ON PSYCHOANALYSIS[175]

After many years' experience I now know that it is extremely difficult to discuss psychoanalysis at public meetings and at congresses. There are so many misconceptions of the matter, so many prejudices against certain psychoanalytic views, that it becomes an almost impossible task to reach mutual understanding in public discussion. I have always found a quiet conversation on the subject much more useful and fruitful than heated discussions coram publico. However, having been honoured by an invitation from the Committee of this Congress as a representative of the psychoanalytic movement, I will do my best to discuss some of the fundamental theoretical conceptions of psychoanalysis. I must limit myself to this part of the subject because I am quite unable to place before my audience all that psychoanalysis means and strives for, all its various applications, its psychology, its theoretical tendencies, its importance for the realm of the so-called "Geisteswissenschaften," e.g. Mythology, Comparative Religion, Philosophy, &c. But if I am to discuss certain theoretical problems fundamental to psychoanalysis, I must presuppose my audience to be well acquainted with the development and main results of psychoanalytic researches. Unfortunately, it often happens that people believe themselves entitled to judge psychoanalysis who have not even read the literature. It is my firm conviction that no one is competent to form a judgment concerning the subject until he has studied the fundamental works on psychoanalysis.

In spite of the fact that Freud's theory of neurosis has been worked out in great detail, it cannot be said to be, on the whole, very clear or easily accessible. This justifies my giving you a very short abstract of his fundamental views concerning the theory of neurosis.

You are aware that the original theory that hysteria and the related neuroses take their origin in a trauma or shock of sexual character in early childhood, was given up about fifteen years ago. It soon became obvious that the sexual trauma could not be the real cause of a neurosis, since trauma is found so universally; there is scarcely a human being who has not had some sexual shock in early youth, and yet comparatively few have incurred a neurosis in later life. Freud himself soon became aware that several of the patients who related an early traumatic event, had only invented the story of a so-called trauma; it had never taken place in reality, and was a mere creation of phantasy. Moreover, on further investigation it became quite obvious that even a trauma which had actually occurred was not always responsible for the whole of the neurosis, although it does sometimes look as if the structure of the neurosis depended entirely upon the trauma. If a neurosis were the inevitable consequence of a trauma it would be quite incomprehensible why neurotics are not incomparably more numerous.

This apparently heightened shock-effect was clearly based upon the exaggerated and morbid phantasy of the patient. Freud also saw that this same phantasy manifested itself in relatively early bad habits, which he called infantile perversities. His new conception of the Ætiology of a neurosis was based upon this further understanding and traced the neurosis back to some sexual activity in early infancy; this conception led on to his recent view that the neurotic is "fixed" to a certain period of his early infancy, because he still seems to preserve some trace of it, direct or indirect, in his mental attitude. Freud also makes the attempt to classify or to differentiate the neuroses, including dementia prÆcox, according to the stage of the infantile development in which the fixation took place.

From the standpoint of this theory, the neurotic appears to be entirely dependent upon his infantile past, and all his troubles in later life, his moral conflicts, and deficiencies, seem to be derived from the powerful influence of that period. The therapy and its main preoccupation are in full accord with this view, and are chiefly concerned with the unravelling of this infantile fixation, which is understood as an unconscious attachment of the sexual libido to certain infantile phantasies and habits.

This is, so far as I can see, the essence of Freud's theory. But this conception neglects the following important question: What is the cause of this fixation of the libido to the old infantile phantasies and habits? We have to remember that almost all persons have at some time had infantile phantasies and habits exactly corresponding to those of a neurotic, but they do not become fixed to them; consequently, they do not become neurotic later on. The Ætiological secret of the neurosis, therefore, does not consist in the mere existence of infantile phantasies, but lies in the so-called fixation. The manifold statements of the existence of infantile sexual phantasies in neurotic cases are worthless, in so far as they attribute an Ætiological value to them, for the same phantasies can be found in normal individuals as well, a fact which I have often proved. It is only the fixation which seems to be characteristic. It is important to demand the nature of the proofs of the real existence of this infantile fixation. Freud, an absolutely sincere and thorough empiricist, would never have evolved this hypothesis had he not had sufficient grounds for it. The grounds are found in the results of the psychoanalytic investigations of the unconscious. Psychoanalysis discloses the unconscious existence of manifold phantasies, which have their end root in the infantile past and turn around the so-called "Kern-complex," or nucleus-complex, which may be designated in male individuals as the Œdipus-complex and in females as the Electra-complex. These terms convey their own meaning exactly. The whole tragic fate of Œdipus and Electra took place within the narrow confines of the family, just as the child's fate lies wholly within the family boundaries. Hence the Œdipus conflict is very characteristic of an infantile conflict, so also is the Electra conflict. The existence of these conflicts in infancy is largely proven by means of psychoanalytic experience. It is in the realm of this complex that the fixation is supposed to have taken place. Through the highly potent and effective existence of the nucleus-complex in the unconscious of neurotics, Freud was led to the hypothesis, that the neurotic has a peculiar fixation or attachment to it. Not the mere existence of this complex—for everybody has it in the unconscious—but the very strong attachment to it is what is typical of the neurotic. He is far more influenced by this complex than the normal person; many examples in confirmation of this statement will be found in every one of the recent psychoanalytic histories of neurotic cases.

