
them up too, in order to avoid coming into conflict with the super-ego.
The more generalized inhibitions
of the ego obey a different mechanism of a simple kind. When the ego
is involved in a particularly difficult psychical task, as occurs
in mourning, or when there is some tremendous suppression of affect
or when a continual flood of sexual phantasies has to be kept down,
it loses so much of the energy at its disposal that it has to cut
down the expenditure of it at many points at once. It is in the position
of a speculator whose money has become tied up in his various enterprises.
I came across an instructive example of this kind of intense, though
short-lived, general inhibition. The patient, an obsessional neurotic,
used to be overcome by a paralysing fatigue which lasted for one or
more days whenever something occurred which should obviously have
thrown him into a rage. We have here a point from which it should
be possible to reach an understanding of the condition of general
inhibition which characterizes states of depression, including the
gravest form of them, melancholia.
As regards inhibitions, then, we may
say in conclusion that they are restrictions of the functions of the
ego which have been either imposed as a measure of precaution or brought
about as a result of an impoverishment of energy; and we can see without
difficulty in what respect an inhibition differs from a symptom: for
a symptom cannot any longer be described as a process that takes place
within, or acts upon, the ego.
II
THE main characteristics of the formation of symptoms have long since
been studied and, I hope, established beyond dispute. A symptom is
a sign of, and a substitute for, an instinctual satisfaction which
has remained in abeyance; it is a consequence of the process of repression.
Repression proceeds from the ego when the latter--it may be at the
behest of the superego--refuses to associate itself with an instinctual
cathexis which has been aroused in the id. The ego is able by means
of repression to keep the idea which is the vehicle of the reprehensible
impulse from becoming conscious. Analysis shows that the idea often
persists as an unconscious formation.
So far everything seems clear; but we
soon come upon difficulties which have not as yet been solved. Up
till now our account of what occurs in repression has laid great stress
on this point of exclusion from consciousness. But it has left other
points open to uncertainty. One question that arose was, what happened
to the instinctual impulse which had been activated in the id and
which sought satisfaction? The answer was an indirect one. It was
that owing to the process of repression the pleasure that would have
been expected from satisfaction had been transformed into unpleasure.
But we were then faced with the problem of how the satisfaction of
an instinct could produce unpleasure. The whole matter can be clarified,
I think, if we commit ourselves to the definite statement that as
a result of repression the intended course of the excitatory process
in the id does not occur at all; the ego succeeds in inhibiting or
deflecting it. If this is so the problem of 'transformation of affect'
under repression disappears. At the same time this view implies a
concession to the ego that it can exert a very extensive influence
over processes in the id, and we shall have to find out in what way
it is able to develop such surprising powers.
It seems to me that the ego obtains
this influence in virtue of its intimate connections with the perceptual
system--connections which, as we know, constitute its essence and
provide the basis of its differentiation from the id. The function
of this system, which we have called Pcpt.-Cs., is bound up
with the phenomenon of consciousness. It receives excitations not
only from outside but from within, and endeavours, by means of the
sensations of pleasure and unpleasure which reach it from these
quarters, to direct the course of mental events in accordance with
the pleasure principle. We are very apt to think of the ego as powerless
against the id; but when it is opposed to an instinctual process in
the id it has only to give a 'signal of unpleasure' in order
to attain its object with the aid of that almost omnipotent institution,
the pleasure principle. To take this situation by itself for a moment,
we can illustrate it by an example from another field. Let us imagine
a country in which a certain small faction objects to a proposed measure
the passage of which would have the support of the masses. This minority
obtains command of the press and by its help manipulates the supreme
arbiter, 'public opinion', and so succeeds in preventing the measure
from being passed.
But this explanation opens up fresh
problems. Where does the energy come from which is employed for giving
the signal of unpleasure? Here we may be assisted by the idea that
a defence against an unwelcome internal process will be modelled
upon the defence adopted against an external stimulus, that
the ego wards off internal and external dangers alike along identical
lines. In the case of external danger the organism has recourse to
attempts at flight. The first thing it does is to withdraw cathexis
from the perception of the dangerous object; later on it discovers
that it is a better plan to perform muscular movements of such a sort
as will render perception of the dangerous object impossible even
in the absence of any refusal to perceive it--that it is a better
plan, that is, to remove itself from the sphere of danger. Repression
is an equivalent of this attempt at flight. The ego withdraws its
(preconscious) cathexis from the instinctual representative that is
to be repressed and uses that cathexis for the purpose of releasing
unpleasure (anxiety). The problem of how anxiety arises in connection
with repression may be no simple one; but we may legitimately hold
firmly to the idea that the ego is the actual seat of anxiety and
give up our earlier view that the cathectic energy of the repressed
impulse is automatically turned into anxiety. If I expressed myself
earlier in the latter sense, I was giving a phenomenological description
and not a metapsychological account of what was occurring.
This brings us to a further question:
how is it possible, from an economic point of view, for a mere process
of withdrawal and discharge, like the withdrawing of a preconscious
ego-cathexis, to produce unpleasure or anxiety, seeing that, according
to our assumptions, unpleasure and anxiety can only arise as a result
of an increase in cathexis? The reply is that this causal sequence
should not be explained from an economic point of view. Anxiety is
not newly created in repression; it is reproduced as an affective
state in accordance with an already existing mnemic image. If we go
further and enquire into the origin of that anxiety--and of affects
in general--we shall be leaving the realm of pure psychology and entering
the borderland of physiology. Affective states have become incorporated
in the mind as precipitates of primaeval traumatic experiences, and
when a similar situation occurs they are revived like mnemic symbols.
I do not think I have been wrong in likening them to the more recent
and individually acquired hysterical attack and in regarding them
as its normal prototypes. In man and the higher animals it would seem
that the act of birth, as the individual's first experience of anxiety,
has given the affect of anxiety certain characteristic forms of expression.
But, while acknowledging this connection, we must not lay undue stress
on it nor overlook the fact that biological necessity demands that
a situation of danger should have an affective symbol, so that a symbol
of this kind would have to be created in any case. Moreover, I do
not think that we are justified in assuming that whenever there is
an outbreak of anxiety something like a reproduction of the situation
of birth goes on in the mind. It is not even certain whether hysterical
attacks, though they were originally traumatic reproductions of this
sort, retain that character permanently.
As I have shown elsewhere, most of the
repressions with which we have to deal in our therapeutic work are
cases of after-pressure. They presuppose the operation of earlier,
primal repressions which exert an attraction on the more recent
situation. Far too little is known as yet about the background and
preliminary stages of repression. There is a danger of overestimating
the part played in repression by the super-ego. We cannot at present
say whether it is perhaps the emergence of the super-ego which provides
the line of demarcation between primal repression and after-pressure.
At any rate, the earliest outbreaks of anxiety, which are of a very
intense kind, occur before the super-ego has become differentiated.
It is highly probable that the immediate precipitating causes of primal
repressions are quantitative factors such as an excessive degree of
excitation and the breaking through of the protective shield against
stimuli.
This mention of the protective shield
sounds a note which recalls to us the fact that repression occurs
in two different situations--namely, when an undesirable instinctual
impulse is aroused by some external perception, and when it arises
internally without any such provocation. We shall return to this difference
later. But the protective shield exists only in regard to external
stimuli, not in regard to internal instinctual demands.
So long as we direct our attention to
the ego's attempt at flight we shall get no nearer to the subject
of symptom-formation. A symptom arises from an instinctual impulse
which has been detrimentally affected by repression. If the ego, by
making use of the signal of unpleasure, attains its object of completely
suppressing the instinctual impulse, we learn nothing of how this
has happened. We can only find out about it from those cases in which
repression must be described as having to a greater or less extent
failed. In this event the position, generally speaking, is that the
instinctual impulse has found a substitute in spite of repression,
but a substitute which is very much reduced, displaced and inhibited
and which is no longer recognizable as a satisfaction. And when the
substitutive impulse is carried out there is no sensation of pleasure;
its carrying out has, instead, the quality of a compulsion.
In thus degrading a process of satisfaction to a symptom, repression
displays its power in a further respect. The substitutive process
is prevented, if possible, from finding discharge through motility;
and even if this cannot be done, the process is forced to expend itself
in making alterations in the subject's own body and is not permitted
to impinge upon the external world. It must not be transformed into
action. For, as we know, in repression the ego is operating under
the influence of external reality and therefore it debars the substitutive
process from having any effect upon that reality.
