BltLOGY 
 
 LIBRARY 
 
 O 
 
'MORBID FEARS 
 AND COMPULSIONS 
 
 THEIR PSYCHOLOGY AND 
 PSYCHOANALYTIC TREATMENT 
 
 BY 
 
 H. W. FRINK, M.D. 
 
 Assistant Professor of Neurology in Cornell University Medical 
 
 College, Adjunct Assistant Neurologist to Bellevue Hospital, 
 
 Ex-president of the New York Psychoanalytic Society. 
 
 Secretary of the American Psychopathological 
 
 Association, Member of the American 
 
 Psychoanalytic Association, etc 
 
 WITH AN INTRODUCTION BY 
 
 JAMES J. PUTNAM, M.D. 
 
 Emeritus Professor of Neurology, Harvard University 
 
 NEW YORK 
 
 MOFFAT, YARD AND COMPANY 
 1918 
 
P8 
 
 L1BRM* 
 G 
 
 Copyright. 1918. by 
 MOFFAT. YARD AND COMPANY 
 
 Published, March, 1918 
 
TO 
 
 CHARLES LOOMIS DANA, A.M., M.D., LL.D. 
 
 PROFESSOR or NEUROLOGY IN CORNELL UNIVERSITY 
 MEDICAL COLLEGE 
 
 THIS BOOK 
 
 IS 
 GRATEFULLY DEDICATED 
 
 376 I 9.1 
 
INTRODUCTION 
 
 The day has fortunately gone by when the far- 
 reaching investigations associated with the name 
 of Sigmund Freud 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- 
 ment, and so pronounced is the interest which it 
 has evoked, that one feels a sense of lack, if, on 
 looking through a volume or a magazine where 
 human 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 "nor- 
 mal" 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" finds 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)' 
 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"? Why is it that 
 some persons are so much more overwhelmed than 
 others by the recitals of the horrors of the war? 
 
INTEODUCTION vii 
 
 People afflicted with these tendencies present, fre- 
 quently, 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 ; 
 but 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 fundamental doctrines are laid down, and in 
 that in which the compulsions and obsessions are 
 more specifically 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 really grasp these elusive motives that play 
 so large a part in all our lives, to exchange a 
 
viii INTEODUCTION 
 
 "knowledge about " them for a real "acquaint- 
 ance 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 shrinking, 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 
 
INTRODUCTION ix 
 
 often been urged against Freud, for example, 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 monographic, 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 
 "love," understood as he defines it. 
 
x INTRODUCTION 
 
 It is true 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 Freud'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 
 
INTRODUCTION xi 
 
 are also many men, whose voices never have been, 
 and never can be, silenced, who feel convinced 
 that the dicta of the natural scientists, that is, of 
 those who would eventually refer everything back 
 to the laws of chemistry and physics, are not to 
 be allowed to have the last word. There are, in- 
 deed, 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 ; they 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 inflexible 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 INTEODHCTION 
 
 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, 1 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 
 
 iE. g. see statements of this sort in his paper entitled Totem 
 und Tabu. Translation Totem and Taboo, N. Y., 1918. 
 
INTRODUCTION 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 physics, 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 clear. 
 
 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. 
 
 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- 
 [ tion 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- 
 
INTRODUCTION xv 
 
 oughly 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. 
 
 Finally 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 Adler 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 INTEODUCTION 
 
 compensation," partly in an effort to escape re- 
 sponsibilities which 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 his 
 recognition of weakness, temptation and defect. 
 
 JAMES J. PUTNAM. 
 
AUTHOR'S NOTE 
 
 There are three classes of readers to whom a 
 book on psychoanalysis might be of interest. In 
 the first, would be those entirely unfamiliar 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 will 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 
 technical 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 
 
 xvii 
 
xviii 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- 
 ume, 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 them. 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 behaviorism. 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 
 Psychoanalytic Review, under the title, "A Psy- 
 
AUTHOR'S NOTE xix 
 
 choanalytic 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, "On 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 III 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 
 
xx AUTHOR'S NOTE 
 
 involve referring almost every paragraph to the 
 same small list of authoritative works. 
 
 In conclusion 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 
 
 PAGE 
 
 THE SEXUAL SYNTHESIS 1 
 
 Sexual origin of functional neuroses suspected by the 
 ancients given a scientific basis by Freud. Meaning of 
 the term sexual. 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 taese two. Everything 
 connected with 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-inhibitory, 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 connection 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- 
 tial impulses: sadism-masochism, exhibitionism, impulse 
 to touch and be touched. "Polymorphous-perverse" and 
 autoerotic nature of infantile sexuality. 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 hierarchy under the primacy of the genital sys- 
 tem. Morbid disturbances possible at every step in this 
 development. Infantile sexual theories and their sig- 
 nificance in determining psychoneurotic symptoms in 
 adult life. Later amnesia. 
 
 xxi 
 
xxii CONTENTS 
 
 CHAPTER II 
 
 PAGE 
 
 THE UNCONSCIOUS .30 
 
 The concept of cause and effect valid in the psychical as 
 well as in the physical realm. Objections answered. 
 Illustrations from hypnosis, abnormal psychology, prej- 
 udices and religious beliefs. Rationalization blinds us to 
 the validtiy of the causal principle in psychology. The 
 Foreconscious and the Unconscious distinguished; 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-externalization of the 
 father imago, and contains more than specific morality. 
 The Ego-ideal a structure of the foreconscious and not 
 consciously formulated. The Censor as an effect of 
 trends in the foreeonscious. 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. 
 The drug-taking compulsion. Its origin in an infantile 
 sexual theory. The descendants of the repressed. The 
 second or superficial censor. 
 
 CHAPTER III 
 
 Two KINDS OP THINKING, AND THE PSYCHOLOGY OP 
 THE DREAM 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 infant realizes satisfaction by the hallucinatory route. 
 
CONTENTS xxiii 
 
 PAGE 
 
 Gives place to Reality Thinking in adult life, but not 
 completely. Day dreams and night 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 
 content of dreams. In night dreams the wish disguised. 
 Dream of shop window, and interpretation. The dream 
 processes: 1. Condensation, 2. Displacement, 3. Drama- 
 tization. Typical symbolism in dreams. 4. Secondary 
 Elaboration. The dream a preserver, not a disturber, of 
 sleep (except nightmares). Significance of the dream 
 for psychoanalysis. Symptom and dream. 
 
 CHAPTER IV 
 
 THE MECHANISMS OF PSYCHOPATHOLOGICAL MANI- 
 FESTATIONS 124 
 
 Neurotic symptoms have psychical mechanisms, the 
 same as those in dreams. The cause of a young woman's 
 forgetting the name "Milton." Overcompensation. Com- 
 pensatory hypertrophy and its analogue in the psychic 
 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 
 what it covered. Most radical movements have neurotics 
 as conspicuous supporters. Antivivisectionism, Southern 
 chivalry and lynching as overcompensations for sadistic 
 trends. Displacement. Sublimation one of its forms. 
 Sublimation of a sadistic trend in the study of chem- 
 istry. Displacements of the drug-taking young woman; 
 of the man catching trains; the young man who breaks 
 rules. Origin of kleptomania. 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 
 feelings into an attack on the physician. The projection 
 of a reproach. A girl's projection of her desires on to 
 the teachers with whom she studied. A man's projection 
 of self-reproach for impotence, into accusing his wife 
 of infidelity. Morbid jealousy in women and in men. 
 Introjection. The reverse of projection and also called 
 t Identification, of which there are two kinds, subjective 
 and objective. Normal identification. Case of a woman 
 identifying herself with Evelyn Nesbit Thaw; of a phy- 
 sician who identified himself with a murderer; of a 
 
xxiv CONTENTS 
 
 PAGE 
 
 patient who identified himself with a patient of Dr. 
 Brill's. Rationalization. Neurotics rather more intel- 
 ligent than the average. Few even normal people really 
 know the causes of their actions. Patient who declared 
 he would marry a rich girl gives wrong reason for 
 marrying a poor girl. Rationalization in another pa- 
 tient's arguments in favor of woman suffrage, of elec- 
 tion of Wilson, against Wilson's election. A married 
 woman rationalizes her wearing of black clothes. De- 
 fense and Distortion Mechanisms. 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; religious 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 OEdipus 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 NEUROSIS AS A WHOLE 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 xxv 
 
 FADE 
 
 senting a partial arrest of development. Fixation and 
 inhibition of instincts by habit. Fixation of holophilic 
 impulse 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 
 exceptionally be satisfied in reality and wishes must 
 remain in the Unconscious. Fundamental difference be- 
 tween neurotic and normal person is that neurotic has 
 learned to love and hate too soon. Fixation points are 
 weak points in the holophilic synthesis. Regression of 
 libido to earlier lines of discharge paralleled by a regres- 
 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 neurosis. 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 
 of damming up of libido. Difference between morbid and 
 normal fear is that former is a relatively excessive one, 
 and is a difference of origin. Normal 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 within the organism nothing 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 taking 
 word sexual too narrowly. 
 
