Vol 3.\1893-99\Early P-A Publicatio\Charot\Defense\Hysteria\Obsession\ phobias\Repression\anxiety\compulsion\substitution\Anxiety Neurosis\ Neurasthenia\aetiology\libido\angst\overdetermination\Heredity\ secondary defense\paranoia\distortion\hallucinations\predisposition\ sexual factors\masturbation\dreams\
This is a collection of Freud`s shorter publications written between 1893-1899.
Freud`s obituary honoring the passing of Charcot--a doctor who Freud had studied under in France in Oct. 1885-Feb. 1886. This period of study was the turning point in Freud`s career in that he decided to turn his clinical interest over to the investigation of hysteria.
Freud begins the paper with a description of Charot's personality and style (which may be seen to be reflected in Freud himself). Charot, as Freud writes, was one who restored dignity to those who suffered from hysteria and those people who worked with them.
(20) Freud gives his description of the hysterical state of mind and states that the hysteric is unaware of when and why the affect exists, that the expression of the affect is somatic and that symptoms are not held together by associative chains.
Freud goes on to imply that Charot did the original "mapping out" of the phenomenon of hysteria and, in fact, discovered the `hysteriogenic` zones.
(21) Freud points out that Charot believed that hysteria had a genetic basis. (23) Freud states that Charot overestimated the role of genetics so much so that "he left no room for the acquisition of nervous illness."
(22) Charot is attributed to be the first to make the claim that hysteria has an ideogenic root.
Editor's Note: (26)
This text is said to be similar in content to the "Preliminary Communication" of Studies. The most notable aspect of this paper is the preponderance of the traumatic factor among the causes assigned to hysteria; the shift to notions of instinctual impulses is still in the future at this point.
(27) Freud recognizes the work done by Charot as being the basis of all his new ideas.
(28) Physical trauma is replaceable by verbal suggestion--espically under hypnosis.
(29) Freud goes so far to explain the contradictions and physical pain that appears in traumatic hysteria. But his analysis goes no further, ie., he does not tell the reader how hysterical symptoms come about in other forms of hysteria.
(32-33) The most common symptoms of hysteria is vomiting and anorexia combined and sleeplessness or disturbed sleep.
(34) Freud follows with a short section on symbolization--eg., a pain in the foot is a symbol of a fear of not finding oneself `on the right footing.`
He writes: "linguistic usage affords a bridge" by which the mental state can be expressed via the physical one. And: "the more intense the trauma, the greater is the adequate reaction." (release of tension)
(36) "The most adequate reaction, however, is always a deed."
(38) Two conditions that make memories pathogenic:
I) (46) Freud defends Breuer's notion that splitting of consciousness is not due to `feeble mindedness` as Charot claimed. Through two examples, Freud indicates that splitting is due to an non- intentional act of will--i.e., (47) through the occurrence of an incompatibility in ideational life (an idea that was experienced was considered so outrageous, etc. that it was forgotten).
(49) Such incompatible ideas are rendered innocent by its sum of excitations being transformed into something somatic (conversion). This partially or totally converted excitation then proceeds along the lines of a motor or sensory innervation which is related to the traumatic experience. Thus, the ego succeeds in freeing itself from the contradiction and instead burdens itself with a mnemic symbol. (50) Freud concludes that the distinguishing feature of hysteria is found in this capacity for conversion and not in splitting.
II) (51) Freud goes on to approach the possibility that one may lack the ability to convert such ideas. Such people still, he says, fend off incompatible ideas by separating it from the affect (displacement) in an non-intentional manner. (52) Thus the idea still remains within the psychical sphere and the idea is separated from all association but the affect attaches itself to other ideas which are in themselves not incompatible. As a result of this connection, such ideas are said to become obsessional.
(57) Freud notes that not all obsessions and phobias occur in this manner.
III) (58) Freud writes about a more energetic form of defense. That is, the ego is said to reject the incompatible idea completely with its affect and then behaves as if the idea never occurred. But, at this moment, the subject is in a psychosis, which can only be classified as `hallucinatory confusion`. (59) Thus the ego is said to have separated itself from reality so that the hallucination can persist.
(71) Editor's note: (German) Zwangvorstrellung = (French) Obsession = (English) Compulsive Idea.
