particular objects, the ‘_adhesiveness_’ of the Libido, so to say, seems
to be an independent factor, varying in individuals, the determining
conditions of which are completely unknown to us, but the importance of
which in the ætiology of the neuroses we shall certainly no longer
underestimate. At the same time we should not overestimate the close
relation between the two things. A similar ‘adhesiveness’ of the Libido
occurs—from unknown causes—in normal people under numerous conditions,
and is found as a decisive factor in those persons who in a certain
sense are the extreme opposite of neurotics—namely, perverted persons.
It was known before the time of psycho-analysis that in the anamnesis of
such persons a very early impression, relating to an abnormal
instinct-tendency or object-choice, is frequently discovered, to which
the Libido of that person henceforth remains attached for life (Binet).
It is often hard to say what has enabled this impression to exert such
an intense power of attraction upon the Libido. I will describe a case
of this kind observed by myself. A man to whom the genitals and all the
other attractions in a woman now mean nothing can be roused to
irresistible sexual excitation only by a shoe-clad foot of a certain
shape; he can remember an event in his sixth year which determined this
fixation of Libido. He was sitting upon a stool by the side of his
governess who was to give him an English lesson. She was a plain,
elderly, shrivelled old maid, with watery blue eyes and a snub nose, and
on this day she had hurt her foot and had it therefore stretched out on
a cushion in a velvet slipper, with the leg itself most decorously
concealed. Later on, after a timid attempt at normal sexual activity
during puberty, a thin sinewy foot like that of the governess became his
only sexual object; and if still other features in the person reminded
him of the type of woman represented by the English governess the man
was helplessly attracted. This fixation of the Libido, however, rendered
him not neurotic but perverse; he became, as we say, a foot-fetichist.
So you see that although an excessive and, in addition, premature
fixation of Libido is an indispensable condition in the causation of
neurosis, the extent of its influence far exceeds the boundaries of the
neuroses. This condition by itself is also as little decisive as the
privation mentioned previously.
So the problem of the causation of the neuroses seems to become more
complicated. In fact, psycho-analytic investigation acquaints us with
yet a new factor, not considered in our ætiological series, and best
observed in someone whose previous good health is suddenly disturbed by
falling ill of a neurosis. In these people signs of contradictory and
opposed wishes, or, as we say, of _mental conflict_, are regularly
found. One side of the personality stands for certain wishes, while
another part struggles against them and fends them off. There is no
neurosis without such a CONFLICT. There might seem to be nothing very
special in this; you know that mental life in all of us is perpetually
engaged with conflicts that have to be decided. Therefore it would seem
that special conditions must be fulfilled before such a conflict can
become pathogenic; we may ask what these conditions are, what forces in
the mind take part in these pathogenic conflicts, and what relation
conflict bears to the other causative factors.
I hope to be able to give you answers to these questions which will be
satisfactory although perhaps schematically condensed. Conflict is
produced by privation, in that the Libido which lacks satisfaction is
urged to seek other paths and other objects. A condition of it then is
that these other paths and objects arouse disfavour in one side of the
personality, so that a veto ensues, which at first makes the new way of
satisfaction impossible. This is the point of departure for the
formation of symptoms, which we shall follow up later. The rejected
libidinal longings manage to pursue their course by circuitous paths,
though not indeed without paying toll to the prohibition in the form of
certain disguises and modifications. The circuitous paths are the ways
of symptom-formation; the symptoms are the new or substitutive
satisfactions necessitated by the fact of the privation.
The significance of the mental conflict can be defined in another way,
thus: in order to become pathogenic _external_ privation must be
supplemented by _internal_ privation. When this is so, the external and
the internal privation relate of course to different paths and different
objects; external privation removes one possibility of satisfaction,
internal privation tries to exclude another possibility, and it is this
second possibility which becomes the debatable ground of the conflict. I
choose this form of presentation because it contains a certain
implication; it implies that the internal impediment arose originally,
in primitive phases of human development, out of real external
obstacles.
But what are these forces out of which the prohibition against the
libidinal longings proceeds, the other parties in the pathogenic
conflict? Speaking very broadly, we may say that they are the non-sexual
instincts. We include them all under the name ‘_Ego-instincts_’;
analysis of the transference neuroses offers no adequate opportunity for
further investigation of them; at most we learn something of them from
the resistances opposed to the analysis. The pathogenic conflict is,
therefore, one between the Ego-instincts and the sexual instincts. In a
whole series of cases it looks as though there might also be conflict
between various purely sexual impulses; at bottom, however, this is the
same thing, because of the two sexual impulses engaged in a conflict one
will always be found ‘consistent with the Ego’ (_ichgerecht_) while the
other calls forth a protest from the Ego. It remains, therefore, a
conflict between Ego and sexuality.
