Chapter XV: Part 15

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

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

_Causation of Predisposition + Accidental
Neurosis_ = resulting from (_traumatic_)
Libido-fixation Experiences
↙ ↘
———————————— ————————————
↓ ↓
Sexual Infantile
Constitution Experiences
(_Ancestral
experiences_)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

TWENTY-FOURTH LECTURE
ORDINARY NERVOUSNESS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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