 CHAPTER VI 
 PSYCHOLOGY OF THE COMPULSION NEUROSIS . . . 270 
 
 Neurasthenia a misnomer. Phobias and panics. Ex- 
 amples of compulsions showing mesalliance between affect 
 and idea content, both qualitative and quantitative. 
 
xxvi CONTENTS 
 
 PAGE 
 
 Source of affects entirely in the Unconscious, and affects 
 are attached to wrong ideas. Necessity of admitting un- 
 conscious psychic activities. Repressed wishes just as 
 dynamic as the undepressed. Compulsion in the drug- 
 taking case shows wish entering consciousness as a wish 
 but attached to new idea. In compulsive fears the wish 
 energy is transformed into anxiety. Case of young man 
 buying a straw hat, showing overcompensation. RCle 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 
 negative of the sadistic perversion. The curiosity im- 
 pulse causes morbid pondering. Superstition in compul- 
 sion neurotics concerning the death of others. Omnipo- 
 tence of wishes. Difference between compulsion neurosis 
 and hysteria. Case of prostitute showing failure to see 
 connection between her neurosis and her life. 
 
 CHAPTER VII 
 A CASE OF COMPULSION NEUROSIS 308 
 
 Introduction. Historical. Results of previous treat- 
 ment. Analytic data. Father complex. (Separation 
 complex. Assault obsession. Resistance against mar- 
 riage. Analysis of the assault obsession. R<51e of the 
 tuberculosis complex in the love choice. Analysis of the 
 Kishef obsession. Further details. Conclusion. 
 
 CHAPTER VIII 
 THE PSYCHOLOGY OP 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 farmer 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 the negative of the masochistic perver- 
 sion. Stella's fear of "dead souls" displaced from anal- 
 erotic wishes. 
 
CONTENTS xxvii 
 
 CHAPTER IX 
 
 PAGE 
 
 A CASE OF ANXIETY HYSTERIA 444 
 
 History. First seizure, followed by two others in 
 three weeks. Hypnotism suggested 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, (5) The 
 talk with the girl friend, (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 thoughts all point- 
 ing to fear of sex. Dream of being chased by a Japanese 
 girl. Dream of being bitten by a dog. Its interpreta- 
 tion withheld. Associations: 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 S.'s remarks about 
 disliking Mr. D. Her fears of going to the office now 
 explained as a fear that she would fulfill her sexual 
 wishes. Interpretation of dream presented to patient, 
 the first sex information imparted, produces increase 
 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 sexual advance of girls. Protestations of 
 ignorance. Her learning about coitus at the age of thir- 
 teen. Her enuresis from five to six. The consequent 
 connection 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 
 by the transference. The feelings thus 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 interpretation. Reading of "His Hour" as material 
 for assault phantasies. Interpretation of the neurosis. 
 1. Flash of sexual feeling toward Mr. D. on subway, 2. 
 reading white slave reports, 3, reading "His Hour," 4, in- 
 cident of being chased by a man, and 5, her first attack on 
 
xxviii CONTENTS 
 
 PAGE 
 
 day of expected visit to her homosexual friend all show 
 inclination for Mr. D. Her idealized love shown as an 
 infantility. 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 OF CHAPTER X 
 v 
 
 THE THEORY AND MECHANISM OP 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 in 
 accordance with an infantile pattern. Psychoanalysis 
 lets the patient know what he is doing. Filling of gaps 
 of memory 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. 
 
 BIBLIOGRAPHY . 555 
 
MORBID FEARS AND 
 COMPULSIONS 
 
 CHAPTER I 
 
 THE SEXUAL SYNTHESIS 
 
 HIPPOCRATES, 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 interior of the body. In accordance with this 
 theory he applied sweet perfumes to the vulva of 
 the patient and evil-smelling substances to her 
 nostrils, with the idea that by such means the 
 mutinous organ might be induced to return to its 
 proper locus. Remnants from this theory are 
 handed down to present day medicine as the name 
 we apply to the disease (hysteria, from voWpa, 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 M0K3ID : FEARS AND COMPULSIONS 
 
 if ill-defined, tendency to locate the cause of the 
 trouble in the organs of generation. The constant 
 search for malpositions of the uterus, cervical or 
 perinea! 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 inclina- 
 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, and 
 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 
 
 further 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 clear 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 amoeba, 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 
 civilized 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) l is revealed, either to 
 
 i J. B. Watson, "Behavior," Henry Holt & Co. 
 
4 MOEBID FEARS 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 broad 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 'Epws (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 the group which are sexual in Freud's 
 sense. 1 
 
 * It 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 
 
 exact meaning he wanted, he had either to invent a new word or 
 else 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 
 generally 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 6Xos, whole, and 
 0iX&;, love, thus meaning all kinds of sexual or love phenomena, 
 might be a convenient synonym for the word sexual in Freud's 
 sense, and that its judicious use would serve to avoid some pos- 
 sible misunderstanding. I do not wish to replace the word sex- 
 ual entirely, for that, too, might lead to misunderstanding. In 
 this book, therefore, I propose to use the two words interchange- 
 ably and as synonymous with one another, hoping by so doing 
 to emphasize 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 FEAES 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 organism. 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 give in the 
 case of the holophilic group of phenomena the 
 name Libido. 1 
 
 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 
 
 i Like the word sexual the word libido must be construed in 
 psychoanalytic 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 former. For this reason Jung has sug- 
 gested that it be replaced by the Greek bpti-fi (Horme"). "On Psy- 
 chological Understanding," Journal of Abnormal Psychology, Vol. 
 IX, No. 6. 
 
INFANTILE SEXUALITY 7 
 
 has any prepubertal representation or in what this 
 representation might consist hardly anybody 
 stopped to enquire. One of Freud's great 
 achievements was the demonstration that the sex- 
 ual instinct 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 
 sexuality are present in the individual from his 
 very birth. 
 
 That this discovery of Freud's should have 
 given rise to astonishment and incredulity is from 
 one point of view very surprising. All the 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 all this com- 
 plicated machinery waited silent and idle, or was 
 responsive only to non-sexual stimuli and capable 
 only of non-sexual reactions 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 FEARS AND COMPULSIONS 
 
 lacking 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 close 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 f eces 
 until there is an accumulation of sufficient size and 
 consistency to give the act of evacuation the great- 
 est possible amount of pleasure. 
 
10 MORBID FEARS 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 holophilic 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 (feHatio, cunni- 
 lingus, 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 plea sure- sucking remain 
 local. But we must remember that the intercom- 
 munication of the various holophilic 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 is 
 
INFANTILE SEXUALITY 11 
 
 not set off so sharply from adult sexuality 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 FEAES AND COMPULSIONS 
 
 philic instinct there appear a little later a set of 
 impulses which have at first no connection with the 
 erogenous areas. These so-called partial impulses 
 (Partial-triebe) 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. 1 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 
 
 i The wish to cause pain is not primary in the sadistic im- 
 pulse, though early becoming associated with it. See Freud's 
 "Triebe und Triebschicksale," Int. Zeitaotvrift 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 certain 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 FEAES 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 
 out of the way so that he could have his mother all 
 to himself. l This early object-selection forms 
 the foundation of those important constellations, 
 the CEdipus 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- 
 
 i That this desire frequently takes the form of a wish that the 
 father were dead need cause no astonishment, for at this period 
 the idea of death means nothing more to the child than simply 
 "gone away," and excites none of the horror that it has for the 
 adult. 
 