Over and over again when psycho-analysis has regarded something
happening in the mind as an expression of the sexual instincts indignant
protests have been raised to the effect that other instincts and other
interests exist in mental life besides the sexual, that one should not
derive “everything” from sexuality, and so on. Well, it is a real
pleasure for once to be in agreement with one’s opponents.
Psycho-analysis has never forgotten that non-sexual instincts also
exist; it has been built upon a sharp distinction between sexual
instincts and Ego-instincts; and in the face of all opposition it has
insisted, _not_ that they arise from sexuality, but that the neuroses
owe their origin to a _conflict_ between Ego and sexuality. It has no
conceivable motive in denying the existence or the significance of the
Ego-instincts while it investigates the part played by sexual instincts
in disease and in life generally. Only, psycho-analysis has been
destined to concern itself first and foremost with the sexual instincts,
because in the transference neuroses these are the most accessible to
investigation, and because it was obliged to study what others had
neglected.
It is not any more accurate to say that psycho-analysis has not occupied
itself at all with the non-sexual side of the personality. The very
distinction between the Ego and sexuality has shown us with particular
clearness that the Ego-instincts also undergo an important development
which is neither entirely independent of the development of the Libido
nor without influence upon the latter. We certainly understand the
development of the Ego much less well than the development of the
Libido, because it is only by the study of the narcissistic neuroses
that we have just reached some hope of insight into the structure of the
Ego. Nevertheless, we have already a notable attempt on the part of
Ferenczi[48] to reconstruct theoretically the developmental stages of
the Ego; and there are at least two points at which we have a secure
foothold from which to examine this development further. We are not at
all disposed to think that the libidinal interests of a human being are
from the outset in opposition to the interests of self-preservation; the
Ego is rather impelled at every stage to attempt to remain in harmony
with the corresponding stage of sexual organization and to accommodate
itself to that. The succession of the separate phases in the development
of the Libido probably follows a prescribed course; it is undeniable,
however, that this course may be influenced from the direction of the
Ego. A certain parallelism, a definite correspondence between the phases
in the two developments (of the Ego and of the Libido) may also be
assumed; indeed, a disturbance in this correspondence may become a
pathogenic factor. More important to us is the question how the Ego
behaves when the Libido has undergone a powerful fixation at an earlier
point in its development. The Ego may countenance the fixation and will
then be perverse to that extent, or, what is the same thing, infantile;
it may, however, hold itself averse from this attachment of Libido, the
result of which is that where the Libido undergoes a _fixation_ there
the Ego institutes an act of _repression_.
In this way we arrive at the conclusion that the third factor in the
ætiology of the neuroses, the susceptibility to conflict, is as much
connected with the development of the Ego as with the development of the
Libido; our insight into the causation of the neuroses is thus enlarged.
First, there is the most general condition of privation, then the
fixation of Libido (forcing it into particular channels), and thirdly,
the _susceptibility to conflict_ produced by the development of the Ego
having repudiated libidinal excitations of that particular kind. The
thing is therefore not so very obscure and intricate—as you probably
thought it during the course of my exposition. To be sure, though, after
all, we have not done with it yet; there is still something new to add
and something we already know to dissect further.
In order to demonstrate the effect of the development of the Ego upon
the tendency to conflict and therewith upon the causation of the
neurosis, I will quote an example which, although entirely imaginary, is
not at all improbable in any respect. I will give it the title of
Nestroy’s farce: _On the Ground-Floor and in the Mansion_. Suppose that
a caretaker is living on the ground-floor of a house, while the owner, a
rich and well-connected man, lives above. They both have children, and
we will assume that the owner’s little girl is permitted to play freely
without supervision with the child of lower social standing. It may then
very easily happen that their games become “naughty,” that is, take on a
sexual character: that they play “father and mother,” watch each other
in the performance of intimate acts, and stimulate each other’s genital
parts. The caretaker’s daughter may have played the temptress in this,
since in spite of her five or six years she has been able to learn a
great deal about sexual matters. These occurrences, even though they are
only kept up for a short period, will be enough to rouse certain sexual
excitations in both children which will come to expression in the
practice of masturbation for a few years, after the games have been
discontinued. There is common ground so far, but the final result will
be very different in the two children. The caretaker’s daughter will
continue masturbation, perhaps up to the onset of menstruation, and then
give it up without difficulty; a few years later will find a lover,
perhaps bear a child; choose this or that path in life, perhaps become a
popular actress and end as an aristocrat. Probably her career will turn
out less brilliantly, but in any case she will be unharmed by the
premature sexual activity, free from neurosis, and able to live her
life. Very different is the result in the other child. She will very
soon, while yet a child, acquire a sense of having done wrong; after a
fairly short time she will give up the masturbatory satisfaction, though
perhaps only with a tremendous struggle, but will nevertheless retain an
inner feeling of subdued depression. When later on as a young girl she
comes to learn something of sexual intercourse, she will turn from it
with inexplicable horror and wish to remain ignorant. Probably she will
then again suffer a fresh irresistible impulse to masturbation about
which she will not dare to unburden herself to anyone. When the time
comes for a man to choose her as a wife the neurosis will break out and
cheat her out of marriage and the joy of life. If analysis makes it
possible to obtain an insight into this neurosis, it will be found that
this well-broughtup, intelligent and idealistic girl has completely
repressed her sexual desires; but that they are, unconsciously, attached
to the few little experiences she had with the childish play-mate.