Just as the ego controls the path to action
in regard to the external world, so it controls access to consciousness.
In repression it exercises its power in both directions, acting in
the one manner upon the instinctual impulse itself and in the other
upon the [psychical] representative of that impulse. At this point
it is relevant to ask how I can reconcile this acknowledgement of
the might of the ego with the description of its position which I
gave in The Ego and the Id. In that book I drew a picture of
its dependent relationship to the id and to the superego and revealed
how powerless and apprehensive it was in regard to both and with what
an effort it maintained its show of superiority over them. This view
has been widely echoed in psycho-analytic literature. Many writers
have laid much stress on the weakness of the ego in relation to the
id and of our rational elements in the face of the daemonic forces
within us; and they display a strong tendency to make what I have
said into a corner-stone of a psycho-analytic Weltanschauung.
Yet surely the psycho-analyst, with his knowledge of the way in which
repression works, should, of all people, be restrained from adopting
such an extreme and one-sided view.
I must confess that I am not at all
partial to the fabrication of Weltanschauungen. Such activities
may be left to philosophers, who avowedly find it impossible to make
their journey through life without a Baedeker of that kind to give
them information on every subject. Let us humbly accept the contempt
with which they look down on us from the vantage-ground of their superior
needs. But since we cannot forgo our narcissistic pride either,
we will draw comfort from the reflection that such 'Handbooks to Life'
soon grow out of date and that it is precisely our short-sighted,
narrow and finicky work which obliges them to appear in new editions,
and that even the most up-to-date of them are nothing but attempts
to find a substitute for the ancient, useful and all-sufficient Church
Catechism. We know well enough how little light science has so far
been able to throw on the problems that surround us. But however much
ado the philosophers may make, they cannot alter the situation. Only
patient, persevering research, in which everything is subordinated
to the one requirement of certainty, can gradually bring about a change.
The benighted traveller may sing aloud in the dark to deny his own
fears; but, for all that, he will not see an inch further beyond his
nose.
III
To return to the problem of the ego. The apparent contradiction is
due to our having taken abstractions too rigidly and attended exclusively
now to the one side and now to the other of what is in fact a complicated
state of affairs. We were justified, I think, in dividing the ego
from the id, for there are certain considerations which necessitate
that step. On the other hand the ego is identical with the id, and
is merely a specially differentiated part of it. If we think of this
part by itself in contradistinction to the whole, or if a real split
has occurred between the two, the weakness of the ego becomes apparent.
But if the ego remains bound up with the id and indistinguishable
from it, then it displays its strength. The same is true of the relation
between the ego and the super-ego. In many situations the two are
merged; and as a rule we can only distinguish one from the other when
there is a tension or conflict between them. In repression the decisive
fact is that the ego is an organization and the id is not. The ego
is, indeed, the organized portion of the id. We should be quite wrong
if we pictured the ego and the id as two opposing camps and if we
supposed that, when the ego tries to suppress a part of the id by
means of repression, the remainder of the id comes to the rescue of
the endangered part and measures its strength with the ego. This may
often be what happens, but it is certainly not the initial situation
in repression. As a rule the instinctual impulse which is to be repressed
remains isolated. Although the act of repression demonstrates the
strength of the ego, in one particular it reveals the ego's powerlessness
and how impervious to influence are the separate instinctual impulses
of the id. For the mental process which has been turned into a symptom
owing to repression now maintains its existence outside the organization
of the ego and independently of it. Indeed, it is not that process
alone but all its derivatives which enjoy, as it were, this same privilege
of extra-territoriality; and whenever they come into associative contact
with a part of the ego-organization, it is not at all certain that
they will not draw that part over to themselves and thus enlarge themselves
at the expense of the ego. An analogy with which we have long been
familiar compared a symptom to a foreign body which was keeping up
a constant succession of stimuli and reactions in the tissue in which
it was embedded. It does sometimes happen that the defensive struggle
against an unwelcome instinctual impulse is brought to an end with
the formation of a symptom. As far as can be seen, this is most often
possible in hysterical conversion. But usually the outcome is different.
The initial act of repression is followed by a tedious or interminable
sequel in which the struggle against the instinctual impulse is prolonged
into a struggle against the symptom.
In this secondary defensive struggle
the ego presents two faces with contradictory expressions. The one
line of behaviour it adopts springs from the fact that its very nature
obliges it to make what must be regarded as an attempt at restoration
or reconciliation. The ego is an organization. It is based on the
maintenance of free intercourse and of the possibility of reciprocal
influence between all its parts. Its desexualized energy still shows
traces of its origin in its impulsion to bind together and unify,
and this necessity to synthesize grows stronger in proportion as the
strength of the ego increases. It is therefore only natural that the
ego should try to prevent symptoms from remaining isolated and alien
by using every possible method to bind them to itself in one way or
another, and to incorporate them into its organization by means of
those bonds. As we know, a tendency of this kind is already operative
in the very act of forming a symptom. A classical instance of this
are those hysterical symptoms which have been shown to be a compromise
between the need for satisfaction and the need for punishment. Such
symptoms participate in the ego from the very beginning, since they
fulfill a requirement of the super-ego, while on the other hand they
represent positions occupied by the repressed and points at which
an irruption has been made by it into the ego-organization. They are
a kind of frontier-station with a mixed garrison. (Whether all primary
hysterical symptoms are constructed on these lines would be worth
enquiring into very carefully.) The ego now proceeds to behave as
though it recognized that the symptom had come to stay and that the
only thing to do was to accept the situation in good part and draw
as much advantage from it as possible. It makes an adaptation to the
symptom--to this piece of the internal world which is alien to it--just
as it normally does to the real external world. It can always find
plenty of opportunities for doing so. The presence of a symptom may
entail a certain impairment of capacity, and this can be exploited
to appease some demand on the part of the super-ego or to refuse some
claim from the external world. In this way the symptom gradually comes
to be the representative of important interests; it is found to be
useful in asserting the position of the self and becomes more and
more closely merged with the ego and more and more indispensable to
it. It is only very rarely that the physical process of 'healing'
round a foreign body follows such a course as this. There is a danger,
too, of exaggerating the importance of a secondary adaptation of this
kind to a symptom, and of saying that the ego has created the symptom
merely in order to enjoy its advantages. It would be equally true
to say that a man who had lost his leg in the war had got it shot
away so that he might thenceforward live on his pension without having
to do any more work.
In obsessional neurosis and paranoia
the forms which the symptoms assume become very valuable to the ego
because they obtain for it, not certain advantages, but a narcissistic
satisfaction which it would otherwise be without. The systems which
the obsessional neurotic constructs flatter his self-love by making
him feel that he is better than other people because he is specially
cleanly or specially conscientious. The delusional constructions of
the paranoic offer to his acute perceptive and imaginative powers
a field of activity which he could not easily find elsewhere.
All of this results in what is familiar
to us as the '(secondary) gain from illness' which follows a neurosis.
This gain comes to the assistance of the ego in its endeavour to incorporate
the symptom and increases the symptom's fixation. When the analyst
tries subsequently to help the ego in its struggle against the symptom,
he finds that these conciliatory bonds between ego and symptom operate
on the side of the resistances and that they are not easy to loosen.
The two lines of behaviour which the
ego adopts towards the symptom are in fact directly opposed to each
other. For the other line is less friendly in character, since it
continues in the direction of repression. Nevertheless the ego, it
appears, cannot be accused of inconsistency. Being of a peaceable
disposition it would like to incorporate the symptom and make it part
of itself. It is from the symptom itself that the trouble comes. For
the symptom, being the true substitute for and derivative of the repressed
impulse, carries on the role of the latter; it continually renews
its demands for satisfaction and thus obliges the ego in its turn
to give the signal of unpleasure and put itself in a posture of defence.
The secondary defensive struggle against
the symptom takes many shapes. It is fought out on different fields
and makes use of a variety of methods. We shall not be able to say
much about it until we have made an enquiry into the various different
instances of symptom-formation. In doing this we shall have an opportunity
of going into the problem of anxiety--a problem which has long been
looming in the background. The wisest plan will be to start from the
symptoms produced by the hysterical neurosis; for we are not as yet
in a position to consider the conditions in which the symptoms of
obsessional neurosis, paranoia and other neuroses are formed.
