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» ' •

I

I

'MORBID FEARS
AND COMPULSIONS-

TBEIR PSYCHOLOGY AND
PSYCHOANALYTIC TBEATMENT

BY

H. W. FRINK, M.D.

AMistut PrefMnr of NeatolDn <d CotdcII L'nlTenJtr Uadkal

Csllccc AdjDDCt AMictut NenroloKlrt to Bdlenw HiMplUl,

Si-prMldent of the New Vork Pirctuuklrtic SociMr.

Saoctarr of tba Amerieaii PtrebopsllMloclol

Ainelatian. Uambar of tbo Ameriaui

Pi^bouulytlc ABoelatiOD. otc

WITH AN INTRODUCTION BT

NEW YORK

HOFPAT, YARD AND COMPANY

1918

'RC34-3

BI^LOOT

O

CopFright. 1918. bf
If OPPAT. TAU> AND OOMPANT

F^IUhed, Marehs MB

• • •

• : .' .*

• . • • : • • ♦ .

• •

TO

CHARLES LOOMIS DANA, A.H., M.D., LL.D.

or NnnuM^MT nr Counnx Unrnfrrr
MiDieAL Couaai

THIS BOOK

IS

ORATirULLT DIDICATID

37619,1

INTRODUCTION

The day has f ortnnately gone by when the far-
reaching investigations associated with the name
of Sigmond Frend need to be introduced^ as if for
the first time, to any such circle of readers as that
to which this book is likely to appeal Indeed, so
familiar have men grown with the more salient
features of the so-called psychoanalytic move-
menty and so pronoimced is the interest which it
has evoked, that one feels a sense of lack, if, on
looking through a volume or a magazine where
hmnan motives are discussed, one does not find
some reference to the doctrines here at stake.

That this increased and growing interest is not
due to curiosity alone is shown by the fact that
many eminent scientific men — ^psychologists, biol-
ogists and educators — ^have used Freud's general-
izations largely, in connection with their own in-
quiries. Not only have these men published books
and papers of which the psychoanalytic movement
was the text, but they have made it the basis of
discussion in academic courses.

This is an important indication. For these able
men stand as representatives of the so-called
"normal'' members of the community; it is **nof-
m^" psychology, both individual and social, and

vi INTRODUCTION

' 'normal'' life processes and the education of
'* normal'' people that they study.

But what is '^ normal/' and to what extent is it
possible to distinguish it from what, for one or an-
other reason, we call *' abnormal"!

Much has been written on this point, and prac-
tically always the answer to the above question
has been that there are no means of distinguishing
these two states. That which goes by the name
of ''evil" or "disease" fmds its analogue in the
instability that is inseparable from life and prog-
ress ; and the forms that disease takes in the so-
called "pervert" or the nervous invalid, or even
the criminal, do but represent, in an accentuated
form, tendencies of which traces are to be dis-
covered in the history, and as an element in the
make-up, of every member of the community.
There is then good reason why all those who wish
to understand the weaknesses of society and work
for the betterment of the race, should take inter-
est in this movement.

What is it (over and above external conditions y
that causes the terrible misery in our social life,
of which the dramatists and novelists have so
much to say and which breaks out in the form of
strikes and anarchy, and lies widespread, just be-
neath the surface, in the form of superstitions,
depressions, unreasonable fears, or of "hatred,
malice and all uncharitableness"f Why is it that
soiQe persons are so much more overwhelmed than
others by the recitals of the horrors of the warf

INTBODnCTION vii

People afflicted with these tendencies present, f re-
qnently, the same front to the community that is
presented by the happiest and most prosperous
of men. But they present this front, in many
cases, not from deliberate and reasoned choice,
but because, separated in feeling from their as-
sumedly happier or more successful fellows, they
feel impelled to seek, as if through a sort of '^pro-
tective coloration," to preserve every outward
sign that is possible, of good health, good fellow-
ship and success. Close observers realize more
or less of what is going on with such persons, and
the more intelligent of these observers see also
that the facts and doctrines that have been brought
out through the psychoanalytic movement afford a
better explanation of these situations than is pro-
vided in any other way.

The present book does not make it one of its
main purposes to take up these social problems ;
bnt the author has a keen sense for the analogies
to which I have referred, and in both parts of his
treatise — ^that is, in the part in which the history
and fundamentid doctrines are laid down, and in
that in which the compulsions and obsessions are
more specifikudly studied — ^he gives illustrations
which every social student may well take to heart,
of the varied and significant modes of action of
men's unconscious motives.

And yet so difficult is the subject ; so hard is it
to realfy grasp these elusive motives that play
80 large a part in all our lives, to exchange a

viii liTTEODirCTION

'^knowledge about" them for a real '^acqaaint-
anoe with" them, that there will be room and wel-
come^ during many years to come, for any book
that deals consciously and clearly with the prob-
lems here involved.

The present volume fulfills these requirements
admirably within the limits which the author sets
for himself, and inspires confidence by evidences
of abundant knowledge and of conscientiousness
in forming judgments. Dr. Frink is evidently
writing for physicians and those who are ready
to take the physician's point of view. This has
always been Freud's method, also; and in follow-
ing it, — ^that is, through keeping before his mind
that he would choose for his imagined audience
those only who were ready to gaze at the truth
without dirinking, — ^he was able to cultivate his
power of accurate observation to a remarkable
degree. If his statements became now and then
too blunt, or too one-sided, or extreme, that fact
should and will be forgiven, when it is borne in
mind that unless he had trained himself to be
keenly alive to the presence of certain special mo-
tives rather than a judicial evaluer of all motives,
the psychoanalytic movement would never have
attained the position that it holds.

This is an important consideration in Freud's
intellectual history and that of the most stalwart
of his followers. If their work has been marked
by ** defects," they have shown, as a rule, ** quali-
ties" enough to justify these defects. It has

^

INTEODnCTION ix

often been urged against Freud, for ezampley that
his analyses of characters in history and fiction, —
such as those of Leonardo, Hamlet and (Edipus,
— give a distorted idea of their lives and person-
alities. In itself this criticism is just, and analo-
gous comments can be made on the psychoan-
alytic movement as a whole. But they should be
made in the light of what I have just now said.
The time has perhaps arrived, it is true, when the
leaders of this movement should be called upon
to cease being nlonographic, and, instead of this,
to take their places, consciously, as students of
the mind and its sources of energy from all points
of view, even if they continued to emphasize espe-
cially one aspect of these matters. And yet, even
now, it must be kept in view that knowledge moves
forward by a zigzag path, and that the most im-
portant thing, where the contributions of men of
genius are in question, is that nothing of value
shall be lost of what they have to give. The
errors of omission of important men and im-
portant movements can easily be forgiven.

This consideration should be especially borne in
mind when one is dealing with the sex problem, —
which Dr. Frink discusses clearly, in a simple and
straightforward manner, proposing at the same
time a new name, in order to call attention afresh
to the very important generalization, that when
one uses the word '^sexual" one should have in
mind all the connotations that go with the word
'4ove," understood as he defines it.

X iNTRODnOTION

It is tme that other emotions are '^ repressed"
besides those classifiable as sexual. But the point
mainly at stake is the pragmatic one that the
sexual emotions involve a peculiarly large num-
ber of dominant, unreasoning passions, of a sort
that each individual is least willing to acknowl-
edge (or else, it may be, is over-zealous in assert-
ing) and the subtle signs of which it is especially
important that the student of medicine should
train himself to detect.

Having said this much about those character-
istics of Freud's work which perhaps more than
any others have laid its author open to criticism^
and having thereby, I trust, made it clear that I
am not inclined to deal with Fteud's conclusions
in anything but a friendly spirit, I shall claim the
privilege of indicating some of the points with re-
gard to which I think his critics are in the right ;
or, to speak more exactly, to indicate the direc-
tions in which, as it seems to me, the boundaries
of his work may profitably be widened.

Freud was, and is, above all things, a man to
whom the exact methods of natural science were
very dear, as, in his estimation, the only reliable
means of investigation even in matters of per-
sonal motive and conduct. In this respect he be-
longs, of course, to that large class of persons
whose labors are absolutely indispensable to the
evolution of human knowledge; and Dr. Frink's
expressions of opinion make it clear that he would
wish to be classified in the same group. But there

INTBODUCTION xi

are also many mei^ whose voices never have been,
and never can be, sil^iced, who feel convinced
that the dicta of the natural scientists, — ^that is, of
those who wonld eventually refer everything back
to the laws of chemistry and physics, — are not to
be allowed to have the last word. There are, in-
deedy many members of the scientific group itself,
who have testified to their belief in this fact.
Such persons not only feel it clear that these
natural laws do not explain all the phenomena of
life ; fhey feel also that one of the most interesting
outcomes of scientific, and still more of logical in-
quiry, is the fact that these sciences seem to prove
not only that the laws which they recognize as
valid are not only themselves limited in their ap-
plication, but also that they actually point to the
existence of forms of energy which they are pow-
erless to describe.

The fact that Freud was so devoted to the scien-
tific method, and, from the same standpoint, so
devoted to the belief that mental phenomena are
just as much subject to infiexible laws of causa-
tion as physical phenomena, and, in fact, that the
causation in the two cases is virtually of the same
sort, would perhaps have done no harm had it
spent itself (as it did to a considerable extent) in
leading him to measure and define the degree to
which this doctrine represents the truth. But, —
unfortunately, as it seems to me, — ^he went fur-
ther than this, and in spite of disclaiming, as he
has always done, any obligation to adopt a general

xii INTEODnCTION

attitude toward the '^ ultimate nature of things/'
in a philosophical sense, he does nevertheless do
this very thing in his claim that we live, body and
soul, in a deterministic world,^ a world in which
the last word belongs to physical science.

No one could, of course, deny him the right to
this opinion ; but if it is held, it should be justified
through the presentation of evidence, on his part,
of having taken all the arguments of both sides
into account; and this evidence Freud has not
given.

Dr. Frink brings the matter to a clear issue in
his thesis (which is quite in accord with Freud's
doctrine) that every individual when looked at
from the standpoint of his childhood must be
recognized as following two, and only two, tenden-
cies,— ^those namely of self preservation and of
race preservation. This is the accepted formula
among perhaps the majority of biologists. But
unless the word ** preservation" is interpreted in
such a way as to include far more than the simple
preservation of life, — that is, unless it is admitted
that from first to last the highest attributes of the
human being are thought of as virtually present,
(as in the form of what is vaguely described as
"free will," existing as a partially guiding influ-
ence),— ^I should not feel at liberty to grant the
claim.

The antithesis is between those who look on

lE. g. see statentents of this sort in his paper entitled Totem
and Tabu. TranBlation Totem and Taboo^ N. Y., 1918.

INTBODnOTION xiii

what (for want of a better term) one must call the
higher, more spiritual manifestations of life, as
definable in terms of chemistry and physios, as
ordinarily conceived of, and those who believe that
chemistry and physics are to be defined in terms
of these higher manifestations of life. The sig-
nificance for therapeutics of the problem here in-
volved is very dear.

The next point which seems to me important
has reference to the scope of psychoanalytic work.
Freud, with his keen sense of the difficulties and
dangers lying in the path of the psychoanalytic
movement, has strongly maintained that psycho-
analysts would never do their best in the direc-
tion of keeping the movement free from degra-
dation, or of helping their patients to make their
memories and power of reasoning penetrate into
the depths of their repressed experiences, unless
they made these outcomes virtually the sole object
of their treatments and resisted the temptation
to act as mentors and advisors with reference to
specific social difficulties of the hours. In spite
of the apparent insistence and importance of the
patient's immediately present problems, Freud
held that the problems which they were really
thinking of and needed most of all to solve, were
those related to their repressed complexes.

On similar grounds he has strenuously objected
to the introduction of ethical considerations, or
aiming for ethical results. While believing that a
psychoanalytic treatment was in a high degree a

xiv INTRODUCTION

form of education, he has felt that the physician's
part was only that of Vergil, in Dante's cele-
brated journey through Hell, Purgatory, and
Paradise ; not at all that of Beatrice. The patient
comes to the physician, let us say, skilled in the
art of self-deception, and suffering under a self-
wielded lash. The physician's task is to see that
he becomes undeceived, by helping him to bridge
the wide chasm between his logical consciousness
and his unlogical phantasies. When this task is
accomplished, and thus a better understanding of
himself is brought about, and when his fears or
compulsions, or such other symptoms as he may
have presented, have been dissipated by a thor-
oughgoing psychoanalysis, the physician's task,
so Freud would say, is ended. The physician is
under no obligation to inquire what use the pa-
tient makes of his newly acquired freedom, or to
lead him further on the path of sublimation.

r As against this view of the duty of the psycho-
analyst, which I trust is fairly stated, it is reason-

\ able to urge that whatever the actual so-called
*' symptoms" are with which the patient comes
to his physician, he brings inevitably the virtual
symptom which consists in an incapacity to ex-
press through his life the recognition of his social
obligations and possibilities as an integral por-

Ltion of the social organism. Yet these obliga-
tions and possibilities are his by birthright.
From this standpoint a psychoanalytic treatment
is not logically complete until the patient so thor-

INTBODnCTION

onghly understands himself that he is not only
able, but feels himself compelled to see himself
and his social obligations in the best form possible
to him. Looked at in this way the functions of
Vergil and Beatrice coalesce.

If this mode of looking at the matter is correct,
the psychoanalyst of the future must himself be
a person of broad and ethical outlook, and yet
must learn to see and avoid the danger that he
may lose sight of his psychoanalytic ideals and
forget the technique of psychoanalytic practice.
Is this possible? I think, Yes.

IMnally it is well known to all those who have
followed the literature of this subject, that many
persons who have been students, (and some of
them well-wishers) of the psychoanalytic move-
ment, claim that Freud has made too much of the
sexual motivation of men's conduct and of the
sexual content of their unconscious yet active men-
tal life. A prominent representative of a view
akin to this is Alfred Adier of Vienna, who ap-
proaches the subject of conduct from a somewhat
special standpoint, though one that Freud himself
has never failed to recognize. He calls attention
to the striking difference between individuals as
they start on their course of life, in that some are
handicapped by defects, of which the most typical
are weaknesses in certain organs and their func-
tions. In consequence of these defects the per-*
son's life is spent partly in an instinctive seeking
for compensation, — which may become **over-

xvi INTRODUCTION

compensation/' — ^partly in an effort to escape re-
sponsibilities whicli he feels he cannot meet.

It is not my place or desire to enter here on any
adequate discussion, or even statement, of the
situation raised by Adler. I would only say that
in my opinion it does represent a more biological
mode of looking at tHe causes of men's conduct,
which at times has its convenience, and which, to
say the least, is not incompatible with Freud's
doctrines. It is unfortunate that his emphasis —
which is a valuable one — could not have been given
without his having found it necessary to attack
Freud's fundamental doctrines, which have been
of such immeasurable value. But behind both of
these modes of approach, there lies the immensely
important fact that man is a social animal and
that he has, of necessity, ideals of life and con-
. duct and the good, which, in a sense, transcend hia
/ recognition of weakness, temptation and defect

James J. Putkah.

AUTHOR'S NOTE

There are three classes of readers to whom a
book on psychoanalysis might be of interest. In
the first, would be tiiose entirely mif amiliar with
Freudian psychology and who wish to make a first
acquaintance with the subject; in the second,
those who already know something about psycho-
analysis and are desirous of learning more, with
the intention in some instances of using it in prac-
tice. The third, and by far the smallest class,
would be made up of those having considerable
training and experience in psychoanalytic work
and whose interest therefore would be in the finer
details of theory and technique and in the more
elaborate reports of analyzed cases. It is to the
second class of these readers that this book wiU be
most likely to appeal.

That such is the case is not entirely in accord-
ance with the plans I had in mind on beginning
to write the book. The ^chapters that are pre-
sented here were intended, according to the orig-
inal scheme, to serve a semi-introductory func-
tion in preparation for two final and more highly
tedmical chapters wherein an elaborately ana-
lysed case and the more intricate details of the-
ory and practice would be considered. But
partly because I found unexpected difficulties in
the way of compressing the case report sufficiently

zvii

xvui AUTHOR'S NOTE

to conform to the physical limits set for this book^
and partly from the reflection that such matter
would have its interest for a different and smaller
audience than the one to which the present chap-
ters might appeal, I eventually decided to use
this clinical material as the basis for a second vol-
umCy supplementary to this one, and in which also
the question of analytic technique could be more
suitably considered.

I am not greatly in sympathy with the theor-
etical and technical innovations in psychoanalysis
introduced rather recently by the schools of Jung
and of Adler, and the views set forth in this book
are intended to represent the purely Freudian
doctrines in so far as I am able to understand
and interpret thenL In some of the more highly
theoretical parts of the present volume I have
followed Freud's writings very closely, not hesi-
tating at times even to borrow his words. Be-
lieving, however, that one may get a clearer view
of involved material by looking at it from more
than one angle, I have ventured to introduce, in
some portions of the book, what amounts to a
hybrid behaviorisnL In doing this I have felt
some misgivings, for behaviorism is a field in
which I have little reason for feeling sure of my-
self, and I am aware that my efforts to produce
clarity may perhaps result in confusion.

Some of the material utilized in this book I
have published before. That which constitutes
Chapter VI is, except for some minor changes
and omissions, as it originally appeared in the
Psycho<malytic Review, under the title, **A Psy-

AUTHOR'S NOTE xix

ohoanalytic Study of a Severe Case of Compul-
sion Neurosis/' A large part of the chapter on
dreams is taken from two papers entitled,
"Dream and Neurosis/* and, **0n Freud's The-
ory of Dreams," which were published in the
Interstate Medical Journal, and American Medi-
cine, respectively. The two analyses of name-
forgetting are taken from "Three Examples of
Name-Forgetting,*' and "Some Analyses in the
Psychopathology of Everyday Life," which ap-
peared in the Journal of Abnormal Psychology.
I wish to express my indebtedness to these jour-
nals for permission to reprint this material. I
owe a similar acknowledgment to the New York
Times, the New York Tribune, and the Louisville
Times, by whose courtesy the cartoons used in
Chapter m are reproduced.

In reporting clinical material throughout this
book I have made such minor changes or omis-
sions as seemed to me necessary to conceal the
identity of the patients in question, but none of
these alterations are serious enough to affect the
scientific value of the reports.

The bibliographies for the various chapters in
this book are intended to serve as general refer-
ences and to indicate lines for collateral reading.
They are not intended to be at all exhaustive.
For more complete lists of psychoanalytic litera-
ture the reader is referred to those given in the
Jahrbuch der Psychoanalyse, Bd. VI., 1914. Spe-
cific references are given in some parts of this
book but omitted in other parts, as for instance,
in the Second Chapter, where to give them would

AUTHORS NOTE

involve referring almost every paragraph to the
same small list of authoritative works.

In condnsion I wish to express my great in-
debtedness to Mr. Wilfrid Lay for his assistance
in the preparation of this book.

H. W. Fbink.

CONTENTS

CHAPTER I
The Sexual Synthesis 1

Sezual origin of functional neuroses suspected by the
ancients given a scientific basis by Freud. Meaning of
the term aesmoL The individual as a separate entity
and as a member of the race. The instincts preserva-
tive of individual and of race — ^hunger and sex. Every
human feeling traceable to one of tiieae two. Everything
connected wiui hunger on the one hand and reproduction
on the other forming two groups, the second correspond-
ing to the broad use of the word sexual. Self preserva-
tive instinct and holophilic instinct. The parallel be-
tween higher and lower is reproduced in the parallel be-
tween infant and adult and first adequately recognized
by Freud. Adult sexuality a composite of impulses
already present in the infant. All physical sexual
machinery present in infancy, needing only the new
secretions of adulthood to set it in motion. Three
phases of development of human sexuality: 1. infantile
or pre-inhibltory, 2. childhood and 3. adult. Infantile
holophilic phenomena. Erogenous zones and pleasure
from their stimulation. Pleasure incidental to alimen-
tation later sought for its own sake. Reason why these
pleasures are classed as holophilic and not as self-pre-
servative in their latest manifest connecti<m with the holo-
philic Similarities between thumb-sucking and adult
sexuality. In infancy all erogenous zones equal in pleas-
ure sensibility and independent of each other. The par-
tM impulaea: sadism-masochismy exhibitionism, impulse
to tondi and be touched. "Polymorphous-perverse'^ and
autoerotic nature of infantile sexualitv. Allerotic phe-
nomena in infancy differing from adult in lack of syn-
thesis of the erogenous zones and the partial impulses
under the primacy of the genital. In adults the re-
lation of partial impulses to the erogenous zones that of
fore-pleasure to end-pleasure, while in infancy all holo-
philic pleasures are end-pleasures. Inhibitions in period
of childhood: shame, modesty, disgust, etc. Ameliora-
tion of the (Edipus complex. The latency period and the
normal interruption of it at puberty. The building up
of the hierarchv under the primacy of the genital sys-
tem. Morbid disturbances possible at every step in this
development. Infantile sexual theories and their sig^
nificuice in determining psychoneurotic symptoms m
adult life. Ijiter amnesui.

• •

CONTENTS

CHAPTER II
Ths UKooKSGions 30

The concept of canae and effect valid in the psychical as
well as in the physical realm. Objections answered.
Ulustrations from hypnosis, abnormal psychologr, prej-
udices and religious beliefs. Rationalimtion blinds us to
the validtiy of the causal principle in psycholo^rsr. The
Foreconscious and the Unconscious distinguish^; ideas
in the Foreconscious accessible; those in the Uncon-
scious inaccessible to consciousness except by analytical
inference. Repression the cause of this inaccessibility;
repression and activation. Activation and counter-
activation, the former mediated by pain, the latter by
society. Origin of repression in infancy. The first re-
pression; the Narcissistic period; the period of the ego-
ideal. The Ego-ideal as an assimilation of the social
environment. Conscience as a re-extemalisation of the
father imago, and contains more than specific morality.
The E^ideal a structure of the foreconscious and not
consciously formulated. The Censor as an effect of
trends in the foreconscious. The Unconscious present in
the psychic apparatus from the beginning both of the
race and of the individual, and has no regard for reality
or for time. Difference between the blind, instinctive
urge and its visible manifestations. The former as real
as the latter. Instinct as a creator of tensions inhibited
in the foreconscious, which is the seat of counter-activa-
tions. The foreconscious likened to a screen not so good
a metaphor as being likened to a theatrical manager, who
impresses certain attributes upon the unconscious ma-
terial. Instability of the control of the foreconscious.
Hie drug-taking compulsion. Its oriffhi in an infantile
sexual theory. The descendants of tiie repressed. The
second or superficial censor.

CHAPTER III

Two Kinds of Thineinq, and the Psyohologt of

Dbeam 89

Thinking according to the Reality Principle and that
according to the principle of Pain and Pleasure. The
former done mostly in words, is fatiguing, is directed by
a goal idea, the latter in images and not so directed and
does not fatigue. The two types correspond roughly to
the two psychic systems. Pleasure Thinking to the uncon-
scious, Reality Thinking to the conscious system. Suck-
ling iskfant realizes satisfaction by the hallucioatory route.

• ••

CONTENTS

VAQB

Gtrw plaee to Beality Thinking in adult life, but not
eomplately. Day dreuns and n^ht dreams a residue of
Pleasure Thinking in adult life. The dream the 'imag-
inary fulfillment of a wish." Falsity of this statement
only apparent. The dream interpretable somewhat as a
rebus, allegory or cartoon. Dream of Palmer's perfume.
Roman soldier cartoon. Symbols in dream and in car-
toon, the latter labelled, the former not. Dream of
Springfield, Mass.; of the peri-anus. Manifest and latent
eontent of dreams. In night dreams the wish disguised.
Dream of shop window, and interpretation. The dream
processes: 1. Condensation, 2. Displacement, 3. Drama-
tization. Topical symbolism in dreams. 4. Secondary
Elaboration. The dream a preseryer, not a disturber, <d
sleep (except nijghtmares). Significance of the dream
for pqrehouialysis. Symptom uid dream.

CHAPTER IV

ThB MbCHAKIBMS of PSTCHOPATHOLOGIGAIi MaNI-

FSSBTATIONS 124

Neurotic symptoms have piychical mechanisms, the
same as those in dreams. The cause of a young woman's
forgetting the name '^Milton." Overoompenaation. Com-
pensatory hypertrophy and its analogue in the psychie
sphere — overcompensation. The neurotic girl's constant
alarm concerning her mother. Married woman's extrava-
gant solicitude for her children. Interest in Christian
Science. Overcompensation in a militant feminist and
wliat it covered. Most radical movements have neurotica
as conspicuous supporters. Antivivisectionism, Southern
chivaliy and lynching as overcompensations for sadistic
trends. Diaplaeefnent. SuUimation one of its forms.
Sublimation of a sadistic trend in the study of chem-
istry. Displaconents of the drug-taking young woman;
of uie man catching trains; the young man vmo breaks
rules. Origin of klentomania. Displacement in young
man needing a studio away from his home. Diffuse
displacement Projection ordinarily a defense mechan-
ism, e.g., in the widow who moved away from a sub-
urb to New York. A girl's projection of her guilty
fedings into an attack on the pnysician. The projection
of a reproadi. A girl's projection of her desires on to
the teadiers with vmom sne studied. A man's projection
of self-reproach for impotence, into accusing his wife
of infidelity. Morbid jealousy in women and in men.
introfeotion. The reverse of projection and also called
« Identtfication, of which there are two kinds, subjeetlva
and dijective. Nonnal identification. Case of a woman
identifying herself with Evelvn Nesbit Thaw; of a phy-
sician who Identified himself with a murderer; of a

CONTENTS

FAOB

Sitient tHio identified himself with a patient of Dr.
rill's. BaHonaUeatUm. Neurotics rather more intel-
ligent than the average. Few even normal people really
know the causes of their actions. Patient who declared
he would many a rich girl gives wrong reason for
marrying a poor ^rl. Rationalization in another pa-
tient's ammiente m favor of woman suffrage, of elec-
tion of Wilson, against Wilson's election. A married
woman rationalizes her wearing of black clothes. De-
fence and Distortion Mechanisma. Patient with un-
conscious wish for mother's death distorted to re-
morse at death of another. Patient who dissuaded his
prospects from buying advertising space, on account of
not giving full return for value received. Patient who
would not bathe in cold water on account of "small-
penis complex." Washing compulsions; reliffious and
charitable work. The physician who blames the patient
for lack of understanding. Transference or objective-
identification. Examples. The ''conditioned reflex" and
the "sensory pattern.'' Reaction patterns formed before
the end of sixth year, e. g., the (Eaipus and Electra com-
plexes. Freud's "Interpretation of Dreams" quoted.
Warning against misunderstanding Freud's statements.
The "Imago," not necessarily an accurate picture. Pa-
tient transfers to physician feelings she has had for
father. Resemblance of this process to psychical proc-
esses of certain primitive races. Case of young man
infatuated with divorcee older than he, to whom he had
transferred his mother imago. Reactions from father
complex; and from mother complex in man who could
have intercourse only with servants. Transference to
physician occurs in every analysis, both positive and
negative; and is uncovered, but not created by it.

CHAPTER V
" The Nextbosis as a Whous 220

Neurosis at time of its appearance seems something
unprecedented in the individual, but is really not dis-
continuous with patient's former life. Continuity every-
where complete. Neurosis conditioned by a failure of
repression, which is, however, never complete. Neurotic
symptoms, like dreams, are manifestations of the Uncon-
scious, which can only wish. Each symptom an at-
tempted realization of one or more unconscious wishes,
chiefly sexual or holophilic. Question why this is so not
relevant. Sexual factor, present in all reported cases,
even when not seen or admitted by the writers. Physi-
cian with unsolved complexes unable to remove his own
and patients' resistances against sex confessions. Neu-
rosis the negative of the sexual perversion; both repre-

CONTENTS

Bcntlpg a partial arrest of development. Fixation and
inhibition of inetincts by habit. Fixation of holophilic
impnlee not merely upon an object but upon an aim or
type of action. Holophilic impulses not specific in aim,
a condition which alone renders sublimation possible.
Libido fixed on type of action becomes specific Second
object selection occurring after puberty influenced in
normals by the unconscious portion of the libido, and
dominated in neurotics. The love specifications of the
neurotic more numerous. Early fixed libido can only
exceptionallv be satii^ed in reality and wishes must
remain in the Unconscious. Fundamental difference be-
tween neurotic and normal person is that neurotic has
kamed to love and hate too soon. Fixation points are
weak points in the holophilic synthesis. R^ression of
libido to earlier lines of discharge paralleled by a r^^res-
sion to more internal paths of imagination^ producing
Introversion. Masturbation and phantasies later giving
way to a real sexual object, a process reversed in neuro-
sis. Regression a preliminary to neurofli«. The neu-
rotic uses his illness as a means to attain various ends.
The neurosis a defense against the pain of non-realiza-
tion of narcissistic wishes. Neurotics neither Immoral
nor unmoraL Immediate cause of outbreak of neurosis
is deprivation of some love gratification; sexual absti-
nence. Freud quoted. Morbid fear or anxiety a result
ol damming up of libido. Difference between morbid and
normal fear is that former is a relatively excessive one,
and is a difference of origin. Kormal fear originates
from external world, morbid from the Unconscious.
Nature of emotion — a deed yet retained within the or*
ganism. Sexual emotion physiologically like any other,
but psychically^ less dependent on external stimulation
than other kinds. Anxiety neurosis as described by
Freud. Biological significance of fear. Source of mor-
bid fear withm the organism nothii^ novel as the dis-
tinction between external and internal is comparatively
late in ontogenetic development. That which causes
pain is regarded as external. Morbid fear causes sub-
ject to act toward a part of himself as if it were hostile.
Morbid fear in one sense not morbid but a normal re-
action to an abnormal condition. Anxiety neurosis a
variety of anxiety hysteria. Warning against talcing
word sexual too narrowly.

CHAPTER VI

PlSrCHOLOGY OP THE COMPULSION NSUROSIS . . . 270

Neurasthenia a misnomer. Phobias and panics. Ex-
amples of compulsions showing mesalHanoe between affect
and idea content, both quwtative and quantitative.

CONTENTS

Source of affects entirely in the UnconaciouB, and affects
are attached to wrooff ideas. Necessity of admitting on-
eonsdouB p^chic activities. Repressed wishes just as
dynamic as the unrepressed. Compulsion in the drug-
takinff case shows wish entering consciousness as a wish
but madied to new idea. In oompultiye fears the wish
energy is transformed into anxiety. Case of young man
buying a straw hat, showing overcompensation. Role of
sadism in compulsion neuroses. Love and hate for same
object. Weakness of will, in matters of love, spreading
to other situations. Compulsions represent effort to
compensate for doubt in love life. Compulsions are sub-
stitute activities. Two-sided compulsive acts, opposite
impulses being discharged separately. Ambivalence.
Regression of libido in compulsion neurosis which is the
neoative of the sadistic perversion. The curiosity im-
piuBe causes morbid pondering. Superstition in compul-
sion neurotics conceniing the death of others. Omnipo-
tence of wishes. Difference between compulsion neurosis
and hysteria. Case of prostitute showing failure to see
connection between her neurosb and her life.

CHAPTER Vn
A Case of Compulsion Neubosis 308

Introduction. Historical. Results of previous treat-
ment. Analytic data. Father complas. Separation
complex. Assault obsession. Resistance against mar-
riage. Analysis of the assault obsession. RAle of the
tuberculosis complex in the love choice. Analysis of the
Kishef obsession. Further details. Conclusion.

CHAPTER Vin

The Psychology of Anxiety Hysteria . •. . . 430

Most common in women, the compulsion neurosis in
men. Chief manifestation of anxiety hysteria is morbid
fear. Phobia and panic. Three examples. Ideational
element. Story of the fanner getting drunk. Genesis
of the anxiety through displacement of wish energy to
substitute idea of dangerous man. Fears cannot be
reasoned away. Revolver no protection against thirst.
Morbid fear an expression of essentially feminine traits
Anxiety neurosis tJie necative of the masochistic perver-
sion. Stella's fear of "dead souls" displaced from anal-
erotic wishes.

CONTENTS xxvu

CHAPTER IX
A Case of Anxiety Htstebia 411

History. Fint seizure, followed by two others in
three weeks. Hypnotism sufflested but rejected. Psy-
choanalysis accepted. (1) The "spookiness" of hypno-
tism, (2) The love look of the hypnotized subject, (3)
The expression: "I'm crazy about him!" (4) The read-
ing of newspaper reports about white slavery, (6) The
talk with the j^rl fnend, (6) The fear of infection and,
(7) The association of it with hair on the back of Mr.
D/s hands. Relevance of these seven thouffhts all point-
ing to fear of sex. Dream of being chased oy a Japanese
girL Dream of being bitten by a dog. Its interpreta-
tion withheld. Aesociations: Talk with girl friend
about prostitution, disease and abduction. Phantasies
about first coitus show sado-masochistic conception of
sexuality. Indentification of the dog in the dream as
Mr. D. The dream contradicts Miss 6/s remarks about
disliking Mr. D. Her fears of going to the office now
explained as a fear that she would fulfill her eexual
wishes. Interpretation of dream presented to patient,
the first sex information imparted, produces mcrease
of resistance signifying a definite sexual experience,
which was then related by patient— an attempt at
masturbation by an older girl friend. Strong feeling of
remorse in spite of words of priest. Overcompensation.
More sex information imparted. Resistance at time of
explanation of dog dream due to the homosexual experi-
ence. Resentment against her parents for not warning
her of possible sexuM advance of girls. Protestations <S
ignorance. "Ber learning about coitus at the age of thir-
teen. Her enuresis from five to six. The consequent
oonnection of intercourse with dirtiness. New resist-
ances. The flower incident. Fear to make the next visit.
Phantasy of the girl who eloped with a doctor. Trans-
ference phenomena. Belittling the psychoanalyst caused
bv the transference. The feeflngs tnus discovered really
directed in the unconscious toward some one else now
represented by the psychoanalyst. Patient admits the
feeling for Mr. D. once experienced when he touched her
arm. Episode of Dr. Y. Interruption of the analysis.
The affair with Dr. Y. a compromise. Dream of riding
on a subway train. Its interpretation resulting in prog-
ress. Her continued dislike of Mr. D. masking a real
sexual attraction toward him. Her ineradicable feeling
that sex was sinful. The dream of going for treatment.
Its interpretatioii. Reading of '*His Hour" as material
for assault phantasies. Interpretation of the neurosis.
1. Plash of sexual feeling toward Mr. D. on subway, 2.
reading white slave reports, 3, reading *His Hour," 4, in-
cident of beiJig chased by a man, and 5, her first attack on

I

0

xxviii CONTENTS

day of expected visit to her homosexual friend — all show
inclination for Mr. D. Her idealized love shown as an
infantili^. Dream of flying bird. Dream of being in
wedding dress. The divorce phantasy. Its unreasonable-
ness not admitted. The displacement-of-disadvantage
mechanism. Dream of running away from marrying a
Chinaman. The wealthy foreigner. Money as a resist-
ance against marrying Mr. D. Conclusion.

SYNOPSIS OP CHAPTER X

Thb Theory and Mechanism of the Psycho-
ANALYTIC Cure 496

Historical; use of hypnosis to restore memory aban-
doned. Emphasis removed from symptom to resistance.
Neurotic compared to imprisoned man. Unhappiness of
both due to sense of guilt. Resistance due to conscience^
which is habit and not instinct. A retriever carries
birds as if they were full of pins. The neurotic acts hi
accordance with an infantile pattern. Psychoanalysis
lets the patient know what he is doing. Filling of gaps
of memorr is the removing of resistance, and shows the
patient the significance of his actions. The reformed
Jew and his reaction to ham. Case of male patient
losing affection for wife an instance of habit or complex
formed by childhood experience. Psychoanalytic expla-
nation cured by showing him what he was doing. Psy-
choanalysis diagnostic and disintegrative. The disinte-
grations are accomplished in two ways; first by patient's
recalling the experiences which formed the complexes and
second by re-living them In the form of transference.
Re-living or re-enactment described in the case of male
patient. While convention is frequently a pushing back
(repression), psychoanalysis is a true re-education or
drawing out of the powers of the individual.

BiBUOGRAPHY 555

t ' •

MORBID FEARS AND
COMPULSIONS

CHAPTEE I

THE SEXUAL SYNTHESIS

HIPPOCBATES, the Father of Medicine,
taught that the malady known as
hysteria arose when the unsatisfied
womb, longing for the seed of the male, broke loose
from its fastenings and restlessly wandered about
the ioterior of the body. In accordance with this
theory he applied sweet perfumes to the vulva of
the patient and evU-smeUing substances to her
nostrils, vnih the idea that by such means the
mutinous organ might be induced to return to its
proper locus. Benmants from this theory are
handed down to present day medicine as the name
we apply to the disease (hysteria, from wrripaj the
womb) and the practice of administering to
neurotic patients certain ill-smelling drugs such as
asafoetida and valerian.

Since the days of Hippocrates the theories ad-
vanced to explain hysteria and the other psycho-
neuroses have been both numerous and varied,
some of them being no less fantastic than his. But
throughout there has been noticeable a persistent,

. 2 M0R3ID. FEARS AND COMPULSIONS

if ill-definedy tendency to locate the cause of the
trouble in the organs of generation. The constant
search for malpositions of the uterus, cervical or
perineal lacerations or other pelvic disturbances
in neurotic women, and the multitude of operations
that have been undertaken with the idea of curing
the neurosis by removing these conditions are but
a few of the manifestations of this tendency.

It remained for Freud to show that this indina-
! tion to regard the reproductive organs as the site
of the causal factors of the functional neuroses
had, in a way, its justification, and really amounted
to a dim, imperfect intuition of what actually is
the truth. We know now, thanks to his genius,
that in these cases the trouble really resides not in
the sexual organs of the patient but in the sexual
instinct.

The violent and bitter prejudice which arose
against this doctrine of Freud's could in large
measure be ascribed to the peculiar feeling preva-
lent among Caucasian peoples that there is some-
thing inherently shameful and indecent about sex,
in consequence of which they are quick to resent
whatever implies directly or indirectly that the
erotic impulses are of much consequence to them.

Another important factor which interfered with
Freud's teachings was that people failed to under-
stand just what he meant by the term sexual, an4
thus saw in his writings meanings that he never
intended, and derived impressions totally differ-
ent from those he wished to convey. These false
notions caused many to reject his teachings who,
had they understood him, might have investigated

INFANTILE SEXUALITY 3

farther and readily accepted his views. What in
many instances excited prejudice was really some-
thing quite different from what Freud had tried
to teach.

In view of this, I think it well to begin by an at-
tempt to make dear what is meant by the term
sexual when used in the Freudian sense, and what
we shall understand the sexual instinct to be.

Each individual leads a double existence ; on the
one hand he is an entity in himself , on the other an
insignificant component of that larger entity, his
race or species.

Corresponding to these two roles he has two
great groups of impulses or instinctive tendencies,
the one wholly egoistic or self -preservative, the
-other essentially altruistic and preservative of
the race. Of the first group hunger is the chief
sensational representative, of the second the desire
for sexual congress.

If one studies some simple organism, for in-
stance the amcBba, it is easily apparent that all
its processes fall readily into one or the other of
the two groups, self -preservative and reproduc-
tive. If comparative studies are then made with
other organisms higher in the phylogenetic scale,
it will be found that there is nothing, not excepting
even the most complicated mental processes of
dvilized man, that is not represented in some sim-
ple and rudimentary way in the lower organisms,
even to the amoeba. Thus every item of human
behavior whether it be'* explicit*' (action) or* im-
plicit'' (thought or feeling) ^ is revealed, either to

1 J. B. WatMm, ''Behavior/' Henry Holt & Go.

r

4 MOBBID FEABS AND COMPULSIONS

direct observation or by tracing it back through
phylogenetic history, as belonging either in the
self -preservative or in the race-preservative group
of reactions.

Now suppose we name these two great groups
each according to its chief representative. All
processes belonging to the self -preservative group
would then be called hunger processes, all those
of the other would be termed sexual processes.
Thus our desire to have warm clothes in winter
and cool ones in summer would be called a hunger
phenomenon, while a wish that these clothes might
look well would be considered to belong to the
sphere of sex. It is exactly in this hroad and in-
clusive sense that Freud uses the term sexual.
With him it embraces all those reactions that are
race-preservative in purpose or effect according
to their phylogenetic or ontogenetic history. His
use of the word would be exactly paralleled by
including all the self -preservative processes under
the term hunger. The word sexual in the Freud-
ian sense is thus most nearly synonymous with the
Greek "Epw (Eros) or the English word Love,
though having an even broader meaning than
either of them. The phenomena popularly termed
sexual represent only a comparatively small por-
tion of Ihe group which are sexual in Fred's
sense.^

;ilt may be conceded that Freud's selection of this term to
denote the large group of phenomena to which he applies it was
not particularly happy, for apparently it has led to much mis-
understanding. Also it has been complained that he stretched
the meaning of the word beyond all reason. The situation was,
of course, that since there is no term current that expressed the

INFANTILE SEXUALITY 5

Corresponding to the two great groups of pro-
cesses or reactions into which the phenomena of
the individual life may be divided, there are as-
sumed two great groups of impulses or tendencies,
the self -preservative or ego-instinct, and the sexual
or holophilic instinct as the source from which each
group of processes gets its primal push and drive.
For our reactions to the stimuli we receive usually
if not invariably represent out-puts of energy en-
tirely out of proportion to the amounts of energy
impinging on our sense organs as the stimuli
themselves. If for instance a photographic plate
in a camera is exposed to the light rays coming
from a grizzly bear, an impression is made on the
plate which is directly proportional to the amount
of light and the length of time of exposure. But

ezaet meaning he wftnted, he had either to invent a new word or
elee broaden the meaning of the one already in use. That he
chose the latter course instead of the former would have been all
right, could people have been made to understand, as they did
not, that it was in this new and broad sense that the word was
generaUy used. As a matter of fact, in a good deal of psycho-
analytic writing the word sexual is used now in the broad sense
and now in the narrow sense, without the authors' always taking
the trouble to state in which sense it is to be construed. It has
occurred to me that the word holophilic, from dXot, whole, and
^iX^, love, thus meaning aU kinds of sexual or love phenomena,
mi^t be a convenient synonym for the word sexual in Freud's
sense, and that its judicious use would serve to avoid some pos^
siUe misunderstanding. I do not wish to replace the word secf-
wU entirely, for that, too, might lead to misunderstanding. In
this bode, therefore, I propose to use the two words interchange-
ably and as synonymous with one another, hoping by so doing
to emphasise the broad way in which the word sexual should be
construed without tiring the reader with repeated statements
about it. I shall attempt particularly to use the word holophilic
in such connections where the word sexual would be most apt
to be erroneously taken in its narrow sense.

6 MORBID FEABS AND COMPULSIONS

if these same rays impinge on another sort of sen-
sitized plate, the retina of a human being or of an
animal, there results an effect in the shape of fear
and flight, the energy output of which bears no def-
inite ratio to the energy-content of the incoming
rays, and is of infinitely greater magnitude. The
role of the stimulus in this and practically all other
cases is that of releasing into kinetic expression
energy that is latent within the organisuL To
express this notion of latent energy we require the
term instinct which we conceive to be the source
of the energy which is released as the responses to
various external or internal stimuli. To the en-
ergy itself which is thus released we g^ve in the
case of the holophilic group of phenomena the
name Libido.^

Just as everything in the lives of the higher or-
ganisms can be found represented in some simple
or rudimentary way in the lives of the lower, so
practically everything in the adult has some sort
of representation in the child. However trite this
statement may appear, its application in the psy-
chosexual sphere was hardly recognized at all until
the work of Freud. The sexual instinct was pop-
ularly supposed to appear at the time of puberty;
the child was tacitly assumed to be practically
asexual before that period. Whether the instinct

iLike the word sexual the woTd libido must be coiutnied in
peychoanalTtic writing in a broad sense while popularly it is
used in a narrow one, and hence the same objections apply to it
that arise against the formet. For this reason Jung has sug-
gested that it be replaced by the Greek 6pft^ (Horm4). "On Psy-
thological Understanding," Journal of Abnormal Psychology, Vol.
IX, No. 6.

INFANTILE SEXUALITY 7

has any prepubertal representation or in what this
representation ought consist hardly anybody
stopped to enqnire. One of Freud's great
adiievements was the demonstration that the sex-
ual instinet as first manifested at the time of pu-
berty is not new but so to speak a synthetic prod-
uct, formed by uniting certain of a number of holo-
philic trends or impulses which were present
throughout childhood and thus that the germs of
sexnality are present in the individual from his
verybirtlL

!niat this discovery of Freud's should have
given rise to astonishment and incredulity is from
one point of view very surprising. All tiie recep-
tor surfaces, all the complicated systems of volun-
tary, sympathetic and autonomic arcs and end-or-
gans involved in the reactions represented by the
love life of the adult are present in practically
their fully developed form long before the begin-
ning of puberty. Apparently the change which
takes place at puberty results not from new arcs
being introduced or in old ones suddenly becom-
ing permeable, but rather in the maturing of cer-
tain glands which now begin to pour their inter-
nal secretions into the blood stream and, in the
male, furnish a new substance for external dis-
charge. It would be hard to believe aU this com-
plicated machinery waited silent and idle, or was
responsive only to non-sexual stimuli and capable
only of non-sexual reaction's during all the years
preceding puberty and this glandular activity.
On the contrary it would be logical to expect the
occurrence of many and complicated reactions,

8 MORBID FEAES AND COMPULSIONS

lackmg to be sure something possessed by the
sexual processes of the adult, but nevertheless
fully deserving to be called sexual. This doctrine
that adult sexuality develops by a sort of synthe-
sis out of a preexisting sexuality we should have
been prepared for by expecting that the effect of
the internal secretions appearing at puberty
would be merely that of adding further power
and emphasis to certain reactions of the compli-
cated machinery already present and freely re-
acting before the attainment of sexual maturity.
We should have known that the psychosexual
phenomena of the adult could not have developed
de novo at puberty, but could only represent what
had been present much earlier, now brought into
high relief through the added effect of the new
secretions.

In the sexuality of the human being three phases
or periods of development may be distinguished :

(1) an infantile or pre-inhibitory period which
corresponds to the first three or four years of life ;

(2) the childhood or latency period which succeeds
the first and ends with the onset of puberty, and

(3) the adult period, or phase of object-love.
The first period may be called the pre-inhibitory

period because it represents a stage in which
the so-called reaction-tendencies, (the inhibitory
trends such as shame, disgust, modesty, sympathy,
etc.) are not yet manifest. The child, during this '
first period, is incapable of any of these feelings ;
as soon as he becomes capable of them the period
comes to a dose and the latency period has its be-
ginning.

INFANTILE SEXUALITY 9

The holophilic phenomena of the first period
consist chiefly in the pleasurable sensations which
the infant derives from the stimulation of certain
sensitive areas which are known as the erogenous
zones. These zones are represented by the anal,
oral, and urethral orifices, the penis in the male
and the labia and clitoris in the female. The first
pleasurable stimulations from them are incidental
to the performing of the functions of alimentation.
In the infant the pleasure derived from the taking
of nourishment is not represented entirely by taste
pleasures and the actual satisfaction of the craving
for food; the tactile and kinesthetic sensations
created during the act of sucking are distinctly
agreeable and pleasurable in themselves. In the
same way the voiding of excrement not only repre-
sents something more than simply the relief from
the discomfort of not voiding, but also gives rise to
tactile and muscular sensations that have a definite
pleasure value in themselves.

Having experienced these pleasurable sensa-
tions as incidents to the performing of the alimen-
tary functions, the infant soon seeks to re-expe-
rience them for their own sake. Thus, for in-
stance, he develops the habit of sucking his thumb
or some other available object, purely for the sen-
sory pleasure the act of sucking affords and quite
apart from any desire for nourishment. In the
same way other children refuse to empty the bowel
when placed upon the toilet, and hold back the feces
until there is an accumulation of sufficient size and
consistency to give the act of evacuation the great-
est possible amount of pleasure.

10 MOBBID FEABS AND COMPULSIONS

It may be asked why such tricks of the infant as
thumb-sucking and the holding back of the feces
are classed in the sexual or holophilio group, and
not as hunger phenomena. We may answer that
the principal reason for so regarding them is be-
cause of their later history. By the study of the
oral perversions or perversities {fellatio, cwnm-
lingua, etc.,) the perverse action can be demon-
strated as a direct descendant of the infantile
pleasure-sucking which in most cases of such per-
version had been indulged in with great fervor and
continued for a long time. Then too the analysis
of certain neurotic disturbances such as hysterical
vomiting and some food idiosyncrasies reveals
them as a reaction against similar oral-
erotic longings and phantasies, now offensive
to the controlling trends of the personality,
but likewise easily traceable through the de-
velopmental history of the individual back to
the pleasure-sucking of infancy. The oral erot-
ism of the infant is represented in the normal adult
as the pleasure in kissing. Of course the rudi-
mentary sexual activities cannot be expected to be
in every particular like those of the adult. Kiss-
ing in the adult excites the genital system while
the sensations excited in pleasure^sucking remain
local. But we must remember that the intercom-
munication of the various holophiUc impulses (the
sexual synthesis) has not yet been established, for
the reason that the glands whose internal secre-
tions are largely instrumental in its accomplish-
ment have yet to mature. Nevertheless the infan-
tile erotism as exemplified in pleasure-sucking ia

INFANTILE SBXUALITT U

not set off so sharply from adult sexaality as one
might perhaps expect. In certain cases at least, it
proceeds to an orgastic climax succeeded by a pe-
riod of complete passivity and relaxation, the
whole phenomenon bearing such a striking similar-
ity to the sexual acme and immediately subsequent
relaxation in the adult that it could hardly escape
the observer.

The first stimulations of the penile and clitoris
zones appear to result either from irritations pro-
duced by discharged secretions or excretions in
contact with them, or from the manipulations in-
volved in keeping the child clean. These pleas-
urably experienced stimulations the infant then
seeks to repeat either by thigh rubbing or the use
of the hand. The former appears to be more com-
mon in female infants, the latter in males.

All the erogenous zones in infancy have, at least
to start with, about the same degree of pleasure-
sensibility. As time goes on the significance of
one zone may be accentuated over that of the
others through repeated stimulation, but there is
nothing corresponding to the primacy that in the
normal adult the genitals have over all other re-
gions of the body. Furthermore, the zones or-
dinarily remain perfectly independent of one an-
other; excitement of one does not of itself produce
an excitement or heightened sensibility in any of
the others, as happens in the adult when for in-
stance the oral zone is stimulated and the phenom-
ena of sexual excitement occur in the genitals
without their being stimulated directly.

In addition to the zonal components of the holo-

12 MORBID FEARS AND COMPULSIONS

philic instinct th^re appear a little later a set of
impulses which have at first no connection with the
erogenous areas. These so-called partial impulses
(Partial-triehe) go in pairs of which the one is ac-
tive and the other passive. One of these pairs con-
sists of the sadistic and masochistic impulse. The
former is an aggressive tendency, and is mani-
fested as a desire to dominate, to use force, rough-
ness or violence, and if it goes far enough, to in-
flict pain. ^ The masochistic tendency has just the
opposite nature, and is shown as a pleasure in obe-
dience, submission, and the enduring of humilia-
tion or pain.

A second pair consists of the impulse to show-
ing and looking, the former passive and the latter
active. They refer not only to the genitals them-
selves, but to the entire body. Out of a union of
the looking impulse with a contribution from the
acquisitive trend of the self -preservative group
there develops the curiosity impulse, of which we
shall have a good deal to say in some of the later
portions of this book. The impulses to touch and
to be touched, etc., belong in the same group of
partial desires.

These partial desires of infancy are readily
identified as fore-runners of tendencies apparent
in the sex-life of the normal adult. The sadistic
impulse, for instance, corresponds to the normal
aggressiveness in courtship shown by the male in
comparison with the female, and his inclination to

iThe wish to cause pain is not primary in tlie sadistic im-
pulse, though early becoming associated with it. See Freud's
<Triebe und Triebschicksale/' Int. ZeitMohrift fUr A. P., 1916.

INFANTILE SEXUALITY 13

master, and occasionally to be rough with the
loved object. This inclination corresponds to an
evolutionary period when the male had need of
other means of overcoming the resistance of the fe-
male than those implied by the term courtship,
(marriage by capture, etc.)

The disposition of the looking and showing im-
pulses in adult life is well illustrated by the differ-
ences in the evening dress of the male and the
female. As shown by this the female has a
greater desire to be looked at than has the male,
while in the male the pleasure in looking and the
curiosity impulse (sexual curiosity) is stronger
than in the female.

It must be pointed out that the partial impulses
represent rudiments corresponding not only to
tendencies normally present in adult life, but also
to those of certahi perversions, sadism, maso-
chism, exhibitionism, etc. In fact there is a per-
version corresponding to each one of the partial
impulses of infancy. The same may be said with
regard to the zonal components. In other words
the perversions represent great exaggerations or
over-developments of some one or other of the
holophilic tendencies which are normally present
in every child. This has led Freud to designate
the infantile sexuality as ''polymorphous per-
verse." This is perhaps an unfortunate term for
while it is true that the infant evinces holophilic
pleasure in all these diverse ways there is nothing
abnormal about it at that stage of development.
The true perverseness results only when those
trends experience a disproportionate develop-

14 MOEBID FEARS AND COMPULSIONS

ment and fail to become subordinate to the genital
zone at the time of the sexual synthesis of puberty.

The conspicuous feature of the sexuality of the
infantile period (and for that matter of the child-
hood period also) is that it is predominantly auto-
erotic. By this is meant that the child for the
most part gains his satisfaction from his own
body; he is not dependent as is the adult, upon a
second person for the satisfaction of holophilic
needs. In the normal adult love life the sexual
object (this second person) is indispensable; the
sexuality of the infant is for the most part ob-
jectless.

Yet the predominance of autoerotism in child-
hood is not absolute. Often as early as the begin-
ning of the second year one can see signs of the
rudimentary object-love which foreshadows, and
in a sense is the model for, that great factor in
adult life. Before the end of the infantile period
these indications are very clear and ordinarily
bear the stamp of the normal heterosexual selec-
tion. The first extra-egoistic holophilic interests
developed by the infant have as their objects the
persons of the immediate environment, parents,
nurses, etc., but the libido is distributed in unequal
quantities to these individuals so that there is soon
revealed (in normal children) a preference for the
opposite sex. Thus the little boy loves the mother
more than he does the father, while with the little
girl it is the father who has the preference. Quite
generally the parent of the same sex as the child
is looked upon as an interferer and rival for the
affections of the parent more greatly loved. The

INFANTILE SEXUALITY 15

little boy, for instance, wishes that his father were
oat of the way so that he could have his mother all
to himself. ^ This early object-selection forms
the foundation of those important constellations,
the (Edipus Complex (in the male) and the Electra
Complex (in the female) which are of great signifi-
cance not only in the later life of the neurotic but
in normal people as well.

In these allerotic phenomena, as distinguished
from the essentially autoerotic processes which
constitute the major portion of the infantile holo-
philic reactions, the nearest approach is made to
the phenomena of love in the adult. The essen-
tial difference is the lack of synthesis of the va-
rious impulses into any definite pattern or hier-
archy such as exists in normal adult life. That
is to say, all the impulses remain as separate and
independent sources of pleasure; the significance
of the genital zone is not, as in the normal
adult, accentuated over that of all the others, and
the partial impulses are not intimately connected
with it. For instance, in the adult the gratifica-
tion of one of the partial impulses, for example the
desire to touch the loved object, though giving
pleasure at the same time creates a desire for a
greater pleasure, that of coitus. Thus the two
stand to each other in the relation of fore-pleasure
and end-pleasure. In infancy there is no differen-

1 That this desire frequently takes the form of a wish that the
father were dead need canee no astonishment, for at this period
the idea of death means nothing more to the child than simply
"gone away/' and eiLcites none of the horror that it has for the
adult

16 MORBID FEAES AND COMPULSIONS

tiation into pleasures of different order. All the
holophilio pleasures are end-pleasures, and what
organization exists among the various impulses is
a pregenital organization. The sexual pleasures
of this period are for the most part lacking in the
genital component, unless the genitals are directly
stimulated.

It must not he understood from what I have said
ahout the CBdipus complex and the heterosexual
predominance in the infantile object-love that all
the child's holophilic interest or libido is distrib-
uted to the opposite sex. On the contrary a bisex-
ual or, to use Ferenczi's term, an amphierotic ten-
dency is apparent. Thus some of the libido takes
a homosexual direction, being applied (in the boy)
to the father, brothers, or other males in the fam-
ily. This hemophilic application of the libido in
infancy corresponds to the normal friendships and
attachments for one 's own sex in the normal adult,
and, in the abnormal, to the homosexual perver-
sions.

The holophilic activities of the infantile period
reach a high point somewhere between the third
and the fifth years of life. There then begins a
period of latency, relatively complete in some in-
dividuals, but broken through in varying degrees
by expression of sexuality in others. The begin-
ning of this period is marked by the first appear-
ances of such reactions as shame, modesty, dis-
gust, sympathy, etc. They are the foundation
and the forerunners of all those ethical and es-
thetic forces which play the role of inhibitions
upon the later sexual life and, like dikes or dams.

INFANTILE SEXUALITY 17

narrow the avenues of holophilic expression. The
first appearance of these inhibitory tendencies is
spontaneons and probably organically condi-
tioned. But the further development of the in-
hibitory forces, which takes place all through the
latency period, is dependent in great measure for
its extent and direction upon the cultural and edu-
cational influences of the environment.^ The
controlling forces which are thus shaped by edu-
cational influence and which eventuate in an appar-
ent disappearance, more or less complete, of the
infantile sexuality as manifested in the flrst period
are in large measure developed at the expense of
the infantile sexuality itself and derive much of
their motive power from it. For instance, the
masochistic partial impulse furnishes the motive
for obedience, and leads the child to accept and to
embody into his own personality the codes or
standards of those about him. The exhibitionistic
impulse manifested at first in the desire to have the
body looked at, later expresses its energy in what-
ever actions may serve to win parental approba-
tion and praise. In other words the energy of
these impulses may eventually lead the child to

1 Freud remarkB tliat edacation remaiiiB properly within its
assigned realm only if it strictly follows the path sketched for it
by the spontaneously appearing inhibitory tendencies and limits
itself to emphasizing and developing them. The truth of this
statement wiH, I think, become clearly apparent at certain points
in the clinical portion of this book, where we shall become ac-
quainted with instances where the well-meant educational and
correctiTe efforts of parents oyerstepped the limits indicated by
the spontaneous inhibitions and went too far in some directions,
thus producing an ultimate effect upon the child that was very
different from the beneficial one intended.

18 MORBID FEABS AND COMPULSIONS

avoid the very acts by which he gratified them orig-
inally. In this maimer the control and suppres-
sion of the primitive infantile sexuality is in large
part accomplished by motives derived from the in-
fantile sexuaUty itself.

The measures of libido distributed to the mem-
bers of the family or other persons of the environ-
ment tend more and more to be displaced from the
sexual aims of the first period and to depart from
manifestations coinciding with the popular mean-
ing of the term sexual, taking on an aspect which
coincides with the meaning of love in its narrow
sense, that is to say, affection. The love for the
mother thus loses whatever crassly sexual appear-
ance it might at first have possessed, whUe the in-
fantile hostility and jealousy exhibited toward the
father may disappear from view entirely or be
represented only as a diffuse inclination to disobe-
dience, dislike of authority, etc. In other words
the manifestations of the OBdipus complex un-
dergo a profound amelioration.

This refining process, through which the ener-
gies of the primary components are divorced from
their original aims and applied to new aims and
activities of a higher and socially more valuable
order, is not limited to the formation of controlling
or inhibiting trends as just described and which in
large measure represent the basis for estheticism
and morality, but occurs in other connections.
The primitive sexual curiosity thus becomes a
desire for general knowledge, the sadistic impulse
finds expression as a desire to win or to excel in
games, sports or any other sort of competition,

1

INFANTILE SEXUALITY 19

eta Snch employment of the primitive energies
for higher aims is known as sublimation. The
extent to which it occurs in normally educable
children is really enormous. We shall hear some-
thing more of it later. ^

The latency period^ as has been said, is by no
means always complete and in many individuals
is occasionally or even constantly broken through
by some form or other of definitely sexual mani-
festation. In children with whom this occurs ex-
tensively it often may be interpreted as the fore-
shadowing of a later neurosis or sexual abnor-
mality.

A wholly normal suspension of the latency oc-
curs with the onset of puberty and with it the
latent period is terminated. The holophilic in-
stinct now changes from its infantile to its adult
form. Hitherto its manifestations have been pre-
ponderantly autoerotic ; now begins the predomi-
nance of object love. Hitherto the various partial
impulses and zonal pleasure sources existed for the
most part side by side in a sort of democratic
equality ; now they become organized into a hier-
archy. The genital zone receives a primacy over
all the other components of the holophilic impulse,
and to this primacy everything else (normally)
is subordinated. The partial impulses, looking,
touching, sadistic aggression, etc., and their pas-
sive counterparts ; the oral or other zones still sus-
ceptible to sexual stimulation, now fall into the
subordinate role of fore-pleasure production, and
the whole fore-pleasure machinery now serves the

1 In Chapter IV on Meehaniams.

20 MORBID FEABS AND COMPULSIONS

imified purpose of preparing for and urging to-
ward the final holophilio act through which sex-
uality is articulated with the function of procrear
tion, in the end-pleasure of coitus. Autoerotism^
though in most cases holding its ground for a time
in the form of the masturbation that ordinarily ap-
peared about the time of puberty, is gradually re-
placed by the new regime of object-love. The lib-
ido is eventually withdrawn from its affectionate
fixations upon members of the family or their sur-
rogates, and, combining with the sensual libido
corresponding to the new glandular influences, is
at length transferred to extra-familial individuals
of the opposite sex with whom, as foreshadowed in
the masturbation phantasies of puberty, a com-
plete love life can eventually be carried out. Only
with the complete synthesis of puberty do the nor-
mal differences between the sexuality of the male
and the female come into high relief. The active
or aggressive trends come to predominate in the
character of the male, the passive in the female.
Incidentally it may be remarked that the change
at puberty from infantile to adult sexuality is
more sharply marked and more sudden in the male
than in the female. The love life of the female
retains in perhaps most cases a good deal of the
character of infantile sexuality all through adoles-
cence and often well into, or even throughout, adult
Ufe.

This sketch of the ontogenetic development of
the holophilio impulses is intended (beyond mak-
ing the reader familiar with the terminology I
shall need to use later) principally to indicate

INFANTILE SEXUALITY 21

what is the normal course of things. I shall not
attempt to discass the abnormalities or anomalies
that may arise ont of the many possibilities for
aberration presented by the developmental
changes taking place in a machinery so compli-
cated. It win be sufficient at this point to say that
every step in ontogenetic development, every tran-
sition that must be passed through, offers possibil-
ities of morbid disturbance, through a persistence
of this or that phase that should normally be
passed, through the opening up of avenues for
aberrant development, or through the formation
of a lotms minoris resistentiae at which the appar-
ently normally accomplished sexual synthesis may
give way under the strains and stresses of adult
life. Later we shall gain some incidental famili-
arity with those partit^ular types of imperfect
synthesis known as the perversions and which
correspond to an over-accentuation of some one or
more of the normal components and to their con-
sequent failure to become subordinated to the
primacy of the genital zone and the end-aim of
heterosexual coitus. Our particular study how-
ever concerns another sort of developmental aber-
ration which we shall learn to know as the nega-
tive of the perversion, namely the psychoneurosis.

Before closing this chapter I must mention a
matter that really belongs under the heading of
infantile sexuality : the formation of the so-called
infantile sexual tiieories, which as we shall learn
are often of much significance in the determination
of the psychoneurotic symptoms in adult life.

22 MOEBID FEAES AND COMPULSIONS

Children of normal intelligenoe, about ike age
of four or five ordinarily pass through what is well
named the period of sexual investigation. Previ-
ous to this period the small child is likely to take
for granted the existence of himself, his family and
his various neighbors and acquaintances, and dis-
plays no particular curiosity as to how he or they
came to be. Then, partly tiirough subjective and
partly through objective influence, a new and burn-
ing desire for knowledge has its birth. In typical
cases this interest appears as a reaction to the ar-
rival of a new baby in the family. Such an event
is not one which, by the average child of four or
five, is looked upon with favor. On the contrary
he is likely to regard the new-comer as an unat-
tractive intruder with whom in future he will be
compelled to share his cherished importance, his
worldly possessions, and, worst of all, the parents '
love.^ Through the feelings of hostility bom of
such considerations the child is led to ask himself
the important question: ^^ Where do babies come
fromt" in many cases apparently in the hope that
an answer thereto may place him in a position to
prevent any repetition of the undesired occur-
rence.

Confronted with this problem the small investi-
gator naturally turns first of all to his parents, a
source of aid and information hitherto found reli-

i A child in whose family no birth takes plaoe during hb carlj
years learns of the dreaded possibility from his acquaintance witii
other households. Older children are much less likely to be jeal*
ous of a newly arrived brother or sister than are younger onesy
and in many cases they welcome their aniall relatiye with Qft-
mized satUfaetion.

INFANTILE SEXUAL THEORIES 23

able. But in most cases he gets little satisfaction ;
his qaestipns meet with a laughing and evasive
answer, an admonition not to speak of such mat-
ters, or some such interesting statement as ''The
stork brings the children," or ''The doctor finds
them in the woods." All such answers ordinarily
affect children in much the same way. The stork
or the doctor story is soon doubted, and, like ad-
monition or evasion, merely serves to give the
child the impression that the theme of birth is one
to be avoided in the presence of adults. These
stories, instead of removing his curiosity, simply
cause him to conceal it and to pursue any further
investigation in a less open and direct manner.
At the same time the failure of his parents to aid
and instruct him in a matter so serious to him
gives rise to more or less distinct feelings of re-
sentment, suspicion and distrust.

Finding that the parents will not explain birth
for him, the child attempts to discover its explana-
tion by himself. In secret he ponders the prob-
lem, and, from watching his elders, from seeing
the sexual acts of animals, from the examination
of his own body, from certain physical sensations,
from vague impulses, inclinations and longings
that begin to stir witldn him, he collects material,
and from it constructs his own theories of repro-
duction, which, though grotesque and faulty, are
on the whole surprisingly near the truth. The
content of some of these theories we shall now con-
aider.

Practically all children who form any theory
whatever come to the rij^t conclusion in the one

24 MORBID FEARS AND COMPULSIONS

important particniar that the baby grows in the
abdomen of the mother. It would seem at first
thought, that if children are able to gaess this
much then the formation of correct concep-
tions of impregnation and birth would naturally
follow. Yet such is not the case, for by certain
faulty premises the infant theorist is led widely
astray. The first of these erroneous premises is
the theory, very commonly entertained, that every
human being, female as well as male, possesses a
penis. That among small boys who have never
seen the female genitals such a belief should exist
is of course not strange. But even those who
have seen the genitals of some small female mem-
ber of the family still cling to this notion, and
reconcile their preconceived views with the actual
evidence to the contrary by the reflection : **She is
still little; when she gets older it will grow."
Some little girls also have the penis theory, for
after having seen the male organ, they conclude
that they too are entitled to a like appendage.
Misled by the faulty premises involved in the penis
theory and by being ignorant both of the exist-
ence and of the functions of the vagina, the in-
vestigating child is prevented from guessing cor-
rectly the route by which the baby reaches the
outer world. His most natural conclusion is that
the baby must make its exit from the abdomen
through the same opening as do the other solid
products of bodily activity, in short that birth
takes place via the rectum (the '^ cloaca theory").*

1 In this connection it must be remembered that children of an
age to form such theories would feel toward this hypothesis none

INFANTILE SEXUAL THEORIES 25

This theory, since it does not contain the con-
cept of anatomical differences between the sexeSi
naturally results in the supposition that males
can bear children as well as females.

When the child has answered to his own satis-
faction the questions of where the baby develops
and how it reaches the outer world, there remains
another riddle to be solved. What starts the
process f How does the baby get into the mother t
The explanation most obvious to the child's mind
is, that since the baby comes out like feces, it must
go in like food. Therefore to start a pregnancy
ihe mother must eat or drink something, a fruit
or seed, or something furnished by the doctor, and
from this substance the baby develops. This be-
lief is strengthened if the child learns that rain
and manure are required for i;he proper develop-
ment of seeds planted in the ground. He reasons
by analogy that urine and feces must be designed
to favor in like manner the development of a
**baby seed'* within the abdomen.

Another fairly common theory, which was first
described by Beitler, is that impregnation is ac-
complished by the parents placing the buttocks to-
gether and blowing flatus into one another.^

A notion somewhat different from these already
described is formed by children who, through shar-

of the evtiietic objectiona which could occur to an adult. ''Tlien,"
aa Freud aaya, "defecation waa something that in the nursery
could be spoken of without reaenre; the child had not yet divorced
himself from hia oonatitutional ooprophilic tendendea; it waa no
degradation to come into the world like a maaa of CKcrement/'
— Ueber infantile Sezualtheorien.
iR. Beittor, ''Zentralblatt ftir Psychoanalyse,'' Hft 2, 1912.

26 MORBID PEARS AND COMPULSIONS

ing their parents ' sleeping room or in some other
way, happen to overhear the act of sexual inter-
course. From such an experience they often de-
rive the so-called ^^ sadistic" conception of coitus.
'^They see in it something that the stronger does,
by force, to the weaker ; and they compare it (boys
especially) to a scuffle such as those with which
they are acquainted from their association with
other children."^ It seems probable that some
children recc^gnize the true significance of coitus
and assume a connection between it and birth.
But a larger number apparently do not guess this
connection, and, therefore, look upon the act sim-
ply as one of violence. The tendency of children
to regard coitus a& a sort of assault and battery
committed by the male is strengthened if they see
the apparently hostile sexual activities of fowls,
cats and other animals, or if they find blood spots
in the bed or upon the linen of some woman in the
family. Added to this is the fact that in certain
homes the entire married life presents to the ob-
servant child the spectade of continuous strife,
expressing itself in loud words and hostile de-
meanor. From this he takes it as a matter of
course that the quarrel is continued into the night,
and is decided by the same means that he is ac-
customed to employ with his brothers, sisters or
playmates.

This early period of sexual investigation and
theory formation ordinarily comes to an end with
the beginning of the latency period. The inhibi-
tions that develop at that time against matters

iFreudy 1. a

INPANTILB SEXUAL THEORIES 27

sexual soon cause these theories to fade from con-
scious memory^ so that in adult life the individual
is usually unable to recall ever having had any
views upon or interest in sexual matters at this
early period.

During the latency period, and consequent upon
the quiescence of the investigating instinct, chil-
dren often accept without any particular conscious
doubt the stories that babies are brought by the
stork or the doctor, or else they conclude that God
makes some mysterious and supernatural ar-
rangement by which infants appear in the homes
of the married. These beliefs then remain in con-
scious memory and are recalled in after life as if
they were the only ones that existed in childhood.

In most children, at the dose of the latency
period, the dormant sexual curiosity again ap-
pears, and a second period of sexual investigation
begins. But the conditions are quite different
from those of the first period. Children now dis-
cuss matters of sex with each other ; the older and
better informed share their knowledge with the
younger, or, occasionally, more or less complete
sex instruction is given by parents or teachers.
Thus in some cases children learn the whole truth
about reproduction. But more often the child is
ignorant or misinformed concerning one or more
important facts and so is prevented from drawing
correct conclusions. Consequently the theories
which are formed at this time are often extremely
absurd and, because they are based upon such
variable external conditions, of infinite variety.
To be sure, a partial revival of the earlier theories

28 MORBID FEAES AND COMPULSIONS

may occur and serve to color or modify later con-
dnsionsy bnt the miif ormity of the primary and,
so to spea^ endogenous theories no longer exists.

As these later theories are from the medical
standpoint much less important than the earlier
ones, I shall limit myself to making little more
than a brief mention of a few of them* One of the
most frequently found secondary theories is the
belief that birth takes place through the umbilicus,
through the linea alba, or through an artificial ab-
dominal opening made by a doctor. Even grown
women occasionally entertain some such view.
Such conceptions are really remnants of the cloaca
theory. When repression of the anal and copro-
philic interests occurs the original cloaca theory
becomes objectionable and is excluded from con-
sciousness. Then some less objectionable part
of the abdomen, such as the umbilicus, takes in the
new theory the place formerly occupied by the
perineal region.

One set of secondary theories depends upon the
fact that many children, though no longer in ig-
norance of the existence of the vagina, have not
yet learned of the seminal fluid. Hence, in some
cases, they conclude that the urine possesses the
power of fertilization ; in others, that mere contact
of the male and female genitals (without penetra-
tion) is all that is necessary for impregnation.
According to my experience, the latter, or ^^con-
tagion'* theory, is usually found only among
females. Other beliefs that may be mentioned
are the following : That impregnation results from
kissing, that coitus takes place by rectum, that

INFANTILE SEXUAL THEORIES 29

birth follows invariably or immediately after
coitus, etc. One of my patients, apparently be-
lieving that some dose analogy existed between
human copulation and the incubation of eggs, con-
cluded that intercourse had to take place every
night for nine months in order to produce a child.
What significance these periods of theory
formation may have in the later life of the neu-
rotic we shall learn in some of the succeeding
chapters of this volmne.

t

J

32 MORBID PEARS AND COMPULSIONS

fio too we must assume the agency of unseen psy-
chic forces if we are to regard the phenomena of
mental life as having any law and order, or even
continuity and connectedness. We are obliged to
posit psychic acts and influences lying outside of
the field of consciousness and inaccessible to ordi-
nary introspection — ^which in other words are un-
conscious. Without this assumption it is abso-
lutely impossible to reduce things psychic to any
semblance of law^ order, continuity or comprehen-
sibility.

Another reason for assuming the existence of
the non-conscious psychic factor is that the con-
tent of our consciousness comprises only an ex-
tremely small portion of what we are wont to call
our conscious knowledge. I <^know" the multi-
plication table, the date Columbus discovered
America and an infinite number of other things
varying from the names of the twelve apostles to
the function of the cerebellum; but the greatest
part of this information only occasionally occu-
pies a place in my conscious thinking, and then
only for a relatively short time. At all other
times it is latent. I can recall any portion of it,
if there is any occasion for so doing, but, unless
attention is directed to them, all these memory
impressions remain unconscious like an electric
light bulb with the current turned oflf, inactive,
xmilluminated.

Yet even when they are inactive we must at-
tribute to these memory residues some sort of
psychic existence. I meet a man on the street
and he speaks to me. I recall where I met him

PSYCHIC CAUSES 33

and all the circumstances, bnt cannot remember
his name. What t^ his namef Is it Marshall?
No it's not Marshall. Is it Parsons? No it is
not Parsons, although it begins with a P. Sev-*
eral other names occur to me but I reject thenL
An hour later I suddenly recall the name; it is
Pierson. But had I not some memory of the
man's name in the meantime, even though that
memory was not a conscious one? How can I tell
what a man's name isn't, unless I have some sort
of psychic record of what it isf And is not this
unconscious memory identical in every respect
with a conscious memory, save that it lacks that
quality which we know as awareness? Is it not a
part of the psyche, even when it is non-conscious?
It has been maintained, on the contrary, that
these memory impressions, when outside of con-
sciousness, are not psychic states, do not belong
to mind but are physical and pertain to physiol-
ogy; that in other words, they are correlates of
somatic processes in the brain cells, from which
the psychical emerges only in response to new
stimuli or with shifts of attention. To such an
objection one might, of course, reply that they are
equally entitled to be called the residues of psychic
processes, and that they are no more physical or
physiological than are conscious psychic activi-
ties, which of course must be assumed to have
their physical, chemical or physiological counter-
parts, although we do not know what they are.
This sort of argument is, however, rather sterUe.
A refusal to call latent memories a part of the
psyche is either a begging of the question as to

34 MORBID FEARS AND COMPULSIONS

whether only that which is conscious is mental, or
else a matter of conventional nomenclature which
arbitrarily defines the mind as that which is con-
scious.

This being the case, the question of whether
we should adhere to the arbitrary and con-
ventional definition of mind or abandon it in
favor of a conception that includes non-conscious
mental elements is reaUy a pragmatic 6ne and
turns upon which one of the two ways of looking
at the matter best accords with known facts and
is the more useful Once stated in these terms,
the question becomes a very simple one. To de«
fine mind as only that whidi is conscious, and to
remove from the field of psychology the latent
memory impressions and other non-conscious ele-
ments of which we are obliged to infer the exist-
ence, is a procedure that cannot be defended from
the point of view of utility. As Freud points out
it separates phenomena that are actually continu-
ous, plunges us into the insoluble problem of
psycho-physical parallelism, and obliges us to
narrow the field of psychological investigation
without correspondingly widening any other
field.^ To accept such a way of looking at the
psyche would be much the same as binding our-
selves never to judge our fellows except on the
basis of what they say, or refusing to employ any
data for interpreting the behavior of our friends,
acquaintances and people in public life except that
furnished by what they choose to tell us. On the

iDaa UnbewuBBten— "International Zeitachrift fllr Antliche
Psychoanalyse/' Vol. lU, 1916.

UNCONSCIOUS CAUSES 35

other handy a psychology which indudes the non-
eonscious is extremely nsefnl. This will, I feel,
be so clearly shown in the following pages as to
relieve me of the task of arguing the point jnst
now.

If now we grant the right to posit an nncon-
scions portion of the psyche, it is evident that
hitent, I e., inactive, memory impressions and
their like are not the only non-consdons mental /
elements which we must assnme to exist. We
have reason to infer the existence of other ele-
ments which are not simply latent bnt which,
despite their not being conscions, are active and
may exert an influence, even a profound one, on
the individual's consdous thinking and behavior.
In order to make this perfectly clear, let us sup-
pose that I hypnotize a man and give him the sug-
gestion that, fifteen minutes after he awakes, his
arm will become completely paralyzed. He is
roused and remembers nothing of what I have said
to him during the trance. Nevertheless, when
fifteen minutes have elapsed he is utterly unable
to move his arm. He still has no recollection of
what was said to him during the hypnotic sleep,
nor does he realize what it was that caused his
paralysis. In other words, my suggestions, the
mental impressions causing his paralysis, though
potent and active are at the same time uncon-
adous. This proves condusively that a mental
element does not necessarily have to be in con-
adousness in order to be active or produce an
effect.

A similar example we can take from the realm

36 MORBID FEABS AND COMPULSIONS

of the abnormal. A young woman, a patient of
the writer's, suffered from an uncontrollable im-
pulse to take drugs. But the case was not one of
a drug habit in the ordinary sense, for the drugs
she took were not as a rule of the habit forming
variety, and she showed no preference for any one
drug over any other. She did not take them
for their taste, nor for any pleasing effect they
had upon her, for many of them were ill tasting or
had some action which she found very unpleasant.
Any substance so long as she could think it was
<< medicine" suited her just as well as any other.
She had many times been questioned as to why
she had this peculiar impulse, and she had tried
very hard to find the explanation herself, but with-
out any success. The reason for her morbid
compulsion was as much a mystery to her as to
every one else, and was utterly inexplicable as far
as the data furnished by her consciousness were
concerned.

But while the compulsion could not be explained
by referring it to anything contained in the pa-
tient's consciousness, our conclusion should not be
that it had no cause, but rather that of its cause
she was unconscious; that it depended upon a
mental activity which lay outside the field of her
conscious introspection. It was just as if some
one had hypnotized her and by suggestion given
her the impulse to take drugs, which upon awaking
she obeyed without remembering the suggestions
from which it originated. In fact such an impulse
could be produced for a time at least, in that way.
In such a case we would know what caused the im-

UNCONSCIOUS CAUSES 37

pulse, even if the subject did not ; in pathologioally
produced compulsion we lack such knowledge untU
after the case has been analyzed. We shall learn
later, indeed, how it is possible to ascertain the
causes even of these compulsions. In the case of
this young woman, for instance, it wUl not only
be shown that we are right in assuming some un-
conscious ideas and impulses as the real basis for
her drug compulsion but also we shall learn what
these unconscious ideas and impulses were.

It should be understood at the outset that we
do not have to go into the field of psychopathology
or to such unusual states as those induced by hyp-
nosis to find examples of the influence of mental
processes which are active though at the same
time unconscious. Many are at hand in the phe-
nomena of every day experience.

Thus a man's religion is rarely chosen by him
only through conscious reflection. When a per-
son is a Protestant, it is ordinarily supposed that
he was caused to be so by what is popularly
termed his ^ ^ bringing up. ' ' That is, it is assumed
that a large number of experiences which he has
undergone, and of influences to which he has been
subjected, have somehow prejudiced him in favor
of the particular religion he has chosen and are
really responsible for his choice. This does not
mean, however, that he rememhers all these ex-
periences or is clearly conscious that they are in-
fluencing him. On the contrary the impressions
having perhaps the greatest influence are usually
the ones that relate to the moral and religious in-
struction he received in childhood, and these can

38 MORBID FEAES AND COMPULSIONS

be recalled only imperfectly, and many of them
not at alL It is obvious therefore that to explain
why a person has accepted a given religion we
have ordinarily to assume that there exists a non-
conscious biasing agent which is probably the
most important factor in determining his dioice.

If we now attempt to formulate some concep-
tion of this biasing agent (of this unconscious
cause of belief) our result will be somewhat as
follows: We shall expect it to be a very large
group of memory traces, ideas and feelings con-
nected in various ways with the central theme of
religion. Some of these presumably had their
origin in the various incidents of early moral in-
struction from the parents, of intimate family
life, of childhood visits to church and Sunday-
school, or in different vague perceptions of things
wonderful and mysterious. Others resulted from
various allied experiences occurring throughout
the person's later years. Some of the elements
of the group are doubtless recalled frequently,
others seldom, a great many others never. That
is, the biasing agent consists very largely of un-
conscious ideas.^

Such a system of connected ideas, having a
strong emotional tone, and displaying a tendency *

to produce or influence conscious thought and ac-
tion in a definite and predetermined direction, is
called a complex.

A great part of our conscious activities is de-
termined by such groups of thoughts, only a few

1 Frink— "What Is a Complex?'' JourwU of the Amwieam
MedUxa A$900iaUim;* Vol. LXII, p. 897, 1914.

EATIONALIZATION 39

members of which are ever in consciousness. We
have complexes concerning the different members
of onr families ; complexes relating to each one of
our important loves, hates, ambitions and recrea-
tions, and complexes concerning our politics,
patriotism, pride, morality.

A statement like this will not be instantly ac-
cepted by every one. According to most people
onr thinking is determined by external facts, by
our logical and reasoned judgment of them, by
what we know and perceive, not by that of which
we are unconscious. But though we do not un-
derestimate the part played by logic and reason
in mental life, it must be admitted that such forces
have not by any means the wholly dominant role
that is often unthinkingly attributed to theuL
^'When the emotions are sitting as judges, facts
make poor witnesses'' will hardly be disputed by
anyone who stops to think. We all have preju-
dices and are subject to their influence. ''The
wish is father to the thought" applies to all of us
at times. But, common as the phenomena are,
how seldom do we hear a person admit that he is
biased in his thinking, or see him give any evi-
dence of a realization that such is the case I Ask
a German if he approves of Zeppelin raids and
he says: ^'CertaiiJy." Ask an Englishman and
he answers: ** Barbarism I" Then ask either one
of them to give the reasons of his opinion, and
you will get a more or less logical explanation.
But is this explanation correct t Is it not more
likely that the reason that the German believes in
Zeppelin raids is that he is a German, and the

40 MOBBID FEABS AND COMPULSIONS

Englishman condemns them because he is an
Englishman f Is it not practically certain that in
nine cases out of ten the person is incapable of
thinking without bias on a question so intimately
affecting his mother country and himself, and that
his complexes even more than the actual merits
of the question are the main determinants of his
opinions? But does the person himself realize
and admit this ? In most instances certainly not.
On the contrary he is sincere in believing that the
reasons he gives for his opinion are the actual
cause of his entertaining it.

It is an extremely common occurrence that
ideas, beliefs, actions, really having their origin
in some one of the individual 's complexes, and be-
ing at least partly determined by ideas and im-
pressions of which at the time he is not conscious,
he represents to himself and to others as being the
result of a logical train of conscious thought. He
manufactures ex post f<icto a plausible explana-
tion of his belief or action which he unquestion-
ingly accepts as its cause. This process of sup-
plying the place of the missing (unconscious) link
in the chain of reasoning with another (conscious)
link has be^n named by Ernest Jones rationalizO'
tion} It is because we all rationalize very ex-
tensively that we greatly overestimate the role
played by logical and reasonable judgment in de-
termining the trend of our conscious thought and
conduct, and, to the same or even a greater de-
gree, underestimate the influence and potency of
those factors which are not in consciousness.

1 'Tapers on PsychoanalyBia/' Chapter I.

N

n

THE FOEECONSCIOUS 41

(b) The Unconscious and the Foreconsdous

Non-consdous mental elements may be roughly
divided into two classes. For instance, it comes
to my mind as I am writing, that the dose of phos-
phorus is one hundredth of a grain. I am sure
that at any time since I first studied materia
medica I could have remembered the quantity of
the dose, if any one had asked me. But I am al-
most as sure that this is the first time I have
thought of it since I left college. Though this
particular memory was in the Unconscious all that
time it could have been brought into my conscious-
ness at any time if I had wished to recall it. On
the other hand, the hypnotic subject may be en-
tirely unable to recall the hypnotist's suggestions,
the neurotic young woman was absolutely unable
to bring to her consciousness the ideas which op-
erated to form her drug compulsion, nor can the
German through any effort of voluntary intro-
spection, become aware of any but a relatively
small portion of all those past impressions, going
even back to his childhood, which make up his
complex concerning the Fatherland. Some un-
conscious mental elements, then, can be brought
into consciousness at the will of the individual;
others can not, but remain in the Unconscious in
spite of any ordinary effort of the individual to
recall them.

Mental impressions or processes of the first
class above mentioned are spoken of as forecon-
scious and are said to belong to a region or system
in the psychic apparatus which is named the Fore-

42 MOBBID PEABS AND COMPULSIONS

conscious.^ Those of the second class are known
as unconscioas and are said to belong to a system
or region called the Unconscious. The word Un-
conscious is often used to embrace both systems —
all the non-conscious impressions and processes,
those of the Foreconscious as well as those of the
Unconscious proper. The mind^ then, in Freu-
dian psychology, is conceived as having three
levels, the superficial one or Consciousness, em-
bracing all those mental processes which at any
given moment possess the quality which we call
awareness. The next, the Foreconscious system
or level, contains those elements which could be
reached by voluntary introspection, and are capa-
ble of being brought to consciousness, but at the
time lack awareness. The third and deepest level,
the Unconscious Proper, embraces all those im-
pressions or processes which not only lack aware-
ness but also cannot, by any unassisted effort of
the individual, have it conferred upon them. Ob-
viously the boundaries between the three systems
are not sharp or absolute. An idea that is con-
scious at one moment may be foreconscious the
next, and perhaps eventually unconscious. But
the interchange between the foreconscious and
consciousness is much more free than that be-
tween the foreconscious and the unconscious or
between the unconscious and consciousness.

What is it that prevents ideas or processes of
the unconscious proper from being accessible to
consciousness? Processes belonging to the un-
conscious system may be active, and capable of

1 called preoonsciooB by some writers.

THE FOEECONSCIOUS 43

exerting a strong inflnence in and through con-
sciousness— ^may, in fact, as I hope to show even-
tually, possess nearly every quality or attribute
of conscious mental processes save that of
awareness. What is it then that keeps them from
gaining entrance into consciousness f

In the case of f oreconscious processes the lack
of awareness seems easy to explain. I walk along
the street with my mind absorbed in some en-
grossing problem. I have no true consciousness
of what is going on about me. Nevertheless I
turn the proper comers, avoid collision with other
pedestrian, and stop at the right house. All
the procenes necessary for doing these things are
carried o§ without exciting awareness or divert-
ing my conscious attention from the problem
which absorbs it. These processes are carried on
in the foreconscious. Not enough attention, or
better, interest is distributed to them to give them
the quality of awareness. Yet at any time they
could come into consciousness and acquire aware-
ness if my interest or attention were directed to
them. In the same way my memory impression
of what is the dose of phosphorus remained
latent and in the foreconscious until attention
and interest were distributed to it. When, how-
ever, it was thus energized or activated, it came
into consciousness, only to return to the forecon-
scious state as soon as the activation-energy was
withdrawn.* Foreconscious memories or proc-
esses seem, then, to be those which either are prac-

U hare preferred to use the terms "activatioii'' and "aetiva-
tloB-cnei|^ intteftd of "oocupation" and "oocnpatian-energy^

4A MORBID FEABS AND COMPULSIONS

tically unactivated or else carried on with such a
low pressure of activation-energy that they fail
to rise above the threshold of consdonsness.

The lack of awareness of those processes be«
longing to the nnconscious proper cannot be ex-
plained in any snch manner. When, for instance,
they produce such an imperative and powerful
compulsion as that exemplified by the young
woman who was impelled to take drugs, we can-
not believe that they possess only a low degree of
activation. On the contrary, their activation must
be very high. We nmst therefore find some other
explanation of their not being conscious than that
of a withdrawal of activation such as would ac-
count for our lack of awareness of the content of
the f oreconscious.

Of the little outlays of money I make during the
day, for carfare, lunch, telephone calls, etc., I
have no conscious recollection at night. If there
were any occasion to do so, I could perhaps recall
how much I had spent and for what I had spent it,
but ordinarily these minor outlays have not suffi-
cient importance to keep their mental records long
before my consciousness. They promptly lose
their activation; its withdrawal is a passive and
negative process.

Suppose, on the other hand, I pay a high price
for a piece of furniture under the impression that
it is a genuine antique. Hardly do I get it home
when a friend, who is an authority on such mat-
ters, demonstrates to me that it is not genuine, but

wbieh Brill, the translator of Freud's works, has employed as the
eqniyalent of the German "Besetiung*' and "Beseteungs-Eneigie."

EEPEESSION 45

a relatively valueless imitation. I investigate
and find that the conditions under which I bought
it are such that I cannot make the dealer take it
back and return my money. Now the memory of
this expenditure does not quietly and passively
fade from my consciousness like the recollection
of the nickel I spent for carfare. Instead it con-
tinually intrudes upon me, causes me to berate
myself for the credulity that allowed me to be
t^en in so easily, and keeps me in a state of exas-
peration and annoyance. But finally I say to my-
seU that there is no use crying over spilt milk.
'^If I am a fool, I am, and that's all there is to it. I
will put the matter out of mind and forget it. I
refuse to think or worry about it any longer.''
With an effort of will I extrude the incident from
my consciousness. It returns again after an in-
terval but I again extrude it. Soon the extrusion
becomes easier. Eventually it is automatic, and
the memory of the annoying incident either en-
tirely ceases to be reproduced in my consciousness
or else appears only at long intervals.

Now it is obvious that the process by which this
memory is eventually rendered unconscious is
quite different from the quiet and passive loss of
activation which causes the f adhig of the memory
impressions of insignificant matters. There is
no passive withdrawal of activation from my
memory impression of the disagreeable incident,
at least not at first. On the contrary it is highly
activated, and insists upon forcing its way into my
consciousness even when I am trying to give my
attention to other things. How then do I get rid

46 MOEBID FEAES AND COMPULSIONS

of itt Apparently by attempting a forcible witlv*
drawal of consdons activation and by initiating
through a conscious act of will a coumter-tictiva*
Hon which is shortly taken over by the f orecon*
scions and becomes automatic, serving to proti^t
me from the displeasi^re of having the recoUe^ion
of the disagreeable incident reproduced in my con-
sciousnessy and apparently persisting at least un-
til the activation of the memory itself in the course
of time is eventually withdrawn. ^

This gives us the key for an understanding of
why it is that certain processes of the Unconscious,
in spite of their high activation, fail to gain en-
trance to consciousness. The reason is that their
reproduction is opposed by a counter-activation lo-
cated for the most part in the f oreconscious, which
automatically and without involving the partici-
pation of consciousness, keeps them submerged.
The non-consciousness of the elements belonging
to the unconscious system is not then something
passively conditioned, but the result of a positive
and active counter-force.

The process which consists of the withdrawal
of conscious or foreconscious activation from a
mental element and which consists also of the es-
tablishment of a foreconscious counter-activation,
which confines it to the Unconscious, is called re-
pression. The mental element so relegated to the
unconscious and unable to return therefrom is

1 strictly speaking, the counter-activation is not initiated by a
^'oonscious act of will*'; in fact, the act of will might be more
aocorately said to be initiated by it. Hie counter-activation is
reaUy represented by my wish to forget the incident.

BEFBESSION 47

said to be repressed. The repressing force im*
peding the return of the repressed element to con'
sciousness is often spoken of as a resistance.

The unconscious consists in large part of re-
pressed material, though not everjrthing in the un-
conscious is repressed or is there by virtue of re-
pression. The facts are as follows: the psychic
apparatus is to be thought of after the model of a
reflex arc. Thus it has its sensory, or afferent,
side, which receives the stimuli coming from the
external world or from the internal end-organs
excited by changes within the body. It has also
its efferent side through which discharges take
place to the voluntary muscular apparatus as mo-
tility, or to the involuntary muscular and glandu-
lar systems as feeling or emotion. The Uncon-
scious is toward the afferent side, the Forecon-
scious next to the efferent. All excitations of the
psychic apparatus (all mental processes) begin
at the sensory end of the system and are thus, to
start with, unconscious. ^ Some of them remain
unconscious, while others pass through to the
foreconscious and to consciousness to discharge
ultimately as emotion or motility. Whether a
given process remains unconscious or is allowed to
gain access to the foreconscious or to conscious-

1 This is not ttrictly true unlees we make the assumption that
sensations or sense perceptions coming from the end organs ap-
plied to the external world pass through an unconscious phase.
Freud regards consciousness as, functionally, a sensory organ
for pereeiving psychic qualities. He speaks of it as having two
snrfaeesy one which is excited by the stimuli entering through the
sense organs applied to the external world, the other by changes
or processes within the psychic apparatus itself.