16 MOBBID FEAES AND COMPULSIONS 
 
 tiation into pleasures of different order. All the 
 holophilic 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 be understood from what I have said 
 about the (Edipus 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 homophilic 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 holopkilic expression. The 
 first appearance of these inhibitory tendencies is 
 spontaneous 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. 1 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 first 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 
 
 i Freud remarks that education remains 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 will, 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 
 corrective efforts of parents overstepped 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 FEAES AND COMPULSIONS 
 
 avoid the very acts by which he gratified them orig- 
 inally. In this manner the control and suppres- 
 sion of the primitive infantile sexuality is in large 
 part accomplished by motives derived from the in- 
 fantile sexuality 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, while 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 (Edipus 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, 
 
INFANTILE SEXUALITY 19 
 
 etc. Such 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. 1 
 
 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 
 
 i In Chapter IV on Mechanisms. 
 
20 MORBID FEAES AND COMPULSIONS 
 
 unified purpose of preparing for and urging to- 
 ward the final holophilic act through which sex- 
 uality is articulated with the function of procrea- 
 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- 
 pears 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 
 life. 
 
 This sketch of the ontogenetic development of 
 the holophilic 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 discuss the abnormalities or anomalies 
 that may arise out of the many possibilities for 
 aberration presented by the developmental 
 changes taking place in a machinery so compli- 
 cated. It will 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 locus 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 particular 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 theories, which as we shall learn 
 are often of much significance in the determination 
 of the psychoneurotic symptoms in adult life. 
 
22 MORBID FEAES AND COMPULSIONS 
 
 Children of normal intelligence, about the 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 through 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. 1 Through the feelings of hostility born of 
 such considerations the child is led to ask himself 
 the important question: "Where do babies come 
 from?" 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 hirth takes place during his early 
 years learns of the dreaded possibility from his acquaintance with 
 other households. Older children are much less likely to be jeal- 
 ous of a newly arrived brother or sister than are younger ones, 
 and in many cases they welcome their small relative with un- 
 mixed satisfaction. 
 
INFANTILE SEXUAL THEORIES 23 
 
 able. But in most cases he gets little satisfaction ; 
 his questions 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 within 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- 
 sider. 
 
 Practically all children who form any theory 
 whatever come to the right conclusion in the one 
 
24 MOEBID FEAES AND COMPULSIONS 
 
 important particular that the baby grows in the 
 abdomen of the mother. It would seem at first 
 thought, that if children are able to guess 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 
 
 i 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 sexes, 
 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 ? How does the baby get into the mother 1 
 The explanation most obvious to the child's mind 
 is, that since the baby comes out like f eces, it must 
 go in like food. Therefore to start a pregnancy 
 the 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 the proper develop- 
 ment of seeds planted in the ground. He reasons 
 by analogy that urine and f eces 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 Eeitler, is that impregnation is ac- 
 complished by the parents placing the buttocks to- 
 gether and blowing flatus into one another. 1 
 
 A notion somewhat different from these already 
 described is formed by children who, through shar- 
 
 of the esthetic objections which could occur to an adult. "Then," 
 as Freud says, "defecation was something that in the nursery 
 could be spoken of without reserve; the child had not yet divorced 
 himself from his constitutional coprophilic tendencies; it was no 
 degradation to come into the world like a mass of excrement." 
 Ueber infantile Sexualtheorien. 
 iR. Reitler, "Zentralblatt fiir Psychoanalyse," Hft 2, 1912. 
 
26 MORBID FEAES 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." 1 It seems probable that some 
 children recognize 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 as 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 spectacle 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 
 
 i Freud, 1. c. 
 
INFANTILE 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 close 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- 
 clusions, but the uniformity of the primary and, 
 so to speak, 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 close 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 volume. 
 
CHAPTER II 
 
 THE UNCONSCIOUS 
 
 IP you hold horizontally in your hand a sheet 
 of stiff paper upon which some iron carpet 
 tacks have been placed, and then move a 
 magnet back and forth under the paper, the tacks 
 will follow the magnet. To an ignorant person, 
 not seeing what was beneath the paper, the be- 
 havior of the tacks would seem lawless and inex- 
 plicable. 
 
 The phenomena of mental life are quite as un- 
 accountable as the movements of the tacks if we 
 take into account in the former only the content 
 of the individual's consciousness. 
 
 Not only in the psychically abnormal but in the 
 normal as well there are many mental occurrences 
 for the cause of which the individual's conscious- 
 ness may be searched in vain. We are frequently 
 surprised to find that we have dreamed of a per- 
 son or event which we have not thought of for 
 years. A tune starts running in our heads, or an 
 unfamiliar verse, or we suddenly begin to hum or 
 whistle some long-forgotten air. What evoked it! 
 We have ideas, impulses, tastes or prejudices the 
 causes of which we do not know; continually we 
 find ourselves entertaining beliefs or arriving at 
 conclusions the origin and basis for which we are 
 entirely unacquainted with. There are sudden 
 
 30 
 
PSYCHIC CAUSES 31 
 
 likes and dislikes, such as an unaccountable antip- 
 athy once felt by a young woman patient of the 
 writer's for all men with light hair. 1 We feel 
 sure of the guilt or the innocence of some one on 
 trial for murder, though we cannot say exactly 
 why we have that feeling. A man will suddenly 
 in the middle of his busy day become sick of his 
 business and want to give the whole thing up. 
 Not only for our dreams but for our defective ac- 
 tions and, in neurotic individuals, for the various 
 symptoms (anxieties, compulsions and the like) 
 the content of the individual consciousness gives 
 no adequate explanation. In short, if we attempt 
 to explain every conscious psychic phenomenon 
 by relating it to some other conscious phenome- 
 non, we are utterly baffled and confused. The 
 majority of mental happenings seem so entirely 
 independent of any other mental happenings as 
 to be entirely inexplicable on any causal basis that 
 includes only conscious factors. 
 
 In psychology, just as in physics, we are com- 
 pelled to assume that the law of cause and effect 
 holds good. Every idea, impulse or feeling that 
 appears in our consciousness, every action we per- 
 form, must have some adequate cause. None of 
 the phenomena of either normal or abnormal men- 
 tal life can be regarded as merely the result of 
 accident or chance. Therefore, just as a think- 
 ing person who saw the tacks moving about a 
 sheet of paper, as if they were themselves autono- 
 mous, would assume that they were actuated by 
 some force the origin of which he could not see, 
 
 i See Chap. IV, p. 126. 
 
32 MORBID FEARS AND COMPULSIONS 
 
 so 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 off, inactive, 
 unilluminated. 
 
 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, but cannot remember 
 his name. What is his name? 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 them. 
 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 is? 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 sterile. 
 A refusal to call latent memories a part of the 
 psyche is either a begging of the question as to 
 
34 MOEBID FEAES 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 really a pragmatic one 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 which 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. 1 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 
 
 iDas Unbewussten "International Zeitschrift far Arztliche 
 Psychoanalyse," Vol. Ill, 1915. 
 
UNCONSCIOUS CAUSES 35 
 
 other hand, a psychology which includes the non- 
 conscious is extremely useful. This will, I feel, 
 be so clearly shown in the following pages as to 
 relieve me of the task of arguing the point just 
 now. 
 
 If now we grant the right to posit an uncon- 
 scious portion of the psyche, it is evident that 
 latent, i. e., inactive, memory impressions and 
 their like are not the only non-conscious mental 
 elements which we must assume to exist. "We 
 have reason to infer the existence of other ele- 
 ments which are not simply latent but which, 
 despite their not being conscious, are active and 
 may exert an influence, even a profound one, on 
 the individual's conscious 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- 
 scious. This proves conclusively that a mental 
 element does not necessarily have to be in con- 
 sciousness in order to be active or produce an 
 effect. 
 