The differences which ensue in these two destinies in spite of the
common experiences undergone, arise because in one girl the Ego has
sustained a development absent in the other. To the caretaker’s daughter
sexual activity seemed as natural and harmless in later years as in
childhood. The gentleman’s daughter had been “well-brought-up” and had
adopted the standards of her education. Thus stimulated, her Ego had
formed ideals of womanly purity and absence of desire that were
incompatible with sexual acts; her intellectual training had caused her
to depreciate the feminine rôle for which she is intended. This higher
moral and intellectual development in her Ego has brought her into
conflict with the claims of her sexuality.
I will explore one more aspect of the development of the Libido to-day,
both because it leads out upon certain wide prospects, and also because
it is well-suited to justify the sharp, and not immediately obvious,
line of demarcation we are wont to draw between Ego-instincts and sexual
instincts. In considering the two developments undergone by the Ego and
by the Libido we must emphasize an aspect which hitherto has received
little attention. Both of them are at bottom inheritances, abbreviated
repetitions of the evolution undergone by the whole human race through
long-drawn-out periods and from prehistoric ages. In the development of
the Libido this phylogenetic origin is readily apparent, I should
suppose. Think how in one class of animals the genital apparatus is in
closest relation with the mouth, in another it is indistinguishable from
the excretory mechanism, in another it is part of the organs of
motility; you will find a delightful description of these facts in W.
Bölsche’s valuable book. One sees in animals all the various
perversions, ingrained, so to speak, in the form taken by their sexual
organizations. Now the phylogenetic aspect is to some extent obscured in
man by the circumstance that what is fundamentally inherited is
nevertheless individually acquired anew, probably because the same
conditions that originally induced its acquisition still prevail and
exert their influence upon each individual. I would say, where they
originally created a new response they now stimulate a predisposition.
Apart from this, it is unquestionable that the course of the prescribed
development in each individual can be disturbed and altered by current
impressions from without. But the power which has enforced this
development upon mankind, and still to-day maintains its pressure in the
same course, is known to us; it is, again, the privation exacted by
reality; or, if we give it its great real name, it is _Necessity_, the
struggle for life, _’ANATKH_. Necessity has been a severe task-mistress,
and she has taught us a great deal. Neurotics are those of her children
upon whom this severity has had evil effects, but that risk is
inevitable in any education. Incidentally, this view of the struggle for
existence as the motive force in evolution need not detract from the
significance of “inner evolutionary tendencies,” if such are found to
exist.
Now it is very noteworthy that sexual instincts and self-preservative
instincts do not behave alike when confronted with the necessity of real
life. The self-preservative instincts and all that hangs together with
them are more easily moulded; they learn early to conform to necessity
and to adapt their development according to the mandates of reality.
This is comprehensible, for they cannot obtain the objects they require
by any other means, and without these objects the individual must
perish. The sexual instincts are less easily moulded; for in the
beginning they do not know any lack of objects. Since they are connected
parasitically, as it were, with the other physical functions and at the
same time can be auto-erotically gratified on their own body, they are
at first isolated from the educative influence of real necessity; and in
most people they retain throughout life, in some respect or other, this
character of obstinacy and inaccessibility to influence which we call
“unreasonableness.” Moreover, the educability of a young person as a
rule comes to an end when sexual desire breaks out in its final
strength. Educators know this and act accordingly; but perhaps they will
yet allow themselves to be influenced by the results of psycho-analysis
so that they will transfer the main emphasis in education to the
earliest years of childhood, from the suckling period onward. The little
human being is frequently a finished product in his fourth or fifth
year, and only gradually reveals in later years what lies buried in him.