48 MOBBED FEARS AND COMPULSIONS

ness and so to efferent discharge, depends on
whether or not it meets on its way with a resist-
ance. For at the border line between the nncon*
scions and the f oreconscions the repressing forces
or resistances exert a certain censor-like action.
Mental processes beginning in the unconscious
have, as it were, to undergo an examination before
they are admitted to the higher psychic degrees
or systems. Depending on their character or
qualities (a matter of which we shall hear more
later) ^ some of them are rejected, and remain re-
pressed and in the unconscious ; others are allowed
to pass to the f oreconscions system from which
they may or may not enter consciousness. In
normal conditions the f oreconscions system must
be traversed before an excitation gains discharge
as affectivity or motility. The most important
function of tbis system is that of opening or clos-
ing the avenues to such discharge. The content
of the unconscious is, then, made up of latent (un-
activated) psychic formations, mental processes
that are in statu nascendi, and other processes or
activated impressions which are not allowed to
pass the censor and are thus repressed. We shall
consider the content of the unconscious from a
different point of view later.* At present we
must devote ourselves to gaining a clearer under-
standing of repression, its function and the motive
for it.

A repressed element, as I have indicated, is one
from which conscious and foreconscious activa-
tion is withdrawn (if the element ever possessed

iPage57. sPltge62.

CONSCIENCE 49

such activation) and against which a connter-ac-
tivation exists in the f oreconscions. Its activa-
tion^ if it has any, belongs entirely to the uncon-
scions system* What is the purpose of this proc-
ess t Why is anything ever repressed? We get
a hint of the answer to this question from the
example I have given. I repressed the recollec-
tion of my being taken in by the furniture dealer
because this memory was annojdng me, and giving
me displeasure, for the most part apparently be-
cause it showed me in such a light as to injure my
self -esteem. That is to say, we get the suggestion
that repression is a protective mechanism, that
its motive is the avoidance of pain, or a painful
feeling. This is, in fact, the correct explanation.
The function of repression is that of defending
the ego against those ideas or processes which are
incompatible with, and painful from the point of
view of, the main trends of the individual 's con-
scious thought and feeling. This means in gen-
eral that the elements in question depend, for
their power to cause pleasure or pain, upon their
being out of accord with his individual ethico-es-
thetic ideals and impulses and upon their militat-
ing against his self-satisfaction and self-esteeuL

(c) Repression and the Psychology of

Conscience

Since the concept of repression is one of the
most vital in psychoanalysis we must consider it
in greater detail But to get a fuller appreciation
of it, we have to depart from the somewhat meta-
psydiological point of view which we have been

50 MORBID FEAES AND COMPULSIONS

occupying and approach the subject from another
angle. This will involve what may seem a con-
siderable digression, though on i^e whole our
course will be one of progress.

In the first years of childhood there is nothing
resembling that which in the adult we call self-con-
trol. The infant fulfills every wish he has, if it
is physically possible for him to do so. There is
no subjective restraint, no inhibition arising from
within, to oppose or interfere with anything he
wants to do. He knows no shame, no disgust,
nothing resembling morality. He has no motives
save those of getting immediate pleasure or avoid-
ing immediate pain. Of pains and pleasures tem-
porally and spatially remote he takes no cogni-
zance ; they mean notlung to him. His behavior
consists solely of simple responses to the stimuli
of his environment, and of expressions of the va-
rious tendencies of the hereditary instincts, the
self -preservative, and the rudimentary sexual.

As we have seen, ^ a different state of affairs is
initiated with the beginning of the period of lat-
ency, somewhere about the third year. There
then appear certain inhibitory impulses or reac-
tion-tendencies: shame, disgust, sympathy and a
rudimentary morality. ^ These new tendencies to
some extent oppose and limit the freedom of ex-
pression previously enjoyed by the primary in*

1 Chapter I. '

a These reaotions which appear spontaiieoiuly do not for the
moBt part bring with them their objeet. That is to say: they
are first represented by a capacity for such responses. The type
of situation or condition which provokes the actual response is
determined in large part by education and environment.

CONSCIENCE 51

stinctive impulses. Situations and reactions that
formerly were wholly pleasnre-giving now be-
come, to a varying extent, sources of displeasure.
Thus acts, like running around naked, so much
enjoyed by young children, which gave pure
pleasure through gratification of the exhibition-
istic impulse now provoke the displeasure of
shame or embarrassment; those acts which, like
torturing animals and teasing, gratified the sadis-
tic impulse now give rise to feelings of sympathy
or moral repugnance, etc. The possibility of in-
ternal conflict has been introduced into the psy-
chic life.

In this way comes about the first repression.
An impulse, when opposed by one of the newly
developed counter impulses in such a way that ex-
pression of it gives a greater amount of displeas-
ure than pleasure, shortly disappears from view.
In other words, it is repressed. The activation
energy which it originally possessed (its Kbido, if
it is a question of a psycho-sexual impulse) is with-
drawn ; a counter-activation, corresponding to the
inhibiting trend, appears in place of it.

The beginning of repression is the beginning of
the Unconscious, as such. In early infancy there
is no differentiation into systems, just as there is
no repression. The first repressed elements form
the nucleus of the unconscious. To them is added
all that which later succumbs to repression in the
course of the psychic development of the indi-
vidual.

But the process of repression is not all so sim-
ple as that which we have described as the first

52 MOEBID FEARS AND COMPULSIONS

repression. Though the avoidance of pain or dis-
pleasure is throughout the immediate motive for
repression (whether the element repressed be a
wish-presentation or a memory) the sources of
such displeasure are not to be found solely in the
hereditary and spontaneously arising inhibitory
reactions, as we shall presently see.

There is in childhood a certain phase of develop-
menty (the existence of which is better demon-
strated by some of the pathological conditions of
adult life than by direct observation of the child)
which is known as the phase of Narcissism. It is
a transitional phase interposed between the pre-
dominant autoerotism of infancy and the later
state of object love, and partakes of the nature of
each. It is distinguished by the fact that the
individual's holophilic impulses and interests
are for the time being directed toward himself^
in mudi the same manner that in the adult they
are directed toward another person. That is to
say, the child is for a time his own sexual object ;
he loves or is in love with himself.

Subsequent to this tpansitional phase in the psy-
cho-sexual development, the mam streams of
libido are withdrawn from the self and applied to
sex interests and objects of the external world.
But not all the libido is so employed. Some of it
remains directed self ward, though not now to the
real self primarily, but rather to an ideal. The
complete self-satisfaction which the child enjoys
during the phase of primary narcissism, when he
is his own ideal, he can not long retam. Admoni-

CONSCIENCE 53

tions and criticisms from the parents, Ms observa*
tion of the people about him and the comparisons
he makes of himself with them soon give him a
sense of imperfection and disturb his self-content-
ment. Thus he begins to desire to be, in certain
respects, what actually he is not ; to have qualities
which actually he lacks ; to be rid of traits which
in fact he possesses. He forms, in other words,
an ideal for himself, of what he would like to be,
and to this ideal that portion of the libido remain-
ing in selfward distribution is now transferred.
In so far as he can bring his real self into corres-
pondence with this ideal of self, his narcissistic
libido is gratified, and in a measure he regains the
self-satisfaction he formerly enjoyed. On the
other hand, to whatever extent a disparity is per-
ceived between the real self and the ego-ideal, to
that extent the narcissistic libido fails of gratifica-
tion and remains free, as some form of self -dissat-
isfaction or discontent.

What later becomes an ego-ideal was at first
an external critique. The control which the child
primarily exercises through fear of his parents'
disapproval (or punishment) he eventually main-
tains through fear of his own disapproval. Such
terms as right and wrong, proper and improper,
at first mean nothing to him in and for themselves.
He would just as soon do a thing labeled "wrong"
as one labeled ** right," if it were equally pleasur-
able. But with one group of terms he learns to
associate displeasure in the shape of disapproba*
tion or punishment from the parents; with the

54 MORBID FEAES AND COMPULSIONS

other, pleasure in the form of rewards and praise ;
and he begins to avoid actions belonging to the
first category and to cultivate those of the second
purely because of the extrinsic consequences of so
doing. But gradually the external standards are
assimilated. To do ^' wrong" begins to mean not
only to be less loved but to be less lovable.
"Eight,'* **proper'* and **nice'' connote not sim-
ply praise but to be praiseworthy.

Just as the first specifications of the ideal are
founded on considerations of what would win or
lose parental approval and love, so later contri-
butions to it have their origin in the desire to be
thought well of by one's teachers, by admired or
respected persons, by one's fellows and by the
general public. Thus the essentially homosexual
libido, originally (in the boy) the desire for the
approval of his father, contributes largely to the
formation of the ego-ideaL

The narcissistic libido, and that portion of the
homosexual libido directed toward the self, find
their satisfaction through the individual's bring-
ing (or thinking he brings) his real self into cor-
respondence with the ideal he has made for him-
self. This gratification is what we know as self-
satisfaction, self-esteem and self -content, the
pleasures of self-respect, of moral or esthetic self-
satisfaction. If, however, a disparity is per-
ceived between the real self and the specifications
of the ego-ideal, a portion of the self ward directed
libido fails of satisfaction, remains a free tension
or yearning, and is felt as shame, guilt, humilia-
tion or a sense of inferiority. The free homosex-

EOO-IDEAL 55

nal libido is converted into anxiety ^ and is per-
ceived as a fear of the public (shynesSi diffidence,
self -consciousness) or a fear of ^*the father"
(self-consciousness, etc., before men who are older
or distinguished or in positions of authority and
who are therefore , unconsciously identified with
the father).

We perceive at this point that what we have
really been talking about is the psychology of con*
science. Conscience is nothing other than a cen-
sorial function or ^'instance'' of the psyche which
performs the task of watching over and insuring
the gratification of our narcissistic libido by warn-
ing us of any disparity existing between an im-
pulse or contemplated action and the specification
of the ego-ideal. The inner voice which torments
us with **You must" and **You must not" was
primarily the voice of the parents, later of our
teachers and those about us, from whose verbally
conveyed praise or dispraise we built up the struc-
ture of our personal moral and esthetic ideals.

In the symptoms of certain pathological states,
notably paranoia, the developmental history of
conscience is seen regressively reproduced. The
patient complains that some one knows all his
thoughts, and watches and foresees all his actions.
He hears the voice of this person continually com-
menting and criticising. At times it reviles him,
accuses him of foul thoughts, of abnormal prac-
tices. In some cases the voice seems to be that of
some particular man, especially an elderly man.

iSee Chapter VII for the reUtion between free deaire and
uudety.

58 MORBID FEAES AND COMPULSIONS

tion with what is ineligible and already repressed.

Let us again point out that the purpose of re-
pression is in every case the avoidance of displeas-
ure or pain. Those elements^ whether they be
wishes, memories or ideas, are repressed which, if
admitted to or retained in consciousness, would
create a sense of disparity between the real self
and the ideal, and deprive some of the nardssistio
libido of its gratification, would in other words
lower the individual in his own eyes, and subject
him to the displeasure of a loss of self-respect or
the tortures of a guilty conscience.

The term conscience, as it is ordinarily used,
implies an endopsychic censorship which deals
with moral matters almost exclusively. But the
ego-ideal contains many other specifications than
merely moral ones, and self-satisfaction has other
components than simply moral self -content. Our
self-satisfaction is disturbed quite as much by
non-moral disparities between the ego and the
ideal as by strictly moral ones, and in either case
the narcissistic libido is freed in just the same
way, and the type of displeasure experienced has
essentially the same quality. To use the wrong
fork at a formal dinner, to pass flatus in public
accidentally, to make a serious mistake in diag-
nosis, or to have on dirty underwear, are not mat-
ters that can be classed as sins, though in certaia
circumstances they can produce a sense of shame
and humiliation which has no essential qualitative
difference from that produced by actions which
the individual does regard as sinful or immoral.
We are apprised of incompatibility between a

EGO-IDEAL 59

wish or contemplated action and the esthetic, am-
bitions or grandiose specifications of the ego-ideal
apparentiy in jnst the same way and by jnst the
same function as that which applies in matters
etbicaL It would seem then not only convenient
but justifiable to broaden the term conscience to
include not only that which measures the self ac-
cording to the purely ethical terms of the ideal, but
also that which does all such self-measurings
whether they be according to moral, esthetic, am-
bitious, patriotic or any other variety of ego-ideal
specifications. ^

If we ask a person (or ourselves, for that mat-
ter) : What is your ego-ideal t What are the
standards and specifications that you try to live
up tot we are not likely to get a satisfying answer.
Some would say frankly that they could not an-
swer such a question. Others might attempt to
formulate their standards for us, and perhaps feel
that they had succeeded in doing so. But in such
a case, if we had a chance to observe the person
further, we would see that he does things that
are entirely contrary to the standards he stated,
yet without displaying any sign of unpleasant
emotion or appearing to suffer any loss of self-
esteem; while certain other acts which are per-

1 Perhaps it ahould be pointed out that the specificatione of the
€go-ideal are not neceesarily oonsietent with each other. Thus,
one of mj patients, who in company with a friend ''picked up" a
eoaple of proetitntee, felt ashamed to go to a hotel to spend the
night with them» yet almost as much ashamed to back out. A
man who would be ashamed to appear irreligious may also feel
ashamed to say his evening prayers in the presence of another
man who occapies a room with him.

60 MORBID FEAES AND COMPULSIONS

f ectly in accord with any standards he mentioned
seem nevertheless to cause him acute shame and
humiliation and seriously to injure his self -con-
tent

Observations like this, if carried far enough^
teach us two important things : first that a mere
intellectual acceptance of a given action as right
or as wrong does not constitute an incorporation
of that judgment into the specifications of the indi-
vidual's ego-ideal. A person may say and really
believe that we ought to return good for evil and
yet not feel the slightest compunction or self-re-
proach when he fails to do so. Nor does an intel-
lectual rejection of a given moral code mean that
it has ceased to exist as one of the stipulations of
that individual's ego-ideal. Thus one of my pa-
tients, an ardent feminist, railed against marriage
and advocated free love, asserting that as soon as
she became entirely self-supporting, she would
enter such a relationship. Nevertheless when at
length she came to the point of actually putting
her long contemplated plan into execution, she was
overcome by a spasm of moral repugnance and
broke out with a neurosis.

Thus for a given code or standard to be a part
of the ideal means not an intellectual but an emo-
tional, not a descriptive but a dynamic acceptance
of it ; it means, on the other hand, that consider-
able libido is attached to it and that it has expe-
rienced an incorporation into the individuaPs per-
sonality. Observation shows that impressions re-
ceived in early childhood are the most potent in
determining what sort of an ideal the individual

EGO-n^^EAL 61

fashioiis. Later experiences which contribute to
the ideal or modify its specifications as a role gain
their power to do so through some sunilarity or
associative connection with the earlier impres-
sions or the persons making them.

The second important fact that is brought out
by questioning people as to the nature of the ego*
ideal they possess is that the ideal is not con-
sciously formulated. They can give some of its
si>ecification8 very readily, but are unable to draw
a definite word picture of it. The ego-iddal is not
a conscious formation. For the most part it be-
longs to the foreconscious system. Nobody is
continuously or completely conscious of what his
ego-ideal is, though perhaps the major portion of
it (even if not definitely formulated) is accessible
to consciousness in accordance with the demands
of any given inmiediate situation.

It should be added that the foreconscious sys-
tem is the seat not only of the ego-ideal but of all
the rest of the controlling trends which distin-
guish civilized man from the savage and the con-
stitutional criminal, and adapt his thinking and
behavior to the demands of civilized life. It is the
system which in the main brings about and main-
tains repression.

I have spoken of the existence of a censor be-
tween the unconscious and the foreconscious,
which determined the eventual admissibility or
inadmissibility to consciousness of the mental
processes starting in the imconscious. By the
term censor was not meant any separate psychic
entity but rather the effect exercised by the trends

62 MOEBID FBAES AND COMPULSIONS

of the f oreconscions upon the tmoonsoious activ-
ities impinging upon their lower sorf ace. ^ The
action of this censor we can now identify with the
action of conscience (I am here using the word in
the broad sense in which I earlier defined it). At
the same time I recognize that the censoring, re-
jecting and repressing action which conscience ex-
ercises upon wishes and ideals that press toward
conscious representation and ei^ression does not
have to be deferred until the elements in question
have already entered consciousness, and is not
limited to ejecting and expelling them therefrom
after they have entered, but may be, and exten-
sively is, exercised still earlier, and may entirely
prevent the presentations from reaching con-
sciousness. Consciousness does not participate
in any but relatively a small number of the acts of
rejection and repression.

(d) The Content of the Unconscious

From what has been said about the development
of conscience and of the role of the f oreconscions
as a controlling and repressing system, we get the
suggestion that the unconscious or the nucleus of
it must represent something existing in the psy-
chic apparatus from the beginning, while the fore-
conscious must develop gradually in the course of
life. This is found to be the fact. The uncon-
scious is the primitive both phylogenetically and
ontogenetically. It represents that which is un-
controlled in the savage but controlled in the civi-

1 1 hope to be excused for using such meduuDlstio phiaMology
la the discossioii of such intangible mattera.

CONTENT OP UNCONSCIOUS 6^

lized; what is uncontrolled in the child bnt con-
trolled in the adult. The f oreconscious repre-
sents all that is introduced in the higher stages of
the evolution of civilized man out of the savage,
and of the adult out of the infant. This is true
not only in the sense that the content of the uncon-
scious consists largely of trends or tendencies to
action that are more primitive than those of the
higher psychic systems, but in the sense that the
mental processes themselves, the ways of thinking,
are also more primitive. ^

The content or nature of the unconscious as
compared to the higher systems will be made
clearer by the consideration of the following ex-
ample. A friend once came to me to ask advice
about a neurotic young woman in whom he was
much interested. The girl was an only child of a
widowed mother who was not in the best of health
or of financial circumstances. The mother
showed the utmost devotion to the girl, thought
only of her, and never hesitated to make any sac-
rifice, no matter how great, if her daughter de-
manded it, or if it promised in any way to contrib-
ute to the girPs health or happiness. The daugh-
ter, my friend said, was equally as fond of the
mother. She was always praising her mother,
worrying about her health, and bemoaning the
fact that she had been the cause of so much
anxiety, and could make so little return for her
mother's sacrifices in her behalf.

Yet strangely enough all the many attempts
she was continually making to relieve her mother

iSee CliApter III— Tlie Two Kinds of Thinking.

64 MORBID FEARS AND COMPULSIONS

of some of her burdens, and be a help and comfort
to her, invariably came to naught, and in many
instances had just the reverse of the happy effect
for which they seemed to be intended. For in-
stance the girl at one time had a physical illness
which left her in a very much incapacitated condi-
tion and required her to go to the country to regain
her strength. The mother succeeded in finding
a satisfactory place for the daughter where at a
very small expense she could remain until her
convalescence was complete. The girl seemed to
improve quite rapidly, and the mother was de-
lighted. Very shortly however the girl returned
home. She could not bear, she said, to be away
from her mother any longer. She felt she must
be home to help her mother, to relieve her strain
and to avoid expense. Compared to her mother's
welfare her own health was nothing.

The fact is that this return home had upon the
mother just the opposite effect to that for which
it seemed to be intended. Instead of helping her
mother and allowing her to rest, the girl caused
more work and more worry by being home than by
remaining away. She saved no expense by being
home for it cost less to keep her away than at
home; because when she was home she was so
helpless that her mother had to hire an extra serv-
ant. And by delaying her convalescence she pro^
longed what was the immediate cause of her
mother's anxiety. This is only a sample of many
instances of a similar character where by attempt-
ing to make life easier for her mother she actually
made it harder.

CONTENT OF UNCONSCIOUS 65

In comineiitiiig npon these things my friend said
^th exasperation : ^^The girl acts as if she wanted
to make trouble for her mother^ as if she hated her
and was not satisfied to let her have a moment's
peace or happiness. But to say such a thing is
absurd, for I've told you how fond she really is of
her mother."

Yet what my friend said was not as absurd as
he thought it. In a way he had interpreted the
girl's behavior oorreotly, only he took no account
of the unconscious. The obvious fact of the girl's
protestations of love for her mother made him
reject this interpretation. His statement (that
the girl acted (is if she hated her mother; as if she
wanted to make trouble) , was right as far as it
went. But where he said as if she hated, he
should, to be entirely correct, have said tmcoii-
sciously.

In the normal person, the f oreconsdous and con-
scious systems dominate the avenues to motor dis*
diarge — ^to affectivity or action. * Only those im-
pulses or excitations which are in accord with the
trends of the f oreconsdous, and which pass its
censorship are given efferent expression.' But in
cases such as that of this young woman the sway
of the higher psychic systems is imperfect. Im«-
pulses which normally belong to the unconscious
and are repressed perfectly are here not fully con-
trolled but find their way to action. The effects
of these actions indicate the quality of the uncon-

1 Of this I dian hare more to say later. Chapter VI.
tXhe higher {Mychic syBteniB control only the form of the ez-
pnukaoL id the mge aod not its quantity or oontinuougnesB.

66 MOBBID FEABS AND COMPULSIONS

scious processes which furnish their motivation.
From these ^^as if 8*^ of the girPs conscious life
we learn the Is of the onconscions.

As far as the consciousness and f oreconsdous
of the girl were concerned she had a real tod
great love for her mother. But unconsciously she
hated her and did desire to make her unhappy. If
we seek to learn how this strange state of affairs
came to be so, we get a good deal of information
about the unconscious. We see first that the un*
conscious is primitive.^ The hostile, vindictive
reactions constantly expressed in the girl's be-
havior are not what we expect from a cultured civ-
ilized woman under any normal circumstances but
are more in keeping with the cfaaracter of an
American Lidian or any other savage.

In the second place we see that the unconsdous
has no regard for reality. It was not to the girl's
ultimate advantage to make her mother miserable.
Nor was hate the appropriate emotion for the
actual situation. The mother was devotion and
kindness itself ; so why should her daughter hate
herf The ethical values of the situation were
entirely ignored.

In the third place, if we go far back into the
girl's psychic histdry (to her childhood, in fact),
we find that there was a time when hostility to-
ward the mother was an emotion not so entirely
senseless as it seemed later. For as a little child
the girl was greatly attached to her father and
envied the position the mother occupied with him.

^ I may say that what is tme of the tmconBcioiu in the ease
of this girl ie true of the unconedoua generally.

CONTENT OP UNCONSCIOUS 67

The hate toward the mother was originally the
hate of jealousy; the little girl wished the mother
out of the way in order to have her father all to
herself. But at the time I saw the patient the
father had long been dead, and there was no pres-
ent reason why the daughter shoidd be jealous of
her mother. Yet the old infantile jealousy and
hate remained. Thus again we see not only that
the processes of the unconscious are uninfluenced
by reality but also that they are not oriented ac-
cording to time. We get the further suggestion
that the unconscious is infantile and that it has
to do with the holophilio impulses ; and that there-
fore its content is in large measure sexual.

To recapitulate then what has been indicated by
this case (for in fact it gives a good indication of
the qualities of the unconscious in general) we
may say that the unconscious is instinctive, primi-
tive, infantile and unoriented as to time and
reality.

Perhaps it may not be entirely clear just what
is meant by these statements. What, for in-
stance, is meant when we say the unconscious is
instinctive f
I say to a man: *^Have you asexual instincts
" Certainly, '^ he replies. **0f course I have.''
^^But how do you know thatf " I ask.
'^How do I know itf How can I help knowing
itf If I see a pretty ^rl, I want to kiss her. If
I fondle her, I get an erection and desire inter-
course. If I have intercourse, I enjoy it and for
a time feel satisfied. And if I do not have it at
regular intervals, I find myself thinking of sexual

68 MORBID FEAES AND COMPULSIONS

things and craving sexual gratification even
though I might will to do otherwise."

"Yes,*' I say, *^but what of the instinct itself?
These thoughts and feelings and actions of which
you speak are not your sexual instinct. The
most you can say is that they are some of its mani-
festations. What of the thing itself? Of that
you say nothing.

^^ As a matter of fact, have you not accepted the
assumption of a sexual instinct simply as a way
of eicplaining the phenomena you describe, very
much as a savage explains the growing of a tree
or the flowing of a river by assuming that a spirit
dwells within them? Is this instinct, as far as
you can say, anything more than a hypothesis?
Have you ever seen it? Or touched it, heard it
or smelt it ? Have you, in short, any direct knowl-
edge of it, any more than the savage has of the
spirit he believes to reside in the tree? Can
you know of it in any other way than inf erentially,
or in terms of its manifestations?"

**No," he replies, **you are right. My sexual
instinct, as such, never is and never can be an
object of my consciousness."

Yet though we cannot have direct knowledge of
any of our instincts or instinctive tendencies, we
must assume their existence, just as we assume
the existence of ether waves which we know as
light, or the waves of air which we know as sound.
We do not doubt them though our knowledge of
them is purely inferential. At the same time we
recognize that what to-day we call instinct may
sometime in the future be translated by science

CONTENT OP UNCONSCIOUS 69

into terms of reflex arcs and glands, of nervous
impulse and tensions, of chemistry and electric-
ity, just as we replace the spirit with which the
savage explains the flowing of a river by another
(and equally hypothetical) something, the attrac-
tion of gravitation. Of the reality of that which
we call instinct and of the reality of what the
savage called spirit there can be doubt. There is
a something which makes the tree grow or impels
us to sexual actions. Only when we try to draw
conclusions as to the nature of the force in ques*
tion do we go wrong.

When we say the unconscious is instinctive we
mean that we include within it all those primal
urges and impulses which we must assume to be-
long to the nature of man, to be inherent rather
than acquired from education or environment, but
which we know indirectly only, as causes inferred
from some of their effects, never as themselves.

Likewise we say the unconscious is infantile, be-
cause of certain phenomena, particularly appar-
ent in abnormal states, which we must infer to be
effects of the persistence of certain urges or tend-
encies which are normally present and quite
manifest in the actions of the child, but which dis-
appear under the refining influences of education
and of which the consciousness of the adult gives
no direct information.

We say further that the unconscious is, in large
part, psychic material that has been repressed,
for we assume that every person has nearly the
same heritage of instincts, and possesses the same
infantile tendencies* Those which are not repre-

/

70 MORBID FEARS AND COMPULSIONS

sented in his consciousness or apparent from his
behavior we do not assume to be necessarily non-
existent but rather that they are inhibited and
perfectly controlled. To our thinking, then, they
exist as potential rather than as kinetic forces,
and in this assumption we are confirmed by the
observation that in certain individuals, in whom
they are the least apparent, they may unexpect-
edly some day become manifest under the guise of
neurotic compulsions or other psychopathological
symptoms.

Inasmuch as the unconscious is largely made up
of instinctive forces or of infantile tendencies
which behave like instincts, the statement that it
is not oriented with regard to time and reality is
not difficult to accept. An instinct represents a
measure of energy which urges toward a certain
more or less specific type of action, and may there-
fore be called a creator of tensions. These ten-
sions remain until they are released in the acts
which satisfy the instinct or, possibly, dissolved
by some change within the organism. Obviously
these tensions occur without regard for time or
for reality. Thus we may feel hungry irrespec-
tive of whether or not it is the logical time to eat
or whether eating is at the moment convenient or
food accessible. The inhibition and control of
the instinctive urge, the deferment of its gratifica-
tion according to the demands of time and reality,
belong neither to anything in the instinct itself
nor to anything in the unconscious, but rather to
forces of the f oreconscious and conscious systems.
In the unconscious there is no inhibition, no nega-

CONTENT OF UNCONSCIOUS 71

tioiii no conflict. Its energy is all wish-energy,
continuously urging and pressing for outlet like
steam within a boiler. It is all tension. There
are no counter-tensions, a phenomenon which oc-
curs only in the conscious and f oreconscious sys-
tems. ''The unconscious can only wish.''

We have said that the unconscious, as far as its
energic content is concerned, is all wish, urge or
tension, pushing for discharge. All inhibition,
denial, conflict, control, moral or esthetic; all
adaptation to the demands of reason, logic and
reality come not from the unconscious but from
the higher pyschic systems, consciousness and the
foreconsdous, especially the latter. Thus the
f oreconscious stands like a screen, to use Freud's
metaphor, between the unconscious and conscious-
ness. It controls, directs, inhibits or modifies the
energy outflowing from the unconscious, decides
the eligibility or ineligibility for consciousness
possessed by the presentations coming from the
unconscious and admits only those compatible
with its trends and which pass its censorship. All
people are practically alike in the content of the
unconscious. The differences between people,
between personalities, depend upon differences in
the foreconscious. For in the foreconscious re-
side all the controlling forces derived from edu-
cation, culture, morality, judgment and reason.
The unconscious comprises all that belongs to
primitive man and to the child ; the foreconscious,
that belonging to civilization.

I believe that the comparison of the forecon-
sdous to a screen between the consdous and the

72 MORBID FEAES AND COMPULSIONS

nnconscions is somewhat unsuitable because of its
implication that the foreconscious is passive.
Really the foreconscious is active and in other
ways than merely that of admitting or obstruct-
ing presentations that press forward to it from
the unconscious. Another figure perhaps more
appropriate to represent the psychic processes of
the foreconscious would be that which compared it
to the managerial staff of a theater. We may
compare the whole mind to all the persons in a
given city engaged, or desiring to engage, in the-
atrical production, whether they be actors, would-
be actors or those constituting the machinery of
management. The persons actually occupying
the stage at any given instant would correspond
to a moment of consciousness. Like our thoughts,
they appear, occupy our attention for a limited
time, and retire to be succeeded by others, or to
reappear after an interval. When off the stage
and waiting in the wings for their cue they are
like thoughts in the foreconscious, latent mem-
ories, such as that of the multiplication table.
They are not dead and non-existent, but merely
out of sight for the time being, though ready and
waiting to play their respective parts as soon as
the cue is given. These are the thought-processes
passed by the censor and eligible for conscious-
ness but not actually in consciousness.

To the unconscious correspond the great mass
of people with histrionic aspirations who have not
theatrical engagements. It is from this horde
that those actually on the stage originally came
and to it some of them will at length return. They

CONTENT OF UNCONSCIOUS 73

represent the primal urge toward the stage, the
force back of it which makes it possible, in a way
its fans et origo. Those actually occupying a
place before the audience are but end-effects,
epiphenomena from that great lift and urge repre-
sented by the whole mass of the theatrically aspir-
ant populace.

As our conscious thoughts correspond to those
persons actually playing in the glare of the foot-
lights, and the unconscious to the horde of as-
pirants from which these players came, the fore-
conscious in its censoring axstion corresponds to
the managerial machinery of the theater, the un-
seen forces which sift from the mass of aspir-
ants those worthy to play a part upon the stage.
Just as the management stands between those who
aspire and the longed-for place upon the boards,
the foreconscious stands between the urge and
drive of the unconscious and the opportunity for
expression in the lime-light of consciousness.
The actors whom we see and the thoughts of
which we are conscious are thus resultants from
the action of two systems of forces both of which
are unseen, the one being a lifting force which
strives for expression, the other a sifting force
which examines, inhibits and directs, and allows
expression to only a relatively small proportion
of the aspirants that present themselves to it.

We come now to the point which this figure was
selected to emphasize. The action of the fore-
conscious is not limited to merely letting through
or refusing to let through the presentations sub-
mitted to it. Those let through do not as a rule

74 MORBID FEAES AND COMPULSIONS

enter consciousness in exactly their original f ornL
The foreconscious adds something to them, or
forces them to conform to qualities of its content-
Its action is therefore more accurately described
by comparing it to the mai;iagerial system of the
theater than to a screen or sieve. Those aspir-
ants who are accepted by the management to play
parts upon the stage are nx>t ordinarily free to
choose their parts. The would-be Hamlet may
have to appear as a coal heaver ; the aspirant for
show-girl honors may be compelled to play the
part of a hag. So it is with the relationship be-
tween the foreconscious and the unconscious. An
jS unconscious idea, in order to become eligible for
consciousness or to enter consciousness must gain
activation from the foreconscious system in addi-
tion to its activation from the unconscious sys-
tem. It must unite with, and conform to, some-
thing already existing in the foreconscious sys-
tem, or else remain in the unconscious, just as an
actor must accept tiie role provided for him by
the theatrical management or else be resigned to
remaining unheard and unseen.

The foreconscious system not only determines
the admissibility or inadmissibility of ideas to
consciousness, but also controls the outflow of
energy toward a motor discharge, whether to the
voluntary system, as motility (conduct and be-
havior) or to the involuntary as affectivity (feel-
ing, emotion). If those excitations or tensions,
belonging to the unconscious and called wishes,
are out of accord with the trends of the forecon-
scious, they are denied efferent expression. TJie

^

PAILUEB OF BBPEESSION 75

ideas representing them are not admitted to con-
sciousness; their energic quota develop no
affects.^

(e) Failure of Repression, and Descendants

of the Repressed

The control exercised by the foreconscious (re-
pression) is none too stable, even in normal per-
sons. This is particularly noticeable in respect to
discharge into affectivity. Even in the most nor-
mal, the unconscious at times forces its way to
emotional expression in defiance of the controlling
tendencies. The periods of unreasonable irrita-
tion or worry, the seemingly inexplicable preju-
dices and antipathies and the transitory feelings
of discouragement and depression to which all
healthy people are at times subject are instances
of imperfect control by the foreconscious over the
avenues to affective outflow, and thus represent
slight failures of repression.

In the psychoneuroses are represented the more
serious failures in the control exercised by the
foreconscious. Tensions and wishes, arising in
the unconscious, and of a nature really incompat-
ible with the trends of the foreconscious, force
their way to discharge as emotions in spite of its
inhibiting tendency, and become manifest as neu-
rotic symptoms. Only in the major psychoses,
however, do such massive failures of repression

1 strictly flpeaUng there are no unooiiBcious affects^ the affect
being a fleneory report of a bodily state. See Chapter IV, also ef.
Freud: '1)aa Unbewueste/' To epeak of unconsciouB affects (love,
hate, ete.), ia a clinical inaccuracy so cnrrent as to be Intimate.

76 MOEBID FEAES AND COMPULSIONS

occur as to allow the unconscious free access to
motility.

The purpose of repression, as we said, is the
avoidance of pain or of the development of pain-
ful affects. This is accomplished by withdrawing
or withholding from objectionable ideas any fore-
conscious activation and by maintaining against
them a counter-activation. Bepressed ideas are
thus activated only by the energies of the un-
conscious system. The activation-energy of the
unconscious (and generally this means holophilio
energy or libido) can never of itself be an object
of consciousness. The libido-strivings, or as we
say, *^ wishes,'' can gain representation in con-
sciousness only when attached to, and activating
some idea. But this idea must be of a kind that
will be passed by the censor. Otherwise neither
affectivity nor movement is developed from the
unconscious wish or striving, no matter how in-
tense it may be.

Though the idea representing or activated by
an unconscious wish is rejected, the wish may in
certain circumstances gain representation in con-
sciousness or in efferent discharge by transferring
itself to some new idea which is not inacceptable
to the censor nor incompatible with the trends of
the f oreconscious or with the specifications of the
ego-ideal. In this way impulses of the uncon-
scious which are qualitatively at variance with
the ruling forces of the personality do at times
evade the repression by hiding behind an appar-
ently unobjectionable idea. Thus the protective

FAILUBE OP EEPBESSION 77

purpose of repression is defeated, for repressed
tensions develop affects, or, less often, produce
action. The repression is in part a failure for it
keeps unconscious only the ideational and not the
energio content of the unconscious presentation.

This matter of the transfer of the activating
libido from a rejected idea to one that will pass
the censor can perhaps be made clearer by means
of a concrete example from a case where it has
taken place. I choose one with which we already
have some acquaintance, namely the case of the
young woman mentioned in the early part of this
chapter who suffered from a morbid impulse to
take medicine.

This drug-taking compulsion was obviously an
example of an effect produced by unconscious
forces, for the young woman was entirely unable
to explain what its motivation was, by any effort
of voluntary introspection. It is dear that the
wish-energy which reached her consciousness in
the shape of the powerful compulsion to take
medicines must have belonged in the unconscious
to some other idea than that of taking drugs, but
this idea we should suppose was repressed by
the censor. The idea of taking medicine, against
which the f oreconscious interposed no resistance,
thus played the part of a substitute for the first
one and took on the activating libido belonging to
it.^ The energy of the compulsion thus presum-
ably belonged to some wish of the unconscious in-

1 Such a BubBtitute idea is ordinarily found to have some dose
associative connection with the first one.

78 MORBID FEARS AND COMPULSIONS

compatible with the trends of the f oreconscionsi a
wish which escaped repression only by means of
displacement.

We find confirmation for these theoretical ex-
pectations in viewing the ascertained facts of the
case. The young woman in question was a de-
vout Catholic. To be a good Catholic involves
more repression than is required of the adher-
ents of most other faiths. This girl was unmar-
riedy and the church not only puts a strict pro-
hibition on a single woman doing anything of a
specifically sexual nature, but it also teaches that
thinking sensual things and entertaining lifstful
wishes is wrong and must be vigorously combated.
Thus the foreconscious of a Catholic girl (assum-
ing that she seriously accepts these teachings)
would contain strong resistances against any
ideasi or wishes of a sensuously erotic character.
Counter-activations would exist against such
ideas ; they would be denied activation in the fore-
conscious or the consciouSi and their activation
which is derived from the sex impulse and from
the unconscious would be likely to find expression
in feeling or action only if it succeeded in attach-
ing itself to some apparently non-sexual ideas
which would not meet with counter-activations or
resistances.

The young woman of whom I speak was in most
robust physical health, and, as might naturally be
expected, had an equally vigorous sexual impulse.
She had a strong instinctive (one might say or-
ganic) yearning for sexual experience and to bear
children. For these longings no legitimate outlet

1

DESCENDANTS OP BEPRESSED 79

was provided, since she was not married, whUe
her conscience and reason withheld her from any
actions that might gratify them in ill^timate
ways. In addition the religions and family teach*
ings incorporated in her ego-ideal and in the
trends of the f oreconsdons created connter-acti-
vations and resistances against her admitting to
herself the whole reality of these wishes or in-
dulging in any phantasies corresponding to their
fulfillment. Had her repression, in accordance
with the teachings of her religion, been perfect
(as it was not), practically no sensuously erotic
ideaer would have been allowed access to her con-
sciousness and no affects would have been de-
veloped from her sexual longings.

Complete repression of such powerful forces is
by no means easy of achievement and we need not
be surprised that this patient failed to accomplish
it. She was fairly successful, to be sure, in ex-
cluding from her consciousness the ideas corre-
sponding to her sexual wishes, but she did not suc-
ceed in keeping their energy confined to the un-
conscious.

In the course of my analytic work with her she
at length recalled that as a little child she had
been much interested in the question of where
babies come from. She had asked her parents
to answer it and had received the very unsatisfy-
ing statement that they grew on trees in the gar-
den. Thereafter she pondered the question in
private and came to some conclusions of her own
that seemed more acceptable. She had made the
observation that the arrival of a new baby in the

80 MOEBID FEAES AND COMPULSIONS

family invariably coincided with an apparently
severe illness on the part of her mother. She
soon conduded that a causal relation existed be-
tween the two phenomena. Then arose the ques-
tion as to what caused these illnesses of her
mother which gave rise to such remarkable se-
quelae. It must be, she at length decided, that her
mother made herself sick by means of some drug
or medicine obtained from the doctor. Little
girls, then, if they only knew what this medicine
was and could get some of it, could have babies
just as well as the mother and would not have to
play with dolls.

We realize at this point what was the meaning
of the patient's compulsion. It is clear that in
carrying out her impulse to take medicine she was
acting just as she might have acted in her child-
hood if she had been desperately anxious to have
children. At the time of her childish meditation
she never did decide what drug the doctor gave
her mother, and thus, as far as she knew, any drug
might have been the one to produce a baby. By
virtue of her infantile sexual theory the taking
of any kind of medicine could be a symbolic equiv-
alent for the act of fertilization. Though an in-
nocent and harmless idea in itself, it served to rep-
resent in consciousness the libido really belong-
ing to the idea of coitus and reproduction,— wishes,
which, because of her moral resistances, were
denied either free entrance to her consciousness
or discharge as feeling or action of obviously
sexual quality. Now that we know from what
source this compulsion derived its motive power.

DESCENDANTS OP KEPBESSED 81

we need not be astonished that the patient was
unable to resist it.

It may be pointed out that the substitute idea of
taking drugs not only bears a dose associative re-
lation to the repressed ideas, but also that it must
once have formed a part of the same sexual com-
plex which, at the time of the patient's illness,
was subject to repression. In short we may say
that it was a descendant of the repressed. It
should here be mentioned that the f oreconscious
is in large measure made up of what in one sense
must be regarded as descendants of the repressed,
and thus of the unconscious. This is true not only
of ideas and memories which have associative con-
nection with unconscious ones, or were at some
time a part of the repressed, but likewise of trends
or activations some of which, from the point of
view of function, are directly opposite to the re-
pressed. Some of the inhibiting impulses, some
of the specifications of the ego-ideal, really had a
common origin with certain trends of the uncon-
scious which in their nature would be regarded as
the least ideal and most fully deserving of re-
pression. Bepressed and repressing forces in
many instances really developed out of the same
primitive instinctive tendencies. This is a fact
which we have mentioned in Chapter I in discuss-
ing the latency period.

I have brought up the matter of f oreconscious
descendants of the unconscious in order at this
point to correct the impression which was per-
mitted to be made in the early part of Hhis chap-
ter, that all of the content of the f oreconscious is

82 MORBID FEAES AND COMPULSIONS

eligible for consdonsness and thus within the
reach of voluntary introspection. Such, as a mat-
ter of f acty is not the case. Though a large part
of the f oreconscious is passed by the censor and
thus is eligible for consciousness and within the
reach of introspection, some of it, represented by
certain descendants of the unconscious cannot be
brought into consciousness by any ordinary in-
trospective effort. These are the descendants of
the repressed which possess dose associative con-
nection and qualitative similarity with it. In con-
sequence of their quite readUy demonstrable exist-
ence in the f oreconsdous we have to assume a sec-
ond censor which stands at the border between the
f oreconsdous and conscious systems just as the
other censor stands between the f oreconsdous and
the unconscious. This superficial censor operates
against certain descendants of the unconscious
which exist in the f oreconscious but which bear
the dosest association with the unconscious and
with the original repressed. Whether such de-
scendants are rejected by the superficial censor or
whether they are admitted to consciousness not
only depends on their quality and their dose asso-
ciation with the unconscious but often on the in-
tensity of their activation. Ideas or phantasies,
which through their content, might be deemed de-
serving of repression may be admitted to con-
sciousness provided they have a relatively weak
desire content. For instance a married woman
may not object to being attracted by a man not
her husband, or to having a few erotic day dreams
about him as long as she feels that the attraction

*»■«•

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^^totiVA ^88^e teaistanee vi^
€»^^.r ^otda that 1 ii» •»

»e o* r^g gj^oTild alBo expect tar. w= ^^^"^
»?'• evetttedttie'WOidlw»««itt^ "- *2*
^*^e8B arose ivot 80 nndn^M*. w. ^'"

86 MOEBID FEABS AND COMPULSIONS

inj incident from my seventh year which appears
to have heen the cause of my forgetting the word
PonA

At the time I refer to I had a dog to which I
was greatly attached. My brother and I were
playing one day on the edge of a small pond near
our house, and this dog was in the water swim-
ming. We began to throw small stones into the
water in front of the dog, and as each stone struck
the surface he would jump for the splash, try to
bite ity and bark in joyous excitement. Finally,
I was seized with the malicious desire to scare
the dog and, picking up a stone weighing three or.
four pounds, I threw it, intending it to strike
just in front of him and frighten him by its enor-
mous splash. Unfortunately, my aim was bad.
The big stone struck the dog squarely upon the
nose and stunned him, so that he sank beneath the
surface and was drowned.

My grief over this incident was without ques-
tion the greatest that I experienced in my child-
hood. For days I was utterly inconsolable, and
for a long time there were frequent occasions
when I would be so overcome with sorrow and re-
morse as 40 cry myself to sleep at night. I sup-
pose, however, that my grief seemed greater than
it actually was. That is to say, it was exagger-
ated to serve as a compensation and penance for
the painful perception that a cruel impulse on
my part was responsible for the dog's untimely
end.

At any rate, as is plain, the memory of the in-
cident was a very painful one, and, in consequencei

DESCENDANTS OF REPRESSED 87

I had good reason to wish to forget not only the
incident itself but also any word (such as Pond)
which might serve to bring it before my conscious-
ness.

The matter to which I wish particularly to call
attention is the relevancy of my seemingly irrele-
vant associations. For instance, my first associa-
tion— ^that of the pitcheri Dr. Pond — contains
three ideas connected with the repressed memory;
viz«y Doctor (myself ), Pond (the place of the inci-
dent), and pitcher (one who throws). My second
association— concerning Indian Pond and my
throwing into the water the big stone used as
anchor — ^is equally relevant. Indian Pond is in
the same town as the other pond in which the
dog was drowned ; my memory of throwing over-
board the anchor is connected with the memory of
throwing into the water the other big stone which
caused the dog's death.

The association pig which came up several times
in the latter part of the analysis seems at first
glance to have no connection with the concealed
memory. A connection does exist, however. The
letters P-I-G reversed are G-I-P, which spells the
name of the dog. Thus the association concern-
ing the pig-like boy and the mud puddle — ^which
contains the elements P-I-G, baseball (t. e., throw-
ing) y and water— or that of the farmer and the
pigs — P-LG, death, throwing, and water — ^is seen
to be perfectly relevant.*

Thus it may readily be seen that every idea that

iFrink — ^"Some AnalysiB in the Psychopathology of Everyday
1M%" Jounua of Abnormal Ptyohology, Vol. XU, No. 1, 1917.

88 MOEBID FEAES AND COMPULSIONS

came to my mind was in some way associated with
the repressed memory, either directly, as are those
I have mentioned, or through some intermediate
idea, such as the drowning of Ophelia, which con-
nects Hamlet and the quotation therefrom with
the drowning of the dog.

This little analysis gives a miniature view of
what takes place in analyzing a case of psycho-
neurosis. The associations the patient produces
in the therapeutic analysis are relevant to, and
suggestive of, the repressed material on which
the symptoms depend just as in this analysis all
the ^associations bore a certain similarity to the
repressed memory, so that, even if it had not come
up to consciousness, one could have, from these
associations, drawn some conclusions as to its
probable content.

Thus we may close this chapter with the state-
ment that our knowledge of the content of the un-
conscious is derived chiefly from the study of the
descendants of the repressed which exist in the
f oreconscious and whidi, by abandoning any goal-
idea in one's thinking and resisting the action o£
the superficial censoring tendencies, may be re-
produced quite freely in consciousness.^

1 The repressed painful memory which caused me to f org«t the
word Pond, though an entity in itself, is at the same time a part
of a larger entity, the whole sadistic complex. The facility
with which it was repressed (I do not suppose I had thought of
it in many years until I attempted to analyze my forgetting)
was doubtless in part dependent upon its association with other
repressed material belonging to this complex.

CHAPIJEB m

TWO KINDS 07 THINKING, AND THB PSYOHOLOQT 07

THB DBEAM

IT is readily apparent upon a moment's reflec-
tion that there are two distinct types of men-
tal processes going on in our minds, and
obeying two entirely different general laws or
principles. The one type of thinking, which is
represented in its most highly developed form by
reasonings, judgments and various sorts of in-
tellectual work, takes place in accordance with
what Freud calls the Beality Principle. The
other, most familiarly exemplified by day-dream-
ing, is governed by what he has termed the Prin-
ciple of Pain and Pleasure, or, more briefly, the
Pleasure Principle.

Thinking of the first mentioned type, or Beality
Thinking, concerns itself mainly with actualities,
with the answering of questions and the solving
of problems, and serves to bring us into closer
touch with the world as it is, and to assure and
perfect our adaptations to it. Thinking of this
type is for the most part done in words, it is di-
rected in accordance with some goal-idea, and it
tends to produce fatigue.

The second type of thought activity, or Pleas-
ure Thinking takes place in pictures, in images
rather than in words. It is not directed by any
goal-idea, but wanders in apparent aimlessness
from one theme to another, and does not tire us.

80

90 MORBID FEABS AND COMPULSIONS

Its only concern is with that which is pleasant, and
instead of bringing ns into closer touch with real-
ity, tends rather to withdraw us from it, particu-
larly when reality is unpleasant. The gain or
pleasure in this type of thinking comes from what
is thought rather than from the result of thought,
as is mainly the case with reality thinking. Beal-
ity thinking seeks to achieve the fulfillment of our
wishes by things actual, and leads to the making
of such changes in the external world as are re-
quired for that result. But in pleasure thinking
the wishes are fulfilled in an hallucinatory man-
ner, by imagination, and in total disregard of time,
space and reality. Thus no amount of reality
thinking can restore the past or awake the dead,
yet in pleasure thinking I can, for example, be-
come a general under Alexander the Great, fight
in his armies, hold converse with him or for that
matter, be Alexander himself ; and if I want more
worlds to conquer, find them and conquer them,
in total disregard of time or space and every law
of nature. Thus in day dreaming we have pleas-
ure thinking exemplified in its most familiar form.
In a measure, though not accurately, the two
types of thinking correspond to the differentiation
of the unconscious from the higher psychic sys*
tems. While processes of the pleasure thinking
type may occur in the conscious or f oreconscious
systems, reality thinking belongs to them exclu-
sively and all the processes of the unconscious are
of the pleasure thinking type. This is in accord
with the statements made in the preceding chap-
ter to the effect that the processes of the Unoon-

PLEASXJEE THINKING 91

BoioaB are imoriented with regard to time, space
and external reality, and that the Unconsoioos
can only wish.

Obviously those processes governed solely by
the pain and pleasure principle and disregarding
reality are the more prinaitive and the older in
the history of the mind. They correspond to phy-
logenetic and ontogenetic phases antedating the
use of words, but in a sense are even more primi-
tive than is implied by that statement One can
conceive of a period in the history of the psychic
apparatus when they were the only type of mental
process.

Against this assumption the objection of course
arises that an organism which merely hallucinates
its inner needs and disregards reality could not
maintain itself for even a short time and hence
never could have existed save as a fiction. But
the employment of such a fiction is, as Freud ex-
plains, justified by the observation that the suck-
ling infant almost realizes such a state of aflfairs
through the aid of the nursing by the mother.
''He apparently hallucinates the fulfillment of
his innermost needs, displaying meanwhile
through the motor dis<diarge of crying and kick-
ing, the displeasure arising through the increas-
ing tension and failed satisfaction, and thereupon
he experiences the satisfaction hallucinated.^
Only later does he learn to use these discharge
expressions purposely as a means of communi-
cation.'' At first he hhs no appreciation of what

1 '^ Jahrlmeli fOr Pi^yielioaaalytische iind PBychopathologiflche
Yonohtiiigai,'' Bd. lU, HH I, 1912.

92 MOEBH) FEAES AND COMPULSIONS

intervenes between a wish and its fulfillment ; for
anything he may sense to the contrary a wish ful-
fills ijtself « His crying, eta, is at first simply an
epiphenomenon of unsatisfied wish-tensions ; that
it informs another person of his desires and that
the satisfaction shortly experienced comes only
throng the instromentality of another being he
does not at first know.

The attempt to realize all satisfactions by the
hallucinatory method is abandoned with the first
disappointments. The psychic apparatus is com-
pelled to image what is actual, not simply what is
wished for ; it must depict the real, even if reality
be unpleasant, and must strive for real changes,
not simply imaginary ones. From these necessi-
ties reality thinking, so important in its results,
begins.

In his paper FormuUeriing uher die zw^
Primipien des Psychischen Geschehens,^ Freud
gives a schematic outline of the development of
the psychic functions a portion of which is some-
what as follows. The progressively increasing
significance of external reality which begins as
soon as the purely hallucinatory method of wish
fulfillment commences to decline, correspondingly
increases the significance of the sense organs re-
ceiving impressions from the external world and
of that part of consciousness connected with them.
The individual now becomes interested in sense
qualities in addition to the qualities of pain and
pleasure with which he was exclusively concerned

i^'Jahrbuch filr FBychoanalytisclie und Psychopathologische
IV>rgchungen/' Bd. lU, Hit I, 1912.

EEALITT THINKING 93

at first. A special function, that of attention, is
then arranged which examines the external world
in order that data concerning it may be on hand
at any time an urgent need arises. Instead of
merely waiting for the coming of sense impress-
ions, this activity goes out to meet them. At the
same time a system of records is devised in which
the results of this examination are preserved and
which constitutes a part of what we call the
memory.

Instead of repressing everything painful, in-
stead of denying activation to all those presenta-
tions tending to create displeasure, of ignoring
everything unwished for, the psychic apparatus
begins to exercise the function of judgment which
seeks to decide whether the incoming presenta-
tions are true or false, that is to say in harmony
with reality, accepting that which so harmonizes
even if it be unpleasant, and determining what
shall be accepted as true by comparing the pre-
sentations in question with the memory records
of reality.

The motor discharges which during the reign
of the pleasure principle simply served the func-
tion of relieving the apparatus from the tensions
produced by incoming stimuli, by draining off
these tensions as affective phenomena, motor rest-
lessness, etc., now become employed in a new func-
tion, that of producing desirable changes in the
external world. They now become purposeful
actions, the forerunners of work.

The stimulus no longer results inunediately in a
complete motor discharge. Between the receipt

94 MORBID FEABS AND COMPULSIONS

of the stinmlus and the motor disoharge as ac-
tion now intervenes the process of thinking whidi
was originally represented hy, and is formed from,
the aot of imaging. Originally thinking as a
process distinct from mere imaging, and applied
to the relations between impressions of objects,
was probably nnoonscions. Only throngh con-
nections with verbal residues does it gain such
qualities as render it perceptible to consciousness.
The psychic apparatus learns to tolerate the
greater degrees of tension necessitated through
the deferment of motor discharge, and thinking,
that is to say reality thinking, really represents a
sort of experimental paying out of these accumu-
lated tensions in small quantities.

While those processes dominated exclusively by
the pleasure principle represent nothing but wish,
and strive for nothing but the securing of imme-
diate pleasure or the avoidance of immediate pain,
the goal of reality thinking is essentially that of
utility. Thus the replacement of the pleasure
principle by reality thinking in the consciousness
of the individual is never complete, as we know.
From the beginning of the influence of the reality
principle in the mental life there remains split off
a certain amount of thought activity dominated by
the old laws and absolved from being tested or
evaluated in accordance with the impressions of
reality. It is represented in the play and '^make
believes" of children and by the phantasies and
day dreams of the adult, where real objects are
dispensed with throughout. The processes of the
unconscious remain always under the domination

PLEASURE THINKING 95

of the old principle of pleasure. It is the only

law they know, and of this fact, we shall, in the

following pages meet with numerous examples.^

The general tendency to satisfy with pictures

1 *Th» relMM fram the principle of pleaaure by meant of the
reality principle^ with the psychical reenlta whidi proceed from
it (the release) which here in a aehematic exposition is restricted
to a single propoaition, really is completed neither at once nor
simultaneously on the whole line. But while this dsTelopment
takes place in the ego-impulses, the sexual impulses are released
from it in a Tery significant manner. The sexual impulses at first
behave autoerotically; they find their satisfaction in the individu*
al's own body, and do not reach the situation of denial which com-
pelled the installation of the reality principle. When later the
individual begins the process of finding an object, he waits a long
time because of the period of latency, which prolongs the sexual
development up to the time of puberty. These two element*—
autoerotism and the period of latency— have the result that the
sexual impulse is retarded in its psychic development and remains
a great deal longer under the dominance of the pleasure prind*
pie, from which many persons can never free themselves.

''Because of these relations there is a closer connection between
sexual impulse and phantasying on the one hand and the ego-
impulses and the activities of consciousness on the other. We
find this connection, in normal persona as well as in neurotics,
a very intimate one^ although, by means of these considerations
from genetic psychology, it is recognized as a MOOfidafy one.
The continually operating autoerotism makes it possible that the
easier momentary and phantastic satisfaction on the sexual object
is retained so long in the place of the real one which however
requires trouble and delay. In the realm of phantasy repression
remains all-powerful. It makes possible the inhibition of ideas
(Vorstellungen) in Miaiu na§e€mdi before they can enter con-
sciousness, if their activation can occasion a release of pain. This
is the weak spot of our psychic organisation, which may be em-
ployed to bring under the dominance of the pleasure principle
again those thought processes which have already become rational.
An essential bit of the psychic disposition toward neurosis is
accordingly produeed by the delayed education of the sexual im-
pulse to regard reality through the conditions which render pos-
siUe this delay.**— F^eud, Lo.

96 MOBBID FEARS AND COMPULSIONS

of the imagination (images jof any dense quality)
the desires that reality leaves nngratified, as most
familiarly exemplified in our day dreams is not
limited in its operation to our waking hours. The
tensions represented by various ungratified wishes
of the day persist in some measure after we go to
sleep and, if of sufficient intensity, serve to dis-
turb our rest. Then pleasure thinking comes to
our aid and, as in the suckling period, an attempt
is made to still and satisfy these longings by the
hallucinatory route — ^by pictures of the imagina-
tion— and upon awakmg we say that we have
dreamed.

In short, the night dream and the day dream are
really analogous. We may define either one as
the imaginary ftUfillment of a wish. Neverthe-
less, the truth of this statement is by no means
self-evident. That the day dream is a phantasied
wish-fulfillment is perfectly obvious. But that
the night dream invariably fulfills a wish seems
on first thought impossible. Over fifty per cent,
of dreams seem to the dreamer distinctly dis-
agreeable, while many others, though not actively
unpleasant, nevertheless apparently fail to rep-
resent anything for which a sane person might
be supposed to wish.

Yet the apparent unlikeness between the night
dream and the day dream is not due to any lapse
of the principle of wish fulfillment but rather to
a difference in the way the desired things are rep-
resented. The representation in the day dream
is direct; the thing or occurrence desired is pic-
tured as actual and present without any ambigu-

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NIGHT DBEAMS 97

ity or vagaeness. But in the night dream the rep-
resentation is indirect. What is desired, instead
of being pictured in its true f orm, is represented
by implications, innuendoes, symbols, allegorical
figures, etc. Thus while the day dream may be
taken more or less at its face value, the meaning
of the night dream is not to be found on its sur*
face. The night dream, like a rebus or an alle-
gory, has to be interpreted if we wish to know its
meaning. Only in this way can we learn what
wish it fulfills. That our night dreams seem to
be senseless and absurd is not due to their actually
lacking meaning but for the most part to the fact
that indirect rather than direct representation has
been employed.

In order to make perfectly clear the diJQFerence
between direct and indirect representation, and
how readily an appearance of absurdity is created
by the use of the latter, I will introduce an ex-
ample of indirect representation in the shape of
the picture. Figure 1.

This is a copy of a cartoon which appeared in
the New York Tribune, March 6th, 1916, just
after Mr. Bryan had made a trip to Washington,
ostensibly in the interests of pacifism. It ex-
presses tbe artist's opinion that this trip did not
spring from entirely altruistic motives — ^that, in
figurative language, the Great Commoner, in ap-
pearing in the role of the dove of peace, really
had an ax to grind.

A direct expression of the ideas represented by
the cartoon would be the simple statement that
Mr. Bryan's visit to Washington was primarily

98 MORBID FEARS AND COMPULSIONS

intended not so much to farther the interests of
pacifism as those of Mr. Bryan himself. But the
cartoon, which expresses the same thought in an
indirect manner, if taken merely at its face value
would seem to refer to something entirely differ-
ent If, for instance we were in the position of an
Icelander, and unfamiliar with American politics
and the figures of English speech, the cartoon
would seem just as senseless, bizarre and fantastic
as do most of our dreams, and precisely for the
same reason, for it would then be a case of indi-
rect representation which we had not interpreted.
To us the cartoon has a meaning only because of
our ability to interpret it. To be able to make
the interpretation we need to possess certain in-
formation which is not given by the cartoon itself.
Thus we have to know the setting— what was go-
ing on in the political world at the time the cartoon
was drawn. We must be able to recognize the
features of Mr. Bryan, and must be familiar with
the symbolic figure, the dove of peace, and the col-
loquialism ''to have an ax to grind." If we do
not have this information we can take the cartoon
only at its face value and then it seems utterly
senseless. What is true of indirect representa-
tion as exemplified in this cartoon also applies
everywhere else. In order to see any sense or
meaning in it, one has to have certain informa-
tion not given in the representation itself, and to
use this as a means of interpretation. When we
have the required information and use it, the ap-
pearance of senselessness vanishes at once.
I will now relate a real dream and I think it

NIGHT DREAMS 99

will be apparent that the means by which ideas are
represented in it are almost identical with those
of the cartoon. To see what it means, the same
sort of extra information and interpretation is
required as in the case of the cartoon, and, when
the interpretation is made, what seemed nonsense
suddenly appears as sense.

An acquaintance of mine once dreamed that he
was kicking a skunk but that animal, instead of
emitting its usual odor, gave off a strong smell
of Palmer's perfume.

This dream of course seems absolutely absurd
and meaningless. But we must remember that
as yet we know nothing of the dreamer, nor of the
setting in which the dream occurred. In short
we are in about the same position as would be an
Icelander in attempting to interpret the cartoon.
When, however, the setting is known the dream
is not at all difficult to interpret.

In discussing his dream with me the dreamer,
whom we may call Taylor, was reminded by the
idea of Palmer's perfume that he had been em-
ployed as derk in a drug store at the time the
dream occurred. This brought to his mind the
following episode which, as will readily be seen,
was what gave rise to the dream.

There had come to the drug store one day a
man who demanded ten cents' worth of oil of
wormseed (Chenopodium), and, as this drug is
not classed as a poison, Taylor sold it to him with-
out asking him any questions. The man then
went home and administered a teaspoonful of the
oil to his six months baby. The child vomited the

100 MOEBID PEAES AND COMPULSIONS

first do86y a second was given and thereupon tlie
child died. Then, instead of taking the responsi-
bility npon his own shoulders, the father sought
to blame Taylor for the child's death. The town
in which the occorrence took place was a small
one and in a day or so most of the inhabitants had
heard his very untrue account of the affair. Then
Taylor, who was naturally very unwilling to be
thus exposed to public censure, sought to defend
himself by setting forth his version of the matter
to every customer that entered the drug store. In
a few days the proprietor, annoyed by this con-
stant reiteration, said to him: ^^Look here, Tay-
lor, I want you to stop talking about this affair.
It does no good. The more you kick a skunk, the
worse it stinks."

That night Taylor had the dream I have related.
It is not difficult to see why it occurred and what
it meant. By the proprietor's command Taylor
had been robbed of the only means at his disposal
for squaring himself with the public, and in con-
sequence he went to bed that night very much
worried and disturbed. Though he dropped off to
sleep, these tensions persisted sufficiently to dis-
turb his rest. He therefore dreams that he is
still kicking the skunk but without any unpleasant
results, for it has a sweet smell instead of an
evil one. In other words the meaning of the
dream is that he continued to defend himself and
that good rather than ill came of it. The way
these thoughts are expressed in the dream is ob-
viously almost identical with that employed by
the artist in the cartoon. For instance the dream

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NIGHT DREAMS t.i'--- 101

uses the proverb of the proprietor in just the
same manner that the artist employed the phrase
**to have an ax to grind/' One might easily
imagine a cartoonist for the local paper in Tay-
lor's town (if all the circumstances were known
to the public) drawing a cartoon with the title
**What Taylor would like to do'' which would
be identical with the dream.

We may now consider another instance of in-
direct representation as exemplified by the news-
paper cartoon. (Fig, 2.) We behold a picture
of a man who, judging from the armor he wears,
would seem to belong to the time of Julius Caesar.
Nevertheless, he stands near a very modem lamp
post on a curb of what one would suppose to be
Sprang Street. He holds in one hand a watch
of remarkable size and in the other a bouquet ap-
parently composed of flowers and bayonets. In
short the picture gives about the same impression
of fantastic absurdity as do most of our dreams,
and like a dream it requires interpretation.

This cartoon is not, however, as easy to inter-
pret as was the first one. In fact, as it stands, it
absolutely defies interpretation. We assume that
indirect representation, some sort of symbolism,
was used in forming it, but in order to interpret it
we must know the meaning of these symbols and
something of the setting or of what the artist had
in mind when he drew the picture. As we look at
the picture now, we are just as ignorant of the
meaning of its symbols as we are of the dream
symbols of another person.

•Ma-MOBBlIi FE^ AND COMPULSIONS

This picture appeared in the New York Times
in the spring of 1915, with the title ^^This is the
Place, but Where's the Oirlt" In the original
the symbols employed by the artist were labeled.
On the sheet of paper which lies on the sidewalk in
front of the man was inscribed the phrase '^ Italy
to go to war in the Spring" and the tag attached
to the bouquet he carried bore the words '^For
Miss Italy.'' At the time the picture was pub-
lished, Italy, in spite of numerous predictions, had
not yet joined in the European war.

By the aid of these hints the picture is very
readily interpreted. The meaning is something
like this : ''Italy is behaving like a fickle girL No
reliance can be placed upon her. " The artist has
used as symbols a man, a bouquet and a lamp post
to express a thought about something entirely
different, namely the attitude of that country to-
ward the great conflict.

In this cartoon, as in the first one, the same
method of indirect representation is employed
that is used in dreams, with one difference how-
ever. The artist has labeled his symbols. The
symbols in the dream are not labeled as they were
in the original of this picture. The dream is like
the picture as I have displayed it — ^that is, with-
out the hints to interpretation that appeared in
the original. Hence if we wish to interpret a
dream we must get the dreamer to label his sym-
bols in the waking state and after the dream is
finished. This is accomplished by the ''method
of free association" with which we already have
some slight acquaintance from the analysis of my

NIGHT DREAMS 103

forgetting of the word Pond. The dreamer is
asked to fix his mind upon each part of the dream
in turn and to relate, without exerting any critique,
all his incoming thoughts. For, as wUl be ex-
plained shortly, the dream is really a product of
the unconscious and of the repressed, and we
learn what it means by getting the dreamer to re-
produce by free association various descendants
of the unconscious. These descendants, or asso-
ciations, play in dream analysis about the same
role as the words the aiAist painted in his cartoon ;
they represent labels for the dream symbols. By
means of them we may learn of the hidden mean-
ing of the dreauL^

The following simple examples in the form of
parts of two dreams show anew the way thoughts
are expressed through indirect representation,
and also the relation of the free associations to
the thoughts represented, or in other words how
dream symbols may be labeled.

A woman received a visit from one of her old
lovers who now lives in Massachusetts. A few
nights later she had a dream in which she found
herself standing in an open window. The grass
all about her was of a very fresh brilliant green.
Close by was a tiny stream of water which seemed
to have its source at the base of a rocky ledge a
short distance away.

1 It may be remarked at this point that not much can be ac-
complished unless there exists a certain trust or rapport on the
part of the dreamer toward the person analyzing his dream.
Without this, so much censorship is exercised over the incoming
thoughts that the reproduced associations are superficial and it
is difficult to deduce much from them.

106 MORBID FEARS AND COMPULSIONS

responds to the actual title of the book in the news-
paper contest. This part is known as the latent
dream content. It is not the manifest but the
latent content of the dream which in each dream
corresponds to the thing or occurrence wished for.
The manifest content simply represents what is
wished for, in the same way that the pictures in
the newspaper represented the title of some book
but were not the actual title.

This distinction between the manifest and the
latent content of the dream has been repeatedly
emphasized by all psychoanalytic writers, but
their readers with almost unbelievable regularity
have failed to comprehend and appreciate it.
Again and again one hears the objection that the
dream cannot represent a wish fulfillment because
all people have unpleasant dreams. Such an ob-
jection is possibly only through misunderstanding.
The manifest content is not what is wished for
any more than the United States Ambassador to
England is the United States. The manifest con-
tent, like an ambassador, merely represents some-
thing, and what fulfills the wish is not the repre-
sentative but the thing represented. The fact,
then, that the manifest content or representative
may appear unpleasant does not imply that the
thoughts represented must be unpleasant.

In the clinical chapters of this book we shall be-
come acquainted with dreams which, from the
point of view of the manifest content, were very
unpleasant but which were revealed upon analysis
to represent wish fulfillments, nevertheless (e. g.
the case of Miss Sunderland, pages 451, 452).

DISTORTION 107

Through what has been brought out by the
examples of dreams already given, we are now pre-
pared for the statement that while the night dream
and the day dream are both phenomena of pleas-
ure thinking and both represent an effort to attain
satisfaction by the old hallucinatory route, the
night dream ordinarily differs from the day dream
in that its wish fulfillment is disguised. The ex-
planation of this fact takes us to a point with
which we are already familiar, namely, the inhib-
iting power and censoring influence exerted by the
foreconscious over wishes and ideas coming from
the Unconscious. The chief reason why the hallu-
cinated wish fulfillment in the night dream occurs
as an indirect and distorted presentation is that
disguise is required to evade the censorship. For
the wishes fulfilled in night dreams are either
those directly repressed or else those closely as-
sociated with the repressed ; are, in other words,
those of such a nature that a phantasy depicting
frankly and directly what is wished for would be
rejected by the censor. The disguise really has
the purpose of protecting the dreamer from real-
izing what it is he is dreaming about. As a matter
of fact it is only because of the relaxation of cen-
sorship that occurs with sleep that many of the
dream wishes are able to find any representation
at all in consciousness. During the day repres-
sion is so strong that their exclusion would be
practically perfect ; in sleep the inhibition by the
foreconscious is relaxed, and the wish tensions of
the Unconscious are then able to secure hallucina-
tory fulfillment provided always that it is so dis-

108 MORBID FEARS AND COMPULSIONS

gnised and distorted as to appear unobjectionable.

The dream then represents a compromise be-
tween two opposed psychic streams or f orces, the
repressing force from the foreconscious which
would repudiate the wish, and the repressed trend
of the Unconscious which seeks wish f ulfiUment
In the dream both are satisfied in a measure. On
the one hand the repressing stream can tolerate
the repressed ideas corresponding to the wish
fulfillment because their meaning is so veiled as to
be unrecognized and the wish is not perceived by
consciousness as a wish. On the other hand the
wish in the repressed stream finds representation
in consciousness but is forced to secure its hallu-
cinatory gratification in a modified form. Fur-
ther conflict is thus avoided and the dreamer con-
tinues to sleep.

The amount of distortion and censoring which
the latent dream content is made to undergo varies
directly with the amount of repression. In young
children there is little or no repression, and so there
is little difference between the manifest and latent
content of their dreams. The dream of a child can
be recognized, often without analysis, as a direct
fulfillment of an unfulfilled wish of the preceding
day. In some dreams of adults that result from
desires arising during sleep, such as the desire for
micturition, there is little or no repression and
hence little or no distortion. Whatever distortion
appears in such dreams comes from their wishes
being associated with others that are repressed.

I will now relate a dream witl\ its analysis and

AN INTERPRETATION 109

after this take up some of the speoial processes in
dream formation.

A young woman, a patient at Cornell Dispen-
sary, told me a dream as follows : ^^I dreamed last
night that I walked up Fifth Avenue with a girl
friend. We stopped at a millinery store and
looked at some hats in the window. I think that
I finally went in and bought one/' The analysis
is as follows: When the patient was asked what
was suggested to her by a walk with the girl of her
dream, she immediately thought of an occurrence
of the preceding day. On this day she had reaUy
walked up the same avenue with the same girl,
and looked at hats in the same store window that
she saw in the dream. In real life she bought no
hat, however. Asked what more came to her
mind, the following occurred to her : On the day of
the dream her husband was in bed with some
slight illness and, though she knew it was nothing
serious, she had been terribly worried and could
not rid herself of the fear that he might die. On
this account, when the friend of the dream hap-
pened in, the husband suggested that a walk with
this girl might help her. After telling me this it
also occurred to the patient that, during the walk,
some mention had been made of a man she knew
before her marriage. When urged to continue,
she hesitated but finally said that she believed that
at one time she had been in love with him. Asked
why, then, she did not marry him, the patient
laughed and replied that she had never had a
chance, and then explained that the man was so

110 MORBID FEABS AND COMPULSIONS

well off and so far above her socially that she had
always considered him out of her reach. After
this, in spite of my urging, she could not be in-
duced to pursue the subject f urther, and persisted
in saying that it had been merely a silly, girlish
affair which amounted to absolutely nothing.

I then asked her to think of buying a hat and
relate everything this suggested to her. She then
told me that she had very much liked the hats she
had seen in the store window and she wished that
she could buy one of them, though she knew this
was out of the question as her husband was a poor
man. Evidently this wish is fulfilled in the dream,
however, for in it she does buy a hat. But this is
not alL She suddenly remembered that the hat
she bought in the dream was a black hat, a mourn-
ing hat, in fact I

This little detail, hitherto concealed, when con-
sidered with the associations previously brought
out, immediately gives the key to the interpreta-
tion of the dream. On the day of the dream the
patient had been fearful that her husband might
die. She dreams that she buys mourning, thereby
implying the phantasy that his death has occurred.
In real life she had been prevented from buying a
hat by the fact that her husband was poor. In
the dream she is able to buy one and this certainly
suggests a husband who is not poor. 13o answer
the question of who this rich husband might be, we
need only turn to the associations of the first part
of the dream, i. e., the man of whom she refused to
talk and with whom she might have been in love.
He, as she said, is well off and as his wife she could

LATENT CONTENT HI

bay hats as she wanted them. One may therefore
conclude that this patient was dissatisfied with
her husband, that she unconsciously wished to be
free from him even at the cost of his life, and that
she longed to marry another man who would be
better able to supply her wants.

When the patient was informed of this interpre-
tation of her dream, she not only admitted the
truth of my conclusions but, as her resistance was
then broken, gave a number of other facts in cor-
roboration. The most important of these was
that, after her marriage, she learned that the man
whom she had considered above her was by no
means as indifferent to her as she had supposed.
This, as she acknowledged, tended to rouse her old
love for him and make her regret her hasty mar-
riage, for she felt that if she had waited only a lit-
tle longer, she might have fared better.

Let us now consider some of the processes at
work in the formation of dreams. In the example
given, the manifest content is the dream story as
related by the patient. This as we have seen,
gives expression in consciousness to certain un-
conscious ideas, the latent dream content, which
may be stated about as follows: '^I am tired of
poverty. I do not care for my husband. He dies
and frees me. I marry the man I prefer and so
am no longer poor." In this dream, as is gen-
erally the case, the material forming the manifest
content (the representatives for the unconscious
dream thoughts) is taken from the thoughts of the
day before. However, in some dreams, older ma-
terial, often from early childhood, is employed.

112 MORBID FEARS AND COMPULSIONS

As in this dream, the dream material usually ap-
pears to concern matters which seem very trivial.

The conversion of the latent dream thoughts
into the manifest content is called the dream work
(Traumarbeit) and is accomplished by the coop-
eration of four different processes or ^'mechan-
isms. ' ' The first of these is called Condensation
(Verdichtung). This mechanism accomplishes
just what its name implies. It forms a conscious
surrogate by abbreviating, symbolizing, fusing
and condensing the unconscious ideas of the latent
dream content. The manifest content of the
dream is therefore laconic. It is always much
less in extent than the latent content. Hence, it
follows that quite generally one element in the
manifest dream represents several in the latent.
Such an element is then said to be ^'overdeter-
mined." This overdetermination is well shown
in the example given. The purchase of a mourn-
ing hat expresses both escape from poverty, the
death of a husband and a new and better marriage.
Condensation may also produce a fusion of the
memories of different scenes or objects into new
scenes or objects, different persons into one com-
posite person or different words and sentences
into seemingly senseless phrases or neologisms.
Thus one of my patients dreamed that he received
a letter signed * * Helva. ' ' This word, upon analy-
sis, resolved itself into the two words ** Helen*'
and "Elva," names which belonged to two young
women with whom he was anxious to correspond.

An example of condensation exactly like that
which occurs in dreams is afforded by the first car*

DISPLACEMENT 113

toon given above. Essentially it is a composite
formed by the fusion of the three images into a
single one, namely that of Mr. Bryan, the dove of
peace and a man with an ax* Similar examples
of condensation in dreams will be found in the
dinical chapters, for instance the dog in the dream
of Miss Sunderland (Chapter IX). Many of the
most fantastic dream figures, such as strange
looking animals, persons half human and half
beast, are condensation products whose absurdity
disappears as soon as they are resolved into their
constituent elements.^

The second dream mechanism operating to form
the manifest content from the latent is called
Displacement (Verschiebung). Through dis-
placement important ideas in the latent content
are made to seem unimportant in the manifest,

•

1 CondeiiBaiioiiy a phenomenon 6f comparatively infrequent oc-
currence in the thought proceBsee of the foreconsciouB and con-
scious ejrstemB, is not a peculiarity of dream thinking per se but
of unconscious processes generaUy. The same may be said of
displacement, the mechanism we are next to take up. The exist*
ence of these peculiarities of the unconscious processes bears wit-
ness to the hig^ importance of the primitive activation energies
being readily mobile and facile of discharge. The fact that we
find these processes frequently occurring in the foreconscious and
conscious systems only in pathological cases does not indicate
that they are abnormal in themselves. The fact is th^ are pri-
mary in the psychic apparatus; they occur wherever thoughts
abandoned by foreconscious activation are left to themselves and
can fill themselves with uninhibited energy striving for discharge
from the Unconscious. They are, in short, natural modes of
activity of the psychic apparatus when freed from foreconscious
inhibition: Compare Chapter VII of Freud's "Interpretation of
Dreams," and his later paper, "Das Unbewusste." When such
activities do reach consciousness they give rise to a feeling of
comicality.

114 MORBID FEARS AND COMPULSIONS

while some minor thought in the latent content
may be represented as the central feature in the
manifest part of the dream. This mechanism is
well shown in the dream just given. In it, the
walk up the avenue is the most prominent portion
of the manifest content, though in reality it is the
least significant part of the dream. At the same
time, the most important part of the dream, the
purchase of the hat, was given a minor place and
mentioned by the patient almost as an after-
thought. Thus the manifest content of the dream
may said to be eccentric. Its central idea is not
directly in line with the central idea of the latent
dream thoughts.

The following cartoon is also an example of
displacement. The central thought in its latent
content is one of impatience over the delay in set-
tling the Lusitania matter. This is expressed by
a mere detail of the manifest content of the car-
toon, namely the long beards and the aged appear-
ance of the men represented. There is nothing in
the cartoon itself save the word ^^Lusitania" to
indicate that it has to do with the sinking of a
great ship and an international controversy.

Equally important is the displacement of af-
fects. In the second chapter we learned that an
unconscious wish whose idea content would be re-
fused passage by the censor might gain represen-
tation in consciousness and access to affective
discharge by transferring its activation energy
to an associated and more acceptable idea. Many
such displacements occur in the formation of
dreams. Thus one finds in a dream some emo-

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Answer

DISPLACEMENT 115

tion Buch as anger, love or fear referring to an
image of some logically indifferent object, or vice
versa. This mechanism is responsible for the
fact that so many dreams are made up of trivial
and hardly noticed impressions of the day pre-
ceding. Such impressions are used in the dream
to represent more significant ideas whose affects
have been transferred to them. One should not
judge that a dream deals only with trivialities if
its manifest content seems trivial. The following
dream is an example of this fact.

A young woman suffering from a compulsion
neurosis, dreamed that there was at her house
some person (whose identity in the dream was
very vague) toward whom she felt herself in-
debted for many attentions. Wishing to recipro-
cate in some way, she offered her hair comb for
this person's use. This is all there was of her
dream. Judging from its manifest content one
would hardly expect that it dealt with anything of
great importance.

As an introduction to the understanding of this
dream I should state that the patient is a Jewess
and that about a year before this dream occurred
a young man, a Protestant, fell violently in love
with her and besought her to marry him. She
liked him very much, and, as she explained to me,
had it not been for the difference in race, she could
easily have reciprocated his feeling. But not only
did ^e regard the question of race and religion as
important in itself but even more so as applied to
the matter of children. Marriages between Jews
and Gentiles turned out well enough, according to

116 MOEBID FEARS AND COMPULSIONS

her observation, so long as there were no childreni
^4 but as soon as children came and the question
arose as to whether they should be brought up as
Jews or Christians, the situation at once became
complicated, and, it seemed to her, trouble and un-
happiness invariably resulted. In view of this
she had schooled herself, she stated, not to care
for her Christian admirer.

The dream which I have related occurred one
night after she had had a violent quarrel with her
mother, as a result of which (when she retired for
the night) she reproached herself for the trouble
she was continually causing, and decided that it
would be better for both herself and her family if
she did not live at home. She fell asleep thinMng
of ways and means to get away from home and to
support herself without calling upon her family
for assistance. Once asleep, she had the dream
just related. In the light of these facts as to the
setting the interpretation of the dream is very
easy.

Without going into details, I may say that the
person in the dream to whom she felt indebted for
many attentions represented her Gentile lover, for
whom, as I have said, she had schooled herself
not to care because of the question of children.
The offer of her comb in the dream refers to this
question, for in telling what she associated with
the comb she mentioned that when one person is
about to use another's comb or brush the remark is
sometimes made : ^^ Don't do that ; you will mix the
breed." In the dream the offer of the comb for
another's use represents an intention to mix the

DISPLACEMENT 117

breed in the sense of marrying a Gentile and hav-
ing children by hinu The dream thns expresses
as fulfilled her wish to accept her Christian lover
and corresponds to a reflection that, in view of the
trouble she has at home, a marriage with him in
spite of the disadvantages of mixing the breed
might be better than remainlAg with her family.
Thus the affective content of a matter of great im-
portance, namely her very real and strong re-
pressed interest in the Protestant lover and her
wish to give herself to him, finds expression in the
dream by displacing itself to ideas apparently
most triviaL

The third dream-forming mechanism is known
as Dramatization (Biicksicht auf Darstellbarkeiti
regard for presentability ) . It concerns the means
by which the thoughts of the latent content of the
dream are represented in consciousness. In the
manifest content of a dream there is no intellec-
tual activity. All the thinking is done in the Un-
conscious. ^ The manifest content consists merely
of various ideas that have been sifted from the
unconscious dream thoughts by the action of the
censor. These ideas are then rendered objective
in the form of pictures (images) mostly visual,
though tactile, auditory or other sensory impres-
sions do occur, and they are comprehended by the

iHie fact that in some dreams inteUectaal operaticiis do ap-
pear (both the forming of Judgments and the drawing of conclu-
sions) is an apparent but not a real contradiction to this state-
ment. These processes originate not in the manifest content but
in the underlying dream thoughts. They may be reproductions
of actual intellectual operations that had taken place previoualyt
Le. memories.

118 MORBID FEAES AND COMPULSIONS

dreamer as something outside of himself. This
mechanism thus presents to the dreamer the rep-
resentatives of the latent dream thoughts by
dramatizing them, so that they are expressed as
in a pantomime or by moving pictures. This is
shown by some of the examples I have given.
This kind of representation, however, has its lim-
itations. For instance, as in a play, events which
really extend over a long period of time have to be
represented in a few moments. Logical relations
often can not be represented at alL Thus ideas
such as **if,^' **when,'' ^'either,'' ^'because,'' etc.,
cannot be pictured and usually no attempt is made
to represent them. Occasionally such relations
between the various latent dream thoughts are ex-
pressed by spedal devices. Thus thoughts cor-
responding to a subordinate clause are repre-
sented in an introductory dream while the ideas
correspondiQg to the principal clause follow as
the main dream.

Identity or similarity between two ideas or
things or persons is expressed by combining their
representing images (Condensation). Many of
the dreams in the clinical chapters show this mech-
anism. It is the same as that employed in the fol-
lowing cartoon from the New York Tribune, No-
vember 26, 1915 (an excellent example of conden-
sation) which expresses through a fusion of im-
ages the idea that this country is like the statue of
Venus, or in other words, is lacking in arms.

In connection with dramatization I desire to
mention two special points. The first is that the
dreamer is always represented in the dream and is

Coorli-jv #/ Ike Utin York Tribuii

Preparedness

DRAMATIZATION 119

nfitially the chief actor therein. The following is
an example. A young lady dreamed that, a man
was trying to ride a very frisky small brown
horse. He made three attempts but each time was
thrown off. At the fourth attempt he was suc-
cessful, however, and b^an to ride the horse up
and down. Apparently the dreamer is not repre-
sented in this dream. Yet we know that she must
be there, masquerading as the man or as the horse.
This is shown in the analysis as follows. When
the patient was asked what horse suggested to
her, she suddenly recalled that, when she was a
little girl, her father told her that her surname,
Gheval, was the French word for horse. The pa-
tient is smaU, dark and lively. In similar words
she had described the horse of her dream. We
suspect therefore that this horse represents her-
self. The man of the dream she recognized to be
one of her most intimate friends. When she was
asked to relate what came to her mind about this
man she finally confessed that she had been carry-
ing on a very ardent flirtation with him. He at-
tracted her very strongly and on three occasions
she had betrayed so much sexual excitement that
the man tried to have intercourse with her. Each
time her moral feelings came to her rescue, how-
ever, and at the last moment she repulsed him.
All this is symbolized in the dream by the three
efforts of the man to mount the horse. But in
sleep the inhibitions that saved her while awake
were less active. Her repression was relaxed and
she dreamed that she received the sexual gratifica-
tion for which she really longed. This is shown

120 MOEBID FEAES AND COMPULSIONS

by the man's finally mounting the horse and rid-
ing it up and down.

This brings me to the second point which I
wish to mention. Any one familiar with dream
analysis would know in a general way, the mean-
ing of the. dream just related without having to
ask the patient any questions or collect any asso-
ciations. That is, in some dreams, of which the
foregoing is an example, the latent content is ex-
pressed by means of symbols which nearly always
mean the same and, if we are familiar with this
symbolism, we can often read these dreams with-
out depending on the lengthy process of free asso-
ciation. This symbolism is not only to be found
in the dreams of all people, no matter what their
language or environment, but also it may be de-
tected in folk lore, myths, proverbs, and ancient
ceremonies of all nations. This is explained by
the assumption that, deep down in the minds of
even the most cultured people, there still goes on
the same kind of primitive thinking that, in our
prehistoric ancestors, gave rise to the legends and
customs that have been handed down to us.

The symbolism in the preceding dream, an ani-
xnal for a person, riding for coitus, is very com-
mon, and is no doubt familiar to many readers.
Others of the many common dream symbolisms
that might be mentioned are the dream of losing
a tooth, which, in women, sometimes means a fan-
cied fulfillment of a wish to have a baby, and in
men usually signifies masturbation; dreams of
sword, spear or snake, all of which usually sym-

SECONDARY ELABOEATION 121

bolize the male genitals, or of fighting, dancing or
climbing stairs which signify coitus.

The fourth dream mechanism is known as 8e(h
ondary Elaboration. It comes into play after the
dreamer wakes. For the waking mind tends to
alter the recollection of the dream by smoothing
out its inconsistencies and forming it into a story
with some semblance of logical sequence. The
portions of the dream most likely to be affected
in this way are those points at which the disguise
of the latent thoughts is weakest, and the changes
in general serve to strengthen this disguise. In
perhaps the majority of dreams the role played
by this mechanism is an insignificant one. Exam-
ples are not required.

The function of the dream is that of satisfying,
in so far as is possible, those unfulfilled wishes of
the day having a combined tension sufficient to
disturb the sleeper and to tend to wake him up.
The dream is thus the guardian of sleep. The
first dream is a good illustration of this function.
What was disturbing the sleeper was the fact that
he would no longer be permitted to defend him-
self in the matter of the child's death. But in the
dream he imagines himself continuing his defense
. and with good results. The dream phantasy was
thus a direct antidote to the reality which caused
the concern menacing his rest. We often hear
people complaining that they rested poorly be-
cause dreams disturbed their sleep. The real
situation is the reverse, however; what disturbed
their rest is the tensions of unsatisfied or conflict-

122 MOBBID FEABS AND COMPULSIONS

ing wishes ; bnt for the dreams they might have
slept even less.

In one notable class of dreams, the nightmares,
the sleep-preserting function of the dream fails
and the dreamer awakes in fear. The origin of
the fear dream is as follows. Dne either to nnns-
ual relaxation of repression or to nnusnal strength
of a repressed desire, the fancy corresponding to
a wish f ulfQIment has begmi to be represented in
oonsdonsness with inadequate disgoise. Just as
the dreamer is about to become aware of what he
is really thinking, the feeling of fear takes the
place of the censorship and awakens him before
his dream is complete. The fear is really con-
verted desire (libido) escaping from repression,
the same desire that the dream phantasy attempts
to satisfy. Of the relationship between fear and
desire we shall learn in detail in the clinical
chapters.

The significance of the dream for psychoan-
alysis grows out of the fact that, as Freud says,
the dream is the via regia to the understanding of
the Unconscious. As we shall shortly learn in
detail, the neuroses represent a breaking through
of wishes of the Unconscious despite the control
of the foreconscious, in other words a partial
failure of repression. The symptoms, like the
dream, thus correspond to a compromise between
two psychic streams, the repressed and the re-
pressing. But the wishes fulfilled in the dream
are, as we have said, repressed wishes, and thus
arise from the same part of the personality as do
those forces which in predisposed individuals

DBEAMS AND NEUROSIS 123

represent the motive force of the neuroses.
Hence by stadying and analyzing a patient's
dreams one gets direct information regarding
those trends responsible for the symptoms of his
neurosis. And since, as we shall shortly see, the
analytic treatment largely consists in Uie physi-
cian's gaining and imparting to the patient a full
knowledge of the impulses or wishes from which
the symptoms derive their motive power, dream
analysis is of infinite importance. This will be
so amply illustrated in the clinical chapters as to
make examples unnecessary here.

CHAPTER IV

THB MEOHAKISMS OP PSYCHOFATHOLOOIGAL

MANIFESTATIONS

IN the preceding chapter we learned that the
manifest content of the dream is formed from
the nnconsdons dream-thoughts by the opera-
tion of certain techniques or processed which were
designated by the not altogether satisfactory
name of ^^ Mechanisms.'' Now, the same or simi-
lar mechanisms participate in like manner in the
formation of stUl other phenomena which occur
in consciousness but have origin in the unconscious
processes. Chief among these are the neurotic
symptoms. These mechanisms likewise play a
role in the mental activities of even the most
normal people, on the one hand, and in the ab-
normal productions of the insane, on the other.
They are not in themselves abnormal though they
take part in the formation of all sorts of psycho-
pathological manifestations.

We have to have knowledge of these mechanisms
in order to interpret or explain any given neurotic
symptom for one or more of them is sure to have
participated in its formation. In addition a
knowledge of them is required for the interpreta-
tion of the material which comes up in the daily
work of an analysis — those ^^descendants of the
repressed" through the study of which we at last

124

COMPENSATION 125

gain msight into the basic trends from which are
derived the symptoms themselves. For this rea-
son I shall devote considerable space to describing
and illustrating these mechanisms and allied mat-
ters even though their bearing on the question
of fears and compulsions as such is not entirely
an immediate one. Unless we are thoroughly
familiar with them the report of an analysis could
not readily be understood or appreciated.

Not all the examples to be given are in them-
selves abnormal or taken from abnormal persons.
The interpretations are in no case exhaustive, for
that would require a fuller description of the de-
tails of the person's life than is practicable in this
connection.

(a) COMFEKSATIOK

At the dose of the chapter on the unconscious
we considered an example of the forgetting of a
name and learned that this forgetting was really
a phenomenon of repression and signified a pro-
tective effort against the reproduction in con-
sciousness of the painful group of ideas with
which this name happened to be associated. We
may now consider another example of name for-
getting and we shall immediately be introduced
to a new form of defense phenomena.

Some time ago I was for a few days the guest
of a certain married couple with whom I am in-
timately acquainted. One evening while my host-
ess, her husband and I sat reading, she suddenly
looked up from her book and asked: **Who was
it that wrote * Paradise Lost'f Was it Dante? '^

126 MOBBID PBABS AND COMPULSIONS

Her husband replied that she had confused the
authors of ^^ Paradise Lost" and of the ^^Li-
femo/' and nothing more was said at the time.
A little while later her husband left the room, and,
just as I was about to speak of her forgetting,
she herself brought up the subject of psycho-
analysis by asking me to explain a very annoying
feeling which she had for some time experienced.
This feeling consisted in a sense of aversion or
repugnance toward all young men with light hair
and blue eyes. She had been caused much dis-
comfort by this singular antipathy as a number
of her husband's friends belonged to this type,
and their frequent visits to her house always
made her uneasy and unhappy. She realized per-
fectly that there was nothing in the character or
behavior of these men to justify her peculiar feel-
ing, but all her efforts to reason it away had been
of no avail. There, obviously enough, was an
affective reaction the source of which must have
been in the Unconscious. No introspective effort
on her part had furnished conscious data suffi-
cient to explain it.

Pursuing the technique of free association,
with which we have already become familiar, I
asked her to fix her mind on the particular type
of man she had described, and to relate all her
incoming thoughts, expecting that in this manner
she would produce descendants of the unconscious
trends causing her strange aversion and sufficient
to give some insight as to its nature. In response,
she reported that she found herself thinking of a
certain blond man, with whom we are both slightly

COMPENSATION 127

aoquainted, next of another of much the same
appearance whom also she knew only slightly.
Then, after a short panse, she suddenly laughed,
blushed and said with some confusion, ^^I just
now thought of some one else/' Having had
from the start some rather definite suspicions as to
the general significance of her antipathy to blond
men, I asked at this point: '^And towards this
man you felt no aversion?'' She at once ad-
mitted that I had guessed correctly, and then
went on to relate what follows, which, as may be
fieen, affords an explanation both of her dislike
of light haired men and also of her failure to re-
member who wrote "Paradise Lost."

The man she had thought of was her first
cousin. He is a very handsome specimen of
the blond, blue-eyed type that later inspired feel-
ings of repulsion. When she was about sixteen
years of age she had seen a good deal of this man
and had found herself falling seriously in love
with him. But because of their close relationship
and the fact that he was nearly ten years her
senior, she had decided that it was very wrong in
her to entertain any amorous regard for him.
She had therefore resisted his attractions and
endeavored to banish from her mind all senti-
mental thoughts concerning him. These efforts
at repression were apparently successful for, bjs
far as she was aware, he had ceased to be of any
particular significance in her emotional life. But
this complex, though it had become in great part
unconscious, was by no means entirely deprived of
expression. For instance, when, just before her

128 MORBID FEARS AND COMPULSIONS

marriage^ she destroyed her collection of photo-
graphs of former admirers, she "forgot'' to
destroy the only picture she had of her cousin.