Obsessions and phobias are not to be: a) included under neurasthenia; and, b) regarded as degenerative. They are rather separate neuroses which contain a special mechanism and aetiology.
Freud distinguishes between traumatic obsessions and the `normal` obsessions which are like memories from: a) true obsessions and b) phobias. The difference is found in that there are two constituents in every obsession which are as follows: 1) they appear as an idea that forces itself upon the patient; and, 2) as an associated emotional state. He means, in terms of phobias, anxiety and, when referring to obsessions, doubt, remorse, anger, and anxiety.
In many true obsessions it is plain that an emotional state is the principle thing, i.e., the emotional state persists unchanged, it is constant even if the ideas change. Freud goes on to suggest that to the patient the emotional state is always justified. He implies that obsessions are pathological because: 1) the emotional state persists indefinitely; and, 2) the associated idea is no longer the original one, related to the aetiology of the obsession, but is the one that replaces it, a substitute.
In reference to the ideas which have been replaced, Freud suggests that such replaced ideas all have some common attributes, that is they correspond to really distressing sexual experiences which the patient is trying to forget. Thus the patient attempts to replace the original idea with one that is ill-adapted for being associated with the emotional state. Freud (79) offers a theory for such substitutions: 1) substitution occurs as an expression of an inherited mental disposition; 2) the motives for substitution is that is acts as a defense against incompatible ideas; and, 3) obsessive emotional states exist by the very fact that substitutions, which allows impossible the disappearance of the emotional state.
Phobias are considered by Freud to be more monotonous and typical than obsessions and the affects of phobias usually include fear and anxiety. Freud suggest that there are two groups of phobias which are as follows: 1) Common Phobias: an exaggerated fear of something that all people tend to fear. 2) Contingent Phobias: fear inspired by a special situation which would cause no fear in others, n.b., such types of fear are with out the obsessional nature that come along with common phobias.
(81) The mechanism of phobias suggests that substitution is no longer dominant. Thus the only thing found, according to Freud, is the emotional state of anxiety which, by a kind of selective process, brings up all the ideas adopted to become subjected to the phobia. It should be noted that anxiety is not derived from any memory.
Phobias are said to be part of anxiety neurosis and are almost always accompanied by other symptoms. Anxiety neurosis also is said to have a sexual origin but it does not attach itself to ideas taken from one's sexual life, i.e., "it has no psychical mechanism." The specific cause of anxiety neurosis is said to be an accumulation of sexual tension produced by the abstinence or unconsummation of sexual excitation (i.e., cue to impotence, forced abstinence, etc.). Freud found these conditions to be especially prevalent in women.
(82) Phobias are also said to possibly develop at the onset of anxiety neurosis as a symptom of the disease.
In this appendix Freud make the claim that Phobias have no psychical basis but he does not seem to offer any real alternative.
EDITOR'S NOTE:-------(87) Neurasthenia is exhaustion of the nervous system.
Here Freud proposes, for reasons of differentiation, the distinction between neurasthenia and anxiety neurosis.
SOME FORMS OF ANXIETY ATTACKS:
Described in terms of acquired (vs. hereditary) sexual life.
In cases of anxiety neurosis in women the following may be involved:
In terms of men we find the following aspects in connection to anxiety neurosis:
In terms of both sexes one may find anxiety in:
103) Freud argues for his notion of sexual aetiology for the following reasons:
107) 1) There is most likely an accumulation of somatic excitation; 2) Anxiety neurosis appears to have no psychical origin. 3) Anxiety neurosis is accompanied with a decrease of sexual libido (desire).
Thus (108): "The mechanism of anxiety neurosis is to be looked for in a deflection of somatic sexual excitation from the psychical sphere, and in a consequent abnormal employment of that excitation." That is, anxiety neurosis (109) is the product of all those factors which prevents the somatic sexual excitation from being worked over psychically.
Freud is of the opinion that most of the symptoms of anxiety neurosis occur in connection with other neuroses. To this end he writes (113) "Wherever a mixed neurosis is present, it will be possible to discover an intermixture of several specific aetiologies." Nonetheless, Freud also notes that the multiplicity of aetiological factors may or may not occur fortuitously; in cases where the intermixture has occurred, however, the symptoms are more intimate, i.e., the same aetiological determinant regularly and simultaneously provokes both neuroses.