IV
LET us start with an infantile hysterical phobia of animals-- for
instance, the case of 'Little Hans' [1909b], whose phobia of horses
was undoubtedly typical in all its main features. The first thing
that becomes apparent is that in a concrete case of neurotic illness
the state of affairs is much more complex than one would suppose so
long as one was dealing with abstractions. It takes a little time
to find one's bearings and to decide which the repressed impulse is,
what substitutive symptom it has found and where the motive for repression
lies.
'Little Hans' refused to go out into
the street because he was afraid of horses. This was the raw material
of the case. Which part of it constituted the symptom? Was it his
having the fear? Was it his choice of an object for his fear? Was
it his giving up of his freedom of movement? Or was it more than one
of these combined? What was the satisfaction which he renounced? And
why did he have to renounce it?
At a first glance one is tempted to
reply that the case is not so very obscure. 'Little Hans's' unaccountable
fear of horses was the symptom and his inability to go out into the
streets was an inhibition, a restriction which his ego had imposed
on itself so as not to arouse the anxiety-symptom. The second point
is clearly correct; and in the discussion which follows I shall not
concern myself any further with this inhibition. But as regards the
alleged symptom, a superficial acquaintance with the case does not
even disclose its true formulation. For further investigation shows
that what he was suffering from was not a vague fear of horses but
a quite definite apprehension that a horse was going to bite him.
This idea, indeed, was endeavouring to withdraw from consciousness
and get itself replaced by an undefined phobia in which only the anxiety
and its object still appeared. Was it perhaps this idea that was the
nucleus of his symptom?
We shall not make any headway until
we have reviewed the little boy's psychical situation as a whole as
it came to light in the course of the analytic treatment. He was at
the time in the jealous and hostile Oedipus attitude towards his father,
whom nevertheless--except in so far as his mother was the cause of
estrangement--he dearly loved. Here, then, we have a conflict due
to ambivalence: a well-grounded love and a no less justifiable hatred
directed towards one and the same person. 'Little Hans's' phobia must
have been an attempt to solve this conflict. Conflicts of this kind
due to ambivalence are very frequent and they can have another typical
outcome, in which one of the two conflicting feelings (usually that
of affection) becomes enormously intensified and the other vanishes.
The exaggerated degree and compulsive character of the affection alone
betray the fact that it is not the only one present but is continually
on the alert to keep the opposite feeling under suppression, and enable
us to postulate the operation of a process which we call repression
by means of reaction-formation (in the ego). Cases like 'Little Hans's'
show no traces of a reaction-formation of this kind. There
are clearly different ways of egress from a conflict due to ambivalence.
Meanwhile we have been able to establish
another point with certainty. The instinctual impulse which underwent
repression in 'Little Hans' was a hostile one against his father.
Proof of this was obtained in his analysis while the idea of the biting
horse was being followed up. He had seen a horse fall down and he
had also seen a playmate, with whom he was playing at horses, fall
down and hurt himself. Analysis justified the inference that he had
a wishful impulse that his father should fall down and hurt himself
as his playmate and the horse had done. Moreover, his attitude towards
someone's departure on a certain occasion makes it probable that his
wish that his father should be out of the way also found less hesitating
expression. But a wish of this sort is tantamount to an intention
of putting one's father out of the way oneself--is tantamount, that
is, to the murderous impulse of the Oedipus complex.
So far there seem to be no connecting
links between 'Little Hans's' repressed instinctual impulse and the
substitute for it which we suspect is to be seen in his phobia of
horses. Let us simplify his psychical situation by setting on one
side the infantile factor and the ambivalence. Let us imagine that
he is a young servant who is in love with the mistress of the house
and has received some tokens of her favour. He hates his master, who
is more powerful than he is, and he would like to have him out of
the way. It would then be eminently natural for him to dread his master's
vengeance and to develop a fear of him--just as 'Little Hans' developed
a phobia of horses. We cannot, therefore, describe the fear belonging
to this phobia as a symptom. If 'Little Hans', being in love with
his mother, had shown fear of his father, we should have no right
to say that he had a neurosis or a phobia. His emotional reaction
would have been entirely comprehensible. What made it a neurosis was
one thing alone: the replacement of his father by a horse. It is this
displacement, then, which has a claim to be called a symptom, and
which, incidentally, constitutes the alternative mechanism which enables
a conflict due to ambivalence to be resolved without the aid of a
reaction-formation. Such a displacement is made possible or facilitated
at 'Little Hans's' early age because the inborn traces of totemic
thought can still be easily revived. Children do not as yet recognize
or, at any rate, lay such exaggerated stress upon the gulf that separates
human beings from the animal world. In their eyes the grown man, the
object of their fear and admiration, still belongs to the same category
as the big animal who has so many enviable attributes but against
whom they have been warned because he may become dangerous. As we
see, the conflict due to ambivalence is not dealt with in relation
to one and the same person: it is circumvented, as it were, by one
of the pair of conflicting impulses being directed to another person
as a substitutive object.
So far everything is clear. But the
analysis of 'Hans's' phobia has been a complete disappointment in
one respect. The distortion which constituted the symptom-formation
was not applied to the [psychical] representative (the ideational
content) of the instinctual impulse that was to be repressed; it was
applied to a quite different representative and one which only corresponded
to a reaction to the disagreeable instinct. It would be more
in accordance with our expectations if 'Little Hans' had developed,
instead of a fear of horses, an inclination to ill-treat them and
to beat them or if he had expressed in plain terms a wish to see them
fall down or be hurt or even die in convulsions ('make a row with
their feet'). Something of the sort did in fact emerge in his analysis,
but it was not by any means in the forefront of his neurosis. And,
curiously enough, if he really had produced a hostility of this sort
not against his father but against horses as his main symptom, we
should not have said that he was suffering from a neurosis. There
must be something wrong either with our view of repression or with
our definition of a symptom. One thing, of course, strikes us at once:
if 'Little Hans' had really behaved like that to horses, it would
mean that repression had in no way altered the character of his objectionable
and aggressive instinctual impulse itself but only the object towards
which it was directed.
Undoubtedly there are cases in which
this is all that repression does. But more than this happened in the
development of 'Little Hans's' phobia--how much more can be guessed
from a part of another analysis.
As we know, 'Little Hans' alleged that
what he was afraid of was that a horse would bite him. Now some time
later I was able to learn something about the origin of another animal
phobia. In this instance the dreaded animal was a wolf; it, too, had
the significance of a father-substitute. As a boy the patient in question--a
Russian whom I did not analyse till he was in his twenties--had had
a dream (whose meaning was revealed in analysis) and, immediately
after it, had developed a fear of being devoured by a wolf, like the
seven little goats in the fairy tale. In the case of 'Little Hans'
the ascertained fact that his father used to play at horses with him
doubtless determined his choice of a horse as his anxiety-animal.
In the same way it appeared at least highly probable that the father
of my Russian patient used, when playing with him, to pretend to be
a wolf and jokingly threaten to gobble him up. Since then I have come
across a third instance. The patient was a young American who came
to me for analysis. He did not, it is true, develop an animal phobia,
but it is precisely because of this omission that his case helps to
throw light upon the other two. As a child he had been sexually excited
by a fantastic children's story which had been read aloud to him about
an Arab chief who pursued a 'ginger-bread man' so as to eat him up.
He identified himself with this edible person, and the Arab chief
was easily recognizable as a father-substitute. This phantasy formed
the earliest substratum of his auto-erotic phantasies.
The idea of being devoured by the father
is typical age-old childhood material. It has familiar parallels in
mythology (e.g. the myth of Kronos) and in the animal kingdom. Yet
in spite of this confirmation the idea is so strange to us that we
can hardly credit its existence in a child. Nor do we know whether
it really means what it seems to say, and we cannot understand how
it can have become the subject of a phobia. Analytic observation supplies
the requisite information. It shows that the idea of being devoured
by the father gives expression, in a form that has undergone regressive
degradation, to a passive, tender impulse to be loved by him in a
genital-erotic sense. Further investigation of the case history leaves
no doubt of the correctness of this explanation. The genital impulse,
it is true, betrays no sign of its tender purpose when it is expressed
in the language belonging to the superseded transitional phase between
the oral and sadistic organizations of the libido. Is it, moreover,
a question merely of the replacement of the [psychical] representative
by a regressive form of expression or is it a question of a genuine
regressive degradation of the genitally-directed impulse in the id?