This forgetting we can hardly regard in any
other way than as purposeful. Unconsciously she
desired to keep the photograph. This little item,
small as it is, has no mean significance. From
it we are easily led to suppose that, in the Uncon-
scious at least, more of her holophilic interest re-
mained attached to the memory of her cousin than
she was consciously aware of or ready to admit.
In other words, her efforts to forget him, instead
of annihilating this interest, had merely accom-
plished its repression. But no sooner have we
made this statement than we notice that her aver-
sion toward all light haired men is a trend dia-
metrically opposite to that which we have just
assumed to exist in the Unconscious. Are we
therefore to suppose that because of this aversion
we must have been wrong in assuming that toward
that particular Ught haired young man, her cousin,
she had feelings just the opposite of aversion!
Hardly. We can better explain the conditions by
assuming that this aversion toward all light haired
young men was rather an overdevelopment of
those trends or counter-activations which pro-
duced the original repression, and that the reason
for this overdevelopment was that the repression
was threatening to fail and required an increase
of activity on the part of the repressing forces in
order to prevent this. In other words this over-
activity on the part of these trends from the fore-
conscious served as a correction or antidote for

COMPENSATION 129

what existed in her Unconscious. Thus con-
sciously she wished to forget her cousin and was
unwilling to care for him ; unconsciously she still
retained some love interest in him and wished to
rememher hiuL Her forgetting to destroy his
photograph is an expression of the love trend.
Her failure to recall who wrote "Paradise Lost'*
was an effect of the repressing trend. For it so
happens that her cousin^ name was Milton.

We have thus been introduced to a new form of
manifestation of unconscious processes, in addi-
tion to the dream and the forgetting of names —
the two with which we are most familiar — ^that is
to say, an exaggeration or overdevelopment of
conscious and f oreconscious trends serving as a
defense against unconscious wishes of an oppo-
site character, which threaten to break into con-
sciousness.' This may recall to us the phenom-
enon known in pathology as compensatory hy-
pertrophy. A defect or deficiency in some organ
IB made up for by an overdevelopment and in-
crease of functional activity on the part of the
same organ or of its mate. Thus the effect of a
leaky heart valve is discounted by an increase in
size and strength of the heart muscle, or an in-
crease in the frequency of the heart's action; dis-
ease or removal of one kidney results in an in-
crease in size and functional capacity on the part
of the other kidney, etc.

The somewhat analogous phenomenon which
occurs in the psychic sphere, as has just been ex-
emplified, goes, by the same name, compensation.
Thus when a given trend succumbs to repression,

130 MOBBID FEABS AND COMPULSIONS

there osaally apjiears what amounts to a compen-
satory hypertrophy on the part of the repressing
foroesi the counter-activations of the foreoon-
scions. When the repressed trend is a partica-
larly strong one and the repression maintained
with difficulty, the counteractivity on the part of
the repressing trends is then correspondingly ex-
aggerated and the phenomenon is known as over-
compensation. It may be added incidentally that
some of the energy manifested in the form of the
compensatory activities is probably derived from
the same instinctive sources as the tendencies they
serve to repress.

One of the most commonly observed over-com-
pensations is represented by the exaggerated anx-
iety so often displayed by neurotics over the
health of some person dose to them. Thus for
example a neurotic girl is continually in a state
of alarm concerning her mother. If her mother
complains of being over tired the girl thinks this
presages an apoplexy. If the telephone rings
while her mother is out, she thinks this is a mes-
sage from the police saying her mother has
dropped dead on the street. If she hears a noise
during the night, she interprets it as her mother
choking' in a death agony.

Or again a married woman shows a similar con-
cern about her children. As soon as they are out
of her sight she begins to worry about something
happening to them. If a fire engine goes by the
house, she has a vision of it crushing their bodies.
If they are late in coming home from school, she
goes out to search for them fearing they have

COMPENSATION 131

been killed or kidnapped If they oongh or
sneeze, she is in terror lest this be a sign of im*
pending pneumonia.

Such exaggerated concern, which ostensibly in-
dicates an affection of unusual strength, is hardly
that in either of these cases but rather an over*
compensation for repressed wishes of a hostile
character. ' The married woman referred to was
unhappy and dissatisfied with her husband. On
more than one occasion she had allowed herself to
think that had she no children she would leave
him. Her exaggerated concern over their welfare
thus serves to compensate for the wish that they
might die and allow her to be free. In the case of
the daughter who worried about her mother a
similar state of affairs prevailed. As a little girl
she had wished her mother might die so she could
have her father all to herself. Later as a young
woman she fell in love with a man and would have
married him had it not been for her mother 's op-
position. Thus her unreasonable worries about
her mother really conceal and compensate for the
instinctive wish that her mother would die and
leave her to the man of her choice.

In these and all other examples of over-compen-
sation it is to be seen that the compensating mo-
tives belong essentially to the cultural, ethical and
acquired group of reactions and so to the fore-
conscious. The repressed trends which are com-
pensated for are in the main more primitive, and
are derived from instinct and the unconscious.

A not uncommon form of compensation for re-
pressed sexual trends that are conceived by the

132 MORBID FEAES AND COMPULSIONS

subject to be base or sinful is represented by an
effort to divert the thoughts to some theme of an
opposite character as for instance religious work,
philosophical or metaphysical -studies, the ascetic
pursuit of music or art An excellent example is
afforded by the case of a young woman who in a
sudden and apparently inexplicable way developed
a profound interest in Christian Science. After
studying for a short time she announced herself
entirely convinced of the truth of its tenets, and
soon after became a healer. Then she alternated
between preaching its doctrines and railing at
doctors in a quite fanatical manner, until at last
she broke out with neurosis.

The analysis revealed the following facts. Pre-
vious to the beginning of her interest in
Christian Science she had suffered from an or-
ganic illness which required the constant atten-
tion of a physician for a long period of time. Not
unnaturally she became much attached to her
medical attendant and, though he happened to be
a married man, she got into the habit of having
certain romantic phantasies about him. He in
turn soon began to display more interest in her
than is demanded by an ordinary professional re-
lationship and shortly a little rather furtive love-
making began. Then, without further warning,
the doctor made what was practically an attempt
to rape her, and before she had time fully to re-
cover from the shock of this experience (which
was not lessened by her discovery that something
within her strongly impelled her to let him have
his way) she learned of his having made a similar

COMPENSATION 133

attempt with another of his female patients who
happened to be one of her acquaintances. Her
suddenly bom Interest in Christian Science was
a reaction to her romance with the doctor and
served as a compensation for that stream of her
libido which was applied to him. Thus in place
of her love for the doctor there appeared mockery
and hate of all medical men. In place of sexusl
interests, which to her mind were of the flesh and
degrading, there appeared interests in the spirit,
in God, in religion. Instead of being absorbed in
what she had felt to be bad she was now steeped in
the g6od.^

II have often wondered if some oonsiderable number of
Cauritftian ScientisiB are not perhaps cases parallel to this one;
bat my experience in this direction is too limited to allow me
to venture any positiye statements. I am inclined to think, how-
ever, that there is a good deal to be said on this point. The
image of the doctor has a most intimate relation with the sex
lifa The child is early impressed with the fact that the doctor
sees what nobody else sees, hears what nobody else hears, and
knows what nobody else knows. He could, if he would, answer
all questions and satisfy aU sexual curiosity. In connection
with "playing doctor" many children have their first gross sexual
experiences. Partly through early impressions of the family doc-
tor along these lines, and partly through the objectiyely condi-
tioned rOle of guide, philosopher and friend to which the doctor
accedes by reason of the necessary intimacies of later life, it is
extremely common for women to develop strong, even though
unconscious, erotic attachments for their medical attendants. It
seems to me highly probable that no small number of the cases
of sudden conversion to Christian Sdoice represent reactions to
trends of this sort which were developing such strength as to
break through foreconscious control. I can also trace one or two
cases to the masturbation complex. The patient could not bear
to undergo examination and treatment at the hands of a medical
man. She feared that the secret guilt would be revealed by such
means. She therefore sought other means of healing her ills
where there would be no danger of such a revelation.

134 MOEBID FEAES AND COMPULSIONS

An interesting example of compensation is af-
forded by the case of an unnsoally intelligent
yonng woman who, from about the age of eighteen
had been a most ardent and militant feminist.
On all such questions as woman suffrage, equal
pay for teachers, marital reform, etc., she had
talked, written and fought with the enthusiasm of
a fanatic. Her dream was of a time when woman
should be on the same plane with man in all par-
ticulars, doing the same work, enjoying the same
rights, having, in short, complete equality. Aside
from problems such as these there was very little
in life that seemed to interest her.

There were certain features of the case, how-
ever, which, even before she broke out with a defi-
nite neurosis, might well have indicated that her
absorption in these matters was not entirely a
normal one. In the first place, for any one pos-
sessed of such really unusual intelligence and
knowledge of her subject, her methods were very
ill-considered and her results surprisingly
meager. Though a very industrious worker, she
was an astonishingly inefficient one. In addition
to this was the fact that her emotions on some of
the questions of feminism were so markedly ex-
aggerated as to be quite obviously abnormal. For
instance, the slightest suggestion that women were
in any way inferior to men, even in physical
strength, would set her in a passion of the wildest
anger and let loose a flood of vehement and for
the most part unreasonable denials. For her to
hear it mentioned that the first coitus is painful to
the woman, or, for that matter, any statement that

COMPENSATION 135

tended to associate the idea of pain with the per-
formance of the sex functions, wonld have a simi-
lar maddening effect, as would a tale of a man's
being brutal or domineering to a woman, compell-
ing obedience from her, or treating her as an in-
ferior.

Upon analysis this patient's violent warfare
against all forms of subordination of women was
revealed to be very largely a compensation for a
strong but imperfectly repressed masochistic
tendency. That is to say, the idea of a man's
mastering, domineering over, and inflicting pain
and violence upon a woman, particularly in an
erotic way, strongly appealed to the patient's in-
stincts and Unconscious, though in the main re-
pellent to her conscious personality. Some of the
very stories of brutality and suggestions of subor-
dination which most excited her rage at the same
time gave rise to intense sexual emotions and com-
pelled her to masturbate. Her militance against
the subordination of women was thus in essence
an effort to do away with those sources of stimuli
which, in her, inspired feelings she felt to be mor-
bid and shameful.

I have reason to believe that this case of mili-
tant feminism is not entirely unique. A cer-
tain proportion of at least the most mili-
tant suffragists are neurotics who in some in-
stances are compensating for masochistic trends,
in others, are more or less successfully sublimat-
ing sadistic and homosexual ones (which usually
are unconscious). I hope this statement may not
be construed as an effort on my part to throw mud

136 MORBID FEARS AND COMPULSIONS

on woman suffrage, for on the whole I am very
much in favor of it. As a matter of fact it is
nothing to the discredit of any movement to say
that perhaps many of its conspicaoos supporters
are neurotics, for as a matter of fact it is the
neurotics that are pioneers in most reforms. The
very normal people who have no trouble in ad-
justing themselves to their environmenti are as a
rule too sleek in their own contentment to fight
hard for any radical changes, or even to take much
interest in seeking such changes made. To lead
and carry through successfully some new move-
ment or reform, a person requires the constant
stimulus -of a chronic discontent (at least it often
seems so) and this in a certain number of in-
stances is surely of neurotic origin and signifies
an imperfect adaptation of that individual to his
environment. Genius and neurosis are perhaps
never very far apart, and in many instances are
expressions of the same tendency.

Compensation for an overdeveloped and im«
perfectly repressed sadistic tendency seems not
infrequently to take the form of a passionate de-
votion to antivivisectionist activities. In certain
cases that have come under my notice the patients,
during early childhood, were exceptionally cruel
to animals, and delighted in torturing them. This
was succeeded by a period of relatively perfect
repression. Then when the repression began to
fail, the antivivisectionist interests became con-
spicuously manifest. That this interpretation of
certain cases is correct will not, I think, be difficult
to believe. One would expect a person really

COMPENSATION 137

lacking in cmelty and possessing a real sympathy
for children «nd animals to he slow to suspect and
accQse others of being cruel to them. In fact such
a person might readily underestimate the likeli-
hood of such cruelty and refuse to believe in its
existence where actually it did occur. At any
rate he would welcome, and be relieved by, reason-
able evidence tending to prove that where he had
feared cruelty existed, there was no cruelty at all*
But not so the antiviviseotionists, if my experience
is worth anything. They see all kinds of out-
landish cruelties and barbarities where in fact
there are none, evidence to prove that there is no
cruelty where they suspected it enrages rather
ihan soothes them, and in spite of their own pro-
fessed tender-heartedness it is impossible to per-
suade them that the rest of the world is not ex-
treniely cruel. This seemingly paradoxical state
of affairs can be readily understood if we remem-
ber what has been said about the Unconscious.
Their tendency to see limitless and fiendish
cruelty where nothing of the sort exists is a prod-
uct of the Unconscious and expresses their own
instinctive pleasure in that very sort of thing.
Their warfare on cruelty, real or phantastic, is
then a compensation for their own unconscious
sadism and represents an hypertrophy and over-
activity of the counter-activations of the f orecon-
scious serving to maintain a repression which con-
stantly threatens to f ail.^
A not altogether dissimilar but more compli-

iThe cruelty which such persons so ^ readily believe others
capable of is really a projection of their own sadism, which by

138 MOBBED FBABS AND COMPULSIONS

caied form of compensation! which, however,
serves a valuable adaptive purpose, is to be found
exemplified so commonly in the character of men
of our Southern states as to be a popular rather
than an individual constellation.^

What I have reference to particularly is the atti-
tude of the southern man to the opposite sex.
Woman is idolized and adored in the South to a
degree that is quite unique. Nowhere in the
world is she treated with more courtesy, delicacy,
respect and homage. Nowhere is she so consist-
ently protected, honored, deferred to and waited
upon. And nowhere is any act involving coarse-
ness, meanness or brutality to a woman so little
tolerated or so summarily punished. Chivalry
toward women is one of the most conspicuous
traits of the Southern character.

This attitude of exalted chivalry is really a by-
product of the influence of the negro upon the
character of the people of the South. It is in
essence a compensatory development serving to
correct some of the ill effects of this influence.
The presence of an inferior race in the environ-
ment of the Southerner, toward the members of
which the same limitations or inhibitions of con-
duct which govern the relations with the whites
do not prevail, serves to develop or keep alive the
inherent sadistic tendencies of man, or at least to

such means they escape from peroeiviiig as an endogenous fores.
The mechanism of projection is discuseed elsewhere. (Page 166.)
1 Certain adaptive reactions characteristic of whole races or
peoples Brill has discussed in a most masterly study, shortly to
be published. His observations on the p^chology of the Jews are
particularly interesting.

COMPENSATION 139

prevent their fundamental repression. In his re-
lations with the negro the Southerner is (and if
we are to believe him, he has to be) somewhat
barbaric. The negro apparently needs a master.
He must be dominated. The resources of fear
and pain cannot always be dispensed with in deal-
ing with him. He cannot always be governed by
the milder methods that serve well enough for
laborers and servants who are white. Thus the
environment of the Southerner has this peculiar
f eature, reminiscent of a barbaric age, which not
only makes possible the relatively free exercise of
more or less brutal or sadistic tendencies but even
encourages and perhaps denwnds them. It is
natural, therefore, that southern men should as a
class be more sadistic than their northern neigh-
bors. That they are so is clearly apparent. The
Southerner is proverbially impetuous, hot headed
and hot blooded. He is quick to resent an injury
and quick to avenge it. In his anger he resorts to
physical violence and to firearms with quite aston-
ishing readiness. Call him a liar and he instantly
responds with a blow. Injure him and he
threatens to shoot you; injure him again and he
keeps his promise.^

lAn artSele in The Bpeotaior, an insurance journal, on "Hie
Homicide Record for 1915" says: "Tlie homicide impulse is most
strongly developed in the Southern and far Western States, and
least so in the New England, Middle Atlantic and North Central
States." Memphis, Tennessee, had the highest homicide rate for
the country, 85.9 per 100,000 population. The rate for New
York City was 4.7. Reading, Pennsylvania, had the lowest
rste, 1.9.

Of the seventy-four lynchings which took place in the United
States during 1915 nearly one-third were oommitted in Georgia*

140 MOEBID FEAES AND COMPULSIONS

But it is in the measures with which he punishes
brutality that his own brutality, or as we prefer to
call it, sadism, is most clearly apparent. Take,
for example, the institution of lynching, an essen-
tially southern one, though unfortunately by no
means unknown in other parts of this country.
Here we find sadistic tendencies plainly express-
ing themselves under the very transparent dis-
guise of a horror of the sadistic. There is little
room for doubt as to the real significance of these
occurrences. Is it conceivable that without a
strong sadistic tendency any man would choose
to assist in lynching a fellow being when the ptm-
ishment of the offender could just as well be left
to properly constituted authorities f Would not
a man lacking in brutality shrink, no matter how
** public spirited*' he might be, from participating
in such an act as the burning of a negro at the
stake t Would he not infinitely prefer to leave
to the law the taking of lives, particularly in view
of the fact that when one joins a lynching party,
he can hardly escape some grave misgivings as
to whether it will be the right negro who will be
lynched f It is true that in many instances of
lynching the provocation has been great, but
this is by no means always so. A good many
lynchings have occurred for some other and much
less serious offense than the ^' usual crime" and
in many instances the alleged malefaction has
been so trivial as hardly to deserve being called
an excuse. The cause of the lynching was not
anything that particular negro had done, but
rather the exuberance of Southern sadism, which

^ COMPENSATION Ul

fionthem environment has so successfully fostered.

The Southerner's chivalry, and, to a less extent,
his generosity and warmheartedness, are very
largely compensatory corrective reactions devel-
oped against his strong and imperfectly repressed
sadism. His environment will not admit of any
complete repression or sublimation of the sadis-
tic tendencies. He has therefore to compensate
for them and perfect his adaptations by over-
developing some corresponding virtues.

The reason the compensations take the form
of chivalry is this : Tendencies to brutality when
fostered always tend to express themselves in the
sexual life. The sadistic instinct is a survival of
those evolutionary periods when it was normal
and necessary for men to take delight in the pur-
suit, capture, torture and killing of other men.
An environment which fosters it by reproducing
even on a milder scale these older conditions
tends also to reproduce the attitude of primitive
times towards women. The male in savage life
courted the female with a dub. Marriage began
as a forcible abduction of the female and con-
tinued as a relationBhip more like that of slave
and master rather than that of husband and wife
in the modem sense. A regression to this sort of
attitude is strikingly exemplified in cases of sadis-
tic perversion, where the sadist is impelled to
reduce the female of his choice to a state of slave-
like subjection, to submit her to gross indigni-
ties, and to inflict upon her various degrees of
violence and physical pain.

But an environment that fosters brutality in

142 MOEBID FEABS AND COMPULSIONS

one direction favors the growth of all tendencies
of that character. A person can not be brutal
or sadistic in one department of his life without
fostering a tendency to the same in all depart-
ments of his lif e^ and particularly in the sexual
sphere — ^to specific sadism. But to be sadistic
or barbaric to a white woman is very different to
the mind of the Southerner from expressing sudi
tendencies toward a negro. A tendency to bar-
barity of the latter sort he can permit to enter
his consciousness. Even so flimsy an excuse as
is afforded by some of the occasions for lynching
is sufficient to reconcile with the foreconscious,
sadism in one of the grossest forms. But sad-
ism of the other sort (toward respected white
women) must be firmly excluded from conscious-
nes6 and withheld from action. And thus^ as if
to make assurance doubly sure against any mani-
festations of such impulses in the direction of his
womankind, the Southerner compensates by go-
ing to the opposite extreme. Instead of making
woman his slave he places her on a pedestal and
professes to be a slave to her. Instead of in-
flicting; pain upon her, he displays an exaggerated
chivalry and is ready to defend and shield her
against anything suggesting violence even at the
cost of his life. His attitude of chivalry and
gallantry is, in short, diametrically opposite to
that of the sadist and savage. And the reason
the Southerner has so consistently to maintain it,
is that, as regards the Unconscious, he is to such
a large extent one with the sadist and the savage.
His chivalry performs the function of correcting

DISPLACEMENT 143

and oompensating for this identity. It is to his
character what a blow-out patch is to an automo-
bile tire. It covers a point where trouble threat-
ens ; it strengthens a weak spot.^

A (b) DISPIiAOBMEKT

As was indicated in the second chapter, the
codtrol and inhibition which the Foreconscious ex-
ercises over the processes and trends of the Un-
conscious is none too stable and, even in normal
persons, i« not perfectly complete. The material
just given, most of which either belongs to or
borders on the domain of the pathological, tends
to demonstrate the instability of repression. The
phenomena of compensation are, for the most part,
representative, so to say, of desperate efforts on
the part of the Foreconscious to maintain the re-
pression of trends so strongly activated that the
repression constantly threatens to fail. In some
of our examples appears a partial failure of re-
pression. A part of the energy of some compen-
satory measures comes from the repressed trends
themselves and in some instances retains their
qualities. In this way a sort of compromise is
formed between the repressed and the repressing

lit maj lie noted that the ''Age of Chivalry,'' a period in
wlddi this highly eonunendahle quality was carried to extremes
far snrpaasing anything to be obeerved in the South, was one in
which, aa in the Southo-n environment, sadistic tendaides were
on the one hand fostered (in wars, the customs of dueling, beating
servants, public whippings, beheadings, etc.) and on the other
required to be controlled and repressed. Thus similar conditions
in periods temporally remote from one another called forth
practicaUy identical adaptive compensationa.

144 MORBID FEARS AND COMPULSIONS

forces so that they find simultaneous expression
in a single form of activity. Lynching is an ex-
ample of this. In it are expressed a sadistic
tendency and a rage against the sadistic. The
tendency of some of the anti viviseetionists to see
unspeakable cruelties where none exist and at the
same time vehemently to condemn them has a
similar significance. So too the sense of discom-
fort and aversion experienced by the young mar-
ried woman in the presence of young men with
light hair and blue eyes. Some of the desire to
get away from them came from the repressing
forces. Yet a part of the unrest she felt in their
presence was really love-desire for them, in a
somewhat transformed state (or, more accurately,
a desire for the person of whom they reminded
her) and was thus a part of the repressed ener-
gies.

The processes by which the trends of the Un-
conscious find representation in consciousness we
must now view more narrowly. Repression is a
process that occurs at the border between the Un-
conscious and the Foreconscious, and I must now
emphasize the fact that it has to do primarily
with ideas. A wish presentation arising in the
Unconscious remains there repressed unless its
idea-representative secures activation in the fore-
conscious. This activation, according to some of
Freud's most recent teachings,^ appears to be a
gaining of access to the word memories which are
only of the Foreconscious. The processes of the
Unconscious are in all probability wordless, just

iBas UnbewuBste — ^Zeitach. f. Aizt. Psychoanaljse— Vol. HI.

4 •w

DISPLACEMENT 145

as the thought processes of infancy are wordless,
but nevertheless contain ideas of things.

Word ideas belong to the conscious and f orecon-
scious systems and correspond to a higher de-
velopmental state of the psychic apparatus than
the thought processes of the Unconscious. So
that unless an imconscious excitation or wish suc-
ceeds in getting the thing-ideas representing it
translated into word-ideas (but not necessarily
into actual words), or, to express it differently,
unless in the foreconscious the word-memory
residues are activated which correspond to the
unconscious ideational representatives of the
wish, it remains an unconscious and repressed
one. Its energy develops neither affects, nor
movement.*

In the chapter on dreams we learned, however,
that an unconscious wish could secure representa-
tion in consciousness by indirect means, provided
that the ideas in the Unconscious corresponding
to the wish were replaced by others more accept-
able to the censor. One of these important dis-
torting mechanisms, which consisted of a trans-
position of the wish energy or activation from its

1 There are no imoonscious affects. One often speaks, to be
snre^ of unconscious affects (love, hate, guilt, resentment, etc.)
and this usage, though not strictly correct, is a legitimate clinical
oonyenience. An affect is really a conscious sensory perception
of a bodily state. Without consciousness it does not exist. When
we speak of an unconsdous affect we mean either that the affect
is really developed and therefore conscious, though attached to
some other ideas than those originally representing it, or else
we mean merely a potentiality of its development — ^the tensions
of the Unconscious that might develop as affects of hate, love»
etc., if released from foreconscious inhibition.

146 MORBID FEARS AND COMPULSIONS

unconscious ideas to new and associated ideas
wliich would pass the censor, is familiar to us
under the name of displacement. Displacement
is a phenomenon occurring not only in dream
formation. It has also very much to do with the
formation of practically aU the various kinds of
psychoneurotic and psychotic symptoms and is
likewise very frequently exemplified in the hap-
penings of normal mental life.

Like aU neurotic symptoms the manifestations
included under displacement are compromises
formed between repressed and repressing trends.
The compromise consists in the fact that though
the ideas which, in the unconscious^ represent
wishes or libido strivings remain repressed and
withheld from translation into word-ideas, yet the
wish-energies themselves are given access to con-
sciousness and to the avenues of expression as
feeling or action by transposing themselves to
word ideas of the f oreconscious which are ap-
parently innocent and so passed by the censor-
ship.

What in the first chapter we briefly referred to
as sublimation is really a sort of displacement
or at least allied thereto. By sublimation is
meant the utilization of the energy really belong-
ing to one of the primitive holophilic impulses or
sexual components for some higher and non-sex-
ual aim. The original crassly sexual aim of the
impulse is abandoned and the libido displaced to
find outlet in some useful and socially valuable
form of activity.^ Thus the exhibitionistic im-

^One of the most interesting contributions to tlie psychology

DISPLACEMENT 147

pulse finds outlet in histrionic activity ; the sadis-
tic is sublimated into an interest in surgery, mili-
tary matters, business competition, etc. ; the curi-
osity impulse leads to istudy, investigation, re«
search or philosophical speculation. In many in<
stances the early sexual curiosity later leads to an
interest in the study of medicine. What in cer-
tain casc^ was originally rebellion against the
authority of the father, later becomes a devotion
to l^;al reform, to socialism, or to other move-
ments designed to better the conditions of the
wage-earning classes who have to submit to au-
thority or to certain forms of oppression.

One of my patients who in his childhood was
very fond of his aged grandfather who was very
tender and indulgent with him, and to much the
same degree hated his mother, a rather puritan-
ical widow who was extremely and unreasonably
strict and severe with him, was always seeking as
a little boy to learn if there were not some medi-
cine that would prevent his beloved grandfather
from growing older and dying. Less openly he
kept on seeking for some other medicine that
would quietly put his mother out of the way.
As a boy he took great interest in doctors, but
finding liiem somewhat disappointing as regards
knowledge of how to preserve and prolong ex-
istence, his early desire to possess the secret of
a control of life and death eventually found a
sublimated outlet in a passionate devotion to the
study of chemiistry, which became productive of

of Bublim&tioB is Brill's study of choice of avocation, to be pub-
Ushed shortly.

148 MORBID FEARS AND COMPULSIONS

socially valuable and financially profitable results
altogether different from the early homosexual
and hostile aims from which these interests de-
rived a large part of their motive power.

But we are more interested in the pathological
forms of displacement than in that sort which is
represented by normal sublimations. Some of
the most interesting examples are afforded by the
symptoms of the compulsion neurosis, a malady
which we will consider in detail later. We are
already acquainted with an example of such dis-
placement in the drug-taking compulsion of the
young woman mentioned in the second chapter.
The energy driving this compulsion was specif-
ically sexual wishes. The ideas corresponding to
these wishes were refused passage by the censor,
but their energic content was able to evade the
censorship by means of displacement to the ap-
parently innocent ideas of drugs, against which
there were no serious resistances. This obses-
sive impulse, like many other compulsive phenom-
ena, resembles in its formation certaia examples
of wit — ^** smutty'* wit, particularly.^ iPor in-
stance, a man says, in mixed company, that though
he was brought up to be religious, industrious and
serious-minded yet there are periods when he for-
gets that it is better to watch, with the wise vir-
gins, than to sleep with the foolish ones. His
words, if taken at their face value, are perfectly
innocent, yet they express, through the double
meaning of the phrase "to sleep with,'* certain
ideas which his hearers would not have tolerated

1 Oompare Freud% "Wit and the Unoonsdoiu.''

DISPLACEMENT 149

had he stated them directly. Bat the resistances
of his audience, operating as an inhibiting force
upon open expression, he circumvented by a spe-
cial technique in much the same way the f orecon-
scious resistances of the young woman just men-
tioned were circumvented and certain essentially
objectionable ideas and impulses allowed expres-
sion by the use of equivocal terms. In the case
of this patient, the word-idea, ^'to take medicine''
could represent two different thing-ideas. One
was the actual thing-idea of taking drugs, while
the other afi the result of an infantile sexual
theory, the memory of which had long faded from
her consciousness corresponded to the thought
*' Something one does to have a baby.'' Yet
by virtue of this double meaning the later thing-
ideas of what one does to have a baby — ^that
is to say, intercourse — ^and the strong corre-
sponding impulses, had at their disposal a word-
idea to represent them in consciousness which
on the one hand seemed totally innocent, yet
on the other contained their true meaning. Hence
the patient could release into action a portion of
her sexual wish-tensions, which had they been
more plainly labeled would have been denied even
this imperfect outlet.

A business man, who had to do a fair amount
of traveling, had a peculiar habit about catching
trains. If he planned to go anywhere, he would
not look up a time table to find what time the
trains went or what would be a convenient one.
Instead he would take his time about attending
to what work he had to do at his office, and when

150 MORBID FBAES AND COMPULSIONS

this was finished, would leisnrely proceed to the
statioDi where, if there was no train ready to
depart when he got there, he would wait until it
was time for one. Naturally this habit caused
him to waste a good deal of time, a fact which
he realized perfectly, but nevertheless he would
not abandon it. He'd be dammed, he said, if any
railroad company could hurry him at his office
and make him adjust his work according to the
demands of a miserable time table. He would
go to the station when he got ready and not be-
fore, and neither the railroad company nor any-
body else might dictate when this should be.

This habit was really a displacement of im-
pulses belonging to the father complex, and rep-
resented a rebellion against the father's author^
ity. The patient's father was really an excep-
tionally fine man to whom he was greatly at-
tached. Nevertheless the old gentleman had a
certain tendency to dictatorialness, from which
the patient had as a boy suffered consideralxly. It
was characteristic of his father that when once
he made up hifi mind he wanted a thing done,
it must be done at once; he would brook no de-
lay. Thus when he gave his son an order, it mat-
tered not what the boy might be doing at the
time, he would have to abandon it instantly and
carry out his father's wish. Because of his very
deep affection and respect for his father the pa-
tient very naturally repressed any resentment
over this impatience, and had no consciousness
of ever feeling rebellious against the authority
which, during his boyhood, at least, the father

^

DISPLACEMENT 151

had exercised in no uncertain manner. Any
snch rebellions impnlses wonld have met with vig-
orous resistances on the part of the f oreconscious,
if directed at his so greatly loved father. They
could, however, through displacement evade the
repression and discharge themselves in some in-
different quarter as for instance against the rail-
road companies. In that connection he could act
the way, which as far as his Unconscious was con-
cerned, he would at times have liked to act towards
his father, but from which he was withheld by
resistances conditioned by love and respect.

Instances of this sort are very common. Some
rule, prescription, specification or anything else
giving the suggestion of authority is taken as
an object to which to displace and discharge re-
pressed impulses to rebellion and disobedience
primarily referring to an authoritative parent —
usually the parent of the same sex. I recall a
young man who, if he saw a sign: ''Don't walk
on the grass," would go out of his way to walk
on it. The legend: ''No smoking" would cause
him instantly to light a cigarette even though per-
haps he had just finished smoking. The direc-
tion: "Slow down to ten nules an hour" would
invariably impel him to speed up his car. The
mania for doing things forbidden which so gen-
erally attacks boys or young men when they first
go away from home to school or college is really
a breaking through of the impulses of rebellion
against the father which hitherto had been better
repressed but now begin to find outlet by dis-
placing themselves to almost anything that is

152 MOBBID FEAES AND COMPULSIONS

prohibited. Often the thing done represents in
a symbolic way some specific act forbidden or
oondenmed by the father (usually a sexual one)
and thus two sorts of impulses find a common
outlet According to Stekel and others, klepto-
mania has this origin. The thing stolen is usually
symbolic of some sexual thing unconsciously
wished for, and which in childhood the authority
of one of tiie parents stood in the way of attain-
ing. The stealing thus simultaneously expresses
through displacement the desire for the thing or
experience in question and the rebellion against
the parent whosjB influence or authority originally
interfered with its fulfillment. I have had one
such case.

I live on Long Island and have my office in an
office building in New York. One of my patients,
a writer by occupation, with whom I was just be-
ginning an analysis, opened the conversation at
the third visit with the question: ''How do you
like having your office away from your house t"
Upon my replying that I liked it very well, he con-
tinued: '*Well, it's the only way to live. IVe
got to do something of the kind. I can't prop-
erly get down to work at home. There's some-
thing always interfering, and my writing suffers
from it. I shall have to rent a room somewhere
in an office building away from my house, where
there will be no one to bother or interfere with
me and then I can get down to real work and ac-
complish something, instead of puttering around
as I do now."

He expressed himself with so much

DISPLACEMENT 153

about the home interfering with his work that my
attention was arrested at once, and I wondered
if we were not dealing with a displacement. Cau-
tious questioning confirmed my suspicions for
it became quite apparent that whenever he showed
a disposition to write, his wife religiously left
him to himself y and took great pains that neither
she nor the children ever disturbed him unless
it was absolutely necessary. It further devel-
oped that he had not felt it any great handicap
to have to work at home until perhaps seven or
eight months before he came to me.

In view of these facts I at length said to him ;
^* Perhaps work is not the only thing you want to
do that the home interferes with." He seemed
quite confused and startled for a moment and at
last said with an embarrassed laugh: '^I guess
you hit it right that time^'' whereupon he went
on to tell me that for two or three years he and
his wife had been gradually getting out of
touch with one another, and the state of sympathy
and harmony which had marked the early part of
their marriage had been slowly replaced by one
of relative indifference. This had not disturbed
him greatly at first for he had felt it to be a part
of the natural course of things that married peo-
ple should eventually become more or less tired
of one another and thought that what he was
experiencing was no exception to the general rule.
Also he had vaguely felt that, as his devotion to
his wife became less, that to his work became
greater, a state of affairs with which he was
quite well satisfied. But then, perhaps about a

154 MORBID FEARS AND CDMPULSrONS

year before he began treatment with me, he made
the acquaintance of a young woman, who as time
went on made it quite apparent that she admired
him exceedingly and would not regard any atten-
tions from him as at all unwelcome.

Her obvious interest in him had at first merely
amused him and left him quite indifferent, but it
was not long before he found himself responding
to it with a warmth of feeling that surprised him^
and the next thing that happened was that when
one day they were left alone together for a few
moments, he threw his arms about her and kissed
her. After this he began to meet her occasionally
and indulge in some love-making, which however
did not go very far. He knew however that she
was a very sophisticated person and in his own
mind was perfectly satisfied that if he wanted
sexual relations with her, she would be completely
responsive. She was a very attractive and ap-
parently passionate woman, and the knowledge of
what he might experience with her exerted on him
a powerful appeal, but nevertheless he hesitated
to go any further because he was married, and out
of regard for his wife. It was the state of con-
flict and uncertainty arising out of this situation
that was really the main reason for his not being
able to settle himself at his work. His feeling
that his home was interfering with his work was
really a displacement, though in a certain sense
there was an element of truth in this idea. It was
toward the possibility of a liaison with the young
woman that his home acted as an interference;
only secondarily and through this medium did

PBOJECTION 155

it interfere with his work. His desire to get a
room where he felt he could work more freely was
really a desire to get away from the inhibiting in-
fluence of his home upon his desires toward the
young woman, or (what is almost equivalent)
from the inhibition of his conscience.

There is a form of what might be called diffuse
displacement which results in a state in which
the person finds fault with nearly everything.
For instance, a woman when she goes out to din-
ner finds the food too hot or too cold, too salty or
not salty enough ; the dress she buys is either too
tight or too loose, or else the wrong color. Al-
ways there is something wrong with her servants,
her house or her friends, in fact, everything she
comes in contact with. The explanation of this
continual dissatisfaction, apparently arising from
a multitude of minor things, is that it really had
origin in a dissatisfaction with her life with her
husband, but she had displaced it elsewhere.

In succeeding chapters we shall become ac-
quainted with other clinical examples of simple
displacement, and no more need be given, at this
point. We will consider instead some examples
of more complicated mechanisms, all of which
more or less involve displacement, but have their
special features and are known by different names.

(c) PBOJECTION AKD INTROJECTION

In early infancy the individual has no com-
plete appreciation of where the self ends and the
external world begins. The small hand the baby
sees before him he does not recognize as a part

156 MOBBID FEABS AND COMPULSIONS

of his own person. The supply of milk that ap-
pears at such times as he is beset with hunger is
not at first referred to the agency of another in-
dividuaL
y In the psychological sphere in adult life, par-
ticularly in abnormal cases, occur phenomena
which parallel this early failure to distinguish
between the ego and the non-ego. Thus on the
one hand mental occurrences belonging to the ego
are perceived by consciousness as of external or-
igin, while, on tJie other, essentially external hap-
penings are assimilated by the personality and
made a part of the self. The former medianism
is known as projection, the latter as introjection.

The mechanism of projection is ordinarily one
of defense. That which is perceived as of exo-
psychic origin represents trends or ideas which
are painful to the conscious personality of the
individual and out of harmony with the ruling im-
pulses of the foreconscious. A completely suc-
cessful repression such as he might desire would
drive them entirely from the sphere of conscious
N. perception; projection represents an effort at re-
pression which is only partially successful. Fail-
ing to accomplish obliteration of the disagreeable
presentations, the repression does succeed in more
or less completely preventing the recognition of
ownership. The presentations are then seen as
of external origin, not as manifestations of tend-
encies of the individual himself.

A simple example of projection which borders
on the pathological is the following. One of my
patients, a widow of forty years of age suffered

PBOJECTION 157

from a mild neurosis which came on shortly after
her husband's death. At the time he died they
had been living in a suburb of New York. She
continued to live there for about a year after
her bereavement and then moved to New York,
feeling, as she explained to me later, that the
atmosphere of this small town was largely re-
sponsible for the nervousness to which she was
becoming subject. For, as she went on to say, in
a place so small every one was interested in every
one else's business and to live there meant being
continually under the microscope. She knew, she
said, that all the townspeople looked upon her as
a ^'designing widow" anxious to entrap a second
husband, and she could not speak a civil word to
a man without the feeling that she was being
watched and that everything she said or did was
certain to excite malicious comment. This sort
of thing made her extremely nervous and uncom-
fortable. It was to get away from it that she
finally moved to New York.

Without denying that small town life does ordi-
narily give some objective basis for the notions of
being watched and criticized from which this pa-
tient suffered, I early recognized that the external
facts, whatever they were, did not represent the
true cause of the patient's complaints. Her sense
of being suspected really had origin in her own
psyche. What appeared to her as thoughts of
her neighbors was really her own ideas external-
ized through the mechanism of projection. For in
a certain sense she was a designing widow and had
reason to know it. Her married life, though not

158 MOBBID FBABS AND COMPULSIONS

positively tmhappy, had not been entirely satis-
f actory^ for her husband was a very matter of fact
person and failed to satisfy her sentimental long-
ings. In spite of her loyalty to him the reflection
had on more than one occasion crossed her mind
that his decease might mean the opening of the
doors to another relationship considerably more
romantic than what she had experienced. Fur-
thermore she found that the craving for physical
sexual gratification, which annoyed her littie dur-
ing her husband's lifetime, began after his death
to be a very insistent yearning with which she
found it very difficult to deal, and not unnaturally
she looked toward a second marriage as a means
of solving this problem.

But her conscience (foreconscious) was of such
a quality as to interpose resistances against these
various wishes. She felt that loyalty to her hus-
band's memory should prevent her from enter-
taining any dreams of a second and more satisfac-
tory marriage, and that the longing for sexual in-
tercourse, at least for a woman of her age, ought
not to be a troublesome factor, that she ought
easily to be able to suppress it. Thus she re-
fused frankly to admit to herself that she really
was a ^'designing widow'' (in the sense that has
been indicated). Consequently the idea that she
was, which she could not completely repress, was
then perceived by her consciousness as something
her neighbors thought, that is to say, as a pro-
jection. Her moving to New York, which pur-
ported to be an attempt to get away from the sus-
picion and criticism of her neighbors, was really

PROJECTION 159

an effort to escape from what she thought of her-
self and, natnrallyi was imsuocessful.

A second illustration of a very common form of
projection occurred in the case of a girl of eight-
een who came to me suffering with attacks of in-
tense pain in one side of her face. Her family
physician and one or two other doctors who had
seen her were not quite certain whether these
pains were of organic origin (tic douloureux) or
psychicy that is to say, hysterical ; and she was sent
to me to have this question settled and, should the
condition prove to be one of hysteria, for analy-
tic treatment. When, after the first examination,
I intimated to the girl and to her mother that the
malady was not organic, the young woman be-
came very angry, and both to me and later to her
family expressed in no uncertain terms her very
great contempt for me in not being able to rec-
ognize an out and out organic disease when I saw
one. Nevertheless she eventually came to me for
treatment and I was finally able to establish that
her extreme emotional reaction against my view
as to the nature of her pain was essentially a
defense against the projected knowledge that I
was right.

For it appeared that these attacks of pain came
on when the young woman was indulging in erotic
day dreams, and then only; that she never had
them apart from these dreams; that they lasted
only as long as she kept on dreaming; and that
she could at any time stop them by stopping the
day dream. Thus she had every reason to know
that they were of psychic rather than of somatic

160 MOEBID FEAES AND COMPULSIONS

«

origin. She was a Catholic and she knew that
if she were to confess to the priest that she was
haying such phantasies he would tell her they
were wrong and that she must stop them, a thing
•she was unwilling to do. As a way of evading
this, her mind formed a compromise in the shape
of the pains, which served the purpose of a punish-
ment and a penance for the phantasies she re*
garded as sinful, and thus in her opinion to a
certain degree absolved her from the obligation of
confessing them and from the sin of not doing
so.

What she attacked as a manifestation of my
stupidity was really a projection of her own un-
willing knowledge that her pains were not or-
ganic.^

Another projection phenomenon displayed in
the same case is as follows. The analysis which,
once begun, proceeded for a time with fair prom-
ise of success, came to a standstill when the young
woman began to display toward me an attitude of
the most open hostility and antagonism. This
was shortly explained as having the following
origin. Her neurosis began at the time her par-
ents interfered between her and a young man in
whom she had become interested and who pro-

^ It iB not rare to find neurotic patients who very much resent
being told that their trouble is psychic. In my experience this
always means that they not only have some reason for knowing
that the condition is p^chic but that they connect it» usually
rightly, with something sexual of which they are ashamed. The
craving of the neurotic to find some physical cause for his trouble,
intestinal indigestion, eye strain, overwork, etc., is really aa
effort to find some other explanation for the neurosis than the
sexual, which he vaguely senses to be its real cause.

PROJECTION 161

fessed to want to many her. Her hostility to
me, as she herself admitted, developed when she
came to the conclusion that the reason her par-
ents sent her to me was that I might be able to
get so much influence over her as to make her
willing to give up the young man and conform to
her parents' wishes, a thing she had asserted
she never would do even if her life depended on
it. The more patient and sympathetic I was with
her and the more I professed to be quite indif-
ferent as to what she did about the young man, the
more convinced she was that this was all a scheme
on my part to get her to like and trust me so that
eventually she would be willing to give him up
to please me, and consequently she became more
and more stubborn and antagonistic.

As a matter of fact she was quite correct in feel-
ing that a strong influence was being brought to
bear upon her in the direction of making her give
in to her parents ' wishes and renounce the young
man, but she was wrong in supposing it originated
with either them or me. In reality it came from
her own mind and consisted of her own impulses
and wishes to give up the young man in order
to please her parents and continue as a dutiful
daughter. Thus the force influencing her to give
up her lover, and which she perceived as emanat-
ing from me, was really her love for her parents
and her wish to do whatever was pleasing to them.
Her antagonism against me was really an antag-
onism to that part of her own self that interfered
with her romantic intentions.*

1 It may be added that she had identified me with her father

162 MOEBID FEAES AND COMPULSIONS

It is to be noticed that in thesd and in all other
examples of projection the reaction against the
ideas projected is really a part of the resistances
cansing the projection and thus a part of the re-
pressing forces. Were it not for these resist-
aQces (these objections) to the presentation in
question, the ideas would be frankly admitted
and there would be no projection. Thus, had not
the girl just mentioned felt that there was a re-
proach contained in the assumption that her mal-
ady was of psychic origin, she would have been
relieved rather than angered that such was my
opinion of the case, or she would have honestly
recognized it herself. The phenomenon of ''the
projection of a reproach" of which these cases
are fair examples, is the basis for such common
phrases as ''A guilty conscience needs no ac-
cuser,*' "The wicked flee when no man pursueth,"
''It's only the truth that hurts'' and the like.

The most elaborate examples of projection are
furnished by paranoia or major psychoses of the
paranoid type. Detailed studies of such cases
are already to be found in the literature of psy-
choanalysis, the most noteworthy being Freud's
analysis of the Schreber case/ and shorter papers
by Ferenczi, Brill and others. I will give some
brief examples of cases approaching the paranoid
type.

A young woman student had at various times
a number of delusional attacks which invariably
began with her becoming attracted by some one

and transferred to me feelings that really belonged to him.
Matters of this sort will be diseussed shortly.

PROJECTION 163

of her professors. She would for a time talk a
great deal about him, of how able and attractive
he waSy but without intimating that she was fall-
ing in love with him. Then she would begin to
think that he was falling in love with her. This
would seem to please and amuse her at first, but
soon she would get the notion that he was hypno-
tizing her, and her pleasure would be succeeded
by anger. She would complain that through
hjrpnotic influence he was putting into her mind
all sorts of erotic phantasies about him, that
against her will he compelled her to masturbate
with him in mind, that by telepathic suggestion
he gave her impulses to come to his apartment, to
have sexual relations with him, etc., all of which
would get her into a state of great rage and excite-
ment and she would have to abandon her studies.
Thereupon the attack would gradually subside,
only to be repeated in connection with some other
teacher when she resumed her work.

It is apparent that this patient's delusional
ideas were nothing but a projection of her own
erotic interests in her teachers. What she felt
as an hypnotic or telepathic influence brought to
bear upon her froiji without was simply an ex-
temalization of her own desires. Her anger
against the. teachers represented her pathological
resistances against these desires. Presumably
had she been able to regard her sexuality in a
normal way, as something perfectly legitimate
and wholesome, what appeared as delusional at-
tacks would otherwise have been ordinary love
affairs.

164 MOEBID FEAES AND COMPULSIONS

Some years ago I learned that the father of
a girl I was treating in the dinic suffered from
the delusion that his wife was untrue to hiuL He
was madly jealous of the multitude of lovers he
supposed she possessed and kept the house in a
continual uproar with his threats and accusations.
I thought little about his condition at the time,
beyond sympathy for his family and some mild
amusement at the idea of his wife (a somber, de-
pressed and most unattractive Jewish woman well
past the menopause) in the role of a Messalina,
until there came to the clinic no less a person
than the father himself, and the basis for his de*
lusions was revealed to me. He had been im-
potent for ten years. This was the reason he
thought his wife unfaithful to him. His own
dissatisfaction at being impotent he had projected
to her. She must, he believed, be dissatisfied with
him. Then by elaborating this idea into the de-
lusion that she consoled herself with other men
he was able to reproach her in the same degree
that he imagined she privately wished to reproach
him.

Notions similar in content but somewhat dif-
ferent in origin are represented by a case of
morbid jealousy in a woman. In this case the
projected ideas did not quite reach the delusional
stage. The woman was continually suspicious
of her husband. If he displayed any ordinary
civility to another woman, she thought he was
trying to flirt. If he was late in coming home
from his office, she was persuaded that a ren-
dezvous with a chorus girl had caused his delay.

PROJECTION 165

If he informed her he was called out of town on
business, she would be convinced that this was
merely a ruse to spend a week end with 6ome one
of his paramours. The chief argument on which
she based her suspicions, which at the same time
discloses their meaning, was that her husband
rarely had intercourse with her more than once or
twice a week. If he were not untrue to her, she
felt, surely he would want intercourse more fre-
quently than that. She knew men, she said, and
no one could make her believe that anything short
of having intercourse six or seven times a week
would satisfy the creatures, and particularly such
a man as her husband.

This woman's ideas of her husband's infideUty
were really a projection of her own imperfect
sexual satisfaction. For the facts were that to
have intercourse only once or twice a week did
not give her complete relief, but left her a prey
to erotic longings in the intervals and inclined her
to have day dreams of relations with men more
passionate than her husband appeared to be.
These, however, were facts that she could not
face squarely. Her bringing up had led her to
suppose that the woman should regard intercourse
merely as a wifely duty to be submitted to with
pious resignation out of consideration for the
baser nature of the male. That a true, gentle-
woman could look upon it in any other way was
almost unthinkable. Hence, when with inter-
course once or twice a week she was incompletely
satisfied, she was caught between the two horns
of a dilemma. If she granted that this was

166 MOEBID FEAES AND COMPULSIONS

enough to satisfy man's evil natorei and that her
husband really was true to her^ this involved the
admission that she was more passionate and
therefore more evil than even the man. But if
she allowed that even a lady might need inter-
course more than once or twice a week, it then
followed that her husband, who, being a male
and therefore infinitely more sensual than the
female, must require it still of tener, which could
only mean that he was satisfying himself else-
where. She chose the latter alternative, for pain-
ful as it was to her to think her husband un-
true to her, this was less painful than would have
been the reflection that she was more erotic than
he. Had her education, and consequently her
foreconsdous, been different, so that she could
have recognized that passion in a woman is no
disgrace, she could have perceived her imperfect
sexual satisfaction directly instead of through
the roundabout route of projection, and then per-
haps, instead of pushing her husband further
away from her through her unjust accusations, she
might have rendered herself sufficiently attrac-
tive to him to bring about the satisfaction of her
sexual needs.^

1 Theie two caaes are quite typical. Undue jealouay in a man
uauallj means that he has, or thinks he has, aome d^dency of
eezual power. It means in a woman not, as many seem to think,
that she is unusually in love with her husband but rather that
she is not perfectly satisfied with him, and often, that she thinks
if he really knew her, He would not be satisfied with her. In
most patients suffering from morbid jealousy there is an over-
aixxataation of the homosexual component of the libido.

INTROJECTION 167

The mechanism known as Introjectioni is as
yC was saidy a process almost the reverse of that of
projection^ Where in the latter case the individ-
ual narrows his ego to a degree that processes
actually belonging to it are perceived as of ex-
ternal origin, in the former he broadens the self
to include within it what really belongs to other
persons or objects. Thus for example that which
happens to some other person causes him to feel
or behave as if it had happened to him instead.
This involves something more than ordinary sym-
pathy. There is a definite, though usually uncon-
scious, sense of oneness or continuity with the
other person. For this reason the phenomenon
is commonly known under the term Identification.^

The phenomena of introjection or identification
are very common and essentially normal. It is
only when carried to extremes that identification
becomes abnormal. It is for example a normal
part of love. He who loves identifies himself
with the love-object, and that person's pains or
pleasures, successes or failures, honor or disgrace
become in a measure his own. It expresses a sort
of reco^ition of this love identification when we
say of a married couple that the two have been
made one.

/

lAa we shall learn shortly, there are really two kinds of
identiflcation. The individual may identify himself with another
person, which might he called subjective or introjective ideutifica-
tion, or he may identify one person with another previously
known person, and experience feelings toward, or see qualities in,
the former that really belong to the latter. This is one of the
many forms of displacement and might be called objective identi-
fication, but is usually spoken of as Transferoice.

168 MORBID FEARS AND COMPULSIONS

We identify ourselves not only with loved per-
sons, our friends and the members of our families,
but also with things essentially impersonal or in-
animate, our possessions, our country, its em-
blems, customs, institutions, etc. Thus we have
a sense of identity with our house, our dog or
our automobile, and see in them virtues peculiar
and different from those of the houses, dogs or
automobiles belonging to other people and which,
in all tangible respects, are equal or superior to
our own.^ The resident of New York or Chicago
experiences a glow of personal pride on listening
to some comment on the greatness of his city (to
which in all probability he has not made the
slightest contribution) or the dweller in the coun-
try may feel a flash of resentment on hearing some
slur at country customs or country manners even
though he is as thoroughly sophisticated and xm-
provincial as well could be.

We have also a great tendency to identify our-
selves with people of importance who excite our
admiration but whom we do not, in any ordinary
sense, love. Such identifications usually corre-
spond to a wish fulfillment The inmate of an
insane asylum who proudly informs us that he
is Alexander the Great and conquered the world,
or that he is Jesus Christ and saved it, is merely
displaying an exaggerated form of the same kind

lA person who suffen from a feeling of inferiority may not
ahow this normal overestimation of his own poflaessiOTs, but on
the contrary project to ererjrthing that belongs to him some of
his own feelings of insuificiency, so that whatever he has never
seems to him as good as the equivalent thing possessed by some-
body else.

IDENTIFICATION 169

of identification which enables ns to find pleasure
in such a statement as that our handwriting
closely resembles ex-president Boosevelt's^ or
that our new maid was formerly in the employ of
John D. Bockef eller. Identifications of this sort
which often lead to imitation have much to do with
the rapid spread of fads or fashions when once
adopted by the great or near-great.

We may now consider some examples of iden-
tification which are taken from the domain of
the pathological, though not all of them are in
themselves abnormal.

A young woman who came to me complaining
of insomnia and a depression of two years stand-
ing, mentioned during the course of the second
visit that the night before she had dreamed of
Evelyn Nesbit Thaw. I asked her, very casually,
what she thought of Mrs. Thaw, whereupon she
at once launched upon a most vehement and pas-
sionate defense of that celebrated young woman.
Since her emotion concerning Mrs. Thaw, whom
she had never even seen, was obviously excessive,
I concluded the patient must identify herself with
her. Inasmuch as her defense had to do entirely
with the question of sexual temptations to which
that lady had been alleged to have succumbed,
I also decided that she too must have yielded to
some temptations of that character, and that such
was the basis of the identification. And this
proved actually to have been the case. The pa-
tient had been seduced two years before and this
experience was one of the chief determinants of
her state of depression. Her defense of Mrs.

170 MOEBID FEAES AND COMPULSIONS

Thaw was then in essence a defense of herself.
Several years ago I was standing on the plat-
form of an elevated railway station waiting for
a train when a doctor with whom I am acquainted
came up and spoke to me. We entered the train
together and while we were talking he noticed in
the headlines of the paper I had been reading the
statement that the Philadelphia physician, Dr.
Crippen, had just been executed in England for
the murder of his wife. My companion at once
dropped the subject which had previously engaged
us, and began to talk about the case of this un-
fortunate doctor and the impression it had made
upon him. Ordinarily, he said, he had taken no
interest in murder trials and had been completely
indifferent to the fate of the murderer, but this
case had affected him profoundly. Almost
against his will he had followed it in the papers,
continually hopiog that either the doctor would be
acquitted or at least get off with life imprison-
ment For, as he explained, it had seemed to him
that for a doctor to have to suffer the death pen-
alty, a man of education and culture and devoted
by profession to the prolonging of life, was some-
thing unspeakably horrible and unjust. If such
a man did commit murder there must surely have
been, he felt, many extenuating circumstances.
^^Who knows," he cried, rather excitedly, ''just
what sort of woman that man's wife wasf May
be he married her with the best intentions in the
world, only to find that instead of a friend and
companion he had on his hands a regular she-devil
who continually pestered him in all those sleek

IDENTIFICATION 171

and fiendish ways of which only a woman is
capable I Who Imowsf Perhaps if all the facts
came ont, the world which now blames him would
in true justice feel that his wif e, who broke no law^
really deserved death more than he!"

At this point something in my expression must
have betrayed that I involuntarily saw more
meaning in his remarks than he had expected to
convey^ for he interrupted himself to say, with a
laugh: ^'Oh, you analyst! I suppose you know
all my secrets now I Well, go ahead and tell me
what you have discovered.''

I protested with well intended mendacity that
I had discovered nothing and, as by that time the
train had reached my station, we parted. A
couple of weeks later I happened to meet the
doctor again, whereupon he said: '^I know that
the other day you suspected that everything is
not well with me, so I may as well tell you the
truth, for I really want your advice/' He then
went on to say that his wife had turned out to be
anything but the sweet and amiable companion
he had expected when he married her, but that
she was selfish and ill tempered and apparently
bent on doing everything in her power to make
him miserable and unhappy. He was profoundly
distressed, for he was very much in love with her
at the time they married, and even though that
love had considerably waned, he still could not re-
sign himself to seeing her as apparently she ac-
tually was, a thoroughly selfish, unscrupulous and
malicious woman. He had tried to be patient and
to please her in every way, feeling all the time that

172 MORBID FEAES AND COMPULSIONS

it was perhaps his fault that she behaved in such
a manneri and that if only he made more effort
or understood better how to please her, the happy
state he had imaged before their marriage might
really be brought about. On the other hand,
though he rarely complaiued to her, he was be-
coming increasingly subject to internal spasms
of rage and resentment against her and at such
times there would flash into his mind all sorts
of murderous thoughts, prayers that she might
die, images of himself choking her or smashing
her head against a wall and other phantasies of
a similar character, the like of which he had never
experienced before. It was bad enough, he f elt,
to have had to make such unpleasant discoveries
concerning his wife's character without being
compelled to add to them equally unpleasant ones
concerning his own.

It requires no further discussion to render per-
fectly dear why this doctor felt as he did over
the case of Dr. Crippen. His compulsive sym-
pathy for that unfortunate man was essentially
sympathy for himself. For on the basis of the
murderous thoughts which, in spite of himself,
his wife inspired in him, he identified himself
.with the murderer. He felt as if he too were on
trial, and his wish for the acquittal of the ac-
cused and his sense of injustice at the execution
were conditioned not by any actual facts of that
man's case but by features of his own.

It may be remarked incidentally that this case
of what appeared to be exaggerated sympathy is
quite typical of manifestations of that kind. The

IDENTIFICATION 173

person sympathized with is very frequently, as
in this case, some one with whom the sympathizer
unconsciously identifies himself and his great con*
cem is thus not so entirely altruistic as it might
at first glance seem.

Another and slightly different example of iden-
tification is as follows. I was treating a young
man for homosexuality and during the course of
one of the early visits he recalled that shortly
after puberty there was a time when his feelings
toward girls had been quite normal, but that his
mother had so vigorously opposed all his inter-
ests in the opposite sex that after a year or more
of struggle with her he finally gave in, and there-
after had only homosexual attachments. After
having lived over again during this visit the bit-
ter conflict he had had with his mother, which un-
til he spoke of it on this occasion had for the
most part faded from his mind, he remarked that
he felt this discussion meant a great step toward
recovery. He added that before he began the
treatment he had had a feeling that we would
suddenly come upon some discovery, whereupon
he would all at once be well, and he now felt that
the recollection of this warfare with his mother
was that which he had been expecting. Upon
my asking him what gave rise to this expectation,
he replied that probably it was some case that he
had read about but could not at the time recall.
Shortly we discovered that the case was one men-
tioned by Dr. A. A. Brill, of a young man who
suffered from an obsessive idea that he was only
killing time, and took all sorts of precautions in

174 MORBID FEAES AND COMPULSIONS

order never to waste a minute. From the analy-
sis of a dream Dr. Brill discovered that the fig-
ure of the old man representing Father Time was
in this patient's case a symhol for the father and
that his fear that he was killing time really rep-
resented a repressed wish to kill his f ather, which
explanation the patient accepted and the obses-
sion at once disappeared. My patient, from read-
ing this case, developed the expectation that he
too would get well in this sudden way. This
meant that he unconsciously identified himself
with Brill's patient. The basis for this identifica-
tion was the wish that his mother would die.
Such a wish was altogether foreign to his con-
scious thoughts, but existed as an unconscious one.
So when he read Brill's case the idea of its simi-
larity to his own instead of being presented to his
consciousness directly and in some such form as :
''I am like that man because I wished my mother
deoAf^ appeared as an identification phenomenon
in the shape of the expectation: ''In the analy-
sis I too will get well through a sudden discov-
ery." He felt that the discussion of the conflict
with his mother was a matter of great import,
because it tended to bring to his mind that it was
in this relation that the wish that his mother might
die mainly arose. The identification contains the
thought: ''If my mother were out of the way I
would be sexually normal," and this idea we can
accept as pretty nearly correct, if for the word
"mother" we substitute "mother's influence."

RA.TIONALIZATION 175

(d) BATIONAUZATIOK

It may have struck some of my readers that the
patients who famished the various examples of
psyehc^athological reactions which have been de-
scribed most have been singularly blind about
themselves not to recognize at least in some cases,
that these reactions were determined by their
complexes and not to realize what the reactions
meant. One might even go so far as to feel that
neurotics, if these cases represent any fair sample
of them, must be a rather stupid lot. As a mat-
ter of fact, neurotics, as a class, are rather above
the average in intelligence (compulsion neurotics
espedally), and their failure to understand them-
Belves is neither a function of a lack of intelligence
nor of the neurosis as such, but results rather from
the resistances, numerous parallels of which are
to be found in the mental lives of even the most
normal. The most well balanced people have
many peculiarities and shortcomings which are all
too apparent to their friends and acquaintances
but to which they themselves are serenely blind.
In fact it may be said with a fair degree of ac-
curacy that neurotics are less blind to the work-
ings of their own minds than are normal people, in
the sense that the neurosis represents an unsuc-
cessfid effort to become oblivious to the same
things that normal people succeed in ignoring
completely. The normal man, who feels that his
every action springs from reason rather than
from his complexes, is deceiving himself more than
does any neurotic.

176 MORBID FEAES AND COMPULSIONS

This may seem a rather mireasonable and nn-
justifiable assertion and therefore demands ex-
planation. Ask of any normal man: ^^Why did
you do that? Why do you like this? Why do
you dislike the other?" and he is pretty certain
to give you an explanation that seems plausible
and to his mind completely satisfactory. He will
not reply: ''That action or feeling came from
some of my complexes or was, I suppose, the re-
sult of something in my Unconscious and I don't
understand it myself. '* Never, practically, will
one hear such an admission, or anything that is
the equivalent of it. Our actions and feelings,
even when most illogical and wholly determined
by unconscious factors, rather than by reason and
judgment, seem to us either perfectly logical and
reasonable and determined on such a basis, or
else accidental and requiring no explanation at
all. This, as was mentioned ia the second chap-
ter, is accounted for by the fact that those reac-
tions which are determined by our complexes and
our Unconscious are almost invariably rational-
ized; that is to say, furnished with an apparently
reasonable and plausible explanation, often manu-
factured ex post facto, and which is more ac-
ceptable and agreeable to us than would be a cor-
rect understanding of the real motive forces. In
the case of intelligent neurotics these rational-
izations are often so extremely plausible that the
analyst has to be constantly on his guard lest he
himself be deceived by them and overiook the un-
conscious factors really at work.

One of my patients confessed to me that it had

EATIONAUZATION 177

always been his intention to marry a rich girl,
though as a matter of fact the girl he had mar-
ried had no money at all. Before he became en-
gaged he had taken advantage of every oppor-
tnnity to meet, and be^in the society of , rich girls,
hoping to find one that would be attractive and
at the same time willing to marry him. I felt
somewhat surprised that his devotion and indus-
try in this direction had met with so meager a
result^ and so expressed myself, whereupon he
explained that all the rich girls he had ever met
were so spoiled by their money and so utterly
selfish that no matter how rich they were he would
not marry any one of them. All of them, he said,
put clothes and dances and yachts and cars, and
aU the other things that money could buy, ahead
of love and sympathy and companionship, which,
he assured me, were to his mind the vital features
of marriage. But though I did not feel in a posi-
tion absolutely to deny that great wealth may
have a prejudicial influence upon character, the
fact remained that this man had known a great
many girls with money, and it did seem rather
unlikely that every single one of them had exactly
the same group of faults which he seemed to dis-
cover in them. His failure to carry out his in-
tention to marry a rich girl (a thing he had many
opportunities of doing) was, it appealed to me,
due in all probability not so much to the alleged
defects in the character of the young ladies, as to
certain peculiarities of his own, while the ex-
planation he offered was not the true one but a
rationalization. The real determining factor, as

178 MORBID FEARS AND COMPULSIONS

at length appeared, was his own money complex.
He felt that rich girls would be more interested in
money than in companionship because to a certain
extent he was that way himself. Since he doubted
if he could care for a girl who was not rich, he was
compelled also to doubt whether, since he was
not rich, any such girl would care for him. He
could feel sure of the love only of a girl who had
no money at all, for such a one would appreciate,
he felt, the moderate amount of money he did
have.

One of my patients was engaged before he came
to me to a rich girl and expected to be married in
about a year. He then received the news that
the parents of his intended lost all their money and
that contrary to his expectation his bride would be
penniless. He then insisted that they be mar*
ried right away. The reason that he gave for this
was the extremely convincing one that since the
girPs parents could now support her only with
difficulty, he f c^t that it was only right that he
should step in, even though at some inconvenience,
and care for her himself. The real reason was
as follows. He had known the girl only slightly
when he became engaged to her, and it was the
fact that her parents had plenty of money that
had been one of her attractions. An important
reason he married her earlier than he had ex-
pected was that he was afraid that some one
might think that now her parents had lost their
money he would want to back out of the engage-
ment, which, o^ a matter of fact, was the very

Nationalization 179

thing he did want to do, though he would not ad-
mit it even to himself.^

Another patient gave me a very lengthy and
rather logical explanation of why he was in favor
of woman suffrage. The farther course of the
analysis revealed, however, that the basic reason
for his position was his racial complex. He is a
Jew and had felt very keenly the effects of the
anti-Semitic prejudice that prevails in New York.
He sympathized with women because he, like
them, belonged to a group often regarded infer-
ior and which is denied some of the rights and
privileges that certain others may enjoy. His in-
terest in equality of the sexes was really a mani-
festation of his more intimate and personal in-
terest in equality of races.^ The reasons given
for his position were simply a rationalization.

At the time of the presidential campaign of 1916
another patient gave me a very logically formed
set of reasons why in his opinion every one should
vote for Mr. Wilson's reelection, the principal
ones being variations of the theme: '^He kept
us out of war." The real reason that this pa-
tient on all occasions took Mr. Wilson's part and
defended him and his, at that time, unwarlike
policies, was that the patient felt himself to be a
coward and afraid to fight. He really thought
Mr. Wilson beloiiged in the same category and

1 ThiB reaction is obviouBly an oyer-oompensaiion. Fortunately
the marriage turned out very well in spite of this unpromising
beginning. *

s In cases such as this the castration complex is sometimes an
important factor.

180 MOEBID FEARS AND COMPULSIONS

secretly despised him as he despised himself,
meanwhile defending and making excuses for him
as he himself wished to be defended and excused.
The perfectly plausible reasons he gave for his
approval of Mr. Wilson really had practically
nothing to do with his position in the matter but
were simply rationalizations of the attitude de-
termined by his complexes.

In the case of another patient who with the
greatest bitterness attacked the President in his
efforts to avoid war, meanwhile giving a most
plausible and reasonable explanation of why he
did this, was also displaying a purely complex-
determined reaction. This young man had quar-
reled with his family, thinking that rather than
avoid an open break with him they would give in
and do a certain thing he wanted. He sadly mis-
judged them for not only did they fail to be dis-
turbed by the prospect of a rupture, but appeared
to be totally indifferent as to his fate, after it oc-
curred, so that he not only failed to gain what he
wanted but lost many tldngs he had previously
enjoyed. Thus not only had he reason to feel that
he had made a great tactical mistake, but at the
same time he suffered from a certain sense of
guilt for the attitude he had taken. But he was
unwilling to admit to himself or to anybody else
that he had been wrong in quarreling with his
family or that there was any reason he should feel
guilty over it. Hence he was compelled to hate
Mr. Wilson or any one else who championed peace
or condemned war, for it was as if that person
were telling him in general terms what his con*

BATIONALIZATION 181

science was insisting in particular ones, namely
that peace was right and his quarreling wrong.^
I noticed that a married woman, a patient of
mine whom I had seen only four or five times,
was invariably dressed in black. I supposed she
was in mourning, though she had said nothing
about a death having occurred in the family, and
at last I asked her about it. She replied that she
was not in mourning and that the reason she wore
black was that she thought such material was more
durable. This explanation seemed to me rather
imsatisfactory, for in the first place the woman
was sufficiently well oflf not to have to be con-
cerned about the durability of her clothing, and
in the second it was summer time, when black
clothing is particularly xmcomf ortable and nobody
wears it unless there is some reason for so doing.
It later developed that her habit of dressing in
black had a symbolic significance and that her ex-

iAb familiar as I am with the frequency with which people's
opinionB on all BOrta of objective matters are determined by their
oomplezea rather than the actual merits of the case, it has been
a never failing source of surprise to me to see the extent this has
been true in r^^d to the present war and Mr. Wilson's policies.
In the case of every one of my patients, and for that matter of
aU other persons with whom I am well enough acquaints to be
able to judge of their complezesy the individual's opinion, whether
pro-German or pro«Ally, pro- Wilson or anti-Wilson, was largely
and in most instances wholly determined not by the facts known
to him with r^^rd to any one of the (juestions, but rather by
his own intimate complexes. The reasons given for his opinion,
though in many cases most plausible and convincing, proved on
close examination to be little more than rationalizations. I
doubt if any one unfamiliar with actual psychoanalytic work can
realize or believe how entirely these statements are true, not
only of neurotics, but of normal persons as well.

182 MORBID FEABS AND COMPULSIONS

planation that such clothing is more durable was
simply a rationalization of that action. She was
dissatisfied with her husband who was a rather
prosaic individual and paid little attention to her;
though as a girl she had been very popular and
liked pretty clothes and masculine admiration.
Her humdrum husband had failed to satisfy her
craving to be admired while her conscience forbade
her seeking to gratify it elsewhere. Her dressing
in black was a symbolic expression on the one hand
of her wish to be a widow and receive attention
as of old, and on the other of penitential impulses
for her guilty feeling that it was her inordinate
fondness for clothes and admiration that made her
unhappy with her husband, who in many respects
was a very considerate and worthy man.

(e) VABIOUS DEFENSE AND DISTOBTION

MECHANISMS

There are a great niany symptoms or symptom-
like formations which serve as defenses against a
sense of guilt. One of these consists in displacing
the guilt affects, which repression has failed to
prevent, to the idea of some other and lesser male*
faction than that from which- they really have
origin. Thus a patient of min^who had volun*
teered to help one of her neigi^ors in caring for a
very sick old woman, f eU asleep while watching at
the sufferer's bedside and was iti consequence half
an hour late in administeriiig a dose of medicine
that the doctor had ordered. When a few days
later the old woman died, my patient began to
reproach herself as being guilty of her death, feel-

DEFENSE MECHANISMS 183

ing that if she had given the medicine on time
it might not have occurred. This was despite the
fact that the old woman had an incurable illness
from which recovery was impossible, and that the
death occurred at just the time it had been pre-
dicted by the doctor. The guilty sense of having
caused the old woman's death really came from
another quarter. My patient was approaching
the forties without having married, a circum-
stance largely attributable to her mother's inter-
ference and tyranny, for she had rarely permitted
her daughter to have any suitors and had soon
interfered in the case of the few that did present
themselves.

The daughter had wished (even at times con-
sciously) that her mother, who was not in the
best of health, would die before it would be so
late as to place marriage out of the question.
When her mother did die, a few months before
the old woman just mentioned, my patient had a
vague sense that her evil wishes had killed her.
The guilty feelings arising in this way she was
able to keep down until, at about the time of the
death of the old woman neighbor, they were aug-
mented by the effect of a certain sexual tempta-
tion to which she was unexpectedly subjected.
Then, no longer able to suppress her sense of
guilt entirely, she partially escaped from it by
means of the displacement just described.

Another method of defense against guilt com-
plexes consists of various sorts of penitential
measures or ceremonies. The aetion of the
woman who wore black in the summer time was

184 MORBID PEAES AND COMPULSIONS

in part conditioned in this wise. Another example
is that of a salesman whose business it was to
secore advertising for a certain magazine.
Though for a time very successful at this work,
his sales at length began to fall off very con-
siderably, to such a degree, in fact, that he even-
tually lost his position. The reason for this
change was that he had become, as he expressed
it, ^^over conscientious." Instead of enthusiast-
ically explaining to the prospective advertisers
the great advantages to be expected to result from
buying space in the magazine, as at first he had
done, he would ask himself : ^ ' Now really would
this man's business profit by the kind of advertis-
ing I am supposed to sell himf " a question that
he often felt had to be answered in the negative.
On such occasions he would be impelled to advise
the prospective purchaser, against buying and
naturally made no sale. He expressed the situa-
tion to me by saying: **IVe gotten so that I
can't stand it to feel that my clients are not go-
ing to get full value received. ' '

The origin of this compulsion, for such it was
(in many instances he advised against the pur-
chases of advertising where it really would have
been of advantage to the buyer), wap from quite
another matter in his life, in which he had a much
more logical reason to feel that he was not giving
value received. He had made the acquaintance
of, and eventually seduced, a somewhat innocent-
minded and unsophisticated young girl, who,
though he had never said so in so many words, had
all along had the impression that he intended to

DEFENSE MECHANISMS 185

marry her. He had not disabused her of this
notion, for on the one haxid he wished to con-
tinue his sexual relations with her, and on the
other dreaded the storm of tears and reproaches
which he knew would be forthcoming as soon as
she knew how she had been duped. Meanwhile
he tried to excuse himself by believing that the
girl was not really as innocent as she appeared
to be and that if she was foolish enough to expect
him to marry her when he had never in so many
words promised that he would, there was nobody
to blame but herself. Failing then to give value
received in this quarter he tried to make up for
it in another, and through the falling off in his
conunissions and the eventual loss of his position,
suffered an essentially self-inflicted punishment
for the sin he really believed he was committing
in spite of all his efforts to persuade himself other-
wise.

A patient of mine who lived on the seashore
where there was an excellent bathing beach of
which nearly every one took advantage, had a
marked aversion to going into the water, in spite
of the fact that he was well able to swim. It was
not through any idea of danger, and he had almost
as much dislike of taking a cold hath in the tub
in his house. Hot water he did not mind. He
could remember a time in his childhood when he
had no such aversion, but enjoyed going in swim-
ming with the rest of the boys.

The explanation of this antipathy is to be found
in what is known as the ''Small Penis Complex.''
Little boys, of say four or five years of age, when

186 MORBID FEARS AND COMPULSIONS

passing through the period of sexual investiga-
tioiiy are often profoundly impressed with the dif-
ference in size between their own organs and
those of grown men, the older brother or the
father. From these comparisons arises a feeling
of envy and jealousy and also a sense of inf erior-
ity, and thifi forms a nucleus for a complex which
grows and persists long after the impressions
with which it started have faded from conscious
memory.

It is a common experience for a person who as
an adult revisits for the first time some place in
which he lived when a small child, to be much as-
tonished to see how much smaller are the rooms
and buildings and how much shorter are the dis-
tances, than he had remembered them. This is
paralleled in the formation of the small penis com-
plex. The memory impressions of the adult or-
gans with which the little boy first compared his
own keep in the Unconscious the original ratio
of bigness, so that despite later comparisons in
adolescence or adult life, which logically should
serve to dispel the original sense of genital infe-
riority, it nevertheless persists. It is as if these
old memory impressions, which became progres-
sively magnified through the period of growth and
so preserved their original ratio, remained as the
final criteria of comparison. Naturally the per-
son may be conscious only of the feeling pf in-
feriority and through various defenses more or
less escape awareness of the idea that this has a
genital basis. Thus the person who unconsci-
ously projects to the female his own high estima-

DEFENSE MECHANISMS 187

tion of the significance of the size of the penis is
apt to be backward with women, and to feel that
he has little sexual desire, the real reason being
that he fears revealing to the woman the (often
purely imaginary) smallness of his genitals.

This patient's aversion to swimming had some-
what this origin. Some of his early painful com-
parisons were made at the country swimming
hole where he and the rest of the youths of the
community were wont to bathe in a state of na-
ture. It did happen that he matured rather
slowly, and most of the boys of his age developed
genital hair and the other signs of sexual matur-
ity before he did. He was painfully conscious
that their organs were larger than his; and par-
ticularly so when he had been in the water, the
coldness of which caused his penis to shrink into
almost complete obscurity. As may easily be
seen, swimming or cold bathing tended in later
life to stimulate the small-penis complex through
reviving these old memories, and thus threatened
to bring into his consciousness, despite his de-
fenses, ideas and affects that were very painful
to him. As a defense his aversion or resistance
to the complex was then transferred to appear as
an aversion to bathing (i. e. to a stimulus of that
complex) a mechanism much the same as that, by
which as we shall see later, some of the symptoms
of anxiety hysteria are formed.

Another and very familiar defense against a
sense of guilt is exemplified by the common wash-
ing compulsions or ceremonials. A sense of
moral impurity or undeanness of whatever origin

188 MORBID FEARS AND COMPULSIONS

is replaced by the notion of physical tmcleanness
or defilement, which the patient then seeks to get
rid of by continual washing and scrubbing.

Even more common, though less often recog-
nized, is a certain feverish devotion to religion or
to church or charitable work. In women par-
ticularly this is a very common defense against a
sense of guilt arising from the masturbation con-
flict. Feeling herself to be **bad*' the patient de-
votes herself to those activities which because of
their nature tend to give her a feeling that she is
''good,'' which then serves as an antidote for her
inculpatory affects.

StUl another very common defense phenomenon
is that of finding fault with others for shortcom-
ings of which one is possessed oneself, though un-
willing to admit it. It is as if one were making
an effort to bring those about him down to the
same level where he feels himself to be. A num-
ber of the examples which have been given to illus-
trate other points are at the same time instances
of this mechanism. For instance the woman who
was continually accusing her husband of infidelity
was really at the same time defending herself
against the guilty sense of having been unfaith-
fid to him in her thoughts. The man who felt
that rich girls put the things that money could
buy before considerations of love and sentiment
was only accusing them of what he vaguely felt
himself also to be guilty. In the case described
in Chapter VII we shall find some excellent ex-
amples of this form of defense. I may also men-
tion one from my own personal experience. I

DEFENSE MECHANISMS 189

>

found at one time that I was becoming very im-
patient at what I was pleased in my own mind to
call the stupidity displayed by a woman I had been
analyzing for some time with very meager suc-
cess. If, for instance, I explained something to
her, and, as often was the case, she did not grasp
my meaning, or asked me to explain the thing
over again, I would feel exasperated at her dull-
ness in failing to comprehend what seemed to me
very simple. On one or two occasions when she
had made some feeble complaint to the effect that
fihe was not improving very much, I had felt an
unreasonable impulse to tell her that a person
with no brains need not expect to get well rapidly
by a method that required xmderstanding.

It is true that this patient was not remarkably
intelligent, yet, as it at length occurred to me, I
was at the same time analyzing another young
woman who was no more intelligent than she, but
toward whom I never felt irritable, and if she
asked me to repeat or clarify an explanation I did
it with complete patience and good nature. The
first patient was not, as I had sometimes told -my-
self, too stupid to be analyzed, for as I knew, once
I stopped to think of it, I had had good success
with other patients no more intelligent than she,
and in some instances her mental inferiors.
Finally I realized that the reason I felt irritated
with her, and in my own mind called her a fool,
was that the circumstances were such that she
was making me feel that I was one.

The reasons for this were as follows. She was
referred to me by a certain doctor who had never

190 MORBID FEARS AND COMPULSIONS

sent me any cases before and who I knew from con-
versations I had had with him was rather skep-
tical as to the value of psychoanalysis. He had
been rather interested in the case of this patient
and had for a long time tried to care her himself
by various physical means. I suspected that one
reason he sent her to me was that he had at last
gotten tired of her continued complainings, more
than that he had any deep faith in my being able
to do her any good. When I saw the patient for
the first time I thought the case would not be a
very difficult one, and I was malicious enough to
take pleasure in the thought that when I did cure
her, I would wind up the thoroughly good-natured
arguments I had had with him about psycho-
analysis by the triumphant statement that it had
succeeded when his methods, carried out for even
a longer time, had met with absolute failure. I
knew also that if I did succeed with this case, the
doctor in question, who has an excellent practice
among well to do people, would send me other pa-
tients, a consideration to which at that time at
least I was anything but indifferent. For these
reasons I accepted the woman for analysis even
though, as I knew, I would have to treat her for
a smaller fee than I was in the habit of charging.
But after the analysis was begun I found that the
case was really a much more difficult one than I
had expected, and that there was a certain amount
of danger that instead of my being able to report
triumphantly to my friend that I had succeeded
where he had failed and to enjoy the rewards of
this success in the shape of other patients referred

DEFENSE MECHANISMS 191

by him, he would be able to crow over me and to
say that the method I had so stoutly defended was
no better in results than his own. In addition
to this I would have to reflect that instead of my
acquaintance with this patient reacting to my
profit, in the form of new cases referred by him, I
would have nothing to compensate me for the
time I had spent on her but a fee so small as to
constitute no reward at all. Thus though all
these facts were not ever continuously before my
mind, nevertheless I had some basis for feeling
that I was a fool or had made a fool of myself,
and I could not see the patient without being, so
to speak, xmconsciously reminded of them. The
irritation I experienced was really not so much
a product of thoughts about her stupidity as about
my own. With the other patients who were
equally or even more slow of comprehension I had
felt no irritation, for there was nothing in the
situation to injure my self-esteem. I may add
that once I had faced these facts which I was in-
voluntarily trying to escape from, I was able to
dispel my sense of irritation with the woman and
to make of the analysis a fairly complete success.
A mechanism of disguise or defense which is
most commonly observed in the compulsion neuro-
sis is that by generalization. Feelings which in
the patient's consciousness are attached to a class
or group really refer in the unconscious to a spe-
cial one of its members. This is exemplified by
the case of the young woman who had an antipathy
to all blond, blue-eyed men, which was really
founded on repressed wishes concerning one par-

192 MORBID FEARS AND COMPULSIONS

tioular man of that type. The woman who was
converted to Christian Science and ''hated" aU
doctors concealed within this generalization mixed
feelings of love and resentment toward one par-
ticular member of the profession. Brill reports
the case of a Hebrew who suffered from the obses-
sive idea that the Gentiles were going to kill all
the Jews.^ This obsession had origin in a death
wish against one particular Jew, namely, the pa-
tient's father.

(f) TBANSFBBBlirOB

' Among the phenomena occurring under the
head of Displacement we became acquainted with
a form of identification which I suggested might
be called subjective or introjective identification.
This was to distinguish it from the other and even
more important variety which we might designate
as objective identification, but which we shall con-
sider xmder the more commonly used term of
Transference.

In subjective identification, as was said, the ego
is broadened to include within it other persons or
objects that are really external. In objective
identification, or transference, the individual, in-
stead of identifying external objects or persons
with himself, identifies them with each other, and
behaves or feels toward one in a way that is ap-
propriate to, and conditioned by, experiences and
impressions which really refer to the other. The
subject is usually not conscious of the existence

1 "PVychoonalyaiB''— Chapter on tlie Compulsio& KeiuoiiB.

TRANSFEEENOE 193

of the identification nor as a mle does he remem-
ber at all completely the experiences from which
the transferred feelings really arise.

To make clear what is meant by transference
I will give an instance of it from my own life. I
was at one time confronted with a very difficult
problem in my personal affairs which I soon felt
was too mnch for me to solve alone and would
necessitate my seeking some help and advice.
There were among my friends three men with
whom I was very intimate, to any one of whom I
might have gone in this emergency with every as-
surance of receiving full cooperation and most
valuable advice. Instead of doing this, I went to
a fourth man about whom, though I had some
pleasant acquaintance with him, I really knew
very little, and whom I could hardly regard as a
friend. I had in fact no logical grounds for be-
lieving that this man, whom we may call X. was
really qualified to give me the help I needed, or
that I could safely trust him with full knowledge
of the situation. I now know that I could not have
chosen a better person, yet for all the informa-
tion at my command then, he might very well have
been the worst.

When I went to him I had no realization that
I was doing a very illogical and possibly unsafe
thing. Such a possibility had not occurred to me
nor did I think there was anything peculiar in
my choosing him in place of some one of the three
other men who, under the circumstances, were
the logical persons for me to go to, until my wife

194 MORBID FEAES AND COMPULSIONS

expressed her surprise at what I had done. Then
all at once I realized how strange my choice had
been.

As soon as I asked myself the reason, it came
to my mind that during the night preceding the
day I went to see X I had had a dream in wliich
appeared certain perplexities, which, I could read-
ily see, represented the problem then confronting
me, and I called to my assistance a certain man
named T., who had been a member of the house-
hold during my childhood. It then at once be-
came dear to me why in my difficulty I had so
unhesitatingly gone for help to X For, as I
now realized for the first time, X. and T., though
of very different ages, look a great deal alike. On
the basis of this similarity in appearance I had
unconsciously identified X. with T. Consequently
I felt toward X. the sense of trust and confidence
that, on the basis of childhood experiences, I really
had reason to feel toward T. In short, I felt and
acted as if I were dealing not with the relative
stranger X. but with T., a person whom I could
logically regard as a tried and true friend. In-
cidentally it may be remarked that X. and T.,
though alike in appearance and, as I can now say,
in being equally dependable friends to me, are, in
most respects, about as unlike as two persons well
could be.

My failure to go with my problem to any one
of the three intimate friends I have mentioned
also appears to be, in part at least, the result of a
transference involving them. When as a little
boy I got into difficulties and needed some help.

TRANSPEEENCE 195

I always went by preference to T. rather than to
my father or grandfather (in whose home I spent
a large part of my boyhood) not only because I
had the greatest confidence in T. 's ability to help
me but because I was sure that he would be toler-
ant and sympathetic, as at times the others were
not. If, as was usually the case, the trouble I
got into was a result of some deviltry or mistake
of mine, T. would be just as good-natured about
helping me out of it as if I had been perfectly
blameless. With my father or grandfather, how-
ever, I ran a certain danger of being scolded and
told that if through my own fault I got into
trouble, it was only what Ivdeserved. The diflB-
culties which led me to consult X. would not have
arisen had I not made certain mistakes of a char-
acter not calculated to enhance my self-esteem.
My three friends, who were the logical persons
of whom to seek advice, as my father and grand-
father had been in my childhood, were, it so hap-
pened, the sort of persons who, whatever mis-
takes they might make, would surely have avoided
the kind which at that time was the cause of my
perplexities. In this respect I could identify them
with my father and grandfather who were entirely
superior to the deviltries responsible for most
of my childhood worries. For this reason I ex-
pected (very unjustly, I think) that my friends
would blame me for the mistakes I had made as,
without being quite ready to a^mit it, I was then
blaming myself. I projected to them my own self-
criticism, which was originally parental criticism.
My behavior and feelings throughout are thus

196 MORBID FEARS AND COMPULSIONS

seen to be a repetition of reactions carried out
many times in childhood and were conditioned al-
most entirely by experiences of the past and only
partiy by the actual facts of the present. That I
was so fortunate as to find in X an equaUy de-
pendable ally as in my boyhood T. had been was
simply a stroke of great good luck.

The point in this example to which I wish espe-
cially to call attention is that the practically com-
plete transference and identification had such a
really insignificant basis, a not even striking simi-
larity in appearance between the two men. Bat
there is nothing unique about this. Psycho-
analysis furnishes multitudes of examples of
transference of even the profoundest of feeling,
where the features common to the two persons
identified are of the most trivial character — ^the
manner of holding a cigar, the color of the hair,
some little mannerism or trick of speech, etc

That such insignificant stimuli should have at
times the power to produce such profound and
apparently disproportionate reactions seems at
first thought hardly credible, or at least without
parallel with anything else within the sphere of
our observation. Nevertheless there is a parallel
to be found (perhaps it is really the same thing)
in certain phenomena that have been observed
particularly by students of animal behavior.
Pawlow, Watson, Lashley and others,* have shown

1 Pawlow — ^^'Investigation of the Higher Nerrous Fonctions."
Watson— "The Place of the Conditioned Reflex in Pflychology"

— Peycholoffical Review, VoL XXIII, No. 2.
Lashley — ^"Human Salivary Reflex and its Use in Psychology**

— P^yohologioal Review, VoL VII, No. 6.

TRANSPEEENCB 197

that when the primary stinmlos of a motor or
secretory reflex is associated a number of times
with an indifferent stimulus, then this indifferent
stimulus alone may have the power of exciting the
whole efferent part of the reaction. Let us con-
sider an example. The sight of food is a stimulus
which normally excites the flow of gastric juice in
the dog. Now suppose that for a period a bell
is rung in a dog's hearing each time just before
food is shown him and he is fed. When at length
he has sufficiently associated this really indiffer-
ent stimulus with the appearing of the food, then
the ringing of the bell alone will be sufficient to
activate the efferent paths constituting the
^' motor pattern" and produce a pouring out of
gastric juice. This is known as a ^ ^ conditioned re-
flex." The principle holds good not only for sec-
retory reflexes but also for affective and appar-
ently for motile responses as well.

These observations that a small and indiffer-
ent part of the stimuli corresponding to an orig-
inal ^^ sensory pattern" gain through temporal as-
sociation the power of exciting the whole motor
pattern and efferent discharge are perfectly par-
alleled by and, to my mind, identical with what
in human beings we call transference. In the ex-
ample of transference I have cited, my feelings
and behavior toward X. really represented a sort
of ^^conditioned reflex." My action and my af-
fective state were really produced by the excita-
tion of an old efferent pattern marked out in my
childhood by contact with T. That which excited
this pattern was the relatively unimportant visual

198 MORBID PBAES AND COMPULSIONS

stimuli corresponding to those features in the ap-
pearance of X. which, though I was not conscious
of it, were reminiscent of T. They were thus a
small and indifferent portion of what corresponded
to the original sensory ]>attem. The fact then
that even trivial similarities may serve to produce
apparently disproportionate affective transfer-
ence is not a phenomenon really unique and with-
out parallel hut rather a manifestation of some-
thing fundamental in animal reaction.

We may now ask how and when those motor
patterns are formed which, when excited hy stim-
uli from new objects, produce the reactions called
transference. What is the source of that which is
transferred? We may answer that the most im-
portant of these patterns are formed in childhood,
usually before the end of the sixth year, and that
the first source of the affects transf erre^d is to be
found in the relations of the child to his parents
and to the other persons constituting his early en-
vironment. This brings us to a matter to which
brief reference was made in the first chapter but
which we must now take up in considerable detail,
namely the formation of those important constel-
lations known as the (Edipus and the Electra com-
plexes, as well as those usually less significant
ones which refer to the brother or sister.

To this end I can do no better than to quote di-
rectly from Freud.^ As he has boldly stated, a
sexual preference becomes active at a very early

1 The paragraphs here quoted are from Freud's ''Interpretation
of Dreams/' Chapter V. I have made some ehanges in their
original order.

TRANSFEBENCE 199

period. ^ * The boy regards the father as a rival in
love ; the girl takes the same attitude toward the
mother, a rival by getting rid of whom she can-
not but profit/'

^'Before rejecting this idea as monstrous, let
the reader consider the actual relations between
parents and children. What the requirements of
culture and piety demand of this relation must
be distinguished from what daily observation
shows us to be the fact. More than one cause for
hostile feeling is concealed within the relations
between parents and children; the conditions
necessary for the actuation of wishes which can-
not exist in the presence of the censor are most
abundantly provided. Let us dwell at first upon
the relation between father and son. I believe
that the sanctity which we have ascribed to the in-
junction of the decalogue dulls our perception of
reality. Perhaps we hardly dare to notice that
the greater part of humanity neglects to obey the
fifth commandment. In the lowest as well as in
the highest strata of human society, piety towards
parents is in the habit of receding before other
interests. The obscure reports which have come
to lis in mythology and legend from the primeval
ages of human society give us an unpleasant idea
of the power of the father and the ruthlessness
with which it was used. Kronos devours his chil-
dren as the wild boar devours the brood of the
sow; Zeus emasculates his father and takes his
place as a ruler. The more despotically the father
ruled in the ancient family, the more must the
son have taken the position of an enemy, and the

200 MOBBID FEABS AND COMPULSIONS

greater must have been his impatience, as desig-
nated successor, to obtain the mastery himself
after his father 's deaths Even in onr own middle-
class family the father is accostomed to aid the
development of the germ of hatred which nataraUy
belongs to the paternal relation by refusing the
son the disposal of his own destiny, or the means
necessary for this. A physician often has oc-
casion to notice that the son's grief at the loss
of his father cannot suppress his satisfaction at
the liberty which he has at last obtained. Every
father frantically holds on to whatever of the
sadly antiquated potestas patris still remains in
the society of to-day, and every poet who, like Ib-
sen, puts the ancient strife between the father and
son in the foreground of his jSction is sure of his
effect. The causes of conflict between mother and
daughter arise when the daughter grows up and
finds a guardian in her mother, while she desires
sexual freedom, and when, on the other hand, the
mother has been warned by the budding beauty
of her daughter that the time has come for her
to renounce sexual claims. All these conditions
are notorious and open to every one's inspec-
tion." ^

iH. G. Welle in ''Ann Veronica" lias given ezpreesion to the
father complex in the following words of hie character Gapes:
"1 don't believe there is any strong natural aJffection between
parents and growing up children. There was not, I know, be-
tween myself and my father — ^I bored him. I hated him. I
suppose that shocks one's ideas. It is trua There are senti*
mental and traditional deferences and reverences, I know, be-
tween father and son, but that is just e3cactly what prevents the
developing of an easy friendship. Father-worehiping sons are
abnormal — ^and they are no good. . . ."

TRANSFEEENCE 201

'^It is found that the sexual wishes of the child
(in so far as they deserve this designation in their
embryonic state) awaken at a very early period,
and that the first inclinations of the girl are di-
rected towards the father, and the first childish
cravings of the boy towards the mother. The
father thus becomes an annoying competitor for
the boy, as the mother does for the girl, smd we
have already shown in the case of brothers and
sisters how little it takes for this feeling to lead
the child to the death-wish. Sexual selection, as a
rule, early becomes evident in the parents; it is
a natural tendency for the father to indulge the
little daughter, and for the mother to take the
part of the sons, while both work earnestly for the
education of the little ones when the magic of sex
does not prejudice their judgment. The child is
very well aware of any partiality, and resists that
member of the parental couple who discourages it.
To find love in a grown up person is for the child
not only the satisfaction of a particular craving,
but also means that the child's will is to be yielded
to in other respects. Thus the child obeys its own
sexual impulse, and at the same time reenforces
the feeling which proceeds from the parents, if it
makes a selection among the parents that cor-
responds to theirs.