 A similar example we can take from the realm 
 
36 MOEBID FEAES 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 pathologically 
 produced compulsion we lack such knowledge until 
 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 will 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 remembers 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 choice. 
 
 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. 1 
 
 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 
 
 iFrink "What Is a Complex?" Journal of the American 
 Medical Association, 1 ' Vol. LXII, p. 897, 1914. 
 
KATIONALIZATION 39 
 
 members of which are ever in consciousness. We 
 have complexes concerning the different members 
 of our 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 
 our 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 them. 
 "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 th ought " 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 ! Ask 
 a German if he approves of Zeppelin raids and 
 he says: "Certainly." Ask an Englishman and 
 he answers: "Barbarism!" 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? Is it not more 
 likely that the reason that the German believes in 
 Zeppelin raids is that he is a German, and the 
 
40 MOBBED FEAES AND COMPULSIONS 
 
 Englishman condemns them because he is an 
 Englishman? 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 facto 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 been named by Ernest Jones rationaliza- 
 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. 
 
 i "Papers on Psychoanalysis," Chapter I. 
 
THE FORECONSCIOUS 41 
 
 (b) The Unconscious and the Foreconscious 
 
 Non-conscious 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 MOEBID FEARS AND COMPULSIONS 
 
 conscious. 1 Those of the second class are known 
 as unconscious 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 
 
 i Called preconscious by some writers. 
 
THE FORECONSCIOUS 43 
 
 exerting a strong influence 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? 
 
 In the case of foreconscious 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 corners, avoid collision with other 
 pedestriarj|, and stop at the right house. All 
 the processes necessary for doing these things are 
 carried of 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. 1 Foreconscious memories or proc- 
 esses seem, then, to be those which either are prac- 
 
 1 1 have preferred to use the terms "activation" and "activa- 
 tion-energy" instead of "occupation" and "occupation-energy" 
 
44 MORBID FEAES 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 consciousness. 
 
 The lack of awareness of those processes be- 
 longing to the unconscious proper cannot be ex- 
 plained in any such 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 must 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 
 
 which Brill, the translator of Freud's works, has employed as the 
 equivalent of the German "Besetzung" and "Besetzungs-Energie." 
 
BEPKESSION 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 
 taken in so easily, and keeps me in a state of exas- 
 peration and annoyance. But finally I say to my- 
 self 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 fading 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 MORBID FEAES AND COMPULSIONS 
 
 of it? Apparently by attempting a forcible with- 
 drawal of conscious activation and by initiating 
 through a conscious act of will a counter-activa- 
 tion which is shortly taken over by the f orecon- 
 scious and becomes automatic, serving to protect 
 me from the displeasure of having the recollection 
 of the disagreeable incident reproduced in my con- 
 sciousness, and apparently persisting at least un- 
 til the activation of the memory itself in the course 
 of time is eventually withdrawn. 1 
 
 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 
 
 i Strictly speaking, the counter-activation is not initiated by a 
 "conscious act of will"; in fact, the act of will might be more 
 accurately said to be initiated by it. The counter-activation is 
 really represented by my wish to forget the incident. 
 
REPRESSION 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 everything 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. l 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- 
 
 i This is not strictly true unless 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 perceiving psychic qualities. He speaks of it as having two 
 surfaces, 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 MORBID FEAES 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 uncon- 
 scious and the f oreconscious 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) 1 some of them are rejected, and remain re- 
 pressed and in the unconscious ; others are allowed 
 to pass to the foreconscious system from which 
 they may or may not enter consciousness. In 
 normal conditions the foreconscious system must 
 be traversed before an excitation gains discharge 
 as affectivity or motility. The most important 
 function of this 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. 2 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 
 
 i Page 57. 2 Page 62. 
 
CONSCIENCE 49 
 
 such activation) and against which a counter-ac- 
 tivation exists in the foreconscious. Its activa- 
 tion, if it has any, belongs entirely to the uncon- 
 scious system. What is the purpose of this proc- 
 ess? 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 annoying 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-esteem. 
 
 (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- 
 psychological 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 the 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 nothing 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, 1 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. 2 These new tendencies to 
 some extent oppose and limit the freedom of ex- 
 pression previously enjoyed by the primary in- 
 
 1 Chapter I. 
 
 2 These reactions which appear spontaneously do not for the 
 most part bring with them their object. 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 pleasure-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 libido, 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 MORBID FEAES 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- 
 ment, (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 much 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 transitional phase in the psy- 
 cho-sexual development, the main 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 selfward, 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 retain. Admoni- 
 
CONSCIENCE 53 
 
 tions and criticisms from the parents, his 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- 
 
EGO-IDEAL 55 
 
 nal libido is converted into anxiety * and is per- 
 ceived as a fear of the public (shyness, 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. 
 
 i See Chapter VII for the relation between free desire and 
 anxiety. 
 
56 MORBID FEARS AND COMPULSIONS 
 
 Other patients complain that all people watch 
 them when they appear in public, pass unfavor- 
 able comments upon them, call them bad names, 
 etc. 
 
 That " something, " however, which knows the 
 patient's thoughts, foresees and criticizes all his 
 actions, is merely an externalization of conscience, 
 which, with all of us was once external, and now 
 for paranoiacs has become external once more. 
 The voice which these patients hear is the same 
 voice to which all of us have to listen; only it is 
 perceived by them not as an inner but as an outer 
 voice as it once was with everybody. 
 
 We see much the same thing in neurotics and 
 even in so-called normal people. The speaker 
 who trembles in stage fright before his audience, 
 which, despite all his reason may tell him to the 
 contrary, seems to him hostilely critical, the over- 
 conscientious clerk who lives in constant anxious 
 expectation of a "call down" from his employer, 
 which however never comes, these and similar 
 people are suffering from symptoms produced in 
 much the same way as are the paranoid delusions 
 of critical observation. For the sense of impend- 
 ing hostile criticism, referred in one case to the 
 audience, in the other to the employer, really has 
 origin in the criticizing instance or element of the 
 individual's own psyche his conscience. 
 
 In some connection (one, however, that has 
 nothing to do primarily with either the audience 
 or the employer) a disparity between the real self 
 and the ideal is felt by the individual; a certain 
 measure of the narcissistic homosexual libido thus 
 
EGO-IDEAL 57 
 
 fails of satisfaction, and regresses in the direction 
 of those earlier points of attachment whence the 
 ideal came, thus becoming an anxious concern 
 over the opinion of the public (the audience) or 
 of the person in loco parentis, the employer. 
 The paranoiac who thinks he is watched and 
 unfavorably commented on by the public, or who 
 hears himself reproached and accused by the voice 
 of some elderly man, is showing regressive phe- 
 nomena of essentially similar significance. 
 
 Our consideration of the psychology of con- 
 science is really but a preliminary to the state- 
 ment we now wish to make that the formation of 
 an ego-ideal is one of the chief conditions for re- 
 pression. Those wish-presentations (impulses, 
 desires, cravings, etc.) which of themselves or be- 
 cause of the sort of action to which they impel us, 
 run counter to, and are incompatible with, the 
 specifications of the ego-ideal, tend to succumb 
 to repression. Thus if they are in consciousness, 
 the conscious or foreconscious activation energy 
 (their libido if it is a case of psychosexual wishes) 
 is withdrawn and a counter-activation is estab- 
 lished against them. Or if they are unconscious 
 to start with, they are prevented by the counter- 
 activation from gaming activation in the conscious 
 and foreconscious systems. Not only wishes are 
 repressed but also ideas, memory impressions or 
 any mental element which is sufficiently incom- 
 patible with the ideal. A considerable amount of 
 psychic material is also repressed which, though 
 in itself eligible for consciousness, meets with re- 
 pression because it has close associative connec- 
 
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 narcissistic 
 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 certain 
 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- 
 bitious or grandiose specifications of the ego-ideal 
 apparently in just the same way and by just the 
 same function as that which applies in matters 
 ethical. 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. 1 
 
 If we ask a person (or ourselves, for that mat- 
 ter) : What is your ego-ideal? What are the 
 standards and specifications that you try to live 
 up to? 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- 
 
 i Perhaps it should be pointed out that the specifications of the 
 ego-ideal are not necessarily consistent with each other. Thus, 
 one of my patients, who in company with a friend "picked up" a 
 couple of prostitutes, 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 occupies a room with him. 
 