It is not at all easy to make certain. The case history of the Russian
'Wolf Man' gives very definite support to the second, more serious,
view; for, from the time of the decisive dream onward, the boy became
naughty, tormenting and sadistic, and soon afterwards developed a
regular obsessional neurosis. At any rate, we can see that repression
is not the only means which the ego can employ for the purpose of
defence against an unwelcome instinctual impulse. If it succeeds in
making an instinct regress, it will actually have done it more injury
than it could have by repressing it. Sometimes, indeed, after forcing
an instinct to regress in this way, it goes on to repress it.
The case of the 'Wolf Man' and the somewhat
less complicated one of 'Little Hans' raise a number of further considerations.
But we have already made two unexpected discoveries. There can be
no doubt that the instinctual impulse which was repressed in both
phobias was a hostile one against the father. One might say that that
impulse had been repressed by the process of being transformed into
its opposite. Instead of aggressiveness on the part of the subject
towards his father, there appeared aggressiveness (in the shape of
revenge) on the part of his father towards the subject. Since this
aggressiveness is in any case rooted in the sadistic phase of the
libido, only a certain amount of degradation is needed to reduce it
to the oral stage. This stage, while only hinted at in 'Little Hans's'
fear of being bitten, was blatantly exhibited in the 'Wolf Man's'
terror of being devoured. But, besides this, the analysis has demonstrated,
beyond a shadow of doubt, the presence of another instinctual impulse
of an opposite nature which had succumbed to repression. This was
a tender, passive impulse directed towards the father, which had already
reached the genital (phallic) level of libidinal organization. As
regards the final outcome of the process of repression, this impulse
seems, indeed, to have been the more important of the two; it underwent
a more far-reaching regression and had a decisive influence upon the
content of the phobia. In following up a single instinctual
repression we have thus had to recognize a convergence of two
such processes. The two instinctual impulses that have been overtaken
by repression--sadistic aggressiveness towards the father and a tender
passive attitude to him--form a pair of opposites. Furthermore, a
full appreciation of 'Little Hans's' case shows that the formation
of his phobia had had the effect of abolishing his affectionate object-cathexis
of his mother as well, though the actual content of his phobia betrayed
no sign of this. The process of repression had attacked almost all
the components of his Oedipus complex--both his hostile and his tender
impulses towards his father and his tender impulses towards his mother.
In my Russian patient this state of affairs was much less obvious.
These are unwelcome complications, considering
that we only set out to study simple cases of symptom-formation due
to repression, and with that intention selected the earliest and,
to all appearances, most transparent neuroses of childhood. Instead
of a single repression we have found a collection of them and have
become involved with regression into the bargain. Perhaps we have
added to the confusion by treating the two cases of animal phobia
at our disposal--'Little Hans' and the 'Wolf Man'--as though they
were cast in the same mould. As a matter of fact, certain differences
between them stand out. It is only with regard to 'Little Hans' that
we can say with certainty that what his phobia disposed of were the
two main impulses of the Oedipus complex--his aggressiveness towards
his father and his over-fondness for his mother. A tender feeling
for his father was undoubtedly there too and played a part in repressing
the opposite feeling; but we can prove neither that it was strong
enough to draw repression upon itself nor that it disappeared afterwards.
'Hans' seems, in fact, to have been a normal boy with what is called
a 'positive' Oedipus complex. It is possible that the factors which
we do not find were actually at work in him, but we cannot demonstrate
their existence. Even the most exhaustive analysis has gaps in its
data and is insufficiently documented. In the case of the Russian
the deficiency lies elsewhere. His attitude to female objects had
been disturbed by an early seduction and his passive, feminine side
was strongly developed. The analysis of his wolf-dream revealed very
little intentional aggressiveness towards his father, but it brought
forward unmistakable proof that what repression overtook was his passive
tender attitude to his father. In his case, too, the other factors
may have been operative as well; but they were not in evidence. How
is it that, in spite of these differences in the two cases, almost
amounting to an antithesis, the final outcome--a phobia--was approximately
the same? The answer must be sought in another quarter. I think it
will be found in the second fact which emerges from our brief comparative
examination. It seems to me that in both cases we can detect what
the motive force of the repression was and can substantiate our view
of its nature from the line of development which the two children
subsequently pursued. This motive force was the same in both of them.
It was the fear of impending castration. 'Little Hans' gave up his
aggressiveness towards his father from fear of being castrated. His
fear that a horse would bite him can, without any forcing, be given
the full sense of a fear that a horse would bite off his genitals,
would castrate him. But it was from fear of being castrated, too,
that the little Russian relinquished his wish to be loved by his father,
for he thought that a relation of that sort presupposed a sacrifice
of his genitals--of the organ which distinguished him from a female.
As we see, both forms of the Oedipus complex, the normal, active form
and the inverted one, came to grief through the castration complex.
The Russian boy's anxiety-idea of being devoured by a wolf contained,
it is true, no suggestion of castration, for the oral regression it
had undergone had removed it too far from the phallic stage. But the
analysis of his dream rendered further proof superfluous. It was a
triumph of repression that the form in which his phobia was expressed
should no longer have contained any allusion to castration.
Here, then, is our unexpected finding:
in both patients the motive force of the repression was fear of castration.
The ideas contained in their anxiety--being bitten by a horse and
being devoured by a wolf--were substitutes by distortion for the idea
of being castrated by their father. This was the idea which had undergone
repression. In the Russian boy the idea was an expression of a wish
which was not able to subsist in the face of his masculine revolt;
in 'Little Hans' it was the expression of a reaction in him which
had turned his aggressiveness into its opposite. But the affect
of anxiety, which was the essence of the phobia, came, not from the
process of repression, not from the libidinal cathexes of the repressed
impulses, but from the repressing agency itself. The anxiety belonging
to the animal phobias was an untransformed fear of castration. It
was therefore a realistic fear, a fear of a danger which was actually
impending or was judged to be a real one. It was anxiety which produced
repression and not, as I formerly believed, repression which produced
anxiety.
It is no use denying the fact, though
it is not pleasant to recall it, that I have on many occasions asserted
that in repression the instinctual representative is distorted, displaced,
and so on, while the libido belonging to the instinctual impulse is
transformed into anxiety. But now an examination of phobias, which
should be best able to provide confirmatory evidence, fails to bear
out my assertion; it seems, rather, to contradict it directly. The
anxiety felt in animal phobias is the ego's fear of castration; while
the anxiety felt in agoraphobia (a subject that has been less thoroughly
studied) seems to be its fear of sexual temptation--a fear which, after
all, must be connected in its origins with the fear of castration.
As far as can be seen at present, the majority of phobias go back
to an anxiety of this kind felt by the ego in regard to the demands
of the libido. It is always the ego's attitude of anxiety which is
the primary thing and which sets repression going. Anxiety never arises
from repressed libido. If I had contented myself earlier with saying
that after the occurrence of repression a certain amount of anxiety
appeared in place of the manifestation of libido that was to be expected,
I should have nothing to retract today. The description would be
correct; and there does undoubtedly exist a correspondence of the
kind asserted between the strength of the impulse that has to be repressed
and the intensity of the resultant anxiety. But I must admit that
I thought I was giving more than a mere description. I believed I
had put my finger on a metapsychological process of direct transformation
of libido into anxiety. I can now no longer maintain this view. And,
indeed, I found it impossible at the time to explain how a transformation
of that kind was carried out.
It may be asked how I arrived at this idea
of transformation in the first instance. It was while I was studying
the 'actual neuroses', at a time when analysis was still a very long
way from distinguishing between processes in the ego and processes
in the id. I found that outbreaks of anxiety and a general state of
preparedness for anxiety were produced by certain sexual practices
such as coitus interruptus, undischarged sexual excitation
or enforced abstinence--that is, whenever sexual excitation was inhibited,
arrested or deflected in its progress towards satisfaction. Since
sexual excitation was an expression of libidinal instinctual impulses
it did not seem too rash to assume that the libido was turned into
anxiety through the agency of these disturbances. The observations
which I made at the time still hold good. Moreover, it cannot be denied
that the libido belonging to the id-processes is subjected to disturbance
at the instigation of repression. It might still be true, therefore,
that in repression anxiety is produced from the libidinal cathexis
of the instinctual impulses. But how can we reconcile this conclusion
with our other conclusion that the anxiety felt in phobias is an ego
anxiety and arises in the ego, and that it does not proceed out of
repression but, on the contrary, sets repression in motion? There
seems to be a contradiction here which it is not at all a simple matter
to solve. It will not be easy to reduce the two sources of anxiety
to a single one. We might attempt to do so by supposing that, when
coitus is disturbed or sexual excitation interrupted or abstinence
enforced, the ego scents certain dangers to which it reacts with anxiety.