114) Here Freud unequivocally states that anxiety neurosis develops out of somatic excitations and not the psychical. (115) Thus he states that anxiety neurosis is the somatic counterpoint to hysteria.
`Angst` is usually translated as anxiety but it is probable that anxiety has a too current and everyday meaning and therefore only a remote connection with any of the German usage of `angst`.
125) Freud responds to L. Lowenfeld`s critiques of the psychoanalytic notion of sexual aetiology.
Lowenfeld argues that
" there exists a specific aetiological factor for anxiety neurosis which can be replaced in its operation by stock noxae in a QUANTITATIVE sense, but not in a QUALITATIVE one; I further maintain that this specific factor determines above all the FORM of the neurosis; whether a neurotic illness occurs at all depends in the total load upon the nervous system (in proportion to its capacity to carry the load."
Thus, he concludes, that as a rule neuroses are over determined as there several factors in their aetiology.
Freud continues the discussion by positing an understanding of the aetiology of anxiety neurosis as dependent upon four factors (factors which are suspiciously similar to the Aristotelian causal scheme) which are as follows:
136) The preconditions are further amplified as follows:
1) whether a neurotic illness occurs at all depends upon a quantitative factor. 2) the dimensions that the neurosis attains depends on the amount of hereditary taint. 3) But the form the neurosis assumes (the direction of deviation it takes) id solely determined by specific aetiological factor arising from sexual life.
143) Freud points to two objections that are derived from (1) factual arguments and (2) arguments out of speculation.
A) Affects which are remote from the domain of neuropathology and which are not necessarily dependent on the diseases of the nervous system, have sometimes been regarded as nervous and show the presence of neuropathic tendencies.
B) All nervous affections found in a patient's family (144) have been accepted as a basis for charging the patient to have a hereditary taint.
C) Our opinion of the aetiological role of heredity in nervous illnesses ought to be based on an impartial statistical examination and not a petito prinicpii (we must not automatically assume that it is hereditary).
D) Progressive paralysis due to syphilis is not due to hereditary aspects alone.
E) There is no doubt that nervous disorders can develop in persons whose family has no previous history of such.
F) In nervous pathology the is both (i) heredity similarity and (ii) heredity dissimilarity.
Freud suggests that at that time too little research has been done in the determination of the causes of nervous disorders. (146) He implies that a knowledge of the specific aetiology of the same will allow a "therapeutic path to success."
Freud groups the aetiological factors in three classes: (147)
149) Disorders of the sexual life of an individual are considered to be the cause of disturbances in the economics of the nervous system.
152) The specific aetiology of hysteria, for example, is that of a passive sexual experience before puberty. (154) Such events are not usually remembered (it is only during analysis, when under the most rigorous pressure, that the defenses are lifted) and later, after puberty, "it comes about in one way or another that this unconscious psychical trace is awakened.... The memory will operate as if it were a contemporary event."
EDITOR'S NOTE: (159) In this text, Freud uses defense in a manner similar to his later usage of repression. (160) That is, repression as being caused by inappropriately early sexual experiences, which is either passive, in the case of hysteria, or active, in the case of obsessions.
This is in the nature of traumatic sexual experiences and the period of occurrence (early childhood).
164) It is "not the experiences themselves which act traumatically but their revival as a memory after the subject has entered on sexual maturity."
166) Since there are cases of people who have suffered such experiences and remain healthy afterwards (i.e., they do not develop hysteria), Freud concludes that there must be some predisposition or susceptibility to a hysterical reaction that existed before the trauma.
Active sexual experiences in early childhood are also considered to be part of the aetiology of obsessional neurosis. But, Freud claims to have found a substratum of hysterical symptoms, in obsessional neurotics, which could be traced back to a scene of sexual passivity that preceded the pleasurable action.
169) Freud`s formula for obsessional ideas: A) Obsessive ideas are invariably transformed self-reproaches which have re-emerged from repression and which always relate to some sexual act that was performed with pleasure in childhood.
This work is said to be completed by the ego. (171) Freud continues to note that if the ideas of the ego are not parallel to the obsessive idea, some sort of logical adjustment to the contradiction occurs between them. And, if two trains of thought come to some conclusion, they reinforce each other, i.e., "wherever a neurotic obsession emerges in the psychical sphere, it comes from repression." Thus, it may be said that obsessional ideas have a compulsive psychical currency. There is a second type in which the self-reproaches, through some mental addition, can be easily transformed into any other unpleasurable affect, e.g., shame, hypochondrial anxiety, social anxiety, etc.