^^Most of the signs of Hiese infantile inclinations
are usually overlooked ; some of them may be ob-
served even after the first years of childhood.
An eight-year-old girl of my acquaintance, when
her mother is called from the table, takes advan-
tage of the opportunity to proclaim herself her

202 MOEBID FEAES AND COMPULSIONS

snocessor. ^Now I shall be Mamma; Charles,
do you want some more vegetables! Have some,
I beg you/ etc. A particularly gifted and viva-
cious girl not yet four years old, with whom this
bit of child psychology is unusually transparent,
says outright: ^Now mother can go away; then
father must marry me and I shall be his wife.'
Nor does this wish by any means exclude from
child life the possibility that the child may love
her mother affectionately. If the little boy is al-
lowed to sleep at his mother's side whenever his
father goes on a journey, and if after his father's
return he must go back to the nursery to a person
whom he likes far less, the wish may be easily ac-
tuated that his father may always be absent, in
order that he may keep his place next to his dear,
beautiful mamma; and the father's death is ob-
viously a means for the attainment of this wish;
for the child's experience has taught him that
^dead' folks, like grandpa, for example, are al-
ways absent ; they never return.

^^ Being dead means for the child, which has
been spared the scenes of suffering previous to
dying, the same as ^ being gone,' not disturbing
the survivors any more. The child does not dis-
tinguish the manner and means by which this ab-
sence is brought about, whether by traveling, es-
trangement or death."

Feelings of hostility and death-wishes are in-
spired not only by the parent of the opposite sex
but in the relation of children to their brothers
and sisters. Freud goes on to say: **I do not
know why we presuppose that it (the relation of

TRANSFERENCE 203

brothers and sisters ), must be a loving one, since
examples of brotherly and sisterly enmity among
adults force themselves upon every one's experi-
encCy and since we so often know that his estrange-
ment originated even during childhood or has
always existed. But many grown up people, who
to-day are tenderly attached to their brothers and
sisters and stand by them, have lived with them
during childhood in ahnost uninterrupted hostil-
ity. The older child has ill-treated the younger,
slandered it and deprived it of its toys; the
younger has been consumed by helpless fury
against the elder, has envied it and feared it, or its
jSrst impulse towards liberty and first feelings of
injustice have been directed against the oppressor.
The parents say that the children do not agree,
and caonot find the reason for it. It is not diffi-
cult to see that the character even of a well-be-
haved child is not what we wish to find in a grown
up person. The child is absolutely egotistical;
it feels its wants acutely and strives remorselessly
to satisfy them, especially with its competitors,
other children, and in the first instance with its
brothers and sisters. For doing this we do not
call the child wicked, we call it naughty ; it is not
responsible for its evil deeds either in our judg-
ment or in the eyes of the penal law. And this is
justifiably so ; for we may expect that within this
very period of life which we call childhood, altru-
istic impulses and morality will come to life in the
little egotist, and that, in the words of Meynert,
a secondary ego will overlay and restrain the
primary one. It is true that morality does not

204 MOBBID FEABS AND COMPULSIONS

develop simnltaneotisly in all departments^ and
furthermore, the duration of the unmoral period
of childhood is of different length in different in-
dividuals. In cases where the development of
this morality fails to appear, we are pleased to
talk about degeneration; they are obviously cases
of arrested development.

'^Many persons, then, who love their brothers
and sisters, and who would feel bereaved by their
decease, have evil wishes towards them from earl-
ier times in their unconscious, which are capable
of being realized in the dream. It is particularly
interesting to observe little children up to three
years old in their attitude towards their brothers
and sisters. So far the child has been the only
one ; he is now informed that the stork has brought
a new child. The younger surveys the arrival,
and then expresses his opinion decidedly: 'The
stork had better take it back again.''

'^I subscribe in all seriousness to the opinion
that the child knows enough to calculate the dis-
advantage it has to expect on account of the new-
comer. I know in the case of a lady of my ac«
quaintance who agrees very well with a sister four
years younger than herself, that she responded
to the news of her younger sister's arrival with
the following words; *But I sha'n't give her my
red cap anyway.' If the child comes to this
realization only at a later time, its enmity will be
aroused at that point. I know of a case where a
girl, not yet three years old, tried to strangle a
suckling in the cradle, because its continued pres-
ence, she suspected, boded her no good. Children

TBANSPEEENCE 205

are capable of envy at this time of life in all its
intensity and distinctness. Again, perhaps, the
little brother or sister has really soon disap-
peared; the child has again drawn the entire af-
fection of the household to itself, and then a new
child is sent by the stork ; is it then unnatural for
the favorite to wish that the new competitor may
have the same fate as the earlier one, in order that
he may be treated as well as he was before during
the interval! Of course this attitude of the child
toward the young infant is under normal circum-
stances a simple function of the difference of age^
After a certaia time the maternal instincts of the
girl will be excited towards the helpless new-bom
child.

<< Feelings of enmity towards brothers and sis-
ters must occur more frequently during the age of
chilhood than is noted by the dull observation of
adults/'*

1 Before going any farther let us be perfectly clear about what
Freud does not mean by the above quoted remarks. He does not
mean that the CEdipus complex ccmsiBts, as some seem to think,
merely of a wish on the part of the four or five year old boy to
have intercourse with his mother. As a rule, boys of that age
do not know that intercourse exists and (except out of curiosity
or a desire to experience everything the father experienced) prob-
ably would not greatly care for it if they did know. There are,
however, cases of more or less marked sexual precocity which
present exceptions to this rule, but a strong desire for intercourse
for its own sake belongs not to the infantile but to the adult
sexuality, and does not appear as a dominant impulse until the
primacy of the genital zone is established and the sexual synthe*
sis is fairly complete. The dreams or phantasies of intercourse
with the mother (oonsdous day phantasies of this character are
by no means uncommon about the time of puberty and in many
instances for some time after) are not manifestations of the

206 MORBID FEABS AND COMPULSIONS

In these ways, through repeated excitations and
discharges, certain reaction patterns are formed
corresponding to each one of the persons impor-
tant in the child's environment. They are well
defined and more or less permanently fixed by
about the time of the beginning of the latency
period and before the end of the sixth year.
Their form or content depends not only on the
nature of the impressions received from the per-
sons constituting the infantile environment but
also upon the child's constitutional make-up.
These patterns the individual carries with him
throughout life and in larger or smaller measure
they serve to determine the form or quality of
his reactions to all succeeding persons. He has a
tendency to repeat in all later contacts the modes
of reacting represented by the primary efferent
patterns. His feeling or attitude to any new per-
son is in part determined independently of the

CEdipuB complex in the infantile fonn but with the addition of
new contributions from the beginning adult aextiality.

In the second place Freud does not mean, as again many have
seemed to think, that the little boy's feeling toward the father
or the other children felt as rivals is all hostile. 6uch a state of
affairs almost never exists. There is always (at least in my
experience) love mixed with the hostility, no matter how great
the latter may be, and in many instances the degree of love ex-
isting alongside the hate or jealousy is of no mean proportions.
Furthermore, it should not be understood that a hostility existing
toward a parent in childhood is never to be replaced by love in
later years. In childhood the father and the father-imago are
essentially one. In later life they may not coincide at alL The
real fathi^ may thus be loved while the father-imago remains
invested with the fuU measure of infantile hate. Mutat%9
mutamdU the same may be said In regard to the mother^imago
and mother love.

TBANSFEEENCE 207

actual sum of peculiarities or total make-up of
this person, but is also partly determined by that
Ofne of the original sensory patterns with which
the stimuli proceeding from this person happen
to coincide.

The extent to which the individual's later reac-
tions follow the old patterns and the degree to
which these patterns are modified or added to by
new impressions and experiences varies a good
deal with different individuals. It may be said,
however, that those of neurotic predisposition and
those who, after attaining adolescence are kept by
objective or other conditions longest under the
influence of the family, have the greatest tend-
ency to repeat in their feelings and behavior the
infantile modes of reacting and to retain the orig-
inal efferent patterns in the least modified form.

To express some of this in more strictly psy-
choanalytic terms,^ there is formed in childhood an
^^ Imago" corresponding to each one of the per-
sons of the family, and these imagines, which rep-
resent a precipitate of a large group of emotion-
ally toned experiences, are permanently retained
by the individual in the Unconscious. Upon each
one is fixed a varying amount of the libido (hostile

1 1 hope I need not apologize for borrowing certain terms from
the behaviorists to express strictly psychoanalytic ideas. It is
to the behaviorists rather than to the ''orthodox" psychologists,
that psychoanalysis will, it seems to me, look for help and co-
operation in the future, and I would like to see the terminology
of the two schools interchangeable as far as possible. The most
understanding and valuable contribution to psychoanalytic litera-
ture yet made by a member of another school is from a be-
haviorist, Prof. £. B. Holt. (''The Freudian Wish.")

. ■ »■«■

208 MORBID PEARS AND COMPULSIONS

or tender) which is not actually applied to reality,
and this tends to become transferred (temporarily
or permanently) to those persons of later life who
can be fitted into the infantile imago, and in such
connection to discharge itself in repetitions of
the corresponding infantile reactions in so far as
subjective inhibitions and external circumstances
will permit Thus a man who as a child hated his
father tends in later life to hate in like manner
those persons, say his employers, who have some
features in common with the unconscious father-
imago, often when these features are of them-
selves indifferent ones, and neither they nor any
others give logical grounds for hate. In the same
way he chooses his love-objects after the model of
the mother. The more dosely a woman tends to
coincide with the unconscious mother imago the
more is she likely to be loved, while toward those
who fail to reciJl the adored parent he tends to
remain cold.

It should perhaps be said that the unconscious
imago of father, mother, sister or brother is not
necessarily an accurate picture of the person in
question. On the contrary it is usually a very un-
true one, as might be expected. The real mother
is seldom as angelic or as beautiful as the boy
of five thinks her, nor the father the cruel and
powerful tyrant he can appear in his son's eyes.
But the fact that in his later years the boy may
clearly see that his mother is not an angel nor his
father an enemy does not prevent him from re-
taining in the Unconscious the quite unaltered par-

TEANSFEEENOE 209

ental imagines formed in early years. Thus it is
quite possible for a person to be displaying hostile
reactions to surrogates for the father (persons un-
consciously identified with the father imago) while
with the real father he is the best of friends.* In
the normal course of things the QSdipus (or Elec*
tra) attitude toward the real parents, which has
experienced an amelioration or apparent disap-
pearance during the latency period, is to some ex-
tent restored for a time with the onset of sexual
maturity, but then, as the adolescent gradually
transfers his libido to objects outside the fanuly,
it ceases to exist as such, even though in the most
normal the influence of the parental imagines al-
ways continues to play an important role. In
neurotics the infantile attitude may be kept up
toward the real parents, even consciously, but in
any event the amount of libido fixed upon the
parental imagines in the Unconscious (as distin-
guished from that which is applied to real objects
in the external world) is with them dispropor-
tionately very large. The fact that in the Uncon-
scious the infantile attitude to the parents or their
•surrogates persists indefinitely is in line with

1 Such statements as that a patient '^tes his father^ or "is
in lore with his mother" have been used rather carelessly by
some psychoanalytio writers when it was not the real father or
mother but the parental imago that was meant. Of course cases
in which the patient in every sense of the word hates the real
father or is in love with the real mother are not at all uncommon,
but this does not justify us in failing to distinguish in our re-
ports whether it is the real parent or the distorted subjective
conception of the parent (the parental imago) which in any given
case is hated or loved.

210 MORBID FEARS AND COMPULSIONS

what was said in the first chapter in regard to
the processes of the Unconscious being nnoriented
as to time and reality.

Imagines of later persons as well as those of
the infantile environment may also be formed and
retained in the Unconscious as the basis for still
other identifications and transferences. For ex-
ample, as described in Freud's ^'Bruchstiicke einer
Hysterie Analyse" (Sammlung kleiner Schriften
zur Neurosenlehre, Bd. 11) his patient Dora iden-
tified Freud with Herr K., the man she had loved,
and applied to the former certain sentimental
and revengeful impulses which really referred
to the latter. In succeeding chapters of the pres-
ent book we shall meet with similar examples, for
instance in the case of Miss S. (Chapter IX) and
in the case of Stella (Chapter VII). It may be
said, however, that, as a general if not always
demonstrable fact, these transferences from one
to another person of adult life are really in the
last analysis transferences from the infantile im-
agines. Thus, had the work been carried far
enough, it might have been dearly revealed that
Dora's love and revenge impulses for Herr K.
which she transferred to Freud, had earlier been
similar feelings for her father which she had
transferred to Herr K.

In regard to the fidelity which our reactions
bear to early impressions it might be said that
we resemble certain primitive races such as the
Bushmen of Australia, who have practically no
abstract words or ideas. In place of such a word
as hard the savage thinks like a stone; long is

MOTHER COMPLEX 211

Wee a fiver; blue is like the sky. In the same way,
to our unconscious thinking, Miss Jones is not
beautifid, amiable or sympathetic, nor Mr. Smith
overbearing, quick tempered or in the way, but
like Mother, like Father, or like brother or sister,
as the case may be. But in a certain sense neu-
rotics, and to a less extent all of us, exceed the
limits indicated by this feature of savage thought
and language. The savage's idea of a path
which is long may be like a river but he does not
act toward the path as if it were a river, and,
for instance, try to swim in it. Yet the qualities
such as beauty in a woman or overbearingnesd in
a man which to the Unconscious are like Mother
or like Father, lead us, within certain limits, to
feel, and even to act, as if the case were not one
merely of like but, more or less completely, of is.
For exampje, a wealthy yoxmg man became in-
fatuated with a divorcee considerably older than
himself, who, as was clearly apparent to every
one but him, was a thoroughly unscrupulous ad-
venturess. But in his eyes she was the purest,
truest and best of all women. His friends who
tried to save him from her clutches by bringing
forth evidence from her past record or present
behavior to show that she was absolutely mercen-
ary, were to his mind but slanderers made malici-
ous through envy of his love. He confided to
her all his intimate affairs, allowed her to ex-
tract large sums of money from him on the flimsi-
est of pretexts, and put himself absolutely in her
power with childlike trust in her being heart and
Boul devoted to him. The explanation is that

212 MORBID FEARS AND COMPULSIONS

certain features of this woman, her being older,
having belonged to another, her treating him like
a small boy, these, together with some vagae
similarities in appearance, caused an nnconsdons
identification with his mother {a, sense not merely
of i^ like but of t^), whereupon the whole motor
pattern corresponding to the mother-imago was
brought into play, and he experienced toward her
all the feelings of love, trust, and devotion which
had been felt toward the actual mother, but which,
as any one but himself could clearly see, were
pitifully inappropriate here.

Reactions from the father complex are exem-
plified in the case of a male patient, an able and
fairly successful professional man, of consider-
able wealth and social standing, who complained
of often being overawed by persons who, in many
cases his reason told him, were really beneath
him. If a loud voiced aggressive man made a
statement, the patient was impelled to agree with
him, even when he knew the other to be wrong.
When a street-car conductor would shout roughly :
**Move up forward I'* he would feel constrained,
instantly to obey, even while he realized that per-
haps nobody else in the car was paying the slight-
est attention. Once when on going to a hotel he
found the room assigned to him was almost unin-
habitable, and he went to the clerk to protest, that
individual's somewhat cold and insolent glance so
overcame him that he instantly abandoned his
purpose and asked for some postage stamps. An
agent was able to sell him a rather large policy of
life insurance, which he had not the slightest de-

FATHEE COMPLEX 213

sire to purchase, because the man had such a com-
manding presence and authoritative manner that
the patient lacked the courage to say No. These
are only a few of a great many instances of a
similar nature, which even went so far that on
one occasion he caught himself saying '^Yes, Sir"
to a waiter whose severe coxmtenance and for-
bidding mien had half consciously impressed
him. T^th persons more logically deserving of
respect he was equally, if less conspicuously, un-
assertive. Meanwhile he hated those persons who
overawed him, and hated himself for being unable
to prevent it.

The significance of these reactions is of course
quite simple. Indications of authoritativeness,
dictatorialness, sternness or severity in another
man (especially an older man) produced an iden-
tification with the father and caused a transfer-
ence-reaction in the shape of the mixed feelings
of submissiveness, fear and obedience, and the
less clearly perceived ones of hate, rebellion and
antagonism, which were appropriate to the father
alone. The rough order of the street-car conduc-
tor or the forbidding countenance of the waiter
which should at most have only served as a re-
minder of the father (an i^ like reaction), instead
activated the whole motor pattern corresponding
to the father and resulted in a reaction of identity.

The feelings belonging to the father complex
may be transferred not only to logical surrogates
for the father (the teacher, employer or any other
person in authority) but likewise are capable of
being brought into play by essentially impersonal

2U MORBID FEABS AND COMPULSIONS

things. As in the life of the little boy restraint,
control and punishment are ordinarily repre-
sented by the father, thus whatever in later life
restrains, prohibits or threatens ill consequences
may be xmconsciously identified with the father.
Thus what was primarily the rebellion of the boy
against his father's authority may in later years
be directed to religion, the law, convention, etc,
and the person so becomes an active atheist, an-
archist or railer at conventional restraints. Or if
over-compensations have developed, he may dis-
play the other extremes of religious fanaticism,
over-conscientious and scrupulous obedience to
every sort of code, standard or prohibition, or of
great devotion to the state or ruler. One of my
patients who belonged in the category of compen-
satory over-conscientiousness well described him-
self by saying: '^I have always been so afraid
of doing something wrong that I have never yet
done anything righf ^

Other examples of objective identification and
transference are as follows. A patient who suf-
fered at times from psychic impotence and who as
a rule seemed to care little for women, was most

iThe cases we have cited to illustrate other points ooatain
instances of transference. For example the girl suflPering with
a pain in her face had identified me with her parents (really
with her father) and her antagonism to me (corresponding to
the notion that I was desirous of breaking up her lore affair)
was a transference of the similar feeling she had had for her
father. Underneath her antagonism was the affectionate trans-
ference, originally the wish to do what he wished in order to
please him. The example of the man who would not submit to
the tyranny of time-tables shows a different iraasferenoe from
the father.

MOTHER COMPLEX 215

attracted by comparatively ignorant servant girls
or nurse maids older than himself, and as a role
only by those who were very thin and dark. His
only serious love affairs were with such women,
and in these relations he was completely potent
His preference for women of this type was espe-
cially striking, since he had always lived in most
refined surroxmdings and was a man of xmusual
intelligence and culture — ^in short, one who would
be expected to find congenial only women who
possessed cultural and educational attainments
comparable to his own. But such women, though
he was perfectly capable of experiencing the great-
est admiration, respect and liking for them, never
aroused in him any sensual emotion or desire for
physical contact and caresses. One peculiarity
of his attachment to the women who did sensually
attract him was that he was very jealous, not of
grown men, but of the children xmder their care,
and quite xmreasonably suspected that some sort
of sexual practices were going on.

The peculiarities of this patient's attitude to-
ward women is readily explained on the basis of
identification and transference. The patient was
the oldest of several children. He had been the
favorite of his mother, a woman of great force and
brilliance, as well as exceptional culture and refine-
ment, who had lavished upon him the wealth of
affection she was unable to bestow upon her quar-
relsome and alcoholic husband. The patient was
attached to his mother most deeply, and regarded
her a« the most wonderful, pure and angelic of
all the women that had ever lived. When he

216 MORBID FBABS AND COMPULSIONS

was about five years old his mother was away for
some months, leaving her children in the charge
of a nurse who had for a long period been in the
employ of the family. This nurse began the prac-
tice of having one of the children sleep with her,
usually the patient, but sometimes one of the other
children. He awoke one morning before she did,
and finding that the bed covers were thrown back
so she was partially exposed, he began a cautious
investigation of her genitals, in the midst of
which she woke up and discovered him. Instead
of scolding him, as his mother had done when on
certain occasions he had displayed some sexual
curiosity, the nurse laughed and kissed him, and
then exposing herself still further encouraged him
to go on with his investigations. After this nearly
every morning she would play with his genitals,
often taking them in her mouth, and would en-
courage him to look at and handle hers. He took
no little pleasure in this, and in the affection and
petting he now received from her; and on those
occasions when she took one of the other children
to sleep with her, he was mad with jealousy, fear-
ing that she might carry on with the others the
same practices he wished to be reserved for him.
The morning sexual play continued until after
his mother's return, when she somehow discov-
ered it, and, in an extremity of rage and horror,
turned the nurse out of the house. Her vehement
expressions of disgust and the attitude of shrink-
ing and aversion which she for some time dis-
played toward her small son, gave him the im-
pression that what had taken place was unspeak-

MOTHER COMPLEX 217

ably evil, and that both he and the nurse were
somehow contaminated for life. This very per-
ceptible change in his mother's attitude toward
him caused him the most acute and profound dis-
tress.

These events, the memory of which had in large
measure faded from his mind, to be recalled or
reconstructed as here given only in the course of
the analysis, were mainly instrumental in determ-
ining the peculiarities of his adult love life. The
nurse was a thin and very dark woman. Those
nurses or servants with whom the patient fell in
love and experienced full sexual attraction were
persons whom he unconsciously identified with
her on the basis of similarity of appearance and
social level. These external similarities caused,
him xmthinkingly to expect a total similarity,
which included a willingness to participate in
about the same sort of sexual experiences he had
known from his childhood.^

But while he tended to identify nurses and serv-
ants with the ''bad" nurse of his childhood and be-
cause of their real or fancied badness to feel com-
paratively free sexually with them, the superior
type of woman, who showed signs of refinement
and culture, he identified instead with his mother,
who had been horrified at what took place with
the nurse and whom he considered immaculate and
far above such base interests as those of sex. To

1 He was beet gatisfied when in bis relations witli these women
the earlier practices were reproduced, perferring them to inter-
oourse, though often feeling some hesitation in statii^ thia
preference.

218 MORBID FEAES AND COMPULSIONS

think of sexuality in connection with such women
was to his mind a sacrilege, while in addition there
existed the unconscious expectation that they
would be horrified and disgusted by any display
of erotic tendencies on his part as, in his childhood,
his mother had been. For this reason he could
love them only the **pure'' way he had loved his
mother. His sensual lon^gs were inhibited by
anything in them reminiscent of her and he was
impotent in consequence.

With these examples we may be prepared for
the mention of another and most important as-
pect of the question of transference, which we have
not yet considered, namely the transference to
the physician which occurs in every analysis.
Many have seemed to think that this transference
consists in little more than the development in
women of love wishes for the doctor. But the
case is not so simple. Any conceivable sort of
impulse or feeling that the patient has previously
experienced may be transferred to the analyst,
irrespective of his age, sex, personality or any
other external factor. The patient may, in other
words, unconsciously identify the analyst with
any previously known person of either sex, and
feel or act toward him accordingly. The trans-
ference is never love or hate alone, but always a
mixture of both sorts of feeling, though one may
predominate and for a time obscure the other.
For this reason we distinguish the "positive" (af-
fectionate) from the "negative" or hostile trans-
ference.

Because of the nature of the relationship the

TEANSFEEENCE 219

doctor (if a man) is most commonly identified
with the father and consequently the feelings
transferred are in women predominantly love
wishes and in men hostile ones, envy, jealousy,
etc But this is not invariably so. The doctor
may be identified with brother, mother or sister
(despite difference in sex) or with persons be-
longing to the patient's adolescent or adult life.
He may at one time be identified with one person,
and later with quite another.

The transference which occurs in the analysis
is not created, but merely uncovered, by it. Pa-
tients carry on the same transferences with other
physicians under different therapeutic regimes,
and to just the same degree. The transference to
the physician is simply one phase of the neurotic's
^'passion for transference" generally, and finds
expression in every contact of life.*

There is no analysis in which transference does
not occur and in which it is not of vital impor-
tance. Its proper handling is the most difficult
but the most vital part of psychoanalysis. In the
clinical chapters we shall deal with examples of
such transference.

iSee Ferenczi: Intro jection and Transference, Chapter II of
liis "ContrilmtionB to PsychoanalyBis."

CHAPTJBB V

THB HEUBOBIB AS A WHOLB

ANETJBOSIS, espedallj when it suddenly
breaks out in a person previonslj in
seeming good health, has the appearance
of something bizarre, foreign and devoid of aU
eontinnity with the rest of the individual's men-
tal life. No data within the reach of his con-
sdousness serve satisfactorily to explidn its ad-
vent or its 'meaning, or to connect it with the
main trends of his ordinary thought. The mal-
ady appears not to be of endopsychic origin, but
more as if the mind had been invaded by a strange
something which, like an infectious disease or a
demoniac possession, would have origin primarily
from without.

The seeming discontinuity between the neuro-
sis and the rest of the individual's personality
and psychic life is not real but only apparent. It
is conditioned by the fact that the malady has
origin in trends which are unknown to the patient,
rather than in those whose existence he realizes.
As soon as these unconscious processes are known
it is easy to see that there is a continuity between
the neurotic symptoms and all other elements of
the patient's mental life — a continuity which is
everywhere complete. The neurosis is neither an
invasion of the personality by something f oreigUi

220

FAILUEE OF EEPEESSION 221

nor a neoplastic excrescence which develops on its
snrf ace, leaving the underlying strata unchanged,
but rather a composite expression of its totality,
an extract which contains something of all its
vital constituents.
^ The necessary condition for the processes of

the Unconscious to manifest themselves in this
abnormal way (as neurotic symptoms) is a fail-
ure of repression. The efferent avenues to dis-
charge as affeotivity or action are normally xm-
der the control of the f oreconsdous and conscious
systems. Only those trends come to expression
which are in accord with their specifications and
are passed by their censorship. When a neurosis
comes into existence it means that the sway of
these normally ruling forces has in some degree
been broken tiirough. The trends of the Uncon-
scious which in this way come to the surface as
symptoms are not necessarily greatly different
from what a normal person would possess. The
essential pathologic feature is the failure of the
repression. Thus an outlet is gained by forces
which in the normal would either be repressed
completely or their energy diverted to paths of
discharge which presented no conflict with the
ruling trends residing in the f oreconscious. The
content of the Unconscious in both normal and
neurotic is qualitatively about the same.

The failure of repression which allows the Un-
conscious to manifest itself in what we know as
symptoms is, however, in the neurosis, never com-
plete. The repressing forces are not overthrown
en masse (as in certaia forms of psychosis) nor do

222 MORBID PEAES AND COMPULSIONS

those of the TJnconscions gain full license to ex-
press themselves. The failure of repression is
only a partial one. To some degree the repress-
ing forces give in to the repressed, and the re-
pressed to the repressing. The result, the neuro-
sis and its symptoms, is thus a sort of comprom-
ise brought about by mutual concessions on the
part of forces which actually are at war.

While the repressing trends sacrifice something
in allowing to the repressed any manifestation
at all, they in their turn make a reciprocal sacri-
fice in the form of limitations as to the modes in
which they are to be expressed. Though allowed
some expression they are restricted to such varie-
ties as appear to conform with the censorship
and show no open disharmony with the individ-
ual's ethico-esthetic feelings and his ego-ideal.
Trends really incompatible with the superior
strata of the personality and which a perfect re-
pression would exclude, now secure representation
in consciousness under the condition that they be
so disguised and distorted that their true mean-
ing is not revealed. The neurotic symptoms, like
the dream, are then manifestations of the Uncon-
scious, accomplished by means indirect, menda-
cious, and equivocal. The qualities of the symp-
toms are neither wholly those of the Unconscious,
nor wholly those of the higher systems, but in
varying degree partake of the nature of both.

As we know, the Unconscious can only wish.
It has no other energy than conative tensions ; its
active content is aU desire. The forces which
break through the repression and supply the mo-

SEXUAL FACTOR 223

tive power for the neurotic symptoms are wishes
of the Unconscious. The symptoms (again like
the dream), are an attempted realization of one or
more unconscious wishes. But we can say some-
thing about the nature of these wishes. '^ Ac-
cording to a rule which I had always found sub-
stantiated," writes Freud, 'Hhe symptom signifies
the representation (realization) of a phantasy
with a sexual content, and so a sexual situation. I
might better say, at least one of the meanings of
a symptom corresponds to the realization of a
sexual phantasy, while for the other meanings
there is no such limitation of content.''^ The
wishes which the symptoms attempt to realize, in
other words, belong in the main to the holophilic
instinct.

Statements of this sort have excited a great deal
of opposition. Why, many have asked, must the
central factor of the neurosis be a sexual one?
Why cannot conflicts between non-sexual wishes
produce symptoms? Why may not cases occur
in which the sex factor plays no important part?

I do not know that these questions really have
to be answered. The essential matter at present
is not so much why the sexual factor is the central
one in the neurosis but that it is. Freud's state-
ments are based on empirical observation, not on
theoretical speculation. I am well aware that cer-
tain individuals have published reports of cases
in which, they assert, the sexual factor was ab-
sent, and that all the symptoms were to be ex-

1 "Bruchgtlick einer Hyvterienanalyae/' Samml. kl. Schr. c.
Neuroienl. II.

224 MORBID FEARS AND COMPULSIONS

plained on other grounds. Bat there are no real
\ exceptions to Freud's rule. I do not hesitate to
assert that the sexual factor was present in these
> cases but that the observer failed to see it. This
is evident ordinarily from the reports themselves.
For on the one hand they show the sexual ele-
ment present in some veiled f orm, and on the other
that the observer was totally ignorant of the
means (and often of the need) of overcoming the
patient's resistances in order to allow this factor
to come to clear expression.

No one would be so absurd as to assert that per^
sons exist who have no sexual instinct at all.
The most frigid woman has a sexual instinct, even
granting (what is most unlikely) that she has not
and never did have any conscious sexual feelings.
And if she has a sexual instinct, it must play some
part in her mental life, even supposing (another
impossible state of affairs) that it is wholly con-
fined to the Unconscious. In the face of the num-
berless observations which found the sexual fac-
tor present and dominant in the neurosis, the
only sort of case report that should have any
weight against Freud's statement would be one
which not only connected^ the symptoms with ex-
clusively non-sexual factors, but at the same time
traced the sexual instinct through all its ramifica-
tions and shqwed what it was doing and how it did
manifest itself. Nobody has ever done this or
apparently ^ver attempted it. Those who assert
that the symptoms in their cases were of non-
sexual origin tell us nothing of how the sex im-
pulses were disposed of in these patients. With

SEXUAL FACTOR 225

a force so subtle, so pervasive and so wide in its
radiations as the sex instinct no one should trust
himself to say where it isn% unless he knows in
fullest detail where it is.

My own experience is that the sexual factor
comes to expression in every analysis almost at
once — ^usually within the first two or three visits.
And I am sure that for this result no special tech-
nique or dexfterities are required ; about all that is
necessary being to let the patient talk. On the
other hand there is something required of the
analyst. Neurotic patients are quick to sense
what sort of impression they are making. And
if the doctor is himself tied up with sexual re-
sistances and repressions, so that he cannot look
upon the content of the patient^s '^ confession"
without prejudice and without emotion, and sim-
ply as a matter of biological fact, the patient, in
many instances, will divine this beforehand and
the confession will consequently never be made.
Nobody can thoroughly investigate the permea-
tions of the sex impulses in another person with-
out having first traced them in himself. And this
he cannot do alone. It requires the help of an-
other person to overcome the resistances (which
all of us have) and until these are overcome and
one is permitted to see himself de&rly, he will be
blind to whatever in his patients he also possesses
but would not wish to see in himself. A person
can not see through the disguises of sexuality in
his patients when in himself the same or sindlar
disguises exist unpenetrated.

When I say that the doctor's own blindness

\

226 MORBID FEARS AND COMPULSIONS

rather than any real absence of the sexnal factor
was responsible for the oases reported as excep-
tions to Freud's rnlCi I intended no reproach to
these men, for I believe that they are thoronghly
sincere. The reproach, if there is any, belongs
not to them bat to our unnatural and hypocritical
cultural and conventional standards, in the face
of which, for those who accept them, self-deceit is
well nigh unavoidable and only ignorance is bliss.
As long as we are taught and believe that there
is something disgraceful about having a sex in-
stinct, we have either to give up being honest with
ourselves or else to give up our self-respect.

To the question with which we began the discus-
sion. Why is the sexual factor dominant in every
neurosis T I shall not attempt to make any de-
tailed reply. The answer is perhaps to be sought
in the direction indicated by Meyer when he says :
''No experience or part of our life is as much
disfigured by convention as the sex feelings and
ambitions." ^ That is to say, if we had other im-
pulses which throughout the whole life of the indi-
vidual were so consistently and unremittingly
warped, cramped and deformed in every conceiv-
able and unnatural manner, and they had the same
strength to rebel against such treatment as have
the sex impulses, then we might have neuroses in
which they and not the sex factor played the
dominant role.

The statement that the wishes which the neu-

1 Adolf Meyer: A Ditouuion of Same Fundamental leeuee ii»
Freud^B Peychoanalpeie, State Hoepitdle BuUetinf Vol. II, Ko.
4, 1910.

SEXUAL FACTOR 227

rotic symptoms attempt to realize are predomi-
nantly sexual requires some qualification. The
word sexual must not here be interpreted in its
popular sense. T}ie wishes in question belong
more to the infantile than to the adult sexuality.
The basic ones are continuations and descendants
of holophilic impulses normally present in infancy
or childhood but which in a perfectly evolved sex
life become subordinate to the genital primacy,
give up their energy to sublimation formations or
subside into a state of latency and perfect repres-
sion. But in the neurotic they either retain
measures of energy that should have been em-
ployed elsewhere, or else, having been temporarily
deprived of such activation, they regain it through
a damming up of libido consequent upon failures
to secure satisfaction through the external world.
It ii9 from that portion of the individual's sexu-
ality which has failed to complete the normal
ontogenetic evolution, rather than from the nor-
mally synthetized and adult portion, that the mo-
tive force of the neurotic symptoms is mainly
derived.^

1 Some yean ago a promineiii neurologist said to me: '^Freud's
theory that the neuroies depend upon uneatiified aeznal wlahes
is absurd on the face of it. Why at least fifty percent, of
neurotic women haven't any desire for Intercourse at all.'*

I quote this as a fair example of some of the criticisms of
Freud's Tiews. It shows quite typically how ignorant many of
his critics are on the one hand of the facts of the sex life* and
on the other of the theories they are criticising.

It is not Freud's theory that a oofMoioiie desire for Merooiirte
Is responsible for the neurosis. In fact the presence of a weU
dereloped desire of that character instead of indicating that a
woman was likely to derelop a neurosis would more reasonably

228 MOBBID FEABS AND COMPULSIONS

Bat to say that the wishes which are expressed
in the neurosis have the character of infantile sex-
uality rather than that of adult life is the same
thing as saying they or their sources are essen-
tially perverse. For we have learned that the
characteristic feature of the infantile sexuality
is that it is ** polymorphous-perverse/' Both
neurosis and perversion represent a disposition of
a portion of the libido to channels at one time
normal but from which, for an adult love-life, its
main currents should be withdrawn and employed
elsewhere. Those tendencies which, in the per-
version, are continued on the surface and con-
sciously, are in the neurosis maintained in the
Unconscious in subjection to varying degrees of
repression. The neurosis, its Freud expresses it,
is the negative of the perversion.^ Both represent
a partial arrest of development. Meanwhile it
may be added that though every neurosis is an
attempted realization of infantile, sexual and per-
verse wishes, not every wish that the neurosis
attempts to realize is either infantile, sexual or

Bignify that she would not. It ia the vmcotuoious and reprened
/■exual wishes of the patient which furnish the neurosis with its
motive power. The desire for intercourse is only a «maZI pari of
•ewwUity, not the whole of it» as this speaker seemed to think
and it is often the least among those sexual wishes which go
to form the neurotic symptom. "Frigid" women are no more
lacking in sexuality than are "passionate^' ones but are more
likely to develop a neurosis. As a matter of fact, many of the
women who are anaesthetic during intercourse are continually
indulging in erotic day dreams, and in many cases are chronio
masturbators.

1 Freud: "Selected Papers on Hysteria and Other Pftyohoneift-
roses," Chapter IX.

NEGATIVE OF PERVERSION 229

perverse. The neurotic symptom is almost in-
variably a condensation product, expressing
several wishes, and is thus ^^overdetermined."
Non*sexual, non-infantile and non-perverse
wishes may furnish determinants, but they alone
do not caitse the neurosis.

What has been said about the libido remaining
in channels of distribution corresponding to de-
velopmental phases that should have been left be-
hind brings us to the important matter which is
tedmically known as ^^ fixation.'' James points
out a phenomenon which he calls ^Hhe inhibition
of instincts by habif **When objects of a cer-
tain class elicit from an animal a certain sort of
reaction," he writes, '4t often happens that the
animal becomes partial to the first specimen of
the class on which it has reacted and will not
afterwards react on any other specimen.

''The selection of a particular hole to live in,
of a particular mate, of a particular feeding
ground, a particular variety of diet, a particular
anything, in short, out of a possible multitude, is a
very widespread tendency among animals, even
those low down in the scale. The limpet will re-
turn to the same sticking-place in its rock, and the
lobster to its favorite nook on the seQ.-bottom.
The rabbit will deposit its dung in the same cor-
ner; the bird makes its nest on the same bough.
But each of these preferences carries with it an
insensibility to other opportunities and occasions
— an insensibility which can only be described
physiologically as an inhibition of the new im-
pulses by the habit of the old ones already formed.

230 MOEBID FEARS AND COMPULSIONS

. • • A habit, once grafted on an instinctive tend-
ency, restricts the range of the tendency itself,
and keeps ns from reacting on any but the hab-
itual object, although other objects might just as
well have been chosen had they been the first-
comers/*^

This establishing through use or habit of a
partiality for particular specimens of general
classes is apparently the same thing as that which,
when occurring in the human sexual sphere,
Freud calls fixation. For the holophilic impulses,
when repeatedly gratified either singly or in con-
junction by a given person (or object), tend to
become partial to that particular person and cor-
respondingly insensitive to others of the same
dass. These impulses or their libido are then
said to be ** fixed** on that person or the corre-
sponding ^ ^ imago. * * Normal love constancy is an
example of an ** inhibition by habit** or ** fixation*'
which involves the main current of the libido and
practically the whole group of the synthetized
holophilic impulses.

But what James has said concerning the tend-
encies of an impulse to become fixed upon the
object which has gratified it also applies (at least
in the case of the human holophilic impulses) to
the aim as well, that is, to the type of action which
gratifies the impulse and gives the libido dis-
charge. A peculiarity of the holophilic impulses
is that they are not in the beginning specific with
regard to aim. Each one may secure gratifica-
tion in mcmy ways, or through any one of a num-

1 William James: "PrindpleB of Psychology/' Vol. II, pa^ 394.

FIXATION 231

ber of really quite different actions, in distinction
to the hunger impulse which can be satisfied in no
other way than by eating. Were it not for this
non-specificity of the holophilic tendencies, such a
thing as sublimation, where the libido belonging
to a holophilic impulse finds satisfaction in actions
that are not sexual at all, would be quite impos-
sible. But, through repeated activity, part or all
of the libido of an impulse may become inhibited
by habit or fixed on the sort of action that pro-
duced the gratification, whereupon the claims of
the impulse to that extent become specific; its
libido is deprived of the original mobility, a pref-
erence is established for this particular sort of
action, with a corresponding indifference to others
which might also have represented possibilities of
satisfaction. In fact the tendency of the libido to
form fixations applies not only to aim and object
but in some degree to the whole ensemble of
repeated gratifying experiences, even including
incidental and essentially indifferent features of
external circumstance associated with the gratifi-
cation.^ The essential point in all this is that the
greater the portion of the individual's libido
which has undergone fixation, the more circum-
scribed is the range of its possibilities for appli-
cation and the more the individual is limited to
loving certain particular objects and in certain
particular and definite ways.

I said in the first chapter that though auto-
erotism preponderates in the picture of the inf an-

1 Compare what has alreadj been said concerning the condi-
tioned refleZf in the section on Transference, psge 197.

232 MOBBID FEARS AND COMPULSIONS

tile holophilic activities, nevertheless there is
some objeot-love even in these early years, namely
that which the child feels for the members of the
family. A second object-selection occurs after
puberty when the sexual synthesis has been com-
pleted and object-love is the main feature of the
sexual life. It has also been indicated (in the
section on Transference) that the first or infan-
tile object-selection has a lasting influence, more
profound in some persons than in others, through-
out the individual's life. In other words, a vary-
ing portion of the individual's libido is fixed upon
the unconscious imagines of the loved persons of
early years and strives continually to repeat the
early love experiences, either in phantasy (con-
scious or unconscious) or in the form of transfer-
ences to new persons who can be identified with
and form acceptable substitutes for the old.^ This
unconscious portion of the libido has a directing

1 We must not be oonf used by such eases as the one mentioned
in the section on transference of the man who reacted to many
persons, including street car conductors and a waiter, as if they
were his father. At first glance such a case might not seem to
be the inhibition by habit through which the individual '*wiU
not afterward react on any other specimen of a certain class.'*
It seems rather the reverse of such inhibition and as if habits
instead of limiting the numbers of a class to which the individual
would reacts had abnormally increased them. The case is only
an apparent contradiction to the rule. Psychologically the pa-
tient was not reacting to d^er&ni members of a class, now a
conductor, now a waiter, etc., but rather to the same person all
the time, namely the father. The fidelity of the fixation was so
great that it required only, as it were, a part of the father (loud
voice, stem manner, etc.) to touch off the reaction. The possi-
bilities of reacting to a waiter, an hotel olerh or a oonductor
were ignored.

FIXATION 233

influence in fhe second object-selection. For in-
stance, the man is most drawn to those women who
give promise of satisfying these unconscious
strivings — ^those who present such qualities that
give rise to an unconscious identification with the
imago of mother, sister or some other loved
woman of the years of childhood. This influence
is perhaps most apparent in the first love affairs
of a young man which quite frequently are with
a woman considerably older than himself, in many
cases a married woman, while he tends to show
toward her more or less of the same respectful
adoration he felt for his own mother.^

But though the influence of the first object-
selection always makes itself felt in the second, it
cannot be said to dominate the picture in the case
of normal people. The normal person reaches
adult life with a wide range for object choice.
Thus a healthy man can fall in love almost equally
readily with any one of a large number of women,
and when, through the accident of propinquity or
some similar factor, he has done so with one of

1 Does the woodpecker flit round the young feraahf
Does the grass clothe a new-built wallT
Is she under thirty the woman who holds a boy in her thrall t
RuDTABD Kipling: "Certain McuHma of Eafits.**

I was a young un at Oogli,

Shy as a girl to begin;
Aggie de Castrer she made me.

And Aggie was clever as sin;
Older than me, but my first un-'

More like a mother she were—

TheLadiea.

Many of this writer's stories give good pictures of object-selec-
tion dominated by the mother complex.

234 MOBBID FEABS AND COMPULSIONS

them, he is satisfied with her, and relatively indif-
ferent to others for an indefinite period. In other
words, his sexnal ideal is qnite indasive and his
love specifications are not very strict

But with the neurotic it is otherwise. His love
specifications are much more strict and numerous,
his sexual ideal is exclusive, his requirements for
loving are difScult to fulfill. Instead of his being
able to content himself with any one of a large
number of women, there are but few whom he
could fall in love with and find satisfying for long.
This results from the fact that a larger portion of
his libido is fixed upon the images and the aims
corresponding to the first object choice. His
tastes in love matters are already formed when
he is still a child, and, up to a certain point, their
demands are peremptory and inexorable.

Fixation means, ordinarily, that the greater
portion of that libido which is distributed to the
infantile channels and strives to repeat the early
love experiences, can only to a limited degree
be gratified by reality. For on the one hand,
there are lacking in reality the objects that would
gratify these earlier formed wishes, or external
obstacles would stand in the way of such gratifi-
cation, even if the objects were available ; and, on
the other, the situations necessary to gratify these
wishes cannot be realized because of internal
inhibitions. That is to say, the unconsciously
desired object is an incestuous one, or the desired
aim perverse ; hence the constellation meets with
resistances on the part of the f oreconscious which
not only prohibit real gratification of the wishes.

FIXATION 235

should real gratification be possible, but also pre-
vents the individual from becoming aware of their
existence. The wishes in question have, in other
words, to remain unconscious and repressed in-
stead of being directed to real and external
things ; and in the main no gratification is possible
save when a breaking through the censorship al-
lows their representation in consdousness in such
forms as neurotic symptoms and dreams.^

1 It has seemed to me that somewhere in this problem of fixa-
tion is to be sought the answer to that very baffling question.
In what respect is the constitutional neurotic different from the
normal person^ fundamentalljt Jung has said: "In a oertaiB
senaitiveness/' which to my mind is about the same as saying:
"In possessing a greater tendency to form fixations.*' Neither
statement^ it must be confessed, means very much. I am, how-
ever, of the opinion that 'the greater tendency to form fixations"
is not something primary or inherent but secondary to a sexual
precocity. The neurotic is a person who has learned to love, and
jh^.fi too soon. His holophilic feelings possess almost adult
intensity while, in years and in his modes of reaction, he is stiU
a child. The greater tendency to form fixations is, then, it seems
to me, simply a result of this holophilic prematurity. It is as if
the holophilic impulses tend to become fixed when they attain a
certain level of intensity or possess a certain measure of libido.
Thus if this intensity is reached prematurely, a premature fixa-
tion occurs. This is in accord with the observations that exter-
nal factors such as repeated seductions or too much love and
petting from the parents, both of which tend to develop intense
love emotions in the child, have almost the same tendency to pre-
dispose to a neurosis as the constitutional factors.

I should perhaps emphasize that I mean not a qualitattve but
a quantitative precocity. So far as I know there is no essential
difference in kind between the infantile holophilic impulses and
Interests of a normal child and those of one who will later become
a neurotic The basic difference is, it seems to me, that those
of the latter are more fiileiMe» and represent a greater measure of
libido. On the other hand, it is just as possible that it is not
so much the intensity as the frequency of the reactions which is

236 MOBBD) FEABS AND COMPULSIONS

The practical dement in the question of fixation
18 that the points at which fixation oocnrs
(whether they be fixation in respect to ob-
ject or in respect to aim) are loci minaris
resistentuB in the synthesis of the holophilio
impnlses. Whatever portion of the libido is sub-
ject to fixation diminishes the amount which is
left free for distribution to aims and objects
of the external world. And when that portion
which has been directed and satisfied externally
is, through meeting with some obstacle, loss
or disappointment, cut off from that which had
satisfied it, a damming up of the libido all too
readily occurs and the tension has a tendency to
expend itself in those directions which formerly
afforded an outlet. In other words, the libido is
apt to regress to earlier lines of discharge and
thus augments that portion already fixed and im-
perfectly satisfied. The unconscious strivings for
repetition of the infantile gratification experi-
ences thus receive a powerful reenforcement,
which me]^aces the previously serviceable repres-
sion and may be strong enough to break through it
and form a neurosis. This regression doubtless
follows the same familiar principle that the
tensions corresponding to states of temporary
excitement may overflow through earlier chan-
nels of discharge, and produce reactions which are
entirely unoriented with and unadapted to the

the deciding factor for fixation. The same reaction patterns
which exist in the normal chUd may be worn more deeply in the
neurotic through being more often traversed. AU thi^ •gaiHt
does not metn very much.

EEaEESSION 237

realities of the immediate situation. For in-
stance, a German living in this country who has
habitually spoken and thought in English for
years nevertheless will, if very angry or otherwise
excited, relapse into his mother tongue, despite
the fact that perhaps none of his hearers can un-
derstand a word he says. Examples such as this
are within the sphere of every one's experience.

When I was an interne in Bellevue I was struck
. by the fact which at that time I could not inter-
pret, that oftentimes a man in sudden and intense
pain (such for instance as might be caused by
manipulating a fracture) would call for his
mother. To hear wails of '^ Mama I Mama!
Help me !'' from some of those hardened old repro-
bates of the alcoholic or prison wards whose grim,
craglike faces gave as little suggestion of the
lurking presence of soft memories of mother love
as would the rock of Gibraltar, was indeed a
thought-provoking experience, particularly if one
happened to know that the mother in question had
been m her grave for years, assisted thereto by
unfeeling abuse received at the hands of the
waller. The essential futility of the reaction
(calling for help to a person neither present nor
living), its implicit lack of orientation as to time
and reality, its infantilism and its utter discon-
gruity witii all that ordinarily held sway in the
individual's character, might well have prepared
me for the regressions I was later to see expressed
in neurotic symptoms, whose only essential differ-
ence is that they are not so short lived.

But the regressions of the dammed up libido to

238 MORBID FEARS AND COMPULSIONS

the old paths left by earlier real or attempted dis-
charge is not merely one from the present back to
the pasty but from the real and the external inward
to the imaginary. The libido, or a portion of it,
is withdrawn from reality, the individual losing
some of his interest in the world and persons
about him, and this energy is then applied to
phantasy, and seeks gratification according to the
old pain and pleasure principle which attempts to
satisfy all wishes by the hallucinatory route.
This process has been generally known as Intro-
version, according to the convenient term which
Jung introduced. Introversion is an essential
preliminary to the production of any neurosis.

The great increase in the amount of libido which
normally attends the attainment of puberty
usually results in a period of masturbation in
which phantasy supplies the sexual object, chosen
after the model of the infantile imagines, but
which reality still withholds. Later the libido
gradually becomes transferred from these phan-
tasies and goes over into action which shall event-
ually win real satisfaction from real objects in
the external world. Now, introversion reverses
this process. The libido is withdrawn from those
actions which might serve to win a sexual object
and real satisfaction in the external world. In-
stead of to the real sexual objects and gratifica-
tions thus despaired of, it is directed to phan-
tdsies of gratification; first perhaps to conscious
ones, but shortly it regresses stUl further to phan-
tasies which are unconscious. The phantasies
thus re-activated are either those which were once

INTEOVEETED LIBIDO 239

conseions, in the form of some of the masturbatic
phantasies of puberty, which were later forgotten,
or those which had been formed in the Uncon-
scions and were never known to the individual.
In them the external sexual object of adult life is
usually succeeded by an incestuous one corre-
sponding to the infantile imagines, while perverse
aims take the place of those of normal sexuality.^
This return of the libido from reality to refill
the channels left by the infantile holophilic reac-
tions and revivify the old unconscious phantasies
corresponding to the incestuous images and per-
verse aims is an invariable and necessary prelim-
inary to the production of any neurosis. The
neurosis has origin from the introverted portion
of the libido which, partially overcoming the re-
pression, seeks to realize unconscious phantasies
corresponding to an earlier developmental phase.

1 Any given Bymptom is ordinarily a condensation product cor-
responding to the attempted realization of several unconacioiui
phantasicBi not aU of which are necessarily infantile nor for that
matter, even sexual, though the central ones are usually both.

When I say that the neurosis attempts to realize the now un-
conscious phantasies corresponding to the abandoned masturba-
tion of puberty, I hope this may not be construed to mean that
masturbation either directly or indirectly oaused the neurosis.
One could more truthfully say that it was not the masturbation
but the giving it up which caused the neurosis, inasmuch as it is
the damming up of the libido and not its gratification which
produces neurotic disease. Both the phantasies attending the
masturbation and the neurosis have a common ''cause" for they
eicpress the tame trends. Masturbation is normal or abnormal
in youth according to whether it expresses normal or abnormal
wish constellations.

Cp. Freud: Hyeterioai Fancies and Their Relation to Biaea^
uality in ''Selected Papers on Hysteria and Other Psychoneuroses,"
Chapter IX.

240 MORBID FEARS AND COMPULSIONS

Bat the neurosis is not only an attempt to grat-
ify, after the manner of the old hallndnatory
method, wishes belonging to the ITnconsdons
which are returning from repression. It may also
serve to secure gratification for other and even
conscious wishes and not through essentially phan-
tastio but through real means. The first form of
wish fulfillment Freud calls the primary function
of the neurosis, the latter its secondary fxmotion.
For, at least in any cases of long standing, the
neurotic fises his illness as a means or instrument
to various ends. Though when the neurosis first
breaks out, it is regarded by the patient as wholly
a calamity, he begins at length to make capital
out of it, after the manner, as Freud expresses it,
of a workman who, having lost his legs in an acci-
dent, becomes a street beggar, thereby converting
what was at first wholly a loss into an important
business asset. The neurotic takes advantage of
his illness to gain attention, sympathy and love,
to avoid things disagreeable, to revenge himself
on others, or to punish himself and do penance for
what he conceives to be his sins. And just as a
legless mendicant with a well established begging
business, who has become adjusted to a life of that
sort and forgotten the trade by which he originally
earned his bread, might hesitate to take advantage
of the opportunity, should he find his legs could
miraculously be restored ; so the neurotic is loath
to give up what the neurosis gains for him, and the
more it wins him through its secondary function
the greater will be his resistance against the

MORAL STRUGGLE 241

analysis or any other procedure which seeks to
bring about a cure.

In pointing out that the neurosis is a wish reali*
zation from the side of the unconscious part of the
personality, we must not lose sight of its other
aspect, namely that, considered from the point of
view of th^ upper strata, consciousness and the
f oreconscious, it is a defense. It signifies a with-
drawal from and a denial of facts that are dis-
agreeable, a purposive blindness to what the
patient does not want to see. For, whatever an
individual's conscience, standards or ideals may
be (and in this respect persons differ enormously)
the trends from the Unconscious which are seek-
ing expression are of the very sort which, accord-
ing to his lights, are the most undesirable to have,
and the most painful and mortifying to acknowl-
edge. The neurosis is thus an effort to maintain
the individual's narcissistic satisfaction or self
esteem ; a sort of self-deception which attempts to
treat as if non-existent whatever trends in his
make-up are uncongenial and would lower him in
his own eyes. It tries to prevent the displeasure
which results from the i)erception of a disparity
between the real self and the ideal set for the self
by denying that there is any disparity. These
resistances, at the same time, are an expression
of the ethical part of the personality, and reflect
a moral struggle and an effort on the part of the
individual to be what he thinks he ought to be, a
yearning to live up fully to his own ideals. Some
who read reports of analyzed cases get the impres-

242 MOBBID FEABS AND COMPULSIONS

sion that the neurotics are by nature exceptionally
immoral or even unmoral people. But this is be-
cause the analysis is particularly devoted to the
study of the unmoral (instinctive) tendendes.
The truth is that neurotics are very moral people
(too moral, perhaps) despite the fact that their
behavior would not in every instance appear to
confirm such a statement. Compared with the
average normal people their moral impulses are
unusually strong and compelling. For whatever
they do that is not moral, they have to pay in re-
morse and self-reproaches to a d^^ee which, in
spite of all their displacements and defensive
mechanisms, exceeds that which the ordinary per-
son suffers for any equivalent misconduct

If it now be asked what is the immediate cause
for the regression of the libido and introversion
which is manifested by the breaking out of a neu-
rosis, no better way of reply can be found than by
quoting at length from Freud's illuminating paper
on this subject.*

^^The cause of neurotic illness easiest to find
and understand is that external factor which may
be described as deprivation. The individual is
healthy as long as his need of love is satisfied by a
real object in the external world ; he becomes neu-
rotic as soon as this object is taken away from him,
without his finding a substitute for it. Fortune
and health, misfortune and neurosis here coincide.
A cure is brought about more easily by fate, which

1 Freud: Ueher die neurotisohen Erkrankung9Pype», Zentral*
blatt f. Psychoon. Bd. II., 1912» pages 297-302.

DEPEIVATION 243

may send a substitate for the lost possibility of
satisfaction, than by the physician.

'^In this type, which inclndes the majority of
people, the possibility of disease therefore begins
only with abstinence, a fact from which one may
estimate how significant the cultural limitations
upon accessible satisfaction may be in the etiology
of the neurosis. Deprivation acts pathologically
because of the fact that it dams up the libido and
so puts the individual to the test of how long he
can endure this increased psychic tension and
what course he will pursue to free himself from it.
There are only two possibilities of remaining
healthy in a long continued actual deprivation of
satisfaction, first that of transforming the psychi-
cal tension into kinetic energy which continues to
be directed towards the external world and finally
forces from it a real satisfaction of the libido ; sec-
ond, that of renouncing the love satisfaction and
sublimating the dammed up libido by turning it to
attainable aims which are no longer erotic. That
both possibilities are actually found in the fate of
mankind shows us that misfortune is not abso-
lutely coincident with neurosis and that depriva-
tion is not the only deciding factor for the health
or illness of the individual. The result of de-
privation is primarily that it brings into action
the previously latent dispositional factors.

''Where these are sufficiently strong, there is a
danger that the libido will become introverted.
It turns away from reality, which on account of its
obstinate denial has lost interest for the indi-

244 MORBID FEABS AND COMPULSIONS

vidnal^ tarns to the life of phantasies, where it
creates new wish formations and revivifies the
traces of earlier, forgotten ones. As a result of
the intimate interdependence of the phantasy
activity and the repressed and nnconscions infan-
tile material existing in every individual, and by
virtue of the fact that phantasy activity is ex-
empted from having to conform to reality,^ the
libido can revert further, find infantile channels
by way of regression and strive toward the aims
corresponding with thent When these strivings,
which are incompatible with the actual circum-
stances of the individual^ have gained enough
intensity, there must occur a conflict between
them and the other part of the personality, which
has retained its true relations to reality. This
conflict is compromised by symptom formations
and comes out as a manifest illness. That the
whole process comes from the actual deprivation
is shown by the fact that the symptoms, with
which the level of reality is again attained, are
substitute satisfactions.

**The second type of the exciting cause for the
illness is not at all as obvious as the first, and as a
matter of fact may be discovered only by penetrat-
ing study in conjunction with the 'doctrine of
complexes ' of the Zurich * school. Here the indi-
vidual becomes ill not as a result of a change in
the external world, which has put deprivation in

iPormulienmgen Aber die ztoei Prineipim det fityohiwhm
Ge§dieh6n9, Jahrb. f. PsychoanalTBey Bd. III.

s Jung: Die Bedeuiwi^f dee Vatere fUr doe Sehiekeal dee Bkh
telnet^ Jahrb. f. Paychoanalyae, I» 1909.

DEPRIVATION 245

the place of satisfaction, but as the result of a
fruitless effort to get the satisfaction which is
accessible in the world of reality. He becomes ill
in the attempt to adapt himself to reality, and to
fulfill the demands of reality, an attempt in which
he meets with insurmountable internal di£Sculties.

''It is desirable to distinguish the two types of
illness sharply from each other, more sharply than
observation generally permits. In the first type
a change in the external world is the prominent
feature, in the second, the emphasis falls on the
internal change. According to the first type one
falls ill of an experience, according to the sec-
ond, of a developmental process. In the first case
there is set the task of doing without a satisfac-
tion, and the individual falls ill of his inability to
endure the privation ; in the second case the task
is to exchange one kind of satisfaction for another,
and the person is wrecked by its difficulty. In the
second case, the conflict between the effort to re-
main as one is and the effort to change oneself
according to new designs and new requirements of
reality exists from the beginning; in the first case
it arises only after the dammed up libido has
chosen new and at the same time unacceptable
modes of satisfaction. The roles of the conflict
and the early fixations of the libido are incom-
parably more striking in the second type than in
the first, where such impracticable fixations arise
only as the result of the external deprivation.

"A young man who has previously satisfied his
libido by phantasies terminating in masturbation,
and now wants to exchange this regime, so near

246 MORBID FEARS AND COMPULSIONS

to autoerotism, for real object love ; a girl who has
given her father or her brother her entire affection
and now in her relations with her lover ought to ad-
mit into consciousness the previously unconscious,
incestuous libido wishes; a married woman who
desires to give up her polygamous tendencies and
prostitution phantasies, in order to be a true wife
to her husband and a blameless mother to her chil-
dren— ^all these fall ill of the most praiseworthy
efforts, if the earlier fixations of their libido are
strong enough to resist a displacement, a matter
in which disposition, constitutional make-up and
infantile experience are the deciding factors. In
a way they all suffer the fate of the little tree in
Grimm's fairy tale, that wanted to have other
leaves. From the hygienic standpoint, which to
be sure is here not the only one, one could but wish
that they still had remained as undeveloped, as
inferior and as irresponsible as they were before
their becoming ill. The change which the patients
strive for, but produce only incompletely or not at
all, has regularly the value of progress in the sense
of the real life. It is another matter if one
measures them with an ethical standard. One
sees that people quite as often fall ill if they wish
to give up an ideal as if they wish to attain it.

** Despite the very significant differences be-
tween the two types of becoming ill, they yet coin-
cide essentially and are easily reduced to a unity.
Falling ill from deprivation also comes under the
heading of a failure to adapt to reality, in the case,
for example, where reality refuses satisfaction of
the libido. Falling ill under the conditions of the

INTEOVEESION 247

second type reduces to a special case of depriva-
tion. In it not every form of satisfaction by
reality is withheld, bat merely the one which the
individual insists is the only one for him, and the
deprivation comes not directly from the external
world, but primarily from certain strivings of
the ego. The deprivation remains the common
element. As a result of the conflict which imme-
diately takes place in the second type, both kinds
of satisfaction, the accustomed and the newly
striven for, are inhibited. This amounts to a
damming up of the libido with the same results
which follow it in the first case. The psychic
processes on the path to symptom formation in
the second type are rather clearer than in the first,
as the pathogenic fixations of the libido had not
first to be established here but had been in force
during the period of apparent health. A certain
degree of introversion of the libido already ex-
isted; a part of the regression to the infantile is
dispensed with by the fact that the development
did not have to travel bade over the entire way.

**The next type which I will describe as a be-
coming sick through an arrest of development,
appears as an exaggeration of the second type,
the falling ill through the demands of reality.
There is no theoretical requirement for differenti-
ating them, but there is a practical one, since it is
a question of persons who fall Ul as soon as they
leave the irresponsible age of childhood and there-
fore have never reached a phase of health, i. e. of
a wholly unlimited efficiency and well being. The
essentials of the disposing process are quite clear

248 MORBID FEARS AND COMPULSIONS

in these cases. The libido has never abandoned
the infantile fixations, the demands of reality do
not suddenly burst upon the partly or wholly
mature individual, but arise from the fact of be-
coming older, for quite obviously they continu-
ously change with the age of the individual The
factor of conflict here recedes before that of de-
fect, and yet, according to all our other views we
must assume an effort to overcome the fixations of
childhood, otherwise the issue of the process could
not be a neurosis but only a stationary infantilism.
''As the third type has shown us the dispo-
sitional factor almost isolated, the fourth, which
now follows, calls our attention to another which
plays a rdle in all cases, and, for that very reason,
might be overlooked in a theoretical discussion.
Thus we see individuals falling ill who were well
previously, but to whom no new experience has
occurred, and whose relation to the external world
has suffered no change, so that their falling ill
must impress us as being spontaneous. Closer ex-
amination of such cases shows us that a change has
taken place in them nevertheless, and one which
we must consider of the greatest significance in
the causing of illness. As a result of attaining a
certain period of life and in connection with reg-
ular biological processes, the quantity of libido in
their spiritual economy has had an increase which
of itself is enough to upset the balance of health
and produce the conditions for a neurosis. Suek
rather sudden increases of libido are familiar and
are regularly connected with puberty and meno-
pause, and the attainment of a certain age in

DAMMING UP OF LIBIDO 249

women. In many men ihey may be manifested
also in still unknown periodicities. The dam-
ming up of the libido is the prime factor here ; it
becomes pathogenic as a result of the relative
deprivation on the part of the external world,
which would still permit the satisfaction of more
limited demands of the libido. The unsatisfied
and dammed up libido can open the path to regres-
sion and kindle the same conflicts which we have
posited for the absolute external denial. We are
thus reminded that we should not lose sight of the
quantitative factor in any consideration of the
etiology of the illness. All other factors (depri-
vation, fixation, arrest of development), remain
without effect if they do not relate to a definite
measure of libido and cause a damming up to a
definite height. This quantity of libido which
seems to us requisite for a pathogenic effect, is of
course not measurable. We can postulate it only
after the illness has taken place. In only one di-
rection can we estimate it more closely; we may
assume that we are not dealing with an absolute
quantity but with the relation of the actual amount
of libido to that quantity of libido which the indi-
vidual ego can control, i. e. maintain in tension,
sublimate or directly apply. Therefore a relative
increase of libido quantity may have the same
effect as an absolute one. A weakening of the
ego by organic disease or by a special requisition
upon its energy is able to cause neuroses which
otherwise would have remained latent in spite
of any disposition.
^^The significance in the causation of the illness

250 MOEBID FEARS AND COMPULSIONS

which we must grant to the quantity of the libido
agrees very well with the two main principles of
the doctrine of the nearoses which have been
gained from psychoanalysis. First with the prin-
ciple that the neuroses arise out of the conflict
between the ego and the libido, second with the
view that there is no qualitative difference between
the conditions of health and neurosis, that the
healthy have to struggle much more vigorously
with the task of controlling the libido, but that
they succeed better.

'^It still remains to say a few words about the
relation of these types to experience. When I
think over the patients whom I am just now an-
alyzing, I must say that none of them is a pure
example of any one of the four types of falling ilL
I rather find in each one of them a bit of depriva-
tion operative alongside of a partial inability to
adapt to the demands of reality. The concept of
arrest of development, which coincides indeed with
the rigidity of the fixations, comes into view in
all, and we can never neglect the significance of
the quantity of the libido, as before mentioned.
Indeed I learn that in several of these patients
the illness has appeared in installments, between
which were intervals of health, and that each one
of these installments may be reduced to a different
type of causation. The putting forward of these
four types has therefore no great theoretical
value ; they are merely different ways of establish-
ing a certain pathojgenic constellation in the
spiritual domestic economy, namely the damming

CAUSATION 251

up of the libido, against which the ego, with the
means it has, cannot protect itself without injury.
The situation is in itself pathogenic only by vir-
tue of the quantitative factor; it is not a novelty
introduced into the mental life by the intrusion of
a so-called 'cause of disease.'

''A certain practical significance we gladly con-
cede to these types of falling ill. In individual
cases they may be observed in their pure state.
We should not have noticed the third and fourth
type, if they had not contained the only causes
for the illness of many individuals. The first
presents to us the extraordinarily powerful in-
fluence of the external world; the second, the no
less significant role of the make-up of the individ-
ual which resists this influence. Pathology can-
not give the correct solution to the problem of
the cause of the disease as long as it concerns
itself merely with the distinction of whether these
affections are of endogenous or exogenous nature.
Against all experiences which point to the signifi-
cance of abstinence (in the broadest sense) as the
cause it must always raise the objection that other
persons suffer the same fate without falling ill.
But if pathology emphasizes the idiosyncracy of
the individual as the essential for Ulness and
health, then it neglects the fact that persons with
such peculiarity may remain healthy for a very
long time, as long as they are permitted to retain
it. Psychoanalysis has suggested our giving up
the fruitless antithesis of external and internal
factors, environment and constitution, and has

252 MOEBID PBABS AND COMPULSIONS

taught xiA regularly to find the cause of the nea-
rotio disturbance in a definite psychic situation

which may be produced in various ways/'

• •••••••

While we still have in mind the question of the
damming up of the libido, it may be well to enter
into some general considerations concerning a
common result of this damming up^ namely mor-
bid fear or ^^ anxiety," a symptom which, as Jones
remarks, is undoubtedly the most frequent one in
the whole realm of psychopathology.^

First let us ask what is the difference between a
fear that is morbid and a normal fear. In the
quality of the emotions themselves there is noth-
ing which would invariably distinguish them.
Though in morbid fears there is often a prepon-
derance of the physical manifestations, this is by
no means invariably the case. Nor is the intens-
ity of the emotion a definite index. Morbid fears
are usually more intense than any fears that a
normal person suffers under ordinary circum-
stances, but situations of great danger can pro-
duce perfectly normal fears which are quite as
intense as any morbid ones. What really dis-
tinguishes the two sorts of fears is the fact that,
as Jones points out, a morbid fear is a relatively
excessive one.^ It occurs on occasions where a
normal person would either feel no fear at all or

iThe word anxiety, as lued in pflycboanalytic writing, has
aboQt the same aignificanoe as the German word Angst, i.e., an
intense fear. The words fear and anxiety are, however, often need
interchangeably.

s Jones: "Pathology of Morbid Anxiety*' in his Papen on Pm^

MORBID FEAB 253

else a less intense one. An additional fact is that
normal fears are nsually short in duration, while
morbid ones may be very persistent. None of
these criteria is, however, absolute. The basic
difference between a morbid and a normal fear is
one of origin, and this is not revealed to superfidal
observation. A normal fear is a reaction to an
external, material situation or condition of which
the individual is clearly aware. A morbid fear,
on the other hand, has its real source in an in-
ternal and psychic situation, of which the individ-
ual is unconscious. The external stimulus which
evokes an attad: of morbid fear is not, as the
patient may think, the cat^e of the emotion, but
merely serves as a cue to set off a reaction which
has its real source elsewhere.

The essential cause of morbid anxiety or fear is
a damming up of the libido. The fear is an over-
flow phenomenon, the result of the pent up energy
forcing a way of escape despite opposition or re-
pression. The dammed up wish-energy which the
repression withheld from action now breaks out
as feeling. The effect of the repression has been
to transform this energy into fear. Morbid fear,
in other words, is really desire — ^in the broad
sense, sexual desire — ^which various inhibitions
have diverted from more natural channels of ex-
pression.

That morbid anxiety really results from desire
seems, at first thought, hardly credible. A wish
and a fear are so utterly unlike in their qualities
that it seems impossible that ever under any cir-
cumstances the one could be the cause of the

254 MOBBID FEABS AND COMPULSIONS

other. Nevertheless, the more we become ae-
qnainted with the facts relating to the sltoatioii,
the less improbable aU this seems.

Let us ask what an emotion is, and see if this
does not throw some light on the question. An
emotion, one mig^t say, is an undischarged action,
a deed yet retained within the organism. Thus
anger is an unf ought combat ; fear an unfled flight.
Perhaps it would be more accurate to say that an
emotion is a state of preparedness for action,
which however in many ways is almost the action
itself. The involuntary nervous system is exdted
in the same way as in action. The same changes
take place in the blood. A state of tonus is pro-
duced in the same voluntary muscles that would
be innervated to produce the action itself. Thus
Grile writes: '^ There is (in emotion) a specific
stimulation or inhibition of every organ and tissue
in the body, in accordance with the rdle each is to
play in the intended adaptive muscular response.
Blood is transferred from the parts non-essential
to muscular action (the stomach, intestines and
genital system) and concentrated upon the ma-
chinery necessary to muscular action (the heart,
lungs, central nervous system and skeletal
muscles). The drcnlation is accelerated, metabo-
lism is increased, the production of waste prod-
ucts is at its maximum, the breath comes faster,
the heart beats quickly, the skin is moist from
excessive perspiration, the limbs tremble, the ex-
tremities tingle, every detail of the intended
muscular action is simulated.''^ The organism

iCrile: '"Man, an Adaptiye Mecbaniam.'*

EMOTION 255

is like a car which, with throttle open, spark ad-
vanced and engine racing, throbs and trembles
with liberated energy, while the dutch which shall
connect this power with the locomotor machinery
is not yet thrown in. The identity of emotion and
action goes so far that, as Crile points out, strong
feeling results in the same fatigae phenomena
(subjective and objective signs of exhaustion,
histologic changes in various organs) that would
result from the exertion itself. In short, emotion
is the same as action in practically every respect,
save that of massive movement.

But what is of particular interest is the fact
that, as shown by Cannon, by Crile and by others,
there take place, in strong emotion, characteristio
chanfes in the blood content which anticipate and
prepare for great exertion, such as that of combat
or flight. Iodized protein, Crile thinks, is thrown
out in abnormal amounts from the thyroid in
strong emotion and has the effect of sensitizing
the organism by facilitating the passage of elec-
trical currents through semi-permeable mem-
branes, and so lowering the threshold to all stim-
uli, and increasing the energy transformation.
As Cannon showed, there is an increased amount
of sugar furnished to the blood, which increases
the capacity of the muscles for work and thus pre-
pares for struggle or flight. Similarly as he
demonstrated there is an increased output of
adrenin, which not only aids in bringing out sugar
from the liver's store of glycogen, but has the
property of restoring to fatigued muscles the same
readiness for response which they had when fresh.

256 MORBID FEARS AND COMPULSIONS

It has the further effect of constricting vessels in
such parts of the body that are not active in exer-
tion and thus driving the blood to those regions
where in strong effort it is most needed. It also
relaxes the muscle fibers in the bronchioles and
favors respiration as in preparation for great
effort* The clotting time of the blood is at the
same time decreased as if to prepare for the pos-
sible wounds that might come in the course of
combat.

The emotion^ from the point of view of physi-
ology, is these various preparatory changes in the
content of the blood, in the innervation of the
various muscles, endocrine glands and other
viscera. The emotion, from the point of view of
psychology, is the afferent, sensory report of these
changes. Thus, as James epigrammatically ex-
pressed it, we are afraid because we tremble, not
that we tremble because we are afraid.^

One is accustomed to think of sexual emotion, or
excitement, as being something essentially very
different from all other emotion, say anger or fear,
and so it is from the subjective side. On the other
hand, from the physiological point of view, it is
not so different as one might expect. In fact it
can be shown that these states of sexual tension
and of fear are so closely related that it need not
be considered surprising that one merges into the
other— i. e. that a condition of tension or prepared-

1 William James: 'Trindplea of Paydiology," Vol. I, page 450.

The state of tension or tonus, which, according to the ehannela
along which it is expressed, is either emotion or action, is the
physiological equivalent of what in Freudian psychology is spoken
ol as the unconscious wish.

SEXUAL EMOTION 257

11688 which is primarily sexaal can give the sub-
jective report of fear. But to show this is as far
as one can go at present Our knowledge is insuf-
ficient to explain why, under some circumstances,
a damming up of libido mttst be felt as fear and
what are the exact details of the process. We
have to be content with knowing that this relation-
fihip, which clinical observation demonstrates cer<
tainly to exist, is, on physiological grounds, well
within the bounds of the eventually explicable.

Popular opinion would regard sexual emotion
or excitement as conditioned mainly by an accumu-
lation of semen in the testicles. This notion is
obviously incorrect, for sexual excitement occurs
in children long before there is any seminal secre-
tion, in males castrated after puberty and in
women, who have no specific external sexual secre-
tion. About the same sort of objection applies to
the theory that sexual excitement is wholly de-
pendent on accumulations of internal secretions
from the specifically sexual glands. In short, the
sexual secretions, either internal or external,
probably are not the chief immediate basis for
sexual excitement, but at most supply only its
specific factors.

Cannon, Crile and others seem to think that
there occur in sexual emotion the same blood
changes anticipatory of exertion that take place
for other emotions, namely an increase of thyroid
products, of adrenalin, of sugar, etc. It is per-
haps, then, not unreasonable to think that sexual
excitement has both specific and non-specific com-
ponents. The specific factors would very likely

258 MOEBID FEARS AND COMPULSIONS

indude the aoctunnlatlons of internal secretions
of the seznal glands, and the stimnli repres^ited
by the pressure of seminal secretion upon the
walls of its receptacles. Most, if not all of them,
would come into play only in adult sexuality.
The non-spedfio elements would be changes in the
blood content and in the sympathetic-autonomic
balance, much the same as tiiose that prepare for
any sort of vigorous action or exertion such as
attack or flight

Sexual emotion, tension or preparedness is less
dependent on external stimulation than are other
normal emotions. We do not feel continuous nor-
mal anger or fear unless we are continuously sub-
ject to an external menace. But sexual tension
or preparedness may arise in the absence of any
external stimulation and tends to persist until
relieved by some suitable action, of which coitus,
in the adult, is normally the most satisfactory one.
Thus, in the absence of actions adequate in quality
or in frequency to discharge the libido, there may
come about a state of organic sexual preparedness
which is chronic.^ In other words a lack of ade-
quate sexual outlet (and by this is not meant
simply abstinence from intercourse) may result in
an accumulation in the blood of abnormal quanti-
ties of thyroid bodies and perhaps of sugar,
adrenin and other substances which constitute an
important part of the state of preparedness for
non-sexttdl exertion such as attack or flight, and
this very likely is accompanied by corresponding

1 ThiB does not mean that the indiTidoal need be oontinuoiisly
0OMoiott« of sexual desire.

ANXIETY STATES 259

changes in the sympathetiG-autonomio balance. It
is not then difficult to imagine that this accnmnla-
tion and these changes in the involnntary nervous
system which have so much in common with the
states of preparedness from which come the
afferent reports known as anger and f ear, could
reach such a point as either to create abnormally
low threshold and exaggerated reaction to slight
occasions for normal anxiety or fear (e. g., an ex-
cessive anxiety over what would normally be a
matter for slight worry) or even give the afferent^
report of fear (or anger) in the absence of any
special external stimulus.^
^. Certainly the clinical facts are in accord with
this hypothesis. In 1895 Freud wrote a paper
describing a condition which had formerly bi^en
classed as one of the varieties of '^ Neurasthenia"
which he named Anmety Neurosis.* The symp-
toms were (1) general irritability and hyperes-

1 It cannot be advanced as an objection to this hypotbeaU tbat
if a damniTiig up of tbe libido can cause fear it also ougbt to
cauae anger, for tbe reaaon tbat, in certain caaea, it doe9 catue
anger (or at least an over intense reaction to wbat in normal
persons would cause but sligbt irritation). Tbe constant state
of irritability, exasperation or ill temper (in abort, of cbronic
anger) wbicb is manifest in some nervous people is so familiar
as bardly to require comment. Wby a damming up of tbe libido
abould more frequently cause fear tban anger is a question tbat
cannot yet be answered more tban to say tbat conditions of in-
bibition or repression wbicb are usually in part responsible for
tbe damming up are surely closely allied to fear; wbile anger
more nearly coincides witb tbe freer or self-assertive state of
mind tbat leads to or goes witb an adequate sexual outlet

s Ueher die Berechiigung wm der Neuraaihenie einm^ hettimm'
ien Bymptomen-homplem ala **Ang9tn€uro9e^ ahMtrennen. Brill's
translation appears in "Seleeted Papers on Hysteria and Otber
Piycboneuroses.

260 MOEBID PEAES AND COMPULSIONS

thesia, (hyperacasis, insomnia, etc), (2) anxions
expectation, fearfuInesSi worry, with perhaps
ocoasional severe attacks or seizures of intense
anxiety, and (3) somatic symptoms such as dis-
turbances of heart action, attacks of dyspncea, of
sweating, trembling, vertigo or diarrhoea.

This condition Freud considered an ''Actual
Neurosis'' (as distinguished from a psycho-neu-
rosis, an essentially psychic disease) which arose
under such conditions as lead to ''an accumula-
tion of somatic sexual excitement" which had not
been allowed to become elaborated into psychic
excitement or to obtain adequate discharge.
Conditions such as those of voluntary sexual ab-
stinence, the practice of coitus interruptus or
reservatus, or the failure of gratification in the i
woman which results from premature ejaculation
on the part of the man, he found to be typical for
its causation. The establishment of a better
regime (for instance, the substitution of coitus
condomatus for coitus interruptus) which made
full sexual gratification possible, had in many
cases the effect of removing all symptoms.

These symptoms which Freud describes indi-
cate very dearly the presence of the endocrine fac-
tors and correlated disturbances of the sympa-
thetic nervous system.^ The condition of general
irritability (i.e. of lowered threshold and too

1 Freud has pointed out the resemblance of the physical ae*
oon^wniments of the anxiety attacks to those of sexual excite-
ment— ^rapid heart action, hurried breathing, perspiration, dry*
ness of the mouth, involuntary muscular oontractionsy etc They
also resemble those of angry excitement.

ANGEE AND HATE 261

ready response to fiH sorts of stimnli) is what we
expect from an abnormal amount of thyroid secre-
tion in the blood. It is altogether like that which
occurs with Graves's disease (a condition, by the
way, in which morbid anxiety is often a promi-
nent symptom) or can be produced by the admin-
istration of thyroid. The palpitation, diarrhoeal
attacks and other symptoms are apparently the
same as those occurring with hyperthyroidism of
other origin. The vaso-motor symptoms and oth-
ers referable to the sympathetic nervous system
might indicate the presence of an excessive secre-
tion of adrenalin or might be the effect of thyroid
bodies themselves. (Elliott^ asserts that adren-
alin can produce every result of stimulation of the
sympathetic nervous system except an increase in
the secretion of adrenalin.)

Anger, hate and the impulses to overcome or
attack blend with the sexual sadistic, aggressive
and self-assertive reactions, while fear and the
impulses to submission or flight are likewise
shaded into the masochistic reactions. The sadis-
tic impulses and the combative or destructive im-
pulses were doubtless identical early in phylo-
genetic history, if not indeed in the ontogenetic.
We know how readily, either in animals or in man,
a state of anger or the act of attacking may be
converted by relatively slight changes in the
incoming stimuli into fear or flight, and vice versa.
It is not so very strange, then, if we find the
energy corresponding, in the broad sense, to
sexual excitations or tensions shifting from pro-

1 Quoted by CannoiL

262 MOEBID FEAES AND COMPULSIONS

gressive or aggressive manifestations and becom-
ing fear in much the same manner as rage or anger
may readily become fear. Coitus, as many have
said, is, in a way, an overcoming, a struggle, a
combat, and this might prepare us for the fact .that
the impulses thereto, and particularly those that
have their somatic fulcrum in the voluntary mus-
cular system, imdergo the same shifts and trans-
formations as do those of anger and combat which
are designed for self-preservation.

At any rate, and however we explain it, there
is abundant and incontrovertible evidence that
dammed up forces corresponding to inhibited, or
ungratified, or undischarged impulses that, in the
broad sense, we must call sexual, do certainly
result in fear. Perhaps for all practical pur-
poses we have sufficient explanation in the follow-
ing principles suggested (in a somewhat different
connection) by Spencer. ** It is an unquestion-
able truth that, at any moment, the existing quan-
tity of liberated nerve force, which in an inscrut-
able way produces in us the state we call feeling,
mt^st expend itself in some direction — ^must gen-
erate an equivalent manifestation of force some-
where. ' ' * * Overflow of nerve force, undirected by
any motive, will manifestly take the most habitual
routes ; and, if these do not suMce, will next over-
flow into the less habitual ones.'^^ * In short, the
holophilic energy (and by this is meant not simply
the desire for coitus), if denied an adequate
natural outlet, sublimated or otherwise, will force

tH. Spencer: "Essays, Scientific, Political,'' etc., quoted by Dar-
win in his "Expression of the Emotions."

FEAB 263

for itself an mmatural one. It '^must expend
itself somewhere. ' ' ^

So much for the physiological aspects of the
question. Let ns now look at it from the psycho-
logical point of view. The biological function or
purpose of fear is protective or preservative.
Every one of us alive to-day owes his existence to
the fact that his human and prehuman ancestors
were afraid. It has often been stated that the
human skin^ with its acute sensitiveness to pain,
is a better protective medium than the enormously
thick and tough hide of the rhinoceroSi or the bony
casing of the armadillo. In the same sense it may
be said that a readiness to fear is as valuable a
protection as the poison fangs of the serpent or
the strength of the elephant.* That is to say, fear
constitutes an insurance for the preservation of
the animal or species by compelling withdrawal
from situations that threaten injury or death, or
by prohibiting approach to such situations.

It hardly seems probable that in morbid fear
the emotion has lost this biological significance.
At most we should expect that there could be only
a miscarriage of it. Normal fear, however, is
provoked only by external conditions or objects.

iWe cannot eyen attempt to explain on a phyBiological basis
why morbid fear attaches itself to certain special objecsts and not
to others.

s As Crile points oat, animals like the rabbit, antelope, horse,
monkey and man, which depend for self-preservation on a swift
locomotor reaction, exhibit fear and an irrepressible impulse to
flee from danger. The skimk, however, whose chief means of
protection is its odor; the porcnpine, defended by its quills; the
tiurtle, protected by its shell; the lion and the elephant, secure
in their superior strength, show little if any fear.

264 MORBID FEAES AND COMPULSIONS

Morbid fear has origin from conditions that are
internal. This seems to ns something entirel7
noveL Nevertheless it is not. We have seen
that in infancy there is no accurate distinction
made between the ego and the non-ego. A similar
state of affairs may also exist in adult life. Ob-
jects or persons really external are felt as a part
of the self (identification) while processes really
belonging to the individual's own psyche are per-
ceived as influences arising from without (pro-
jection). This really is the expression of a gen-
eral principle. That is to say^ the ego has a tend-
ency to treat all sources of pleasure, whether they
be internal or external, as a part of the self (for
instance, the identification that comes with love) ;
while to all sources of pain or displeasure, whether
they , are inner or outer, it tends to react as if they
were hostile and a part of the external world.^
That the ego can react to really endopsychic
processes or conditions as if they were external
and hostile is really then no absolute novelty to us.
Morbid fear seems to occur according to the
principle just stated. Though it is justifiable to
speak of morbid fear clinically as being converted
libido, this may not be entirely accurate, as Jones
points out.* The morbid fear is perhaps not the
libido itself, converted, but rather a fear reaction
against the libido. That is, the repressed libido,
striving for forms of wish-fulfiUment, which from
the point of view of the individual's conscious and

1 Compare Freud's "Triebe and TriebwhlckBale," Int. Zdtaehr.
1 Arzt Pgychoanalyse, Vol. 111, 1916.
sL. c.

FEAB AND DESIRE 265

f oreconscions trends, are repugnant and would
cause displetisure, is treated like other sources
of displeasure, as something external and hos-
tUe, and so provokes the protective reaction of
fear.

The prayer: '^Lead us not into temptation" in
a certain sense implies that the individual is
afraid of his own desires. We often hear it said
that a certain man is his own worst enemy, which
means that his welfare is menaced, as through a
hostile influence, by wishes that are really his own.
In morbid fear it is as if such a statement were
taken literally, and the individual reacts to what
is really a part of himself as if to an enemy.
When a woman, finding herself in danger of being
forced to have intercourse with a strange man,
reacts with fear, we call the emotion normal. If,
however, the impulse that threatens to force her
into sexual relations with a stranger is her own
dammed up libido, and the danger is thus one that
arises primarily from within, we call the fear ab-
normal, though in each case the impending experi-
ence which she dreads is exactly the same.

Morbid fear is then an excitation of the normal
/ fear instinct provoked, however, by the individ-
ual's own sexual impulses, which, breaking
through the control of the higher psychic systems,
threatens to become a menace. Naturally the
more powerful the unruly impulses and the greater
the failure of repression, the more intense will be
the morbid fear. In one sense morbid fear is not
morbid at all. It is rather a normal reaction to

266 MOEBID FEABS AND COMPULSIONS

the danger arising from an ahnormcX conditum-—
the damming np of the libido to a point where it
breaks through f oreconsdoos control.

As I have pointed out elsewhere, the existence
of a causal relationship between desire and fear
has not everywhere been unsuspected, even before
Freud. Certain writers such as Krafift-Ebing,
Nystrom, Bohleder, Eisch, Leyden ^ have noticed
that sexual abstinence resulted in states of anxiety
and nervousness. There has also been some pop-
ular recognition of this fact. I have used the fol-
lowing story to bring out the latter point.

The traditional Miss Antique came to the board-
ing house table one night in a state of great exdte-
ment. * * Oh, ' ' she cried, * * I Ve had such an experi-
ence t Just now as I was coming home through a
dark and lonely street I saw a Man! And, My
Goodness, how I did runl''

'^ You don't say so 1'' returned one of the board-
ers, looking up with an expression of sympathetic
interest, '^and did you catch him. Miss Antique!''

To illustrate the point in question this story
does not have to be true. Women of the sort it
describes unquestionably do exist. And their ex-
aggerated fear of men has, in other instances than
that of the cynical boarder, been correctly inter-
preted as an over compensation for unsatisfied
desire.*

We have offered two explanations of the origin
of neurotic fear from dammed up desire, a physio-

1 See H. EUie: "Sex and Society.''

> Fielding and Dickeno, among other writers, show a keen
Insight into defensive reactions of about this sort.

FEAB AND DESIRE 267

logical and a psychologioal one. The latter seems
to me the more satisfactory and perhaps the best
substantiated. As a matter of fact it is probable
that both are correct. In one case what we would
call the strictly physiological factors may predom-
inate, and the psychic ones in the next, while both
are, in varying degrees, involved in alL

This may be paralleled with the fact that morbid
fear cases may have two types of origin. In one
the damming up of the libido results primarily
from physical factors, in the other mainly from
psychic ones. Where the essentially physical
factors form the starting point (as for instance
where coitus interruptus, or premature ejacu-
lation on the part of the husband, leaves the
woman ungratified) the symptoms may be done
away with by establishing a better regime (coitus
condomatus in place of coitus interruptus) which
allows the woman ^s gratification to be completed.
A damming up which arises as the result of psy-
chic factors (repressions, resistances and con-
flicts) is not noticeably affected by any alteration
of the physical factors in the sex life.

Pure cases of the anxiety neurosis, which corre-
spond to the first type of origin, and which, when
Freud first described the condition, he regarded as
an '^ actual" neurosis (a non-psychogenic mal-
ady), probably do not exist. It now seems quite
certain that even in those cases where the physical
factors interfering with discharge of the libido
are the primary and significant ones, psychic con-
flicts come into play secondarily and have a rdle
in the formation of the symptoms— conflicts which.

268 MOEBID FEABS AND COMPULSIONS

however, may subside as soon as the physical pri-
mary factors are properly attended to. But the
anxiety neurosis nevertheless remains as a valu-
able concept, and represents a real condition, even
though it cannot be observed clinically in a pure
state. The anxiety neurosis is now included
within the term anxiety hysteria, which at one
time was reserved for those cases where primarily
physical factors played no important role. It
may be added, however, that even in the cases
which are most truly "psychical,'* the physiolog-
ical element of endogenous intoxication by reten-
tion of secretions is without doubt always present
and has a definite role.^

In the hope of correcting certain false impres-
sions that may have arisen in the course of this
discussion, let us again warn against taking the
word sexual in a too narrow sense, and regarding
genital sexuality as the whole of sex. When we
say that for health any individual requires an
adequate sexual outlet, it must be understood that
this outlet may be secured in a great number of
different ways. A person may be having regular
and frequent sexual intercourse (excessive inter-
course, in fact) without this affording him an ade-
quate outlet or preventing his libido from becom-
ing dammed up. On the other hand, another per-
son may not be having intercourse at all, and yet
his sexual outlet be entirely adequate, for he can
work off most of his libido through sublimations

iCf. Jones: 'The Relation Between the Anxiety Neurosis and
Anxiety Hysteria/' JourwU of Almormal Pwychology^ Vol. VIII,
1918.

SEXUAL OUTLET 269

and in aims that of themselves are not erotic If
all that is required for an adequate sexual outlet
were frequently repeated orgasms^ then masturba-
tion would cure every neurosis.

CHAPTER VI

THE PSYOHOLOGY OF THB COMFUI^IOK

NEX7B0SIS

OT very long ago practically all neurotic
disturbances which on the one hand were
not manifest cases of hysteria nor on the
other of major psychoses, were as a rale grouped
indiscriminately under the one designation of
Neurasthenia. Though this easy if slipshod diag-
nostic practice is not yet entirely done away with,
even among neurologistSi nevertheless most neu-
rologists and psychiatrists now clearly recognize
that what was formerly called neurasthenia really
comprises several distinct disease entities differ-
ing from one another in clinical characteristics
and pathological structure, and that, as applied
to most, if not all of them, the term neurasthenia
is a dedded misnomer. For most of these con-
ditions are not, strictly speaking, nerv(yus disor-
ders at all. They are states of mind, psycholog-
ical disturbances ; and the nerves, as such, are not
immediately involved in their pathology. The
term "nerve weakness,** whether in Englisli or
Greek, is therefore a poor name to apply to them.
A group of cases most obviously purely psycho-
logical and among the first to be recognized as such
are those which Janet rescued from the diagnostic
waste basket and designated by the name psy-

270

PSYCHASTHENIA 271

chasthenia. They comprise the variously called
obsessions, fixed ideas, morbid fears (phobias)
doubts, compulsions and impulsions. Later ob-
servations, particularly those by Freud, resulted
in the division into two groups of these cases
which Janet included under the one term psychas-
thenia. One contains certain fear states or ^'pho-
bias" of which agoraphobia is a type, and is desig-
nated by Freud as anxiety hysteria. The other is
now usually known as the comt)ulsion (or obses*
sional) neurosis. We shall b^gin with a consider-
ation of the latter condition.

Let us study some examples. A man killed a fly
which annoyed him by buzzing about the room.
Hardly had he done so when there came to him
the thought, accompanied by an intense feeling of
horror and fear : ^^My God, what if I should kill a
person like that!'' He was not conscious of ever
having had a desire to Mil any one; he was not
really in fear that he ever would kill any one, but
nevertheless the thought ^^But wouldn't it be
awful if I didf " stuck in his mind for months at a
time and he was utterly unable to banish it.

A young married woman, who happened to be
watching another woman who was seated at a
window across the street, suddenly discovered that
she could not get the thought of tiiis other woman
out of her mind. She hctd to think of her, she did
not know why nor to what end, but she could not
stop it. These thoughts, accompanied by a sense
of apprehension and depression, persisted for the
greater part of the time for four or more years.
These two cases are examples of what are known

272 MORBID PEABS AND COMPULSIONS

variously as compulsive ideas, fixed ideas or ob-
sessions.

An intelligent yonng Jewish girl, who was her-
self not at all superstitious, was induced by a rela-
tive to consult a fortune teller in reference to a
love affair. Shortly afterwards she was sud-
denly seized with a terrific fear that the fortune
teller was exerting some sort of magical speU over
her and that as a result she would go insane. She
knew this was perfect nonsense, yet the fear con-
tinued to force itself upon her with remarkable
intensity and she was absolutely powerless to
drive it from her mind. (Obsessive or compul-
sive fear.)

A young woman, whenever she uses the word
"I'* is tormented by the question "Who is It
What is it!'' To use or to hear the word "My"
has a similar effect. "Who is Myf she has to
ask herself. "Jfy is not my body or I wouldn't
say ^my hands.' It's not my mind or I wouldn't
say 'wy mind.' Who or what then is it!" She
felt continually impelled to ask other people these
questions, and many had tried to answer them or
convince her that they were unanswerable, but to
no avail. "I've got to know I" she would say.
"I must find out. I never can rest until I do."
All the time she suffered from a tense, anxious
feeling which, it seemed to her, could be relieved
only by her finding the answers she sought.
(Compulsive thinking, Ombelsucht)

A boy in high school was supplied with some
second hand books. He began to doubt the accu-
racy of them, for, as they were not new, he thought

COMPULSIONS 273

they might be out of date, and what he read might
not be the truth. Before long he would not read
a book unless he could satisfy himself that it was
new and the writer of it an authority. Even then
he was assailed with doubts. For he felt uncer-
tain as to whether he understood what he read.
If for example he came across a word of which he
was not sure of the exact meaning, he could not go
on until he had looked up the word in a dictionary.
But as likely as not in the definition of the word
there would be some other word with which he was
not entirely familiar and he would have to Ibok
that up, so that at times half an hour or more
would be taken up in reading a single page, and
even then he would feel doubtful as to whether he
had gotten the exact truth. (Compulsive doubt.)
A young woman was impelled at frequent inter-
vals to rip up her clothes and make them over
again, feeling that she could improve their fit.
Another was forced to eat bread in enormous
quantities. Still another had to count ten before
every contemplated action and then while carry-
ing out the action she would have to tell herself
what it was she was doing. Thus if she were go-
ing out she would have to say: **Now I am put-
ting on my hat ; now I am opening the door ; now
I am going down the steps ; now I am turning the
comer, etc.'^ Before beginning each of these
actions she would have to count ten. These are
oases of compulsive or obsessive actions. In
each case the patient had to obey the impulse in
question. An effort to resist it invariably re-
sulted in an unbearable sense of tension and

V

J

274 MORBID PEARS AND COMPULSIONS

anxiety which was relieved only when the act was
carried out.