But this takes us nowhere. On the other hand, our analysis of the
phobias seems to admit of no correction. Non liquet ['It is
not clear.' An old legal verdict used when the evidence was inconclusive;
compare the Scottish 'not proven'.]
V
WE set out to study the formation of symptoms and the secondary struggle
waged by the ego against symptoms. But in picking on the phobias for
this purpose we have clearly made an unlucky choice. The anxiety which
predominates in the picture of these disorders is now seen as a complication
which obscures the situation. There are plenty of neuroses which exhibit
no anxiety whatever. True conversion hysteria is one of these. Even
in its most severe symptoms no admixture of anxiety is found. This
fact alone ought to warn us against making too close a connection
between anxiety and symptom-formation. The phobias are so closely
akin to conversion hysteria in every other respect that I have felt
justified in classing them alongside of it under the name of 'anxiety
hysteria'. But no one has as yet been able to say what it is that
determines whether any given case shall take the form of a conversion
hysteria or a phobia--has been able, that is to say, to establish what
determines the generating of anxiety in hysteria.
The commonest symptoms of conversion
hysteria--motor paralyses, contractures, involuntary actions or discharges,
pains and hallucinations--are cathectic processes which are either
permanently maintained or intermittent. But this puts fresh difficulties
in the way. Not much is actually known about these symptoms. Analysis
can show what the disturbed excitatory process is which the symptoms
replace. It usually turns out that they themselves have a share in
that process. It is as though the whole energy of the process had
been concentrated in this one part of it. For instance, it will be
found that the pains from which a patient suffers were present in
the situation in which the repression occurred; or that his hallucination
was, at that time, a perception; or that his motor paralysis is a
defence against an action which should have been performed in that
situation but was inhibited; or that his contracture is usually a
displacement of an intended innervation of the muscles in some other
part of his body; or that his convulsions are the expression of an
outburst of affect which has been withdrawn from the normal control
of the ego. The sensation of unspleaure which accompanies the appearance
of the symptoms varies in a striking degree. In chronic symptoms which
have been displaced on to motility, like paralyses and contractures,
it is almost always entirely absent; the ego behaves towards the symptoms
as though it had nothing to do with them. In intermittent symptoms
and in those concerned with the sensory sphere, sensations of unpleasure
are as a rule distinctly felt; and in symptoms of pain these may reach
an extreme degree. The picture presented is so manifold that it is
difficult to discover the factor which permits of all these variations
and yet allows a uniform explanation of them. There is, moreover,
little to be seen in conversion hysteria of the ego's struggle against
the symptom after it has been formed. It is only when sensitivity
to pain in some part of the body constitutes the symptom that that
symptom is in a position to play a dual role. The symptom of pain
will appear no less regularly whenever the part of the body concerned
is touched from outside than when the pathogenic situation which it
represents is associatively activated from within; and the ego will
take precautions to prevent the symptom from being aroused through
external perceptions. Why the formation of symptoms in conversion
hysteria should be such a peculiarly obscure thing I cannot tell;
but the fact affords us a good reason for quitting such an unproductive
field of enquiry without delay.
Let us turn to the obsessional neuroses in
the hope of learning more about the formation of symptoms. The symptoms
belonging to this neurosis fall, in general, into two groups, each
having an opposite trend. They are either prohibitions, precautions
and expiations--that is, negative in character--or they are, on the
contrary, substitutive satisfactions which often appear in symbolic
disguise. The negative, defensive group of symptoms is the older of
the two; but as illness is prolonged, the satisfactions, which scoff
at all defensive measures, gain the upper hand. The symptom-formation
scores a triumph if it succeeds in combining the prohibition with
satisfaction so that what was originally a defensive command or prohibition
acquires the significance of a satisfaction as well; and in order
to achieve this end it will often make use of the most ingenious associative
paths. Such an achievement demonstrates the tendency of the ego to
synthesize, which we have already observed. In extreme cases the patient
manages to make most of his symptoms acquire, in addition to their
original meaning, a directly contrary one. This is a tribute to the
power of ambivalence, which, for some unknown reason, plays such a
large part in obsessional neuroses. In the crudest instance the symptom
is diphasic: an action which carries out a certain injunction is immediately
succeeded by another action which stops or undoes the first one even
if it does not go quite so far as to carry out its opposite.
Two impressions at once emerge from
this brief survey of obsessional symptoms. The first is that a ceaseless
struggle is being waged against the repressed, in which the repressing
forces steadily lose ground; the second is that the ego and the super-ego
have a specially large share in the formation of the symptoms.
Obsessional neurosis is unquestionably
the most interesting and repaying subject of analytic research. But
as a problem it has not yet been mastered. It must be confessed that,
if we endeavour to penetrate more deeply into its nature, we still
have to rely upon doubtful assumptions and unconfirmed suppositions.
Obsessional neurosis originates, no doubt, in the same situation as
hysteria, namely, the necessity offending off the libidinal demands
of the Oedipus complex. Indeed, every obsessional neurosis seems to
have a substratum of hysterical symptoms that have been formed at
a very early stage. But it is subsequently shaped along quite different
lines owing to a constitutional factor. The genital organization of
the libido turns out to be feeble and insufficiently resistant, so
that when the ego begins its defensive efforts the first thing it
succeeds in doing is to throw back the genital organization (of the
phallic phase), in whole or in part, to the earlier sadistic-anal
level. This fact of regression is decisive for all that follows.
Another possibility has to be considered.
Perhaps regression is the result not of a constitutional factor but
of a time-factor. It may be that regression is rendered possible not
because the genital organization of the libido is too feeble but because
the opposition of the ego begins too early, while the sadistic phase
is at its height. I am not prepared to express a definite opinion
on this point, but I may say that analytic observation does not speak
in favour of such an assumption. It shows rather that, by the time
an obsessional neurosis is entered upon, the phallic stage has already
been reached. Moreover, the onset of this neurosis belongs to a later
time of life than that of hysteria--to the second period of childhood,
after the latency period has set in. In a woman patient whose case
I was able to study and who was overtaken by this disorder at a very
late date, it became clear that the determining cause of her regression
and of the emergence of her obsessional neurosis was a real occurrence
through which her genital life, which had up till then been intact,
lost all its value.
As regards the metapsychological explanation
of regression, I am inclined to find it in a 'defusion of instinct',
in a detachment of the erotic components which, with the onset of
the genital stage, had joined the destructive cathexes belonging to
the sadistic phase.
In enforcing regression, the ego scores
its first success in its defensive struggle against the demands of
the libido. (In this connection it is of advantage to distinguish
the more general notion of' 'defence' from 'repression'. Repression
is only one of the mechanisms which defence makes use of.) It is perhaps
in obsessional cases more than in normal or hysterical ones that we
can most clearly recognize that the motive force of defence is the
castration complex and that what is being fended off are the trends
of the Oedipus complex. We are at present dealing with the beginning
of the latency period, a period which is characterized by the dissolution
of the Oedipus complex, the creation or consolidation of the super-ego
and the erection of ethical and aesthetic barriers in the ego. In
obsessional neuroses these processes are carried further than is normal.
In addition to the destruction of the Oedipus complex a regressive
degradation of the libido takes place, the super-ego becomes exceptionally
severe and unkind, and the ego, in obedience to the super-ego, produces
strong reaction-formations in the shape of conscientiousness, pity
and cleanliness. Implacable, though not always on that account successful,
severity is shown in condemning the temptation to continue early infantile
masturbation, which now attaches itself to regressive (sadistic-anal)
ideas but which nevertheless represents the unsubjugated part of the
phallic organization. There is an inherent contradiction about this
state of affairs, in which, precisely in the interests of masculinity
(that is to say, from fear of castration), every activity belonging
to masculinity is stopped. But here, too, obsessional neurosis is
only overdoing the normal method of getting rid of the Oedipus complex.
We once more find here an illustration of the truth that every exaggeration
contains the seed of its own undoing. For, under the guise of obsessional
acts, the masturbation that has been suppressed approaches ever more
closely to satisfaction.
The reaction-formations in the ego of the obsessional neurotic, which
we recognize as exaggerations of normal character-formation, should
be regarded, I think, as yet another mechanism of defence and placed
alongside of regression and repression. They seem to be absent or
very much weaker in hysteria. Looking back, we can now get an idea
of what is peculiar to the defensive process in hysteria. It seems
that in it the process is limited to repression alone. The ego turns
away from the disagreeable instinctual impulse, leaves it to pursue
its course in the unconscious, and takes no further part in its fortunes.