We must admit that this conception is a very plausible one, because the hypothesis of fixation is based upon the well-known fact, that certain periods of human life, and particularly infancy, do sometimes leave determining traces for ever. The only question is whether this principle is a sufficient explanation or not. If we examine persons who have been neurotic from infancy it seems to be confirmed, for we see the nucleus-complex as a permanent and powerful activity throughout the whole life. But if we take cases which never show any considerable traces of neurosis except at the particular time when they break down, and there are many such, this principle becomes doubtful. If there is such a thing as fixation, it is not permissible to base upon it a new hypothesis, claiming that at times during certain epochs of life the fixation becomes loosened and ineffective, while at others it suddenly becomes strengthened and effective. In such cases we find the nucleus-complex as active and as potent as in those which apparently support the theory of fixation. Here a critical attitude is peculiarly justifiable, when we consider the often-repeated observation that the moment of the outbreak of the disease is by no means indifferent; as a rule it is most critical. It usually occurs at the moment when a new psychological adjustment, that is, a new adaptation, is demanded. Such moments facilitate the outbreak of a neurosis, as every experienced neurologist knows. This fact seems to me extremely significant. If the fixation were indeed real we should expect to find its influence constant, i.e. a neurosis continuous throughout life. This is obviously not the case. The psychological determination of a neurosis is only partially due to an early infantile predisposition; it is due to a certain actual cause as well. And if we carefully examine the kind of infantile phantasies and events to which the neurotic individual is attached, we shall be obliged to agree that there is nothing in them specific for neurosis. Normal individuals have pretty much the same kind of internal and external experiences, and are attached to them to an even astonishing degree, without developing a neurosis. You will find primitive people, especially, very much bound to their infantility. It now begins to look as if this so-called fixation were a normal phenomenon, and that the importance of infancy for the later mental attitude is natural and prevails everywhere. The fact that the neurotic seems to be markedly influenced by his infantile conflicts, shows that it is less a matter of fixation than of a peculiar use which he makes of his infantile past. It looks as if he exaggerated its importance, and attributed a very great artificial value to it (Adler, a pupil of Freud's, expresses a very similar view). It would be unjust to say that Freud confined himself to the hypothesis of fixation; he also was conscious of the impression I have just discussed. He called this phenomenon of reactivation or secondary exaggeration of infantile reminiscences "regression." But in Freud's conception it appears as if the incestuous desires of the Œdipus-complex were the real cause of the regression to infantile phantasies. If this were the case, we should have to postulate an unexpected intensity of the primary incestuous tendencies. This view led Freud to his recent comparison between the so-called psychological "incest-barrier" in children and the "incest-taboo" in primitive man. He supposes that a real incestuous desire has led the primitive man to the invention of a protective law; while to me it looks as if the incest-taboo is one among numerous taboos of all sorts, and due to the typical superstitious fear of primitive man, a fear existing independently of incest and its interdiction. I am able to attribute as little particular strength to incestuous desires in childhood as in primitive humanity. I do not even seek the reason for regression in primary incestuous or any other sexual desires. I must state that a purely sexual Ætiology of neurosis seems to me much too narrow. I base this criticism upon no prejudice against sexuality, but upon an intimate acquaintance with the whole problem.

Therefore I suggest that the psychoanalytic theory should be liberated from the purely sexual standpoint. In place of it I should like to introduce an energic view-point into the psychology of neurosis.

All psychological phenomena can be considered as manifestations of energy, in the same way as all physical phenomena are already understood as energic manifestations since Robert Mayer discovered the law of the conservation of energy. This energy is subjectively and psychologically conceived as desire. I call it libido, using the word in the original meaning of this term, which is by no means only sexual. Sallustius applies the term exactly in the way we do here: "Magis in armis et militaribus equis, quam in scortis et conviviis libidinem habebant."

From a broader standpoint libido can be understood as vital energy in general, or as Bergson's Élan vital. The first manifestation of this energy in the suckling is the instinct of nutrition. From this stage the libido slowly develops through manifold varieties of the act of sucking into the sexual function. Hence I do not consider the act of sucking as a sexual act. The pleasure in sucking can certainly not be considered as sexual pleasure, but as pleasure in nutrition, for it is nowhere proved that pleasure is sexual in itself. This process of development continues into adult life and is connected with a constantly increased adaptation to the external world. Whenever the libido, in the process of adaptation, meets an obstacle, an accumulation takes place which normally gives rise to an increased effort to overcome the obstacle. But if the obstacle seems to be insurmountable, and the individual renounces the overcoming of it, the stored-up libido makes a regression. In place of being employed in the increased effort, the libido now gives up the present task and returns to a former and more primitive way of adaptation. We meet with the best examples of such regressions very frequently in hysterical cases where a disappointment in love or marriage gives rise to the neurosis. There we find the well-known disturbances of nutrition, resistance against eating, dyspeptic symptoms of all sorts, etc. In these cases the regressive libido, turning away from its application to the work of adaptation, holds sway over the function of nutrition and provokes considerable disturbance. Such cases are obvious examples of regression. Similar effects of regression are to be found in cases where there are no troubles in the function of nutrition, and here we readily find a regressive revival of reminiscences of a time long past. We find a revival of the images of the parents, of the Œdipus-complex. Here things and events of infancy—never before important—suddenly become so. They are regressively reanimated. Take away the obstacle in the path of life and this whole system of infantile phantasies at once breaks down and becomes again as inactive and as ineffective as before. But do not let us forget that, to a certain extent, it is at work influencing us always and everywhere. I cannot forbear to mention that this view comes very near Janet's hypothesis of the substitution of the "parties supÉrieures" of a function by its "parties infÉrieures." I would also remind you of ClaparÈde's conception of neurotic symptoms as emotional reflexes of a primitive nature.