60 MORBID FEAES AND COMPULSIONS 
 
 f ectly in accord with any standards lie 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 individual's 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-IDEAL 61 
 
 fashions. Later experiences which contribute to 
 the ideal or modify its specifications as a rule gain 
 their power to do so through some similarity 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 
 specifications very readily, but are unable to draw 
 a definite word picture of it. The ego-ide*al 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 immediate 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 unconscious. By the 
 term censor was not meant any separate psychic 
 entity but rather the effect exercised by the trends 
 
62 MOEBID FEAKS AND COMPULSIONS 
 
 of the foreconscious upon the unconscious activ- 
 ities impinging upon their lower surface. * 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 denned 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 expression 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 foreconscious 
 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 mechanistic phraseology 
 in the discussion of such intangible matters. 
 
CONTENT OF UNCONSCIOUS 63 
 
 lized; what is uncontrolled in the child but con- 
 trolled in the adult. The foreconscious 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. l 
 
 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 Chapter III The Two Kinds of Thinking. 
 
64 MOEBID FEAES 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 commenting upon these things my friend said 
 with 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 correctly, only he took no account 
 of the unconscious. The obvious fact of the girPs 
 protestations of love for her mother made him 
 reject this interpretation. His statement (that 
 the girl acted as 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 uncon- 
 sciously. 
 
 In the normal person, the f oreconscious and con- 
 scious systems dominate the avenues to motor dis- 
 charge to aff ectivity or action. 1 Only those im- 
 pulses or excitations which are in accord with the 
 trends of the foreconscious, and which pass its 
 censorship are given efferent expression. 2 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 shall have more to say later. Chapter VI. 
 
 2 The higher psychic systems control only the form of the ex- 
 pression of the urge and not its quantity or continuousness. 
 
66 MORBID FEAES AND COMPULSIONS 
 
 scious processes which furnish their motivation. 
 From these "as if's" of the girl's conscious life 
 we learn the Is of the unconscious. 
 
 As far as the consciousness and foreconscious 
 of the girl were concerned she had a real 'and 
 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. 1 The hostile, vindictive 
 reactions constantly expressed in the girPs be- 
 havior are not what we expect from a cultured civ- 
 ilized woman under any normal circumstances but 
 are more in keeping with the character of an 
 American Indian or any other savage. 
 
 In the second place we see that the unconscious 
 has no regard for reality. It was not to the girPs 
 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 
 her? The ethical values of the situation were 
 entirely ignored. 
 
 In the third place, if we go far back into the 
 girPs psychic history (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 true of the unconscious in the cast 
 of this girl is true of the unconscious generally. 
 
CONTENT OF 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 should 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 holophilkj 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 ? 
 
 I say to a man : ' * Have you a sexual instinct I ' ' 
 ' ' Certainly, " he replies. "Of course I have." 
 "But how do you know that?" I ask. 
 "How do I know it? How can I help knowing 
 it? If I see a pretty girl, 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 MOEBID 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 explaining 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 OF 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 FEAES 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 foreconscious and conscious systems. 
 In the unconscious there is no inhibition, no nega- 
 
CONTENT OF UNCONSCIOUS 71 
 
 tion, 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 
 foreconscious, 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- 
 scious to a screen between the conscious and the 
 
72 MORBID FEARS AND COMPULSIONS 
 
 unconscious 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 action 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 form. 
 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 managerial 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 not 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 
 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 the 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. The 
 
FAILURE OF REPRESSION 75 
 
 ideas representing them are not admitted to con- 
 sciousness; their energic quota develop no 
 affects. 1 
 
 (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 
 
 i Strictly speaking there are no unconscious affects, the affect 
 being a sensory report of a bodily state. See Chapter IV, also cf. 
 Freud : "Das Unbewusste." To speak of unconscious affects ( love, 
 hate, etc.), is a clinical inaccuracy BO current as to be legitimate. 
 
76 MORBID 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. Eepressed ideas are 
 thus activated only by the energies of the un- 
 conscious system. The activation-energy of the 
 unconscious (and generally this means holophilic 
 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 
 
FAILURE OF REPRESSION 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 
 energic 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 clear 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. 1 The energy of the compulsion thus presum- 
 ably belonged to some wish of the unconscious in- 
 
 i Such a substitute idea is ordinarily found to have some close 
 associative connection with the first one. 
 
78 MOEBID FEAES AND COMPULSIONS 
 
 compatible with the trends of the f oreconscious, 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- 
 ried, 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 lustful 
 wishes is wrong and must be vigorously combated. 
 Thus the f oreconscious of a Catholic girl (assum- 
 ing that she seriously accepts these teachings) 
 would contain strong resistances against any 
 ideas, 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 conscious, 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 
 
DESCENDANTS OF REPRESSED 79 
 
 was provided, since she was not married, while 
 her conscience and reason withheld her from any 
 actions that might gratify them in illegitimate 
 ways. In addition the religious and family teach- 
 ings incorporated in her ego-ideal and in the 
 trends of the foreconscious created counter-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 
 ideas 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 MORBID FEAES AND COMPULSIONS 
 
 family invariably coincided with an apparently 
 severe illness on the part of her mother. She 
 soon concluded 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 OF REPRESSED 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 close 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 foreconscious 
 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. Repressed 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 foreconscious 
 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 ihis chap- 
 ter, that all of the content of the foreconscious is 
 
82 MORBID FEARS AND COMPULSIONS 
 
 eligible for consciousness and thus within the 
 reach of voluntary introspection. Such, as a mat- 
 ter of fact, 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 close associative con- 
 nection and qualitative similarity with it. In con- 
 sequence of their quite readily demonstrable exist- 
 ence in the f oreconscious we have to assume a sec- 
 ond censor which stands at the border between the 
 foreconscious and conscious systems just as the 
 other censor stands between the foreconscious and 
 the unconscious. This superficial censor operates 
 against certain descendants of the unconscious 
 which exist in the foreconscious but which bear 
 the closest 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 close 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 
 
DESCENDANTS OF REPRESSED 83 
 
 for him is not strong or that the happenings de- 
 picted in the day dreams do not indicate an in- 
 tense wish that they might take place in reality. 
 But if, for any reason, her feeling for the man 
 threatened to become stronger, her resistances 
 would be brought into action, the ideas and phan- 
 tasies might be repressed completely, and she 
 would soon cease to be conscious of any interest 
 in him whatever. 
 
 To illustrate what has been said about the ex- 
 igence in the f oreconscious of numerous descend- 
 ants of the repressed, a concrete example may well 
 be in order, even though the introduction of it may 
 involve anticipating certain matters the full dis- 
 cussion of which is reserved for later chapters. 
 
 A friend once asked me if I knew of a firm 
 dealing in a certain commodity he desired, and no 
 sooner had I replied that I did than I found that 
 I had forgotten the name of the firm. I did re- 
 member the location of their place of business, 
 a large down-town office building, and, as I hap- 
 pened to be passing there a few days later, I 
 stepped in and found that the missing name was 
 Pond. 
 
 This forgetting is to be explained as follows: 
 We should assume that in my mind there must 
 have existed some resistance against the word 
 Pond, in other words that I was unable to recall 
 this name, which really is very familiar to me, be- 
 cause of the action of the censor which refused to 
 pass it. We should also expect that the resistance 
 which prevented the word from coming to my con- 
 sciousness arose not so much against the word it- 
 
84 MOEBID FEAES AND COMPULSIONS 
 
 self as against some group of ideas of which the 
 word formed a part or with which it was associ- 
 ated. The word, presumably, was repressed not 
 because it was offensive in itself, but because of 
 its association with the offensive and repressed. 
 At the time I was unable to recall it we should 
 suppose it existed in the foreconscious as one of 
 the descendants of the repressed to which the 
 superficial censor denies entrance into conscious- 
 ness. 
 