This view cannot be absolutely correct, for we are acquainted with
the case in which a hysterical symptom is at the same time a fulfillment
of a penalty imposed by the superego; but it may describe a general
characteristic of the behaviour of the ego in hysteria.
We can either simply accept it as a
fact that in obsessional neurosis a super-ego of this severe kind
emerges, or we can take the regression of the libido as the fundamental
characteristic of the affection and attempt to relate the severity
of the superego to it. And indeed the super-ego, originating as it
does from the id, cannot dissociate itself from the regression and
defusion of instinct which have taken place there. We cannot be surprised
if it becomes harsher, unkinder and more tormenting than where development
has been normal.
The chief task during the latency period
seems to be the fending-off of the temptation to masturbate. This
struggle produces a series of symptoms which appear in a typical fashion
in the most different individuals and which in general have the character
of a ceremonial. It is a great pity that no one has as yet collected
them and systematically analysed them. Being the earliest products
of the neurosis they should best be able to shed light on the mechanisms
employed in its symptom-formation. They already exhibit the features
which will emerge so disastrously if a serious illness follows. They
tend to become attached to activities (which would later be carried
out almost automatically) such as going to sleep, washing, dressing
and walking about; and they tend also to repetition and waste of time.
Why this should be so is at present not at all clear; but the sublimation
of anal-erotic components plays an unmistakable part in it.
The advent of puberty opens a decisive
chapter in the history of an obsessional neurosis. The genital organization
which has been broken off in childhood starts again with great vigour.
But, as we know, the sexual development in childhood determines what
direction this new start at puberty will take. Not only will the early
aggressive impulses be re-awakened; but a greater or lesser proportion
of the new libidinal impulses--in bad cases the whole of them--will
have to follow the course prescribed for them by regression and will
emerge as aggressive and destructive tendencies. In consequence of
the erotic trends being disguised in this way and owing to the powerful
reaction-formations in the ego, the struggle against sexuality will
henceforward be carried on under the banner of ethical principles.
The ego will recoil with astonishment from promptings to cruelty and
violence which enter consciousness from the id, and it has no notion
that in them it is combating erotic wishes, including some to which
it would not otherwise have taken exception. The over-strict super-ego
insists all the more strongly on the suppression of sexuality, since
this has assumed such repellent forms. Thus in obsessional neurosis
the conflict is aggravated in two directions: the defensive forces
become more intolerant and the forces that are to be fended off become
more intolerable. Both effects are due to a single factor, namely,
regression of the libido.
A good deal of what has been said may
be objected to on the ground that the unpleasant obsessive ideas are
themselves quite conscious. But there is no doubt that before becoming
conscious they have been through the process of repression. In most
of them the actual wording of the aggressive instinctual impulse is
altogether unknown to the ego, and it requires a good deal of analytic
work to make it conscious. What does penetrate into consciousness
is usually only a distorted substitute which is either of a vague,
dream-like and indeterminate nature or so travestied as to be unrecognizable.
Even where repression has not encroached upon the content of the aggressive
impulse it has certainly got rid of its accompanying affective character.
As a result, the aggressiveness appears to the ego not to be an impulsion
(but, as the patients themselves say, merely a 'thought' which awakens
no feeling. But the remarkable thing is that this is not the case.
What happens is that the affect left out when the obsessional idea
is perceived appears in a different place. The super-ego behaves as
though repression had not occurred and as though it knew the real
wording and full affective character of the aggressive impulse, and
it treats the ego accordingly. The ego which, on the one hand, knows
that it is innocent is obliged, on the other hand, to be aware of
a sense of guilt and to carry a responsibility which it cannot account
for. This state of affairs is, however, not so puzzling as it would
seem at first sight. The behaviour of the super-ego is perfectly intelligible,
and the contradiction in the ego merely shows that it has shut out
the id by means of repression while remaining fully accessible to
the influence of the super-ego. If it is asked why the ego does not
also attempt to withdraw from the tormenting criticism of the super-ego,
the answer is that it does manage to do so in a great number of instances.
There are obsessional neuroses in which no sense of guilt whatever
is present. In them, as far as can be seen, the ego has avoided becoming
aware of it by instituting a fresh set of symptoms, penances or restrictions
of a self-punishing kind. These symptoms, however, represent at the
same time a satisfaction of masochistic impulses which, in their turn,
have been reinforced by regression.
Obsessional neurosis presents such a
vast multiplicity of phenomena that no efforts have yet succeeded
in making a coherent synthesis of all its variations. All we can do
is to pick out certain typical correlations; but there is always the
risk that we may have overlooked other uniformities of a no less important
kind.
I have already described the general
tendency of symptom-formation in obsessional neurosis. It is to give
ever greater room to substitutive satisfaction at the expense of frustration.
Symptoms which once stood for a restriction of the ego come later
on to represent satisfactions as well, thanks to the ego's inclination
to synthesis, and it is quite clear that this second meaning gradually
becomes the more important of the two. The result of this process,
which approximates more and more to a complete failure of the original
purpose of defence, is an extremely restricted ego which is reduced
to seeking satisfaction in the symptoms. The displacement of the distribution
of forces--in favour of satisfaction may have the dreaded final outcome
of paralysing the will of the ego, which in every decision it has
to make is almost as strongly impelled from the one side as from the
other. The over-acute conflict between id and superego which has dominated
the illness from the very beginning may assume such extensive proportions
that the ego, unable to carry out its office of mediator, can undertake
nothing which is not drawn into the sphere of that conflict.
VI
IN the course of these struggles we come across two activities of
the ego which form symptoms and which deserve special attention because
they are obviously surrogates of repression and therefore well calculated
to illustrate its purpose and technique. The fact that such auxiliary
and substitutive techniques emerge may argue that true repression
has met with difficulties in its functioning. If one considers how
much more the ego is the scene of action of symptom-formation in obsessional
neurosis than it is in hysteria and with what tenacity the ego clings
to its relations to reality and to consciousness, employing all its
intellectual faculties to that end--and indeed how the very process
of thinking becomes hypercathected and erotized--then one may perhaps
come to a better understanding of these variations of repression.
The two techniques I refer to are undoing
what has been done and isolating. The first of these has
a wide range of application and goes back very far. It is, as it were,
negative magic, and endeavours, by means of motor symbolism, to 'blow
away' not merely the consequences of some event (or experience
or impression) but the event itself. I choose the term 'blow away'
advisedly, so as to remind the reader of the part played by this technique
not only in neuroses but in magical acts, popular customs and religious
ceremonies as well. In obsessional neurosis the technique of undoing
what has been done is first met with in the 'diphasic' symptoms [p.
113], in which one action is cancelled out by a second, so that it
is as though neither action had taken place, whereas, in reality,
both have. This aim of undoing is the second underlying motive of
obsessional ceremonials, the first being to take precautions in order
to prevent the occurrence or recurrence of some particular event.
The difference between the two is easily seen: the precautionary measures
are rational, while trying to get rid of something by 'making it not
to have happened' is irrational and in the nature of magic. It is
of course to be suspected that the latter is the earlier motive of
the two and proceeds from the animistic attitude towards the environment.
This endeavour to undo shades off into normal behaviour in the case
in which a person decides to regard an event as not having happened.
But whereas he will take no direct steps against the event, and will
simply pay no further attention to it or its consequences, the neurotic
person will try to make the past itself non-existent. He will try
to repress it by motor means. The same purpose may perhaps account
for the obsession for repeating which is so frequently met
with in this neurosis and the carrying out of which serves a number
of contradictory intentions at once. When anything has not happened
in the desired way it is undone by being repeated in a different way;
and thereupon all the motives that exist for lingering over such repetitions
come into play as well. As the neurosis proceeds, we often find that
the endeavour to undo a traumatic experience is a motive of first-rate
importance in the formation of symptoms. We thus unexpectedly discover
a new, motor technique of defence, or (as we may say in this case
with less inaccuracy) of repression.
The second of these techniques which
we are setting out to describe for the first time, that of isolation,
is peculiar to obsessional neurosis. It, too, takes place in the motor
sphere. When something unpleasant has happened to the subject or when
he himself has done something which has a significance for his neurosis,
he interpolates an interval during which nothing further must happen--during
which he must perceive nothing and do nothing. This behaviour, which
seems strange at first sight, is soon seen to have a relation to repression.