172) A secondary defense is said to occur as the ego tries to fend off derivatives of the initial repressing memory. If there is success in keeping the repressed from returning, the result is a third form obsessional neurosis which is characterized by obsessive actions.
173) The secondary defense may be effected by a forcible diversion into another thought with a content as contrary as is possible or otherwise the patient tries to master the obsessive ideas through logical work via recourse to his memory and this is said to lead to obsessional thinking, i.e., a compulsion to test things and a doubting mania. Such secondary defenses against the affects result with the following:
Paranoia is described as a psychosis of defense (repression), i.e., it proceeds from the repression of distressing memories and its symptoms are determined in their form by the content of the repressed. Thus Freud postulates that paranoia must have a special mechanism of repression (vs.: 1) hysteria = conversion into somatic innervation, obsessional neurosis = substitution, i.e., displacement via associations). That is, the experience and memory are both represses!! or (178) the repression of contemporary memories or things, actions, etc. that might bring about the repressed (179).
In paranoia and obsessional neurosis repression is the nucleus of the psychical mechanism as there are sexual experiences involved in both.
184) In the paranoid the self-reproaches are represses through "projection." Therefore, the subject withdraws their acknowledgment of the self-reproach and therefore is deprived of a protection against the self-reproaches which return in the patient's delusional ideas. Condensation and displacement is also said to occur in paranoia especially in relation to delusionory ideas. Thus auditory hallucinations are said to be due to a double distortion: first they are subjected to censorship which leads to, second, its replacement by associated thoughts (which conceal the original thought) (185) which refer to recent experiences.
There is a third group of experiences of obsessional neurosis which are not found in paranoia. Thus these experiences develop their own source for the formation of symptoms. i.e., delusionary ideas enter the consciousness through a compromise which makes demands on the thought- activity of the ego until they are accepted without contradiction. Since they are not open to influence, the ego must adapt itself to them. Therefore, the result is similar to the secondary defense of obsessional neurosis--i.e., " interpretative delusions which end with an alteration of the ego."
EDITOR'S NOTE: 190 This paper is essentially an amplified repetition of the first section of the second article on the neuro-psychoses of defense (repression).
193) The tracing of a hysterical symptom back to its traumatic scene assists our understanding only if the scene satisfies two conditions, which are as follows: 1) if it posses the relevant suitability to serve as a determinant, and 2) if it recognizably possesses the necessary traumatic force.
196) A chain of hysterical traumatic scenes ramify and are interconnected like genealogical trees (197) so that in any new experience two or more earlier experiences come into operation as memories. Thus "no hysterical symptom can arise from a real experience alone, but that in every case the number of earlier experiences awakened in association to it plays a part in causing the symptom."
198) Such chains of hysterical symptoms eventually will become inter-twined--each with its own nodal point. (199) It is at these nodal points that the separate association chains converge and in the end they move towards sexual experiences. (200) Freud suggests that these association chains refer back to puberty, but (202) this is not far enough and that the analyst must go back to infantile sexual experiences.
(203) Thesis is that: "at the bottom of every case of hysteria there one or more occurrences of premature sexual experiences." That is (206) genital stimulation. Freud continues to meet what he expected to be general objections to this thesis.
(207-209) Freud notes the requirement for a predisposition to hysteria.
(208) Here Freud enumerates three groups of sexual experiences:
(210) Freud discusses the notion of threshold barriers that must be overcome in individuals who have experienced such activities before there is any possibility of hysteria occurring, i.e., (211) these threshold barriers must be overcome in order to permit the repression of the objectionable idea\experiences which, upon its return, eventually causes the neurosis. Thus (212) the view is that infantile sexual experiences are a fundamental precondition for hysteria and that they produce the hysterical symptoms. Freud postulates that after the age of eight, such early experiences no longer have the necessary force to cause hysteria while those who have already had such experiences are capable of developing the symptoms. The problem is connected with the developmental process of the sexual system.
Each case of hysteria has symptoms that are caused by recent events and not just by infantile experiences, while other symptoms go all the way back to the infantile.