To appreciate the full significance of this difference between the two
groups of instincts we must digress some distance, and include one of
those aspects which deserve to be called _economic_; we enter here upon
one of the most important, but unfortunately one of the most obscure,
territories of psycho-analysis. We may put the question whether a main
purpose is discernible in the operation of the mental apparatus; and our
first approach to an answer is that this purpose is directed to the
attainment of pleasure. It seems that our entire psychical activity is
bent upon _procuring pleasure_ and _avoiding pain_, that it is
automatically regulated by the PLEASURE-PRINCIPLE. Now of all things in
the world we should like to know what are the conditions giving rise to
pleasure and pain, but that is just where we fall short. We may only
venture to say that pleasure is _in some way_ connected with lessening,
lowering, or extinguishing the amount of stimulation present in the
mental apparatus; and that pain involves a heightening of the latter.
Consideration of the most intense pleasure of which man is capable, the
pleasure in the performance of the sexual act, leaves little doubt upon
this point. Since pleasurable processes of this kind are bound up with
the distribution of quantities of mental excitation and energy, we term
considerations of this kind _economic_ ones. It appears that we can
describe the tasks and performances of the mental apparatus in another
way and more generally than by emphasizing the attainment of pleasure.
We can say that the mental apparatus serves the purpose of mastering and
discharging the masses of supervening stimuli, the quantities of energy.
It is quite plain that the sexual instincts pursue the aim of
gratification from the beginning to the end of their development;
throughout they keep up this primary function without alteration. At
first the other group, the Ego-instincts, do the same; but under the
influence of necessity, their mistress, they soon learn to replace the
pleasure-principle by a modification of it. The task of avoiding pain
becomes for them almost equal in importance to that of gaining pleasure;
the Ego learns that it must inevitably go without immediate
satisfaction, postpone gratification, learn to endure a degree of pain,
and altogether renounce certain sources of pleasure. Thus trained, the
Ego becomes “reasonable,” is no longer controlled by the
pleasure-principle, but follows the REALITY-PRINCIPLE, which at bottom
also seeks pleasure—although a delayed and diminished pleasure, one
which is assured by its realization of fact, its relation to reality.
The transition from the pleasure-principle to the reality-principle is
one of the most important advances in the development of the Ego. We
already know that the sexual instincts follow late and unwillingly
through this stage; presently we shall learn what the consequences are
to man that his sexuality is satisfied with such a slight hold upon
external reality. And now in conclusion one more observation relevant in
this connection. If the Ego in mankind has its evolution like the
Libido, you will not be surprised to hear that there exist
‘Ego-regressions’ too, and will wish to know the part this reversion of
the Ego to earlier stages in development can play in neurotic disease.
TWENTY-THIRD LECTURE
THE PATHS OF SYMPTOM-FORMATION
In the eyes of the general public the symptoms are the essence of a
disease, and to them a cure means the removal of the symptoms. In
medicine, however, we find it important to differentiate between
symptoms and disease, and state that the disappearance of the symptoms
is by no means the same as the cure of the disease. The only tangible
element of the disease that remains after the removal of the symptoms,
however, is the capacity to form new symptoms. Therefore for the moment
let us adopt the lay point of view and regard a knowledge of the
foundation of the symptoms as equivalent to understanding the disease.
The symptoms—of course we are here dealing with mental (or psychogenic)
symptoms, and mental disease—are activities which are detrimental, or at
least useless, to life as a whole; the person concerned frequently
complains of them as obnoxious to him or they involve distress and
suffering for him. The principal injury they inflict lies in the expense
of mental energy they entail and, besides this, in the energy needed to
combat them. Where the symptoms are extensively developed, these two
kinds of effort may exact such a price that the person suffers a very
serious impoverishment in available mental energy, which consequently
disables him for all the important tasks of life. This result depends
principally upon the amount of energy taken up in this way, therefore
you will see that “illness” is essentially a practical conception. But
if you look at the matter from a theoretical point of view and ignore
this question of degree you can very well say that we are all ill, i.e.
neurotic; for the conditions required for symptom-formation are
demonstrable also in normal persons.
Of neurotic symptoms we already know that they are the result of a
conflict arising when a new form of satisfaction of Libido is sought.
The two powers which have entered into opposition meet together again in
the symptom and become reconciled by means of the _compromise_ contained
in symptom-formation. That is why the symptom is capable of such
resistance; it is sustained from both sides. We also know that one of
the two partners to the conflict is the unsatisfied Libido, frustrated
by reality and now forced to seek other paths to satisfaction. If
reality remains inexorable, even when the Libido is prepared to take
another object in place of that denied, the Libido will then finally be
compelled to resort to regression, and to seek satisfaction in one of
the organizations it had already surmounted or in one of the objects it
had relinquished earlier. The Libido is drawn into the path of
regression by the fixations it has left behind it at these places in its
development.