We know that in hysteria it is possible to cause a traumatic experience
to be overtaken by amnesia. In obsessional neurosis this can often
not be achieved: the experience is not forgotten, but, instead, it
is deprived of its affect, and its associative connections are suppressed
or interrupted so that it remains as though isolated and is not reproduced
in the ordinary processes of thought. The effect of this isolation
is the same as the effect of repression with amnesia. This technique,
then, is reproduced in the isolations of obsessional neurosis; and
it is at the same time given motor reinforcement for magical purposes.
The elements that are held apart in this way are precisely those which
belong together associatively. The motor isolation is meant to ensure
an interruption of the connection in thought. The normal phenomenon
of concentration provides a pretext for this kind of neurotic procedure:
what seems to us important in the way of an impression or a piece
of work must not be interfered with by the simultaneous claims of
any other mental processes or activities. But even a normal person
uses concentration to keep away not only what is irrelevant or unimportant,
but, above all, what is unsuitable because it is contradictory. He
is most disturbed by those elements which once belonged together but
which have been torn apart in the course of his development--as, for
instance, by manifestations of the ambivalence of his father-complex
in his relation to God, or by impulses attached to his excretory organs
in his emotions of love. Thus, in the normal course of things, the
ego has a great deal of isolating work to do in its function of directing
the current of thought. And, as we know, we are obliged, in carrying
out our analytic technique, to train it to relinquish that function
for the time being, eminently justified as it usually is.
We have all found by experience that
it is especially difficult for an obsessional neurotic to carry out
the fundamental rule of psycho-analysis. His ego is more watchful
and makes sharper isolations, probably because of the high degree
of tension due to conflict that exists between his super-ego and his
id. While he is engaged in thinking, his ego has to keep off too
much--the intrusion of unconscious phantasies and the manifestation
of ambivalent trends. It must not relax, but is constantly prepared
for a struggle. It fortifies this compulsion to concentrate and to
isolate by the help of the magical acts of isolation which, in the
form of symptoms, grow to be so noticeable and to have so much practical
importance for the patient, but which are, of course, useless in themselves
and are in the nature of ceremonials.
But in thus endeavouring to prevent
associations and connections of thought, the ego is obeying one of
the oldest and most fundamental commands of obsessional neurosis,
the taboo on touching. If we ask ourselves why the avoidance of touching,
contact or contagion should play such a large part in this neurosis
and should become the subject-matter of complicated systems, the answer
is that touching and physical contact are the immediate aim of the
aggressive as well as the loving object-cathexes. Eros desires contact
because it strives to make the ego and the loved object one, to abolish
all spatial barriers between them. But destructiveness, too, which
(before the invention of long-range weapons) could only take effect
at close quarters, must presuppose physical contact, a coming to grips.
To 'touch' a woman has become a euphemism for using her as a sexual
object. Not to 'touch' one's genitals is the phrase employed for forbidding
auto-erotic satisfaction. Since obsessional neurosis begins by persecuting
erotic touching and then, after regression has taken place, goes on
to persecute touching in the guise of aggressiveness, it follows that
nothing is so strongly proscribed in that illness as touching nor
so well suited to become the central point of a system of prohibitions.
But isolating is removing the possibility of contact; it is a method
of withdrawing a thing from being touched in any way. And when a neurotic
isolates an impression or an activity by interpolating an interval,
he is letting it be understood symbolically that he will not allow
his thoughts about that impression or activity to come into associative
contact with other thoughts.
This is as far as our investigations
into the formation of symptoms take us. It is hardly worth while summing
them up, for the results they have yielded are scanty and incomplete
and tell us scarcely anything that we do not already know. It would
be fruitless to turn our attention to symptom-formation in other disorders
besides phobias, conversion hysteria and obsessional neurosis, for
too little is known about them. But in reviewing those three neuroses
together we are brought up against a very serious problem the consideration
of which can no longer be put off. All three have as their outcome
the destruction of the Oedipus complex; and in all three the motive
force of the ego's opposition is, we believe, the fear of castration.
Yet it is only in the phobias that this fear comes to the surface
and is acknowledged. What has become of it in the other two neuroses?
How has the ego spared itself this fear? The problem becomes accentuated
when we recall the possibility, already referred to, that anxiety
arises directly, by a kind of fermentation, from a libidinal cathexis
whose processes have been disturbed. Furthermore, is it absolutely
certain that fear of castration is the only motive force of repression
(or defence)? If we think of neuroses in women we are bound to doubt
it. For though we can with certainty establish in them the presence
of a castration complex, we can hardly speak with propriety
of castration anxiety where castration has already taken place.
VII
LET us go back again to infantile phobias of animals; for, when all
is said and done, we understand them better than any other cases.
In animal phobias, then, the ego has to oppose a libidinal object-cathexis
coming from the id--a cathexis that belongs either to the positive
or the negative Oedipus complex--because it believes that to give
way to it would entail the danger of castration. This question has
already been discussed, but there still remains a doubtful point to
clear up. In 'Little Hans's' case--that is, in the case of a positive
Oedipus complex--was it his fondness for his mother or was it his
aggressiveness towards his father which called out the defence by
the ego? In practice it seems to make no difference, especially as
each set of feelings implies the other; but the question has a theoretical
interest, since it is only the feeling of affection for the mother
which can count as a purely erotic one. The aggressive impulse flows
mainly from the destructive instinct; and we have always believed
that in a neurosis it is against the demands of the libido and not
against those of any other instinct that the ego is defending itself.
In point of fact we know that after 'Hans's' phobia had been formed,
his tender attachment to his mother seemed to disappear, having been
completely disposed of by repression, while the formation of the symptom
(the substitutive formation) took place in relation to his aggressive
impulses. In the 'Wolf Man' the situation was simpler. The impulse
that was repressed--his feminine attitude towards his father--was a
genuinely erotic one; and it was in relation to that impulse that
the formation of his symptoms took place.
It is almost humiliating that, after
working so long, we should still be having difficulty in understanding
the most fundamental facts. But we have made up our minds to simplify
nothing and to hide nothing. If we cannot see things clearly we will
at least see clearly what the obscurities are. What is hampering us
here is evidently some hitch in the development of our theory of the
instincts. We began by tracing the organization of the libido through
its successive stages--from the oral through the sadistic-anal to
the genital--and in doing so placed all the components of the sexual
instinct on the same footing. Later it appeared that sadism was the
representative of another instinct, which was opposed to Eros. This
new view, that the instincts fall into two groups, seems to explode
the earlier construction of the successive stages of libidinal organization.
But we do not have to break fresh ground in order to find a way out
of the difficulty. The solution has been at hand for a long time and
lies in the fact that what we are concerned with are scarcely ever
pure instinctual impulses but mixtures in various proportions of the
two groups of instincts. If this is so, there is no need to revise
our view of the organizations of the libido. A sadistic cathexis of
an object may also legitimately claim to be treated as a libidinal
one; and an aggressive impulse against the father can just as well
be subjected to repression as a tender impulse towards the mother.
Nevertheless we shall bear in mind for future consideration the possibility
that repression is a process which has a special relation to the genital
organization of the libido and that the ego resorts to other methods
of defence when it has to secure itself against the libido on other
levels of organization. To continue: a case like 'Little Hans's' does
not enable us to come to any clear conclusion. It is true that in
him an aggressive impulse was disposed of by repression, but this
happened after the genital organization had been reached.
This time we will not lose sight of
the part played by anxiety. We have said that as soon as the ego recognizes
the danger of castration it gives the signal of anxiety and inhibits
through the pleasure-unpleasure agency (in a way which we cannot as
yet understand) the impending cathectic process in the id. At the
same time the phobia is formed. And now the castration anxiety is
directed to a different object and expressed in a distorted form,
so that the patient is afraid, not of being castrated by his father,
but of being bitten by a horse or devoured by a wolf. This substitutive
formation has two obvious advantages. In the first place it avoids
a conflict due to ambivalence (for the father was a loved object,
too), and in the second place it enables the ego to cease generating
anxiety. For the anxiety belonging to a phobia is conditional; it
only emerges when the object of it is perceived--and rightly so, since
it is only then that the danger-situation is present. There is no
need to be afraid of being castrated by a father who is not there.