Now what feature have these cases in common
to be classed as compulsions? In what does a
compulsion consist?

From the point of view of the patient the term
compulsion is accurately descriptive of his own
feeling with regard to his symptoms. The com-
pulsive idea, fear or impulse, as the case may be,
appears in his consciousness as something foreign
which is forced upon him as if from without.
There is to him a sense of must-ness which invests
the compulsive activities. He is compelled to
think, to fear or to act in a eeiriain definite way,
although his reason and his inclinations are op-
posed to his so doing.

From the point of view of the observer the
essential fact of a compulsive symptom would
appear to consist in a mesalliance between affect
and idea-content. This mesalliance is most com-
monly quantitative. The emotion or impulse ap-
pears altogether excessive for its ideational ac-
companiment. The fear of the young woman that
the fortune teller was driving her insane by means
of magic might not have seemed excessive, had she
really believed that he had that power, but as a
matter of fact she did not believe it, and was quite
convinced that he was merely an ignorant char-
latan. Thus the amount of her fear was entirely
disproportionate to her ideas of the thing feared.
In the same way it was quite reasonable for the
high school boy to wish to assure himself that the
books he studied were reliable and that he under-

COMPULSIONS 275

stood what he read, but his feeling in the matter
was altogether excessive in proportion to the like-
lihood of his receiving any serions misimpression
either through inaccuracy of his books or a failure
to understand all the words he read.

There may also be a qualitative disharmony in
addition to a purely quantitative incongruity be-
tween the affective and idea content of a compul-
sive symptom. Such was the case in the example
of the patient who could not stop thinking about
the woman across the street. There was a quan-
titative incongruity inasmuch as the woman across
the street was a perfect stranger and there was no
apparent reason why the patient should have any
emotion about her at all. But the kind of feeling
which accompanied her thoughts was also qualita-
tively unsuitable, for there seemed to be nothing
in the woman's appearance or the patient's con-
scious knowledge of her to account for the fact
that thinking of her gave rise to apprehension and
gloouL

It would seem, on approaching the matter as
we have done, that the chief problem presented*
by compulsive phenomena is that of explaining
the lack of accord between affect and idea. If.
the considerations represented by the idea-con-
tent of a compulsive symptom are obviously in-
adequate to account for its emotional content, we
feel then that we must account for the emotional
content in some other way. It would seem,
short, that the affects must have some othe
source than that represented by the ideas to whic
they are attached. But if in pursuance of this'

276 MOEBID FEABS AND COMPULSIONS

hypofhesis we ask of a patient: ^^Is there any-
thing in yonr life that troubles you, or that could
give rise to the strong emotions of which yon
complain? " he replies: ' 'No, nothing at alL If
I could only get this terrible fear out of my nund,
I'd have nothing else to bother me, and I'd be
perfectly happy and well." In the face of such
an answer, unless we are willing to abandon our
hypothesis entirely, we are forced to condade
either that the patient is lying or that he does
not know*

But with these last words he does not know we
have hit upon the truth of the matter. If we were
acquainted with every detail of the patient's men-
tal life, it would at once be plain that there are
most adequate reasons for the strong affects in
question, but that he was not fully aware of them,
that they were partly unconscious. Or we might
find that though he was conscious of the causes
of the strong affects, he was not conscious of them
as causes of these affects, that, in other words,
he did not recognize the connection between the
affect and its cause. The apparent dispropor-
tion between affective and ideational content in
the compulsion would then be seen to be due to
the fact that the affects had been attached to
the wrong ideas. Of the right group of ideas
(those in full accord with the affects) he had
been at best only dimly conscious while the con-
nection of these ideas with the '' morbid" impulse
and emotion he had not recognized at alL^ In
other words, to seek to explain the phenomena

1 Thii fact alone goes a long way toward explaining why logic

COMPULSIONS 277

of the compulsion on the basis only of what the
patient is aware of is really to seek the impossible.
Their true significance does not appear until we
bring the symptoms into relation with certain
motives, wishes and considerations of which the
patient has not complete comprehension and con-
Bcionsness.

Such a word as ** Unconscious** or ** Subcon-
scious'' as applied to mental processes for most
people smacks of the transcendental and the un-
real. It seems to them hard to believe that ideas
or impulses which are more or less unconscious
can at the same time be significant and exert a
potent influence in the individual's conscious life
and conduct. And it often appears particularly
hard to believe that unconscious or unrecognized
thoughts produce symptoms, that is to say pain-
ful effects, sickness and suffering. '^If there is
anything in a person's life bad enough to make
him sick, surely he'd know all about it" I once
heard a prominent physician say, and this remark
expresses a quite general feeling in regard to the
matter.

But, as a matter of fact, all of us, even those
who have been most vehement in denying the real-
ity or significance of unconscious mental proc-
esses^ do in a way recognize both their existence
and their potence in determining human conduct,
and we frequently interpret the behavior of our
acquaintances upon such a basis. How often, for
instance, do we hear some such statement as this :

and reason are powerless to dispel obsessions. Such attempts
cannot be directed to the real (unconscious) cause.

278 MOBBID FEABS AND COMPULSIONS

'^Stokes thinks he is in love with Miss Bhodes,
hut I'm sore he isnt. It's really her money he's
marrying her for, hut he doesn't know it." And
what does such a statement imply, if not that
Stokes is swayed hy a powerful motive of whioih
he is not vividly conscious f Who has not made
remarks containing similar implications?

Even the physician quoted ahove, who does not
'^helieve in" the Unconscious, gave evidence of a
keen appreciation of the potence of the non-con-
scious factors in determining behavior. Com-
menting upon a woman who had suddenly dis-
played a fanatical and obviously neurotic enthusi-
asm and activity in the cause of woman suffrage,
he said: ''It isn't a vote that she wants." His
meaning, obviously enough, was that what she
did want was a man, and that her feverish activity
in behalf of ''the Cause" was really the product
of repressed longings the reality and nature of
which she was unwilling to recognize and admit
— ^longings which were, in part at least, uncon-
scious.

It is hardly to be denied then that an impulse
or an idea does not have to be a clearly compre-
hended and conscious one in order to be of sig-
nificance in the life of the individual Conse-
quently the statement that the real causes of the
apparently exaggerated affects in the compulsion
neuroses are for the most part unrecognized or
unconscious is not really so much at variance
with every day experience as perhaps it first ap-
peared.

It is now to be asked what the reason is that the

PAETIAL BEPRESSION 279

forces causing the compulsive symptoms are not
apprehended by the patients. What is it that
prevents them from being aware of the factors
that are really at workf We had a hint of the
answer to sudi questions from the two examples
of unconscious influence that have been given.
For in both cases it will be noted that the unrec-
ognized trend was of a nature which the individ-
ual would have been rather reluctant to admit of
possessing or giving in to. And if one searches
his memory for similar cases, as furnished by the
behavior of his acquaintances, he is quite cer-
tain to find this feature common to all. Such is
the explanation of why the neurotic patient does
not know the nature of the forces producing his

compulsions. "R^nr ^n fli<> Tnair ^^^^nn iTnpnlnnft^

(and their repr.esjBnting ideiBts) ar.e.i)f Hunh a kind

and contrary to^or out of accord witji^thejjr^nds^
of hifl.athical self. The lack pf knasdedge is a
result of the automatic ceBsoisliip -eitorciaod -l^
consciousness and the foreconscious, — ^an effect
of r^ression.

But, as has been many times indicated, the
fact that a wish is out of consciousness does not
mew that It has ceased to exist. Repression is
not annihilation. A wish which is repressed may
persist in the Unconscious entirely unchanged in
quality or intensity and in no way differing from
a conscious wish save in the one particular that the
individual has ceased to have awareness of it.

A neurosis is then a partial failure of repres-
aion. The repressed elements in such a case are

280 MOEBID FEARS AND COMPULSIONS

neither completely excluded from consdonsness
nor have they wholly free entrance into it. What
happens is that the repressed forces again mani-
fest themselves in consoiousnessi not, however in
their original, hut in a disguised and distorted
form which conceals their true meaning. The
disguise corresponds to what is left of the repres-
sion, and in general the more extensive its fail-
ure, the less complete the disguise.

Depending to some extent on the degree of
failure of repression, we have three types of
neurosis: (1) hysteria proper, or conversion hys-
teria, (2) anxiety hysteria and (3) the compulsion
neurosis. The mechanism or structure of the
symptoms differs with each type. That which
returns from repression (the active element at
least) consists of instinctive and infantile wishes
and strivings which, as was said, are out of ac-
cord with the individual's adult and ethical self.
Now, in what we may call a wish-presentation
there may be distinguished two parts: a purely
energic element called by Freud the ** affect-
sum'* (Affektbetrag) whidi I have already men-
tioned as activation energy, and an ideational ele-
ment. Thus when, in the middle of the day I find
myself desirous of eating, I am able to divide
this presentation into its energic content (the
more or less undifferentiated urge or tension) and
its ideational content (thoughts of lunch instead
of thoughts of dinner, ideas of some particular
kinds of food, certain anticipatory images of eat-
ing, thoughts about where the meal is to be ob-
tained, etc.)

CONVERSION HYSTERIA 281

v^ In conversion hysteria the ideational elements
remain repressed (unconscious) while the energic
element (the libido) is employed in somatic in-
nervatioUy sensory or motor, exciter or inhibitory,
producing a purely bodily symptom (a pain,
ansesthesia, spasm, paralysis or the like). The
locus, thus over-innervated, is found, on analysis
of the case, to bear a definite relation ^ to the na-
ture and content of the wishes thus side-tracked
and in some way represents an attempted fulfill-
ment of them. In cases where the conversion is
complete, the patient shows toward the symptoms
the typical ** belle indifference '* of hysteria.
Some of the activation energy may, however, es-
cape somatic conversion and lead to the develop-
ment of affects (anxiety, depression, etc.) in a
varying degree. In the one case a woman tells
uSy for instance, that she has a perfectly excru-
ciating pain in her abdomen, yet at the same time
she is perfectly serene and smiling and seems
totally indifferent to her "agony.'* But in the
other, the patient is worried. She asks anxiously
if the pain may be due to a cancer, she expresses
a fear that her case is incurable, and she begs for
some medicine to bring her relief. Since in cases
of complete conversion no affects are developed,
the repression or defense may be said to be fairly
successful inasmuch as it is the purpose of re-
pression to spare the individual the development
of painful affects.

In anxiety hysteria and the compulsion neurosis,
on the other hand, the repression is essentially im-

1 Freud: "Sammlmig Eleiiier Schreften/' VoL II, Chapter I.

282 MOBBID FEABS AND COMPULSIONS

sncoessful. The idea-content of the repressed
presentation is withheld from consdonsness and
remains repressed. Bnt the activation energy
(the libido) goes fnlly over into affect develop-
ment. In the former neurosis it is converted
without loss into an equivalent amount of fear.
In the latter there is again no loss, affects are
developed proportionate to the amount of libido,
which may take the form of fear or almost any
other, usually impleasant, feeling or impulse.
The repressed idea is replaced in the individual's
consciousness in each case by a substitute idea.
In other words all that is accomplished by the
repression is an avoidance of the ideas. By
means of the mechanism of displacement the en-
ergies themselves break through the repression
and fully manifest themselves in consciousness.

The energy displayed in the compulsive symp-
tom (wish, fear, imperative impulse, prohibition,
inhibition or what not) is displaced or misplaced
energy, in other words a force designed for some
other activities than that in which we fificL it ex-
pressing itself. The symptoms are thus substi-
tute activities and take the place of some other
form of action which has been inhibited. This
will perhaps become clearer when we have con-
sidered the examples which follow.

I shall first take up some cases in which the
energic element of the wish-presentations return-
ing from repression entered into consciousness
unchanged, that is, still in the form of a wish.
The ^^ compulsion" in these cases depends upon
^e fact that this wish-energy is attached in con-

SUBSTITUTE ACTIVITIES 283

sdonsness to some new idea-content, is, in other
words, directed to a substitnte, rather than to
what is actually wished for. With such a com-
pulsion we are already acquainted, namely that
of the young woman who had a morbid impulse
to take drugs. A similar case is that of the
woman who suffered from an imperative craving
to eat bread. When a little girl, she, Jike many
other children, gained the impression that the
fertilizing substance entered the body by way of
the mouth, that pregnancy was brought about by
the mother's swallowing something — ^a seed or
some medicine. Bread is very familiarly the
"Staff of Life'' and hence could be a symbol of
the penis. Her compulsion came on when, after a
not very happy wedded life, her husband died,
leaving her childless. The unhappiness of her
married life had caused the patient to resolve not
to make a second venture. But her natural crav-
ings for sex satisfaction and for motherhood, thus
denied their natural outlet, were displaced, to find
expression in a substitute action. The symbolism
of the substitute action was, as is easily seen, com-
pounded partly from infantile and partly from
adult conceptions of the initial act of reproduc-
tion.

In these cases it is to be seen that practically
the sole effect of repression was to push the wish-
energy or libido away from its natural ideational
accompaniment over to a new one, thus producing
a compulsive wish and a compulsive action. In
another type of compulsion, repression not only
separates the wish from its original ideational ao-

284 MOBBID FEABS AND COMPULSIONS

>,' compaiiiment but also produces a transformation
of the wish energy into anxiety. We have then
a compulsive fear. Indeed it is not diffionlt to
imagine such a thing oocnrring in the case first
mentioned, that, instead of a desire for drugs
and an impulse to take them, there had appeared
a fear of drugs, or, as is usually the case, a fear
of being poisoned. Such fears are not uncom*
mon and, ordinarily, have precisely the same sex-
ual significance as in the case we have mentioned.
I have in mind a very similar case in which the
patient, a young unmarried woman, suffered from
a fear of dust, particularly a fear that she might
swallow some accidentally. Thus, as soon as her
food was cooked, she covered it with a carefully
shaken napkin, which remained in place until she
was ready to eat. Before she could bring her-
self to eat, she would carefully brush her clothes,
dust the table doth, and repeatedly wash and
rinse her dishes, all for fear that some particle of
dust would get upon her food and she would un-
knowingly ingest it. She was very conscious of
the absurdity of her fear and often argued with
herself saying : ^ ^ Why should I be afraid f Dust
couldn't hurt me, even if I ate a lot of it. It's
perfectly harmless; in fact, according to the
Bible it's what we are made of. So how could it
do me any harm!"

But these thoughts, though not interpreted by
the patient, disclose the meaning of the compul-
sion. Dust being ^^what we are all made of"
is a symbol for the fertilizing substance, semen,
and thus, to an unmarried wopian, at least, is not

SELF BBPEOACH 285

in every sense harmless. Her fear of eating dust
is similar in its symbolism to the other cases that
have been mentioned and depends upon the same
infantile theory of oral impregnation.

As I was carefnl to emphasize in the second
chapter, the role of the f oreconscions is not a
pnrely passive one, or limited to the screening
ont of elements that would be objectionable to
consciousness. It represents rather an active,
positive force. A wish remains repressed only
through the continuous activity of a counter-wish.
That this is true the cases thus far cited do not
sufficiently emphasize.

By virtue of the fact that repression is active
and positive we often, and in fact ahnost invari-
ably, find that the energy or driving force dis-
played in a compulsion is not derived from the
repressed force alone but that some of it is con-
tributed by the repressing forces. This is true
to an even greater extent in the compulsion
neuroses than in hysteria or anxiety hysteria.

This fact is indicated in the first case analyzed,
as I may now mention, for the young woman had
herself often felt that the desire to make herself
sick was to some extent an impulse to self -punish-
ment, an abortive suicidal attempt, so to speak,
which was designed to expiate what she regarded
as sinful in her thoughts and actions. This is
very typical. A compulsion as a rule is a result-
ant of two sorts of forces, the one represented by
the repressed wishes which are breaking through
repression, the other (of a character directly op-
posite to the repressed) has its origin in the

286 MORBID FEABS AND COMPULSIONS

ethico-esthetic part of the self and corresponds
to the repressing forces. The following is a good
example.

A yonng professional man, onmarriedi began to
suffer from compnlsive self-reproaches which
came on rather suddenly after A disappointment
in love. The reproaches concerned themselves
with most trivial matters, as a rule, sometimes
one thing, sometimes another, yet he was re-
proaching himself about something practically
all the time, and in a seemingly exaggerated man-
ner. Thus one day he went into a store to buy
a straw hat. He selected one that suited his
fancy, put it on and left the store. Hardly was
he outside the door when the thought came upon
him: "You ought not to have bought that hat.'*
Absurd as it may seem, the sense of having done
wrong which he experienced was of very great
intensity. He continued on Ills way, arguing with
himself to the effect that his feeling was absurd,
that he had done nothing wrong, yet all the while
the sense of self-reproach remained. Finally his
distress was so great that he turned and began
to retrace his steps toward the store, intending
to exchange the hat for another one. On the way
back he was assailed with new doubts, for he kept
thinking: "Maybe it would be better if I kept
this hat. Maybe I am making a mistake if I
take it back." By the time he had- reached the
store, he had decided that it would be better to
keep the hat, so he started for home again with
his purchase still on his head. Before he had gone
very far, the first sense of guilt again assailed

SELF BEPROACH 287

him and finally he did return to the store and^
when exchanging the hat for another one, felt
considerably, if not entirely, relieved. He went
through a similar performance on another occa-
sion when he had gone to his bank to get a new
check book. No sooner had he received the book
than he felt he ought not to have it, that he must
take it back, that he was doing a great wrong in
delaying an instant On stiU another occasion,
a friend suggested to him that he ought to join
a certain regiment. Without thinking of the mat-
ter at all seriously, he replied: ^'Well, perhaps
I will join before long." Soon after leaving his
friend the idea suddenly seized him : ^ ^ You ought
never to have said that. You shouldn't join the
regiment," and he could not rest until he had got-
ten into communication with his friend and taken
back his words. Having done so, however, he
still felt dissatisfied, and kept thinking: ^^ Maybe
it would be better if I did join. Maybe I
should not have said I wouldn't, etc." A day
or two later, having berated himself continually
in the meantime, he called up his friend and told
him he had decided to join after all, and then im-
mediately the first set of reproaches returned,
so that still later he had to retract this decision,
etc

This patient, let it be understood, was a man
of education and of unusual intelligence. Yet
against these absurd doubts and fears he was
absolutely powerless. And though continually
beset with an overwhelming sense of doing wrong,
he could not in any instance point out what there

288 MORBID PEARS AND COMPULSIONS

was wrong in the things he had done, or explain
why he felt guilty and reproached himself. I
shonld add that there was apparently nothing in
his life that should give oGcasion for such feelings
of guilty for he was a man of quite exceptional
morality, and commanded the liking and respect
of every one.

His peculiar symptoms are, however, by no
means inexplicable, if we take into account cer-
tain elements of his mental life that were not
clearly before his consciousness. He had, as was
said, been disappointed in love. The situation
and circumstances of the disappointment were
such as to give rise to a considerable degree of
resentment on his part toward not only the young
lady herself, but towards his family, his father
in particular. His hostility to his father was,
however, really a revival of earlier hostilities
dating from his childhood, which related to in-
terference and punishment but which, for the most
part, were quite fully repressed and withheld
from his consciousness.

A knowledge of the existence of this hostile or
sadistic trend is sufficient to enable us to explain
the symptoms that have been mentioned without
taking up its origin in further detail. The ex-
planation of his compulsion is really absurdly
simple. The straw hat which he selected in the
store had, at the back of the sweat-band inside the
crown, a tiny bow of red ribbon. This fact he
perceived as he examined the hat, without its
really arresting his conscious attention. But the
important thing was that the tiny red bow looked,

SELF REPROACH 289

as he glanced at it, not unlike a small splotch of
blood. Thus, for him to wear that hat was, in a
way, to have blood upon his head. This was the
reason he reproached himself. For if he had
put into action the hostile impulses he was re-
pressing, he would in fact have had blood upon
his head ; he would have murdered some one.

The incident of the check book depends upon
a similar association of ideas. The one he first
received at the bank had a bright red cover, thus
suggesting blood, and to keep it suggested having
^^ blood upon his hands." When he had taken it
back and exchanged it for a yellow one, he felt
considerably relieved.

In the same way the idea of joining the regi-
ment had become connected with the repressed
murderous trend, for there had passed through
his mind the thought: ^^ Suppose I join the regi-
ment and there is a strike or a riot, for which the
militia are called out.^ Then I might kill some
one.'*

His compulsive vacillation is thus seen to have
had its origin in two opposed and displaced trends.
The one which led him to reproach himself for
having purchased the hat, received the check book
and promised to join the regiment was derived
from his conscious, ethical, social and affectionate
self. The other consisted of primitive, savage,
asocial impulses, inhibited very naturally from
direct expression, but nevertheless not kept en-
tirely subdued by repression. It was the non-
satisfaction of this trend which led him to criticize

1 This WM before the beginning of the European War.

290 MOEBID PEAES AND COMPULSIONS

hiB desire to take baok the hat and the oheok
booky eta and was responsible for his laok of
oomplete satisfaction when he had done so.
/ It is to be seen that in this case, if anything,
more energy is contributed to symptom forma-
tion by the repressing forces than by the re*
pressed. His compulsion for the most part was an
overcompensation on the part of his conscious
personality for his unconscious sadism. It was
as if, vaguely perceiving his subliminal murder-
ous tendencies, he could not be content merely with
avoiding actual murder but must avoid also every^
thing even remotely suggesting it.

We may now take advantage of this case to
introduce a consideration of some typical features
of the history and characteristics of compulsion
neurotics. This young man was, as I have said,
quite exceptionally moral in his ordinary behav-
ior. He was a most dutiful son, devoted to his
parents in a very marked degree. He was to all
appearances good tempered, cpnscientious to a
fault, and inclined more to gentleness and sub-
missiveness than to aggression and pugnacity.
But these traits, be it remembered, were expres-
sions of his consciotis personality.^ The history
of his early childhood presents quite a different
picture. For as a very small boy he was very un-
ruly, jealous and subject to most violent fits of
anger and rage. He had also shown at times a
certain tendency to be cruel to other children and

1 Hie words "conseioiiB personality^ as used in this book mean
the combined tendencies of the foreconscions and consdons
(systems.

BEPBESSED SADISM 291

to animals. His brother, of whom he was jealous
at times, he had often wished dead, and on one
occasion in a fit of anger neairly killed him.

Now this early history, or the equivalent of it,
is typical of the compulsion neurosis. Careful
study invariably shows that the so-called sadistic
impulse (the tendency to aggression, anger, vio-
lence and cruelty, a trace of which is found in every
person) is manifested very early in the lives of
these patients and in a very vigorous form. But,
and partly, no doubt, because of its premature
display, the impulse early gets into disrepute,
for, coming into conflict with the corrective dis-
cipline on the part of the parents, often not very
gently administered, it succumbs to a premature
and all too fundamental repression. This repres-
sion is often very complete by the fifth or sixth
year of the child's life, and thereafter, instead of
showing the sadistic tendencies which earlier
manifested themselves, he is more apt to be dis-
tinguished by an exaggerated over-conscientious-
ness and even submissiveness, particularly to par-
ental authority. What happens is as follows.
The repression of the sadistic impulse produces
not its annihilation but merely its transfer from
consciousness to the Unconscious. And there,
withheld from the neutralizing influence of con-
scious reasoning, this impulse and the phantasies
derived from it are not only preserved without
deterioration but may even grow in vigor and in-
tensity. Thus, despite the fact that in many in-
stances the individual's conscious life is appar-
ently singularly irreproachable, nevertheless this

292 MOBBID PEABS AND COMPULSIONS

life is £ved ooincidently with an tmderoEarrent of
impulses of anger, hate, hostility, and revenge and
their corresponding phantasies. To compensate
for this snbstratnm of hostile trends the consdons
qualities of love, sympathy, considerateness and
scmpnlonsness are developed often to an unusual
extent and participate in the task of maiTttAJning
the repression.

The period of apparent normality, but really of
successful repression, which succeeds upon tiie
earlier phase of more or less free sadistic activity
is terminated with the outbreak of the neurosis
when, the repression in part failing, the hostile
tendencies are allowed a certain limited access
to consciousness, subject, however, to disguise and
distortion, particularly in the form of displace-
ment. The symptoms produced by the return
from repression are in part then derived from
impulses, in the shape of hate, hostility, etc, com-
ing from the Unconscious and in part from the
highly developed conscious and f oreconscious im-
pulses of love and conscientiousness which serve
as reaction against them.

The fact that the hostile responses (or rather
the impulses so to respond) are for the most part
confined to the Unconscious produces a very sm-
gular condition, namely, that the individual is able
to have toward the same persons simultaneous im-
pulses of both love and hate, both possessing a
high degree of intensity. The love, no matter how
great, fails to neutralize the hate, which is with-
held from it in the Unconscious and merely ac-
complishes its repression.

/f

ABOULIA 293

The first effect of this strange constellation of
the love-life is a sort of ^^ weakness of will," an
inability to make decisions in matters which per-
tain to love. For the nnconscions hostility pro-
duces an inhibition or resistance in carrying out
all those actions for which love would be the im-
pelling motive. Thus important and decisive ac-
tions are put off^ while those of minor importance
are carried uncertainly, irresolutely and without
any subjective sense of full satisfaction and final-
ity. Evading major love decisions, the patient
very typically concentrates his energies on mat-
ters preparatory to deciding, but here too the ir-
resolution and lack of decisiveness displays itself
and the patient is unable to achieve anything
final, even in these minor matters. The abonlia,
the inability to decide, thus does not long remain
limited to the original love problems but gradu-
ally diffuses itself over all departments of the
patient's life.

The further the spread of irresolution and doubt
is carried, the greater is the tendency for thinking
to take the place of action. ^^The native hue of
resolution is sicklied o'er with the pale cast of
thought''; doing is replaced by doubting, per-
formance gives way to pondering.

The compulsions themselves represent an ef-
fort to compensate for the doubt and conflict in
the love-life. The energy dammed up through
the mutual inhibition of the opposed impulses of
love and of hate is continuously seeking an outlet.
Unable to discharge into the actions appropriate
to its qualities, it forces for itself new avenues

296 MORBID FEAES AND COMPULSIONS

hostile movement alternates with a tender one.
They are a manifestation of the state of ambival-
ence, the coexistence of opposite trends of love and
hate toward the same individnal. Freud gives
the following example.^ His patient, a young
ofiBicer, while walking along a street struck his
foot against a stone lying in the roadway. The
young man's fiancee was going away that day, and
the thought came to him that on her way to the
station her carriage might pass along this street
and be wrecked on this stone, and she come to in-
jury. In consequence he was compelled to pick
up the stone and carry it to one side of the street.
But a few minutes later it occurred to him that
what he had done was very foolish and absurd,
whereupon he had to return and replace the stone
in its original position in the middle of the road-
way.

Gases such as this one of Freud's or my case
of the young man who had such a conflict about
his straw hat show a type of symptom formation
that is usually not to be found in conversion hys-
teria or anxiety hysteria. In those maladies the
rule is that compromises are formed which sat-
isfy opposite trends in a single presentation ; here,
however, the opposite impulses are discharged
separately, first one and then the other, of course
not without some attempt to rationalize into some
semblance of harmony the contradiction between
them. The patient's removal of the stone from
the street is an expression of the overdeveloped

1 "Bemerkiingen fiber einen Fall Zwangsneurofle/' Jahrbach f.
peychoan. u. psychopath. Forach. Bd. I., Hft. 2, 1009.

AMBIVALENCE 297

love impulses; but his action in returning it to
its original position did not come from a purely
objective judgment of his morbid act nor signify
a healthy erasing of it, as the patient might have
thought. It was in itself a compulsion, a part of
the morbid action, and motivated by an opposite
trend from that of the first part. The first part
expresses the thought: **I hope no injury be-
falls my beloved"; but the second does not mean,
as the patient probably believed, "I must not be
so foolishly anxious about her" but rather "I
hope something does happen to her. ' '

The state of ambivalence which distinguishes
the compulsion neurotics seems to arise through
a constitutional accentuation of the sadistic com-
ponent of the holophilic instinct. The undercur-
rent of hostility which in these patients exists in
all relationships is a continuation of the strong
sadistic trends which in early childhood had suc-
cumbed to a premature and perhaps too extensive
repression. The neurosis itself coincides with a
fixation in, or a regression to, a certain stage in
the evolution of the holophilic impulses which
precedes the final genital organization. The
holophilic impulses, as I said in the first chapter,
are more or less independent of one another be-
fore puberty. Their complete synthesis into an
harmoniously operating hierarchy under the
primacy of the genital zone does not occur until
the beginning of sexual maturity. Nevertheless,
preceding this final synthesis, there are states of
incomplete organization or synthesis, and the com-
pulsion neurosis results from a regression to one

298 MOEBID FEARS AND COMPULSIONS

of these, namely the so-called sadistic-anal-erotic
organization. This is a stage in which the in-
dividual is past the predominantly autoerotio
phase, and object-love has already been well es-
tablished ; but the primacy of the genital zone has
not yet come about. A division of the holophilic
impulses into antithetical groups which rule as
'^masculine'' and ^'feminine" in the normal adult
sexual life, has taken place, but the groups at
this stage cannot be so distinguished, and are
rather to be called ** active *' and ** passive.*'^
The active or sadistic group coincides with the in-
stincts for acquisition and mastery and its main
organic complement is the voluntary muscular
and kinesthetic systems (as the genital system is
the prime organic complement in the adult organ-
ization) while for the passive group the anal zone
is the chief somatic focus. Each group has its
sexual objects which are not necessarily alike or
identical. A regression of the libido (after a
period of more normal distribution) to the old
channels marked out by the pregenital organiza-
tion is the underlying essential factor in the out-
break of a compulsion neurosis.

A somewhat similar return, Freud points out,- is
at times to be observed in women when, having
passed the menopause, the genital function is
given up. They become on the one hand ill tem-
pered, quarrelsome, tyrannical and malicious
(sadistic traits), and on the other envious and ob-

iThe antitheflifl "masculine-feminine'' as diBtinguished from
"actiyepaB&iye" does not exist until the goiital zones become the
prime foci of sexual reference.

»--

CUEIOSITY IMPULSE 299

stinate (anal-erotic traits) though daring the
period of sexual functioning they had shown no
tsuch characteristics.^ Thus, as he says, such
oharacteristicSy corresponding to a sadistic-anal-
erotic organization of the impulses may not only
be a precursor to the genital phase of the sexual
life but likewise its aftermath. But whereas the
post-climacteric regression meets with no par-
ticular opposition on the part of the individual,
it is resisted in the case of compulsion neurosis,
is confined chiefly to the Unconscious, and causes
conflicts, reaction formations, compromises, com-
pensations, etc. The character of the compulsion
neurotic might be described as that of an ill tem-
pered, willful sadistic child or of a querulous hate-
ful old woman, upon which has been superimposed
a corrective stratum of such qualities as senti-
mentality, over-conscientiousness and over-moral-
ity— ^which the tumultuou'S undercurrents continu-
ally threaten to break through. The compulsion
neurosis is the negative of the sadistic perversion.
The curiosity impulse which, like the sadistic,
has one of its roots in the acquisitive and domina-
tive impulses is unusually highly developed in
cotnpulsion neurotics and may contribute a good
deal to the clinical picture. These patients as a
class are above the average of intelligence and are
great thinkers, though their intellectual activi-

ft

^Freod: 'IMe Bispoflition zur Zwangsneurose," Int. Zeltsehr.
f. Aerztliche PBycboanalyse, Vol. I, Ko. 6, 1013. Cp. Freud:
''Charakter imd Anal-Erotik," Sammlung kleiner Schriften xor
Neuroaenlehre, Bd. II or Brill: Anal-Eroiicigm and Character
in his boolc on ^^PBychoanalyBia."

300 MORBID FEARS AND COMPULSIONS

ties, at least after the outbreak of the neurosis,
are by no means regularly productive of any tang-
ible or valuable results. But a good deal of the
libido that in less inhibited persons would go over
into action is in these cases taken over by chan-
nels derived from the curiosity impulse and ex-
pends itself in thought ** Where the curiosity
impulse preponderates in the constitution of the
compulsion patient, morbid pondering will be the
chief symptom of the neurosis. The reasoning
process itself becomes sexualized, while the sex-
ual pleasure, which was already connected with
the content of thought, now becomes diverted to
the act of thinking, and the satisfaction of accom-
plishing an intellectual operation becomes felt as
sexual satisfaction. This relation of the curios-
ity impulse to the reasoning process makes it par-
ticularly able, in the different forms of compulsion
neurosis in which it plays a part, to tempt toward
reasoning, where there is offered the possibility
of pleasure gratification, the energy which labored
in vain to express itself in action.'*^ Freud is
of the opinion that there occur cases of compul-
sion neurosis which have as their basis not the
sadistic impulse but the curiosity impulse alone.
Compulsion neurotics have a certain typical
peculiarity with regard to superstition and the pos-
sibility of the death of other persons. Though
a great proportion are very materialistic and not
religious, nevertheless they are almost invari-
ably superstitious. Their superstitious ideas

^ Freud: ''Bemerkongen fiber einen Fall Zwanganeoroae,*' Jahr*
bucb ftLr peychoan. u. pBychopath. Forachungen^ Vol. I^ 1909.

SUPEESTITION 301

exist along side, and in spite of their mate-
rialistio convictions. As Frend expresses it,
they are superstitions and at the same time not
superstitions, having, as it were, two convictions
on the matter, rather than the uncertainty of an
unformed opinion. In many cases their super-
stitions are not of the sort current among the un-
educated, but rather private ones which have a
common origin with their neurosis.

The thoughts of the compulsion neurotics are
continually occupied with the possibility of the
death of others. ''At first their superstitious
tendencies had no other content, and in general
perhaps no other origin. Above all things they
need the possibility of death in the solution of
their yet unsolved conflicts. Their essential char-
acteristic is that they are incapable of decision,
particularly in love matters. They endeavor to
postpone each decision and, in doubt as to what
person should be decided for or against, or as to
what rule should be employed in making the de-
cision, they follow the model of the old German
courts, the processes of which were commonly
ended by the death of one of the contesting par-
ties before any judgment was handed down. So
in each conflict they He in wait for the death of
some one significant to them, usually a loved per-
son, whether it be one of the parents, or a rival
or one of the love-objects between whom their
inclination wavers.*'^

The superstition of these patients is related to
and based largely on a belief (unformulated and

302 MOBBID FEABS AND COMPULSIONS

in the main nnoonscioiiB) in the onmipotenoe of
their wishes^ particularly their evil wishes against
others,— the so-called Omnipotence of Thought.
This is something, however, that is to be observed
more or less in persons with other types of
nenroses and in many normal persons. How such
a belief arises has been ably discussed by
Ferenczi and need not be considered here.^ It
is sufficient for our purposes merely that we know
it exists.

Inasmuch as in the preceding chapters we have
heard so much about the highly important rdle
of the Unconscious in the neurosis, while in the
next chapter we are to consider a case in which
we shall find that a leading part was played by
factors which were not unconscious, it may be
well for me to say that in the compulsion neurosis
the rule is that the recent factors in the patient's
falling sick are not reduced to amnesia by the
repression, as is so often the case in hysteria, but
are dealt with by a different defensive technique.
In the compulsive cases the '^ infantile precursors
of the neurosis may sink into an (often incom-
plete) anmesia. On the other hand the recent
cause of the illness is retained in memory. The
repression has here employed a different and
really more simple mechanism. Instead of caus-
ing the trauma to be forgotten, it has withdrawn
the affect belonging to it, so that there is left in
consciousness an idea-content which is deemed
indifferent and non-essential. The difference re-

1 Ferenczi: ''GontribuiloiUi to PflychoaiialyBis,'' Chapter Vm,
tr. by Ernest Jonee.

DISPLACED EEPROACH 303

sides in the psychic process which we mast infer
as being back of the phenomena. The result is
about the same as in hysteria, for the indifferent
ideas only seldom become reproduced and play no
role in the thought activities of the patient. In
differentiating the two forms of repression we can
utilize the assurance of the patient that the con-
tent of the ideas recovered in the analysis was
in the one case always known, and in the other
had been forgotten for a long while."

^^It is therefore no rare occurrence that the
compulsion patients who suffer from self re-
proaches and have connected these affects with
false causes, make the correct confession to the
doctor without perceiving that it is from what
they have confessed that their reproaches are de-
rived.'' ^ And when it is explained to them what
the relation is, they still fail to see it, saying:
^^Oh, that doesn't bother me. I never worried
about it."

I recall a striking example of this which, though
I did not analyze the patient, is sufficiently con-
vincing. One day as I was entering the rooms be-
longing to the neurological department at Cor-
nell Dispensary, an intelligent looking young
woman got up from the benches belonging to the
flkin department^ which is next door, and stopped
me.

^^Doctor," she said, ^'is there any one in your
department who knows how to hypnotize f"

"Yes," I replied, **why do you askf "

"Because I want to stop smoking cigarettes.

304 MORBID FEABS AND COMPULSIONS

and I can't I thought maybe if I oonld be
hypnotized it would help me. I've got to stop.
The things are killing me."

<<A11 right," I 8aid| ^'oome in and well see
what can be done," and, sitting down, I began to
take the usual routine history.

"Your aget"

"Twenty-five."

"Occupation?"

"I am a prostitute."

"What diseases have you hadf "

"IVe had gonorrhea and syphilis. I'm being
treated for syphilis now in the skin department."

"Do you drinkf "

"Yes, I drink quite a lot. I smoke dope and
snuff cocaine a little too, but I don't think I
have a real habit for them."

"How long have you smoked cigarettes? "

"Five years."

"How many a dayf " (I expected her to say
forty or fifty.)

"Oh, seven or eight."

"But that isn't very many," I said. "I don't
believe seven or eight cigarettes a day would hurt
you at all, to say nothing of their *Mlling' you."

"But they are killing me. I know. I feel so
nervous and worried and blue, and all the time
I am always thinking I am going to die. It's the
cigarettes that's doing it. I'll be dead or dippy,
if I can't stop them soon." She spoke most earn-
estly and seriously.

"But maybe it is something else — ^for instance,
the kind of life you lead, or having syphilis — ^that

DISPLACED EEPEOACH 305

really makes yon feel bine and worried, and yon
only think it's the cigarettes that are doing it.''

**No," she said, *'it's the cigarettes. They're
what's killing me. I know, becanse I never felt
this way nntil I began to smoke them."

^^How long ago did yon begin the sort of life
you are now leading?"

**Five years ago. I was a perfectly straight
girl np to then."

^^Bnt that's jnst the time yon began to smoke
cigarettes, isn't it f"

**Ye8, that's right," she admitted.

**Bnt," I asked, ** since yon began to smoke
cigarettes and to do these other things at jnst the
same time, how do yon know which it is that makes
yon feel badly f Being a prostitnte and having
gonorrhea and syphilis might mnch more easily
cause a girl to feel bine and worried than smok-
ing a few cigarettes. Don't yon think it possi-
ble that some of these other things and not the
smoking are the real reasons why yon do not feel
weUf"

^^No," she said, ^'I see what you mean, but I
don't agree with yon. Somebody else might
worry about such things, bnt I never do. Old
B. E. Morse never bothers me. If I conld stop
the cigarettes^ I'd feel fine. They're what's kill-
ing me and nothing else." It was very apparent
that she really believed this, and that no ordinary
argument conld shake her out of her conviction
— ^and this despite the fact that the girl was by
no means unintelligent.

The case clearly enough was one in which the

306 MORBID PEARS AND COMPULSIONS

patient had made the ^'correct confession"^
without realizing that what she had confessed
was the real source of the affects that were trou-
bling her. Naturally she could not become amnesic
to i}^e fact that she was a prostitute and a suf-
ferer from venereal disease. She was, in other
words, unable to defend herself against these
sources of painful affects by completely forget-
ting theuL The next best defense to denying
their existence (amnesia) was that of denying
their importance. ^^ Somebody else might worry
about these things, but I never do." This the
repression could accomplish, whereupon the pain-
ful affects, which as depression, nervousness, etc,
continued practically unaltered, she explained to
herself as the result of something relatively in-
nocent, namely the cigarette habit.

This defensive mechanism, of which we shall
have further illustration in the next chapter, re-
minds one of the following familiar story. A
sporty young man who was not feeling '*fit," con-
sulted a physician. **My boy," said the doctor,
when he had made his examination, ^^you have
been going too fast a pace. There lies your
trouble. Wine, women and song are killing you."

**A11 right, Doc," replied the young man cheer-
fully; **I'll cut out singing."

This story serves to bring out an important
point in connection with defensive displacement.

1 Without doubt the "oonfession** web inoomplete. I imagine
that oral perversities or tendencies thereto constituted one of the
sources of the displaced affects, and that this was one of the
reasons why the cigarette habit was selected as a substitute idea,
for it too had to do with the mouth.

DISPLACED EEPEOACH 307

If the young man confined his reformative efforts
to the non-essential, singing, he would spare him-
self the renunciation of those other activitieSi
which, being more pleasorable, would be harder
to give up. Likewise the young woman, by mak-
ing, as it were, a scapegoat of her cigarette smok-
ing, dodged the problem of so reforming the rest
of her life that there would be no cause for the
development of guilt affects. She had thus, in
the shape of whatever sexual satisfaction or
pecuniary gain she derived from the sort of life
she was leading, a certain ^'reward of illness,"
corresponding to the ^^ secondary function of the
neurosis/*^ This she would have to forego, if
(her instincts and economic situation permitting)
she abandoned such a life in favor of one more in
accord with the demands of her conscience.

1 Freud: '^Allgemeineg fiber den hysteriachen Anf&Ue"; Samm-
luag kldner Sduriften nir NeuroMnlelire, Bd. II.

CHAPTER Vn

A CASE OF COMPULSION NEUBOSIB
(tHB case OF STELLA J.)

A COMPLETE report of an analysis would
sometimes be as long as the stenographic
report of a hard fought legal battle. An
absolutely full analysis is impracticable as it
would include an inventory of every thought and
impulse the patient had ever had since birth.

The fact that up to the year 1917 there were
not more than half a dozen comparatively com-
plete reports of analyses published iu any lan-
guage, (one of Freud's was an unsuccessful case
and the other a full analysis but incompletely
communicated) has led me to give the following
case in as great detail as the limits of this book
allow. The ordinary objections against publish-
ing such material are less weighty in the present
case because the subject is a clinic patient whose
friends are not likely to read it, and the circum-
stances of her neurosis were known only to
her husband, who is now dead, to herself and to
me.

The case is unsatisfactory because the work
was interrupted and so the analysis is not a full
one, but it is illuminating because of the documen-
tary corroboration of the facts disclosed by the
analysis and because of the clearness with which

308

A COMPULSION NEUEOSIS 309

it shows that the confessions of the patient were
not ^'suggested" by the psychoanalyst. It con-
firms the correctness of some of Frond's con-
clusions as to the mechanism of neurotic disturb-
anceSy particularly the displacement of affects.

The case is also valuable in the light it throws
on some points in psychoanalytic technique, show-
ing as it does (1) the gross sexual element emerg-
ing first, (2) a non-sexual but exceedingly import-
ant factor disclosed later but with great resist-
ance, (3) the insignificance from a therapeutical
point of view of an apparent willingness to get
well on the part of the patient, (4) the refutation
of the charge that psychoanalysts read sex into
everything and (5) the confirmation of the em-
phasis which psychoanalytic theory lays on sexual
factors. The last point does not diminish the
value of the present analysis as an illustration
of the fact that other elements are not overlooked.

' PaBT L HiSTOBIOAZi

(a) Data of the First Visit

In May, 1911, there came to my office a small,
plump, young woman who bore upon her round,
good-natured-looking countenance an expression
of distinct anxiety.

** Doctor,'' she said hurriedly, **I am afraid I
am going insane. I once went to a fortune teller
and I imagine he* is bewitching me ; do you think
it is all right for me to get married f"

This obsession had appeared in July, 1910, ten
months earlier, when she was madly infatuated

310 MORBID FEAES AND COMPULSIONS

with a yonng man, and upon the advice of her*
cousin, a very superstitious girl, had sought the
services of a fortune-telling magician. She had
the idea that through his influence the young man
would be stimulated to ask her hand in marriage.

Two days after this visit she was suddenly
seized with a terrific fear that the fortune teller
was exerting some spell over her as a result of
which she would die. This fear of death was suc-
ceeded after a time by a fear of insanity. She
soon sought treatment, and in November the ob-
session, which had continued with great intensity
up to that time, almost completely subsided, only
to appear again the following March (1911) in
all its original intensity.

I was surprised to learn that the young man,
Max by name, her infatuation for whom appeared
f o be the cause for her getting into all this trouble,
was not the one she had in mind when she asked
me about marriage. For in the early months of
her illness. Max, serenely unaffected by the al-
leged powers of the man of magic, had passed out
of the young lady's life. Another young man,
whom we shall call Barney, had then presented
himself and, swayed by no other form of sorcery
than that which she herself exerted, had proposed
to her and had finally been accepted.

The immediate cause of her great anxiety at
the time she came to me seemed to be that the day
set for her marriage to Barney was only three
weeks off. She feared the fortune teller was
making her insane and that she was thus destined
to bring nothing but trouble and unhappiness

A COMPULSION NEUROSIS 311

npon her husband. She could not make up her
mind what to do, for despite the fact that the
various physicians she had consulted had without
hesitation assured her that there was not the least
likelihood of her ever losing her mind, she was
not satisfied and could not banish the fear that
in marrying she would do a great wrong to an
iimocent man.

I finally said that although I, too, was convinced
that she was in no danger of becoming insane, I
felt, nevertheless, that it would be well for her
to postpone her marriage for some months in the
hope that meanwhile she could get over her fears
and thus take without any undue handicap the im-
portant step she contemplated.^ But this, she

iFhysidaiiB are often conmilted by neurotic patients oonton-
plating matrimony who eacpress some more or less vague fear that
th^ may be impotent^ or have syphilis, or suffer from some other
111 which would render marriage inadvisable. They wish to be ex-
amined and assured that their fears are groimdless, and as the
physician usually does not find any evidence of the condition
which the patient seems to fear, the assurance desired is as a
rule promptly given. Now, as this case shows, one should, as a
matter of fact, be extremely careful in such cases. The patient's
fear that some condition exists which would prove an obstacle to
marriage usually means either a vnsh that' such were the case
(showing that the individual in question is really of two minds
in regard to the object of his affections and that to a certain
degree he would welcome some excuse for not marrying) or that
there actually is some reason why he ou^t not to marry, although
moi the one he fears. Both these things were true in the case of
this young woman. But although in some cases it would be a
serious mistake to advise the patient to go ahead and marry in
spite of his fears, yet on the other hand there are cases in which
to advise against marriage would be almost equally serious. In
short, in most cases of this sort the physician has no way of
knowing with any certainty what he should advise, unless he ana-
lyzes the patient, which unfortunately is in most instances imprac-

312 MORBID FEARS AND COMPXJLSIONS

replied, was impossible. AU the arrangements for
her wedding had been made, the invitations had
been sent out, and, finally, neither her own nor her
fiance's parents would listen to any proposal of
delay. To follow my advice was out of the ques-
tion.

After some further discussion relating to the
treatment of obsessions and to the probability of
her recovery, she told that she was very poor and
asked if it would not be possible for me to treat
her in a clinic. On this account I referred her to
Cornell Dispensary.

(6) Results of the First Period of Treatment and
Detailed History Obtained During that Time

At Cornell the young woman was treated for
nearly a year with the ordinary medical remedies
employed for such cases, and, in addition, with
hypnotic suggestion administered once or twice a
week by Dr. Stechmann or myself. Suggestion
occasionally gave her relief which lasted for a few
hours. Bromides and other drugs seemed to have
no effect. Cold tonic baths received at another in-
stitution often gave her temporary relief. On the
whole, however, she had not made the slightest
permanent improvement at the end of this period
of treatment. Her fear was just as intense and
just as compelling as when I first saw her. Her
marriage, which took place at the appointed time,
seemed to have no particular effect upon her symp-

ticable. Gf. Jones, ''Der StellungBnahme des Aerztes zur dea
Aktual Konflikten," Internationale Zeitwhrift fur Aergtliche Pty-
ohoanalyw. Vol. HI, 1015.

A COMPULSION :NETJE0SIS 313

toms other than to cause temporary exacerbation
of her fears jnst before it.

Dnring this first period of the young woman's
attendance at the clinic, although I made no
real attempt at analysis, I talked with her from
time to time and endeavored to obtain an accu*
rate and detailed^ history of her neurosis
and the events which attended its develop-
ment. When, then, late in the spring of 1912 I
decided to begin an analysis, I had at my com-
mand the following items of history. The pa-
tient, whom we may call Stella, was then twenty-
three years old. Her family history was decid-
edly psychopathic. Her mother, two brothers,
and her sister had at different times suffered from
various forms of psychoneurosis.

The clinical past history which she gave con-
tained nothing of particular interest. She had
had the usual diseases of childhood, and had been
inclined to be nervous as long as she could remem-
ber. Her menstruation had often been irregular
and scanty. Sometimes weeks elapsed between
her periods, and on a few occasions the interval
had been as long as several months.

When thirteen and a half years old she had suf-
fered, she stated, from some sort of nervous illness
which lasted about two years. It was brought on,
she believed, by the sudden death of an aunt about
four years older of whom she had been extremely
fond. The symptoms of this nervous illness she
could not describe definitely, but she remembered
that she lost weight, was very much depressed, and
dreamed of her aunt nearly every night. One of

314 MOBBID FEARS AND COMPULSIONS

the doctors who attended her made the statement
that she was "very poor in blood." She could
not remember what her aunt died of, bnt thought
"it was from worrying about something.''

Physical examination was practically negative.
The patient was well nourishedi rather fat in fact ;
examination of the heart and lungs and nervous
system failed to reveal anything significant She
had a moderate anaemia; the urine was negative.

Stella was bom in a small village in Bussia.
Her parents were Hebrews, religious to the point
of fanaticism and full of all sorts of Old-World
fables and superstitious beliefs.

Stella's father, a Talmudic school teacher in his
old home, had come to this country when she was
five years old, but his family, which already in-
cluded two boys both younger than Stella, did not
join him until four years later.

In the New World little prosperity awaited
them. The father, a man whose reputation for
piety, honesty, and religious scholarship gave him
no little standing in synagogic circles, did not
shine in the world of business; and, although he
managed to keep his family from falling into ac-
tual want, he was never able to provide any other
home for them than a cheap flat in a lower East
Side tenement.

When Stella was sixteen the f amUy, by that time
augmented by the arrival at different intervals of
three more boys and one girl, threatened to become
an economic problem so far beyond her father's
power of solving that she sought employment in
order to lighten his burdens. She soon obtained a

A COMPULSION NEUBOSIS 315

place in a department store where she worked np
to the year she was married.

Stella's education, began in Enrope along the
most old-fashioned orthodox Jewish lines, was
continued in this country in the public schools.
From the beginning she not only displayed a great
fondness for study, but also gave every evidence
of possessing more than average intelligence.
Throughout her school days she worked hard and
almost invariably led all her classes. Her educa-
tion was not extensive, however, for at thirteen
and a half she had to stop school ^^ because her
mother needed her help with the housework."

Her religious ideas were in her early years a
replica of those of her parents. She prayed and
worshiped in the most orthodox manner, and,
in addition, accepted without question the beliefs
in magic, witches, the evil eye, and similar super-
stitions which prevailed in the town of her birth.
After passing her fifteenth year, however, she
went rapidly to the opposite extreme and, soon
abandoning both religion and superstition, pro-
fessed herself to be an absolute atheist and ma-
terialist.

Her infatuation for Max was her first love affair
of any importance. She had always been popular
with the young men, and she liked them, but at no
other time had her affections become seriously
involved.

Stella's affair with Max, her visit to the fortune
teller, and the immediate sequelsB of this visit are
of so much importance that I must take up the his-
tory of these matters in considerable detail.

316 MOEBID FEABS AND COMPULSIONS

In the early stuniner of 1910 Stella went to a
country boarding house for her vacation. There
8he first heard of Max. He had been at the place
the previous summer and made himself a general
favorite. All spoke with enthusiasm of his intel-
ligence, his refinement, and his good looks. He
was to arrive shortly, and on the day he was ex-
pected, Stella, whose curiosity had been awakened
by the praise she had heard of him, went to the
railroad station in order to get an early glimpse of
the paragon. Catching sight of him just as he
stepped from the train, she felt, from that very in-
stant, that she loved him. Immediately and with
a sense of deepest conviction she said to herself,
**Here is the man I must marry."

He was introduced, and appeared to like her at
once. Soon, to her joy, it became evident that he
preferred her society to that of any of the other
girls, and in a short time her love became an all-
consuming madness such as she had previously
never dreamed of. She was in the most tensely
excited emotional condition imaginable. She
could neither eat nor sleep. At night, or whenever
she was alone, she cried continually. She lost
weight rapidly and to such a degree that her
friends began to comment upon her appearance.

Max, though by no means in a condition of equal
distraction, was to all appearances in love. From
morning to night he was in her company, paid her
every attention, and showed the utmost jealousy
of every look or word she bestowed upon possible
rivals. All the guests at the boarding house were
sure that a proposal was imminent. Nevertheless

A COMPULSION NEUEOSIS 317

it did not come. On the contrary, Max maintained
a most loflezible reserve. Not the slightest hint
of love passed his lips ; never did he attempt even
the most fleeting and noncommittal of caresses.

When their vacations ended and they both re-
turned to the city, Max called on Stella frequently,
took her to various places of amusement, and, as
far as his acts were concerned, gave every evi-
dence of love and devotion. But, in what he said,
he was as reserved as ever. On no occasion did
he let fall a single word that could be construed to
mean anything more than that his feeling for
Stella was the most ordinary unromantic sort of
friendship.

This paradoxical attitude on the part of Max
struck me as being so singular that I at once asked
Stella if she knew the reason for it. '^Yes,'' she
replied, ''Max was not a marrying man. I know
that because he said so to a friend of mine, who
told me all about it. But he assured my friend
that if he were to marry anybody he certainly
would marry me, and I know that is so. "

When I asked why Max was not a marrying
man, Stella explained that he was very ambitious,
but had only a small salary, and, as he felt that an
early marriage would seriously handicap him in
business, he had decided to forego that pleasure.
But this explanation, though seemingly plausible
enough, left me with the vague suspicion that per-
haps Stella was not telling all she knew.

Stella's disastrous visit to the fortune teller
occurred in August of the same year she met Max.
She had continued in a state of mad infatuation all

I

318 MOBBID FEABS AND COMPULSIONS

sunmiery and, when she confided her condition to
her consin Boee, the latter immediately suggested
magic as a way of inducing in Max a like state of
mind, and ultimately bringing about a wedding.
Bosoy who was superstitious and credulous to the
highest degree, supported her recommendation
by relating a great number of instances of maid-
ens (with whom, she said, she was personally ac-
quainted) who had resorted to such methods with
most remarkable and gratifying results. But
Stella scoffed at these stories, as she did at all the
rest of the wonder tales Bose was continually tell-
ing, and at first refused to have anything to do
with magic and fortune teUers.

Some days later, however, when Stella had ac-
companied Bose, who had some eye trouble, to
what we will call St Christopher's Clinic, she said
suddenly as they were walking home, ''Bose, I
think I would like to go to a fortune teller after
aU/'

This suggestion Bose received with much en-
thusiasm, and, informing Stella that she had only
recently heard of a man reputed to possess truly
extraordinary powers, she proceeded to conduct
her to him without delay.

The fortune teller, magician, or Mahoshef, as
they called him, proved to be a fat, dirty, and
ignorant Austrian Jew who inhabited a greasy
tenement in the neighborhood of Canal Street.
Bose was ushered into his presence first, while
Stella waited in a room outside where the Maho-
shef 's wife entertained her with tales of his prow-

A COMPULSION NETJEOSIS 319

Soon Bose retained in great excitement ' ' Ete 's
a wonder, Stella!'' she cried. ''He knows every-
thing! He knew what your trouble was the min-
ute you came in. He said right away that^ou
were very nervous over a love affair. What do
you think of that!''

Stella replied to this somewhat sarcastically,
but she arose and went into the Mahoshef 's room.
She was already a little afraid of him. In spite of
the fact that his wife's recital of his achievements
had excited her profound contempt, and that the
man's appearance and behavior, once she was in
his presence, served to increase this feeling, she
had, nevertheless, a vague fear of him all through
the visit.

The first thing he did was to offer to tell her,
without asking any questions, her own name and
the name of her sweetheart, and though he suc-
ceeded in doing so by means of a somewhat clumsy
trick, Stella immediately saw through it and
jeered at him for his pains. But the Mahoshef,
not in the least discouraged, wormed out of her the
story of her affair with Max, and promptly as-
sured her that by means of certain powers of
which he was master be could not only obtain Max
for her as a husband, but, if she preferred, any
other man she would name, regardless of what his
race, creed, color, or social position might be. As
evidence of his ability in this line he showed her
a book wherein, so he said, were written the names
of many of the most prominent and wealthy women
of the city, for all of whom he assured her he had
performed similar services.

320 MOEBID FEAES AND COMPXJLSIONS

**I can do everything I'* he cried boastfully.
"For me all kinds of Kishef (magic) are easyl"

It was just about this point, however, that in
spite of her contempt, in spite of her full apprecia-
tion of the grotesque incongruity between what
the man professed to be and what his manner of
living indicated, Stella began to believe him. She
therefore directed him to proceed with his Kishef
and bring Max to her feet at the earliest possible
moment, while she permitted him to collect in ad-
vance the fee of fifty cents which he demanded
for this important service. Her belief in him
was so strong that when she left him — after he
had urged her to buy an infallible cure he had in-
vented for rheumatism and she had politely de-
clined on the grounds that she was not at the time
afflicted with that malady — she returned home in
the most cheerful state of mind she had experi-
enced in some months.

"I*m so happy," she said to Rose ; "now I know
I can marry Max.'' ^

There followed two days of joyful expectation.
Stella and Bose talked continually of magic and
witches, and of the pleasing results they expected
from their venture. And all the while Stella's
faith in the Mahoshef seemed unshaken ; yet, para-
doxically enough, her skepticism appeared to be
almost as strong as ever. "It was all Rose's
fault/' Stella complained to me afterward;
"she talked so much superstition into me that
finally I got to believe it, although I really knew
better."

On the evening of the second day after their

A COMPULSION NETJEOSIS 321

vifiit to the magician the two girls were lying in
bed discussing the usual theme. Stella again said,
**I'm so happy— now I can marry Max" ; but after
a pause she continued, '^I'm sorry, ijiough, to
have to get him in this way. I don't like this
magic business — ^I'd rather get him in the right
way. I wonder what he 'd think if he knew. I 'm
afraid I'm going to worry— I think that after we
are married I'll tell him all about it — ^I'll worry
myself sick if I don't"

"You're a fool," returned Bose. *'Why should
yon worry about how yon get him as long as you do
get him? You're too honest I You make me
sickl"

This matter was soon dropped and Bose went
on to teU the story of a young woman who had
caused a man to fall violently in love by secretly
putting some menstrual blood in his tea. "It
worked wonderfully," concluded Bose. "The
man was crazy about her, but all the rest of his
life he was never very well. " " Oh, by the way, ' '
she went on, "did you know, Stella, that if Max
has magic done to him he'll be weak and sickly all
the rest of his life? He can't live to be older than
fifty at the very most, and maybe not even that
long."

Immediately upon hearing these words Stella
was seized with terrible fear. "Ohl" she cried,
"isn't that awfull I cant have a man's days
shortened for my pleasure I I can 't have him lose
his life on my account. ' '

"You are so stupid," replied Bose in great con-
tempt ; ^ ^ why should you care ? I wouldn 't let the

322 MORBID FEABS' AND COMPULSIONS

lives of fifty men stand in the way of my happi-
ness."

But this lofty sentiment had no effect upon
Stella. Almost the very instant she heard the
wordSi **it Max has magic done to him hell be
weak and sickly all the rest of his life/' the ter-
rific fear had come upon her that the Mahoshef
was exerting magic npon her and that she was
going to die. All the rest of the night she spent
crying and screaming in constant terror.

Early the next morning she went back to the
Mahoshef, told bim she did not want the yomig
man after all, and begged him to stop the Kishef
at once. He immediately and repeatedly assured
her that she had nothing to fear, but this did not
help her, and, returning home, she told her family
that she was going to die, ordered her clothes to
be given away, and indicated where she wished to
be buried.

On the following day, although she was as much
alive as ever, her fear was unabated, and she re-
turned to the fortune teller to renew her entreaties,
but, as before, without relief. For several days
she continued to visit him, but, fiinally, as his as-
surances brought her not the slightest comfort,
she told him she was going to see a doctor. He
was evidently alarmed by this, and threateningly
forbade her to do anything of the kind.

Eventually of her own accord, she went to the
Broadway Clinic. There one of the dinio physi-
cians became much interested in her case, and, as
I have said, she finally improved under the hyp-
notic suggestion which he administered. But be-

A COMPULSION NEUROSIS 323

fore this improvement took place she spent five
days as a voluntary patient in a hospital for the
insane and a week or so in a neurological hospital

With the onset of her obsession, her attitude to-
ward Max underwent a peculiar modification. Up
to that time, although apparently she was madly
in love with him, she had maintained the most per-
fect maidenly reserve. As soon as the obsession
came on, however, her love for him seemed to di-
minish, but, singularly enough, her reserve dimin-
ished also. Though she had invariably been any-
thing but forward in her relations with men up to
that time, she now b^an to pursue Max in a most
vigorous and aggressive manner. She continually
pressed him to come to see her, hinted most
broadly at the state of her affections, and used
every means at her command to bring him to the
point of proposing. But in spite of all her efforts
he remained as noncommittal as ever — ^indeed, if
anything, he became more reserved.

At last, driven to desperation by this Fabius
of the affections, she adopted tactics which not
only forced the issue, but, from the point of view of
decisiveness, left nothing to be desired. Thus, one
day in November, when Max was calling upon her,
she said to him, '^If a yoimg man loves a young
lady, and wants to marry her, he should say so.
Otherwise, she might learn to love some one else.''

Max, doubtless feeling unable to attack this ob-
viously unimpeachable precept, replied, ^^If a
young man were in love with a young lady, and
felt that he was in a position to marry, he wovld
say so.''

324 MOBBID FEABS AND COMPULSIONS

And to this highly abstract proposition, which
Stella apparently found to be quite as nnassail^
able as her own, she made no reply.

Max then changed the subject, and, after dis-
coursing for a short time upon the weather and
other matters of equally profound public and pri-
vate interest, politely wished her good evening
and withdrew. Except for one occasion, when she
happened to meet bim on the street, she has never
seen him since.

It was shortly after Max's final visit that she
began to improve. From the time her obsession
began she had been so sick that work was out of
the question, but now she felt so mudi better that
she became anxious to earn money again, and, in
December, she went back to her old place in the
store.

Her acquaintance with Barney began in Novem-
ber, soon after her friendship with Max ended.
Previous to this time Barney had been living in
another city and Stella had never seen him. How-
ever, she had heard of him frequently through his
sister, Esther, who was one of her closest friends.
Barney appeared to like Stella from the first, and,
as time went on, his feeling rapidly became
warmer, so that by the end of three or four months
they reached a secret understanding and still later
announced themselves as engaged.

For a while things went fairly well with Stella
after she returned to work. Her fear of the for-
tune teller had almost disappeared, and she seemed
to be in very good spirits. Then, in March, the

A COMPULSION NEUBOSIS 325

fear suddenly returned and she was as sick as
ever.

The revival of the obsession occurred under the
following drcumstances. Just before Saint Pat-
rick's Day Stella heard some of the girls in the
store talking of the coming celebration and asked
one of them what it was that gave the Saint his
particular claim to distinction. '^Oh, don't you
know that ? ' ' returned the girl. * * Why, he was the
one who drove the snakes out of Ireland."

Stella became fearful immediately. ^^Oh, that
must have been magic ! ' ' she said to herself. ^ ' I 'm
afraid— if that could happen, n:iaybe the Mahoshef
can do n:iagic to me ! "

All the rest of the day she felt anxious and un-
easy and kept thinking about magic and witches.
The next morning when she awoke the old fear
was upon her, in all its original fury.

She went to work, however, but in the store she
was so overwhelmed by fear that she lost all con-
trol of herself, fell to the floor crying and scream-
ing, and had to be taken home in a taxicab.

As soon as she was able to do so, she again went
to the Broadway Clinic, but the treatment she re-
ceived there helped her no longer. The fact of
her approaching marriage added to her perplex-
ities, and she felt her condition to be most des-
perate. Finally, she took some of the money she
had saved for her wedding finery and went to see
Dr. Dana, hoping that he could either convince her
that she had nothing to fear, or else show her some
way out of her difficulties.

326 MOKBID FEAES AND COMPULSIONS

She gave him her history, telling him particu-
larly of her great fear that she onght not to marry,
because, as it seemed to her, she might go insane at
any moment. Dr. Dana stated in most positive
terms that she w^s not going insane and that she
need have no fear on that score of making her
husband unhappy. This comforted her for per-
haps an hour, but no longer, so in a few days she
returned for further assurances. Dr. Dana then
referred her to me.

After this, as has been said, Stella came to Cor-
nell Dispensary for nearly a year without obtain-
ing any particular relief from her fears. To be
sure, she was no longer subject to the wild attacks
of crying and screaming which occasionally had
taken place during the first few months of her ill-
ness, and certain minor obsessive ideas connected
with her major fear had apparently disappeared,
for she ceased to talk of them. On the whole,
however, she had made no real improvement.
These transitory obsessive ideas should be men-
tioned, for they will be of interest later.

When Stella first came to me she feared not only
that the fortune teller was able to do Kishef to
her, but also that people he knew — his friends or
acqimintances — likewise had this power. For this
reason she was afraid to go to the neighborhood in
which he lived.

In this same early period, Stella was also afraid
of any one who looked at her fixedly, particularly
strangers. Thus, if she were on the street and
saw some one staring at her, she would imme-
diately fear that this person was performing

A COMPULSION NEUEOSIS 327

magic on her and that she wonld become insane as
a result.

In a similar way she was afraid of the doctor
who had hypnotized her at the Broadway Clinic.
Whenever she thought of him she feared that he
was doing Eishef to her. He was in Europe the
first summer she came to me, but the fact that she
knew he was thousands of miles away from her
did not diminish her fear in the slightest.

All these ideas were never very prominent, and,
as I have said, Stella ceased to refer to them after
a short time.

But her main obsession, the fear of the fortune
teller, was remarkable for its intensity. Appar-
ently she was in constant terror throughout all
her waking moments. There was practically noth-
ing that would interest her or take her mind away
from herself more than momentarily. Over and
over again she would say in a certain stereotyped
way, **He has power over me — ^I'm afraid he's
doing me harm — ^I feel I^ not safe — ^he bosses
my thoughts — ^he's making me insane.''

She continually questioned me about magic and
similar matters. '^Are you sure there isn't any
magic!" she would ask. **How do you know
there isn't — ^have you studied itt Is it a scientific
fact that there can't be anyt There were great
men in the Bible, and Shakespeare was a great
man, but they believed in magic and witdies — ^how
do you know they were wrong ? If such bright men
beUeved in those things there must be some truth
in them — ^it makes me afraid — ^I think the Maho-
shef has power over me," etc.

328 MOBBID FEARS AND COMPULSIONS

Any attempt I made to reassure her on any of
these points usually ended in making her feel
worse rather than better. For she would invari^
ably oomer me in some way, and, as soon as I
failed to give a satisfactory answer, she would be
in a panic.

Before her illness began Stella had always ap-
peared to possess a very sunny, fun-loving dispo-
sition. Even during it at times she showed a keen
sense of humor and talked in a very witty and
amusing way, but usually she was greatly de-
pressed and ready to cry at a moment's notice.
Her depression, however, was as nothing when
compared to her fear. Indeed, I recall no other
case of neurotic fear whidi so deeply and vividly
impressed me with the terrible reality of the pa-
tient's suffering, or in which the familiar hypo-
critical note of satisfaction was so conspicuously
absent from the patient's complainings. There
was no doubt whatever that Stella was really and
honestly sick.

There are many other suggestive circumstances
which I could have included in this record of his-
torical data, but I will omit all but three which
seem most significant in furnishing the back-
ground for the problem at the time of beginning
the analysis. The first of these was Stella's
intense and lasting rage when she discovered,
after her illness began, that at the time they first
went to him Bose and Uie Mahoshef were not total
strangers but had known each other some time;
the second was that for some time Stella concealed

A COMPULSION NEUROSIS 329

from me her dvil marriage which had taken place
a week before she first consulted me. (Jewish
people often have a civil ceremony performed by
a city official some little time before the religious
ceremony.) These two facts will be accounted
for later. (Pages 403 note and 424.)

A third matter which in part was equally mys-
terious, while at the same time another part gave
some hint of the nature of Stella's unconscious
psychic process, was her evident belief that if
Max had Eashef done to him he would be weak
and sickly all the rest of his life, and could not
live to be over fifty. Such credulity was entirely
inconsistent with her attitude toward all other
superstitious ideas. Though her obsession, and
certain compulsive thoughts connected with it,
represented a sort of belief in superstition, yet in
all these instances her '^ belief,'' if it may be so
called, was accompanied by an even more positive
disbelief, so that she would say in speaking of
these things, '^I fear this or that is so, but I know
my fear is perfect nonsense," whereas in respect
to aU superstitions not related to her morbid fears
she showed not a sign of credulity. But she never
said that she thought the prediction that Max
would be weak and sickly was perfect nonsense,
while her whole attitude, in ways I cannot de-
scribe in detail, thoroughly convinced me that she
had accepted this prediction as the absolute truth.
In short, her (apparently real) belief that Max
would be sickly was not, as in the case of her com-
pulsive superstitions, accompanied by the simul-
taneous opposite feeling of disbelief.

330 MOBBID FEARS AND COMPULSIONS

But, although I could not explain why Stella did
believe that Max would be weak and sickly^ yet
some of her remarks in this connection disclosed
the existence of a conflict, and brought to light one
of the several wishes or impulses which furnished
the motive power of her obsession. Thus, she
once remarked, ''The thought that Max woidd be
a sick man made me doubtful about marrying him.
I was crazy to have him, but I didn't want to marry
a man who was going to be ill for years and unable
to support me. I felt that if I married him, and
that if he was sick and had to die anyway, I wanted
him to do it soon, and not to wait until I was so old
I would have no chance of marrying again. ' '

Here, obviously, was a distinct conflict Stella
was unwilling to give up Max, but she was appar-
ently almost unwilling to be burdened for years
with an invalid husband, which, for reasons not
yet explained,^ she believed Max would be. Un-
der such circumstances she desired a compromise
— ^namely, that Max's life would be short, for if
she could look forward to this, she would neither
have to forego the pleasure of marrying him, nor
would she have to bear indefinitely the burden of
an invalid husband.

But we can hardly suppose that Stella could
have entertained a wish for Max's early decease
without having a certain feeling of guilt. And
guilt demands punishment. It seems, then, not
unlikely that the obsession served this purpose,
among others. She had wished for the Mahoshef
to do magic to Max, and she had wished for Max's

iSee page 368.

A COMPULSION NEUEOSIS 331

death. What finer example could be desired of
'Hhat even-handed justice which commends the
ingredients of our poisoned chalice to our own
lips" than that as a punishment for these wishes
she should have to fear that the Mahoshef was
doing magic to her, and that she, too, was in dan-
ger of death t The fact, then, that the obsession
was so well suited as a punishment for what Stella
must have felt guilty of, makes it not unreasonable
to suppose that an impulse to penance and self-
punishment formed the first, though by no means
the most important, of its determinants.

(c) PreUmmary Survey

Before proceeding to report the results obtained
during the period in which Stella was under analy-
sis it may be well to state the problem as I saw it
at the beginning of this treatment.

To those who hold to the suggestion-theory of
the genesis of obsessions, this history, as I have
related it, presents no conspicuous problems. A
young woman of neurotic and presumably impres-
sionable temperament, brought up among ex-
tremely fanatical and superstitious people, de-
velops a neurosis during the strain and excitement
incident upon an unsatisfactory love affair. This
neurosis, judging from its content, is simply a re«
awakening of a belief in magic which she enter-
tained as a child. The visit to the fortune teller
and the various remarks of the superstitious
cousin — occurring, as they did, when the young
woman was in a very excitable condition — ^would
be looked upon as sufficiently influential to bring

332 MORBID FEABS AND COMPULSIONS

about the reawakening, and thns canse the nenro-
sb. From roch a viewpoint the case is little more
than a simple equation. Neurotic predisposition,
environmental influences, an event of presumably
high suggestive value — ^all three factors tending
in the same general direction — ^produce, when
added together, an obsessive fear. What could be
plainer t The case explains itself!

The psychoanalyst, however, would see in this
history many points that call for extensive and
earefid investigation, and would feel utterly at a
loss to explain the obsession without knowing a
great deal more about the patient's life than has
yet been recorded. Nevertheless, he might read-
ily find in the material at hand matters whidi
would lead to interesting speculations as to the
etiology of the neurosis, and would give some hints
both as to the nature of the problems confronting
him and as to the sort of causal factors which he
might expect to find.

For instance, it appears that the patient became
sick ui the midst of a love affair, improved as soon
as it ended, but again became sick shortly after
entering into an experience with another lover. Is
this correlation between romance and illness to
be looked upon as accidental or as causal t And
if the latter, what sort of causes might be at
work?

On theoretical grounds we may give partial and
tentative answers to these questions. A neurosis,
as Jung has said, invariably expresses some trend
of thought and feeling away from, or hostile to, the
individuals who stand in closest psychological re-

A COMPULSION NEUROSIS 333

lation to the patient.^ Sndi a position was once
oocapied by Max, later by Barney. We may there-
fore infer that some sort of emotional confliot
existed in the mind of the patient in regard to
these two persons — ^that for some unknown reason
it was impossible for her to adjust herself per-
fectly to either one of them, and that this non-
adjustment had to do with the outbreak of the
neurosis.

And this view is supported when we oome to ex-
amine certain facts already at our command. For
example, Stella's love for Max was apparently
pathological. It began as a typical case of '^love
art first sight. '' Although this phenomenon is per-
haps normal enough in stories, it is seldom so in
real life. The condition, judging from the few
cases I have had a chance to study, is always a
compulsion. The patient has formed a strong
love-fixation — ^usually upon some individual of
high significance in the years of childhood — ^but
this fixation becoming for some reason offensive
to the patient's conscious personality has been sub-
jected to repression and driven more or less com-
pletely from consciousness. The phenomena of
love at first sight represent either a transference
— ^usually incomplete — of this love, now partly jor
wholly unconscious, to some new love-object,
against whom there are no particular conscious

I "Analytical Psychology,'* p. 120. As a matter of fact the per-
flons to whom Stella stood is closest psychological relation were
her parents, and her neurosis showed that she was as poorly
adjusted to them as she was to Max and Barney. But the matter
^f her adjustment to her parents is one that for the moment we
need not consider, although we shaU take it up later.

334 MORBID FEAES AND COMPULSIONS

resistanoeSy or else a flight from the old love-ob-
ject, or a combination of both transference and
flight. In any case, the person apparently loved
is not the person actually loved, though in time, in
some cases, a complete transference may take
place.

If we now apply these principles to Stella's case,
our conclusion would be that Stella seemed to love
Max so much, simply because, in some unhnofvn
way, he represented a substitute for, or a flight
from, some one else with whom she was actually
in love, although probably she would not permit
herself to realize it.^

Incidentally, if the foregoing conclusions are
correct, certain other features of her affair with
Max become comprehensible. Thus, though ladies
in story books are supposed to lose flesh and appe-
tite, and to spend long hours in weeping whenever
they fall in love, we cannot regard these manifes-
tations as normal accompaniments of love in real
life. If, however, we are right in supposing that
Stella's love for Max was either an imperfect
transference or a flight, these morbid phenomena
are not so difficult to understand. That is, if,
while she was consciously scheming to marry Max,
she was unconsciously in love with some one else
she had good reason to be depressed.

Other signs indicated a lack of adjustment in
Stella 's relations with Barney. It did not require
a long acquaintance with Stella to convince me

iThis does not meui, of courfle, that aR her seeming lore for
Max had this origin— HBerely that a part of it did, jparticnlarly at
first.

A COMPULSION NEUKOSIS 335

that she felt toward Barney none of the mad in-
fatuation which she seemed to have experienced
for Max. For instance, whenever she talked of
Max her face would light up, and, for the moment
forgetting her fears, she would plunge into the
most vivid and enthusiastic description of him
imaginable. **0h,/' she would say, **he was so
refined I How I loved him I I thought I 'd die if I
couldn't be his wife. If I could have married him
I would have been contented to live in only one
room all the rest of my days.''

But when she spoke of Barney there was a great
difference. ' ' Of course I love Barney, ' ' she would
say in a somewhat argumentative tone, as if ex-
pecting immediate contradiction from some in-
visible hearer : "I love him as a friend. My feel-
ing for him is geistliche lAebe — ^not Leidenschaft
He is intelligent and refined and I respect him —
yes, I have the greatest respect for him." But
these protestations were accompanied by none of
the enthusiastic animation that characterized her
references to Max.

It was quite evident, then, that she felt for Bar-
ney a much less intense love than she appeared to
feel for Max. But a still more positive conclusion
in regard to this matter could be drawn. If an
emotional, neurotic girl, on the very eve of her
wedding, cannot work herself up to the point of
saying of her betrothed something more enthu-
siastic than, **I love him as a friend — ^I respect
him," one need have little doubt as to the true
state of her feelings — ^in all probability she does
not love him at all.

336 MORBID PEAES AND COMPULSIONS

In fall accord with this condosion is another
matter that has already been mentioned. Stella
felt that she was doing wrong in getting married,
and that she was almost certain to make her hus-
band unhappy. To be sure, these ideas appeared
to be a logical result of her fears. Seemingly, she
thought, ^'I am going insane, and therefore 1 ought
not to marry — insanity will be the means of my
bringing trouble upon my husband. '^ But psy-
choanalytic experience shows quite conclusively
that a compulsive idea, or any similar symptom, is,
generally speaking, never the cause of anything
— it is always an effect.^ We may conclude,
therefore, that, in Stella's case, her feeling that
she ought not to marry, and that she would make
her husband unhappy, depended not upon her ob-
session, but upon some other, concealed factor,
which adequately justified this feeling. In other
words, there must have been some good reason
why she should not marry Barney, although ap-
parently she would not frankly admit this to her-
self. This reason was, perhaps, that she did not
love him, but did love some one else.

But if we continue these speculations we are
in great danger of falling into the error of feeling
that we understand the case when we have only
begun to study it. Let us, therefore, enter as
soon as possible into an examination of the ma-

ilf, for eacample, a man develops a neuroUc ■ymptom which
apparently caueee him to be unable to continue hli businessy we
are likely to find upon analysis that for some reason the man
vocmted to give up hi9 huuvnesB, and that this wish was the imme-
diate cause of his doing so.

A COMPULSION NEUROSIS 337

terial brought out by my analysis, for by this
means any danger of our feeling prematurely that
we understand the neurosis will soon be effectu-
ally dispelled. Incidentally, it should be re-
marked at this point that iim& far I have given
Stella's history as I received it — not as I know it
now — ^and that we may be prepared to find it in
many respects erroneous, misleading, and incom-
plete.

Paet II. Akalytio
(a) The Father-Complex

When I had finally decided to begin the analy-
sis I informed Stella that I wished to try a new
treatment — one which would require her fullest
cooperation to be a success — and that her part
would be to perform the difficult task of follow-
ing a very simple rule, viz., to tell everything that
came to her mind, whether or not the thought
seemed to her pleasant or unpleasant, important
or unimportant.

Having heard this solemn injunction, Stella be-
gan to laugh.

* * That 's silly, ' * she said. * * That will never cure
me. Anyway, you know all about me already.
What more can I tell youT"

But, after a few moments, she began to talk
about her mother.

**My mother,*' she said, **i8 a very nervous
woman. She is just like I am ; she isn 't well. I
am more fond of my mother than of any one else
in the world. Whenever she is out of my sight I

338 MORBID PEAES AND COMPULSIONS

worry about her and fear something will happen
to her — that she may get sick or be killed in an
accident. ' '

I felt that my acquaintance with Stella had
lasted long enough to allow me to venture some
comment on these remarks. I began by saying
that not all that goes on in our minds is accom-
panied by consciousness ; thus, we could have va-
rious impulses or wishes of quite considerable
strength without being clearly aware of them.
Such wishes sometimes presented themselves in
consciousness in the shape of fears.

But at this point Stella interrupted me.
**WhatP* she cried excitedly, **do you mean that
I hate my mother, that I want her to die!"

I said I was not able to deny that such a condi-
tion of affairs might exist and asked her what she
thought about it.

**0h, I know you are wrong, '* she exclaimed; "I
love my mother and always wilL If she died, I
would want to die, too. ' '

To this I replied that the existence of a very
great love would not necessarily disprove the co-
existence of an opposite feeling. Stella paid no
attention to this, however, and in a somewhat il-
logical way continued her protests. At this point
we were interrupted and had to defer the discus-
sion to the next setting.

At the next visit she immediately began with
the question, ^'What could make me hate my
mother!*'

**I cannot say,*' I replied; **what do you think
about it!*'

A COMPULSION NEUBOSIS 339

She answered that she cotdd offer no explana-
tion ; but, after a considerable pause, she suddenly
said, ^^ Doctor, there is something I think I ought
to tell you. My father used to touch me/'

When I asked her to explain this remark she
finally furnished me with the following informa-
tion. When she was about twelve years old her
father began a practice of coming to her bed at
night, fondling and caressing her quite amorously,
and placing his hand upon her breasts and geni-
tals. This, Stella frankly admitted, had excited
her greatly ; and, though she had protested against
these practices, she had always enjoyed them.
She added, in explanation, that up to the time
her obsessions began she had always been ex-
tremely passionate and easily excited.

Her father's visits had continued two or three
times a week until she was somewhere between six-
teen and nineteen years of age, when they ceased,
but exactly when or under what circumstances
Stella professed to be unable to remember. I
can, however, supply the missing information from
what I learned much later in the analysis. When
she was seventeen and a half years old a number
of friends were staying at her house, in conse-
quence of which Stella slept in a different room
from her usual one. In the middle of the night
she was suddenly awakened by her father's stand-
ing over her bed and fumbling with her bedclothes.
Not recognizing him for the moment, and being
confused at not finding herself in her own room,
she was very much frightened ; but, when she did
realize who it was, her fear was changed to anger

340 MOEBID FEARS AND COMPULSIONS

for the fright he had given her. '^ Why can 't yon
leave me alone I" she said indignantly. ^^Dont
ever do that to me again! I've had enongh of
your nonsense. "

^^Gan't a father kiss his own daughtert" he re-
plied. '^ Anyway, I was only trying to see that
you were covered warmly enough."

^^That is not so,'' returned Stella. ^^If you
must amuse yourself , why don't you go to my sis-
tert If you ever try to touch me again, I swear I
will tell my mother!"

This threat seemed to have its effect, for her
father never ventured to resume his visits. SteUa
had often protested against them before, but this
was the first time she had threatened to tell.

I trust that it is now plain that Stella had an-
swered the question of why she ^^ hated" her
mother. This hate, if it may be so called, de-
pended upon her attachment to her father. The
fears that her mother would die, etc., were part of
the wish phantasy, which, as I later learned, she
had often entertained consciously, that her mother
would die, in order that she might assume the
mother's place with the father. These death
wishes and feelings of hate existed in spite of a
well-developed love for the mother. Let me again
emphasize that the ability to entertaiu simultan-
eously the two opposite feelings of love and hate,
with a high degree of intensity and toward the
same person, is one of the prominent characteris-
tics of compulsion neurotics. In them love and
hate may coexist indefinitely, instead of one drown-
ing out the other as would normally be expected to

A COMPULSION NEUROSIS 341

occar. The opposed feelings in these oases are
not as a rale simnltaneously eonscious. The hate
is usually confined more or less successfully to the
unoonscious, and the conscious and f oreconscious
love becomes overdeveloped to serve as a reaction
and a cover for it.

A great deal more could very well be said of
Stella's father-complex, which, it should be evi-
dent to any one, must have been extremely strong.
I will not pursue this subject, however, simply for
the lack of space, as there is so much else that re-
quires discussion. We shall later hear more of
the effect of this complex.

(6) The SeparationrComplex

The next matter that came into prominence in
my talks with Stella was the question of her feel-
ing and attitude toward her husband. Even be-
fore beginning the analysis I had come to the con-
clusion that she cared little for Barney and had
asked myself why she had married him. The
question became even more puzzling, for I learned
that while she had been receiving attention from
Barney, Stella had had still another suitor, upon
whom she had looked with much more favor. This
man, whom I will call Lehmann, was not only
much better looking than Barney, but, in addition,
he was a manufacturer in most comfortable cir-
cumstances, while Barney was practically penni-
less. Lehmann was madly in love with Stella,
and his family would have looked with favor upon
the match. And so I felt sure she would have
much rather married Lehmann than Barney, though

342 MOEBID TEAES AND COMPULSIONS

whether she would have preferred Lehmann to
Max I was not certain. The question of why she
married Barney was, then, greater than before.^

Early in the analysis Stella had a dream, which,
although throwing some light on the problems
in the case, seemed at first to add to them rather
than otherwise. The dream was simply that a
certain recently married woman had left her hus-
band, then residing in Boston, and come to New
York.

This dream was a reproduction of an actual
fact that had occurred in Stella's experience. The
woman referred to, after living with her husband
only a few weeks, had run away from him and re-
turned to her parents in New York.

We are familiar with the observation that the
chief actor in the dream is practically always the
dreamer. With the woman of the dream Stella
could readily identify herself, for both had worked
in the same store and both had been married for
only a short time. One could suppose, then, that
the woman represented none other than Stella
herself. Stella dreamed, then, that she followed
the example of her friend; and this could only
mean that she, too, had a wish to leave her hus-
band and return to her parents.

1 1 ahould, perhaps, state at this point that this and similar
questions that came up in the analysis I sulmitted to Stella in
the hope that she would answer them. It was quite uselessy how*
ever, for she would either reply that she ''did not know^ or else
would give some evasive explanation which it was quite impossi*
ble to accept. For instance, many times she maintalniwi that she
had married Bam^ for love alone, whereas at other times her
own admission, as well as many other indications, showed ttiat
this explanation was entirely incorrect.

i

A COMPULSION NEUROSIS 343

Hoping, however, to find some more significant
source of identification than that just mentioned I
asked Stella to tell me more about the woman.
She responded by informing me that the woman
was very fat, while her husband was quite the re-
verse ; and then added this most singular remark,
''J thif^ she was, too strong for him/'

What Stella meant by this I had not the slight-
est idea, so I asked at last if she had used the
phrase in some sexual sense, and to this she as-
sented with such alacrity that I was quite sure
she had meant nothing of the kind — ^that is to say,
I felt she was unwilling to explain exactly what
she had in mind, and so when I had suggested that
it was something sexual she readily agreed, think-
ing this would satisfy me and that I would press
her no further. Being now quite convinced that
there was some really important reason for Stella's
identifying herself with the woman, and that it
probably was contained in her relations with
Barney, I asked, "Did you ever feel that you
were too strong for Barney f

**Tes,'* she answered rather reluctantly and
would say nothing more.

I kept on questioning her and finally brought to
light, first, that Barney suffered from ejactdatio
pracox, and, second, the following matter, which
seemed even more important. Barney had suf-
fered several attacks of gonorrhea before his
marriage. A short time before I began the analy-
sis he, discovering what he believed to be a return-
ing gleet, had consulted a doctor, who for some
reason examined his semen and told him, in

344 MOBBID FEABS AND COMPULSIONS

Stella's presence, that in all probability he was
sterile and would remain so. This was very
painf nl to Stella, for, as she then told me, she
was extremely anxions to have children, not only
because she was most fond of them, but also be-
cause, as she expressed it, to have them would
make her marriage stronger.

I was not at all convinced that the information
I had obtained had exhausted the significance of
the dream, and I was even in doubt as to whether
all of it had to do with the dream, because, as
I had broken in with questions, I could not regard
all of Stella's statements as free associations.
At any rate, whether connected or not, both the
information I brought out and the dream were
evidently of no small importance. The dream
showed plainly enough that Stella had a wish to
separate from her husband, but whether this arose
from the mere fact that he was sterile, .or whether
there were other reasons for it, could not at the
time be determined.

I told Stella that I interpreted the dream as
an expression of a wish on her part to leave her
husband, but she promptly disputed this, say-
ing, ^^I will never want to separate so long as we
are both alive.'* But, as this sounded to me as
if she had an alternative in mind, I said, ^^Do
you mean that you would like him to die and free
youf

"No,'* she replied instantly, "I do not wish him
dead"; but, after a pause, she suddenly said, ^'I
am not going to lie to you ; I have wished him dead,
often. This morning when I was washing his

A COMPULSION NEUEOSIS 345

clothes I swore to myself and said that I wished
they were his death clothes. ' '

She went on to say, however, that she did not
feel this way all the time. ^^When he is nice to
me, and when I think we can go ahead and make
money, keep up a nice home, and maybe have
children, I feel that I can love him and I do not
wish him dead; bnt, when he is m€fan, I hope he
will die right away. Usoally, when I wish him
dead, I am sorry afterwards and think maybe I
will be punished for such thoughts."

It was not until after this communioation that
Stella told me of a new detail of her fears. It
seemed that before her marriage she was afraid to
let any one know about her illness for fear that
it would come to Barney's ears and he, thinking
her either insane or about to become so, would
withdraw from the engagement. After her mar-
riage she was even more afraid that, as a result
of magic, she would become insane and he would
then be able to divorce her. After she had once
told me this detail, it became one of the most fre-
quent themes in Stella's conversation. She con-
tinually asked me to assure her that she was not
insane ; she did all sorts of things for fear people
would think her so ; she would never admit to any
one that she felt ill in any particular for fear they
would immediately conclude that she was losing
her mind ; and she was never tired of questioning
me in regard to the laws relating to insanity and
divorce. She was particularly distressed by the
fact that her history was on file at the Broadway
Clinic and similar places.

346 MORBID FEARS AND COMPULSIONS

**I know/' she would say, "if that history, in
which it is written that I went to a fortune teller
and then thought I was insane, was brought into
court, the judge and jury would surely believe I
really was insane and give Barney a divorce in a
minute."

When I reminded her that all the doctors she
had consulted had instantly told her she was not
insane or ever likely to be, she would reply; "I am
afraid if it came to court they would change their
minds/' **I don't believe they would stick to
what they said." "I am afraid they would go
back on me. " * * Maybe they were afraid to tell me
the truth, anyway," eta

I noticed that she talked more about her history
at the Broadway Clinic than about any of the
other histories and seemed ever so much more
anxious over it. She was continually planning
to go to this Clinic and, on pretense of requiring
treatment, get hold of her history and tear it up,
but she never planned to do this with the history
at the neurological hospital or at Cornell. In-
deed, many times she started for the Broadway
Clinic, intending to do away with the record, but
on the way would come the reflection, "Maybe it
would look worse if I did tear it up— maybe peo-
ple would think I did it because I knew I was in-
sane and was trying to destroy the proof," eta,
and thus she never got to the point of putting her
plan into execution.^

1 This element of her fear, namely, that by means of the history
at the Broadway Clinic it would be proved that she was inhume,
etc.| is what I had in mind particularly when, in the introdnctkOt

A COMPXJLSION NEUEOSIS 347

Two Bets of reproaches, quite similar in content
to the obsessive fear that she would be divorced
she frequently made against her husband. The
first originated in the fact that he had once lived
in the same house with a young woman named
Ada, who apparently would have liked very much
to marry him, although there is no reason to sup-
pose he reciprocated this feeling. That he was in
all probability utterly indifferent to Ada, Stella in
her '^ sober moments'' seemed to know as well as
any one. Nevertheless, the greater part of the
time she was loud in her complaints that Barney
oared nothing for herself but was only waiting
until she should become insane so that he could
divorce her and marry Ada.

**He is no man!*' she would cry. ** Anybody
else would stick by a wife if she got sick, but he
wouldn't! As soon as he found he could prove
me insane he would do it, and get rid of me as
quickly as possible."

These complaints, uttered in the most spiteful,
angry tones imaginable, Stella repeated hundreds
of times ; and, when she was in the mood for com-
plaining, no argument could make her see what at
other times she freely admitted, viz., that her ac-
cusations were entirely without foundation.

Another set of reproaches against Barney re-
ferred to his attitude in money matters. She con-
tinually complained that he was mean and stingy,

I spoke about diBplacement aa ahown by this case. We shall see
eventually that her anxiety about her history at this clinic was
indeed well founded, but that the foundation for it was some-
thing entirely different from what appeared in her obsession.

348 MORBID FEAES AND COMPULSIONS

that he insisted on her working at the store when
she should have been caring for things at home.
She was particularly venomous over the recollec-
tion that one time he nmde her go to work in a
snowstorm, when, in her opinion, the weather was
so bad that she should have stayed at home. ''I
might easily have caught pneumonia and died
from being out on a day like that,'' she said, "but
he wouldn't care. A few pennies are more to
him than my health and life. The only thing he
married me for was<that I should work for him."

As a matter of fact, her husband did insist upon
her working at times, but, apparently, not from
choice. Financial conditions were bad; he had
little work ; and what she could earn was not only
a very acceptable addition to the family income
but at times an absolutely necessary one. He, as
in a way she really well knew, did not demand of
her anytliing that other men in the same walk of
life did not expect from their wives.