 The essential procedures of psychoanalytic 
 technique rest upon the assumption that many de- 
 scendants of any repressed trend or complex ex- 
 ist in the foreconscious, and one seeks to learn of 
 the repressed by bringing into the patient's con- 
 sciousness some of these descendants. The pati- 
 ent is therefore instructed to give up any goal-idea 
 in his thinking and to tell all the thoughts that 
 come to his mind, carefully resisting every tend- 
 ency to ignore or reject any of them. This really 
 means that he is to combat as far as possible the 
 rejective action of the superficial censor and so to 
 allow some of the descendants of the repressed to 
 enter his consciousness, for this is just what these 
 seemingly random and meaningless associations 
 really are. 
 
 In seeking then to discover why I could not re- 
 call the name Pond, or rather with what group 
 of ideas painful to me it had become associated, 
 I applied the technique above described with the 
 results that are here recorded. 
 
 Upon fixing my mind on the word Pond it oc- 
 
DESCENDANTS OF REPKESSED 85 
 
 curred to me that a certain Dr. Pond used to be a 
 pitcher on the old Baltimore baseball team. Next 
 I thought of Indian Pond, where I used to go fish- 
 ing as a small boy, and I had a memory picture of 
 myself throwing into the water the large stone 
 used as an anchor for the boat. Then I thought 
 of a man named Fischer who is at present a 
 pitcher for the New York Americans. 
 
 Continuing, I thought of Pond's Extract and of 
 the fact that it contains witch hazel. This re- 
 minded me that I used witch hazel to rub my arm 
 when in my school days I was pitcher on a base- 
 ball team. I also thought of a certain fat boy 
 who was a member of the same team and recalled 
 with amusement that in sliding to a base this boy 
 once went head first into a mud puddle, so that 
 as he lifted his face plastered with dirt, this, com- 
 bined with his marked rotundity, had given him an 
 extremely laughable and pig-like appearance. I 
 further recalled that at that time I knew a boy 
 nicknamed " Piggy 7 ' and that at a later time I 
 had been nicknamed "Pig." 
 
 At this thought I was interrupted for a few mo- 
 ments, and when I returned to the analysis the 
 word Pond brought the associations: Ponder 
 think "sicklied o'er with the pale cast of 
 thought" Hamlet the memory of my having re- 
 ferred to a certain village as a hamlet the recol- 
 lection that a farmer in this village once told me 
 that a neighbor, out of spite, killed two pigs and 
 threw them into his (the farmer's) well. 
 
 Then there suddenly occurred to me the follow- 
 
86 MOEBID FEAES AND COMPULSIONS 
 
 in 1 incident from my seventh year which appears 
 to have been the cause of my forgetting the word 
 Pond. 
 
 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 it, 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 -to 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 consequence, 
 
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 pitcher, Dr. Pond contains 
 three ideas connected with the repressed memory ; 
 viz., 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-l-G, baseball (i. e., throw- 
 ing), and water or that of the farmer and the 
 pigs P-I-G, death, throwing, and water is seen 
 to be perfectly relevant. 1 
 
 Thus it may readily be seen that every idea that 
 
 i Frink "Some Analysis in the Psychopath ology of Everyday 
 Life," Journal of Abnormal Psychology, Vol. XII, 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 which, by abandoning any goal- 
 idea in one's thinking and resisting the action of 
 the superficial censoring tendencies, may be re- 
 produced quite freely in consciousness. 1 
 
 i The repressed painful memory which caused me to forget 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. 
 
CHAPTER III 
 
 TWO KINDS OF THINKING, AND THE PSYCHOLOGY OP 
 THE DREAM 
 
 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 Reality 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 Eeality 
 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. 
 
 89 
 
90 MOEBID FEARS AND COMPULSIONS 
 
 Its only concern is with that which is pleasant, and 
 instead of bringing us 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. Real- 
 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 Uncon- 
 
PLEASURE THINKING 91 
 
 scious are unoriented with regard to time, space 
 and external reality, and that the Unconscious 
 can only wish. 
 
 Obviously those processes governed solely by 
 the pain and pleasure principle and disregarding 
 reality are the more primitive 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 affairs 
 through the aid of the nursing by the mother. 
 "He apparently hallucinates the fulfillment of 
 his innermost needs, displaying meanwhile 
 through the motor discharge of crying and kick- 
 ing, the displeasure arising through the increas- 
 ing tension and failed satisfaction, and thereupon 
 he experiences the satisfaction hallucinated. 1 
 Only later does he learn to use these discharge 
 expressions purposely as a means of communi- 
 cation. " At first he hks no appreciation of what 
 
 i"Jahrbuch ftir Psychoanalytische und Psychopathologische 
 ForBchungen," Bd. Ill, Hit I, 1912. 
 
92 MOEBID FEAES AND COMPULSIONS 
 
 intervenes between a wish and its fulfillment ; for 
 anything he may sense to the contrary a wish ful- 
 fills itself. His crying, etc., 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 
 through the instrumentality 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 Formulierung uber die zwei 
 Prinzipien 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"Jah.rbuch fiir Psychoanalytische und Psychopathologische 
 Forschungen," Bd. Ill, Hft I, 1912. 
 
EEALITY 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 immediately in a 
 complete motor discharge. Between the receipt 
 
94 MOEBID FEAKS AND COMPULSIONS 
 
 of the stimulus and the motor discharge as ac- 
 tion now intervenes the process of thinking which 
 was originally represented by, and is formed from, 
 the act of imaging. Originally thinking as a 
 process distinct from mere imaging, and applied 
 to the relations between impressions of objects, 
 was probably unconscious. Only through 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. 1 
 
 The general tendency to satisfy with pictures 
 
 i "The release from the principle of pleasure by means of the 
 reality principle, with the psychical results which proceed from 
 it (the release) which here in a schematic exposition is restricted 
 to a single proposition, really is completed neither at once nor 
 simultaneously on the whole line. But while this development 
 takes place in the ego-impulses, the sexual impulses are released 
 from it in a very 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 elements 
 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 princi- 
 ple, 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 persons as well as in neurotics, 
 a very intimate one, although, by means of these considerations 
 from genetic psychology, it is recognized as a secondary 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 statu nascendi before they can enter con- 
 sciousness, if their activation can occasion a release of pain. This 
 is the weak spot of our psychic organization, 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 produced by the delayed education of the sexual im- 
 pulse to regard reality through the conditions which render pos- 
 sible this delay." Freud, I.e. 
 
96 MOEBID FEAKS AND COMPULSIONS 
 
 of the imagination (images .of any sense quality) 
 the desires that reality leaves ungratified, 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 awaking 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 fulfillment 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- 
 
Courtesy of the New York Tribune 
 
NIGHT DREAMS 97 
 
 ity or vagueness. But in the night dream the rep- 
 resentation is indirect. What is desired, instead 
 of being pictured in its true form, 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 difference 
 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 the 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 FEAES AND COMPULSIONS 
 
 intended not so much to further 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 clerk 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 MORBID FEAES AND COMPULSIONS 
 
 first dose, a second was given and thereupon the 
 child died. Then, instead of taking the responsi- 
 bility upon his own shoulders, the father sought 
 to blame Taylor for the child's death. The town 
 in which the occurrence 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 
 
" !*;**,* I* * * I J&S-* 
 
 Courtesy of the New York Times 
 
NIGHT DREAMS 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 modern lamp 
 post on a curb of what one would suppose to be 
 Spring 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. 
 
1C2 MORBID FEARS 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 Girl?" 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 will 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 artist 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 dream. 1 
 
 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. 
 
 i 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. 
 