On the other hand one cannot get rid of a father; he can appear whenever
he chooses. But if he is replaced by an animal, all one has to do
is to avoid the sight of it--that is, its presence--in order to be
free from danger and anxiety. 'Little Hans', therefore, imposed a
restriction upon his ego. He produced the inhibition of not leaving
the house, so as not to come across any horses. The young Russian
had an even easier time of it, for it was hardly a privation for him
not to look at a particular picture-book any more. If his naughty
sister had not kept on showing him the book with the picture of the
wolf standing upright in it, he would have been able to feel safe
from his fear.
On a previous occasion I have stated
that phobias have the character of a projection in that they replace
an internal, instinctual danger by an external, perceptual one. The
advantage of this is that the subject can protect himself against
an external danger by fleeing from it and avoiding the perception
of it, whereas it is useless to flee from dangers that arise from
within. This statement of mine was not incorrect, but it did not go
below the surface of things. For an instinctual demand is, after all,
not dangerous in itself; it only becomes so inasmuch as it entails
a real external danger, the danger of castration. Thus what happens
in a phobia in the last resort is merely that one external danger
is replaced by another. The view that in a phobia the ego is able
to escape anxiety by means of avoidance or of inhibitory symptoms
fits in very well with the theory that that anxiety is only an affective
signal and that no alteration has taken place in the economic situation.
The anxiety felt in animal phobias is,
therefore, an affective reaction on the part of the ego to danger;
and the danger which is being signalled in this way is the danger
of castration. This anxiety differs in no respect from the realistic
anxiety which the ego normally feels in situations of danger, except
that its content remains unconscious and only becomes conscious in
the form of a distortion.
The same will prove true, I think, of
the phobias of adults, although the material which their neuroses
work over is much more abundant and there are some additional factors
in the formation of the symptoms. Fundamentally the position is identical.
The agoraphobic patient imposes a restriction on his ego so as to
escape a certain instinctual danger--namely, the danger of giving
way to his erotic desires. For if he did so the danger of being castrated,
or some similar danger, would once more be conjured up as it was in
his childhood. I may cite as an instance the case of a young man who
became agoraphobic because he was afraid of yielding to the solicitations
of prostitutes and of contracting a syphilitic infection from them
as a punishment.
I am well aware that a number of cases
exhibit a more complicated structure and that many other repressed
instinctual impulses can enter into a phobia. But they are only tributary
streams which have for the most part joined the main current of the
neurosis at a later stage. The symptomatology of agoraphobia is complicated
by the fact that the ego does not confine itself to making a renunciation.
In order to rob the situation of danger it does more: it usually effects
a temporal regression to infancy (in extreme cases, to a time when
the subject was in his mother's womb and protected against the dangers
which threaten him in the present). Such a regression now becomes
a condition whose fulfillment exempts the ego from making its renunciation.
For instance, an agoraphobic patient may be able to walk in the street
provided he is accompanied, like a small child, by someone he knows
and trusts; or, for the same reason, he may be able to go out alone
provided he remains within a certain distance of his own house and
does not go to places which are not familiar to him or where people
do not know him. What these stipulations are will depend in each case
on the infantile factors which dominate him through his neurosis.
The phobia of being alone is unambiguous in its meaning, irrespective
of any infantile regression: it is, ultimately, an endeavour to avoid
the temptation to indulge in solitary masturbation. Infantile regression
can, of course, only take place when the subject is no longer a child.
A phobia generally sets in after a first
anxiety attack has been experienced in specific circumstances, such
as in the street or in a train or in solitude. Thereafter the anxiety
is held in ban by the phobia, but it re-emerges whenever the protective
condition cannot be fulfilled. The mechanism of phobia does good service
as a means of defence and tends to be very stable. A continuation
of the defensive struggle, in the shape of a struggle against the
symptom, occurs frequently but not invariably.
What we have learnt about anxiety in
phobias is applicable to obsessional neuroses as well. In this respect
it is not difficult for us to put obsessional neuroses on all fours
with phobias. In the former, the mainspring of all later symptom-formation
is clearly the ego's fear of its super-ego. The danger-situation from
which the ego must get away is the hostility of the superego. There
is no trace of projection here; the danger is completely internalized.
But if we ask ourselves what it is that the ego fears from the super-ego,
we cannot but think that the punishment threatened by the latter must
be an extension of the punishment of castration. Just as the father
has become depersonalized in the shape of the super-ego, so has the
fear of castration at his hands become transformed into an undefined
social or moral anxiety. But this anxiety is concealed. The ego escapes
it by obediently carrying out the commands, precautions and penances
that have been enjoined on it. If it is impeded in doing so, it is
at once overtaken by an extremely distressing feeling of discomfort
which may be regarded as an equivalent of anxiety and which the patients
themselves liken to anxiety.
The conclusion we have come to, then,
is this. Anxiety is a reaction to a situation of danger. It is obviated
by the ego's doing something to avoid that situation or to withdraw
from it. It might be said that symptoms are created so as to avoid
the generating of anxiety. But this does not go deep enough. It would
be truer to say that symptoms are created so as to avoid a danger-situation
whose presence has been signalled by the generation of anxiety. In
the cases that we have discussed, the danger concerned was the danger
of castration or of something traceable back to castration.
If anxiety is a reaction of the ego
to danger, we shall be tempted to regard the traumatic neuroses, which
so often follow upon a narrow escape from death, as a direct result
of a fear of death (or fear for life) and to dismiss from our
minds the question of castration and the dependent relationships of
the ego. Most of those who observed the traumatic neuroses that occurred
during the last war took this line, and triumphantly announced that
proof was now forthcoming that a threat to the instinct of self-preservation
could by itself produce a neurosis without any admixture of sexual
factors and without requiring any of the complicated hypotheses of
psycho-analysis. It is in fact greatly to be regretted that not a
single analysis of a traumatic neurosis of any value is extant. And
it is to be regretted, not because such an analysis would contradict
the aetiological importance of sexuality--for any such contradiction
has long since been disposed of by the introduction of the concept
of narcissism, which brings the libidinal cathexis of the ego into
line with the cathexes of objects and emphasizes the libidinal character
of the instinct of self-preservation--but because, in the absence
of any analyses of this kind, we have lost a most precious opportunity
of drawing decisive conclusions about the relations between anxiety
and the formation of symptoms. In view of all that we know about the
structure of the comparatively simple neuroses of everyday life, it
would seem highly improbable that a neurosis could come into being
merely because of the objective presence of danger, without any participation
of the deeper levels of the mental apparatus. But the unconscious
seems to contain nothing that could give any content to our concept
of the annihilation of life. Castration can be pictured on the basis
of the daily experience of the faeces being separated from the body
or on the basis of losing the mother's breast at weaning. But nothing
resembling death can ever have been experienced; or if it has, as
in fainting, it has left no observable traces behind. I am therefore
inclined to adhere to the view that the fear of death should be regarded
as analogous to the fear of castration and that the situation to which
the ego is reacting is one of being abandoned by the protecting super-ego--the
powers of destiny--so that it has no longer any safeguard against
all the dangers that surround it. In addition, it must be remembered
that in the experiences which lead to a traumatic neurosis the protective
shield against external stimuli is broken through and excessive amounts
of excitation impinge upon the mental apparatus; so that we have here
a second possibility--that anxiety is not only being signalled as
an affect but is also being freshly created out of the economic conditions
of the situation.
The statement I have just made, to the
effect that the ego has been prepared to expect castration by having
undergone constantly repeated object-losses, places the question of
anxiety in a new light. We have hitherto regarded it as an affective
signal of danger; but now, since the danger is so often one of castration,
it appears to us as a reaction to a loss, a separation. Even though
a number of considerations immediately arise which make against this
view, we cannot but be struck by one very remarkable correlation.
The first experience of anxiety which an individual goes through (in
the case of human beings, at all events) is birth, and, objectively
speaking, birth is a separation from the mother. It could be compared
to a castration of the mother (by equating the child with a penis).
Now it would be very satisfactory if anxiety, as a symbol of a separation,
were to be repeated on every subsequent occasion on which a separation
took place. But unfortunately we are prevented from making use of
this correlation by the fact that birth is not experienced subjectively
as a separation from the mother, since the foetus, being a completely
narcissistic creature, is totally unaware of her existence as an object.
Another adverse argument is that we know what the affective reactions
to a separation are: they are pain and mourning, not anxiety. Incidentally,
it may be remembered that in discussing the question of mourning we
also failed to discover why it should be such a painful thing.
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