That Stella 's complaints were absolutely unfair
and unreasonable no one was in a better position
to know than herself. Why, then, could she not
take a reasonable view of the situation and give
up her unjust complaining ? The obvious explana-
tion that she wanted to think her husband at fault
in these matters — ^that it gave her some sort of
comfort or satisfaction to be able to accuse him
in this wise. But why should this sort of thing
give her satisfaction? This question, to any one
with a little analytic experience, is not difficult to
answer. She must have felt herself guilty of the
same things for which she reproached her hus-

A COMPULSION NEUEOSIS 349

band. This defense mechanism is a very familiar
one and has been referred to earlier in Chapter IV.
Stella's reproaches against her husband could,
then, be applied to herself ; and this means, first,
that she had the intention of getting rid of her
husband and marrying some one else, and, second
(since she reproached her husband with being too
interested in money matters), that some financial
or economic condition must have interested her
more than she felt was right. This interest per-
haps, in some unknown way, had been a factor in
bringing about their marriage; possibly she had
married Barney merely to have some one to sup-
port her.

It is to be observed that Stella's complaint that
her husband wished to get rid of her is quite in
harmony with the dream just analyzed. Both
indicated that Stella wished or intended her mar-
riage to Barney to be only temporary. She would
not admit, however, that she wished for a sep-
aration, although, as the analysis progressed, she
ehowed little hesitation in confessing that the
greater part of the time she most heartily wished
her husband was dead. That she really did wish
for a separation, perhaps as an alternative less
acceptable than her husband's death, I firmly be-
lieved in spite of her denials. Indeed, I was dis-
posed to think that this wish was a determinant
of her fears that through the fortune teller's Kis-
hef she would become insane and be divorced.
But as I was in no position to prove my point I
had to let the matter drop for the time.

Before leaving the theme of Stella's reproaches

350 MOEBID FEAES AND COMPULSIONS

against others, I must take up her attitude toward
her husband's sister. This girl originally had
been one of her closest f riends, but Stella had not
been married very long when they began to quar-
rel most frightfully. It was plain to be seen, how-
ever, that these quarrels were really Stella's fault.
They usually originated from her making without
the slightest provocation some unreasonable and
unjust accusation against her sister-in-law. One
thing which seemed to be concerned with Stella's
inclination to pick these quarrels, and to which
she frequently referred during her visits to me,
was this. It seems that shortly before her mar-
riage, Stella on the advice of some doctor and
contrary to her own inclination, had told Barney
of the obsession from which she suffered, and he in
turn had told his sister. (I should add here that
Stella promptly repented of her confession and
soon after her marriage told her husband the ob-
session had entirely disappeared.) Some time
after they were married Barney was out of the
city for a few days, and, as it so happened, his de-
parture had followed closely upon an argument in
which Stella, his sister, and himself were all in-
volved. During his absence his sister wrote him
a letter which Stella, prying through his things
upon his return, found and read. This interest-
ing document contained among other matters the
following words: ^^That girl (Stella) was insane
when you married her. Maybe she isn't exactly
insane now, but just the same she will always
have a crazy head. She knew she was a sick girl

A COMPULSION NEUROSIS 351

when she married, but you were an easy mark and
let her rope you in."

Stella's rage upon perusing these amiable senti-
ments should have found adequate expression in
her having torn her dothes and hair, yelled^
screamed, rolled on the floor, and ornamented with
her nails the faces of her husband and his offend-
ing sister ; still all this by no means removed the
memory of the incident from her mind nor served
to prevent her from bearing a lasting resentment.
Indeed whenever she thought of the matter she
would immediately become incoherent from anger
and excitement. '^Boped him inl"; she would
cry. ^ ' A nice remark for a friend to make I The
mean, low, false thing I Gould any decent per-
son say a thing like thatt There isn't a more
false and tricky girl in the world. I'd like to
scratch out her eyes and wring her neck," etc.

Again applying the principle of interpretation
already described, one would have to conclude that
Stella thus reproached her sister-in-law because
she herself felt guilty of being a false friend. In
just what respect she had been false remains to be
seen, however.*

The fact that Stella found the accusation, ^^she
roped you in," so painful has to be explained in
another way. The reason this remark so aroused
her anger must have been, I concluded, that it con-
tained a very considerable element of truth. If
the accusation had been entirely unjust, I felt, she
would not have minded it nearly so much. ^^It's

1 Page 423.

352 MOEBID FEAES AND COMPULSIONS

only the truth that hurts. ' ' But, having come to
audi a condusion, I was no better off than before,
f or, as far as I was aware, Stella had never done
anything that could well be described as ^'roping
in" Barney. To be sure, she married him with-
out caring particularly for him, but, even so, it
was Barney who had been the aggressor, and if
any ^^roping in'' had occurred he himself had
done it. In spite of these facts, I could not reject
my original conclusion that in some sense Stella
had '^ roped in" Barney and that she felt guilty
about it, but the only course left for me was to
wait in the hope that in the course of the analysis
new material would be brought out to confirm my
views.

Let me now sum up what has been learned in
regard to Stella's feeling and attitude toward her
husband. First, the conclusion that Stella mar-
ried Barney caring little or nothing for hin[i, which
was reached before taking up the analysis proper,
has been fairly well confirmed. Second, from an-
alyzing one set of Stella's reproaches against Bar-
ney there has been furnished reason to "suppose
that some unknown economic conditions caused her
to marry him. At the same time, this was hard to
understand, since she had another suitor, Leh-
mann, whom, apparently, she preferred to Bar-
ney, and who was better off finandally. Third,
we have readied the conclusion that Stella wished
to be free again either through Barney's death, or,
possibly, through divorce or separation. Fourth,^
we have two other pieces of information which
are as yet of uncertain significance; viz.^ that

A COMPULSION NEUROSIS 353

somehow or other Stella felt guilty of roping
Barney in, and that, whatever it might mean, she
felt that she was ^^too strong for him."

(c) The Assault Obsession

Let us now leave for a time the subject of
Stella's relations with Barney and take up another
matter which at first seems to have no connection
with the first. Stella bad been coming to me some
considerable time when one day she said suddenly,
'* Doctor, the Eishef obsession is not the only one
I ever had. Several years ago I had another that
I have been afraid to tell to you.'*

The complete history of this first obsession I
was a long time in learning. I will, however, give
it here without going into the details of how I
acquired my information. Stella, when about sev-
enteen and a half years of age, had once taken
supper at the house of a friend of hers, a young
married woman named Mrs. Denzer. Mr. Denzer
was not present at this meal, but considerably later
in the evening he came in accompanied by two
other young men, who boarded in his household.
For some unknown reason Stella began to have a
certain fear of these men, although in her previous
acquaintance with them nothing had occurred to
justify such an emotion. But, in consequence of
this feeling, she soon arose and, putting on her
hat, announced that it was time for her to go home.
But Mrs. Denzer would not hear of her departure
^and insisted that Stella must spend the night.
This made Stella more anxious than ever, and she
protested with no little vehemence that for her to

354 MOBBID FEABS AND COMPULSIONS

remain all night was impossible. Mrs. Denzer
was deaf to these protests, and finally settled the
matter by locking the only door of exit and put-
ting the key in her pocket, so that Stella had to
stay whether she liked it or not. By this time
Stella's anxiety had shaped itself into a definite
fear, viz., that after she had retired for the night
one of these men would attempt to assault her in
her sleep. That such a fear was utterly absurd
she was quite well aware, for none of the men
had ever betrayed the slightest inclination to do
anything improper either to her or, as far as she
knew, to any other well-behaved young woman.
But, in spite of this, she was unable to drive the
fear from her mind. She decided, therefore, that
after going to bed she would try to remain awake
all night, while as an additional precaution she
took her underskirt and bound it over her genitals,
so that, should she fall asleep in spite of herself,
any evilly intentioned person would have diffi-
colty in carrying out his purpose. However good
her intentions may have been, she did fall asleep
eventually, and when she awoke an hour or two
later she found herself possessed by the horrible
fear that while she slept the dreaded occurrence
had actually come to pass, namely, that one of the
men — she knew not which— had assaulted her
while she was unconscious. After a hasty self-
examination for evidences of such a happening
she was momentarily relieved to find that the band-
age she had made of her underskirt was undis-
turbed and that such signs as genital soreness,

A COMPULSION NEUEOSIS 355

drops of blood, or any of the similar phenomena
which she had been led to expect were accompani-
ments of the first coitus, were entirely absent.
The relief following upon this examination was
short-lived, however, for it occurred to her that
while she slept any blood stains might have been
removed and the bandage readjusted or that
her imaginary seducer might have known of some
method of performing the act without leaving any
painful results. Thus, her fear persisted, and
she said to herself, '^ Since I was asleep, I have no
absolute knowledge or proof that it didn't hap-
pen."

At any rate, she left the house of her friend as
quickly as possible and in a most distracted condi-
tion hurried home. Arriving there, she threw her-
self upon a bed, crying and screaming. Her
mother, attracted by the noise, came in, and Stella
soon told her what she feared and insisted upon
being examined then 'and there for evidences of
defloration. Her mother promptly complied with
this request and assured Stella that there was abso-
lutely nothing the matter with her except ^^Mus-
hagahs im Kopf.'' ^ But this did not satisfy the
young lady, and in a day or two she had herself
examined by a doctor, but with the same result.
Her fear remained unabated in spite of the doc-
tor's assurances. In the next few weeks she went
to one doctor after another, receiving from each
assurances that everything was as it should be,
but without gaining any relief from her fear.

1 CimzliMM in thft bflftd.

356 MOBBID PEABS AND COMPULSIONS

Why these assurances did not assure her will
later become clearer. They did not touch the
right spot.

All this time she was extremely anxious to ob-
tain a certificate to the effect that she was a vir-
gin, but she hesitated to ask for it for fear that
the doctors would suspect her of ^^ something
queer. " At last, after returning home from hav-
ing been examined by a woman doctor, who, by the
way, had hurt her considerably, Stella found a
drop or two of blood on her underskirt. This dis-
covery greatly excited her, for she felt that even
if up to this time she had been wrong in fearing
her hymen was ruptured, there was no doubt of its
being ruptured now, as the result of the doctor's
examination. Hence, she returned to this physi-
cian, demanding a certificate which should state
either that her hymen was entirely intact, or else
that it had been ihiptured accidentally during ex-
amination. Such a certii^cate, somewhat am-
biguously worded, she did finally receive.

The assault obsession lasted without abatement
for some eight or nine months, but then it gradu-
€illy cleared up. After this it reappeared oc-
casionally even up to the time the ELishef obses-
sion began, though never with any great severity.

Naturally enough, Stella told of this obsession
to very few people. One she told was her mother,
who, much to Stella's real or assumed dissatisfac-
tion, told it to her father. The only other person
to whom Stella spoke about it was Bose, the same
cousin who was connected with the Eashef incident.
To Bose she did not speak frankly, however.

A COMPULSION NEUKOSIS 357

Bose had observed that Stella seemed to have
something on her mind, and questioned her as to
the nature of the trouble. Stella at once began
to cry, saying, ^^Bose, I am afraid something aw-
ful has happened to me — something that has made
my body different than it was. If what I fear is
really true, it would be wrong for me to get mar-
ried, and I ought not to do it.*'

I should, perhaps, state that the question of
marriage had come up at this time, for Stella had
a suitor, a young man in good circumstances, who
was highly favored by her parents, although not,
if we are to believe her, by Stella herself. But,
at any rate, his attentions lasted only a short time,
and he soon passed out of her life.

Now, toward understanding the motivation of
this obsession the following matters can be pro-
duced. First, it is to be noted that the obsession
came on only a short time after the incident I have
described and which put an end to her father's
masturbatic visits to Stella's bedside. One might
suppose, then, that her libido, thus cut off from
its earlier outlet, had found a new channel of ex-
pression in the shape of the obsession. Inciden-
tally, Stella, ill with an obsession, was in a position
(of which, I may add, she took every advantage)
to demand more in the way of sympathy and at-
tention from her father than she would have been
able to secure under ordinary circumstances.
Thus, she received a sort of compensation for the
loss of the more physical form of gratification
which was no longer forthcoming. Furthermore,
the illness, which gave her father an enormous

358 MOEBID FEABS AND COMPULSIONS

amount of trouble and distress, served as a
weapon with which she revenged herself upon him
for taking her too readily at her word and stop-
ping his visits.^ It also seems probable that the
self-reproach connected with the idea of assault
represented a displacement of the guilt which she
had felt for allowing her father to touch her and
for wishing he would continue to do so.

But there is also reason to suppose the obses-
sion represented a direct fulfillment of certain
wishes that Stella had previously entertained.
For both in day dreams and in night dreams she
had frequently imagined herself to be the subject
of an assault, and she was perfectly conscious of
having had a wish that through no fault of hers
such a thing might happen to her. For, as she
explained, though she would never part with her
chastity voluntarily, yet, if in spite of her best en-
deavors to the contrary it was taken away from
her by force, the situation would then be quite dif-
ferent. Her virginity once lost, the chief motive
for remaining in the paths of virtue would have
been done away with, while, on the other hand, she
would feel almost justified in compensating her-
self for the catastrophe by indulging in inter-
course, a form of pleasure which, as she was of a
very erotic nature, she was extremely desirous of
having.

iTiM relation between the obeeeslon end a wish on Stdla'e part
to be maetorbated by her father will be referred to again in con-
nection with the analysis of the Kishef obsession, where at the
■ame time the significance of Stella's repeated visits to doetors
will be given further consideration.

A COMPULSION NEUROSIS 359

That some erotic wishes were in her mind the
night the obsession came on is not to be doubted,
for she distinctly remembers that all the evening
she was at Mrs. Denzer's she had been occupied
in comparing, with a certain envy, her friend's
situation with her own. Thus, she not only re-
flected on the pleasures that were accessible to
her friend upon retiring, but also indulged in cer-
tain erotic fancies in which she occupied her
friend's place in the domestic relation, or passed
through similar experiences with a husband of her
own. It seems highly probable, then, that Stella's
erotic wishes formed one of the determinants of
the obsession ; that is, as she herself summed up
the situation, '^What I imagined that evening at
first for pleasure soon became a fear and finally
an obsession."

But the obsession probably corresponded to
the imaginary fulfillment of still another wish,
namely, a wish for pregnancy. I have already
stated that Stella's menstruation had always been
irregular. During the period of her father's noc-
turnal ministrations, and on such occasions as she
did not become unwell when she expected, she was
always terrified by the thought that she was preg-
nant by him. (It should be added that this fear,
which, of course, can be readily translated as the
fulfillment of a wish, is not as absurd as it seems,
for her knowledge of how impregnation is effected
was at that time very vague.) A wish to be preg-
nant by her father as well as by others had even
entered her consciousness at times, for she well
remembered that she had frequently indulged in

360 MOBBID FEABS AND COMPULSIONS

day phantasies having such a content. That the
wish to be pregnant was uppermost in Stella's
mind on that particolar night can hardly be
doubted, for Mrs. Denzer had two children the
possession of which Stella greatly envied her and
which she at times took pleasure in imagining were
her own. An additional fact which I learned
much later was that Stella was expecting to be
unwell on the night the obsession appeared. But,
since she had this expectation on the fateful night,
her bandaging herself on retiring was not so en-
tirely without reasonable motivation as it at first
seemed. This act was in jmrt prompted by the
reflection that the flow was due to appear, and
when on the morrow it had not done so, she had
a sort of confirmation of the idea she had been
assaulted; that is, she found herself displaying
one of the symptoms of pregnancy.^

To sum up, then, our present knowledge of the
obsession, it formed an imaginary fulfillment to
two wishes, one to be assaulted and the other to be
pregnant and to have children. The wish to be
assaulted, as Stella pointed out, was not so mudi a
desire for the act itself as a wish that through no
fault of hers she would be placed in such a posi-
tion that she would have nothing further to lose
by illicit sexual relations. The obsession also
served as a means of obtaining compensation for
the loss of her father's sexual attentions and for
denying herself the pleasure of marrying the
young man who was then courting her. Just why

1 An additional fact in regard to the delay of this period will
be produced later. Pag« 387.

A COMPULSION NEUROSIS 361

she did not take advantage of this opportunity to
gratify her desires in a normal way by marrying
him ykn become clearer as we go on with the an-
alysis.

But, before temporarily leaving the subject of
this obsession, as we will have to do now, let me ex-
press a hope that no one will be hasty in judging
the interpretation offered as fanciful and absurd,
for at a later stage in the report of this analysis,
material is to be produced, which, to my mind at
least, forms most adequate and surprising con-
firmation.

(d) The Main Sources of Resistcmce against

Marriage

We shall now again occupy ourselves with the
theme of Stella's relations with her husband.
The analysis had been in progress, if I remember
correctly, between two and three months when a
very serious occurrence took place. Barney, who,
without my knowledge, had for some little time
complained of a cough and a tendency to become
easily tired, finally presented himself at a public
clinic, where, after being examined, he received the
depressing intelligence that he suffered from pul-
monary tuberculosis. This diagnosis was soon
confirmed at other clinics, and, consequently, prep-
arations were immediately made for sending him
to a sanitarium in the country.

When Stella, who for a few days had been so
fully occupied that she did not present herself at
the dispensary, resumed her visits and communi-

362 MOBBID FEABS AND COMPULSIONS

cated to me this distressing information I was
surprised to observe that there apparently was not
the slightest change in her mental condition, either
for the worse or for the better. One would nat-
urally expect a crisis of this sort to have produced
some exacerbation of her symptoms or, possibly,
the reverse, and the fact that nothing of the kind
occurred arrested my attention immediately, al-
though at the time I could think of no way of ex-
plaining it. I did arrive at an explanation, later,
however, upon the basis of the facts whidi I shall
now present.

The first fact which upon analysis seemed to
have a bearing on the question in hand was this.
Stella had once told me that some time in the first
three or four months of her coming to the clinic
she had conceived the idea that I was an Irishman,
and that this thought had caused her to feel a cer-
tain aversion or resistance toward me. That she
did feel so surprised her considerably, for she had
never before been conscious of any prejudice
against the Irish ; and, in addition, her reason told
her that, despite her peculiar feeling to the con-
trary, I was not Irish. I learned eventually that
she first felt this aversion toward me one morn-
ing when she noticed a spot of blood on my lip,
where I had cut myself in shaving. We shall de-
fer for a moment the analysis of this peculiar idea
in order to take up the presentation of another.

One day, some weeks before the matter of her
husband's tuberculosis came up, Stella inadver-
tently addressed me as Mr. Frink. This particu-
larly impressed me because in our acquaintance

A COMPXJLSION NEUEOSIS 363

of over a year she had not done so to the best of
my recollection. I inunediately asked her to ex-
plain her mistake, and she replied that she could
not, adding, however, that there came to her
mind the thought of a certain Mr. Schermer.
Asked for some information about this man, Stella
told me that she had made his acquaintance a few
days before under the following circumstances.
A certain relative of her husband had had the mis-
fortune to be arrested for the violation of some
sanitary law and at the moment of our conversa-
tion was languishing in jaiL Stella had been
detailed to interview Mr. Schermer, the head of a
certain lodge to which the incarcerated one be-
longed, in the hope of invoking some financial and
political aid in that gentleman's behalf. Mr.
Schermer had listened to Stella's representations
with many expressions of sympathy, but it soon
became apparent that his position in the matter
could be summed up in the words, ^'I am sorry, but
/ canH do anything/*

Having concluded the description of her visit
to Mr. Schermer, Stella paused. Urged to give
further associations, she stated that there came
to her mind a certain Mr. Frank, but immediately
explained that this association was of no conse-
quence, for she had thought of him merely because
his name was so similar to mine.

We are accustomed to find that when two idea
groups are connected by a superficial association
—one of soxmd, for instance, as in this case — they
are also connected by some deeper, more impor-
tant, but concealed association. With this in mind,

364 MORBID FEAES AND COMPULSIONS

I asked Stella to tell me what occurred to her
abont Mr. Frank. And, since her association con-
cerning Mr. Schermer had contained the idea, '^he
couldn't do anything,'' I was not surprised when
Stella told me that there had been confided to her

by Mrs. Frank the information that Mr. F was

impotent. My explanation of Stella's slip of
speech was, then, that she had identified me with
some other individual who in some undiscovered
particular resembled Mr. Frank in being sexually
weak and Mr. Schermer who, in another sense,
**couldnt do anything."

Now, I happened to know that, at the time, Stella
was identifying me with both Max and Barney,
for she frequently took occasion to remark that in
our looks and manners she perceived many points
of resemblance. But, feeling that there was some
basis of identification deeper than mere similarity
in appearance and manners, I asked of Stella,
"Did you think Max was sexually weak!"

"I did," she replied, after a moment's hesita-
tion.

**And do you think me sot" I continued.
« * * I hope you will excuse me, ' ' she replied, laugh-
ing, **but I think you are weak, too."

Upon considering this information, however,
it at first did not seem very illuminating, after all.
I had supposed that Stella had in some way iden-
tified Max, Barney, and me ; that is, that there was
some unknown common factor which she ascribed
to us all. The associations just recorded seemed
to indicate that this was sexual weakness, and she
had already told me that Barney suffered from

A COMPXJLSION NEUROSIS 365

prematnre ejacnlation. Yet the view that she as-
cribed to all three of uts some sexnal weakness was
difBcnlt to accept, for by what conceivable process
of reasoning conld she have formed any opinion
in regard to the sexual power of Max and myself T
Fnrthermore, something in Stella 's tone made me
suspicious that the phrase, ** sexually weak,'' did
not comprehend all she had in mind, but merely
served as a cover for something else she was not
ready to betray. The phrase must have had some
significance, however, for it had come up in con-
nection with the dream already related when it
was associated with the idea l^at she was '^too
strong'' for her husband.

It occurred to me that sterility might be the con-
cealed common factor, for Stella supposed her
husband to be sterile and knew that I had no chil-
dren. But here again arose the same difficulty.
Though she might suppose two members of the
triad to be sterile, how could she have formed any
opinion about Max in this particular?

I had, then, either to abandon my hypothesis
that some reproductive weakness was, in her
opinion, common to the three of us, or else con-
clude that she had in mind some other sort of de-
ficiency, possibly related to sex, and that it was
this that she supposed to be common to Barney,
Max, and me. This latter conclusion seemed to
me the most acceptable, for there had been a hint
of this same elusive deficiency, whatever it might
be, in the results of the analysis of the dream.

There soon came to light another transference
phenomenon, which proved to be the key to a solu-

366 MOEBID FEAES AND COMPULSIONS

tion of the mystery. Stella began to manifest a
considerable anxiety abont my health. She would
tell me I smoked too much, that I should spend
more time in the open air, and that I must be care-
ful abont my diet. These remarks usually ended
in her laughing at herself and saying that, since
I was a doctor, I must think her very presimiptn-
ous in advising me on matters of health. But, in
spite of this, as likely as not at the next visit she
would repeat the whole performance.

This anxiety about my health might very well
indicate that she suspected or feared that I had
some malady of a general nature and not prima-
rialy sexuaL But some essentially nonsexual ill-
ness might have, secondarily, an injurious effect
upon one's potence and reproductive ability.
Thus the hints that had come up to the effect that
Stella thought Barney, Max, and me deficient in
the sexual sphere might really have had an origin
in her thinking that all three of us suffered from
some nonsexual physical malady. Upon analyz-
ing Stella's peculiar notion that I was an Irish-
man, not only is the hypothesis confirmed but the
analysis also discloses what physical illness she
supposed we had.

It wUl be remembered that her thought that I
was Irish came on when she saw a spot of blood
upon my lip. Blood upon the lips might well sug-
gest hemoptysis, and, hence, tuberculosis. Now,
Stella was accustomed to refer to tuberculosis as
the **Con" and to a person suffering from that
disease as a ^ ' Conner. ' ' But Connor is a familiar
Irish name. I am thin and quite subject to colds ;

A COMPXJLSION NEUROSIS 367

hence, when Stella saw a drop of blood upon my
lip there conld easily have started in her mind a
train of thought having as its theme a question as
to whether I were not a consumptive. But, if for
any reason Stella had a resistance against the
theme of tuberculosis, what more natural than
that, if she began to suspect that I was a ' ^ Conner ' '
in the sense of being consumptive and to feel a
certain aversion to me on that account, this affect
of aversion should be displaced by way of the
other mei.aing of the word (Connor) and so ap-
pear in her consciousness attached to the thought
that I was an Irishman f In this way it becomes
clear how Stella could feel a repugnance to me as
being an Irishman and yet at the same time be
convinced that I was not Irish.

This interpretation, I confess, might easily be
regarded as rather fanciful were it not for the fact
that the thought that I was Irish had such a sig-
nificant starting point, viz., the spot of blood upon
my lip. This, it seemed to me, placed my inter-
pretation practically beyond question and justified
my forming the hypothesis that the defect which
Stella had supposed to be common to Barney, Max
and me was, in fact, pulmonary tuberculosis.

Let us now see how this hypothesis fits the facts
at our command. The supposition that Stella
thought — or perhaps I should say knew — ^that Max
bad tuberculosis explains, in part at least, several
important things which at first were most mys-
terious.

The first one is the fact that, although Max ap-
peared to be in love with Stella, he made no defin-

368 MOBBID FEABS AND COMPULSIONS

ite advances and did not ask her to marry him.
This attitude was quite natural if he really had
tuberculosis, for under such circumstances, no
matter how much he cared for the young lady, he
might well have hesitated either to make love to
her or to ask for her hand.

Second, Stella's remark that she knew Max was
not ^^a marrying man," which I had never been
able to get her to explain satisfactorily, is now
easy to xmderstand. If she thought he had tuber-
culosis she would suppose that he would on ac-
count of it not intend to marry.

Third, it no longer seems utterly incomprehen-
sible that Bose's remark concerning Max, '^ he'll
be weak and sickly all the rest of his life," should
have had sudi a profound effect upon Stella and
have formed the starting point of an obsession.
If Stella believed that Max had consumption, this
remark, coming as it did from some one who had
never even seen him, might well have startled
Stella and filled her with a superstitious dread.

Fourth, the fact which at first seemed so singu-
lar, viz., that Stella seemed to believe in Bose's
prophecy that Max would be sickly all his life, no
longer appears strange. If Stella believed Max
had tuberculosis, she had good reason for accept-
ing Bose's prediction that he would never be
strong.

Fifth, the doubt in Stella's mind as -to the advis-
ability of marrying Max, which we concluded ex-
isted, without knowing its exact cause, we can now
explain. Presumably it was her belief that Max
was tubercular that was the source of the conflict

A COMPULSION NETJBOSIS 369

which resnlted in her wishing that if she married
him his life would be short.

Sixth, the idea that Stella was 'Hoc strong"
for Barney, which was met with in analyzing the
dream already recorded, and which, although
Stella said the phrase had a sexual meaning, I
thought represented some other sort of deficiency,
can now be explained. The deficiency was tuber-
culosis, and Stella felt that she was too strong to
be married to so weak a man.

Seventh, assuming that the idea of deficiency
met with in analyzing the dream really referred
to Barney's being tubercular, it is possible to ex-
plain why Stella showed no particular reaction
and experienced no change in her symptoms when
Barney went to the clinic and the diagnosis of
phthisis was made. That is, the dream occurred
only a short time after I began the analysis of her
case and if, as it seems, the weakness on Barney's
part, at which the analysis of the dream hinted,
was really tuberculosis, it is clear that Stella sus-
pected Barney had this disease when she first came
to me and long before he was examined by a doc-
tor. This explains why the report of the doctor's
findings failed to affect her — she was entirely pre-
pared for it ; the fact that her husband had tuber-
culosis was to her an old story, and the doctor's
assertion of what she already knew of course pro-
duced no reaction.

It is clear, th^n, that the hypothesis that the
weakness or defect which Stella apparently sup-
posed to be common to Max, Barney, and me, was
in reality tuberculosis, not only is perfectly bar-

370 MOEBID FEARS AND COMPULSIONS

monious with the facts that have been brought out,
bnt it enables us to explain very readily many
previously bafiSing things — ^things which, it seems
to me, could be explained by no other hypothesis.
For these reasons I felt pei^ectly justified in look-
ing on it not as a mere hypothesis but as an expo-
sition of actual f act.^

I therefore began to lay before Stella the ex-
planations just set forth, with expectation that
she would confirm me in every point. But she
did nothing of the kind. I asked her if she had
ever thought me tubercular, and she admitted that
such an idea had once or twice crossed her mind.
She also admitted that shortly before Barney was
examined she had wondered if perhaps he had not
some lung trouble, but in regard to Max she would
make no such admission, saying, ^^Do you think I
would have been such a fool as to want to marry
him if I had suspected that he was sickf ' ' To this
I replied by calling her attention to the fact that
by her own admission she had wanted to marry
Max in spite of the fact that she supposed he
would be * * weak and sickly all his life. ' ' But this,
instead of making her agree with me, had just the
opposite effect. She at once retracted her former
admissions, disagreed with everything of any sort
that I undertook to tell her, and so clearly mani-
fested an inclination to combat at all costs my at-
tempts to explain her neurosis that I stopped with-

1 My belief was that Stella in some way knew tliat Max and
Barney had tuberculosis — ^in the latter case independently of the
doctox^s report*— and that because I am thin and have a smoker's
cough she had transferred to me the idea that I too suffered from
the same malady.

A COMPULSION NEUROSIS 371

out having told her of all the condnsions that have
been set forth.

But though Stella had not confirmed me in
words, I looked upon her quite obviously unreas-
onable opposition as an involuntary confirmation.
That is, I thought that she knew me to be right,
and was, in fact, surprised to find how much I had
been able to learn of what she wished to conceal.
Her vigorous opposition was then determined, I
believed, by the fact that there were other things
she did not wish to disclose, for she now felt she
could not keep them from me and concluded that
her greatest safety lay in disputing every conclu-
sion I made and making no admission whatsoever.

I explained this to her without materially de-
creasing her resistance however, and there fol-
lowed a very long period in which I made prac-
tically no progress in the analysis of her obses-
sions. She had no dreams, would give but few
associations, '^nothing came to her mind," and
she was late for every sitting. The only themes
tihiat she was always ready to talk about were the
hopelessness of her case, the futility of psychoan-
alysis, and the impossibility of her being able to
respect me either as a physician or a man after I
had made against her such stupid accusations and
persisted with them in such a stubborn and un-
reasonable manner.

All this I could interpret as an effort to avoid
facing the perception that it was very largely her
own fault that we were not making better prog-
ress— that is, she endeavored to believe me and
my method of treatment at fault as a defense

372 MOEBID FEAES AND COMPULSIONS

against the feeling that she herself was to blame in
not doing her part by disclosing all she could.

I was soon convinced that there was something
in her life that was so painful to her that she
would almost rather remain sick than have it
known, and on this account I would have given up
the treatment had it not been for two reasons:
first, the hope that in spite of her resistance I
would some time find out ^at she was concealing
and so gratify my very considerable curiosity as
to what made her sick ; and, second, that a set of
anxiety hysteria symptoms came into prominence
at this time and that I had no great difficulty in
analyzing them. These kept up my interest and
prevented me from giving up the work. I will
not refer to these symptoms here, for they repre-
sent a sort of digression from the theme of the
main obsession which is already long enough.

The long period of intense resistance was finally
brought to an end in the following way.

Stella came one day and began immediately:
* * I 've been awfully sick, Doctor. Last night I had
a terrible attack of fear — ^the worst I ever had, I
thinf

**What were you afraid of f I asked.

**0f the fortune teller, of course,'' she replied;
"I thought surely I was going insane right away.
I don't see how my mind can stand sudi terrible
fear."

She went on with her usual complaints, "111
never get well," **I'm lost," **I have no future,"
etc., but I interrupted her by asking: ** Don't you

A COMPXJLSION NEUROSIS 373

know what made you afraid t What happened to
bring on the attack?"

"That I'll nev — ^nothing happened — ^I don't
know what brought on the attack, ' ' she replied.

But she did not interrupt herself soon enough to
prevent my realizing that what she had started to
eay was, * * That I '11 never tell you I ' '

I had already become convinced that there was
something of importance in Stella's life that she
was concealing from me. I now had confirma-
tion of this belief, for it seemed plain that Stella
knew very well what had occasioned the severe at-
tack she spoke of. I therefore said to her that I
was sure she could explain why this attack oc-
curred, but she insisted that this was not so and
that there was nothing she could tell me. I re-
plied that I could not believe her, and also said
that, since it seemed to me that she was intention-
ally concealing something important, I was unwill-
ing to exert myself any longer unless she would
do her part — ^in short, unless she told me the cause
at once I would give up the treatment, for I felt
that as long as it was concealed my efforts would
do her no particular good, and that for me to con-
tinue would be simply a waste of thne. *

She protested that I was very unjust, that she
was concealing nothing, and ended by saying,
"How can you think there is anything I would

1 Although it had some results in this case, the use of threats
is not a technical procedure that can be recommended. The phy-
sician should try to understand the patient's resistances against
disclosing information and oTercome them by explaining them,
rather than, so to speak, by using force.

374 MOBBID FEABS AND COMPULSIONS

keep back after all the embarrassing things I have
told youf "

I replied that I was satisfied I was right, and
that at any rate, right or wrong, I was no longer
willing to treat her unless the important piece of
information I expected was immediately forth-
coming. She knew that I meant what I said.

At this point I was called ont of the room for a
few minutes. When I came back she said, ''Well,
doctor, IVe been thinking it over and I've made
up my mind. I know I shouldn't take np your
time unless I let you know everything. At last
I'm going to tell you my secret."

**Well," I ask^, **what is your secret?"

**Con," she replied briefly; ''I've had tubercu-
losis. I've been in two different sanitariums."

Then followed a story which gave an entirely
new insight into Stella's psychic conflicts and soon
proved to be the key to the solving of many of
the mysteries of her neurosis.

Stella's tuberculosis began when she was thir-
teen and a half years old, manifesting itself by
cough, marked loss of weight, and severe and re-
peated hemorrhages. ^

The diagnosis was made by several private phy-
sicians and also at the Broadway Clinic, from
where after a little delay she was sent to a sani-
tarium in the country. There she remained for
about five months, improving considerably, but
finally she ran away and returned to New York

1 It WM on aeooimt of her hmg trouble thftt Stella liad to leave
mIiooI at an early age rather than, ae she stated at tint, that her
mother "needed her to help with the house work." Plege 315.

A COMPULSION NEXJBOSIS 375

because she was ''so homesick/' After remain-
ing in New York for a few months her symptoms
returned to such an alarming degree that she again
applied at a dispensary and was sent to a second
sanitariunu In this place, which we may call Oak-
wood, she remained for several months and im-
proved a great deal. But she was again overcome
with homesickness and finally left the institution
in spite of the fact that the doctors advised her to
the contrary. Having returned home, she con-
tinued to improve, so that before long she was en-
tirely free from symptoms, and at sixteen years
of age she was able to begin work in the store,
apparently in the best of health. Unfortunately,
this was not the end of her trouble. Later she
suffered two distinct relapses, both of which as
will shortly be seen, gave rise to most important
problems in her life and played a highly signifi-
cant role in the development of her obsessions.

The history of her tuberculosis is what I re-
ferred to in the introduction as the important set
of facts I was able to corroborate by outside evi-
dence. And one of the instances of undoubted
affective dis]f)lacement whidi I had in mind was
the incident which occasioned the severe attack
of fear just referred to. On the day in question
a nurse from the Board of Health had called at
the house during Stella's absence, in regard to
something in connection with Barney's case. But
Stella's mother, who can not speak English, did
not understand just what was wanted and so when
she told Stella about the nurse's visit Stella got
the impression that inquiries were being ntiade in

376 MOBBID FEABS AND COMPULSIONS

regard to her own tubercular history. She re-
acted to this — ^a thing, as we shall see later, which
might well have been the occasion for some alarm
— ^by anxiety not about the tuberculosis problem
but about Kishef. In short, she displaced her
emotions from the thoughts with which they really
belonged and attached them to an associated idea,
the fear of the fortune teller. Just why she se-
lected this particular idea as the one to which
to make the displacement will be explained later.

The knowledge that Stella had had tuberculosis
already begins to throw a new light on certain dark
problems of her history. Thus, it is to be seen
that the onset of her lung trouble coincided with
that mysterious *' nervous illness" in her child-
hood which followed the death of her beloved Aunt
Ida, and in which she suffered from depression,
anaemia, and loss of weight. In short, it is now
evident that this early illness was at bottom not
nervous at all, but physical. The anaemia, loss of
weight, etc., were due to the tuberculosis directly.
Nevertheless, Stella was not altogether wrong
when she stated that this nervous illness was a
reaction to her Aunt Ida 's death, as we shaU see
in a moment. There was a ' 'nervous'' element
in it.

In the first place, Stella, after admitting that
she had had tuberculosis, soon disclosed the fact
that Ida had died of the same malady, instead of
''from worrying about something" as she had at
first alleged. A fact of some significance is that
Ida's death had followed very shortly after she
and Stella had had a terrible quarrel Stella,

A COMPULSION NEUROSIS 377

though extremely fond of her aunt, had neverthe-
less, in the heat of this quarrel, wished that Ida
would die. When, then, Ida did die, Stella more
than half believed that this murderous wish had
killed her. And when still later Stella found that
she too had the same malady of which Ida died,
she felt that this disease had come upon her as
a punishment for her evil wish. This doubtless
had something to do with her depression. Inci-
dentally this sequence of wish, wish fulfillment, and
punishment no doubt had a considerable, effect in
fixing in Stella's mind a belief in the power and
in the punishment of evil wishes, and this belief
was apparently a factor in the development of the
Kishef obsession.^

The most important consideration in connec-
tion with Stella's neurosis was not so much that
she had had tuberculosis, but that people knew, or

iThe fact that Ida died of tuberculosis did not dispel Stella'a
belief that a wish had killed her. It was not known that Ida was
tubercular until a very short time before she died; not, in fact,
until after the quarrel that has been spoken of. Stella's idea was
that her wish had caused Ida to become infected with tuberculosis.

There is a Jewish superstition with which Stella was familiar
that in each day there is one minute during which whatever wish
a person expresses will be omnipotent. When Ida died Stella
thought that she had ''hit the minute" — that her wish for Ida's
death at the time of their quarrel had happened to come at just
the fateful moment Just which minute of any given day was
the fateful one no one, according to the superstition, ever knew.
On a number of occasions when she wanted something very badly
Stella made the ingenious experiment of trying to wish for It
every minute of the day so as to be sure to "hit" the particular
minute that conferred omnipotence. Unfortunately, on every oc-
casion she eventually went to sleep or allowed her attention to
wander so that the minute theory was never conclusively proved
or disproved.

378 MOBBID PEABS AND COMPULSIONS

might know, that she had it As she herself said,
'^I never worried so much that I had T. B. — ^I
wasn't afraid of dying. What I did fear was
that other people wonld find out that I was sick
and that this would prevent me from getting mar-
ried" In fact, when Stella first developed tu-
berculosis she was rather proud of it and liked the
sympathy and attention it brought her. Soon,
however — ^at least by the time she was sixteen — she
took a very different view of the situation and
would never admit to any one that there had been
anything the matter with her, while she instructed
her parents and relatives to follow her example.
Her reason was, as she said, that if it were known
she had once had lung trouble no one would want
to marry her. Economic conditions are so stren-
uous in the sphere in which Stella lived that the
young men cannot afford to let sentimental come
before practical considerations in choosing a wife.
Thus, if a girl had a tubercular history, she would
not be likely to have any suitors, for, no matter
how attractive she might be, none of the young
men would care to marry her and run the chances
of being burdened with an invalid. That this is
so, Stella knew from painful experience. In more
than one instance some young man who had been
pajring serious court to her had suddenly ceased
his attentions and avoided her thereafter, while
investigation revealed that the knowledge of her
history, conveyed to his ears by some busybody,
was the cause of his sudden change of front. In
Stella's own words — ^which, I think, are not a great

A COMPULSION NEUBOSIS 379

exaggeration — ^'^ Among the Jews on the East Side,
it ooold be known of a girl that she drank, that
she stole, or that she'd had a dozen illegitimate
children, and she 'd still have some chance of get-
ting married But if it were known she had T. B.,
then as far as marriage is concerned she might as
well be dead — ^if she lived for a hundred years no
one would ever believe she was really strong and
no one would marry her. You can't convince an
East Side Jew that any one ever recovers from
tuberculosis — ^unless, perhaps, he has it him-
self."

Now, in spite of the fact that as she grew older
Stella did everything in her power to conceal her
tubercular history, there was always danger of
its being found out, and under the most inoppor-
tune circumstances. Through her visits to va-
rious clinics and during her sojourn in the two
sanitaria, she had met a great many people— pa-
tients and others — ^who, of course, learned that she
had tuberculosis. On this account her secret was
never safe and the tuberculosis problem conse-
quently remained a constant source of anxiety and
dread because it threatened to destroy her chances
of a satisfactory marriage. At the same time she
rebelled against the idea of concealing her history
from the man whom she would marry, as well as
that of becoming a burden upon him should her
lung trouble recur. These conflicts and the part
they played in producing the neurosis we shall
take up in the interpretation of her earlier obses-
sion.

380 MORBID FEAES AND COMPULSIONS

(e) Analysis of the Assault Obsession

This obsession came on at a time of great con-
flict and difficulty. In the first place, Stella had
recently been deprived of a source of sexual grat-
ification through the incident which put an end to
her father's nocturnal visits. From one stand-
point she was glad these visits had ceased, for she
no longer had to reproach herself for permitting
them. But, on the other hand, she felt a certain
regret, for, in spite of herself, her father was in a
way more attractive to her as a sexual object than
any one else she had ever known, and the pleasure
of his visits was not easy to renounce. She knew,
furthermore, that with merely a look or a word she
could give him to understand that he was welcome
to resume his attentions, and that he would not
long delay in taking advantage of the hint. One
conflict, then, concerned her feelings for her father
and the question of what her attitude towards him
should be in the future. That is, on the one hand,
she wanted to get completely away from his in-
fluence, while on the other she was strongly
tempted to give the signal that would restore the
same conditions that formerly existed.

A still greater conflict arose in another connec-
tion. The fact that she was at the time deprived
of her old source of gratification, as well as her
wish to break completely away from her father,
predisposed her to welcome some new sexual ob-
ject as a substitute for him. It so happened that
such a substitute was offered. A suitor had pre-
sented himself and was highly favored by her pa-

A COMPULSION NEUROSIS 381

rents* She was not in love with him, it is truiB,
but he was a manufacturer and in most comfort*
able circumstances, and this was a matter to which
she was by no means indifferent* It is possible
that despite her strong father complex a marriage
might have resulted had it not been for a compli-
cation that had arisen. Stella had begun to feel
ill, to cough, and to lose weight. These symptoms
gave her good reason to fear that her old tubercu-
losis was active again. This made the question
of marriage a most perplexing one. From one
standpoint, a return of her lung trouble was in
itself an argument in favor of marriage, for mar-
riage offered a most favorable opportunity for
recovery from the disease. If she were to accept
her suitor she would be sure of more leisure, more
comforts, and better food than had ever been her
lot before, or than she could obtain in any other
way, and she knew that all these things, in view of
her health, were of great importance. Marriage
too would not only give her certain advantages
in the fight with disease, but would also remove
her from a position of great disadvantage which
she might otherwise occupy. Unless she married
she would have to work, and if she kept on work-
ing her condition was almost certain to become
worse, so that sooner or later she would have to
give up and go to a sanitarium. This latter pos-
sibility was something she could not face. Com-
paratively few people knew of her first attack of
tuberculosis, but, if she had to go to a sanitarium
agaiu, practically every one of her acquaintances
would ^ow it, she would be branded as a consump-

382 MOBBID FEABS AND COMPULSIONS

tive for many years to come, no matter how fully
she recovered, and her chances of making a suit-
able marriage in the future would consequently
be reduced almost to zero.

In spite of the arguments in favor of accepting
her suitor there was much to be said against such
a course. In the first place she did not love the
man. In the second, she was convinced that if
he knew her past history, to say nothing of her
present fears, he would drop her instantly. If,
then, she were to marry she would have to conceal
everything pertaining to her tuberculosis and to
do this was most repugnant to her. Not only was
she reluctant to make false pretenses in such a
matter as matrimony, but, in addition to this, she
would always be in danger of having her husband
find out that he had been deceived, either through
her developing active symptoms of the malady,
or from some one who knew of her earlier attacks.

It is to be seen that her immediate problems at
this period centered upon the question of whether
or not she was really having a relapse. To be
sure, she had symptoms of apparently serious
import, but they did not settle the matter beyond
all doubt. Thus, she could say to herself, ''I feel
badly, it is true, but how do I know that this is
tuberculosis t I am no doctor, so I can't be sure.
Maybe I only imagine that I don't feel welL"
Under such circumstances the logical course would
have been to go to a doctor and have her lungs
examined. This would have settled the question
immediately. If her lungs were found to be nor-
mal she could have obtained a certificate to that

A COMPULSION NEUROSIS 383

effect and married with a relatively clear con-
science. Bat as a matter of fact she was nnwilling
to have the question settled. In her inmost self
she was practically certain that her Inngs would
not be found normal, and she was not disposed to
exchange what opportimity she had of doubting
the return of her malady for the cold reality of
knowing it. On the other hand, she had certain
resistances against marriage which were derived
from her father complex. Though of course had
she been examined and pronounced normal by a
physician she would have been glad, nevertheless
these resistances gave her a tendency to welcome
any excuse for not marrying. An excellent ex-
cuse would be removed if she were examined and
her lungs found normal. As was pointed out
much earlieri she had a wish to return to her for-
mer relations wiih her father, but the fulfillment
of this wish was opposed by her ethical self. In
the event of her being deprived by tuberculosis or
anything else of all opportunity to marry, the wish
for her father would take advantage of such a
situation and make out of the deprivation an
excuse for a return to him.

All these conflicts and difficulties had been in
existence before Stella's fateful visit to Mrs. Den-
zer's, without, however, bringing forth a neuro-
sis. We should suppose, then, that something
in this visit must hiave reenf orced these conflicts
and thus given rise to the obsession. And such
was actually the case. As has already been in-
dicated, Stella's immediate problems were, first,
had she tuberculosis t and second, if she had it

384 MORBID FEARS AND COMPULSIONS

should she conceal it and marry in spite of her
feeling that this was not honest t If some evil
genius had set out to lead her into this particular
kind of wrongdoing it is doubtful if he could have
devised anything better suited to his purpose than
simply taMng her to Mrs, Denzer's at that par-
ticular time. Nowhere could he have found an
argument in favor of dishonesty more subtle or
better calculated to appeal to Stella than that pre-
sented by Mrs. Denzer's life. Like Stella, Mrs.
Denzer had had tuberculosis as a girl — ^in f act, it
was in a sanitarium that they became acquainted.
Like Stella again, Mrs. Denzer had had a suitor —
in the person of Mr. Denzer — ^at a time when she
was none too sure of the soundness of her health
and whom she felt she would lose if he knew her
history or her condition. But at this point, unlike
Stella, Mrs. Denzer had not hesitated. On the
contrary, she had accepted him instantly and mar-
ried at the earliest possible moment without ^v-
ing the least hint that she had ever had trouble
with her lungs. Her marriage turned out welL
Thus, on the fateful evening of the obsession,
Stella beheld her in possession of a nice home, a
devoted husband, and two fine diildren, to say
nothing of the best of food to keep up her strengfli
and a competent maid to relieve her of all occasion
for spending it And when before the eyes of
sick, tired, and penniless Stella there was dis-
played this so seductive spectacle which seemed
to say to her, **If only you would be dishonest,
you too might have all these things," it is not sur-
prising that something extraordinary happened.

A COMPULSION NEUROSIS 385

Let OB now consider just what this happening
was. What, in other words, was the relation of
the ohsession to Stella's various problems? It
will be remembered that Stella's first fear began
when Mr. Denzer and the two other men returned
to the house, and that it consisted in the feeling
that she must remain no longer or one of these
men would assault her. As has also been said,
she had no actual reason to fear these men. All
three of them were attractive to her. Mr. Denzer
made a great pet of her, one of the men had told
Mrs. Denzer that he would like to marry Stella,
and the other was a medical student of that re-
fined type that always excited her interest. Un-
der ordinary circumstances each might have been
expected to excite desire in some form, rather
than fear. In fact, this was the very reason that
Stella felt herself to be in danger. The situation
was one which, even before the coming of the men,
presented colossal temptations. The arrival of
the men, all of whom were attractive to Stella, re-
enforced the temptations to such a degree that she
was no longer sure of herself. She could scarcely
avoid thinking, '^Oh, if I were not so honest I If
only I had no conscience, what advantages and
what pleasures would be mine!" That is, if it
were not for her moral inhibitions she could either
enjoy the sexual, hygienic, and economic advan-
tages of marriage after the manner of her friend,
or, throwing to the winds all thought of marriage,
go to a sanitarium, resolved that upon her recov-
ery and return home she would indulge herself
without limit in the erotic pleasures afforded by

386 MOBBID FEABS AND COMPULSIONS

the paternal finger. Her f ear, then, was a fear of
temptationi and expressed a wish to be robbed of
her virtae, and to be ^^ dishonest'' in one or both
of the ways indicated.

This fear took the form of a dread of assault
for two reasons. The first was that an assault
would, through no fault of hers, place her in a po-
sition where she would have comparatively little
to lose by further sexual activity— would, in other
words, fulfill her wish to be robbed of her con-
science, or as nearly so as such a wish is possible
of fulfillment. The second reason was that the
words '^ honest'' and '^ dishonest" had for Stella
a double meaning. She was accustomed to speak
of a virgin as an '^ honest girl" (apparently a di-
rect translation of ^'ehrliche Madchen"), and thus
'^honest" meant to her chaste, ^'dishonest" signi-
fied unchaste, although these words in addition
had for her the same meaning that is usually given
to them. Thus her wish to be, or her fear of be-
ing, ^^ dishonest" in the usual sense of the word —
which here referred to her inclination to conceal
her tuberculosis and marry under false pretenses
as Mrs. Denzer had done — ^was represented in the
focus of her consciousness as a fear of becoming
dishonest in the other meaning of the term. ^ * Dis-
honest" was thus a common term which expressed
both types of the temptation to which she was
subject.

During the night the fear that she would become
'^ dishonest" changed to a feeling that she was
'^ dishonest" — that she had been assaulted. This
was brought about by a feeling of certainty that

A COMPULSION NEUBOSIS 387

had oome to her that she really was again suffer-
ing from tuberculosis. The absence of menstrua-
tion she had found to be a symptom, in her case at
least, indicating that an active pulmonary process
was going on. For several days before going to
Mrs. Denzer 's she had been expecting to be unwell,
and had the flow appeared she would have been
relieved. When, in the morning, she awoke to
find that it was still absent her fear that she had
suffered a relapse changed to a conviction that
such was the case and thus dispelled all expecta-
tion that she would be able to lead the life that her
conscience dictated.

Stella's obsession that she was assaulted in her
sleep represents, then, among other things, a down-
ward displacement of her tuberculosis complex.
Thus the fear she expressed to Bose that some-
thing ^' awful'' had happened to her and had made
her body '^different" was fundamentally correct,
but she located the trouble in the wrong region —
in her genitals instead of her lungs. Also when
she went from one doctor to another to be exam-
ined for a rupture of the hymen she was carrying
out the perfectly logical impulse to go to a doctor
for an examination of her lungs. Her wish to be
examined was entirely right— 'the only thing wrong
was that she had displaced the examination sev-
eral bodily segments downward.

in the same way the obsession, by means of dis-
placement, gave outlet to another impulse. Stella
had threatened to tell her mother that she had
been *' touched" by her father, but this threat she
had not carried out. When she developed the ob-

388 MORBID FEARS AND COMPULSIONS

session she did tell her mother that she had been
'^touched" (to be touched is a slang phrase for
intercourse — ^a virgin is a girl who **ha8 never
been touched '0 ^^^ the ambiguity of the word
'Houch" allowed her to discharge her impulse to
tell, but without disclosing just what had occurred.
This obsession lasted some months. Fortu-
nately Stella WES able to get together enough
money so that she could give up her work and go
to the country for a time. This change gave her
the start she needed, so that when she came home
her physical symptoms eventually disappeared,
and after a time she was able to return to her work
in the store. Her obsession cleared up after the
symptoms of lung involvement had disappeared,
but not until she had at last decided to refuse the
young man ** because," she told herself, **she was
not a virgin." The obsession reappeared from
time to time up to the beginning of the Kishef fear,
though never with any great severity. These re-
currences coincided with those times in which she
had some reason to doubt the soundness of her
physical health, or was confronted with some sex-
ual temptation or the problem of marriage.

(/) The Role of the Tuberculosis Complex in
Determining SteUa's Love Choice

When Stella had once admitted that she had
had tuberculosis her resistance diminished enor-
mously and it was possible to work out many
things that had previously been inexplicabia
Thus, I was able eventually to discover the reason
for her sudden infatuation for Max and to answer

A COMPULSION NEUROSIS 389

the extremely baflUng question of why she married
Barney. Once she had confessed the great secret
of her tuberculosis, Stella not only ceased to deny
that I was correct in my conclusion that she had
supposed Max, Barney, and myself to be tubercu-
lar, but she corroborated me in every particular.
Thus, she confessed that she felt Max was a con-
sumptive from the very first instant she saw him,
and that she was confirmed in this belief, first, by
the fact that, although apparently m love with her,
he was so paradoxically reticent, and, second, by
her learning that he, like herself, took a six weeks'
vacation every summer. For, said she, when poor
people take long vacations it means they have to
— ^they cannot afford it unless it is a question of
health.^

Now, the singular fact that Stella's infatuation
for Max and her belief that he was tubercular
began at the same instant was paralleled by a
similar occurrence in her affair with Barney.
Now that her resistances had diminished, Stella
not only agreed that I was right in thinking that
before he was examined she believed that Barney

1 With the knowledge of tuberculoeU which she had gained by
the observation of her own case, and through being in clinics and
sanitaria, Stella was a diagnostician of no mean skill. Her abil-
ity to detect tuberculosis from the general appearance of a person
was such that a physician might envy her. But a fact that is
of more importance is that she had absolute confidence in her
powers in this line and once she had made up her mind that a
person was a consumptive she would have been slow to change
her opinion even if a physician skilled in physical diagnosis had
disagreed with her. I mention this in order to make it plain that
though it might seem that she had insufficient grounds for being
certain that Max and Barney had tuberculosis she umm certaiuy
nevertheless.

390 MORBID FEABS AND COMPULSIONS

was a oonsnmptiyey bat ahe also told me that even
before she married him she was oonvinoed he had
the disease. In fact, her family also suspected the
same thing, and, calling him ^'der tote Mann,^' did
everything in their power to prevent the match. ^
Now, it may be added, that sometime earlier in
the analysis Stella told me she first felt that she
wanted to marry Barney jnst after he had told
her he had been giving some lectures at the Y. M.
H. A. The fact that he lectured, she said, gave
her the impression that he must be very intellec-
tual, and for this reason she felt she would like
to marry him. When, after her confession, I hap-
pened to ask what first made her suspect that Bar-
ney was not well she answered that whUe he was
telling her about the Y. M. H. A. lectures she no-
ticed that he was very hoarse and that this imme-
diately aroused her suspicion. In other words,
in her affair with Max, and again in her affair with
Barney, a desire to marry had arisen exactly at
the same moment as the st^spicion that the object
of this desire was tubercular. This looked to me
very much as if a causal relation had existed be-
tween the two phenomena — ^I mean to say, that ap-
parently Stella had wanted to marry Max and
Barney because she thought them tubercular.
This sort of desire, at first thought, seems a very

lit may be noted at her firgt visit to me Stella said, in re-
sponee to my suggestion that she put off her marriage for a time,
that neither her own nor her husband's parents would Usten to
any proposal of delay. As we have learned, quite the reverse was
fcrue, at least so far as Stella's parents were concerned, lliey not
only would have been glad to have her put off this marriage, bat
would have done almost anything in their power to prevent it.

A COMPULSION NEUROSIS 391

strange one, yet there were reasons enough for
its existing.

In the first place, Stella felt that if she married
a well man without having sound health herself
she would be doing wrong to her husband. But
if she could pick out a tubercular husband she
would in a way be doing him no greater wrong
than he was doing her, and, thus, in a sense, they
would be quits. Again, if she married a well
man she would have to reproach herself for ex-
posing him to infection, whereas if her husband
were already tubercular this occasion for self-
reproach would not exist.

In the second place, she could look upon a mar-
riage with a tubercular man as a temporary one.
That is to say, she could expect that her husband
might die, and with that superstitious faith in the
omnipotence of her wishes which is so common
among neurotics, she had a sort of belief that he
would do so when it would most suit her conven-
ience. Another reason for a belief that such a
marriage would be a temporary one was this. At
the time she married, Stella knew practically noth-
ing of the laws of divorce, and she thought that if
she wished to be free from a tubercular husband,
particularly if he were not well enough to support
her, all she would have to do would be to state
the case before the nearest judge, and, provided
she successfully concealed the fact that she too
had had the disease, he would give her a divorce
instantly.

The chief advantage of a temporary marriage
was that it would give her a chance for compara-

392 MORBID FEABS AND COMPULSIONS

tive rest from her work in the store, to build up
her healthy and thus get into condition to make a
permanent marriage should the right man come
along.

Another element in the case was her family.
Because she had had tuberculosis they were very
anxious to have her married and off their hands.
In a way she wanted to assist them in this en-
deavor, for she realized that at times she had
been a great burden. But, on the other hand, she
resented their anxiety to get rid of her, and espec-
ially so because they made it pretty plain that on
account of her history they felt any husband who
could support her was good enough and, conse-
quently, never made the slightest effort to get her
one that would be really worth while. Conse-
quently, Stella felt that it would serve her parents
right if she contracted a second-rate marriage,
and, as a result of her husband's inability to sup-
port her, soon had to. return to the parental flat.
In other words, it would give her a certain spiteful
satisfaction to make an unsuccessful match.

But there was still a more important reason
why Stella wished to return home to her parents,
namely her attachment to her father, which, it
need hardly be said, was a very strong one. As is
well known even quite ordinary family relations
between a father and daughter are not infre-
quently sufficient to produce such a fixation of
the child's love upon the father that she is never
able — or willing — ^to transfer it to a more suitable
object. But where, as in this case, there had been
actual physical sex-relation between parent and

A COMPULSION NEUBOSIS 393

ohild the tendency to develop a fixation that
would form a permanent obstacle to normal trans-
ference is of course very great. In f act^ it is by
no means impossible that even if there had not
been the difficulties in the way of marrying which
tuberculosis created, and even if Stella's suitors
had been much more nmnerous and desirable than
was actually the case, she still might have been
unable to break away from her father and fall in
love in a normal way. At any rate, since Stella's
feelings toward her father amounted to her being
consciously in love with him — ^not even stopping
short of the wish to bear children by him — ^it is
clear that, however strongly she felt that she ought
to break away from him and form a more normal
attachment elsewhere, she was incapable of a thor-
oughly sincere effort in that direction, for the wish
to succeed in it was constantly opposed by an
equally strong, even though less clearly perceived,
hope tiiat she might fail and so retain her original
state.

If then we bear in mind that because of her love
for her father, Stella was reluctant to take any
step that would mean a permanent separation
from him, we are better able and understand why
she chose a consumptive for a husband and to com-
prehend the analysis of the Kishef obsession, upon
which we are about to enter.

(g) The Affair with Max and the Analysis of the

Kishef Obsession

In this obsession Stella's tuberculosis played
the same role as it had in the assault obsession.

394 MOEBID FEARS AND COMPULSIONS

The prime object of her vacation in the coontry
which led to her acquaintance with Max, had been
the restoration of her heath. For again the hard
work in the store had been too much for her, and
she had perceived signs of returning lung trouble.
It is to a recurrence of her tuberculosis rather
than to the kind of love described in story books
that the loss of weight and similar symptoms
which accompanied her infatuation are to be at-
tributed.

The infatuation itself was determined very
largely by the elements we have just described in
discussing the influence of tuberculosis on Stella's
love-choice. That is, although she would not have
admitted it, she was already alarmed about her
health and worried by the knowledge that soon her
vacation would be over and she would have to go
back to work in the store. When with her first
glance at Max she saw he was tubercular and at
the same time attractive, she felt that marriage
with him represented a way out of her difficulties,
and this thought, though not clearly perceived by
her consciousness, made her say to herself ''Here
is the man I must marry," and was largely re-
sponsible for her seeming infatuation. That over
and above considerations of mere expediency Max
was extremely attractive to her can hardly be
doubted.

When her vacation ended and she returned to
work in the store she knew that the rest had done
her comparatively little good and not only that
she was still far from well but also that she had a
good prospect of becoming worse if she kept on

A COMPULSION NEUROSIS 395

working. Naturally she began to feel that she
should consult a doctor, and possibly go to a sani-
tarium, but here again, as at the time of the as-
sault obsession, she could not bring herself to face
this painful necessity, or, indeed, to admit that
it really existed.

When, earlier in the day of her first visit to the
Mahoshef, she accompanied Rose to St. Christo-
pher's Clinic, thoughts about tuberculosis and the
need of consulting a doctor must have been in her
mind. To visit any clinic would have inevitably
brought up such reflections, but St. Christopher's
was particularly well suited to have this effect, for
Stella had been told there by one of the clinic phy-
sicians, when several years earlier she applied to
be treated for nasal catarrh, that he found signs
of active tuberculosis in her lungs.

Now that we know that Stella's tuberculosis
complex must have been stimulated by the visit
to the clinic, it is easy to explain her sudden change
of front in regard to consulting a Mahoshef. Be-
fore going to the clinic with Rose she had scoffed
at all that lady's suggestions of magic, but imme-
diately after the visit she veered about and ex-
pressed a desire to see a fortune teller after all.
The reason is plain enough. The need of going to
a doctor for an examination and treatment was
brought forcibly to her mind by going to the clinic.
She could not bring herself to face the ordeal of
an examination, however. What she did do, then,
was to make a compromise. Instead of going to
a doctor she decided to visit some one like a doc-
tor—in short, a magician— for she had often heard

396 MORBID FEARS AND COMPULSIONS

from Rose and others that these individuals could
cure all the ills that flesh is heir to. Thus her
visit to the Mahoshef was really a substitute for a
consultation with a physician — ^and the motive for
it was a wish to get rid of that great obstacle
to marriage, tuberculosis, rather than a desire to
have Max's state of mind changed by supernatural
means. Without doubt she thought his mind was
in the proper state anyway — ^that he would marry
her if his body were sound.

Some time before making this visit Rose had
said to Stella, ''You are so much in love with Max
that you'll make yourself sick worrying about hun.
You know you once had hemorrhages, and you
can't be very strong now. If you let yourself get
so worked up the old trouble may come back."
Stella replied to this that she never really had
tuberculosis and tried to convince Rose that this
was so without being at all satisfied that she had
succeeded, although Rose did not dispute the point
and pretented to be convinced.

When, then, at their first visit to the Mahoshef,
Rose, having preceded her into his presence, re-
turned crying, **He knew what your trouble was
right awayl" Stella, demonstrating the truth of
her own proverb, *'Auf dem Gonef brennt die
Hiittel,"^ began to feel uncomfortable and to
wonder if he could possibly have guessed that
she had tuberculosis. But at the same instant it
dawned on her that Rose might have given him
some hint of her history, for, knowing that Rose
was suspicious and feeling sure that she had not

1 On the thief the hat bunii.

A COMPULSION NEUROSIS 397

fiuoceeded in convincing her that she had never
had the disease, Stella thought it not unlikely that
Bose, shrewdly suspecting that the problem of
tuberculosis was worrying her a good deal, had
conununicated this suspicion to the Mahoshef with
the kindly intention of giving him every possible
advantage. The vaguo fear of the Mahoshef,
which, as we have said, Stella felt all through her
first visit, can now be accounted for by the fact
that she suspected that he had some idea of her
tubercular history.

It will be remembered that Stella began to be-
lieve in the Mahoshef when he boasted to her, '^I
can do everything; for me all kinds of Kishef are
easy." This meant to her an implication that he
could not only make love matches but also cure
diseases, and it was the latter point that interested
her, for this was just what she had hoped he could
do. Her faith in him which then began was, in
part perhaps, a remnant of the old superstition
of her childhood, which had been reenf orced by
the wonder tales which Bose had told with such
convincing sincerity, but more largely it was a
wish product. That is, she believed because she
wished to believe. Her faith was the ordinary
spes phthisica which leads consumptive patients to
put so much reliance on all sorts of outlandish
remedies.

Finally, the idea that the Mahoshef possessed
the powers of a doctor, or that he could be re-
garded as a substitute for one, was strengthened
when, as has been said, he offered to sell her a cure
for rheumatism. Thus, when Stella said to Bose

398 MORBID FEAES AND COMPULSIONS

after leaving the Mahoshef, ''I'm so happy, now
I can marry Max," her thought was ''Perhaps the
Mahoshef can core Max and me of tabercnlosis
and thus make it possible for us to marry," rather
than any idea that some change in Max's emo-
tional state was to be brought about.

In her conversation with Rose two days later
Stella said, "I had rather get him in ti^e right
way. After we are married I will tell him all
about it." And what she had in mind was her
tuberculosis history. Her words were clearly the
result of a feeling that for her to marry without
telling her suitor of her history was a "wrong
way ' ' of getting a husband

At the same time, these remarks show that her
faith in the ability of the Mahoshef to cure her
was by no means absolute, for had she been posi-
tive that he could make her entirely sound and
well she would have felt little guUt about marry-
ing, no matter what her past history had been.
When, then. Rose told the story of the man who by
drinking menstrual blood was made to love, Stel-
la's already overtaxed credulity gave way, for to
be confronted with the task of believing a tale so
utterly absurd and beyond the bounds of probabil-
ity was the proverbial last straw. Thus, without
clear consciousness of doing so, she had to think,
"If Rose can believe a thing so foolish as that,
how can I put any confidence in her when she teUs
me that the Mahoshef has such wonderful powers T
What a fool I have been to think he could cure
tuberculosis 1 " ^

1 Probably the esflential nature of these thoughts is that ori^

A COMPULSION NEUROSIS 399

It was natural, then, that when a moment later
Bose said, '^Do yon know, Stella, that if Max has
magic done to him he will be weak and sickly all
his life and can't live to be over fifty, if even that
longT" there should form somewhere in Stella's
mind the ironical and contemptuous reflection
which may be expressed as follows: /'Indeed,
you are more right than you realize, friend Bose ;
he tuiU always be weak and sickly if he has magic
done to him — and if he doesn^t have it done to
himl He has tuberculosis, and, in spite of what
any Mahoshef or doctor can do for him, he will al-
ways be weak and sickly, and of tuberculosis he
will die."^ But, naturally, there also came the
thought ''The same thing, I fear, is true of me,"
which was formulated in the same ironical way,
"Just as truly as Max is going to die of Kishef,
80 truly I am going to die of it. The same sort of
magic that will cause his death will also cause
mine (that is, what we will die of will be tubercu-
losis). This thought, then, "I am going to die
of the fortune teller's Kishef {in the same way
as is Max)/^ which is simply another way of say-
ing/^I have tuberculosis, and I will never be cured
of it," formed the starting point of her obsession.

To gain some understanding of why this thought
became obsessive, that is to say, why all the affects
belonging to the tuberculosis complex were trans-

inaUy th^ were wordless, altbough I am here obliged to express
them in words.

^This pessimistic reflection corresponds to the opinion regard*
ing the curability of tuberculosis which is held by the old-fash-
ioned Jews of Stella's acquaintance. Most of them believe that
real consumption can never be cured.

400 MORBID FEAES AND COMPULSIONS

f erred to it, we need only to represent to ourselves
what must have been the state of Stella's mind
at that time. The theme of tuberculosis was one
that for a long time she had not faced squarely.
As soon as she began to realize, in her girlhood,
that tuberculosis would diminish her value in the
eyes of men, she not only denied to others that
she had had the disease but refused to admit even
to herself that she had ever had it. Thus, she dis-
puted the significance of repeated hemorrhages,
loss of weight, cough, and similar symptoms, and,
although all the doctors who ever examined her at
the times she showed symptoms had made the
same diagnosis of tuberculosis, she always told
herself that as the result of prejudice or some
other influence they were mistaken, basing this
contention on the fact that she had never had a
positive sputmn, and that for the greater part of
her life she had maintained fairly good health
though working in an unfavorable climate and
under unfavorable conditions.

But for Stella to maintain a conscious belief
that she was not and had never been tubercular
would mean simply that she repressed and refused
to admit to her consciousness various perceptions
that would inevitably lead to the formation of a
directly opposite opinion. In other words, even
supposing that she could believe consciously that
she never had had the disease, yet unconsciously
she entertained an entirely different conviction.
Thus, though at the time of her affair with Max
she kuew in a way that she was having a relapse.

A COMPULSION NEUROSIS 401

she would not admit to herself that such was the
case.

The concern consequent upon her unwilling and
unadmitted knowledge of her condition was tem-
porarily diminished by her visit to the Mahoshef ,
f or, with a faith like that which a drowning man
has in a straw, she had hoped that he would be
able to do away with her malady. But in a mind
so shrewdly materialistic as Stella's any belief in
his powers was of necessity short lived. The ab-
surdity of Rose's story of menstrual blood as a
love potion was enough to swing her back to her
normal position of incredulity. Thus as her tran-
sitory faith in the Mahoshef gave way she was
plunged into a state of despondency in which she
was on the point of admitting not only that she
really was sick but that perhaps she might always
be so, but Rose's remark, which caused her to
think, '^I am going to die of Kishef (in the same
way as is Max)," supplied at the critical moment
tf euphemistic phrase with which to make the ad-
mission. To say, ^^1 am going to die of Kishef/'
since Kishef was a thing she really neither be-
lieved in nor feared, was less painful than the bald,
cold statement ^^I have tuberculosis, and it is of
that I must eventually die." But no matter how
delicately expressed, a thought having such a
meaning, and coming as it did at the moment when
a forlorn hope had just been destroyed, was in-
evitably accompanied by intense and disagreeable
emotions. The thought **I am going to die of the
fortime teller's Kishef" appeared in Stella's con-

404 MORBID FEARS AND COMPULSIONS

The thoughts from which affective displacement
came about by this route arose as follows. Not
only did Rose divine the facts with Kishef-like ac-
curacy in her prediction concerning the health of
Max, but also, it seemed to Stella, in another con-
nection. It will be remembered that early in the
analysis we learned that Stella wished tha^ if Max
turned out to be a helpless invalid after she mar-
ried him, his life would be short. Because of these
wishes she could regard herself, as far as her
thoughts were concerned, as a murderess. It was
also pointed out that in connection with Ida's death

before they went to him changed what had been in the first place
only a vague suspicion into a practical conviction that Roae had
betrayed her. For the fact that Rose had seen fit to conceal this
acquaintance indicated a certain duplicity on h^ part, while the
existence of the acquaintance, implying as it did that Rose had
confided in the man and had some secret understanding with him,
made it seem highly probable that she had told him all she knew
about Stella. Thus, it is to be seen that the reason Stella became
angry at Rose when she discovered the old acquaintance between
her and the Mahoshef was that this discovery, to Stella's mind,
represented quite positive evidence that Rose had betrayed her.
She was angry at Rose's seeming untrustworthiness, for she felt
that if that young lady could so readily betray the great secret
to the Mahoshef she might just as readily betray it to almost
any one else, and where such a betrayal would be much more
serious. Another element was the fact that Stella felt no small
resentment toward Robc because the latter had apparently refused
to be convinced that Stella was not a consumptive. Stella's wish
to convince Rose of the soundness of her health was at bottom
a wish to convince herself. Her resentment at Rose's apparent
skepticism thus oorresponds to that familiar phenomenon known
as the projection of a reproach.

It must be added, however, that Stella's anger at Rose was not
quite as real as it seemed. That is to say, it served as an over-
compunction for a feeling of a different sort — a matter which will
be clearer when we take up the wish element in the obsession.

A COMPULSION NEUEOSIS 405

Stella did regard herself as a murderess not only
in thought^ but also in f act^ for she believed that
fihe had killed Ida with an evil wish. Stella could
think of herself as^ potentially, a murderess for
still another reason, for she was not sure that she
would not adopt some means of hastening Max's
departure more material than mere wishes if after
she married bitri he became incapacitated and lin-
gered on a hopeless invalid unable to support her.
Indeed, the fact that she had something of this
sort in mind explains her exclamation, ''I can't
bear to have a man's days shortened for my pleas-
ure! I can't have him lose his life on my ac-
count I " ^ But it is clear that though SteUa had a
certain basis for saying to herself, '^I am a mur-
deress," it was an admission that she would have
been very reluctant to make; and, consequently,
her mind would automatically take advantage of
any mechanism representing an escape from a
thought so painfuL Such a means of escape was
provided in this way. When Rose had said of
Max, ^^If he has Kishef done to him he can't live
to be over fifty," Stella of course thought, ^^ When-
ever Max dies, no matter of what cause, Rose will
think that it was Kishef that killed him ; and, since
I am the one who caused the Kishef to be done,
Bose will look upon me as a murderess." And,
as we have just shown, Bose, in Stella's opinion,
would be right in thinking her a murderess. Here

1 After she married Barney and St became evident that his
health was failing she often had impulses to choke him or poison
him and was by no means always sure that she would not act
upon them.

406 MOBBID FEAES AND COMPULSIONS

again Rose, though through wrong premises,
would reach a oorrect conclusion in a way so re-
markable that it could be thought of as mind read-
ing or **Kishef/' Of this figurative way of ex-
pressing the disagreeable fact that Rose's esti-
mate of her would be in a way true, Stella's mind
took instant advantage. Hence, instead of saying
to herself, '^Bose will be right if she thvnks lamQ
murderess,*^ or, in other words, instead of putting
the psychic accent on the last part of the ideas
represented by the above sentence, where it be-
longed, her mind accented the first part, the idea
^^Bose guesses my thoughts rightly," which as she
thought in Yiddish would have the form, ''That
Machseveh is doing Kishef to me" (Die Mach-
seveh tut mir Kishef) ; and this thought, construed
literally by her consciousness, and further dis-
torted by the condensation whereby the masculine
''Mahoshef " was substituted or merged with the
feminine ''Machseveh," bore with it all the affects
of displeasure and self-reproach originating from
the unwilling knowledge of her murderous tend-
encies.^

But still another group of ideas came to be rej)-
resented in Stella's consciousness by her fear of
the Mahoshef. Not only in the two connections
just spoken of but in still another Bose had seemed
to divine what Stella was thinking; for as has al-
ready been said, Stella thought that Bose guessed
that she was worrying about tuberculosis. She
felt sure that when they discussed the matter of

1 Compare the diBCuasion of thing^ideaa and word-ideaa in CShap-

tap IV.

A COMPULSION NEUROSIS 407

hemorrhages Bose, though pretending to be im-
pressed by her protestations, was really not at all
convinced that Stella had never had the disease.
And Bose's warning, *^If you worry so about Max,
T. B. will come back on you" had made Stella won-
der if Bose did not suspect that this had already
occurred and that it was a return of the T. B. more
than any thoughts about Max that was the real
source of her worry. So, too, when they went to
the Mahoshef SteUa thought it not improbable
that if Bose told him anything about her history
she had added, ''and very likely she is not feeling
any too strong now, which may be the reason she
seems so worried." ^

1 It Ib perhaps tme that Stella's grounds for thinking that Bose
had divined and perhaps disclosed to others that her tuberculosis
had recurred were not particularly good ones. As a matter of
fact» for Stella to fear that another had guessed her secret — a
aecrety be it remembered^ which she hardly admitted to herself—-
did not require sound logical grounds. It is well known a
guilty person fears in a characteristically illogical way that his
guilt is suspected by others, even by those who cannot possibly
know anything about it. In the same way it often happens that
a person thinks that another suspects him of something that he
consciously believes he is not guilty of but of which he is actually
guilty, though unconsciously. One of my patients, for example,
who developed a neurosis diortly after he became engaged, told
me he believed a friend of his suspected that he became ill only
as a means of backing out of his engagement; and, as it turned
out eventually, a wish to withdraw from the engagement actually
was one of the chief determinants of his illness. But at the time
he became iU this wish was a totally unconscious one. Phenom-
ena of this sort are well known under the term, '^e projection
of a reproach," and that the existence of this mechanism is well
recognized is evidenced by such familiar phrases as: *'A guiliy
oonseience needs no accuser.*' "The wicked flee when no man pur-
sueth.'' To some extent, then, Stella's thought that Rose and the
Mahoshef knew she had tuberculosis depended upon a projection

408 MOBBID FEABS AND COMPULSIONS

At any rate, for Bose to gaess that Stella was
having a relapse — for in fact Stella was fat and
looked perfectly well — ^was remarkable enongh to
be expressed in terms of mind reading or divina-
tion« Hence, whatever affects belonged to the
idea ^ ^ That I have tabercnlosis is known to others ' '
conld be displaced in Stella's consdoosness to the
idea '^The Mahoshef is doing magic to me.''

This point, that magic meant among other thingfs
to have knowledge of the secret of her tuberculosis,
has been emphasized because upon it depended
some of the minor fears from which Stella had
suffered. Since for her to think a person was
doing magic to her could be a substitute for the
thought that that person knew of her tuberculosis,
one can understand why she had fears of friends
of the Mahoshef, of people who stared at her on
the street, and of the doctor who hypnotized her
at the Broadway Clinic. All of these persons
she had reason to think knew or might know that
she was a consumptive. She feared friends of the
Mahoshef, and under this guise friends of Bose
also, because she thought Bose and the Mahoshef
were untrustworthy persons and might betray her
secret to their acquaintances. She feared the doc-
tor at the Broadway Clinic because her old tuber-
culosis histoty was there on file, and he might have
seen it or have learned of her story from some of

of the represBed thought **I know I have it/' This thought^ ^
know I have tuberculosis/' then, contributed to the obsessioii
through two mechanisms: first, identification with Max; second,
that of projection. In addition, as we shall learn shortly, there
was a wish element in the case that made Stella exaggerate any
real likelihood of her tuberculosis becoming known to others.

A COMPULSION NEUROSIS 409

the men in the department for tuberculosis.
(This particular physician served also as a substi-
tute for several physicians, at this clinic and else-
' where, who might tmow of her lung trouble.) The
reason that she feared that people who stared at
her on the street were doing magic to her was this.
Any one is apt to think when he sees another per-
son staring at him, ^'Is that some one who knows
me but whom I do not recall!" but Stella would
add to such a thought, ''Is that some one who
kiJbws me from having seen me in a sanitarium or
T. B. clinic,, and so is aware that I am a consump-
tive!'' a thought which, because of her resistances,
reached her consciousness as a fear of divination
or of magic.

But there remains still another determinant of
Stella 's obsession to be considered. We have seen
that, according to the wording of the young lady's
obsession, the source of all her troubles was the
Mahoshef • It was he and his influence which, it
seemed to her, menaced her mental integrity and
after her marriage threatened to bring about a
divorce from her husband. The role which the
Mahoshef played in her obsession was, then, quite
analogous to that occupied by the arch persecutor
in the delusions of a paranoiac. But we have
come to believe that in paranoia and allied condi-
tions the person hated and feared as the arch
persecutor either is, or represents, some one whom
the patient, usually without realizing it, actually
loves.* It is not unreasonable to conclude, then,

1 Freud — Psvchoanalytische Bemerkungen fiber einen autobi-
ographiBch beschriebenea FaU von Paranoia. Jahrbuch f Or Pay-

410 MORBID FEARS AND COMPULSIONS

that a similar state of affairs must have existed
in this case. But, since there is no reason to think
that Stella loved the Mahoshef, it wonld seem that
he must have stood as a representative of some
one whom she really did love.^ The power which
to Stella seemed to emanate from the Mahoshef
we may suppose, then, was really her love for this
person whom the Mahoshef represented. Thus,
as we might naturally expect, magic or Eashef
was a symbol for love, for in the figures of ordi-
nary speech love is spoken of as a magical power,
a form of enchantment, the lover is said to be be-
witched by his mistress, and she to have cast a
spell over him, etc '^The Mahoshef is doing
magic to me'' means then, among other things, '^I
am in love with him/' i. e., with some person whom
the Mahoshef represents.

But who was the person loved by Stella and
represented in the obsession by the Mahoshef!
There seems to be little room for doubt on this
point. All the evidence indicates that Stella's
father was the person in question. As has al-
ready been said, she was in love with him in the
fullest sense of the word. She wished to remain
with him, to assume the place occupied by her
mother, and to be sexually gratified by him.

choanalytische und Psychopathologische ToTBchnngm, BcL m.
Bit. 1, 1912.

1 This line of reasoning has brought us to a oondnsion almost
identical with that reached when before beginning the analysis
we were considering the question of love at first sight» namely,
that Stella must have been in love with some person, then un-
known to us, and that presumably this love was an important
factor in the development of the neurosis.

A COMPULSION NEUEOSIS 411

These wishes were opposed and to some extent
obscured by others of an ethical order which im-
pelled her to marry and leave home. But the
conflict of these f orces, reenf orced by the conflicts
arising out of the tnbercalosis problem, eventually
resulted in a sort of pseudo-marriage — ^a marriage
with a consumptive. That is to say, her love for
her father led her to contemplate and eventually
to take a step which must lead to infinite trouble,
anxiety, and unhappiness. It is evident, then,
that if all of Stella's troubles could be attributed
to the influence of any one person, that person was
not the Mahoshef, but her father. From the
standpoint of harm done he was the real Maho-
shef. He, and not the fortune teller, was the one
who ** bossed'' her thoughts, had ** power" over
her, and was ^'driving her crazy,'' or as we can
better express it, to do ** crazy" things. **The
Mahoshef is doing magic to me and I am going to
die — or go crazy" is then a substitution for the
thought ^^I am in love with my father, and this
love is leading me to do insane things that will
lead to my destruction."

In addition to the factors just mentioned there
were stUl others which had some influence in caus-
ing Stella to identify the Mahoshef with her father.
The fact that the two men were of about the same
age and appearance, and that they were both ob-
viously old-fashioned and superstitious, without
doubt had some significance. Furthermore, both
were in some degree deserving of the term Maho-
shef in its colloquial significance of rascal. But
a more important factor was this. It will be re-

413 MORBID FEABS AND COMPULSIONS

membered that Stella's visit to the Mahoshef was
really a substitute for going to a doctor. Now,
the idea of visiting a physician had for Stella a
peculiar significance. As a little girl of nine or
thereabouts she and other little girls had been
wont to amuse themselves by * Splaying doctor.*'
They examined one anotheri pretended to deliver
each other of babies, administered enemas, etc.
But the most interesting form of ^^ treatment''
which took place in these games consisted in the
masturbation of the ^'patient'' by the pretended
medical man. Thus, the idea of going to a doctor
for examination and treatment was always asso-
ciated in Stella's mind with some thought of sex-
ual gratification by means of masturbation. For
the same reason a doctor, or more especially a per-
son who, though not actually a medical man as^
sumed the role of one, as did the Mahoshef, could
stand as a dispenser of masturbatic gratification^
and, consequently, as a substitute for her father,
who had afforded her pleasures of that sort.^
The starting point of the identification seems to
have been the moment when during her first visit
to him the Mahoshef took Stella's hand and so held
it that his thumb was interlocked with hers in a
peculiar way, of which she says, ^'It made me
think of sexual intercourse."

iThiB same idea of playing doctor obviously had to do with
the assault obsession. Her repeated visits to physidans at that
time signified among other things a vish to have restored the
masturbatic visits of her father, which had terminated just before
this obsession began. She wanted to be "examined" or "treated"
in the earlier sense of the words, but her father, the "doctOT*
■he really wanted, she would not go to for the purpose directly.

A COMPULSION NEUEOSIS 413

Up to this point the ideas which determined
Stella's obsession have been considered purely
as painful ones and little has been said about
trishes having anything to do with it. We are
taught, however, that the wish element is inva-
riably present in any neurosis and, as will shortly
appear, this case was no exception to the general
rule.

Stella was of a very passionate nature and had
possessed almost from her girlhood an intense
longing for sexual intercourse. But though at
times she had been sorely tempted to do otherwise
she had resolutely deferred any fulfillment of this
wish, partly on account of moral considerations,
but more largely, as she was well aware, because
she expected to marry eventually and felt that it
would be highly inadvisable for her to be lacking
in the physical evidences of virginity when that
event should take place. But she could expect
to marry only if she preserved good health — or at
least the appearance of it — ^and succeeded in keep*
ing her tubercular history more or less secret. If
it were evident that she was a consumptive or if
her history became widely known, then the chances
of her making a satisfactory marriage would be
reduced to a practical zero, and consequently the
consideration which had been most potent in with-
holding her from gratifying her desire for inter-
course would no longer exist. And she felt — or
feared — that if there were no practical advantage
in keeping her hymen intact, then mere ethical
considerations alone would be insufficient to pre-
vent her from yieldiag to the temptation to have

414 MORBID FEARS AND COMPULSIONS

sexnal intercourse.^ Furthermore, she had often
said to herself that a girl who liirough such a
stroke of ill fortune as having tuberculosis was
deprived of an opportunity to secure the advan-
tages of marriage was on Hie whole morally justi-
fied in compensating herself for such a hard fate
by taking advantage of any opportunity for en-
joyment that was presented to her, whether sanc-
tioned by convention or not It is to be seen, then,
that for Stella to say to herself, ''You are never
going to be well, and there are so many people who
do know, or through Rose, the Mahoshef and
others, will know of your trouble that you will
have no chance of marrying a desirable man'' was
practically the equivalent of saying, ''There is no
longer any particular reason, moral or otherwise,
why you should not have sexual intercourse if you
want if The fear of the Mahoshef then both
from the point of view of its face value — ^since it
represented her as being "bossed'' by some one
else or about to be deprived of her reason and con-
sequently as not responsible for her acts — and
in view of its inner meaning, "I am going to die
of Kishef in the same sense as is Max ; my tuber-
culosis is divined by so many that my chances of
marriage are spoiled," was a wtsh-ftdfiUment in
the sense that it represented various excuses for
doing as she pleased, particularly in matters of
sex.

1 That the temptation was a real one la indicated by the fact
that she had a great many dreams which upon analysis proved
to be prostitution fantasies. The financial as well as the sexual
element played an important role here.

A COMPULSION NEUROSIS 415

It must not be thought from this that Stella
ever ceased to want to be well or to have other
people think her so. She wanted these things
very much and the thought that she might not get
them was indeed painful. And she was on the
whole willing to lead a moral and virtuous life as
long as she could think it probable that in the end
she would be rewarded by securing the sort of
husband that would suit her. At the same time,
the more the probability of her getting this reward
was decreased the greater was the tendency for
her libido to revert to former interests within the
family, and to fantasies of prostitution. That
portion of her libido that was directed progres-
sively toward the goal of a suitable marriage, im-
pelled her to repress or belittle any indications
that she was not or could not be physically well,
while the portion directed regressively towards
her father or towards immediate and financially
profitable gratification had just the opposite effect,
and impelled her to exaggerate the obstacles in
the way of matrimony. Thus when circumstances
were such that she had definite reasons for saying,
''There isn't much use in my being good, for the
chances of my getting a suitable husband are
smalV there was always an impulse to think ''I
have no chance of getting a good husband, there
is no use in my being good — Whence I no longer have
to control myself," thoughts which of course were
apt to come to her consciousness in a more or less
distorted form. The various obstacles to mar-
riage represented in her obsession were painful
in so far as she desired a suitable marriage and

416 MORBID FEABS AND COMPULSIONS

the eventaal sexual outlet it would represent, bat
pleasing in so far as she desired an excuse for
retoming to her father and for gaining a sexual
oatlet immediately.

One reason that she sought to make a tem-
porary marriage instead of gratifying herself
without any formality was in part because she was
not sure tiiat she would not eventually recover
and have a chance to make a satisfactory mar-
riage. A temporary marriage allowed her to
mark time until she could know more definitely
whether she was going to recover fully or not
If she should regain her health she could then
decide either to remain with her husband or else
seek to make a permanent marriage elsewhere,
while on the other hand, if she found herself get-
ting worse it would be time enough to return to
her father or indulge with other men who took
her fancy. In the meantime she could get what
sexual gratification her husband might be able
to give her, though she did not expect that it would
be very much.

This meager expectation was realized, for coitus
with Barney rarely gave her pleasure, though it
was her resistances just as much as any weak-
ness on his part that was responsible for this.
That is to say she would not allow herself to love
him or to enjoy herself with him. To love him
meant to be in a state where she would want to
be faithful, unselfish, and devoted, but the pros-
pect of being faithful, unselfish, and devoted to a
penniless consumptive, especially when she her-
self was one, was so uninviting that her mind auto-

A COMPULSION NEUEOSIS 417

matically resisted whatever tendency she had to
make the transfer of libido that would resnlt in
her wishing to do these things. Thus^ though
she was bound legally she was not bound emo-
tionally. Her attitude on the whole was one of
waiting for the time to arrive when either she
would be well — ^when she would want to get rid
of Barney and make a better marriage— or when
she would know positively that she was not going
to recover^ at which time she would think about
promiscuous gratification.

We can now understand why she was afraid
that if the Mahoshef was making her insane Bar-
ney would divorce her. This fear can be trans-
lated as follows: ''If it is true that like Max I
will always be a consumptive, and consequently
cannot look forward to a satisfactory marriage
even if I am moral, I will cease to be a responsible
person — ^in short I will lose control of myself and
do things which will g^ve Barney full grounds for
a divorce. ' * That the sort of ' ' Kishef ' ' her father
exerted upon her was also an element in this fear
need hardly be said. The ideas represented by
her obsession (namely: that she was incurably
tubercular and that too many people knew of her
condition for her to have a chance to make a suit-
able marriage), all of which amounted to the
thought that there was no particular use in her
being moral, and also the thought that she was in
love with her father, corresponded to the main
sources of her resistances against Barney. Her
love for her father gave a motive for not loving
her husband and the fact that her own health was

418 MORBID FEAES AND COMPULSIONS

poor she used as an excuse for not iwRlriTig the
best of things after he became an invalid.^

The Significance of the Return of the Kishef Ob-
session, and Further Details of Interpretation

When, shortly after the Kishef obsession first
appeared, Stella of her own accord went to the
Broadway Clinic for treatment, her action was
altogether similar to that of her making repeated
visits to doctors at the time of the assault obses-
sion. In both instances she felt that there was
something wrong with her lungs and that she
should be examined. But in the one case she di-
rected the examination to her genitals and in the
other to her mind, carefully avoiding the critical
region of the thorax. But though when she went

iThe fear of insanity and divorce had a further detenninant
than the one just mentioned. When the oheeseion first dereloped
she feared that as a result of the fortune teller's magic she would
die. When she first met Barney he happened to speak one day of
flarry Thaw and stated (incorrectly, but Stella did not Imow
this) that Mrs. Thaw divorced her husband, when after the mur-
der he was declared insane. It was then that Stella feared that
through Kishef she too would become insane, and that when she
married her husband could divorce her on that ground. This
fear obviously corresponds to an identification with Thaw— -or in
other words, with a murderer, who, however, was excused by the
law. The reason for this identification was that she thoni^t
that if she got well and Barney did not, she would wish him
dead or perhaps kill him, while if she didn't get well and had no
chance to make a better marriage her love would then revert to
her father and she would wish her mother dead. (If die had a
satisfactory husband she would not have been jealous of her
mother nor had the fears to which, at the beginning of the analy-
sis, we referred as manifestations of a desire to replace her
mother.)

A COMPULSION NEUROSIS 419

to the Broadway Clinic she entered the wrong de-
partment yet she was in the right clinic for a lung
examination to be made. For this was the clinic
at which she had been examined, and from which
she was sent to a sanitarium when she suffered
from tuberculosis as a child. Her old history was
still on file there, and some of the doctors who at-
tended her in that early period were still con-
nected with the clinic. She did get into the tuber-
culosis clinic eventually and received treatment
there up to the time, when, after Max went out of
her life, she became well enough to work again in
the store.

The return of her obsession in the spring coin-
cided with a renewal of conditions practically
identical with those under which it first made its
appearance. Barney came into Stella's life about
the time Max went out of it, but naturally it was
some little while before she began to think of him
seriously as a possible husband. But at the time
she met Barney she was being courted by another
man, Lehmann. We have already said that as
time went on Stella became secretly engaged to
Barney. But as I eventually learned, Stella, as
if to make assurance doubly sure in respect to get-
ting a husband when she wanted one, became at
the same time secretly engaged to Lehmann. She
remained engaged to these two men until, shortly
after her obsession returned, she suddenly mar-
ried Barney at the City Hall. Not until after this
event did she inform Lehmann that she was not
to be his. As has been said much earlier, I was
convinced that Stella would have greatly preferred

420 MORBID FEABS AND COMPULSIONS

Lehmann to Barney. I did not understand ^y
she married Barney nntil the following informa-
tion came to light Lehmann went South in the
fall of 1910 and expected to return in January.
Later be wrote Stella that he had been delayed
by business matters and his return was postponed
indefinitely. For a time^ however, he kept up an
active correspondence with her, but then suddenly
his letters ceased. Almost simultaneously, his
sister who had made it a point to call upon Stella
every week suddenly ceased her visits. As Stella
learned eventually the reason for this was that
Lehmann and his sister had both been taken seri-
ously ill, but this she did not know until after she
married Barney. In other words, she of course
thought that the sudden cessation of Lehmann 's
letters and his sister's visits had only one cause
— ^namely that some one had told the Lehmann
family that she was a consumptive. Her sudden
decision to marry Barney was in part a reaction
to the reflection that Lehmann was out of her
reach.

But a more potent reason for this sudden mar-
riage was the fact that the symptoms of aotive
tuberculosis which had subsided in December were
again returning. In fact she gave up her work
again and went back to the Broadway Clinic where
she was under treatment up to within six weeks
of her marriage. Her decision to marry Barney
was then in some degree a result of the reflection
that he was a last resort. She felt if she did not
take him she might never get another chance to
marry, for if she got much worse she would have

A COMPULSION NEUROSIS 421

to go to a sanitarinin, and with that she thought
her morality would come to an end.

The return of her obsession just before St, Pat-
rick's Day was a reaction to the conditions just
described. When the girl in the store said of the
Saint, '^He was the one who drove the snakes out
of Ireland" Stella thought something of this sort,
"That is a likely story I If I could believe that
(viz. : that one man could rid a country of snakes)
I could believe the impossible." But the impossi-
ble seemed to her, about that time, to be a com-
plete recovery from tuberculosis. She was suf-
ficiently discouraged by the return of her pulmon-
ary symptoms to be on the point of saying, * * There
is no use deceiving myself any longer — ^ITl never
be really well." Hence the impossible story of
St. Patrick and the snakes could connect with her
tuberculosis complex. Her thought was some-
thing like this, ** Yes, if St. Patrick could drive the
snakes out of Ireland (a thing which I believe im-
possible) then the Mahoshef could do magic to me
— that is, could cure my tuberculosis, which also
I believe to be impossible." Thus the return of
the obsession corresponded to an ironical com-
ment on the hopelessness of her disease, or in
other words, to the same sort of thought, occur-
ring under similar discouraging circumstances as
that with which the obsession started in the first
instance. And just as the idea "My tuberculosis
is known" was one of the important determinants
at the time the obsession first appeared, so it was
now; in this case it referred pnntiarily to fhe

422 MOEBID FEARS AND COMPULSIONS

events which had led her to believe that the Leh-
maniiB had learned of her malady.