(216) Ideas which are chosen for the production of a symptom are ones that have been called up by a combination of several factors which have been aroused from various directions at once, i.e., "hysterical symptoms are over determined."
(217) Abnormal, hysterical reactions to physical stimuli are due to the fact that "the reaction of hysterics is only apparently exaggerated; it is bound to appear exaggerated to us because we only know a small part of the motives from which it arises." In reality the reaction is proportionate to the exciting stimulus.
EDITOR'S NOTE: (225) These abstracts show that Freud`s "complete psychological works" are very far from coinciding with his `complete works.` That is, Freud had written 15 years worth of scientific material previous to his inauguration into psychology.
EDITOR'S NOTE: (261) Freud felt this paper was "fairly impudent and chiefly designed to cause trouble--which it will succeed in doing." (262) It should be noted that Freud`s self-analysis began in the summer of 1897 and by fall it led to the following discoveries:
Strachey notes, however, that very little of these three discoveries made it into the present paper--i.e., it was reserved fro The Interpretation of Dreams.
Freud begins with a discussion of the propriety of a medical doctor learning of the sexual life of his patients especially in terms of women patients. Freud`s concerns are reflected in the statement that
"A doctor can always do harm if he is unskilled or unscrupulous, and this is no more and no less true when it is a question of investigating his patient's sexual life than it is with other things."(265)
Freud continues by noting that it is also not true that patients put insuperable obstacles in the way of investigations into their sexual life (here Freud is specifically referring to women) and that the contrary is often the case--i.e., they are glad to have someone with which to talk about it.
(267) In terms of treatment Freud suggests that "...the morphology of the neuroses can with little difficulty be translated into aetiology and a knowledge of the latter leads quite naturally on to new indications for methods of cure."
Freud notes that the big question here is in the distinction made by the therapist as to whether the case bears the characteristics of neurasthenia or the psychoneurosis. Neurasthenia refers to the fact that it is only in cases of this kind that the patient is consciously aware of the aetiological factors in his or her sexual life. In the case of the psychoneurosis, on the other hand, questions as to this aspect of the disorder have very little result--i.e., the patient is not consciously aware of the aetiological factors in any way as they have been repressed. Nonetheless, in every instance of the psychoneurosis, the aetiology lies in the field of sexuality-- infantile, unconscious sexual factors.
(268) Freud further characterizes neurasthenia as always being traceable to a condition of the nervous system as such as would be a result of tension acquired by excessive masturbation or that which arises spontaneously from frequent emissions. The anxiety neurosis is contrasted as regularly disclosing the sexual influences which have the factor of the reservation or incomplete satisfaction in common.
(269) After diagnosing a case of neurasthenic neuroses and classifying its symptoms "we are in a position to translate the symptomology into aetiology; and we may then boldly demand confirmation of our suspicions from the patient." Thus Freud demands that only serious and long-continued abnormality in sexual life carries we weight as an explanation. If one follows this procedure, one gains that conviction that, in so far as theory of the sexual aetiology of neurasthenia is concerned, there are also no regular cases.
(275) The role of the doctor is to break the patients of their addiction to masturbation.
(276) Freud notes that narcotics are meant to serve directly or indirectly as substitutes for a lack of sexual satisfaction (as a substitutive addiction ?).
The aetiology of the anxiety neurosis causes the doctor to induce the patient to give up all detrimental forms of sexual intercourse and to adopt normal sexual relations.
(278) Freud then makes a call for moral attitudes to parents and doctors (toward sexuality, etc.) to change. "But above all," he continues, "a place must be created in public opinion for the discussion of the problems of sexual life."
(280) In connection to the above Freud notes that we must remember early childhood and its role in the aetiology of the neuroses -- more so than considerations of heredity. "In my experience," Freud writes, "children are capable of every psychical sexual activity, and many somatic sexual ones as well." (This is a early reference to his notion of the child as "polymorphous perverse"). In other words, human life does not start at puberty.
(281) It is noted that the deferred effects (i.e., the repressed memories) invariably return at a later date. That is, during the period between their occurrence and reoccurrence the psychical or psychical body has undergone important developments (puberty); and, therefore, it is then that the influences if these earlier sexual experiences now lead to abnormal psychical reactions and psychopathic structures come into existence.