104 MORBID FEAES AND COMPULSIONS 
 
 This, it will be remembered, was indirect repre- 
 sentation. We cannot interpret it without the 
 dreamer 's associations ; we must get her to label 
 her symbols. Her associations were as follows: 
 The bright fresh color of the grass reminded her 
 that she had seen just this color when as a girl she 
 lived in the country and went out to gather cow- 
 slips early in the spring. The little stream of 
 water coming from the ledge of rocks she recog- 
 nized as a memory picture of an actual stream 
 which rose from a spring in a meadow near where 
 she lived in her childhood. This particular 
 meadow was spoken of in her family as the 
 "spring lot." 
 
 Her associations, then, were a field in the spring 
 and a field with a spring in it, which, furthermore, 
 was known as the spring lot. I may therefore, 
 state, without more ado, that the field in which 
 she found herself in the dream represented the 
 city of Springfield in Massachusetts. This is the 
 town in which her former lover lives. The dream 
 fulfills a wish to be there with him. 
 
 A second example of indirect representation 
 is the following. A man who was much annoyed 
 with himself for having done something very fool- 
 ish had a dream in the first part of which he found 
 himself in the center of an oval sheet of paper. 
 The sheet of paper had a hole in the middle and 
 his body was thrust through this hole so that the 
 paper stuck out horizontally from his waist on 
 all sides. When he wa-s asked for associations, 
 the sheet of paper brought to his mind the fact 
 that he always carries with him sheets of tissue 
 
NIGHT DREAMS 105 
 
 paper with a hole in the center which he uses to 
 cover the closet seat when he has occasion to use 
 a public toilet. A sheet of paper of this sort he 
 is accustomed to refer to humorously as a "peri- 
 anus. ' ' In the dream then he finds himself in the 
 center of a * * peri-anus. ' ' But the thing one might 
 expect to find in the center of a * * peri-anus "is an 
 anus itself. This fact the dream utilizes to make 
 reference to the foolish act I have spoken ; that is, 
 the dream, by representing the dream in the center 
 of a "peri-anus," expresses his annoyed convic- 
 tion that he is an ass. 
 
 I hope that these examples have made it clear 
 that in a way there are two parts to every dream. 
 These are the actual text of the dream (the collec- 
 tion of pictures which the dreamer remembers on 
 awaking) and the hidden thought which these pic- 
 tures represent, and which can be obtained only 
 by analysis. Those who read the New York 
 Evening Mail may realize that the way in which 
 the thoughts are expressed in the examples of 
 dream symbolism I have given is very similar to 
 that employed in the "Book Lovers* Contest" 
 which used to appear in that newspaper. The 
 Mail used to print a series of pictures, each one 
 of which was supposed to represent the title of 
 some book, and the reader sought to guess from 
 the picture what particular book was represented. 
 Now the dream as we remember it upon awaking, 
 corresponds to the picture representing the title 
 of a book. This part of the dream is known as its 
 manifest content. The hidden part of the dream 
 (the part which we obtain only by analysis) cor- 
 
106 MORBID FEAES 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 
 f oreconscious 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 
 f oreconscious 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 FEAES AND COMPULSIONS 
 
 guised and distorted as to appear unobjectionable. 
 
 The dream then represents a compromise be- 
 tween two opposed psychic streams or forces, the 
 repressing force from the foreconscious which 
 would repudiate the wish, and the repressed trend 
 of the Unconscious which seeks wish fulfillment. 
 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 with its analysis and 
 
AN INTERPKETATION 109 
 
 after this take up some of the special 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 really 
 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 FEARS 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 further, 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 ! 
 
 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. To 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 111 
 
 buy 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 MOEBID FEAES 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 
 clinical 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. 1 
 
 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, 
 
 i Condensation, a phenomenon of comparatively infrequent oc- 
 currence in the thought processes of the foreconscious and con- 
 scious systems, is not a peculiarity of dream thinking per se but 
 of unconscious processes generally. 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 high 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 they 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 FEAES 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- 
 
Courtesy of the Louisville Times 
 
 Von Bernstorff Presents Lansing with Germany's Revised 
 
 Answer 
 
DISPLACEMENT 115 
 
 tion such 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 she 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 MORBID FEAES AND COMPULSIONS 
 
 her observation, so long as there were no children, 
 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 thinking 
 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 him. The dream thus 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 remaining 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 (Riicksicht auf Darstellbarkeit, 
 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 
 
 iThe fact that in some dreams intellectual operations 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 previously, 
 i.e. 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 special devices. Thus thoughts cor- 
 responding to a subordinate clause are repre- 
 sented in an introductory dream while the ideas 
 corresponding 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 
 
Courtesy of the New York Tribune 
 
 Preparedness 
 
DKAMATIZATION 119 
 
 usually 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 began 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, 
 Cheval, was the French word for horse. The pa- 
 tient is small, 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 MOBBID 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- 
 mal 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 ELABORATION 121 
 
 bolize the male genitals, or of fighting, dancing or 
 climbing stairs which signify coitus. 
 
 The fourth dream mechanism is known as Sec- 
 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 MOEBID FEAKS AND COMPULSIONS 
 
 ing wishes ; but for the dreams they might have 
 slept even less. 
 
 In one notable class of dreams, the nightmares, 
 the sleep-preserving function of the dream fails 
 and the dreamer awakes in fear. The origin of 
 the fear dream is as follows. Due either to unus- 
 ual relaxation of repression or to unusual strength 
 of a repressed desire, the fancy corresponding to 
 a wish fulfillment has begun to be represented in 
 consciousness with inadequate disguise. 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 
 
DREAMS AND NEUROSIS 123 
 
 represent the motive force of the neuroses. 
 Hence by studying 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 the 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 
 
 THE MECHANISMS OF PSYCHOPATHOLOGICAL 
 MANIFESTATIONS 
 
 IN the preceding chapter we learned that the 
 manifest content of the dream is formed from 
 the unconscious dream-thoughts by the opera- 
 tion of certain techniques or processes 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 still 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 insight 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) COMPENSATION 
 
 At the close 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 l Paradise Lost'? Was it Dante?" 
 
126 MORBID FEARS AND COMPULSIONS 
 
 Her husband replied that she had confused the 
 authors of " Paradise Lost" and of the "In- 
 ferno," 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 
 
 acquainted, next of another of much the same 
 appearance whom also she knew only slightly. 
 Then, after a short pause, 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 
 seen, 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, as 
 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 MOEBID FEAES 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 light haired young man, her cousin, 
 she had feelings just the opposite of aversion f 
 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 
 remember him. 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 foreconscious 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 
 is 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 MORBID FEAES AND COMPULSIONS 
 
 there usually appears what amounts to a compen- 
 satory hypertrophy on the part of the repressing 
 forces, the counter-activations of the forecon- 
 scious. When the repressed trend is a particu- 
 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 close 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 cough 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 born 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 sexual 
 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 good. 1 
 
 il have often wondered if some considerable number of 
 Christian Scientists are not perhaps cases parallel to this one; 
 but my experience in this direction is too limited to allow me 
 to venture any positive 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 
 life. 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 all 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 objectively 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 Science 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 unusually intelligent 
 young 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, would 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 MOEBID FEAES 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 conspicuous supporters 
 are neurotics, for a?s 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 environment, 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 cruelty and possessing a real sympathy 
 for children -and animals to be slow to suspect and 
 accuse 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 antivivisectionists, 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 
 than 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- 
 tremely 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 fail. 1 
 
 A not altogether dissimilar but more compli- 
 
 i The cruelty which such persons so readily believe others 
 capable of is really a projection of their own sadism, which by 
 
138 MORBID FEAES AND COMPULSIONS 
 
 cated 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. 1 
 
 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 perceiving as an endogenous force. 
 The mechanism of projection is discussed elsewhere. (Page 155.) 
 i 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 psychology 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 
 feature, 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 demands 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. 1 
 
 iAn article in The Spectator, an insurance journal, on "The 
 Homicide Record for 1915" says: "The 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 
 rate, 1.9. 
 
 Of the seventy-four lynchings which took place in the United 
 States during 1915 nearly one-third were committed in Georgia. 
 