In the light of our knowledge of the motives
which led Stella to marry Barney and of the dr-
eomstances under which the marriage took place,
we are able to understand a number of the minor
features of the case the meaning of which has here-
tofore not been apparent. At her first visit to me,
Stella expressed the fear that the Mahoshef was
making her insane and that consequently she ought
not to marry for by doing so she would inevitably
bring trouble and unhappiness upon her husband.
As was pointed out, her belief that she ought not to
marry could not be regarded as merely a logical
deduction from her obsessive fear of the Maho-
shef, but must have depended on other considera-
tions which adequately justified it. We now
know what these considerations were. She mar-
ried knowing that six weeks earlier when she last
visited the Broadway Clinic signs of tuberculosis
were present in her lungs, she believed Barney
was also a consumptive, she was not in love with
him, and she did not intend that their marriage
should be a permanent one. In short, she had the
best of reasons for feeling she ought not to marry,
and that trouble and unhappiness must inevitably
result if she did. Her fear of the Mahoshef might
therefore from one point of view be regarded as an
explanation of these feelings which she had ac-
cepted because it was less painful to her than the
true one.

Her desire to have Dr. Dana and me assure
her that her fears of insanity were groundless and

A COMPULSION NEUEOSIS 423

that -there was no reason why she should not marry
amounted to a wish to shift to some one else the
responsibility of her doing something she felt to
be wrong. But under the circumstances it is easy
to understand why any assurances she received
gave her no permanent satisfaction and failed to
do away with her feeling of guilt.

It was her perfectly well founded sense of guilt
which caused her to make against Barney and his
sister the reproaches to which reference was made
early in the analysis, and which we have con-
cluded could be turned against herself. She ac-
cused Barney of having married her only to have
her work for him, because one of the chief reasons
ehe had married him was to have him work for
her — ^she wanted some one to support her in or-
der that she might have an opportunity to recover
her physical health without going to a sanitarium.
But as she had not intended to remain bound to
Barney after that end was attained, or in the event
of his lung trouble depriving him of the ability to
support her, she brought against him the reproach
that if she became IQ (insane) he would instantly
get rid of her and marry Ada. Her bitter resent-
ment at being required to work after she married
him — ^which was particularly venomous upon that
occasion when she had to go out in a snow storm
— ^was peculiarly significant in view of the fact
that one of her chief reasons for marrying was her
wish to be relieved of the menace to her health in-
volved in having to work and the exposure to in-
clement weather which this had necessitated.

She reproached Barney's sister with having

424 MORBID FEARS AND COMPULSIONS

been a false friend becanse she herself had been
false. If she had been a true friend to the girl,
she would not have married her brother under dr-
eumstances that could mean nothing else than ul-
timate disaster. In truth, she had '^ roped in"
Barney, and it was because the accusation to that
effect which Barney's sister Esther made was, in
substance, true, that Stella so deeply resented it
In the same way, another of Esther's statements,
**She was a sick g^rl when you married her" en-
raged Stella because of its essential correctness.

The fact that Stella must have been sure that
at the time of her wedding her tuberculosis was
still active — she could hardly believe that in the
six weeks that elapsed between her last visit to
the Broadway Clinic and the day of her wedding
she could have made an absolute perfect recovery
— accounts for her having concealed from me the
fact of her civil marriage to Barney which took
place at the City Hall. That is, the reflection that
she could not have been well when she married
made her overcautious, and, as the probability
that she still had pulmonary signs at the time of
her marriage varied inversely as the length of
time that elapsed between her last examination at
the Broadway Clinic and the day of her marriage,
she was anxious to represent this time to be as long
as possible and so she concealed from me the fact
of her first wedding ceremony.

The reason Stella seized every opportunity to
quarrel and find fault with Barney in the few days
that preceded his departure for Oakwood was that
this was a time when she was especially conscious

i

A COMPULSION NEUROSIS 425

of a sense of guilt. For Oakwood was one of the
two sanitaria in which she had been a patient in
her girlhood. The thought that he was going to
an institution where she herself had stayed
brought vividly to her mind the deceit she was
practicing upon him, and especially so since she
felt that he might meet some patient or attendant
who would remember her and accidentally disclose
her history. (As a precaution against any such
misadventure she secretly removed from Barney's
suit case a photograph of herself he had intended
to take with him, for she was afraid that some one
might see it and exclaiming, ^^Oh, I know that
girl, she used to be a patient here,'' thus disclose
the secret of her history.) But as a defense
against the guilty feeling which then possessed
her she reacted by trying to find Barney guilty
of something and by blaming him instead of her-
self.

ConcUision

After Stella had confessed to me that she had
had tuberculosis, some six or eight weeks were
spent in working out and discussing with her the
various explanations that have been here set forth.
Her fear of the Mahoshef and of Eishef then dis-
appeared entirely and has never returned since.
A minor obsessive idea relating to morality, which
she had had throughout the greater part of the
time she was coming to me, still persisted, so that
even though she had improved remarkably she
was not entirely welh (This minor obsession has
not been mentioned here.)

426 MOBBID PEABS AND COMPULSIONS

At this point the analysis was intennpted and
I have done no work of any consequence on the
case since. As soon as Stella told me that she had
had tnbercolosis I of course sent her to be exam-
ined by an expert internist. He reported that
though it was evident she had once had active ta-
berculosis the process appeared to be entirely
healed and there was nothing to be feared at the
time. Eight weeks later she had some bloody ex-
pectoration, and upon examining her again he re-
ported that she did have a few signs. But she
began to lose weight, so as soon as possible I sent
her to the country, where in a comparatively short
time she gained thirty pounds. Her mental con-
dition remained exactly the same as it had been
when she left. When she returned from the coun-
try, her husband soon joined her and they de-
parted for a place where they thought they could
make a living and at the same time be benefited by
a more favorable climate. Soon after reaching
this new home, however, Barney began to drink
heavily — ^this he had never done before. His
health immediately showed the effects of the dissi-
pation and he died in about a year. Stella kept
her physical health and on the whole has been
very well mentally. She writes me that occasion-
ally she has fears ^' about morality" but that they
are neither constant nor very distressing.

Lest the reproach be made against me that in
the beginning I neglected the physical aspects of
this case, I wish to state that I made a careful ex-
amination of Stella's heart and lungs when she
first came to me, but found nothing pathologicaL

A COMPULSION NEUROSIS 427

She was distinctly fat all through the period I
knew her, and there was nothing in her appearance
or — save a slight ansemia in her blood examination
— to suggest that she was tubercular. The anae-
mia was no more marked and in no way differed
from that often found in women with severe neu-
roses. I may add that she was examined by a
number of neurologists about the time she came
to me and that they too failed to find anything in
her lungs. But in view of what she eventually
told me of her physical symptoms during this
period, and of the findings of the physician in the
tuberculosis department of the Broadway Clinic,
I think it highly probable that she did have signs
at the time I first examined her, but that they were
so obscure that to detect them it would have re-
quired some one more skilled in making pulmon-
ary examinations than is the average neurolo^st.
I am surprised not that the patient failed to be-
come entirely well after the analytic work, but, on
the contrary, that she improved so much. Though
she gained a considerable understanding of why
she was sick the analysis stopped before the resist-
ances were sufficiently overcome for her to set
about making the adjustments in her life that
should follow upon a complete understanding of
the mechanism of the illness. It is, I think, now
quite generally understood that psychoanalysis
cures not so much through its leading patients to
know in detail why they are sick, but through the
changes and readjustments in their lives which
they are enabled to make in the light of this
knowledge. Beyond the fact that Stella eventually

428 MOBBID FEABS AND GOMFUISIONS

told Bamey of her tabercnlar history she made
no definite attempts at readjustment or toward
improving her life with him.

The history of Stella 's tuberculosis is of course
the set of facts which in the introduction I re-
ferred to as having been established by external
evidence. On reading over what I have written,
it appears to me that in my desire to make the
confirmable facts conspicuous I have made them
seem unduly important — or rather, that their con-
spicuousness has overshadowed and obscured the
importance of the wish element, and particularly
the sexual wish element in the case. Despite the
fact that the problem of tuberculosis, as such, was
very important to Stella, nevertheless it alone
would have never given rise to an obsession. It
was from her unsatisfied desire for sexual grati-
fication that much of the real driving force of her
obsessions was derived. Both obsessions tended
to fulfill this wish by representing that that con-
sideration which made for chastity had ceased to
obtain. In the one case she feared — ^wished —
that through no fault of hers she had lost her
chastity, a state of affairs which appealed to her
because she could feel that by sexual indulgence
she had nothing further to lose. In the other case,
she felt that she was "bossed" by an evil person,
that her mind was leaving her, and that, conse-
quently, she would not be to blame for whatever
acts, sexual or otherwise, she chose to perform.

By way of emphasizing these facts it may be
well for me to include here a piece of information
which, among many others, I had intended, for the

A COMPULSION NEUROSIS 429

sake of brevity, to leave out At the time of the
assault obsession Stella, though apparently in an
extremity of fear that her hymen had been rup-
tured, made repeated attempts to rupture it with
her finger, and was deterred from accomplishing
her purpose only by the pain that these efforts in-
volved. She continued these attempts until, after
having visited the woman physician who has been
spoken of, she finally obtained a certificate to the
effect that her hymen had been ruptured by va-
ginal examination — L e., in a perfectly legitimate
way. Such seemingly paradoxical behavior on
Stella's part can be understood only if we re-
member that her fear that she had been robbed of
her chastity was really a wish for such to be the
case. Clearly enough, what she really wanted to
get rid of was not her hymen but that ethical part
of her personality which withheld her from sexual
gratification. But since her ethical self was not
done away with, neither fears, certificates nor any
other of her justification mechanisms ever re-
sulted in her doing what she wished to do.^

iFor the sake of accuracy I should perhaps say that what I
have spoken of in this chapter as Stella's desire ''for intercourse"
could really be separated into several constituents. Curiosity, a
wish to experience everything her mother had experienced, and
certain perverse tendencies corresponding to childhood concep-
tions of the sexual act composed a large part of this desire. (See
the further reference to Stella in Chapter VIII.)

CHAPTER Vm

THB P8TCHOL06T OF AHZIXT7 HT8IXBIA.

MOBBID fears of jpeychonearotic origin
(i. e^ those not belonging to psychoses,
to toxic deliria, etc) come under the
head either of the compnlsion nenrosis or of anxi-
ety fiysieria.**" TEeTaRef "Term, as we have sai<
before^ now includes the condition called the anxi-
ety nenrosifl, L 6., th6fle Cftfies in wl

nrn ill a iTTiii « VEE

f a($tOTff are tn tne foreground in causing the dam-
ming up of the IIBidb. "'

Anxiety hysteria is lEe commonest of all the
psychoneuroses. It may occur at any time of
lif e, and is common in childhood, while the com-
pulsion neuroses rarely develop in any obvious
form until after the attainment of puberty. It is
the neurosis most frequent in women, while the
compulsion neurosis occurs most often in men.
The vast majority of cases carelessly called
*' neurasthenia,^' '^nervous breakdown" or just
*^ nervousness '^ are really examples of anxiety
hysteria.

While in conversion hysteria the symptoms are
chiefly somatic, and in the compulsion neurosis a
mixture of various emotional and volitional dis-
turbances appears, the chief manifestation of
anxiety hysteria is morbid fear ImiT the physical

accompaniments there(^ These fear symptoms

"«o "

PHOBIA AND PANIC 431

may be divided mto two sorts, the ^^ phobia ^^ and
the **pa£c/|

For instaBce, a woman suffers from the fear
of being on the street alone. While she is at
home she is comparatively though not absolutely
free from anxiety. Also, she can go walking
upon the street that leads from her home to her
husband's office, and for a certain distance on
6ome of the side streets, but outside of this very
limited orbit she is afraid to venture unaccom-
panied. If she tries to do so, she is at once seized
with a spasm of most agonizing fear, accompan-
ied by tachycardia, dyspnoea, cold perspiration,
vertigo and faintness, and the idea that she is
about to have a stroke of apoplexy. This attack
of acute fear is the ** panic.'* The deterring fear
is the ^'phobia." As long as she obeys the limi-
tations imposed by the phobia, and does not at-
tempt to venture alone beyond certain specified
regions, she rarely has panics, and suffers rela-
tively little active fear.

Another woman has a phobia of dogs, thinking
one may bite her and she will have hydrophobia.
She never leaves her house without wondering
anxiously if she is going to meet a dog. If she
flees one approaching, the typical panic ensues.
Whenever possible she rides in cabs in order to
be safe against the animals. If she goes walk-
ing with her husband, she insists that he carry a
heavy cane in order to protect her. The mere
mention of dogs, particularly if anything is said
about their going mad or biting any one makes
her very nervous.

432 MORBID FEARS AND COMPULSIONS

A third patient has a phobia of knives. If
she sees a sharp knif e, she becomes afraid that
she may use it to injure herself or some other
person. She cannot go into a batcher shop, a
hardware store or any other place where she is
likely to see knives or other sharp instroments
exposed* She will not be left alone in her house
until she is assured that the carving knif e, sds-
sorsy and all such instruments are put away and
locked up out of her reach. If she were ever left
alone in a room with an open pen knife lying on a
table, she would have a panic at once.

The three special features of anxj^ hysteria

are thfin liie Attafik n^t^fy^ip. th^<pholj)ia^ wl

serves to keep the individual awavfrom auch sit-

/and ££e ideational element — the notion of what
is that is feared. In addition to these typicaT"

^-symptoms ike patient also suffers in varying de-
grees from minor ones such as restlessness, in-
digestion, flatulence, insonmla, depression, etc.
In not all cases are the symptoms developed to
typical phobia formation as described here, but in
mild ones may be limited to a diffuse uneasiness
or anxiousness, or a tendency to unreasoning
worry.*

1 Worry is often spoken of as a cause of insomnia, of depres-
sion, and in fact of almost any sort of psychoneurotic state, par-
ticularly among those all too numerous non*medical writers who
flood the popular magazines with shallow articles on medical
subjects. "Don't worry," they glibly advise, "and then you wont
have insomnia or depression or nervousness or whatever it is
you may be sulTering from." They might just as well say:
''Don't have insomnia, and then you'll sleep," or *'Don't have de-

MECHANISM OF PHOBIA

433

What then is the relation of the typical symp-
toms to the processes of the U^omj^i&IL^ ^^^
what are the mechanisms by which they are
formed? The fear, the impulse to ran away f ronf|
fiomethmgy is conditroned^^ as was said \)eioTe^ by j
*^ ^ailTlT^^^g ^P Qf libido which threatens to^break

is his own nnconsgiogs gpmiftl jigQuJggg. Bnt in

j)lace of the ideas corresponding to these impulses

tnere appear m nis consciousness some substi-

tute ideas, bearing, to be sure, a certain relation

to the repressed ones, but ^^nerallv referrin^^

. to .sofflfi PPgLsibJft. gXJ;grnardanger.^ The jnner

menace is represented through projection by an

outer one,, and, by iakmg care to avoid tnis outer

"one, the patient is really attempting to escape

from a part of himself. The essential proce'sIS

of tJie symptom formation is that of a displace- |

menT'or'tlie anxiety affects Ihlo^ 'which'tfie te- I

pressed libido has been converted. — i

TThere is a story of a farmer who, when driv-
ing slowly along the road leading to the town, was
met by a neighbor who asked him: ''Well, Gy,
whar ye goin'f

**I'm a goin' down to the village to get drunk,*^
replied Cyrus, gloomily, ''and, Oosh, how I dread
itl'*

pression and then you'll be cheerful." For, generaUy f^pealdng,
'^vorry" U not a cause of the neurotic state, but a symptom of
it. The Spr^y, which these writers would regard as a cause of
insomnia, nervousness and so on, is TeaJJj.A^saorUd^amaiMu *
which, in common with the insomnia, depression and other symp-
toms in the case, results primarily from conflicts^ resistances, and
a dammingup of the libido.

434 MORBID FEABS AND COMPULSIONS

This story impresses ns as fmmyy for we are not
aocnstomed to think of people loddog with dread
upon the falfinment of their own wishes. We
should he tempted to say to the farmer: ^^Well,
if that's the way yon feel abont getting dmnk, why
do yon do itT Yon dont have to get dmnk if yon
don't want to." Yet snch a remark wonld show
a lack of appreciation of the situation. For Gy
did want to get drunk. On the other hand he
wanted to avoid it, or at least its unpleasant con-
sequences. He had in short, two perfectly incom-
patible wishes, one just as real as the other. His
state was that of conflict — a conflict which re-
sembles those that cause a neurosis, save for the
fact that both sides of it were conscious. We
are not accustomed to think of people dreading
the fulfillment of their wishes, because ordinarily
when there is a conflict between two conscious
wishes, we cast up accounts between them, and
fulfilling the more urgent one, tend to overlook
the fact that the other existed. For instance, a
man sees a fine looking runabout and says : ' * My,
I want a car like that." But then, when he has
inquired the price and finds it to be two or three
times what he expected, he then says, ^^No, I dont
want iV* just as if the wish for it had suddenly
evaporated.

The wishes which give rise to the neurosis are
those which Tjeliav;e Just as the farmer's wish to
become intoxicated. They persist in trying to
fulfill themselves in total disregard of all possible
unpleasant consequences of this f ul^Ilinent and of
the existence of other wishes incompatible with

I

FEAB AND DESIBE 435

their beinir fulfilled. The individual fears them

-as he-might tear BStt companions whose demoral-
izing influence would lead him into forms of in-
dulgence whose consequences would not be a
source of pleasure but of pain.

It is clear that if the farmer had no objection
to getting drunk, or to the consequences of so
doing (if he had no resistances against this form
of wish fulfillment) his desire for alcohol would
not have been a cause of ^ ^ dread. ' ' Let us imagine
that he did go to town and that his worst fears
were realized, that his getting drunk had more
painful consequences than ever before, that he
was robbed of a large sum of money, got into
various scrapes, and finally landed in jail. Let us
further imagine that while he was thus incarcer-
ated and had time to meditate upon his sins, an
eloquent preacher visited him, and not only suc-
ceeded in convincing him of the error of his ways,
but converted him to religion, and made him firmly
and sincerely resolve never to touch alcohol again.
In short, let us suppose that his resistances
against drinking were enormously increased. At
the same time we shall suppose that his craving
for alcohol (which, to make the point clear, we
must conceive to be a very intense one) remained
as strong as ever (as it very well might) and con-
tinually assailed and tormented him. Under such
circumstances as these, we might very easily con-
ceive that the farmer would be afraid to go into
saloons. TUs would be a very real and reason-
able fear caused hy desire.

Now let us go further and imagine that through

436 MOBBID FEAES AND COMPULSIONS

some miracnlous process his craving for drink is
transferred from consciousness to the Uncon-
scionSy but without in the slightest degree dimin-
ishing its vigor. The desire is just as urgent as
ever^ though the farmer no longer knows that it
exists. Under such circumstances we can easily
conceive that if he went into a saloon, say to
collect a billy he might very well experience a sense
of uneasiness, of impending evil, of fear, ^DUhout
being aware of the cause of this fear, since the
craving on which it depends is an unconscious one.
Such a fear would be just like those which exist in
anxiety hysteria. This attack of fear would cor-
respond to the panic.

When the farmer first experiences this fear, he
says to himself: ** What's the matter! I feel
frightened. Why am I so scared?" He cannot
say to himself: "You are afraid you will break
your pledge, and get drunk again and shortly go
to the dogs," which would be the correct explana-
tion, because his desire for drink is now an un-
conscious one, and to get drunk is the very last
thing in the world he ever expects again to do.
Nevertheless he is seeking for an explanation of
his fear. We will suppose that at this point he
looks up and sees scowling at him an evil-looking,,
blear-eyed, ragged, dirty and vIQainous old alco-
holic who is leaning against the bar. Here is pre-
sented an opportunity for rationalization of the
anxiety. The farmer thinks: ** Maybe it's that
man I'm afraid of. He looks mean enough to
murder somebody. Perhaps he is planning some
harm to mel" And we can imagine that this

FEAE AND DESIEE 437

rationalization is accepted as the true explanation,
particularly as the evil looking alcoholic might
become connected in the farmer's mind with the
unconsdouB desire for drink, through some such
train of thought as : ^ ^ There, but for the grace of
God, stands myself!'' In this way what is really
a fear of drinking could become what appeared to
be a fear of evil looking men. Then, if the matter
developed along the lines of an anxiety hysteria,
the farmer would thereafter have panics when he
found other villainous looking alcoholics in his
vicinity, for they would serve as a reminder of
hi^iy^lljljjj^and he would develop phobias concem-
m^piaoes in which they might be found. Per-
haps he might even become afraid to leave home
alone. Yet these fears would at the same time
protect him against the real cause of his anxiety
by keeping him at home or out of saloons and sim-
ilar places where alcohol as well as evil looking
men are to be found. This feature would also be
very much like what often happens in anxiety
hysteria.

This may all seem very fanciful, but neverthe-
less it gives a good picture of the way an anxiety
hysteria develops. The essential differences are
that in the case of anxiety hysteria the symptom-
producing wishes belong to the holophilic im-
pulses. (There is no such thing as unconscious
desire for alcohol — ^rather the craving for alcohol
itself results from unconscious desires, and sev-
eral desires instead of a single one go to produce
the symptom.) The first phase, as in the case we
have imagined, consists in the appearance of

438 MOEBID FEAES AND COMPULSIONS

anxiety without the individual having any notion
of why it occurred (a phase, by the way, that is
generally overlooked). That is to say, scnne of
the libido of the wish-presenta^^^^ifi frrftAlriTip
throngfl tne repre^RiQTi> la draw^ off as anxie^
whUe their idea-content rc^ynn^^" ^^^1*^00/^1 ki
the next discharge of this energy a substitute idea
from the f oreconscious is found which serves to
rationalize or explain the anxiety, and at the same
time bears some associative connection with the
repressed ideas, just as the farmer's fear of vil-
lainous alcoholics connected with his unconscious
desire for drink. The ener^ of the wishes escap-

Jng reprgflgion ia iil other words dvit^lacpA to a

substitute idea, which ordinarilv corresponds to
somVobjecCor situation in the externalworkL.
Attacks of anxiety may then be brought on in two
"wayS^iie by aiimcreMfi of the unconscious libido
tensionsapd the otbiSS^'^itlmliii proceeding trom

tne i eared object fiorreBpoDf^JTig fn th^ anhatitntA

^idea>^ The feared object is often a substitul
kthe sexual object toward which the repressed
wishes are striving. Phobia formations then de-
velop and tend to protect more and more against
the evoking of active anxiety by prohibiting the
patient from approach to situations in which stim-
uli from the feared object or condition are to be
received. Naturally even if the patient gives in

J to the limitations which the phobias impose, he is
not totally free from anxiety. Flints from the
external stimuli of the substitute idea have no in-
fluence upon those attacks of anxiety which de-

FEAB AND DESIBE 439

velop throngh an increase of the libido tensions
within.

Why the patient is absolutely unable to reason
away these fears which he himself knows to be
foolish, we can understand if we imagine our
farmer trying to dispel his fears of evil looking
men by carrying a revolver to protect himself from
possible attacks, or by trying to assure himself
that they mean no harm to him anyway. These
measures have no effect for they do not bear at
all on the real cause of the fear. A revolver is no
protection against getting drunk I Those meas-
ures which in some cases do have some effect in
reassuring the patient against his fears are found
on analysis to have a definite bearing on the real
cause of fear. For instance, if the farmer took
some righteous person with him whenever he went
to town, with the consci(ms idea of having protec-
tion against the attacks of evU men, this person
might however give a real and rational sense of
security, for he would be the sort to prevent, if he
could, the farmer from indulging in alcohol.

It may be said that morbid fear generally, and (
in the anxiety neurosis in particular, is an expres-
sion of the essentially passive or feminine traitcr
in the personality. The anxiety neurosis may
then be considered as the negative of the maso-
chistic perversion, though at the same time other
perverse tendencies are expressed in the symp-
toms. The matter of pregenital organization or
synthesis, sudi as we spoke of in connection with
the compulsion neurosis, has not been as well
worked out for the hysterical conditions.

440 MORBID PEAES AND COMPULSIONS

To supplement what has been said as to the
medhanisms of the symptoms, I will now give some
brief extracts from the analysis of certain fear
symptoms which were at one time suffered by the
patient Stella, whose acquaintance we made in the
preceding chapter.

Several years before I first saw her she began
to experience a marked sense of fear if she were
left alone in the house. She felt a still greater
fear of having to pass through any hallway alone,
and if she were compelled to do so, she would
ordinarily have an intense panic, accompanied by
weakness, tachycardia, pallor and similar symp-
toms. It was not until I had known of these fears
for some time that she told me that in the panics
she had the idea that there was a ghost (a '^dead
soul") coming upon her from hehmd to choke her.

She had panics not only in hallways but also
when she went to the toilet — ^unless her mother or
sister stood waiting outside the door aU the while
Stella was within. On such occasions it would
seem to her that a dead soul was about to come
out at her from the hole in the closet seat. I
should perhaps say that Stella never really be-
lieved that she saw any of these ghosts, and was
perfectly well aware that her fears were utterly
unreasonable and absurd.

These fears were expressions of anal-erotic and
birth wish-phantasies. A hint that they had such
origin came while she was describing a particu-
larly severe attack. She was leaving a certam
house at night and had passed through a door at
the bottom of the stairway. This door slammed

FEAR AND DESIBE 441

beliind her before she had opened the outer one.
Thus she was for a few moments shnt in the entry-
way between the two doors as if in a very smaU
room. Before she could open the outer door and
escape to the street she was seized with a terrible
fear that some one was coming through the hack
(inner) door to choke her. Concerni/ng the door
in front of her she felt no fear whatever.

Immediately after telling me this^ she made ai
rather suggestive slip of speech. She was speak- 1
ing in German, and used the words von dem Hwir j
terer (from the behind^ i. e. the gluteal regions)/
when she had intended to say von hint em (fromj
behind). After this she told me that she felt no
particular fear when alone in a house, so long as
she stayed in the front part. She recalled at
length that as a child she had entertained the usual
theory that children are bom from the rectum.
Also she reproduced a great number of memories
of phantasies of anal coitus, wishes for which she
had even consciously experienced, at least momen- 1
tarily, during most of her married life. As we I
already know, her great desire for children was/
left ungratified through the sterility of her husJ
band. These wishes for children, expressed in tha
form of anal birth phantasies, together with analj
erotic desires, formed the basis for her phobiasl
Of the truth of this statement little further evi-1
dence is required than that furnished by a record
of the occurrence of her attacks. This showed
that panics appeared when she found herself in
any situation suggesting hack part, hack entrance,
hack opening or hack passage.

442 MOBBID FEABS AND COMPULSIONS

The idea of the ''dead soul'' or ghost, which was
to come from behind to choke her, has the follow-
ing eiq>lanation. The analysis revealed it as a
condensation of phantasies of rectal coitus and
births represented by a fusion of certain infantile
sexual theories. An early notion among children
is sometimes that the fertilizing element is either
flatus or breath. This ''vapor'' is readily identi-
fied with the soul, for both the breath and the soul
leave the body at death. But the souls of the dead
are supposed to go to some mysterious region
where they remain for a time and then return to
earth as a new bom child. In this way the ghost
or soul of a dead person is the same as a yet un-
born child. And when we alter the idea in Stella's
fear according to the suggestion afforded by her
slip of speech — i. e. that the dead soul was to come
not so much from behind as from the behind (the
anus), it is evident that we have represented a
phantasy of birth by rectum. The toilet seat,
from which she feared a ghost would come, is
easily recognized as an external representative or
symbol of the anus, a hole into which feces go in
place of one from which they come out. Choking,
in which tiie breath or soul leases the body, in like
manner stands for conception, in which a new soul
enters it.*

What Stella really was afraid of was, then, her
own wishes for children, and for what amounted

1 The representatloii of an idea by its oppprite ig a common oe-
currence In "ojWlpfnm' Qn.^.5^^**jLTn fnrnfft^iOP— ^* *" ^^ almtit tJiA
game principle that a N^gro Is ealled ''SnowbaU" or a fat man
nidmamed "Skinny."

FEAB AND DESIBE 443

to a perverse method of getting them, anal coitnSi
which was one of her early conceptions of the
seznal act. Against both of these wishes she had
strong resistances. Before marriage, to have
children meant to sacrifice her virginity ; after it,
to be unfaithful to her husband. Her objections
to anal intercourse were more of the ssthetic than
of the moral order. Consequently, in place of the
ideas correctly representing these wishes there
had entered her consciousness substitute ideas
which, though closely resembling the repressed
ones, not only concealed their meaning but allowed
the developing affects to be referred to external
situations from which escape could be made by
flight

CHAPTEB IX

a ga8e of anxiety hystebia
(thb oasb of miss sukdeblanb)

THIS patient was an nnmarried girl of
twenty, bom in America. At the time she
became ill she was employed as secretary
to a business man. Her previous history revealed
nothing of importance. Except for the usual dis-
eases of childhood she had always been in good
health. The physician who referred her to me, a
very careful internist, reported that he had
examined her most thoroughly and found no or-
ganic trouble. Neurological examination was also
negative.

Her nervous illness began seven or eight months
before she came to me. One day while at work
she was suddenly seized with a sort of fainting
attack, which came on without any apparent cause.
After five or ten minutes, she was revived through
the efforts of some of the office force and was able
to go home, though in a very weak and nervous
condition. In a day or two she returned to work,
but within the three weeks following she had two
more of these attacks. The seizures were not
convulsive. She appeared to be unconscious dur-
ing them, but her loss of consciousness was not
complete, for there was all the time before her

444

AN ANXIETY HYSTERIA 445

mind the idea that she was dying, that her end had
come.

While out for her lunch one day shortly after
her third experience, she was suddenly seized with
an appalling fear of being alone. The idea had
stntbk her that she might at any time have another
fainting attack, in which she would die, or be run
over, or meet with some other serious accident.
This fear rapidly became so much worse that in a
short time she was unable to leave her home alone,
or to ride on the subway or street cars even if
there were some one with her. Any attempt she
made to go out unaccompanied or to ride in a pub-
lic conveyance nearly always resulted in her de-
veloping a feeling of uncertainty and dizziness,
with such an intense fear of falling in a faint and
dying, that she would have to return home imme-
diately.

In addition to these panics which appeared when
she attempted to leave the house, attacks of fear
occasionally occurred at home, though what
brought them on or what she feared she was
usually unable to say. Much of the time she was
depressed and nervous. She slept poorly, and
complained of palpitation and dizziness. Her
fear, of course, had made it impossible for her to
return to the office where she had been employed,
so when I first saw her she had not worked for
several months. A vacation in the country and
various medical and dietetic treatments had had
no effect on her symptoms.

The medical friend who sent her to me had ex-
plained to the girl and her mother that hypnotic

446 MOEBID FEAES AND COMPULSIONS

suggestion might be of benefit, and she came to
me to have it tried. At the first interview, as I
started to explain to her something about sug-
gestion, she interrupted me by saying she was
very much afraid of that sort of thing and that
she thought she might die if she were hypnotized.
I attempted to reassure her, but she said, ''Oh, it
is a spooky thing! It is like this," (holding her
arms above her head and waving her hands). ''I
am terribly afraid of it/' After some more dis-
cussion she and her mother both asked if I could
hypnotize some one else so they could see the proc-
ess ; and I therefore invited them to come to the
clinic at Cornell, where I hypnotized one of the
patients in their presence. After this demon-
stration. Miss Sunderland was even more afraid
than at first, so that at last I explained to her that
there was another land of treatment that could be
used in her case if she wished to try it, namely,
psychoanalysis. She promised to think it over
and in a week or so had decided to come to me.

Before the treatment was begun I had a private
talk with the girl's mother, who assured me that
her daughter was very innocent-minded, having
been brought up with the greatest of care and
shielded from all knowledge of evil. The mother
shrewdly observed that the girl seemed to be
afraid of men, adding that there was a very, fine
young man who had seriously courted her, but she
seemed to dislike him and always appeared un-
happy and ill at ease in his presence.

Another and rather surprising bit of informa-
tion which the mother furnished was that the girPs

AN ANXIETY HYSTEEIA 447

first attack occnrred on the day following a severe

fright. Miss S had been walking through a

lonely street, when a man some distance behind her
suddenly shouted, and waving his arms, ran after
her. She was very much frightened and tried to
run, but she made little progress for her legs
seemed heavy and she felt the same sense of inhi-
bition or paralysis that is sometimes experienced
in dreams. At any rate, the man who apparently
was drunk or insane, soon gave up the pursuit, and
the girl escaped seemingly none the worse for the
incident, until there occurred the next day the
fainting attack with which her illness began.

When the girl came to me for the visit which
began the analysis her mother asked her in my
presence if she had told me about this fright. The
girl replied, "No,'* and when she and I retired to
my office she seemed rather reluctant to speak
about it and did so only after a little urging. As
she described the behavior of the man, I was
struck by the fact that she raised her arms and
waved her hands with exactly the same gestures
that she had used in speaking of the ^'spoohvness^*
of hypnotism.

She then began to talk about the girl she had
seen me hypnotize at the clinic, saying how afraid
she would be to undergo anything of that kind.
Then after a pause she asked, '^Did you notice
how that girl looked at youf " **No,'' I replied,
^ ^ what do you mean f ^ ^ She looked as if she were

in love with you, '* Miss S replied with a laugh.

Miss S then with apparent irrelevance began

to tell me that her brother was engaged to a girl

448 MORBID FEABS AND COMPULSIONS

she disliked very mnch and tliat she hoped fhey
would not marry. After this there was a pause,
and then she langhed, explaining again with ap-
parent irrelevance that there had come to her
mind the recollection of how her sister, a very
amusing child of thirteen, had remarked after a
certain man had left the house, ''Oh, I am cra^
about him! I could love him to death I"

Then followed a still longer pause, after whidi
the patient begged me to tell her what she should
talk about. I replied, of course, that she was to
tell whatever she wished me to know about herself.
At length she went on by saying, ''I think one of
the things that made me nervous was reading the
newspapers.'' Bather reluctantly she explained
that, some weeks before her first fainting attack,
she had read a number of reports in regard to an
investigation of white slavery which was then go-
ing on and that, partly through the reports and
partly through a talk with a girl friend she had
been led to believe that all young men were in-
fected with ''bad diseases/' This, she said,
troubled her a good deal. She felt as if she
wanted to have nothing to do with men. She was
afraid, also, to touch the straps in the subway, or
to handle money, fearing she might get some in-
fection. She added that a young man in the office
where she had worked (the same young man, I
learned later, that her mother had referred to) had
somewhat hairy hands and this made her think of |
dirt and infection so that she could not bear the
thought of touching anything he had touched or
even of being in his presence. She added, how-

AN ANXIETY HYSTERIA 449

ever, that while this man, whom we may call Mr.
Densmore, had everywhere the reputation of be-
ing an exceedingly dean and straight person, this
did not lessen her aversion to him.

These bits of inf ormation, which I have re-
corded, though at first glance seemingly irrelevant
and disconnected, are when carefuUy examined,
really reducible to one common element The
girl seemed to have a great fear of hypnotism.
Now to most people, hypnotism means to be under
the spell of another person, and hence it is a fre-
quent symbol for sex attraction, as has often been
shown through the analysis of neurotic symp-
toms, dreams and the delusions of the insane.
That the fear of hypnotism in this case had such
a meaning seemed to be true, inasmuch as the pa-
tient imagined that the girl I had hypnotized
looked as if she were in love with me. Then, too.
Miss Sunderland had used the identical gestures
and expressions in speaking of hypnotism that
she had later used in describing the actions of the
man who had chased her. This would seem to indi-
cate that in some way she identified hypnotism or
the hypnotist with the man who had frightened her.
And when it is remembered that in a woman's
fear of an insane or drunken man there is usually,
consciously or unconsciously, some thought of a
possibility of sexual violence, it would seem that
the sex or love element must have been the basis
for the identification. Again, as the mother had
remarked, the girl seemed to be afraid of men in
general, and such a fear upon analysis usually is
found to have origin in a sex conflict.

450 MOEBID FEAES AND COMPULSIONS

Farther, the girl had mentioned, apparently
apropos of nothing, that her sister had confessed
to being ^^ crazy" about some man. This associa-
tion can be explained on the same basis. Patients
who do not want to talk about their intimate lives
are apt to talk about other people with whom they
identify themselves. Hence one might suppose

that the reason Miss S spoke of her sister

was because of an identification based on the fact
that she too was, in some degree ^^ crazy" about
some man, or was likely to become so.

The meaning common to all this material then,
seems to be that the girl was afraid of love or sex.

We could suppose certain romantic or erotic im-
pulses had begun to make themselves felt within
her, but that she was trying to repress them, and
in consequence they were distorted so as to be per-
ceived by her in the shape of fear, instead of ap-
pearing in their true form.

But we can go still further. Since she was
afraid she would die if hypnotized, and since hyp-
notism seemed to represent some sex influence^ it
would appear that death was a symbol for some
result of sex influence both in this case and, pre-
sumably, also in connection with her symptomatic
fear that if she went out alone she might fall in a
faint and die. As Jung has remarked, young girls
who speak of death think of love.*

That her fear of infection was connected with
the sex problem, is obvious, but in just what man-
ner it was connected will become more apparent
later.

1 'a)iagii08tiBche AasSziatioiiBBtudien/' Bd. I, Bdtrag Vm.

AN ANXIETY HYSTERIA 451

At the second visit, the subject of dreams came

up, and Miss S remembered that some time

earlier she had had a dream in which she was
being pursued by a Japanese girl and from which
she awoke very nervous and frightened. Men-
tion of this dream will be made later.

For several succeeding visits our talk was of
more or less superficial things and revealed little
of the patient's unconscious processes. I learned
that her family were very religious; that her
mother, though very kindly on the whole, was
somewhat strict and puritanical; and that her
father was extremely indulgent and affectionate.
He petted and made a great fuss ove^ her, and she
was devoted to him. On the surface at least Miss

S and her mother were on the best of terms.

Of her brother, who was a little older than her-
self, she was very fond, and she admitted that she
was displeased and somewhat jealous when he
began to pay attentions to the girl to whom he
eventually became engaged. On the whole the pa-
tient's home seemed to be a very happy one. Mr.
libby, the man by whom she had been employed,
had been an intimate friend of the family for
many years ; and, though not actually a relative,
he had behaved as one. The patient was a great
favorite with him ; and, as he was very wealthy, he
had been able to do a great deal for her. It was to
gratify a whim of his, rather than that there was
any need of her working, that she had taken a posi-
tion in his office.

After several visits the patient had the follow-
ing dream : She was struggling with a large, slim^

452 MORBID FEARS AND COMPULSIONS

long-nosed, gray dog, which was trying to bite her,
while she endeavored to prevent it by holding his
month shnt with her hands. The dog finally did
bite her somewhere in the thigh. She saw a little
blood flowing from the wonnd, and then her body
began to swell np to a great size, and she awoke
terrified.

This is evidently a sexnal dream. Its symbol-
ism is very typical. Yonng girls are apt to con-
ceive of sexuality as something animal-like and
violent When, therefore, a girl dreams of some
violent attack or assault, one can feel quite as-
sured that what she has in mind is something sex-
ual And, when this attack results in the shed-
ding of a little blood and is followed by swelling
of the body, the analogy to defloration and a re-
sulting pregnancy is so striking that there need
be little doubt as to what the dream means. In
designating the thigh as the point attacked the
dream employs the same sjrmbolism that is famil-
iar from the Bible, wherein the word "thigh'* is
often used when another part of the body is meant.
Li the case of a girl who, as this one, had been
brought up in "innocence'' and taught to regard
sexuality as something sinful and dirty, to be
avoided and feared, it is quite natural that dreams
about sex should be accompanied by a sense of
horror and fear instead of pleasurable emotions.
Of all this, of course, I said nothing to the girl, but
simply asked her to give associations to the dream,
without in the least intimating that I suspected
what it meant.

Though she said at first that the dream brought

AN ANXIETY HYSTEEIA 453

nothing to her mind, after a little urging she ad-
mitted she had thought of something which she
had felt ashamed to tell me because it had to do
with sex. What she had in mind was this. Up
to the time she read about the white slave investi-
gations she had known nothing about sex and had
felt no curiosity. ^ But these articles aroused her
interest, and at last she went to a girl friend and
asked for enlightenment. This girl gave with no
little relish a description more vivid than accu-
rate of prostitution, venereal diseases, the abduc-
tion of girls, and other matters of a similar char-
acter. The chief impressions which Miss S

derived from all this were that the first coitus is a
very terrible and bloody affair, in which a girl
screams, faints, or even dies of pain, and that,
when swayed by erotic emotion, men are little if
at all removed from savages and wild beasts.

Not unnaturally. Miss S was shocked and

frightened, and she resolved to have nothing to
do with men as long as she lived. At the same
time, she had some dim suspicion perhaps things
were not quite as terrible as they had been repre-
sented to her. In addition, the picture of the

1 Before this, Bhe said, she had had no knowledge of aeznal
relations and had not known how children came into ezistenoe.
In fact, when she was nineteen years of age she had created some
commotion by asking before a whole roomful of people why It
was that widows did not have children. Knowing in a vagne way
that marriage had something to do with birth, she had not been
able to understand why widows, since they had been married,
did not continue to reproduce. She said she was not sure that
ahe had known at that time that babies developed in the body of
the mother. We shall see later that the patient's ignorance was
not as profound as it seemed.

454 MORBID FEABS AND COMPULSIONS

sexual act which her friend had painted had a cer-
tain strange fascination for her and kept recur-
ring to her mind with annoying insistence in spite
of the fact that she felt it wrong to have such
thoughts and made every effort to banish them.

At any rate, these associations, which were
brought to the patient's mind by the idea of vio-
lence, blood, etc, in her dream, show plainly her
sado-masochistic conception of sexuality, and con-
firm my conclusion that her dream could be inter-
preted on such a basis. The dog in the dream
may be regarded as a symbol for a sexually ex-
isted man, for as shown by her associations she
had thought of men under such drcumstanoes as
being wild animals. The shedding of blood, the
swelling of the body, etc, are details which com-
plete the phantasy of defloration and pregnancy.

There now arises the question. Who is the man

that the dog represents? Miss S ^ when

asked for associations concerning the dog, recalled
that on the evening of the dream some young peo-
ple had been at her house. She had shown them a
set of snapshots, among which was a picture of
herself with her arms around a large dog. The
dog in the picture, however, did not look like the
one in the dream.

After telling me this the girl stopped and ssdd
that she could give no further associations. But
when I insisted that there must be something in
her mind, she began to laugh and told me that Mr.
Densmore, her **pet aversion,'* who was among
those present on the evening of the dream, had

AN ANXIETY HYSTERIA 455

said when he beheld the picture just mentioned^
**MyI How I'd Uke to be that dogl"

Chir question as to whom the dog in the dream
represents is now answered. It did not look like
the one in the picture, but was slim, gray, and had
a long nose. Mr. Densmore is slim, has a long
nose, and on the evening in question wore a gray
suit of the same color as the dog in the dream.
Thus, the dream dog is a composite formed by
fusing his image with that of the dog in the pic-
ture. It is he that the dog represents.

The analysis of this dream, which showed it to

be a sexual fantasy with Mr. D as its object,

on the one hand accords with the suspicions which
have already arisen that the source of the young
lady's fear was the sex conflict; but, on the other,
it contradicts certain statements she had made.
She had repeatedly asserted that she had disliked

Mr. D intensely. If, as sometimes happened,

some one jokingly accused her of liking him, she
took the greatest pains to deny the accusation in
most emphatic terms and to create the impression
that her feeling toward him was one of boundless
contempt She had admitted that he had courted
her and that she was convinced he would propose
to her if she gave him the least encouragement.
She never did encourage him, however, but, on the
contrary, treated him as meanly as she could, tried
to avoid him whenever possible, and spared no
pains to prevent his rare visits to her house. All
this is entirely at variance with what the dream
seems to indicate, namely that Mr. D x>ossessed

456 MORBID FEARS AND COMPULSIONS

a strong sexual attraction for her. Bat we can
easily interpret her aversion, dislike, etc, as cor-
responding to the straggle in the dream against
the dog and to her efforts to hold his mouth shut
CTo keep his mouth shut" equals ''to keep him
from proposing.") The dream thus shows two
sides of the patient's personality, a concealed
phase upon which Mr. D exerted a strong sex-
ual appeal, and the conscious phase which repelled
it. In other words while hardly realizing it, she
had a certain wish that in spite of her protesta-
tions he would continue his attentions and that she
might eventually marry him, have sexual relations
with him, and bear his children, while her feelings
of dislike, etc., were really an overcompensation
for this submerged stream of feeling.

In the light of all this, the fears from which fhe
patient suffered can be interpreted as fears of
desire, or of temptation. Thus, the reason she
was afraid to ride on the subway, etc., was that, if
she were able to ride, she would have no reason
for not going to the office, where she would see

Mr. D every day — ^a thing which she thought

would result in her eventually accepting him and
fulfilling her sexual wishes. Her dislike of Mr.
Densmore and her fear were thus designed to
serve the same function of protecting herself
against her longing for him. She tried to dislike
him in order to prevent herself from Hking him
too much, or in a way that, in her opinion, was not
right.

I explained the dream to the patient, indicating
what wishes it seemed to fulfill and the reasons for

AN ANXIETY HYSTEEIA 457

my condusionSy though without attempting to
point out the relation of these wishes to her symp-
toms. (This, by the way, was the first reference
on my part that had been made to matters of sex«)

She replied that although she regarded my ex-
planation of the dream as a very ingenious and
plausible one, it was entirely wtong. As far as

Mr. D was concerned, she did not like him,

never had liked him, and never would. In addition
to this, she felt that it was depraved and sinful to
have sexual thoughts. She never had sexual feel-
ings and never expected to have them; her
thoughts were always pure. She admitted that
there were certain older men she had liked very
much, but denied that in this liking there was any-
thing sexual. I did not argue with her about
these matters, but preferred to wait, feeling sure
that sooner or later something would come up to
confirm my interpretations.

After this the girl showed an increase of resist-
ance, and for some time I could get little out of
her. She said I was welcome to ask her any ques-
tions, but there was nothing more she could tell
me. Of course I explained to her that there were
no questions I wanted to ask and that the only
thing expected of her was to tell what thoughts
came to her mind, even if they did not appear to
be of any great significance. She insisted that
everything had been told and that nothing more
occurred to her. At last I explained that this
seeming absence of associations came about ordi-
narily when the patient was withholding something
of which she was clearly conscious. I added later

458 MOBBID FEAES AND COMPULSIONS

that this something not uncommonly proved to be
the recollection of some definite sexoal experience.
As soon as I made this remark, I saw from the
girl's expression that I had hit upon the truth, and
I told her so. She protested, but after a time she
suddenly began to cry, and, saying that she was
very miserable, ashiuned, and unhappy, begged
me not to ask her to tell any more. I replied that
I would not insist on her telling me anything she
did not want me to know, but asked if she felt she
could be really satisfied not to tell, now she had
gone this far. Finally, after imploring me not to
think too hardly of her, she related the following
story.

About a year previous to her illness, she formed
a friendship with a girl a little older than herself
and they had become very fond of each other.
The older girl made a great deal of her and petted
and kissed her continually, all of which she had
enjoyed. At length, they were invited to spend
a night at the house of a friend, where, because
there were other guests, it was necessary for the
two girls to sleep together in the same bed. After
they retired they lay for some time in each other's
arms, talking. At length the older girl became
very affectionate, kissing Miss S — ^, praising
her beauty, stroking her face and arms, and press-
ing their bodies together. After a time she began

to stroke Miss S 's thighs, gradually bringing

her hand higher and higher until it reached the
younger girl's genitals, where the stroking process
continued. Miss S— — lay perfectly still, half
pleased and half frightened, until, when she began

AN ANXIETY HTSTEEIA 459

to experience sensations of an munistakable char-
acter, she suddenly pushed the girl from her in
anger and shame, protesting that they could never
be friends or see each other again. The other
girl tried to apologize and make up, but Miss

S repulsed all these attempts, and lay awake

the rest of the night tormented with guilt and
humiliation. The next morning she left for home
as early as possible, and strictly avoided the other
girl thereafter. *

After this experience, she was greatly worried.
Not only did she feel that she had committed a ter-
rible sin in permitting such advances, but, when
she noticed, on one occasion, a slight leucorrhoeal
discharge, she immediately attributed it to what
had occurred, and was greatly in fear that she
might have been seriously injured.

Soon after she heard a married woman of her
acquaintance telling about a Catholic girl who
had had a similar experience. The priest, this
woman said, had told the girl that such occur-
rences were by no means unheard of, and that, if
she was truly penitent, nothing further was re-
quired of her than to forget about it. Miss S

had derived some comfort from this, but at the
same time had never ceased to reproach herself.
Of course I assured her that the incident was of
very little significance and she need feel neither
remorse nor alarm about it.*

iThe other girl looked considerably like a Japanese and was
often called "Jap." This explains the dream In which Miss S
was chased by a Japanese.

s One usually has to give such assurances but can not rely upon
than to remoTe the patient's self-reproach entirely^ If the emo-

460 MORBID FBABS AND COMPULSIONS

At the next vifiit to me Miss S said that

she felt better and that she was glad she had had
the courage to telL At the same time she re-
proached herself a good deal and still seemed to
take a very serious view of what she had done. I
told her that such an experience was by no means
unusual among girls — she had said that she could
not believe any one else in the world had com-
mitted that sin — but she was by no means satisfied.
In succeeding visits, it became apparent that her
remorse though partly real was partly an exagger-
ation. She was serious in believing that she had
committed a great sin, but at the same time she
was overremorseful in order to compensate for
the fact that in some degree the experience had
been pleasurable and to assure herself that any
longing for its repetition was absolutely foreign
to her thoughts.

When we were discussing the homosexual expe-
rience, I took occasion to tell her a little of the
significance of the sex instinct, saying that the im-
pulse which led to her experience was primarily
something perfectly normal and possessed by
everybody and that the only thing to be criticized
in her case was that it had been misdirected. I
also remarked that the incident showed she was
not so entirely devoid of a sex instinct as she had
claimed at the time of the analysis of the dog
dream. ^

tioa la strong it is dispelled only wlieii the patient recalls and
connects with it the oorrective experiences of childhood oat of
which arose the ego-ideal specification or resistance applying to
the immediate cause of the sense of guilt.

^ It is to be seen that the resistances which began when ths

AN ANXIETY HYSTEEIA 461

In connection with our discussion of the homo-
sexnal experience, the girl remarked that ever
since it she had felt a certain resentment toward
lier parents for not warning her that such things
conld occur. They had always been very zealous,
she said, in cautioning her against allowing boys
to kiss her or take any liberties with her, and these
T^amings she had heeded, and made friends only
^th girls. Her parents' warnings had, she felt,
driven her from one danger into another, and
perhaps worse one, where she had least expected
it. She felt she had been rendered over suscep-
tible to the possibility of homosexual experience
by the fact that she had been led by her parents to
so carefully avoid the heterosexual — ^a reproach
that perhaps is not entirely without foundation.

She continued to dwell at considerable length on
how profound her ignorance of sex matters had
always been, until at last I remarked that such
absolute innocence, as, for example, she had
seemed to display by her question of why widows
did not have children, was usually more appar-
ent than real. A person of normal intelligence
living in our environment would not reach the age
of nineteen or more without divining more of sex
matters than she had seemed to know, unless there
had been produced by repression an inhibition of
the thought process and an artificial blindness to

dream was analyzed were connected with the homosexual ezperi«
ence. The mention made of sex matter in connection with the
dream of course brought to her mind the homosexual episode and
made her afraid either that she would have to tell about it or
that in some way I might find it out. The result was that for
the time being her associations were blocked.

462 MOEBID FEAES AND COMPULSIONS

thingis sexual. In other words, such apparent ig«
norance as hers ordinarily denoted not a real ig-
norance of sex matters but rather an early ao-
quaintance of some sort with them which was suc-
ceeded by a later repression.

After a time she admitted that perhaps there
was some truth in what I said, for she suddenly
remembered that when she was about thirteen
another girl had told her about intercourse, ex-
plaining that such was the way babies were made.
She could not believe what this girl told her, say-
ing that she was sure her parents would never do
such a dirty thing. The next day this girl told
of her reply to a number of otiier girls, who
laughed so heartily over the patient's innocence
that she became convinced that what she had heard
was the truth. She felt shocked and frightened
that such a thing had taken place between her pa-
rents and thought them very hypocritical and dis-
honest to have kept up a front of smug morality
and virtue when all the time such awful things
were going on. These reflections, however, she
had put out of mind ; and now, as she looked ba<^
upon the matter, it seemed as if she had for a long
time really succeeded in forgetting what she had
been told.

Shortly after this visit she had a dream in whidi
she was a little girl and she lifted her skirts and
urinated on the ground. This dream led her to
remark that at five or six years of age she had had
scarlet fever, which resulted in ** kidney trouble."
Upon questioning her I found that what she had
meant by kidney trouble was really nocturnal enu-

AN ANXIETY HYSTEBIA 463

resiSy a condition which had lasted for a year or
more.

This bed wetting, since it came on so late, was
in all probability a pollution-equivalent and con-
neoted with masturbation. Her connecting it with
kidney trouble as a sequel to scarlet fever was a
memory condensation serving to conceal the true
nature of the condition.

The homosexual incident shows that the patient
was not so utterly devoid of a sex impulse as at the
time of the dog dream she had maintained, and the
later recollection just narrated proved that she
was equally incorrect with regard to her state-
ment of absolute ignorance of sex matters, for she
did have some knowledge of things sexual even
from her early childhood. It may be noted inci-
dentally, that in these early ideas the sexual was
associated with the excretory processes, a fact,
which together with the attitude of the parents
toward sex, had to do with her strong feeling that
the sexual was essentially ** dirty. '^

In spite of the fact that the material just pre-
sented was contradictory to the statements made
by the patient at the time of the dog dream, she
was no more ready to accept my interpretation of
it than she had been in the first place, and no es-
sential change was produced in her attitude to-
ward it. Fortunately, more corroborative mate-
rial was not long in forth coming.

I was expecting that after the homosexual ex-
perience had been discussed, the analysis would
progress smoothly for a while, but instead the pa-
tient began to show resistances of a new type.

464 MORBID PEABS AND COMPULSIONS

She talked enough, to be sure, but what she said
was obviously intended to be meaningless and mis-
leading. She laughed a great deal and made
many silly remarks. She showed a tendency to
belittle everything I said, to be derisive and sar-
castic, and to make fun of me. The motive for
this soon became apparent, and in the following
way.

Jn the early part of one visit, the patient spoke
of a man much older than herself, whom she had
mentioned on other occasions, and related that on
the preceding evening, when she was at a theater
party, he had b^ged for one of the flowers she
wore but she was embarrassed and refused to give
it to him. I noticed perhaps half an hour later
that while we talked she was folding her hand-
kerchief in some peculiar shape. As soon as she
saw me watching her she laughed and covered the
handkerchief wifluher hands. **What were you
doing f I asked. ^^I was making a flower,'' she
replied. ^^And what had you in mindf I con-
tinued. She seemed embarrassed^ but at last said,
**I thought if it was a real flower I would like to
give it to you.'' ** Flowers are sometimes sym-
bolic," I said at last (I had never told her what
they symbolized). "Is it possible the flower rep-
resents something elsef What comes to your
mindt" **Nothing," she replied; "I don't think
of anythiQg — except, perhaps, the lamp on your
desk." (Lamp is often a penis symboL) "Are
you sure that is all?" "Yes," she replied;
but after a pause she suddenly said, "I have
thought sometimes I would like to give you a kiss."

AN ANXIETY HYSTERIA 465

I felt that the flower had possibly symbolized even
more than a kiss^ but thought it unwise to press
the matter then; and the sitting ended. At the
door just as she was leaving she said, ^^I was fool-
ing ; I didn't mean what I said. I would not want
to kiss an old married man.''

At the next visit she reported that she had felt
quite badly during the two days that had inter-
vened. As she was going up the stairs on reach-
ing home from the last visit she had felt a pain in
her hearty and this, with occasional dyspnoea, had
persisted ever since. She had been very much
frightened, fearing she had heart disease and
might drop dead any instant. She had been very
much afraid to make the next trip to my office,
thinking she would die on the way ; and she would
have telephoned to break the appointment had not
her mother insisted upon her coming.

The same night this pain began she awoke from
her sleep saying over to herself, '^And then we
went to Asheville, but my cousin was there; and
then to Palm Beach, but my sister was there," and
possibly some other words that she could not re-
member. This dream, if it may be so called, has
the following explanation. A few days before.

Miss S happened to meet a girl of her sl(^

quaintance who had recently married, having
eloped with a doctor. It seems that the eloping
couple had wished to keep their marriage a secret
until they had heard from the bride 's parents, to
whom they had telegraphed the news. The young
woman gave an excited description of their diffi-
culties, for there was some relative or acquaint-

466 MORBID FEAKS AND COMPULSIONS

ance at nearly every place they went, on acoonnt
of which they had to keep moving. In speaking of
this the yonng wife had used the same words the
patient was saying over to herself in the dream.

The dream words can easily be interpreted as a

part of a wish-phantasy in which Miss S has

an experience similar to that of the yonng bride, a
phantasy, in other words, that she had ran away
with a doctor. The dream, then, is a continuation
of the same trend which was responsible for the
incident of the flower and for the wish to give me
a kiss. All of these were transference phenom-
ena. The heart symptoms and the anxiety which
accompanied them belong in the same categ^ory.
She had begun to think that she was developing a
sentimental affection of the heart with regard to
me, but this somewhat alarming reflection was
substituted through conversion by what appeared
to be an organic affection of the heart.

I explained to Miss S my interpretation of

the dream and also of the heart symptoms. She
laughed very heartily at both but admitted I was
right. (The heart symptoms disappeared imme-
diately after the explanation.)

She then confessed that she had entertained
some more or less sentimental thoughts concern-
ing me almost from the very first, adding that she
had not known for certain that I was married un-
til the time of the last visit. She had been afraid
to ask her mother or me for fear it would look as
if she were **too interested.'* But on that oc-
casion she had said ^^I would not want to kiss an
old married man" as a way to make me commit

AN ANXIETY HYSTEEIA 467

myself withoat her having to ask a direct questioiL
When, from the way I replied, she saw that I was -
married, she felt considerably perturbed over the
fact that she had allowed herself to get into such
a state of mind concerning me. She felt it wrong
to have such thoughts about a man who was mar-
ried though as long as she had not known for cer-
tain that I was married she had not particularly
reproached herself. The belief that such things
were wrong gave rise to a resistance which caused
what had been a normal expression of the libido
to be transformed into heart symptoms and anxi-
ety.

The discovery of the existence of this transfer-
ence to me now explains why the patient had dis-
played a desire to belittle and make fun of me.
This impulse was a reaction against her senti-
mental interest, and was intended to conceal it.

These and otiier transference phenomena which
manifested themselves in immediately succeed-
ing visits were just the material I needed to cor-
roborate my analysis of the dog dream and my ex-
planation of her symptoms derived from that
analysis. As I explained to her, the sentimental
feelings she had had toward me were not new and
did not refer to me actually, but represented a
transference and re-edition of feelings, perhaps
more intense originally, that she had had to-
ward some one else without being willing to
realize them. In other words, what was now tak-
ing place con$ci(yusly with regard to me, had pre-
viously taken place xmconsciously in regard to
some other person who for the time being I rep-

468 MORBID FEARS AND COMPULSIONS

resented. This person I was quite disposed to
think was Mr. Densmore. She could no longer
deny that she was capable of sentimental feelings,
because she had had them toward me ; while, since
she had had them toward me, it was probable they
had also occurred elsewhere, even admitting that
she might not have been aware of thenu Her ap-
parent detestation of Mr. Densmore, was, I
thought, analogous to her impulse to belittle me.
Her heart symptoms and the fear associated with
them, that she would die — a fear which, if she had
had her own way, would have prevented her from
coming to my office, served, obviously enough, as a
protection against developing sentimentality and
expressed her wish not to see me in order to get
over any interest in me. They were in perfect an-
alogy with her fear of riding on cars and of going
out alone, which had prevented her from reaching

the office, where she would see Mr. D daily.

In short, her reactions of interest, compensatory
disparagement, and defensive fear symptoms in-
tended to protect again an increase of interest by
preventing her from seeing me, gave in miniature
a view of the reactions that had taken place with
greater intensity and extent in respect to Mr.
Densmore.
But here again, as in reference to the dog dream,

Miss S J though admitting the plausibility of

my explanations, was by no means convinced by
them. She protested that she had always disliked
Mr. D and could not believe that either con-
sciously or unconsciously she had ever experienced
toward him any sentiments of a more tender sort

AN ANXIETY HYSTERIA 469

But, finally, after much hesitation she stated that
one day, perhaps a year before the beginning of
her iUness, she was with him in a crowded subway
train and, when to steady her he put his hand on
her arm, she experienced a sudden flash of intense
sexual feeling. This sort of feeling, she acknowl-
edged, had frightened her, for she thought such
emotions depraved and sinfuL She would not
admit, however, that it was her objection to such
feelings that prevented her from having them more
frequently, stubbornly maintaining that it was not
that she was repressing such a tendency but that
the tendency did not exist. She did admit that
after the incident of the subway her resistances

against Mr. D had decidedly increased, but she

refused to see that they were intended as a defense

against an increase of sex interest in him.

. During the period this discussion was going on

Miss S opened the conversation at one of her

visits with the laughing remark ^^I have made a
new transference; you are not in it any more."
She went on to explain ihat there was a young
doctor who had paid her some attention of late
and on the Saturday night preceding this visit
she had attended a dance where he was present.
He danced with her a number of times, held her
quite dose, and gently squeezed her hand while
they were dancing. Toward the close of the eve-
ning he took her to a side room which happened to
be empty and in a very gentle and tender way put
his arms around her and kissed her. She had
been quite well aware of what was coming when he
jtook her to this room, and submitted to the caress

470 MORBID FEABS AND COMPULSIONS

with very little protest. On the whole she quite
enjoyed the experience. She liad expected to feel
a little more thrill in response to the caress than
actually took place, and, though a little disap-
pointed in this respect, she viewed the experience
as a very pleasurable one. She found herself
afterward thinking about it and about the doctor
with considerable sentimental interest.

This affair with the doctor continued. Miss

S displayed an increasing interest in him, had

many daydreams about him, and allowed him to
kiss her occasionaUy. His kisses were of a tender
sort and gave no evidence of passion* Miss

S 's feelings seemed to correspond to his. She

liked him and his attentions, but neither actually
nor in her daydreams did she experience any feel-
ings that were definitely sexual in the popular
sense. This, she said, was just the way she wanted
things to be. She asserted that if she had had any
physical sex sensations, she would have felt so
guilty that she would have had to stop seeing him.
Even as it was she felt a little guilty about allow-
ing herself to be kissed.

About this time the analysis was interrupted for
a considerable period because of my absence from

the city. Miss S had improved a good deaL

She could not go out alone yet, but could ride on the
cars if there was some one with her, which as a
rule, she had not been able to do before. She was
almost free from the anxiety attacks, g^ieral nerv-
ousness, and depression from which she had pre-
viously suffered even when she did not go out
For about a month after I left she kept what she

AN ANXIETY HYSTERIA 471

Had gained, and then she got worse again. I
learned after the analysis was resumed that this
xelapse had taken place when her friend the doc-
tor left New York under circumstances that led her
to believe that he was not likely to return. Until
the analysis was resumed, she remained in about
the same condition. At no time, however, were
her symptoms as bad as when she first came to me.
Her friendship with the doctor quite obviously
had been a factor in her temporary improvement.
He was a sort of compromise between Mr. Dens-
more and me. He resembled me in being a doctor
and Mr. Densmore in that he was not much older
than the patient. Her feelings toward him were
not sufficiently ** physical* ' for her to object to
them and for this reason he represented an emo-
tional outlet which, while she had it, made easier
the suppression of any love feelings toward Mr.
Densmore or me. In a sense, it was a case of
simiUa simUibtis curantur. By encouraging her-
self to take an interest in the young doctor she at-
tempted to cure herself of the attraction Mr. D

exerted upon her, one motive for so doing being
her reluctance to admit the definitely sexual feel-
ings that Mr. D seemed able to inspire in her in

spite of her resistances. But when the safety
valve represented by her friendship with the doc-
tor was closed by his leaving New York, her libido,
thus dammed up, reverted to its earlier channels,

namely to Mr. D and myself. By getting

worse she restored her defense against Mr. D

and at the same time had a reason for continuing
under my care.

472 MORBID FEARS AND COMPULSIONS

All this was explained to her when the analysis
was resumed; and, though she said she could not
believe it to be entirely true, she gave the impres-
sion that dhe was more nearly convinced than she
would admit. The analysis then continued for
some little time without much real progress, al-
though she had immediately improved a little as
soon as the treatment was resumed— obviously a

transference phenomenon. Then Miss S had

the following dream, which shows a reason for the
standstill and at the same time discloses a piece
of new information about the factors whidi had
operated to produce her neurosis. This is her
dream.

'^I was ridiog on a train or subway oar. A fat
man who sat near me dropped something and or-
dered me to pick it up for him. I resented being
asked to wait on him and, seeing a key on the floor,
I picked that up, with the thought that instead of
doing what he wanted I was doing just the oppo-
site. Then, I ran and, getting off the train, hid in
a house to get away from him. After a time the
scene changed, and it seemed that I had started
out to enlist in the German Army. Finally, I
found myself in an office, where sat a man who
seemed to be a priest, but was also Eong James IL
The man said, ^Tell me about the key,' and I be-
gan to do so. He listened with great interest, but
he kept having to answer the telephone, and other
interruptions occurred, ^so that the dream ended
with my story unfinished.''

This dream is too long to be interpreted here
in all its details. I shall tell only the most import-

AN ANXIETY HYSTERIA 473

ant of the patient's associations to each element
of the dream, and explain them without taking up
all the reasons upon which the explanation is
based.

The first thought in the dream, ''I was riding
on a train, ' ' led the patient to remark : ^ ^ Well, that
is just what I cannot do now." We may, there-
fore, regard the fantasy '^I was riding on the
train" as the equivalent of the thought ** Before I
was taken sick" — ^thus, a sort of subordinate time-
clause, which introduces the main part of the
dream.

The fat man in the dream proved to be the pati-
ent's employer, who, in fact, is very stout. His
dropping something and asking her to pick it up
and her resentment at this request have the fol-
lowing explanation.

Soon after she began to work for him, she
had reasons to be not altogether satisfied with
the step she had taken. For, though outside of
office hours her employer maintained his usual
attitude of thoughtfulness and consideration, yet
in the office he treated her like any ordinary sten-
ographer,— ordered her around, scolded her for
mistakes, swore in her presence, and heaped an
enormous quantity of work upon her. This made
her both unhappy and resentful, and, had it not
been for the fear of hurting his feelings and the
danger of the considerable materia} loss that
ndght result if she incurred his displeasure, she
would gladly have given up her position. In fact
if anything had presented itself which would have
furnished a good excuse for her leaving his em-

474 MORBID PEAKS AND COMPULSIONS

ploy, she would have been happy to take advan-
tage of it The inconsiderate attitude of her em-
ployer during business hours and her consequent
resentment are expressed in the dream by her
resentment at being asked by the fat man to pidc
up something he had dropped. Gallantry pre-
scribes that gentlemen should pick up things for
ladies ; in the dream just the opposite takes place,
and a lady is asked to pick up something^ for a
man. In this way is represented the attitude of
her employer in tiie office, which was just the op-
posite of gallant

But in the dream she picked up a key which she
saw lying on the floor, with the thought that she
was doing just the opposite of what he wanted.
Now, what does the key meant Asked to associ-
ate, the patient remarked, '^A key is something
you use when you want to get into things — ^Yes-
terday my mol^er tore her dress on a key in the
bureau. She was very much exasperated, but I
told her she must not blame the key, because it
was herself, through her carelessness, that was at
fault I meant that she had made of the key a
sort of excuse."

The key which the patient picked up in the
dream was, then, according to her assodations,
something that could be made a sort of excuse^
something upon which the blame could be placed
when one^s self was really at fault, and perhaps
also something which, like a key, could be used not
only when one wants to get into things but, in a
different sense, when one wants to get out of them.
Now, as we know, the patient wanted to get out of

AN ANXIETY HYSTERIA 475

working for her rich benefactor. She would have
been glad of an excuse to withdraw from his em-
ploy. But we have already seen that her neurosis
brought about this withdrawal, or in ot}ier words
was the excuse she wanted. In short, the thing
that she picked up in the dream, and that her asso-
ciations indicated was an excuse, was as a matter
of fact her neurosis. She could use it to get out of
things. She could blame it when what was actu-
ally at fault was her wish to shirk responsibili-
ties.*

The first part of the dream is, therefore, his-
torical, and its meaning or latent content may be
summed up as follows. '^Before I became ill, my
employer treated me during business hours with
so little gallantry and consideration that I wished
to leave his employ ; so instead of trying to please
him, I did just the opposite by developing a neu-
rosis, which enabled me to escape from the officei
and hide myself at home.''

The rest of the dream refers to the question of
treatment, for in the dream after she had hidden
in the house for some time the scene changed and
she started out to join the German Army. Her
associations, which I need not repeat, indicated
that to join the German Army meant to be brave,
and in her case thus represented an attempt to
overcome her fear, or, in other words, an effort
to be cured of her neurosis.

At any rate, after setting out to join the German
Army, or, as we know it, after taking up medical

iThe "Seeondary function*' of neurotic illness. See Freud's
'Simmlung Kleiner Schriften Zur Neurosenlefarey" Bd. II.

476 MORBID FEARS AND COMPULSIONS

treatment, she found herself , as has been said, in
the office of a man who was King James II, but at
the same time seemed to be a priest. What doea
this meant

Her associations concerning King James II
finally led, without her realizing the drift of them,
to her speaking of a certain man of about my age
whom she had often mentioned to me because it
seemed to her we were so remarkably alike. Now,
this man's name was James. But, since I was so
much like him, she could regard me as a second
James, or in other words, as James the Second.
I, then, was the king in her dream. In view of this
there is no real incongruity in the fact that James
n in her dream seemed to be a priest and sat in
an office equipped with a telephone. She looked
upon me as a priest because she had to confess to
me.

The King's request, "Tell me about the key,"
was my request for her to tell me about her neu-
rosis. The interruptions which occurred in the
dream so that it ended with her story unfinished
represent the wish f ulfilhnent. She feared that if
she got well she would have to go bacd: to work for
her former employer. Hence she wished inter-
ruptions or anything else to occur which would put
off the completion of the analysis. In short, the
dream shows that a wish to get out of working was
not only a factor in producing her neurosis but
would also delay her recovery. She wished to re-
tain some of her symptoms, for in this way she
could avoid having to go back to work. She ac-
knowledged also that she enjoyed coming to me

AN ANXIETY HYSTERIA 477

and that this had furnished a motive for wishing
to defer her recovery. I must add that one feat-
ure possessed by the fat man in the dream — ^a
feature which for reasons of discretion I may not
describe-H9uggested that the dream also referred
in some way to Mr. Densmore. We shall learn
later that this was true, and that her dislike of
work meant more than at first appeared.

After this dream and its analysis had been dis-
cussed— and this time Miss S accepted my ex-
planations ahnost in toto — things began to pro-
gress much more rapidly. Though she admitted
that she was not at all enthusiastic about return-
ing to work, she remarked that she did not intend
to let this interfere with her recovery, for, as she
said, if she could not become resigned to working,
she could doubtless find some way to avoid it even
if she were welL

At this period the patient rarely saw Mr. Dens-
more, though he formed a frequent theme in our
conversations. She still protested that she dis-
liked him, and as of old she ridiculed and made fun
of him. If any of her friends spoke of him she al-
ways took pains to refer to him in terms of de-
rision and contempt. Nevertheless, it seemed to
me that she was beginning to realize that, as I had
explained to her, these reactions were merely a
compensation for a real and strong attraction
which he exerted upon her, and which, in my opin-
ion, was definitely sexual in the ordinary accep-
tation of the word.

That it was sexual in this sense seemed to be the
chief reason why she would not let herself like

478 MORBID FEARS AND COMPULSIONS

1

]

him. In spite of all I could do she had not yet ap-
peared to be able to overcome the feelings that s^
was essentially sinful. Though now admittmg
that she was not entirely sexless and that sex im-
pulses must be normal, she asserted that she had
never experienced such a base longing as that for
physical sex relations with a man and she hoped
she never would. But these statements were soon

to be contradicted. About this time Miss S 's

mother, who all along had felt that perhaps some

uterine trouble was responsible for Miss S 's

illness, expressed a desire to have the girl exam-
ined by a gynfiBcologist. Miss S told me about

this ; and though she felt that such an examination |
was unnecessary she thought perhaps she might
better have it merely to satisfy her mother. I gave
her the name of a friend of mine to whom she oonld
go for the examination (which, however, was never
made) ; and then she asked if it was all right to
go, meaning, might not her hymen be ruptured.
I of course told her that the doctor would take care
to avoid anything of the kind, and she seemed sat-
isfied. A night or two after this she dreamed that
on my recommendation she had gone to a man, ap-
parently a doctor, for some sort of treatm^it*
She found herself in a room reading a large book
which apparently the doctor, who seemed to be a
negro, had given her. From the title page she
saw that the book was by a Professor F. B. E. D.

(the name of a man who will be mentioned

later). The treatment seemed to consist in the
reading of this book. She saw in the book some-
thing about ^ Aplenty of cracked ice and exercise.''

•

AN ANXIETY HYSTERIA 479

WMe reading she kept glancing at the dock, the
idea being that at a certain time the doctor's office
hour wonld be over and then she would go.

In view of what has been said the meaning of
some parts of this dream are almost self-evident,
though on the whole the dream is obscure. The
person to whom in the dream she went for treat-
ment apparently has some connection with the
gynsecologist we had spoken of and who she was
afraid might rupture her hymen. But the man
seemed to be a negro. A negro, to most American
girls is, in their dreams at least, a symbol or per-
sonification of masculine sexual aggression. Thus,
the patient dreams that through my recommenda-
tion she finds herself in a situation where appar-
ently she is exposed to a certain danger of sexual
aggression and rupture of her hymen. Just what
this situation is will appear later.

The large book which she read in the dream
brought to her mind a '^Family Medicine Book"
which her mother possessed. She now admitted
that she had occasionally referred to this work in
the hope of satisfying her sexual curiosity, and of
obtaining some information about the relation of
the sex impulse to nervousness. The words
'^ Plenty of cracked ice and exercise'' were a con-
densation of certain passages in this book which
referred to the treatment of masturbation. The
name which she saw on the title page of the book
in the dream was a condensation of the name of
Professor Freud, of a psychoanalyst to whom I
told her she could go if during my absence from
the city she needed advice, and of another man

480 MORBID FEAES AND COMPULSIONS

whom she regarded as an authority on sex. At
any rate^ the reading of the book, which seemed to
be a sort of treatment, apparently represented the
doing of something that would satisfy her sexual
curiosity. What this something was, together
with additional associations with regard to the
book, was brought out in discussing the idea which
appeared in the dream that at a certain time the
doctor 's office hour would be up and she could go.
When asked for associations on this point she soon
reverted to the theme of books, and at length told
me of having read an erotic novel entitled ^'His
Hour." The substance of the part that im-
pressed her was as follows. A woman who had
been married is alone in the house of a man who is
in love with her. He suggests intercourse but she
refuses and is prepared to defend herself with a
revolver. He knows she will not kill him and sits
down as if to tire her out. At length, she faints.
When she recovers consciousness she finds her
clothing torn and disarranged and so concludes
that the man had had intercourse with her while
she was unconscious. Not until the end of the
book does she realize that this is not so and that
during her faint her lover ^'did but kiss her little
feet"

In reading this book the patient had experi-
enced considerable sexual pleasure. l%ie idea of
the helplessness of the woman during the fainting
attack strongly appealed to her, and she f antasied
herself in a similar situation, in which more hap-
pened than the kissing of feet. Now this, as
shortly appeared, had been a determinant of her

AN ANXIETY HYSTERIA 481

neurosis. The time when the man chased her on
the street, on the day preceding her first fainting
attack, she was still under the influence of the
erotic excitement occasioned by the reading of this
book. Her inability to rtm was due to her assault
fantasies, which now, though in a not very accept-
able way, seemed about to become realities. That
is to say, her wish to be caught (not by this par-
ticular man, of course) operated as a counter wish
to impede her.*

It is dear that the fainting attack which oc-
curred on the day after her fright was in imitation
of the woman in the story. It occurred when she

knew Mr. D was near at hand, and it served to

bring him to her side and cause him sympathetic
concern about her. Now in the dream she is, at
my suggestion, in a situation which apparently ex-
posed her to sexual aggression and the loss of her
hymen, but which is some sort of treatment, and
has to do with the gratification of sexual curios-
ity. Her looking at the dock, etc., suggests that
it is **His Hour.'^ Expressed in this way, the
dream is not difficult to interpret. The idea of
treatment is associated with the idea of gratify-
ing sexual curiosity. And the best way to gratify
such curiosity is by actual experience. From
what I had said with regard to repressed wishes
being pathogenic, the patient concluded that one
way to get well was to fulfill these wishes. Hence
she dreams that she is having a **His Hour" ex-
perience— ^that as a means of getting well she f ul-

iThis is an excellent example of the utter disregard which
wishes of the unconscious have for reality.

482 MORBID FEAES AND COMPULSIONS

fills her sexual wishes. The idea that I was re-
sponsible for her undergoing this sort of treat-
ment corresponds to her wish to shift responsi-
bility for what she thought was wrong. It is evi-
dent too, that she was maldng of the psycho-analy-
sis a substitute for the wish for sexual experience

with, presumably, Mr. D ^ and that she had

thought of me, in his place, as the hero in an as-
sault phantasy.

It will be remembered that the patient's chief
symptom was a fear that if she went out alone or
in the subway she would get weak, faint, and die.
But we can now interpret this by saying that she
had been afraid that if she continued well and able
to work at the office she would get weak in the sense

of giving way to Mr. D 's charms, and that

^^her hour" would come, in the sense of ultimate
sexual relations. Thus, as I had suspected at the
beginning of the analysis the fear of death was
actually a fear of love, or rather of her repressed
longing for it.

The discussion provoked by the analysis of this
dream marked the first pronounced relaxation of
her resistances. I could point out to her a se-
quence that showed most convincingly the exist-
ence of a relationship between her symptoms and
repressed sexuality. First, was the sudden flash
of sexual feeling toward Mr. Densmore in the
subway. Then came the reading of the white
slave reports which led her to asking questions
and resulted in a condition in which in spite of
herself the theme of sexual relations gained for
her a fearful fascination. Next was the reading

AN ANXIETY HYSTERIA 483

of the erotio book wHch| together with what the
girl had told her, provoked fantasies of fainting
and assault and caused a condition of consid-
erable sexual tension. Then the incident of her
being chased by the man in the street Her in-
ability to run was determined by her assault fan-
tasies which now, though in a not very acceptable
way, seemed about to become a reality. On the
following day (the day of her first attack) she
was expecting to make a visit to the scene of her
homosexual experience and this expedition would
have led, had it not been for her resistances, to
her indulging in pleasant recollections or fantasies
of a homosexual coloring. But in reacting against
this tendency, her libido reverted more strongly
to Mr. D — — and she fainted, the motive on
the one hand being a wish to escape from sexual-
ity, which seemed to be on all sides of her, and
on the other for erotic experience corresponding
to that of the woman in the book, but with Mr.
Densmore in the rdle of the hero.
To this interpretation of the situation Miss

S gave partial confirmation. She admitted

that probably I was right in supposing that her in-
terest in Mr. D was greater than she had been

willing to acknowledge. Soon after she declared
that she had been in love with him all along but
that she had tried to avoid admitting to herself
that such was the case. She stated too that she
was sure that if she were willing to ''let herself
go*' her love would rapidly increase. But though
she now admitted these things she was not con-
tent with them. Though admitting that Mr.

486 MORBID FEABS AND COMPULSIONS

the dream we had spoken of the biological mean-
ing of the sex instinot and I had taken occasion to
use some matter that came up to support the prop-
osition that sexuality could not be essentially
* * bad. ' ' She demurred and kter I said * * Perhaps
you do not want to see these things." Still later
I had used the phrase * * There are none so blind
as those who won't see." This was the source of
the dream material In the dream she gazes on the
forces of nature, or of sex, in wonder and awe.
Her mother to whom she tries to point out the re-
markable sight, seems blind or stupid. In the
dream the mother represents that phase of her
personality which is identified with her mother;
the same phase from which arose the sex resist-
ances I had been combating. At last in the dream
she did get her mother ^Ho look in the right direc-
tion," or in other words, she finally became wiQ-
ing to see the sexual life as something fijie and
wonderful instead of as ''dirty" and debasing.

The stimulus which had resulted in this dream
was, I learned, as follows: It seems that across
the court in the apartment house where she lived
there was a young married couple whom she had
often watched from her bed room. They had
seemed to her to be singcQarly sweet and tender
with one another, and she had regarded them as
strikingly '*good" young people. On the day of
her dream she had learned that this young woman
had given birth to a baby, and in the face of this

BntpfanffwiM der JungfrtM Maria duroh dot Ohr. Jahrbucb der
PsychoanalyBe 1914. Algo, childreo are told that babieB an
brought by a bird, the stork.

AN ANXIETY HYSTERIA 487

conclusive evidence that they must have had in-
tercourse, she said to herself that surely if such
sweet and innocent appearing young people prac-
ticed coitus there could hardly be anything really
wrong about it.^ The dream shows that there
had been in existence two phases of her person-
ality; the one caused in her by her mother's ap-
parent attitude toward sex matters (a forecon-
scious trend) y and another which secretly sided
with me (essentially of the Unconscious).

The interpretation of this dream the patient
readily accepted and her resistances appeared
greatly decreased. She had been slowly improv-
ing up to this time but now her improvement be-
came much more rapid, and she felt as if soon she
would be entirely well. But then one morning,
she came late for her appointment and reported
that she had felt so badly that she had been al-
most afraid to make the trip to my office thinking
she would probably die on the way. She felt much
disappointed, for the night before she had been
thinking that on this day for the first time, she
would try to make the trip to my office alone.
During the night she had dreamed tiiat she was in
a wedding dress and about to be married. Then
suddenly she changed her mind and felt that she
did not wish to marry and that she would die if
she did. She told this to her mother, who stood
by in the dream, but her mother urged her to go
ahead. The girl would not do so, however, and
was about to run away when she awoke.

1 Another element in the life of these young people also affected
her^ as we shaU hear later.

488 MOBBED FEABS AND COMPULSIONS

The general meaning of the dream is plain
enough. She had regarded herself as just on the
point of getting welL In the dream she is just
on the point of gettrog married. Apparently she
had identified the two things. Her illness had ex-
pressed her resistances against marriage, and to
get well meant to overcome these resistances, and,
in this sense, to be ready to marry. The dream
thus shows that she has changed her mind; that
she still had some resistances toward the idea of
marriage, or, what was equivalent, toward Mr.
Densmore.

After this her resistances against sex seemed
to return somewhat for she again began to re-
peat her earlier assertions that such things were
dirty. She decided that she did not want to see
Mr. Densmore and let herself become more fond
of him, because of her repugnance to the dirty
things that marriage would involve.

She said also that there was another and equally
important reason why she did not want to mariy
him and of this she began to talk a good deaL It
seems that Mr. Densmore had a woman relative
who had divorced her husband. Miss Sunderland
asserted that she was unwilling to marry into a
family where such a thing had taken place. She
felt, she said, that the whole family was somehow
tainted, and that the tendency to infidelity and
cruelty ^ which she supposed had been displayed

1 She had no definite information ae to what wwe the gronndt
upon which the divorce was obtained. The divorce occurred in
another state, and that infidelity and cruelty were the grounds
for it, Miss Sunderland merely assumed.

AN ANXIETY HYSTERIA 489

by the divorced husband would sooner or later
crop out in Mr. Bensmore. This fear that he
might be cruel had arisen on a certain occasion
when she heard him order a waiter around rather
roughly.

I could not convince myself that a girl as intel-
ligent as Miss S could be deterred from marry-
ing a man she loved merely because there was a
divorce in his f amily, nor could I believe that she
was really sincere in supposing that the assumed
brutal and immoral tendencies of the divorced
man could have been transmitted to Mr. Densmore
and the rest of his family — Mr. Densmore was not
a blood relative of the man, but only a connec-
tion by marriage. Nor did I think that a little
roughness in her husband — ^such, for instance as

Mr. D displayed toward the waiter — would be

altogether distasteful to her. She seemed to have
a rather strong masochistic tendency and a certain
degree of masterfulness in a man would, in my
opinion, have appealed to her. The fact was un-
questionable, however, that these resistances,

against Mr. D , absurd as they seemed, were

not to be removed by pointing out their very ap-
parent absurdity. That the resistances were real,
there seemed to be no doubt, though I could hardly
believe that they arose from the source to which the
patient attributed them. At no time would she ad-
mit their unreasonableness and absurdity.

There came to my mind finally an observation I
had made in certain other cases which seemed to
afford a possible explanation of this resistance,

490 MORBID FEAES AND COMPULSIONS

namely, that when a person is vacillating between
two divergent courses and can not bring himself
to give np the attractive features of either one in
favor of the advantages of the other, he has a
tendency to see, or to imagine that he sees, in one
course disadvantages that really belong to the
other, where, however, he is loath to see them.
Thus, for example, if a man were trying to find
excuses for staying in the city in the summer, he
might say to himself, ''Oh those country houses
are so terribly hot and ill ventilated, etc.,'* while
as a matter of fact, the heat and the lack of air
circulation is one of the most disagreeable feat-
ures of remaining in the city, and one of the
strongest reasons for going to the country.

On this basis I began to suspect that the patient
wished to follow some course contrary to that of
marrying Mr. Densmore but against this course
the stigma of divorce and of the possibility of
cruelty arose, not as an imaginary but as a real
objection, and that it was the attractive features
of this course which were the real sources of that
resistance against marriage with Mr. Densmore
which we have been discussing.

This conclusion was finally confirmed by the
analysis of the following dream. ''I was some-
where in a fine house. A woman was showing me
beautiful dresses which I was to try on. It
seemed I was about to marry a rich man, who
was giving me all these things and who could
give me anything I wanted. Then, I realized that
the man I was marrying was a foreigner, perhaps
a Chinaman, and I ran away, feeling that I could

AN ANXIETY HYSTERIA 491

much more easily do without the things he could
give me than get them at such a price.''

The idea of a Chinaman brought to the patient's
mind a newspaper story she had recently read
about a wealthy Chinese who had a beautiful white
girl as his mistress. Then came something she
had never mentioned before.

She confessed that before she became ill she had
met at a dinner a very wealthy foreigner who im-
mediately becamQ impressed with her and paid her
most conspicuous attentions. She was quite dis-
posed to think he would ask her to marry him if
she gave him the least encouragment. She did
not love the man but the idea of a rich marriage
strongly appealed to her.^ On the other hand,
Mr. D- — , as she now admitted, had less money
than almost any of the other young men she knew.
Though his prospects were good, she knew her
life, if she married him, would at first be anything
but luxurious, and she would have to consider
herself lucky if she had a servant to help her
with the work. Such a prospect was not alto-
gether to her fancy.

After this disclosure there came a still more
interesting item. The foreigner had already been
married and his wife had divorced him, on the
ground of infidelity. In the newspaper accounts of
the divorce which Miss S- — had read there were
some more or less definite charges of cruelty.
These were the facts that had caused the patient

iHer desire for a rich marriage was partljr the result of her
experience with her rich employer. The foreigner was a suhstl*
tuie for him.

492 MORBID FEAES AND COMPULSIONS

to exaggerate the significance of a divorce having

oocnrred in Mr. D 's family and to persuade

herself that he might be craeL Her wish for
wealth was the motive. If she could make herself
believe that the objections to the foreigner also ap-
plied to Mr. D y then there would be that mneh

less reason for not taking the one who had the most
money. Dirt is often a symbol for money and this
may have had something to do with her resistance

to marrying Mr. D , which she rationalized by

saying that sexuality is dirty. It was really the at-
traction of dirt — ^filthy lucre — ^from another quar-
ter which was the source of this resistance.^

In the light of all this the meaning of her dream
is evident. To marry the rich foreigner would
be to make of herself a sort of prostitute — Whence
her identification with the white slave mistress
of the rich Chinaman. The dream shows that
Miss S had decided to give up the idea of ob-
taining wealth in this way.

After the dream, Miss S went on to explain

that Mr. D had begun to pay her attentions,

and she to like him, before she met the foreigner.'
But when she did meet him, and began to believe
that all his wealth would be at her disposal if she
wanted it, she commenced to repress her interest

1 The dream about the bird which seemed to be connected with
thoughts about the young couple next door and which marked a
relaxation of her resistances must be connected with an idea
gained by watching the young people that one could be happy
without wealth.

2 The foreigner was 40 years of age— one of her alleged objec-
tions to Mr. Densmore was that he was too young — ^'a mere boy^"
though he was eight years older than she.

AN ANXIETY HYSTERIA 493

in Densmore^ and to try to like the foreigner,
without however meeting with entire success in
either direction. Then she made up her mind that
she would not attempt to decide the matter either
way, but that instead, she would go to parties and
dances as much as she could, in the hope that she
might meet some new man who on the one hand
would be as rich as the foreigner and on the other
as lovable as Densmore. But at this point came
the outbreak of the neurosis. It was a sort of re-
sultant of all these conflicting forces. On the one
hand it interfered with the social activities she
had planned and thus served to keep her faithful
to Mr. Densmore. On the other, it kept her from
seeing so much of him that she would become
deeply enough in love to renounce the money, and
in like manner it kept her from seeing much of
the foreigner.

Her morbid fear that if she went out alone she
would **fall'' (in a faint, etc.) which, as we know,
came on shortly after her reading about white
slavery in the papers, is really connected in a
more intimate way with the idea of white slavery.
If she married the foreigner merely for his money
she would in a certain sense fall. Her act would
be a form of prostitution and she a white slave.
On the other hand, if she married Mr. Densmore
she might regard herself as being a white slave
in quite another sense — ^that is she might have to
work harder than was to her liking. We now
see that these matters were dealt with in the
dream of King James II. Her running away
from the fat man who ordered her around referred

494 MORBID FEARS AND COMPULSIONS

on the one hand to her wish not to have to work
(as the wife of Mr. Densmore) and on the other
to her impulse to escape from the wealthy man
(the foreigner who was concealed behind her em-
ployer) because she did not like him as a husband*

After the analysis of this dream the patient
improved with great rapidity. She seemed now to
understand what her illness meant, and felt confi-
dent that she would soon be welL Of her own su^
cord she came to my office alone, and she experi-
enced no fear or other unpleasant symptoms on
the way. At last, she told me of a plan she had
devised to get Mr. Densmore to renew his atten-
tions— she had not been seeing him for some
time, for he apparently had given her up in de-
spair— and at the same time announced that she
did not feel it necessary that she should come to
me any more. I saw her a month later and she
reported that Mr. Densmore had promptly re-
sponded to her scheme and that she was having
a most delightful time with him. She felt that
she loved him and that everything would be welL
I saw her a few other times at long intervals and
each time she reported herself to be in the best
health and spirits. She married Mr. Densmore a
year or more after the completion of the analysis,
and when I last heard from her, she was well and
happy.

For the sake of completeness, I might add that
my experience with later and more deeply an-
alyzed cases indicates that morbid fears of attacks
of unconsciousness — ^fainting, epilepsy, etc. — ^have
reference to a period of bed-wetting in the child-

AN ANXIETY HYSTERIA 495

hood of the patient and possess as one of their old-
est and deepest roots a certain urethral-erotio
tendency and the corresponding unconscious fan-
tasies. Though this was not definitely worked out
in the case of Miss Sunderland, considerable of the
material brought out in her analysis (not all of
which I have reported) strongly suggests that
such was one of the determinants of her symp-
toms, e. g. her dream of urinating on the ground,
the history of bed-wetting, her notion that the sex
relations are dirty, etc.

The only state of unconsciousness and irrespon-
sibility which children know about is that of sleep,
and it must be a rather impressive experience for
them to find that a condition is possible in which
they do, without knowing about it and without
being held very much to blame, a thing which if
done voluntarily and in the conscious state would
win them severe punishment. It is not surprising
then that in later years when there break out con-
flicts with wishes which, if acted upon voluntarily
would expose the individual to social censure or
punishment or to the misery of self reproach,
there should arise a wish (or fear) of sleep-like
states in which the repressed desires could be con-
ceived of as being involuntarilj/ fulfilled.

Furthermore, the teasing and ridicule over not
having control of their sphincters, and the occa-
sionally none too tolerant attitude of the parents,
have, in certain cases, the effect of laying the
foundation f 6r a feeling of inferiority and sensi-
tiveness which may persist throughout the indi-
vidual's life and forever act as an inhibition upon
the normal expression of the sexual activities.

CHAPTER X

THB THBOBY AND ME0HANI8M OF THB
PSYOHOANAIiYTIO CI7BB

IF the reader has closely followed the preoed-
ing chapters, he may complain, on having
finished them, that certain of the items set
forth in the discussion of theory were not brought
out concretely by the two case reports which have
been given. These cases did not, for instance,
demonstrate the infantile factors to be as impor-
tant as perhaps he had been led to expect, nor did
they show beyond all peradventure the neurosis to
be the negative of the perversion. The matter of
transf erejace, though it came up, apparently did
not play the dominant role which the reader might
have been prepared to find it occupying.