"...Dreams belong to the same section of psycho pathological structures as hysterical idées fixes, obsessions, and delusions."
(282) Psychoanalytic therapy, said to be unsuited for the young or for adults who are feeble-minded or uneducated -- i.e., it requires a great deal of maturity and understanding in order to be effective.
(283) The main difficulties in the way of the psychoanalytic method is due to lack of understanding on the part of doctors and laymen as to the nature of psychoanalysis.
EDITOR'S NOTE: (288)
This paper is said to be very similar to the first chapter of The Psychopathology of Everyday Life. The chain of argumentation, however, is quite differently arranged and one of the two point of the material is amplified.
The types of forgetfulness considered is the case of proper names. This type of forgetfulness refers to the experience of "on the tip of the tongue" which causes an irritated affectual response. Freud notes that the following phenomena appears when one tries to remember the forgotten object, they include: concentration on the forgotten thing which is a pointless task as it is hardly ever remembered in this manner; in place of the name searched for another arises which we recognize as being false and try to put it away, but it keeps reappearing. Instead of a substitutive name one mat come across a letter or syllable (the name, however, usually does not begin with that letter). Thus Freud concludes that the best way to get at a name is to divert one's attention.(my emphasis).
291) Freud writes: "When a memory is repressed, there often emerges into consciousness with unusual vividness an image of something which is not the repressed memory itself but which, though unimportant and irrelevant, is closely related to the repressed memory." (See footnote #1)
293) Thus the recollection of other names is due to a displacement. The lines of displacement are laid down by the names that were contained in the repressed topic. Thus the trains of thought, in spite of the intensity of the interest in them, are subject to a resistance that keeps them from being worked over by a particular psychical agency and therefore from becoming conscious.
294) "...every psychical product shall be fully elucidated and even over determined." (295) That is, by the means of superficial associations, a repressed train of thought takes possession in the neurosis of on innocent recent impression and draws it down with itself into a repression. Thus the same mechanism that causes substitute names to appear also govern the formation of obsessional thoughts and paranoiac paramnesias. In all instances, Freud claims, unpleasure is released when the problem is solved. NB: the above helps to demonstrate the role of repression in both "normal" and neurotic people as well as indicating the resistance aspect of repression -- i.e., people do not know what they do not want to know.
301) This is the first introduction of the concept in Freud`s published papers (there is an instance of an unpublished Fliess letter-- 25.5.1899). The type of screen memories discussed in this text -- ones in which an early memory is used as a screen for a later one -- almost entirely disappears in the later literature. However, the later, general meaning of screen memories -- a situation in which an earlier memory is screened by a later one -- is barely alluded to in this text although it is almost exclusively dealt with in The Psychopathology of Everyday Life. The incident Freud describes in this text is autobiographical.
303) Screen memories are memories from childhood that contain little or no affect while (306) other, intensely affective, memories are completely forgotten. Freud prefers to refer to such memories as being omitted (suppressed) and not forgotten. This led Freud to question why it is that important memories are suppressed while the inconsequential remain. The explanation, he thinks, is related directly to the mechanism of the process -- i.e., that there are two psychic processes involved in bringing about such memories. (307)
"The result of the conflict," writes Freud, "is therefore that, instead of the mnemic image which would have been justified by the original event, another is produced which has been to some degree associatively displaced from the former one." Since the elements of the experience caused the objection are the important ones, the substituted memories will necessarily lack these important elements and it will most likely strike us as trivial.
315) Freud suggests, via an example, that screen memories may occur when one projects two phantasies onto each other and produce a childhood memory from them. It is possible that a remnant of a visual image from childhood or some sort of experience is adapted and used to represent the two phantasies -- spontaneous symbolism.
320) Classes of screen memories:
(321) "Whenever in a memory the subject himself appears in this way as an object among other objects this contrast between the acting and the recollecting ego may be taken as evidence that the original impression has been worked over." I.e., where a early childhood memory is translated back into a plastic and visual form, which occurs on the date that the memory is aroused.
NB: there are also memories that when tested turn out to be complete inventions. "They are false in the sense they have shifted an event to a place where it did not occur...or that they have merged two people into one or substituted one for the other, or the scenes as a whole give signs of being combinations of two separate experiences."
NB: falsification of memory serve the purposes of repression and replacement of objectionable or disagreeable impressions.