Therefore I no longer find the cause of a neurosis in the past, but in the present. I ask, what is the necessary task which the patient will not accomplish? The whole list of his infantile phantasies does not give me any sufficient Ætiological explanation, because I know that these phantasies are only puffed up by the regressive libido, which has not found its natural outlet into a new form of adjustment to the demands of life.

You may ask why the neurotic has a special inclination not to accomplish his necessary tasks. Here let me point out that no living being adjusts itself easily and smoothly to new conditions. The principle of the minimum of effort is valid everywhere.

A sensitive and somewhat inharmonious character, as a neurotic always is, will meet special difficulties and perhaps more unusual tasks in life than a normal individual, who as a rule has only to follow the well-established line of an ordinary life. For the neurotic there is no established way, for his aims and tasks are apt to be of a highly individual character. He tries to follow the more or less uncontrolled and half-conscious way of normal people, not fully realizing his own critical and very different nature, which imposes upon him more effort than the normal person is required to exert. There are neurotics who have shown their increased sensitiveness and their resistance against adaptation in the very first weeks of life, in their difficulty in taking the mother's breast, and in their exaggerated nervous reactions, &c. For this portion of a neurotic predisposition it will always be impossible to find a psychological Ætiology, for it is anterior to all psychology. But this predisposition—you may call it "congenital sensitiveness" or by what name you like—is the cause of the first resistances against adaptation. In such case, the way of adaptation being blocked, the biological energy we call libido does not find its appropriate outlet or activity and therefore replaces an up-to-date and suitable form of adaptation by an abnormal or primitive one.

In neurosis we speak of an infantile attitude or the predominance of infantile phantasies and desires. In so far as infantile impressions and desires are of obvious importance in normal people they are equally influential in neurosis, but they have here no Ætiological significance, they are reactions merely, being chiefly secondary and regressive phenomena. It is perfectly true, as Freud states, that infantile phantasies determine the form and further development of neurosis, but this is not Ætiology. Even when we find perverted sexual phantasies of which we can prove the existence in childhood, we cannot consider them of Ætiological significance. A neurosis is not really originated by infantile sexual phantasies and the same must be said of the sexualism of neurotic phantasy in general. It is not a primary phenomenon based upon a perverted sexual disposition, but merely secondary and a consequence of a failure to apply the stored-up libido in a suitable way. I realize that this is a very old view, but this does not prevent its being true. The fact that the patient himself very often believes that this infantile phantasy is the real cause of the neurosis, does not prove that he is right in his belief, or that a theory following the same belief is right either. It may look as if it were so, and I must confess that indeed very many cases do have that appearance. At all events, it is perfectly easy to understand how Freud came to this view. Every one having any psychoanalytic experience will agree with me here.

To sum up: I cannot see the real Ætiology of a neurosis in the various manifestations of infantile sexual development and their corresponding phantasies. The fact that they are exaggerated and put into the foreground in neurosis is a consequence of the stored-up energy or libido. The psychological trouble in neurosis, and neurosis itself, can be considered as an act of adaptation that has failed. This formulation might reconcile certain views of Janet's with Freud's view, that a neurosis is—under a certain aspect—an attempt at self-cure; a view which can be and has been applied to many diseases.

Here the question arises whether it is still advisable to bring to light all the patient's phantasies by analysis, if we now consider them as of no Ætiological significance. Psychoanalysis hitherto has proceeded to the unravelling of these phantasies because they were considered to be Ætiologically significant. My altered view concerning the theory of neurosis does not change the procedure of psychoanalysis. The technique remains the same. We no longer imagine we are unearthing the end-root of the disease, but we have to pull up the sexual phantasies because the energy which the patient needs for his health, that is, for his adaptation, is attached to them. By means of psychoanalysis the connexion between the conscious and the libido in the unconscious is re-established. Thus you restore this unconscious libido to the command of conscious intention. Only in this way can the formerly split-off energy become again applicable to the accomplishment of the necessary tasks of life. Considered from this standpoint, psychoanalysis no longer appears to be a mere reduction of the individual to his primitive sexual wishes, but it becomes clear that, if rightly understood, it is a highly moral task of immense educational value.