Such complaints would not be unjust, for, as
I am well aware, the reports I have given do
possess these defects, as well as other similar
ones. On the other hand the fact that I have
chosen them for reporting is not without justifica-
tion. As I originally planned this book, I had in-
tended that the last chapter should consist of a
report of a case so completely analyzed as fully
to illustrate all the points raised in discussing the
theoretical aspects of the neuroses. I thought by
this means to make up for the defects of the two
earlier cases, which I had felt would serve an XBr

496

CATHARTIC METHOD 497

troductory function better than others more elab-
orately analyzed. But I know now, from having
failed at it^ that I had set myself an impossible
task. That is to say, my later and better analyzed
cases, which gave full illustration of the theories
here set forth, represented such an enormous mass
of intricate and almost endless detail that, without
destroying their scientific value, I could not com-
press any one of them into a narrative short
enough to be included within this volume. I
therefore decided to complete this book with a
chapter on the theory of the psychoanalytic treat-
ment and to endeavor to make up for the fact that
my two cases here reported fail to fulfill all that
might be desired of them as illustrative material
by writing a supplementary volume which would
be devoted to a single detailed case report* For,
as a matter of fact, the full report of any case
which is completely analyzed deserves a volume
by itself and cannot be accurately presented by
anything short of it.

In the twenty-five years that have elapsed since
Breuer and Freud published their first paper on
hysteria, the theory and technique of psychoanaly-
tic treatment have passed through a number of
evolutionary changes. The method had its be-
ginning in 1880 when, in studying the case of an
hysterical girl, Breaer found that the symptoms
of her malady vanished when she could be made
to remember in full detail the situations and as-
sociative connections under which they first ap-
peared. When ten years later Breuer and Freud
together took up the investigation, which in the

498 MOBBID FEAES AND COMPULSIONS

meantime had been neglected, there was developed
the so-called cathartic method of treatment.
They came to the condnsion that certain patho-
logical experiences, to which the patients had in-
adequately reacted, played the role of psychic trau-
mata, causing the neurotic symptoms analogously
to the physical traumata which Charcot had re>
garded as causative for hysterical paralysis. The
technique of the treatment then was to restore to
the patient, by means of hypnosis, a perfect mem-
ory of these pathogenic experiences and of the set-
ting in which the symptoms first appeared, afford-
ing in this way free discharge to the previously
strangulated affects. (Abreaction.)

After a time Freud abandoned hypnosis as a
means for filling out the gaps in the patient's
memory, and adopted instead the method of free
association. The patient was asked to concen-
trate his mind on some given symptom or on some
point where his memory of connections or of
events was obviously incomplete, and then to re-
late all the thoughts that came to him. The phy-
sician sought to divine from the associations thus
produced the missing material that the patient
was unable to remember. The resistances which
had kept this material unconscious and prevented
recall were then to be circumvented by the phy-
sician's imparting to the patient the reconstruc-
tion derived from the study of the associations.
Abreaction, upon which so much emphasis had
been laid earlier, now retired from the foreground
and its place seemed to be taken by the expendi-
ture of energy required of the patient in resisting

PBESENT TECHNIQUE 499

the censorship over his incoming associations.
The doctrine of complexes came into vogue, and
the physician bent his energies to figuring out
what complexes were behind each given symptom
and describing them to the patient as soon as the
discovery was made.

Then came a further change which brought
the technique into the form which is in use to-day.
The physician no longer concentrated upon the
symptoms themselves or strove to discover and as
soon as possible to impart to the patient a correct
interpretation of them. Instead of making an
attack upon some definite manifestation of the
disorder, the physician now assumed a more pass-
ive and expectant attitude, and, directing the pa-
tient to talk about whatever came to his mind,
waited for him to unfold his personality to view
without being concerned as to what manner and
what order the different constituents took in mak-
ing their appearance. Instead of using the inter-
pretation of free associations, dreams, etc., as a
means of getting hold of the submerged psychic
material and dragging it to the surface while the
resistances were still in force, these procedures
were principally employed in attacking the resist-
ances themselves, which were interpreted and ex-
plained to the patient so that through understand-
ing they might be overcome. For it was found
that when, through successive interpretations, the
resistances were worn away, the patient was then
able, spontaneously and without effort, to recall
and relate the forgotten situations, phantasies,
wishes, connections and so on which were re-

500 MORBID FEARS AND COMPULSIONS

quired for a complete picture of the ensemble of
factors, conscious and unconscious, which had to
do with the development and continuance of the
disease.

As soon as the resistances became the first con-
sideration in the technique, the transference,
which is the source of the most stubborn and baf-
fling of all resistance, became one of the most im-
portant problems.

The essential goals of these various techniques
have remained the same from the start; on the
one hand the overcoming of the repression resist-
ances, on the other the filling out of the gaps of
memory, the bringing into consciousness of the
pathogenic material from the unconscious. «

In thinking this over we come upon one of the
most interesting and yet most baffling questions
that analysis has yet presented. Why is it that
when the resistances are overcome and the mem-
ory gaps filled out, the patient is then wellf How
does this cure himf

That a person can be cured in this way is in-
deed a remarkable fact. It is by no means self-
evident why the overcoming of repressions or the
filling out of gaps of memory should render a
sick person well. In fact ** common sense*' would
perhaps tell us that at least the latter feature (the
filling out of gaps of memory, the bringing up of
all sorts of unpleasant recollections out of the
past) should tend rather to make him worse.
Indeed the psychoanalytic cure seems to be with-
out parallel in human experience. How are we to
explain itt

EXPLANATION OF CUBE 501

As a matter of f act, a completely adequate ex-
planation has yet to be formulated. Most psy-
choanalytic writers have made no very serious
attempts to account for the results of analysis.
Freud himself has said comparatively little about
the question. The explanations of the cure which
have been given amount to little more than say-
ing: ''It is the understanding of himself which
the patient gains through the analysis which cures
him'* or *'when the previously unconscious patho-
genic trends are rendered conscious, the patient
is then in a position so to dispose of them that
they no longer work pathogenically.*' These ex-
planations are perhaps correct enough as far as
they go, but they by no means tell the whole story.
Why^ for instance, should the understanding of
himself, which the patient gains in the analysis,
have the effect of curing himf

To tell the truth, it seems to me that -in the pres-
ent state of our knowledge the analytic cure can-
not be fully explained. The only explanations
that can at present be advanced involve items
which themselves require explaining, or give rise
to questions which as yet no one is fidly prepared
to answer. On the other hand the cure which
results from analysis is no absolute mystery.
We can go a certain and perhaps a considerable
distance toward explaining it — ^further, possibly,
than any one has made any effort to go, for, as it
seems to me, the question of why analysis does
cure is one which, on the whole, has been rather
neglected by psychoanalytic writers.

The explanation I should like to offer is some-

502 MORBID FEAES AND COMPULSIONS

what more elaborate than those nsnally given
thongh I cannot claim that it adds anything really
new to thenL In attempting to set it forth I wish,
first of all, to emphasize, and to ask the reader to
bear in mind thronghont, that, in point of view of
effect, the overcoming of resistance and the filling
oat of gaps of memory are identical, or at least
inseparable. The filling out of memory gaps re-
qnires the overcoming of resistances; the over-
coming of resistance requires gaps of memory to
be fiUed out. The two processes go hand in hand;
each is a part of the other. This fact of the con-
fluence or basic continuity between what, at first
glance, seem to be two essentially different proc-
esses gives, it seems to me, the indication of the
direction which any adequate attempts to explain
the psychoanalytic cure must at first take.

Let us look at the problem first from its dyna-
mic side, namely, Why is it that a cure is brought
about through the overcoming of resistances f A
partial answer to this question may be given by
way of an analogy. It need hardly be said that
the state of a man having strong and continually
unfulfilled wishes and no prospect of fulfilling
them may, without the introduction of any addi-
tional factor, be one of considerable unhappinesa.
The constant tension of desires unsatisfied is in
itself a source of pain. For instance, a man serv-
ing a term of life imprisonment is ordinarily a
very unhappy person, yet, save for the actual
physical discomforts of prison life (which cer-
tainly in most instances are not nearly so great as
those which a soldier in the trenches bears very

NEUROTIC UNHAPPINESS 503

cheerfully) he has not much to worry him except
his unfulfilled wishes. His unhappiness results
for the most part we would say from his ^^lack of
freedom.'* Almost everything he would like to
do he cannot do. Nearly every wish he has must
forever remain unsatisfied. And as is well known
there results in a certain number of cases not only
a state of great unrest and unhappiness, but of
actual mental illness, the prison psychoses and
other disturbances. In fact some of these condi-
tions, much like the neurosis, represent an effort
to ameliorate the unbearable state of tension from
the non-fulfillment of all wishes by supplying a
phantastic fulfillment — ^the delusion of a pardon
and other psychotic wish-fulfillment formations.
Now the unhappiness, the suffering, the sense of
being ill, which the neurotic suffers is in many re-
spects analogous in origin to the unhappiness of
a man in prison. A part of it corresponds to the
pain of desires ungratified ; the constant tensions
of longings unassuaged. A part of it, too, corre-
sponds to a sense of guilt, which of course may be
a factor in the unhappiness of the prisoner in con-
finement. And though I have had no opportunity
to study prison inmates, I am very much disposed
to think that a sense of guilt is a much larger com-
ponent in the misery which the scrupulously
moral neurotic suffers, than in the unhappiness of
the incarcerated criminal. For the one has a con-
science which in many cases is over acute while
the conscience of the other is as a rule subnormal.
The one does not have to violate any important
moral law in order to feel guilty, while the

504 MORBID FEAES AND COMPULSIONS

other may violate almost any law without re-
proaching himself at all, providing he escapes
punishment.

But while in the case of the prisoner the re-
straints responsible for the pain of many wishes
chronically unfulfilled are physical and external
oneSy those restraints which have the similar ef-
fect in the neurotic are endogenous and psychic
ones. The prisoner may straggle against bolts,
bars and chains, but the struggle of the neurotic
is against himself. His prison is his own mind,
he was condemned by his own laws and sentenced
on his own judgment; he himself is his own
keeper. He has therefore not only the miseries
that are much the same in origin as those suffered
by a person in prison (the pain of unsatisfied
wishes and the torment of a sense of guilt) ^ but
others more difficult to factor which arise from
the circumstance that the restraining forces are
psychic and a part of himself. Morbid fear, in
part at least, belongs to that category.

Now the codes according to which the neurotic
was sentenced and the psychic bars by which he is
confined are none other than the resistances which
the analysis overcomes. The analysis renders
him free to fulfill his wishes — ^not that, except to a
limited extent, he then fulfills them in their orig-
inal form, for the analysis does not confer license;
the patient still has to adapt himself to reality, to

iThe flense of guilt which may he a large contrihutor to the
neurotic's misery is by no means invariably perceiTed by him as
guilt. More often it is so subject to displacement or distortion as
to be regarded hy him as some other sort of unpleasant feeling.

OEIGIN OF EESISTANCES 505

the demands of civilized existence. Bather the
analysis makes practical the establishing of a
TninJTnnTn of non-fulfilled wishes and a maxi-
mum of wish fulfillment by making it possible for
the patient to satisfy by way of sublimation many
wishes of such a nature that previously they could
only be expressed in symptoms. In this sense the
overcoming of resistances releases him ; he is now
free to gratify in suitable manner a great number
of wishes that previously were relatively unful-
filled. To some extent the analytic cure is then
analogous to the relief which a prisoner expe-
riences if he is declared innocent and let out of
prison. There is done away with the constant
urge of unsatisfied wish tensions^ the torments of
guilty conscience (if that had been an element in
the case) and in addition that less easily defined
factor which depends on the fact that the individ-
ual's struggle for freedom was against himself.
But such an explanation as this tells only a part
of the story and gives a very inadequate picture
of what really takes place in the analytic cure.
We must go into the matter further.

Let us now ask what are the resistances which
the analysis overcomes. How are they consti-
tuted? What is their origin!

After a fashion we have answered these ques-
tions in earlier chapters. The resistances belong
in the main to the higher psychic systems, espe-
cially to the foreconscious. In general they are
trends which have an inhibiting, a repressing ef-
fect upon the primary tendencies of the individual,
the instinctive and infantile, or, in other words.

I

506 MORBID FEAES AND COMPULSIONS

upon the nnconscioos. Furthermore they cor-
respond to that in the personality which is ac-
quired rather than to that which is innate^—
they are the result of experience, of environmental
influence, of training, even though to some extent
their energy may be in part derived from primary
tendencies that have been added to or modified by
influences to which the individual was subject in
the course of development. The resistances in-
clude many, if not all, of those f unctionings which
we would set down to conscience. But the point
to be remembered is that they are acquired, the
result of experience.

It may well be of service to look at these resis-
tances from a different angle from the one to
which we have become accustomed. All organized
responses that can be called forth in both man and
animal, declare the behaviorists, fall under one
or the other of two headings, instincts (including
here the simplest forms of reflexes) and habits.'
Both instinct and habit are analyzable into sim-
ple congenital reflexes. Instinct is defined by the
behaviorists as ^^a complex system of reflexes
which function in serial order when the organism
is confronted by certain stimuli.'' In exactly the
same terms do they define habit. '^ After habits
are perfected they function in all particulars as
do instincts.'' The only essential difference be-

1 This must be accepted only as a general statement to which
there are many exceptions. Some of the transference resistances
with which one has to deal in the analysis may belong more to
the instinctive or infantile part of the personality than to that
part which comes from training. •

s J. B. Watson: Behavior, Chap. VI.

OBIGIN OF EESISTANOES 507

tween habit and instinct is, then, that of origin.^
In instinct the ^^ pattern" (the nmnber and local-
ization of the different reflex arcs involved) and
the ** order'' (the temporal relations of the nn-
folding of the elements of the pattern) are in-
herited, while in the case of habit both pattern
and order are acquired during the lifetime of the
individual All organized behavior, whether it
be ** explicit'' (action) or *^ implicit" (thought or
feeling) is then from the behaviorist's point of
view, the expression either of habit, of instinct or
of the two combined.

Some of the important Freudian concepts are
quite readily translatable into behavioristic terms.
The unconscious (i. e. that which is primary in the
personality, the instinctive and infantile) em-
braces the same functioning^ which the behavior-
ist calls 'instinct." Likewise that which is ac-
quired, and which controls and supplements in-
stincts and is called ^' habit " by the behaviorist, is
about the same as that which psychoanalysis con-
ceives of as belonging to the higher psychic sys-
tems, especially to the foreconscious. Even
though the correspondence between the "habit"
of the behaviorists and the foreconscious of Freud

iL. e. That which the behavioriits and which Freud would
call Instinctiye is about the aame. Freud, however, uses the term
instiiict as the heading for large groups of tendencies, while the
term impalse or wish applies to the subdiTisions of the group.
The behaviorists would call instinctive these or even finer sub-
divisions. I trust it is dear that the term habit as here employed
has a much broader meaning than is given to it when in common
speech we speak of a cigarette habit or the habit of twiddling
one's thumbs.

^»

508 MORBID FEABS AND COMPULSIONS

is not absolutely perfect, yet for practical pur-
poses they may be thought of as identical.

This being the case, it is not difficult to see that
what we are accustomed to call a ** resistance "
might, in most cases at least, be called a habit. At
least this is true of all resistances, all repressions,
that are acquired by the individual, and not innate.
Even some of those resistances which have an
hereditary basis can be regarded as instinct modi-
fied or reenforced by habit.^ All the repression
or inhibitions which the individual develops be-
cause of training, everything in conscience which
is acquired, can just as well be regarded as an ex-
pression of habit as of the f oreconscious or of the
libido.

Let us ask ourselves what is the significance of
habit, with the intention of thereby enriching our
understanding of what is meant by resistance.
We may answer this question by considering an
example of habit. Young retriever dogs, when
first taken hunting, will in many instances chew
the birds they are to retrieve to such an extent as
to spoil them. A way to train a dog not to do
this is to make him retrieve repeatedly a dead
bird or a ball which has been thrust full of pins.

iThe term ''complex" does not quite coincide either with in-
stinet or with habii. Most complexes have an instinctiye basis
to which are added the effects of experience or training. Minor
complexes are perhaps pure habits but the major ones have both
instinctive and habitual constituents. Also, habit participates in
the forming of fixations of instinct, and the infantile fixations
though really representing the effect of experience upon instinct
are considered from the psydioanalytic standpoint as belongimg
to the unconsdoufl.

4

SIGNIFICANCE OF HABIT 509

After the dog has pricked his month a few times
by shutting down upon such an object, he learns
to carry it so gently that in spite of the pins he
will not hurt himself. He can then be trusted
to carry with equal gentleness the game which the
hunter shoots. A habit has been established by
the use of pins which remains in force and in-
hibits the dog's original tendency to mouthe the
birds while retrieving them. Because of this
habit he now carries the game m if it contained
pins.

Now this latter fact about the habit is an im-
portant one. The behaviorist seeks to formulate
an individual's reactions in terms of external
objects or conditions, of which the behavior is said
to be a ^ ^function." Thus he asks concerning the
animal or person to be studied, **What is he do-
ing?" and the reply is supposed to be made in
terms of immediate external circumstance. But
in the case of a dog whose original tendency was '
to mouthe game, but who now, after the sort of
training just described, carries it gently, the ques-
tion ^^What is he doing f" cannot be completely
answered by the statement '^He is retrieving a
bird." For such an answer quite obviously does
not tell the whole story. He is retrieving a bird
in a (for him) special manner, namely, as if it
contained pins. His behavior is a function of
something more than the bird he at the moment
holds in his mouth. It is partly determined by
past experience, without which he would be still
mouthing the game. In other words, we cannot
adequately formulate his behavior, when this

510 MORBID FEARS AND COMPULSIONS

habit is involved, if we employ terms only of tiie
present To make an adequate picture of the
significance of the habit requires us to draw in it
phantoms of past pins.

Now much the same thing applies to habits gen-
erally.^ Their significance cannot be expressed
without historical references. The question
'^What is he doingf " cannot, when it is a case of
habit, be answered satisfactorily without bring-
ing in terms of the past experiences which jwere
instrumental in integrating the reflexes which
constitute the habit. In short, in those responses
of an individual which belong to habit, he is be-
having very much as if he were stiU surrounded
by those same external circumstances to which the
actions which eventually became habitual were
originally an adaptation^ .

The Bible says: ** Train up a child in the way
he should go and when he is old he will not depart
from if This is the equivalent of saying:
'^Devise a system of rewards and punishments,
of praise and blame, which will lead your child to
react for a period in the wa3rs that seem to you
best, and these ways of reacting will eventually
become habits which he will retain throughout his
life. In other words he will, even after you are
dead and buried, continue to act, to feel and to
think in response to certain stimuli, AS IF you
were stUl watching over him; AS IP your orig-

1 Naturally I am tMnking in this connection only of acnaori
motor habits — not of the sort which depend on some artiflctally
produced changes in the chemistry of the body such aa oeeor with
the morphine or tobacco habit.

SIGNIFICANCE OP HABIT 511

incU system of rewards and punishments were
still in force.^ To be sure he will soon cease to
interpret his own behavior in any snch light.
When the habits that yon instilled function in his
adult life, he will very likely rationalize his ac-
tions, thoughts or feelings by saying for instance
that now he has become a man, he sees that his
parents were ** right'* in their training of him or
that he believes or behaves in this or that way
because one ** ought to" or because his ** con-
science prompts it/' But the whole business is
but the manifestation of habit, or instinct plus
habit.*

iMany parents have been grievously disappointed to find that*
after they have devoted themselves assiduously to training up a
child "in the way he should go," he departed from it with the
greatest dispatch as soon as he left the parental fireside or ceased
greatly to fear parental punishment. But this by no means
alters the fact that the biblical statement expresses a perfectly
correct general principle, and one which holds good to an even
greater extent than superficial observation would consider pos*-
sible. The general principle is that the effects of training tend
to be permanent, whether they be in the direction of the way the
child should go, or of the way he should not go. Many of the
parental disappointments of the sort described depend upon the
fact that the efforts that were made to train the child in the way
he should go were really training him in very different directions,
for example, to react with feelings of hate, rebellion and sus-
picion to all stimuli that would come under the head of "au-
thority."

si know very well how difficult it is for one to recognize in
himself the ftmctioning of deeply ingrained habits or instincto-
habits for what they really are. The more fully a given response
is the product of habit, or of habit grafted on an instinct, the
more likely, generally speaking, is the individual to rationalize
it into something else and thus to believe sincerely that he is
acting in this or that way because it is "right" to do so, or for
some similar reason. The people of this country, for instance.

514 MORBID FEARS AND COMPULSIONS

iiig off stimuli. The question, What is he daingf
when acquired organized responses are involved
(habit or resistance) cannot be fuUy answered
without reciting the history of the experiences
which produced the integraiums now functionat-
ing.

Now in the case of the dog in whom there has
been bnilt np, by the use of pins, a habit or re-
sistance which inhibits his original tendency to
monthe game, we can describe his behavior in
objective terminology by introducing the words
as if. We take account of his habit and its his-
tory by saying that he now retrieves game as if
he were trying to avoid getting his mouth hurt
A step beyond this, which would bring us nearer
to the psychoanalytic way of looking at thingps,
would be to say he was behaving as if he thought
the game contained pins, as if he desired to avoid
getting his mouth hurt.^ In answering the ques-
tion. What is he doing t we have now introduced
the concepts of thinking, of wishing and of ideas.
Now the psychoanalytic way of answering such
questions goes still further than that just indi-
cated. In matters of human behavior which in-
volve the functionating of a habit, or a resistance,
the answer runs not *^ as if he thought^' nor as if
he wished'' so and so, but rather ** he does think
it, he does desire it," but in the main '' uncon-
sciously/' And this is not purely conceptional
nor merely a convenient way of describing. As

1 This way of expressing the facts Is quite permissible eren
though we may know that the dog is incapable of "thinking,"
in any ordinary human sense, anything of the kind.

SIGNIFICANCE OF RESISTANCE 515

onr previous chapters have indicated, the assumed
unconscious thinking or wishing can with all rea-
sonable certitude be demonstrated to have existed,
even though the evidence is not wholly direct.
The history of the past experiences which first
called forth the responses which eventually be-
came integrated as habit or resistance is pre-
served as memory traces in the mind of the indi-
vidual Some of these records are foreconscious
and subject to voluntary recall ; others are uncon-
scious and can be reproduced only in the course
of an analysis. But the point is, that there is
contained in the individuaPs own mind that same
historical material which, as we have said, is re-
quired to express the full significance of any item
of acquired organized behavior — ^action, thought,
or feeling.

It is now to be seen that we have stumbled upon
an answer to the questions from which we set out.
The filling out of gaps of memory is nothing else
than a process of bringing to the surface the his-
torical records of the experiences instrumental in
integrating the systems of habits or resistances
which are now functionating. It supplies the pa<
tient with the data which are required for him to
see the whole meaning of his present behavior,
implicit and explicit. It shows him what he is
doing, in the fullest possible sense. We have said
that when acquired integrations are functionating
the behavior of the individual is the same as if
there were still present the original conditions
which first called forth these responses. He is
reacting as if surrounded by phantoms of the past.

516 MORBID FEAES AND COMPULSIONS '^

though this he himself does not recognize. The
filling out of the gaps of memory which takes
place in the analysis allows him to see this, and
to appreciate the significance of that part of his
present acting, feeling or thinking for which hahit
is responsible. This, apparently, is what cares
him. The reducing of acquired integrations to
the terms of the original experiences frees the
individual from their automaticity and enables
him to adapt to the facts of the present instead,
as previously, to phantoms of the past. When he
knows in full detail what he really is doing, then
he can do otherwise if his inner needs and ex-
ternal circumstances demand it. Habit, write
Dewey and Tufts,* is a stage "of unconscious ac-
tivity along the lines set previous action. Con-
sciousness thus ^ occupies a curious middle ground
between hereditary reflex and automatic activities
upon the one hand and acquired habitual activi-
ties on the other.'* Where the original equip-
ment of instincts fails to meet some new situation,
when there are stimulations for which the system
has no ready-made response, consciousness ap-
pears. It selects from the various responses those
which suit the purpose, and when these responses
have become themselves automatic, habitual, con-
sciousness 'betakes itself elsewhere to points
where habitual accommodatory movements are as
yet wanting and needed.' To apply this to the
moral development we need only to add that this

1 Dewey and Tufts: Ethici» page 9.
sAngell: Peycfaology, page 69.

OVEECOMINO EESISTANCES 517

process repeats itself over and over.'' The
analysis is exactly the reverse of this. By it,
consdonsness, which had '^betaken itself else-
where'' is brought back to the points at which
'^responses which have become themselves auto-
matiCy habitual" had origin; the individual is al-
lowed to deliberate, to value, to choose anew.
New, better, more intelligent ways of reacting to
present situations are thus opened up to him to
replace those in his repertoire of ready-made
automatic responses, which, because they were
integrated when his intellect had not yet reached
its maturity, and when his capacities for analyz-
ing and choosing were especially limited, do not
fully utilize his adaptive possibilities or allow him
to put forth his actual best

The overcoming of resistances, as was indicated
in the beginning, is inseparable from and almost
identical with the filling out of the gaps of mem-
ory. The resistances, which maintain the repres-
sion against which the instinctive forces struggle,
exist as it were in layers. The first resistances
that present themselves in the analysis are over-
come by explaining them; by filling out what is
missing from the patient's consciousness to give
him a full view of their significance ; in short, by
showing the patient what he really is doing when
they act. In the breaking up of resistances the
personal association of the patient with the phy-
sician plays an important part. The role of the
analyst, as Ferenczi says, is that of ''a catalytic
ferment that temporarily attracts to itself the af-

518 MORBID FEAES AND COMPULSIONS

fects split off by the dissection/' ^ With one re-
sistanee, or one layer of resistances, out of the
way there becomes accessible new historical ma-
terial which is serviceable for filling out the gaps
of memory that will lead the patient to an under-
standing of the next. Eventually, if this process
is continued far enough, the purely instinctive
and infantile levels are reached. Then with his
unnecessary internal inhibitions dissolved the pa-
tient can make the adaptations that shall give him
a maximum of wish-fulfilhnent, and do away with
the damming up of the libido, without at the same
time overstepping the requirements for a moral
and socially commendable life. Morality and
wishf ulfillment are both easy and compatible when
one's problems are simplified by the elimination
of unreality and reduced solely to the question of
adaptation to external facts.

In order that we be perfectly clear about all this
it may be well to make some concrete applications.
The orthodox Jew reacts negatively to hanu If
he were compelled to eat it by force, he would
doubtless be able to swallow ham but not however
without some slight feeling of shrinking or of
guilt. Such a reaction is not instinctive, but the
result of training, of earlier experience. In other
words it is the expression of a habit. But in per-
haps most cases, the individual himself would not
spontaneously recognize this. If he were asked

iFerencd, ''CkmtribotioiiB to PsyclioaiialyBifly'' p. 84. He eon-
tinuee^ "In a technically correct psycho-analyais the bond thus
formed is only a loose one, the interest of the patient being led
back as soon as possible to its original, oovered-over aonrcsa and
brought into permanent oonneetion with them."

EXAMPLE OF HABIT 519

why he so reacted to ham, he would say it is be-
cause ham is Trafe and it is a sin to eat it. But
this would be attempting to formulate his be-
havior in terms only of the present, which is quite
inadequate to express the full significance of the
habit which is functionating. He would not know
what he was doing in any full sense of the phrase.

But I have been told by certain Jews who were
orthodox as children but later abandoned their old
religion in favor of some other, or no religion at
all, that their first attempts to eat ham were at-
tended by considerable feelings of aversion, and
a vague sense of guilt, and this despite the fact
that they were fully convinced that ham is a per-
fectly wholesome food, and that there was no rea-
son at all why they should not eat it. In this
case the habit was left functionating in a state of
greater or less isolation by the individual's per-
sonality having passed on to newer developmental
phases. But these men, however, knew something
more of what the reaction meant (of what they
were doing) than was true in the first cases.
They would have said themselves: "I feel this
way because of my bringing up. It is a matter
of habit or training which I have not yet over-
come.'* But this knowledge would not go very
far toward breaking up the integration. The
history of the integration would still be incom-
plete.

Now these particular Jews that I have in mind
did eventually overcome their habit of reacting
negatively to ham by the simple process of con-
tinuing to eat it. They never knew precisely

520 MOBBID FEABS AND COMPULSIONS

what were the original experiences which caused
the habit to be integrated. But I can very well
imagine that there are other cases where in spite
of the individual's being convinced intellectually
that ham is something altogether desirable to eat,
and in spite of his wishing to eat it, the old habit
was not overcome, but continued to function in-
definitely. Now an enormous number of habits
we once have possessed have spontaneously ceased
to function when, as we grow older, they ceased
to serve any adaptive purpose. Were this not the
case we would never be able to adapt ourselves to
any later environment that was not almost identi-
cal with that in which we grew up. But other
habits in many persons persist long after they
have outlived their usefulness, and when instead
of being of advantage to the individual they are
of great disadvantage both in themselves and by
way of interfering with his making the new
adaptations that nught readily come, once these
old integrations were out of the way. Such is
the case with the neurotic He has been unable
to shake off the old habits of childhood in favor of
the new ones that would adapt him to adult life.
In this case the analysis may intervene, and by
breaking up the old integrations for him, allow
him to express his instinctive energies in the man-
ner best adapted to the requirements of his par-
ticular place in life.

If in the case of a Jew who continues the habit
of reacting negatively to ham after he had aban-
doned his religion and really desired to eat ham, it
should become highly essential that the habit be

UNCONSCIOUS MEMOEIES 521

overcome artificially, he would have to be made
to recall the actual experiences of his childhood
which had brought the habit into existence, to
be shown, in other words, what he was doing.
When these memories were recalled, the uncon-
scious elements belonging to the habit rendered
conscious, he would then perhaps see that his reac-
tion was only to a most limited extent a function of
what ham is actually, but perhaps much more so
a function, let us say, of his father — ^L e. that what
originally caused him to avoid those things called
Traf e was that he was scolded and punished by
his father when he did not.^ When then he could
see clearly that his negative reaction to ham was
really conditioned by an unconscious, but still
operative, fear of punishment from his father, it
would without doubt cease.'

In the case of this habit, as that of any item of
acquired organized behavior, the reaction of the
individual represents a precipitate from certain
past situations and experiences which continue to
live as present ones in his unconscious memories.
While these memories remain unconscious, his
response to such present situations as contain
stimuli for the constellation is for the most part
a blind, unreasoned and automatic one. In other
words, responses which come from habit do not
take advantage of the possibilities for other and

^ Of oourse the history of the hute^ratioii of the habit could not
be as simple as this, but what I have said is suiBdent for our
immediate purposes.

sThis fear belongs to the foreoonscious rather than to the
unoonsoioua proper.

522 MOBBID PEABS AND COMPULSIONS

perhaps more suitable and intelligent responses
offered by the increases in knowledge, experience
and intellectual development which have taken
place in the individual subsequent to the time the
habit was formed. Habit is static, unprogressive,
retardative. But by bringing the unconscious
memories to consciousness, by showing the incU-
vidual in full exactly what he is doing, there is
quite understandably restored to him adaptative
flexibility and the opportunity to exchange the
automatic habitual response for action from re-
flection and deliberation, which shall eliminate
unreality and take advantage of whatever he has
gained from maturity and increased knowledge
and experience in the period succeeding the for-
mation of the habit. We miss the full significance
of this discussion of habit unless we keep con-
tinually in mind that there are habits of thought
and feeling just as well as habits of conduct

I will now attempt to illustrate some of our
earlier points by reference to the analysis of a
particular case, drawing meanwhile some par-
allels between it and the problems suggested by the
matter of the Jews' reaction to ham.

A man came to me suffering from a mild neuro-
sis. He had, as he expressed it, lost confidence in
himself. A feeling of uncertainty attended
everything he did ; for instance he coiQd no longer
feel satisfied that his judgment of business mat-
ters was correct. He was continually apprehen-
sive of making mistakes that would have some
sort of serious consequences. He could not do his
work either with the ease or with the enthusiasm

A CASE OF INHIBITION 523

he had had formerly. In addition to this he felt
somewhat depressed the greater part of the time.
Everything seemed to have lost interest for him.
He could not enjoy himself at the theater, in read-
ing or in any of the other recreations he had pre-
viously cared about. His trouble, though not a
serious one, was very unpleasant and hampering
and he had been unable to shake it off.

He very soon said that he himself had felt that
his difficulties were somehow connected with the
sexual problem. His symptoms had come on
gradually toward the end of the first year after
his marriage. He frankly admitted that his home
life was not in just the state he thought it should
be. Not that there was any open friction between
him and his wife, or that he had any just reason
for complaining of anything in her attitude
toward him. She was a very beautiful, intelli-
gent, refined and good tempered woman, who, he
felt, should make an ideal wife and completely
satisfy him. Nevertheless he was not content.
He admired and respected her enormously, and
had for her a very deep affection. On the other
hand she did not, as he expressed it, appeal to
him in a ** physical way." In spite of her per-
sonal beauty he felt little passion towards her and
their sexual relations gave him none of the full
sense of gratification and enjoyment that he had
known in his premarital experiences with other
womeiL Why this should be he could not un-
derstand. He had sometimes told himself that if
his wife were more passionate he would enjoy
himself better, yet at the same time he had to

524 MOBBID FEABS AND COMPXJLSIONS

acknowledge that on the one hand she was far
from f rigid, and on the other that in his premar-
ital affairs he had experienced full enjoyment
with women who showed even less signs of pas-
sion than she. Bnt at any rate, and, as it seemed
to him, in consequence of his lack of fnll sexnal
satisfaction with her, he had become more and
more subject to a sense of unreasonable irritation
against his wife and a certain distaste for her
society. It had seemed to him that he was be-
coming less and less in love with her, and that at
the same time this was somehow his own fault
Meanwhile he had found his mind continually
dwelling on erotic phantasies about other women,
either those he had known before his marriage or
others he had met since. Sometimes they were
about perfect strangers, as, for instance, some at-
tractive looking woman he might see on the street
At times he found himself wishing that he had not
married or were again free to pursue some of
these women who seemed to have a stronger sex-
ual appeal to him than his wife. Such thoughts
distressed him profoundly. He felt that he ought
to be perfectly satisfied with his wife and that
longings and phantasies concerning other women
should not enter his mind at all. He had made
every effort to be content with his marriage and to
resist these outside appeals, but even though he
knew he had done Ms best, he continually felt
guilty for not having succeeded. He had sus-
pected, quite correctly, that his distrust of him-
self in business affairs, his lack of interest and his
depression were merely diffusions of feelings of

A CASE OF INHIBITION 525

self-distnist and dissatisfaction that really arose
in connection with his home.

The story which this man related is indeed a
very common one, with the analytic significance of
which I was familiar from previously studied
cases. The patient mentioned during one of his
early visits that he had not known anything about
intercourse until, when he was some ten years
oldy another boy had described it to him, saying
that was the way all babies were made. Like
many other children in similar circumstances, he
had refused to believe this explanation of repro-
duction, saying: **That may be true of some
people, but I know my mother would never have
done such a dirty thing. ' '

When he had related to me this incident, I took
it as a text upon which, with certain other ma-
terial not mentioned here, to set forth the follow-
ing explanation of his difficulties with his wife.
His apparent lack of passion toward her and his
inability to experience full satisfaction in their
sexual relations was not, I said, the result of a
real absence of sensual appeal, but was produced
by an inhibition, a repression. The repressing
or inhibiting agent was a habit, complex or resist-
ance (whichever one might choose to call it) which
had been integrated by certain incidents and edu-
cational influences to which he had been subject
in the course of his bringing up. Though the
details were lacking, it was possible to describe in
general terms how this integration had been
formed. No doubt, as a small child, he had gotten
into trouble when he showed some infantile sexual

526 MOEBID FEAES AND COMPULSIONS

interest in his mother. There were probably a
large number of as yet nnremembered incidents
which led him to feel that all erotic interests were
" dirty *' and **bad'' and therefore offensive to
and to be concealed from his mother and all
"good*' women, who, naturally, were conceived of
as having no feelings of so base a sort. In short
through training there had been built up a re-
sistance, or inhibition, a habit, in short) which
caused him to react toward his mother in a way
quite different from what would have been the
case had he been left perfectly free to follow his
primitive holophilic impulses.

Now it was this habit or complex which was
responsible for his lack of complete satisfaction in
his sex relations with his wife. For, not unnat-
urally, it was brought into action not only by the
mother herself but by other **good'' women who
had certain traits in common with her which pro-
duced an unconscious identification. Thus such
qualities as virtue, refinement and culture which
caused him to hold a woman in high esteem did
not reenf orce the effect of her physical charms to
excite all his holophilic impulses, but served
rather to bring more or less fully into action the
old repressive integration and thus to ifAibit in
some degree the more sensual components of love.
And just as in the case of the Jews I have men-
tioned, the habit of reacting negatively to ham
continued even after they were convinced intel-
lectually that it is a perfectly wholesome food,
so in this patient the inhibitive reaction upon his
sensual erotic impulses continued to be exerted

A CASE OF INHIBITION 527

even after he had ceased intellectaally to think
that a display of passion would be offensive to the
good woman (his wife) and could not meet with a
corresponding excitement in her.

This explanation, when I had outlined it to the
patient he said impressed him greatly and he felt
convinced that it was entirely correct In sub-
stantiation of it he remarked that now he came to
think of the matter he realized that the women
with whom in his premarital affairs he had ex-
perienced a high degree of passion and full sexual
enjoyment were invariably ones whom he had rea-
son to think ^^bad'' even before he made advances
to them. Furthermore, when he felt attracted by
some woman he might pass on the street, it was
always by one, as he now realized, who used a
good deal of paint and powder, dressed flashily,
showed her legs, or had some suggestion of
^^sportiness" about her which indicated to his
mind that she was not overburdened with virtue
nor likely to be offended by any sort of sexual dis-
play, provided it were made under favorable cir-
cumstances.

Now in the case of the Jew reacting negatively
to ham after he had ^ven up his reli^on, the
individual was aware in a general way of why he
so reacted. He would have said, if any one had
asked him: '^The reason I feel this way is be-
cause of my bringing up. It's a matter of habit
or training. '* But in the case of this patient, the
reason for the inhibition, or indeed the fact of its
existence, was not understood until I had ex-
plained it to him. But after he had heard the ex-

528 MORBID PEABS AND COMPULSIONS

planatioiiy his state was analogous to that of the
Jew. He too could say and believe, ^' It's a mat-
ter of bringing up, of habit and training/' but
without being able to remember any but a small
number of the incidents by which he was trained.

The Jews who abandoned their religion lost
their n^ative reaction to ham through their con-
tinuing to eat it. The old habit spontaneously
ceased to functionate. But this was not par-
alleled in the case of the inhibition suffered by
this patient. The explantion given above had the
effect of making his sexual relations with his
wife slightly less unsatisfactory, but the change
was by no means profound. The old integration
continued in operation despite all the changes
which had taken place in the patient's conscious
thinking since the period in which it was formed
and in the course of the analysis. He went right
on reacting towards his wife in the same manner
(if not to the same degree) that he had been
trained to react toward his mother.

Now the analytic explanation I had given him
had, in a certain sense, rendered conscious some-
thing that had previously been unconscious. He
knew that there was an inhibition exerted upon
the sex-impulses directed toward his wife, and,
in a general way, what this inhibition sprang from
— ^that is to say, from the training he had received
in childhood, from various incidents of the past
But this explanation had merely placed him in
about the same position as that of the Jew who
continues a negative reaction to ham even when,
having abandoned his old religion, he desires to

A CASE OF INHIBITION 529

eat ham and knows of no reason why he should
not. The analysis had simply formulated the pa-
tient's problem, had diagnosticated his situation.
The problem still remained to be solved, the trou-
ble whioh was diagnosed had yet to be cured.

How then was this old habit or integration
which still continued to functionate eventually
broken upf Obviously the integration was pro-
duced by, and the continued habit was an effect
of, certain earlier experiences which we would in-
dude under the head of 'draining." The num-
ber of individual experiences which had been in-
strumental in fonning the integration quite
obviously must have been large. And the same
might be said of those experiences of religious
training and family life which produced in the
Jew a feeling of aversion to ham. But in each
case only a small number of the integrating ex-
periences could be spontaneously recalled in de-
tail by the individual and observation goes to show
that those which can be recalled are by no means
invariably the most important or the ones which
had the prof oundest effects. In short the mem-
ories and records of the experiences which had
served to build up these habits still remained in
great measure unconscious. Now the way that
the analysis eventually breaks up these integra-
tions or complexes and frees the individual from
the habits of reacting that have outlived their
usefulness is, as we have said, by reducing them
to the original individual experiences through
which they were buUt up. They have, in one way
or another, to be recalled. The individual is, as

630 MOEBID FEAES AND COMPULSIONS

it were, taken back in memory to the original ait-
nations, allowed to review them in the light of
new knowledge and to start from them afresh in
snch a way as to form new integrations better
adapted to the demands of adnlt existence than
were the old.

One conld, then, divide the analytic work, on
theoretical grounds, into two parts: the ^ag-
nostic, which discovers what complexes, resist-
ances or habits are responsible for the patient's
troubles and which formulates his problems for
him, and the disintegrative or analytic proper,
which breaks up the undesirable habits or com-
plexes by making the patient re-live the original
experiences by which they were built up. As a
matter of fact, in practice there is no such dis-
tinction possible. Both diagnostic and disinte-
grative analysis occur together and are indis-
tinguishable. Nevertheless the division I have
suggested has a certain value. Some mild cases
and some of the elements involved in severe
cases require little more than a diagnostic anal-
yjais. Once the problem is clearly formulated
for the patient he may be able to meet it un-
aided further, just as the Jew would overcome
his resistance to ham by simply continuing to
eat it. Perhaps a larger part of the analytic
cure than we are wont to realize is brought about
in this way. In fact if every troublesome com-
plex and integration required as detailed analysis
as do some of the most important ones, the
already lengthy process of an analjrtic treatment
would be really endless. In the case of Miss

BEMEMBEBINO 531

for instance, an adjustment was brought
about and a cure resulted from an analysis that
was more largely diagnostic than disintegrative.
None of her complexes were reduced to the terms
of the original integrating experiences with any-
thing like the fullness of detail with which I am
familiar from cases of a more severe type, and
which is required in them to bring about a cure.

How then is the distiutegrative living-over-
again of the earlier complex-producing experi-
ences accomplished? Apparently in two essen-
tially different ways, the one by the patient *8 di-
rectly recalling these past experiences, the other
by his re-living them in the form of transference.^

Let us first consider remembering. The an-
alysis is begun when, after the history is taken
at the first sitting, the patient is directed to talk
of whatever presents itself to his mind (to think
aloud, in short) relating whatever occurs to him,
whether or not it seems to him important or
trivial, pleasant or disagreeable. Many patients
when started in this way, will produce a good deal
of valuable material. Once they have begun to
think over their past history and the story of

iln the original hypnoiie analyBis flrat used hy Breaer and
Freud this taking of the patient back to earlier experiences
■eemed mneh eimpler than it does now. It was Buggested to the
patient that he was In this or that situation and he was then
required to desorihe it and his feelings in detalL Hie most un-
fortunate feature of this otherwise yery desirable method of
procedure Is that the physicisn does not always know what
situations he should make the patient go back to, and that to
flome, against which the patient has strong resistances because
they are in some way painf ul, he cannot be made to go back in
i^ite of aU suggesting.

532 MORBID FEABS AND COMPULSIONS

the development of their symptomSi they will not
only remember and relate mnch that they had
known to be important at the time of its ooenr-
rence, bnt also many things the importance of
which had previonsly escaped them and is now
recognized for the first time. A good deal of this
material, which we could consider as belonging to
the nnconscionSy the patient assures us he knew
all along. '^Only until now I didn't happen to
think of it " The ^ ' forgetting ' ' of such material,
the repressing of it, had consisted merely in its
being isolated.^ This sort of forgetting is par-
ticularly common in the compulsion neurosis. In
hysteria and anxiety hysteria an absolute forget-
ting is met with more frequently. There are also
'^ remembered" certain internal psychic processes
which as a matter of fact had never been con-
scious; phantasies, wishes, conclusions, i>ercep-
tion of connections and relations aU of which had
come into being without ever exciting awareness.

The memory material thus collected gradually
enables the patient to view his behavior and his
neurosis (which is a form of behavior) in a new
light and from the point of view of its history.
He can see more and more what he really is doing,
more and more that he is reacting (is if persons
and conditions of the past were still present as
objects of environment. He even passes a little
way from the stage as if I thought to that of /
realise that I have been thinking, unconsciouslif.

Yet on spontaneous memory alone one can never

iCf. Freud's Weitert BdttMiffe, Int. Zdt 1 Ant Fajdba^
n» 1914.

EE-ENACTMENT 533

rely for a complete picture of a neurosis. A
good many gaps can be filled out in this way, in
some cases. In others, as early as the first or sec-
ond visit, the flow of associations stops and the
patient declares nothing more occurs to him. But
in every case memory sooner or later stops adding
to the patient's understanding, the associations
cease to flow freely, he no longer repeats with any
fidelity what comes to his mind* Instead of be-
coming increasingly conscious, by way of the re-
production of associations, of what, in the larger
sense, he has been doing, he now goes ahead and
does it. 1 mean by this tliat he begins to re-enact,
in the transference to the physician, what he has
been unable to remember. Old patterns, which
had previously found expression mainly in the
symptoms, now come more fully to the surface, but
with the physician in the role formerly occupied
by some other person. Naturally the transference
re-enactment does not take place entirely without
distortion nor without seemingly logical connec-
tion with the actual facts of the immediate sit-
nation. In other words it appears to the patient
as a product of the present, not as a relic of the
past. As the two previously recorded cases did
not illustrate this very fully, I will go on to
relate what took place with the male patient last
spoken of.

For a short time after I had given him my ex-
planation of his lack of passion for his wife, he
added more and more confirmatory material to
it and seemed more and more satisfied of its cor-
rectness. But though he could plainly see that, as

534 MORBID FEABS AND COMPULSIONS

he himself expressed it, he was in a measure
afraid to love his wife in any other way than
he had been allowed to love his mother, yet he
complained that he could remember very little of
his early childhood, and of the period where it
appeared that the events responsible for the in-
tegration of the inhibitory mechanism took place.
He could not recall, for instance, that he had ever
had an interest other than a ^'pure" affection for
his mother, to say nothing of remembering any
occasion when he had been scolded or punished for
'^improper" interests in her. The events which
constituted his repressive training were, in short,
completely lacking from his memory.

At length he began to doubt very much whether
I had explained his inhibition correctly, saying
that if there had occurred in his childhood train-
ing any punishments or other repressive events
sufficient to have a lasting effect upon him, they
surely would have made such a deep impression
that he would easily b& able to remember them.
But as he was quite unable to recall any such
occurrences he ceased finally to believe that any
inhibition upon his sex impulses really did exist,
declaring that he was now convinced that he was
right in the first place when he thought that he
and his wife were '* sexually mismated" (L e.
that there was no attraction to inhibit and that she
simply did not appeal to him in a physical way).
Meanwhile his attitude of great interest in the
analysis and of profound confidence in me changed
into one of a sulky antagonism. Instead of being
as at first perhaps over credulous he was now

TBANSFERENCE RESISTANCE 535

always on the defensive and ready to pick flaws in
anything I might say, even though this was gen-
erally done in a somewhat hesitant manner, as if
he were a little afraid of me.

After a considerable time the set of facts which
explained this change was forthcoming. They
belonged mider two headings. In the first place
there was a matter he was not telling me. Across
the court in the apartment house where he lived
were the rooms of a young woman. It was in the
summer and he had discovered that she very often
neglected to pull down the shades when she was
undressing for bed. He had fallen into a habit
of watching her. Apparently she was an actress,
for she usually came in quite late in the evening,
after he and his wife had gone to bed. He would
tell his wife that he could not sleep, and, getting
up, would go to the living room of his apartment,
from which this girl's bedroom was plainly vis-
ible if her shades were up, and, sitting there in the
dark, would watch her while she was disrobing.
This would get him into a state of great sexual
excitement and sometimes he would return to his
bedroom and have intercourse with his wife,
meanwhile imagining she were this girl, which
added considerably to the pleasure he was ac-
customed to gain from his sexual relations.

He had not felt particularly troubled about
what he was doing until one evening when he was
watdiing the young woman there came upon him
the thought: "What a contemptible picture you
make — ^you, a married man — sitting here in the
dark, peeping at this girl, like a nasty minded lit-

536 MORBID FEARS AND COMPULSIONS

tie boy I Suppose 70a told this to the doctor!
He would give you hell I He might refuse to treat
you if you did not stop it at once I"

But these feelings of mortification and self-re-
proach soon became mixed with a sense of resent-
ment against me. ^'Why should I tell him about
itr' the patient had thought, ^^ What business is it
of hist Am I not a man and can I not do as I
please, without running to him and confessing t"
And then at other times he would think: '^Why
should I be afraid to tell himf Suppose he does
criticize me, he is not God. Why shoxdd I caret
He is no better than L Very likely he'd do the
same thing if he got the chance I"

While this conflict was going on, a second arose.
As he was sitting one day in my waiting room, he
heard me laughing with the patient who preceded
him and who was just leaving. As she passed the
waiting room door, he saw that she was a good-
looking young woman. '^ Aha !" he thought, ^Hhe
doctor is very friendly with his lady patients 1
I'll bet there's something doing!" From that
time on he was continually on the alert to find
out something about me. If I was called on the
telephone when he was in my office, he would
listen to see whether he could figure out from the
conversation whether the other person was a
woman and whether there was anything '^inti-
mate" between us.

If I ever left the room when he was in my office,
he would be assailed by a great curiosity to look
at the letters and papers lying on my desk, and
this temptation on one or two occasions he was

TEANSPEBENCE BESISTANOB 837

unable to resist. On the street one evening he
saw at some distance in front of him a man he took
to be me, walking with a woman. He wondered
whether this was my wife with me or whether I
was out for a ** party'' with one of my patients.
Overcome with cariosity to see whom I was with
and where I was going, he hastily followed, keep-
ing in the shadows of the buildings in order to
escape observation himself, only to discover after
he had gone some distance that the couple he had
been watching were really perfect strangers.

He became consumed with curiosity about my
private life. What sort of person was my wifet
How did I get along with hert What were our
sexual relations? Did I have affairs with other
women? He had an impulse to picture to him-
self in phantasy intimate scenes of my home, feel-
ing at the same time a certain envy, as if in some
mysterious way evergrthing sexual in my existence
must be somehow superior to and different from
anything he could experience, and that I had un-
known pleasures which would be forever denied
to him. Sometimes he felt hurt that I did not take
him into my confidence and tell him all about these
intimate things. I must, he thought, know a
good deal about sex that he did not, and why had
I to be so reserved? Why couldn't I tell him
frankly of my own feelings and experiences and
let him improve his relations with his wife by
copying me instead of through the disagreeable
and lengthy process of analysis?

All this took place with the greatest conflict.
He felt himself utterly mean, dishonorable and

538 MORBID FEABS AND COMPULSIONS

contemptible to be so continually suspicious of me
and to have such an irresistible curiosity about my
private affairs. That he had looked at my letters
or been willing to spy upon me on the street
seemed to him the lowest limit of sneaking eon-
temptibility. But what is more to the point is
that he was mortally afraid of my anger if I
found out what he had done. ' ^ How can y ou, ' ' he
thought, *^ confess to the doctor how nosey you
have been? He would never forgive you I He
never talks of his own affairs, and that should
have warned you how he would resent any one's
prying into them I What would he think if he
knew you had tried to picture his sexual rela-
tions with his wife ; that you had tried to imagine
how she would look undressed; that your foul
mind had attempted to invade every nook and
comer of his privacy; that you had suspected
him of immorality with his women patients 1
Suppose he were to discover some of these things
from one of your dreams. He would be furi-
ous I"

He not only feared my anger as such but also
what I would do if I were angry. "This man,"
he thought, "has no inhibitions or fears. In his
anger he would be absolutely merciless. There
is no telling what he ntdght do to you. He could
cause a lot of harm if he told what he knows
about you, and he might not hesitate to do it
Doubtless he has powerful friends among busi-
ness men, and in his desire for revenge, he would
enlist their help and ruin you, or he might do you
some physical injury.'' These and other fears of

TRANSFERENCE RESISTANCE 539

my vengeance (some of them quite fantastic),
assailed and tormented the patient unspeakably.
In spite of the great absurdity of most of them
they were entirely real to him.

The material which I have here recited, with
more of a similar tenor, was brought out slowly
and f ragmentarily, with every sign of the great-
est resistance on the part of the patient. It
seemed hardly to have occurred to him that there
was any possibility of my not resenting his ** pry-
ing'' or of my failing. to take action against him
once I discovered it. And when he had, after
great difficulty, told me one item, the fact that I
took it quite indifferently seemed to give him no
assurance that, when he had come to the next one,
I would not resent that. At such times as he was
about to tell me some one of these things, he
would squirm about in his chair with every sign
of the greatest uneasiness and apprehension. In-
variably he would raise his hand to his face and
turn his head from me at the moment of making
the "confession." This, when I first called his
attention to it, he said was because of mortifica-
tion. He could not bear to look at me when he
was relating things about himself which showed
him to be such a "dishonorable sneak." Yet at
length it dawned upon him that the real purpose
of the gesture was to ward of an tmconsciously
expected blow.

It was only when this realization came to him
that he began to see what was really meant by his
feelings of guilt before me and his fears of my
anger-— namely that all these manifestations were

540 MOBBID FEABS AND COMPULSIONS

transf erenoe phenomena and reproductions of the
long-forgotten past. What he had experienced
with me was really a living over again of nnre-
membered incidents of his childhood, subject to
enough distortion and rationalization to accord
them with the present. The important episodes
of his early corrective training which he had been
unable to remember, he had reenacted with me.
The inquisitiveness, the spying and the suspicions
he had expected I would resent and avenge, cor-
responded to the infantile sexual curiosity that
had been active in his childhood. His sense of
guilt and his fear of me were a reproduction of
what he had originally felt, on much more logical
grounds, in connection with his father.

At last when he understood what all this really
meant, there came the direct recollections of ac-
tual experiences, which had previously eluded us.
When he was about five years of age, or perhaps
even younger, he had been playing in a neighbor's
garden with a little girl of seven. She had volun-
teered to show him ''what papa and mama did,"
and after unbuttoning her clothing, and assisting
him to do the same, they displayed to one an-
other their buttocks and genitals, and urinated in
each other's presence. She told him that all mar-
ried people diid this in their bedrooms every night
In the midst of the proceedings the little girPs
mother spied them from the window, and, sending
her daughter into the house, took the little boy
home and told his mother what had been going on.
Both children were severely punished and not al-
lowed to play together again. In the transfer-

ANALYSIS OF TRANSFERENCE 541

ence, the spying on the yonng actress, about which
the patient feared to tell me and over which he
felt so very guilty, apparently corresponded to
this episode. He unconsciously expected that I
would take much the same attitude with regard
to this adult experience that his parents had taken
toward the earlier one.

Some little time later, shortly after his experi-
ence with the little girl and before the patient was
six, he had hidden under the bed in his mother's
room, hoping to see her use the chamber vessel
What the little girl had told him and what he had
seen of her genitals had greatly excited his curios-
ity and at the same time puzzled and disturbed
him. Why had she no projecting organ like his
ownf Was his mother that way toof And did
married people really do at night what the little
girl said they didf If so, why was it he had been
so severely punished? He felt he must find out,
and therefore embarked on the adventure in his
mother's bedroom. But she discovered him in
his hiding place, and seemed to divine at once
what was his purpose in being there. She ques-
tioned him closely but he desperately maintained
that he was merely 'Splaying," and begged her not
to tell his father as she had threatened to do.
She seemed not to be fully convinced of his in-
nocence but finally said she would not tell if he
would promise to be a good boy.

After this, what attempts he made to gratify his
sexual curiosity were carried on in the most crafty
manner, and, though he did not at once abandon
his investigations but for a time continued on the

542 MORBID FEARS AND COMPULSIONS

alert to find oat anything possible as to what went
on between his parents, this was all done with
such an appearance of artless innocence that they
were completely deceived. Never did he really
satisfy himself as to what did take place between
them and at length the somewhat deferred latency
period set in, and the whole history of this period
of investigation was almost completely lost to his
consdons memory, so that when he was later told
abont interconrse, he was snre his mother would
not do such a ''dirty thing.'' It is easy to see,
however, that his transference cariosity aboat my
sexaal life, his desire to have me describe to him
my own feelings and experiences, his thoughts
about my wife (whom he had never even seen),
his uncertainty as to my morality, etc., coincided
with the early inquisitiveness and uncertainty
about his parents, while his antagonism toward
me and his ideas about how, in my anger, I would
take revenge on him, were descendants of the
early and well-founded fear of punishment from
his father.

With the filling out of memory gaps that came
from the transference itself and from the addi-
tional memory reproductions which occurred after
the transference had ceased to act as a resistance,
the patient became at last not only fully con-
vinced that his lack of contentment with his wife
was due to the functioning of a compound habit
which exerted an inhibition upon the more sen-
sual components of the love life, but he could now
see the constituents of this habit, its unconscious

ANALYSIS OP INHIBITION 543

factors, and the why of its continaed operation.
It became dear to him that an important constit-
uent of this habit or inhibition was an uncon-
scious ^ f ear, on the one hand, of punishment from
the f ather, and, on the other, of exciting the dis-
approval of the mother (his wife) — ^that he was
reacting as if the original conditions, which
through exciting such fears had served to sup-
press his sex impulses in childhood, were still
present and still to be feared. With this vision of
what he really was doing came the freedom to
make new and more satisfactory adaptations.

As must now be clear, the curiosity or looking
impulse was strongly developed in this patient.
But it had been very much inhibited in his rela-
tions with his wife. For instance, if he came into
the room when his wife was partially dressed, he
would quite automatically look away from her or
act as if he had not noticed that she was not fully
clothed. What exposure of her person took place
with the performance of their sexual relations he
seemed almost to ignore. Though previously he
had not recognized this, he at length saw that
whatever gratification of his looking impulse he
had allowed himself in his relations with his wife
was accomplished in a furtive manner and in such
a way as to conceal from her the fact that he had
any desire to look. He behaved with her, in short,
just as if she would react, should she catch him
looking at her, as his mother would have reacted.
Unconsciously he expected she would scold him

1 strictly speaking, f oreoonadouB.

544 MOEBID FEARS AND COMPULSIONS

or give him over to punishment. But this inhibi-
tion had functioned so subtilely that he had not
realized what was taking place.

Instead of being aware* that really he had a
strong desire to look at his wife's person, and
oould derive great pleasure from doing so were it
not for an inhibition, he felt that she did not in-
terest him physically, that her bodily charms were
not of the special sort that could appeal to him.
In short, he could freely gratify his looking im-
pulse only in phantasies of sexual scenes with
other women, or, as in his premarital experi-
ences, when his inhibition was overcome by the
woman's making manifest that she was not over-
burdened with modesty, and that, like the *^bad"
little girl in his childhood, she would take pleasure
in being looked at, instead of resenting it. The
fact that in his unconscious the looking desire in-
cluded a wish to witness the excretory process of
the female, in short, to repeat what, as a child, he
had experienced with the neighbor's litUe girl,
of course made the inhibition upon the looking im-
pulse even more difficult for him to overcome than
might otherwise have been the case.

What I have related of the analysis of the
inhibiting habits that functionated in the patient's
love life is of course only a part of the whole
story, but the rest is not required for our purposes
here. The inhibition on the looking impulse was
completely paralleled in respect to others of the
patient's sensuously erotic tendencies. As the
analysis drew to a close he was able to see dearly

ANALYSIS OF INHIBITION 545

that, as he had at first surmised, the doubts, re-
siBtances and inhibitions that he met with in his
business life were merely a diffusion or displace-
ment of affects that really had their immediate
origin in his life at home — for instance, his fear of
making a mistake that would have most serious
consequences was really a descendant of the old
fear of being punished by his father for the ex-
pression of (now repressed) sexual interests. It
need hardly be said that, once the interfering in-
hibitions were broken up, the patient was enabled
thoroughly to content himself with his wife, while
the phantasies about other women and his desire
to be free to pursue them disappeared entirely.

The integrations which functioned in his rela-
tions with me had been set in motion by many
other sorts of stimuli and in many other contacts
in his life. But outside of the analysis, however,
the system of habits, the complex, had worked for
the most part from beneath the surface, so to
speak. Even when its influence was profound,
only a small part of the entity appeared in con-
sciousness, and even this was rationalized into
accord with the immediate situation. !bi the
analysis, however, as the constellation was stimu-
lated and rose to the surface, it was caught and
held. Instead of being permitted, as ordinarily,
again to recede to unconscious levels, it was hauled
out further and further, and at last delivered in
its entirety from the depths of the non-perceiv-
able and surrendered to examination into its every
part. Then and only then was it deprived of

546 MORBID FEABS AND COMPULSIONS

antonomoasnesB and independence of action and
rendered assimilable with the resnlts of adult ex-
perience and the requirements of adnlt life.

The breaking up of the pathological integra-
tions which function either as repression resist-
ances or as fixations of instinctive tendencies is
accomplished, as has now been illustrated, by mak-
ing the patient live over again the experiences
which were instrumental in forming the intgera-
tions. These experiences he may re-live either in
memory, which he does not confuse with the pres-
ent, or in the form of transference, which he feels
arises from the present. By this re-living of the
past he can see what he is really doing in the
present, namely, that he is reacting as if much
of the past were still in existance. We have said
that when he knows what he is really doing he is
then free to do otherwise if adaptation demands
it But I must now state that this knowing has
to be of a very special sort. It must be a know-
ing that comes from re-living , either in memory,
or in transference. A mere intellectual knowl-
edge of the significance of a habit, a resistance
or a symptom ordinarily does not break up the
integration, or prevent it from continuing to func-
tionate. In this particular case, for example, I
was able to divine quite completely from dreams,
symptoms, and associations, what sorts of occur-
rences had taken place in the patient's childhood
to create the repression resistances that were func-
tioning. I told him a good part of what I had
discovered, and for a time at least he agreed that
in all probability I was correct. But this did

ANALYTIC UNDBSTANDING 647

not have either the effect of bringing to his con-
sdousness the actual recollections of the incidents
in question, nor of producing any amelioration of
the symptoms. When the physician gives to a
patient a perfectly correct explanation of the un-
conscious ideas or wishes which are responsible
for a symptom or resistance, he merely introduces
into the patient's consciousness new ideas having
the same content as the unconscious ones. This
is not the same as bringing the unconscious ideas
into consciousness, and the explanation has' no
great effect upon the symptom unless it serves (as
it may do) to bring up this missing material from
the unconscious.

This shows that the explanation that has been
here given of the effect of psychoanalysis does not
explain very extensively. Certainly it is not any
ordinary kind of ** knowing'' or '^understanding"
that cures the patient. It is a living-over-again
of that which had subsided from consciousness
that has the therapeutic effect, but just what this
really consists in, or why it should have just this
effect, is, to my mind at least, decidedly obscure.
Obviously, an important fact is that the patient
is released from depending on ready-made and
outworn responses to meet present situations, and
gains thereby an enormous freedom to make new
adaptative reactions — he becomes flexible, while
before he was crystallized — ^but exactly what takes
place inside of him we can express only in terms
of ideas. What changes are made in the integra-
tion of reflex paths, and exactly how they come
to be made, we can hardly even guess.

548 MOBBID FEABS AND COMPULSIONS

It is dear, however, that psychoanalysis is a re-
education, in the very fullest sense. As Burrow
has remarked, education, as it is ordinarily car-
ried on, really belies its name. The word im-
plies a leading out ; the process is largely a press-
ing in. Familial, and to a less extent, school train-
ing have not been predominantly devoted to dis-
covering what were the special tendencies with
which instinct had endowed each individual, and
to leading out these energies along the lines that
would give them fullest and most advantageous
expression. The training most children receive,
in the home especially, has generally been some-
what in imitation of the mythological Procrustes
who had a bed in which he would invite traveler
to sleep. If the guest were too short for the bed,
the host would stretch him until he was long
enough to fill it ; if he were too long for the bed,
enough of his person would be chopped off to
make him fit it perfectly. Education has shown
similar tendencies. There has been a disposi-
tion to fit the child to the training, rather than
to fit the training to the child. This has been
espedally true in regard to the developing sex im-
pulses. Scoldings, punishments, and other re-
pressive measures are applied with the greatest
energy toward making the sexuality of the grow-
ing individual conform to fixed and predetermined
standards of what should be, and which, inci-
dentally, are in many instances founded more
largely upon prejudice, superstition and igno-
rance, than upon any accurate knowledge of sexual
psychology and physiology, or upon sympathetic

ANALYTIC BE-EDUCATION 549

oommon sense.^ Where familial influence and
training have established habits which inhibit nor-
mal sexual tendencies from expressing themselves,
or which maintain fixations of others that, for the
adulty are really abnormal, psychoanalysis per-
forms a truly educative function. The pathogenic
habits, inhibitions, or resistances are overcome
and the individual's instinctive energies led out to
express themselves in the fullest measure possible,
either in the form of normal love activities or by
way of sublimation.

It is evident in the case of the patient we have
just considered that the habits established by the
moral training received in childhood, the purpose
of which was to withhold him from immoral ac-
tion when he grew up, formed the very factor
which interfered with his making a moral adapta-
tion and bid fair to drive him into immorality (in-

1 It is very commonly true that parents, in bringing up their
children, do not utilize much of the knowledge and good sense
they really possess, but instead fall into an unconscious identi-
fication with, and consequent imitation of, their own parents.
Thus they not only reproduce with their' own children practically
all the mistakes of their own bringing up, but fail to take ad-
vantage of what opportunities for advance are offered to the
newer generation.

The fidelity of such unconscious imitations is not only in many
cases most striking but at times reaches the point of the ludi-
crous. I am acquainted with a man who, not entirely without
reason, considers his father an utter fool, whose opinion on any
subject under the sun could by no chance be correct or worth a
moment's consideration. Nevertheless this man. In training his
own son, imconsciously reproduces, with absolute fidelity, the
training his despised father gave him.

The psychology of parenthood, as well as the psychology of
childhood might be studied with profit by those who are working
for educational advance.

550 MORBID FEAES AND COMPULSIONS

fidelity to his wife) in the search for a field in
which his sex impulses could secure free outlet
That which saved the patient from this danger and
made it easy for him to be content with a i>er-
f ectly moral marital life was really the overcom-
ing of certain moral impulses. In other words,
as this case exemplifies, the resistances which are
dissolved in the analysis are in part moral re-
sistances, habits which have been instilled by eth-
ical training.

If psychoanalysis dissolves certain moral in-
hibitions the effect, one would think, must be to
make it easier for the individual to be immoral
In a measure this is true. But on the other hand,
as in the case we have considered, the effect is like-
wise that of making it easier for the individual to
be moral, and to feel content in so being, while
according to all experience the moral course is
that which after the analysis he ordinarily pur-
sues. Thus the result of overcoming certain
moral inhibitions may really be the attainment of
a higher degree of morality than was possible
while they were in force. Nowjreally the pnr-
I20S6. of .psychoanalysis is practically identical wiOi
that of moral instruction and moral codes (if
viewed -according.,TQ~Jtheir Jbasic significance),
joameLy, the highest welf are_of the individual as
a member.of the social group, the best possible
adaptation-of hiTnflftlf f q ^ir ftTyyirnnniftTif If psy-
choanalysis led to a real immorality, it would de-
feat its own purpose. Its prime role really is to
step in and do for the individual what the ordi-
nary moral forces had tried to do for him bat

ANALYTIC RE-EDUCATION 561

failed. The analysis does not seek to overcome
morality bnt rather certain moral inhibitions or
habits which have ontlived their nsefnlness, and
defeat their proper purpose by interfering with,
rather than furthering, the welfare of the individ-
ual and his adaptation to life. It assists him to
abandon these old moral inhibitions in favor of
newer controlling and adaptive machinery more
efficient than the old. It tries to perfect, to im-
prove upon, that intricate system of '^habits not
only of acting, but of feeling and believing about
actions, of valuing or approving and disapprov-
ing"^ which the individual calls his conscience
and which has as some of its basic constituents
certain pathological resistances and inhibitions
which result from ignorant, if well intended, par-
ental efforts to shape the child's personality ac-
cording to standards that take no account of the
natural.

Sexuality, even perfectly normal sexuality,
gives rise to most serious and difficult adaptive
problems, and may easily be the spring of actions
which will end in pain or misery or disaster for
the individual But for this very reason, and
quite apart from the question of making the most
of the instinct's great potentialities for happiness
and for good, all efforts toward establishing hab-
its that shall control and direct the erotic ener-
gies need to be xmdertaken in the most carefully
considered and enlightened manner that is hu-
manly possible. Man's effort to overcome the im-
perious domination of sexuality has been at-

1 Dew^ and Tiift8» SiMeB, p. 178.

552 MOBBID FEABS AND OaMFOLSIONS

tempted, as HmUe remarks, ^^hy lowering the iit*
stinct, and seeing in it something Tile or mr-
dean, something unspeakable and nnholy. In-
stead of destroying the power of sexnaHty this
stmggie has only warped and distorted, injured
and mutilated tiie expression; for not without
destruetiou of the individual can these fundamen-
tal instinots be destroyed. life itself has needs
and imperiously demands ei^ression throikgh the
f onmi created. AH nature answers to this freely
and simply except man. His failure to recognize
himself as an instmmei;! through which life is
coursing and the demandi of whidb must be
obeyed, is the cause of his misery—" ^ Ignorant
and too rigorous early r^ressive trmning, bad
family inSuenoes^ or unaataral ideals establish in
the diild such habits ''of feeling and believing
aBout aetiens" that when he becomes an adult
he can not without pain and horror see hiTuaetf as
lie actually is. Tendencies wfaadk are imiate and
inevitaUe become sources for the develoimient of
tormenting affects of guilt; eneri^es that are
normal and deserving of direct expression, and en-
ergies that, though not normal, could become so,
are fruitlessly and wastefully confined and re-
pressed. Instead of securing outlet in the form of
activities that are compatible with the require-
ments of Bodal existence, and which could be given
them once they were faced and understood, many
of these fundamentally normal and natural im-
pulses remain as skeletons in the closets of the

iB. M. Hinkle, Ifttroduceiaii to Jvb^b Pifokolofff of ^ Vth
h P' zlii.

ANALYTIC RE-EDUCATION 553

individnal's psychic household, which whenever
he gets a glimpse of ihem, excite him to spasms
of morbid fear. The overcoming of resistances
which occurs with analysis reeducates him to new
points of view. It enables to see the whole of
himself as it actually is; to face his defects,
whatever they may be, without horror or self re-
proach, but simply as matters of biological fact;
and to develop the energies at his disposal along
the lines that will most fully adapt him to his
place in life. This is accomplished not so much
hy teaching him new standards as by unteaching
old, erroneous and distorted ones.

CHAPTEBI ^

EUifly H«— AutoerotiBm ; AnalyBis of the Sexual Ln-
pnlae; Love and Pain; Erotic Symbolism; Sezoal
Invexsion, in the Studies in ike Fsycholagy of Sex, ^

F. A. Dayia C!o.

Fread, &— Three Contributiona to the Sexoal The-
ory, 2d Edition, translated by A. A. Brill, The
Jawmal of Nervoue and Mental Dieeaee Monograph
Series, No. 7.

Triebe nnd Triebahicksale, Ifiternatiandle Zeit-^
sehrift fur SrztUche Psychoanaiyse, YoL III., 1915.
Beitrage zor Pqrchologie des Liebeslebena IL,
Jakrhuch fur psyckoanalyiische und psyehopathr'
ohgisehe Forsehungen, Bd. IV., Hit I., 1912.
TTeber Infantile Sexoaltheorien, Sammlung hteiner
Sekriften zur Neurosenlekre, Bd. n., S. Ej^ger,
Berlin.

The Origin and Development of Psychoanalysis,
American Journal of Psychology, Vol. XXI., No.
2, 1910.

Analyse der Phobic einea fflniQahrigen Ejiaben,
Jakrhueh fUr Psychoanal^istihe und PsyehopathoU
ogische Forsehungen, Bd. I, Hft 1, 1909.

'Frink, H. W.— The Sezoal Theories Formed in Early
Childhood, and Their Bdle in the Psyehonenroses,
New York Medical Journal, November 15, 1915.

Hng-Hellmnth, H. von. — ^Aus den Seelenleben des
Ejndes, F. Deaticke, "Vienna.

Jones, B. — ^Die Empfangnis der Jnngfran Maria dnreh

556 BIBLIOGBAPHT

das Ohr, Jdkrbuck der Ptyehoandlyse, Bd. 6^

1914.
Jang, C. J«— EzperieQces Conceniiiig the Pgychic Life

of the Child, Andlftieal Psychology, translated

by Oonstanoe Lmg, HeflCat, Tsfd & Co.
MoU, A.— The Sexual life of the Child, Maftmillan

Go.
Beitlei^ B.*-Eiiie infantile Sezualtheoria luid ihie

Baaridinng xur Selbstmordqrmbolik. ZeniralNatt

fiir PMychoamlys^ Bd. n, Hft 2, 1912.
Watson, J. B.— Behavior, Henry Hok & Go.

CHAPTEBn

Fiend, S. — Das Unbewnsst^ IntemaHonale Zeitsekrift

fir AntUehe PiyehomOyse, Bd. IIL, Qd 4-5,

1915.

Do YerdiSngnng, Ibid., Hft 3.

Znr Einfiifarang des Narziasmns, JahrbwA der

Psychoanalyse, Bd. VL, 1915.

Einige Bemerkongen fiber den Begrifl des TJnbe-

wnsBten in der PsycSioanalyse, Intematioiude Zett-

schrifi fur Arztliche Psychoanalyse, Bd. I., Hit 2,

1918.

The Interpretation of Dreams, Chapter TEI., The

Maomillan Co.

The FAyehqiMKtiboIogy of Ereryday Life, Macmil-

Ian Co.
Frink, H. W.— What is a Com]^exf Journal of the

American Medical Association, Vol. LXn., p. 897.
Hart, B. — ^The Conception of the Snbconscioas, Jfow-

nal of Abnormal Psychology, Vol. IV., No. 6, 1910.
*^The Psychology of Insanity,'' Cambridge Univennty

Holt, E. B.— The Freudian Wish, Heniy BOt ft Co.

BIBLIOGBAPHr SB7

Jones, E. — ^The Significance of tlie Unconscioas in
Psychopathology, Review of Neurology and Psy-
ckiair^. Vol XIL, No. 11, 1914.

Pflster, O.— The Pfi^choanaljtic Method, Part I, Moffat,
Taxd & Co*

Putnam, J. J.^^Hunum Motives, Little, Brown ft Co.

CHAPTER HI

Abraham, K.— Dreams and Myths, Nervous and Men-
tal Disease Monograph Series, No* XV»

Blenler, E. — ^Das antistiche Denken, Jahrhuch fur
psychoanalytische und psychopathologische For-
sehungen, Bd. IV., Hft. L, 1912.

Brills A* A. — ^Dreams, Chapter II. of Psyehoanaiysis,
iW. B. Satmders Co.

Ferenozi, S. — ^The Psychological Analysis of Dreams,
and Stages in the Development of the Sense of
Beality, Chapters III. find YII. of Contribuiions
to Psychoanalysis, Bichard G. Badger.

Fread, S.r— Formnlierong fiber die zwei Prinzipien dea
pqrchischen Oescbehens, Jahrhuch fur .psycho-
ancdytische und psychopathologische Forschungen,
Bd. ni, Hft. 1, 1911.
The Interpretation of Dreams.
On Dreams, The Bebman Co^
Die Handhabong der Traumdentung in der Psycho-
analyse, ZentraXblatt fur Psychoanalyse, Bd. II,
Hft. 3, 1912.

Jones, E. — ^Freud's Theory of Dreams, Chapter XV
of Papers on Psychoanalysis, William Wood & Co.

Jnng, C. G. — ^Concerning Two Bands of Thinking,
Chapter I., of The Psychology of the Unconscious,
Moffat Ywd&Ca

5SS BIBLIOGBAPHT

CHAPTER IV

Ferenczi S. — ^Introjection and TransfereQce, Chap. IL of

Contributiang to Psychoanalysis.
S*rend, S. — ^The Pcfychopathologj of Eveiyd^r life, ICac-

millanCo.
The Interpretation of Dreams, Chap. V.
Znr I)ynani]k der Ubertragung, Zentralblatt fur Psy-

ckoanalyse, YoL IL, 1912.
Hones, B. — ^Papers on Pi^ehoanalysis, Chapters L, IIL,

XII., XIX., and XX.
Jung, C. G.— The Significance of the Father in the Des-
tiny of the Individual, Chapter in., Analytiedl Psy-

ehciogy, Moffat, Yard & Co.
Pfister, 0. — ^The Psychoanalytic Method.
Bank, 0.— Das Inzest-Motiv in Dichtong nnd Ssg^

Denticke, Vienna.
Watson, J. B. — Behavior.

CHAPTEB V

Brill, A. A. — ^Pgychoanalysis, W. B. Sannders Co.

Cannon, W. B. — ^Bodily Changes in Pain, Hunger, Fear
and Rage, Appletons.

Crile, O. W.— -Man, an Adaptive Mechanism, Maffmillnn
Co.

Darwin, C. — ^The Expression of the Emotions in Man
and Animals, D. Appleton & Co.

Bllis, H. — ^The Problem of Sexual Abstinenoe, Chapter
VI. of Sex in Relation to Society, YoL VI. of the
Studies in the Psychology of Sex, F. A. Davis Co.

Ferenczi, S. — ^Introjection and Transference, in his Ccm-
tributions to Psychoanalysis, Richard G. Badger.

Freud S. — Selected Papers on Hysteria and other Piqr-
choneuroses. Nervous and Mental Disease Mono-
graph Series.

BIBLIOGRAPHY 559

Frmky H. W. — The Freudian Conception of the Pgycho-

neuroseSy Medical Record, Nov. 29, 1913.
Hitschmann, B. — Freud's Theories of the Neuroses,

Moffat, Yard & Go.
STones, E. — ^The Pathology of Morbid Anxiety, in his

Papers on Psychoanalysis.
The Belation between the Anxiety Neurosis and

Anxiety Hysteria, Journal of Abnormal Psychology,

Vol. Vni., No. 1, 1913.
Jung, C. G. — ^Analytical Psychology, Moffat, Yard & Co.
Seif, L. — ^Zur Psychopathologie der Angst, Interna-

iianale Zeitschrifi fur arztliche Psychoanalyse,

Bd. 1, 1913.

CHAPTER VI

Brill, A. A. — Anal Eroticism and Character; and The
Compulsion Neuroses, Chapters IX and IV of his
Psychoanalysis.
Freud, S. — ^Bemerkungen liber einen Fall Zwangsneu-
rose, Jahrb. /• psychoanal. u. psychopath. Forsch.,
Bd. I, Eft. 2, 1909.
Die Disposition zur Zwangsneurose, Int. Zeit. f . a.

Pqrchoanalyse, Bd. 1, 1913.
Das TJnbewusste, Int. Zeit. f . S. P.A., Bd. IH, 1915.
Triebe und Triebschicksale, ibid., Bd. Ill, 1915.
Drie Abhandlungen zur Sexualtheorie, 3d edition,
1915, p. 54, ff.
Selected Papers on Hysteria and other Psychoneu-
roses, Chapters V and VII. — Nervous and Mental
Disease Monograph Series.
Jones, E. — ^Einige Falle Zwangsneurose, Jahrb. /. p^-
choanal, u. psychopath. Forsch., Bd. IV, 1912.
Hass und Anal-erotik in der Zwangsneurose, ibid.,
Bd. 1, 1913.

560 BIBU0GBAFH7

CaiAPTEBYm

Freud, S.— Analyse der Phobie anes fun^ahrigen

Esabeoi, Jahrb. f. psychoawd. u. psychopaik

Forsch., Bd. I, Hft 1, 1909.
Die YerdranganK, Int. Zmt. f. a. PA.—Bd. UI, 1915.
Daa UnbewuBBten, ibid.
DToneSy E. — ^The Relation between the Anxiety NenroBk

and Azixietjr Hyateria, Journal of Ahnormol Pjy-

ekologff, Vol. VIII, No. 1, 1913.
Stekel, W.---Niervo6e Angst^iistinde und ihie Bdiand-

longen, Urban & Schwartssenberg, Beilia.

CHAPTER X

Buroow, T. — The Meaning of PQfdioanalyaia, Journal
of Abnormal Psychology, Vol. XII, Ho. l^ 1917.
Coneeptiona and Misconeeptiona in PfliyehoanaljM^
Journal of the Amorieam Madical Anaeiaiion, VoL
LXVin, Feb. 3, 1917.
Dewey and Tofta— E tibies, Henry Holt & Co.
Ellia, H. — Sexual Education, Chapter II, of Sex In Re-
lation to Society, Sixth Volniae of the Studiaa in
the Piyehology of Sax.
Freud, S.— Weitere RatoehlSge zur Tedmik der Psycho-
analyse, Nos. I, II, and m. Int. Zeit. f. a. Piyeko-
analyse, Bd. I, II, and HI, 1913-16.
Uber ''wilde'' Psychoanalyse, Zentratblati f. Payduh

analyse, Bd. I, 1911.
Origin and Development of Psychoanalysis^ Amerimm

Journal of Psychology, Vol. XXI, No. 2, 1910.
History of the Psychoanalytic Movement, Psyoko-

analytic Review, Vol. Ill, No. 1, 191£.
Beitrage zur Psychologic des Liebensldliens, IL— <

BIBUOGEAPHT 561

Uber die aUgemeinste Erniedrigang des Liebede-

henB-^ahrbuch f. psyekoanal. u. psychopath.

Forsch, Bd. IV, Hft I, 1912.
Holt, E. B.— The Freudian Wish.
Jones, E. — The Therapeutic Action of PqrchoanalyBia,

Chapter XIY of Papers on Psychoanalysis. See

also Chapters XIX and XX.
MacCurdy, J. T. — ^The Ethics of Psychoanalysis, Johns

Hopkins Medical BuUetin, 1915.
Beik, T. — ^Einige Bemerkungen zur Lehre vom Wider-

stande, Int. Zeit. f . a. Psychoanalyse, Bd. Ill, 1915.
Watson, J. B.^Behavior.

/

INDEX

Abonlimy 293

Afareaetioiiy 408

ActiTation energy, 48

AettTo and paasive, 208

Active and paaaiTe partial im-
pulaesy 12

Affeet and idea in compnkion,
274

Affect really a oonaeious sen-
sory perception of a bodily
state, 146n.

Affect-Bom, 280

Affects, strangulated, 408

Affeetivity least controlled by
foreconsdous, 75

AggreesiTe tendency, 12, 20

Aim and object of holophilio
impnlaesy 230

Allerotic phenomena^ 16

Ambivalence^ 207

Ampbierotie, 16

Analysis, a brief, 83-88

Anger, 261

AntLTiviseetionism, 186

Anxiety, 66, 262 n.

Anxiety Neurosis, 260

Anxiety Hysteria, 280
commonest of all p^yeboneu*
roses, 430

Ahxzett Htstbia, thb Pbt-
GBOUNiT or, 430

AnziErr Htbteka, ▲ Case of,
444

Association, random, tbe de-
scendant of tbe repressed,
84
relevancy of tbe apparently

irrelerant, 87
free, method of, 102

Attention, 83

Autoerotism, 14

BebaTior, explicit and implicit^

607
Bebaviorists, 606
Bisexual tenden<7, 16

Gannon, 265
Catbartic metbod, 498
Censor, 48, 61

activity of, same as tbat of
conscience, 62

a second, between forecon-
conscious and conscious
systems, 82
Cbivalry, 138

Cbristian Science, 132, 133 n.
Cloaca tbeory of blrtb, 24
Coitus, 21

cbildren's view of, 26
Compensation, 126
Complex, 38, 506 n.

doctrine of, 400

Zuricb doctrine of, 244
Compulsion Neurosis, 148, 280

COHFULSIOll NSUBOBIB, PST-

OHOLOOT OF, 270
C6MPUL8I0N NEUB06I8, A. CA8B

OF, 308

Compulsive acts, two-sided, 206
Compulsive doubt, 273
Compulsive fear, 272
Compulsive ideas, 272, 204
Compulsive self-reproacb, 286»

303
Compulsive tbSnkIng, 272
Condensation, 100
Conditioned reflex, 107
Oonfeasion, 306
Confessions of patient not sog-

gested, 300
Conflict, 51
Conscience, 40

564

INDEX

"Omtigkn'' flnory of i^mf -

GoBVcnioa hywk&nik, 281
Goioiter-MtiTatkM, 76
Cril0» 264

Cnriodtj imipfiilM^ 12, 18, IB
Guriottty hnpnliw In oompul-

Daj-dicamii^ 80
Defcnw and &lortloB

UDM, 182

Deprivation, 242

•f the
76,81

of, is dMB
108
DiMiro and fcnr, 266
OfagBoatie and diaittt^grntlTo
parta of annlytae worie, 630
Dii«iiiaa of wiab-fiilillmNKl»

107
Dlaiaiqgrati^ and dIagwMlle
parta of anmlytle work, 680
Di^^laocttcnl^ 76, 118, 148, 488

diifiiae, 166
Diatoriiott, 107
anomit o^ govanad faj
of fapnaai
182
Boobt, ompalahv, 278
Dramatization 117

89
Dnua, HtB ImagfaiaTj fnttll*

meat of n wiik, 86
rapraacntatiaB In, la Indtoart,

67
gymhollawi of, analogoQa to

that of eartoona, 07
maaitet oontant of, 106
latent oontMit of, 106
a coinpiowuia mwwd vivo

oppoaed pa;fddo rtuami^

106
fdnctloB of, ISX
the via regia to tlin

Dream, Gonttnned

atanding of tlie unoon-
8cioiia» 122
analyaia of, in ^gyAoihenr
peattci^ 122

Ednottiott, 17 n^ 648
Educative fonctiott n(

anaiyaia, 649
E^ ideal, 68
ia not aaani^ nftallastanl

ia largely fore6anaei0a% 61

Ellifl, £L, 266

Bmotlon n alata ^ prepand-

■eaa far netton, 264
End pleaaore, 16
Energy of aezoal

eaajf to laptaai, 76
Iki'irgi of eoaifniBiw

torn mliplaoed, 282
Eroginova aonca, 6
Bithatia loNee,

16
Ethical foraab tha

nera of, 16
Ezfaifaitiaoiam, 1% 17

Father complex, 211

Fear, diffarenaa

mal and moryd, 268, 26»
morbid, defined, 266
ia eonvavtod deaire, 122

IVminiam, 136

Ferencd, 16, 802

Vizatian, 280

Fixed idea% 272

Foraaonaeloiiv 41
Foreeonaeioiia eyatem, aaaA of

ego-ideal, 61
Fqneonaelons like a aeraaB be-
tween Uneonadoua and
fiiinariionan<;nB» 71
like a theatrical manager, 73
imperfectly ceBiiola affect-
ivity, 76

INDEX

565

Foiujuugeiew, Contiinied
laigely made up ol deaeend-

snte of the repmaed, 81
not all content of, eligible

lor oonseioiiniMSy 82
Fore-plea8ure« 15
Free association, method of,

102
Freud quoted, 92, 96 b., 210,

242, 296

CtaiiiuB and neoioaii, 136
Guilty lenee of, 603, 604
distortion of sense of, 604 n.

Habit aad tnstiiiet compsred,
606

Habit, signiflcanoa of, 608, 616
eq;aiyalent to resistance or
oomplez, 613

Habits that function indefi-
nitely, 620

Habits of thougbt 6nd feelings
622

Hallucinatory satisfaotloa of
widies» 91, 96

Hate, 261

Hippocrates^ 1

Holopbilic, deflnitian of term,
6n.

Homophilic tenden^, 16

Homosexual, 16

Hunger, 8

Hysteria, 1

Hysterical Tomiting, 10

Idea and affect In compulsion,

274
Ideas, compulsive or fixed, 272
Ideas but not energy of sexual

wisbee confined to uneon-

eciooe, 79
Identification, 167
Imago, 207

Infantile sexualil^, 8-21
Infantile sexual theories^ 21,

80
fading of, 27

Ijiferiority feeling, 16S
Inhibitory tendencies, 17
Instinct a creator of twislft,

70
Instinct and habit oompaTsd^

606
Integrations, dumges in, 647
Bitrojection, 166, 167
Xntroverrion, 238

James> William, 280, 266
Jones^ Ernest, 40, 262, 26»

Kissing, 10

Kleptomania, 162

Knowing, intellectual, ▼■. !•»

UTiag, 646
no ordinary kind of, etaw

the patient, 647

Latency period, 16, 19
Latent content of dream, 106
Latent memories, 82
Libido, 6, 14, 61
Looking and showing impulses,

13
I^eidag, 140

Manifest content of dream, 106
Masculine and feminine, 298
Masochism, 18
Masochistic-sadistio impulse,

12, 17, 18
Masturbatian, 20, 239 b.
Mbohanismb or Pstohopath-

OLOOIOAL MinDTEBTATIOirB,

124
Mechanisms of peychoanal^tlo

cure, 496
ifind not to be defined as imly

consciousness, 84
Morbid fear defined, 266
Morbid fear, two origins for,

267

Mareissism, 62
Neurasthenia, 270, 480

1

566

INDEX

Nmirosii, * pre-Frendian view

of, 2
Neorods m putiAl f milure of

repreMion, 122, 270
KCOWMU AS ▲ Wholx» 220
Neorods the negauTe of tlie

pervertion, 228
NeuriDsia, primary and aeoond-

ary funetioa of » 240
Kenrotie qrmptonis, are unoon-

■eiovs meehaiilaiiSy 124
Neurotic^ the, has learned to

loTe too soon, 235 n.
Nearotie unable to shake off

habits of childhood, 620
Kearotic's greater tendency to

form flzationB» 235 n.
Nightmares, 122

Object loTe, 10

Obsessions, 272

ObsessiTe fear, 272

(Edipns complex, 15, 19, 206 n.,
200

Omnipotence of thought, 802

Oral-erotic, 10

"Order'' and ''pattern" of in-
stinct reiiezes, 607

Ofcr-compensaticn, 130, 200

0?er-determination in neurosis,
220

Panic, 431

Paranoia, 56

Partial impulses, 12

PassiTe tendency, 20

•Tattem" and •*ord«r« of in-
stinct reiiezes, 507

Penis complex, 186

Penis theory, 24

Periods, three, of human sex-
ual deyelopment, 8

Perversions, 13, 21

PbobU, 271, 431

Pleasure-sucking, 10

Pleasure thinking, 80

Pleasure thinking the more
primltiTe, 01

Polymorphous-perrerse, 13

Pre-inhibitoiy period, 8

Primacy of genital zone, 10

Projection, 165

Projection ordinarily * def<
mechanism, 156

Pflychasthenia, 271

Psychoanalysis, educative fnno-
tion of, 640
dissolves certain moral inhi-
bitions, 650

PSTOHOANiXTlIO GUBB, THB-
OBT AlVD MBOHAHIBK OF,
406

Psychoanalytic cure, theory of,
neglected hfy writers, 601

Pqrchoana^ytic tedmi^pie, 84
changes in, 407

PSTCHOLOGT OF AlTXIBrT HTB-

TKBEA, 430
PSTCHOLOCIT OF GOMPDLSIDK

Nkubobib, 270
Ptaychoneuroses, 21
are more serions f allurea of
of the foreconsdous to
control, 76

Rapport, 103 n.
Bationalization, 40, 176, 611

n. 2
Bationalization of anxiety, 430
Reality thinking, 80
belongs to higher psychic

systems, 00
an ezperimental paying out

of accumulated t<miyiA«^

04
goal of, is utiUty, 04
Re-enactment of what cannot

be remembered, 633
Regression, 236, 244, 200
Regression is from present to

past and from real to

imaginary, 238
Repressed, descendants of, 75,

81, 103

INDEX

567

BepreMion, 46
a protecttTo meoluuiiiiiiy 49
brought about 1^ foreoon-

adouBp 61
failure of, 76
failure of, a conditioD of neu-

rouBy 221
primarily affects ideas, 144
Besistance, 47
overoomiiig of, identical with
flUing of menary gaps,
602, 617
origin of, 606

might be caUed habit, 606
Betention of f eoes, 9

Sadism, 13
in antivivisectionism and

chiyalry, 137 n.
in iTDching^ 140
unconscious, causes compul-

siTe self-reproach, 200
repressed, 291
Sadistic-masochistio impulse,

12, 18
Sadistic peirersion, 141
Sadistic impulse in compulsion

neurosis, 300
Secondary defense measures,

296, 807
Secondary elaboration, 121
Secondary function of the neu-
rosis, 307
Self-reproach, compulsive, 286
Sexual, the term, 3
Sexual emotion, 267
Sexual factor in neurosis, 223,

309
Sexual ideal in neurotics, 234
Sexual instinct, 2
development of, in education,

648
Sexual investigation, 22
Sexuality, human, three phases

of, 8
effort to overcome^ 661

Sexual Stutbbbib, 1

Sexual theories, infantile, 21

Small penis complex, 186

Subconscious, 277

Sublimation, 19

Sublimsition a kind of displace-
ment, 146

Substitute activities, 282, 294

Substitute idea, 17

Superstition and compulsion
neurosis, 301

Symbols in dream, 120

Symbols in dream not labeled,
102

Syinptoms, neurotic, 124, 277

Synthesis, sexual, 1

Thbobt Ain> Mbohanism of

THE PSTCHOANALTTIO

Cube, 496

lliing-ideas, 146

Thinking, compulsive, 272
two kinds of, 89

Thought, omnipotence of, 302

Thumb-sucking, 9, 10

Transference, 192
positive and negative, 218
not created by analysis, 219
the most important problem,

600
as a re-living of complex-
producing experiences, 631
phenomena, 640

Trauma, psychic, 498

UirooNBOious, The, 30
Unconscious is prbnitive, 66
Unconscious has no regard for

reality, 66
Unconscious is infantile, 66
Unconscious is unorlented in

time, 67
Unconscious Is instinctive, 68
Unconscious contains no inhi-
bition, no negation, no con-
flict, 70

568

INDEX

Uii«>iueioii8 has free access to
'motility only in major
psychoses, 76
Unconscious habits, 621, 545
Utility the goal of reality
thinking, 94

Verbal residues, 94
Vomiting, hysterical, 10

Will, "weakness of," 293

Wish. 76

Wish, alone represented by
pleasure thinking, 94

Wish that has to remain un-
conscious, 285

Wish exists even in uncon-
scious, 279

Woman suffrage, 136

Word-ideas, 145, 146

Worry in healthy persons an
instance of imperfect con-
control of foreconscioufl, 75

Worry not the cause of insom-
nia, 432 n.

Worry a symptom of neurotic
state, 433 n.

Zones, erogenous, 9, 11
stimulation of penile and cli-
toris, 11

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