140 MORBID FEARS 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 pun- 
 ishment of the offender could just as well be left 
 to properly constituted authorities? 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! 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? 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 
 le>ss 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 141 
 
 southern 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 club. Marriage began 
 as a forcible abduction of the female and con- 
 tinued as a relationship more like that of slave 
 and master rather than that of husband and wife 
 in the modern 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 FEARS 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 life, 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 such 
 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- 
 ness 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 compensating 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. 1 
 
 (b) DISPLACEMENT 
 
 As was indicated in the second chapter, the 
 control 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, is 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 may be noted that the "Age of Chivalry," a period in 
 which this highly commendable quality was carried to extremes 
 far surpassing anything to be observed in the South, was one in 
 which, as in the Southern environment, sadistic tendencies 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 
 practically identical adaptive compensations. 
 
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 vivisectionists 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 
 i-dea-representative secures activation in the fore- 
 conscious. This activation, according to some of 
 Freud 's most recent teachings, 1 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 
 
 Unbewusste Zeitsch. f. Arzt. Psychoanalyse Vol. III. 
 
I 
 
 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 unconscious 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. 1 
 
 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 
 
 i There are no unconscious affects. One often speaks, to be 
 sure, of unconscious affects (love, hate, guilt, resentment, etc.) 
 and this usage, though not strictly correct, is a legitimate clinical 
 convenience. An affect is really a conscious sensory perception 
 of a bodily state. Without consciousness it does not exist. When 
 we speak of an unconscious 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 FEAES AND COMPULSIONS 
 
 unconscious ideas to new and associated ideas 
 which 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 all the various kinds of 
 psychoneurotic and psychotic symptoms and is 
 likewise very frequently exemplified in the hap- 
 penings of normal mental life. 
 
 Like all 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. 1 Thus the exhibitionistic im- 
 
 i One of the most interesting contributions to the 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 study, 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 easels was originally rebellion against the 
 authority of the father, later becomes a devotion 
 to legal 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 them 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 chemi'stry, which became productive of 
 
 of sublimation is Brill's study of choice of avocation, to be pub- 
 lished shortly. 
 
148 MOEBID 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 certain examples 
 of wit "smutty" wit, particularly. 1 For 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 
 
 i Compare Freud's, "Wit and the Unconscious." 
 
DISPLACEMENT 149 
 
 had he stated them directly. But 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 ais 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 FEAES AND COMPULSIONS 
 
 this was finished, would leisurely proceed to the 
 station, 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 damned, 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 considerably. It 
 was characteristic of his father that when once 
 he made up Ms 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 
 such rebellious impulses would 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 miles 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 MORBID FEAES AND COMPULSIONS 
 
 prohibited. Often the thing done represents in 
 a symbolic way some specific act forbidden or 
 condemned 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 the 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 whose 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?" 
 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 feeling 
 
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, 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 MOEBID FEAES AND COMPULSIONS 
 
 year before lie 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 
 
PROJECTION 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) PROJECTION AND INTRO JECTION 
 
 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 MOEBID FEAES 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. 
 
 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 the other, essentially external hap- 
 penings are assimilated by the personality and 
 made a part of the self. The former mechanism 
 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 
 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 
 
PEOJECTION 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 MORBID FEAES AND COMPULSIONS 
 
 positively unhappy, had not been entirely satis- 
 factory, 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 little 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, naturally, was unsuccessful. 
 
 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 
 psychic, 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 MORBID FEAES AND COMPULSIONS 
 
 origin. She was a Catholic and she knew that 
 if she were to confess to the priest that she was 
 having 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. 1 
 
 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- 
 
 i It is 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 psychic 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 an 
 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 marry 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 
 
 i It may be added that she had identified me with her father 
 
162 MOKBID FEAES AND COMPULSIONS 
 
 It is to be noticed that in these and in all other 
 examples of projection the reaction against the 
 ideas projected is really a part of the resistances 
 causing the projection and thus a part of the re- 
 pressing forces. Were it not for these resist- 
 ances (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 discussed shortly. 
 
PROJECTION 163 
 
 of her professors. She would for a time talk a 
 great deal about him, of how able and attractive 
 he was, 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 
 hypnotic 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 from without was simply an ex- 
 ternalization 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 MORBID FEAKS AND COMPULSIONS 
 
 Some years ago I learned that the father of 
 a girl I was treating in the clinic suffered from 
 the delusion that his wife was untrue to him. 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 some 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 infidelity 
 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 nature, 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 oftener, 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 
 foreconscious, 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 
 
 i These two cases are quite typical. Undue jealousy in a man 
 usually means that he has, or thinks he has, some deficiency of 
 sexual 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- 
 accentuation of the homosexual component of the libido. 
 
INTROJECTION 167 
 
 The mechanism known as Introjection, is as 
 was said, 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. 1 
 
 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 recognition of this love identification when we 
 say of a married couple that the two have been 
 made one. 
 
 iAs we shall learn shortly, there are really two kinds of 
 identification. The individual may identify himself with another 
 person, which might be called subjective or introjective identifica- 
 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 Transference. 
 
168 MOKBID 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. 1 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 un- 
 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 
 
 iA person who suffers from a feeling of inferiority may not 
 show this normal overestimation of his own possessions, but on 
 the contrary project to everything that belongs to him some of 
 his own feelings of insufficiency, 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 us to find pleasure 
 in such a statement as that our handwriting 
 closely resembles ex-president Koosevelt's, or 
 that our new maid was formerly in the employ of 
 John D. Eockefeller. 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 FEARS 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 hoping 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 was? 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! Who knows? Perhaps if all the facts 
 came out, the world which now blames him would 
 in true justice feel that his wife, 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! 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 FEARS AND COMPULSIONS 
 
 it was perhaps his fault that she behaved in such 
 a manner, 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 complained 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 felt, 
 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 clear 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- 
 cern 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 symbol for the father and 
 that his fear that he was killing time really rep- 
 resented a repressed wish to kill his father, 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 1 wished my mother 
 dead/' 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." 
 
KATIONALIZATION 175 
 
 (d) EATIONALIZATION 
 
 It may have struck some of my readers that the 
 patients who furnished the various examples of 
 psychopathological reactions which have been de- 
 scribed must 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 
 especially), and their failure to understand them- 
 selves 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- 
 cessful 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 MOEBID FEARS AND COMPULSIONS 
 
 This may seem a rather unreasonable and un- 
 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 in 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 overlook the un- 
 conscious factors really at work. 
 
 One of my patients confessed to me that it had 
 
EATIONALIZATION 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- 
 tunity to meet, and bean 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 
 all 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 appeared 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 
 girl's parents could now support her only with 
 difficulty, he fejt 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, as a matter of fact, was the very 
 
RATIONALIZATION 179 
 
 thing he did want to do, though he would not ad- 
 mit it even to himself. 1 
 
 Another patient gave me a very lengthy and 
 rather logical explanation of why he was in favor 
 of woman suffrage. The further 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. 2 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 belonged in the same category and 
 
 1 This reaction is obviously an over-compensation. Fortunately 
 the marriage turned out very well in spite of this unpromising 
 beginning. 
 
 2 In cases such as this the castration complex is sometimes an 
 important factor. 
 
180 MOEBID FEARS AND COMPULSIONS 
 
 secretly despised him as lie 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 things 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. 1 
 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 
 unsatisfactory, for in the first place the woman 
 was sufficiently well off 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 uncomfortable 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- 
 
 iAs familiar as I am with the frequency with which people's 
 opinions on all sorts of objective matters are determined by their 
 complexes 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 regard to the present war and Mr. Wilson's policies. 
 In the case of every one of my patients, and for that matter of 
 all other persons with whom I am well enough acquainted to be 
 able to judge of their complexes, 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 regard to any one of the questions, 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 FEAES 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) VARIOUS DEFENSE AND DISTORTION 
 MECHANISMS 
 
 There are a great many 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 mine 1 who had volun- 
 teered to help one of her neighbors in caring for a 
 very sick old woman, fell asleep while watching at 
 the sufferer's bedside and was in consequence half 
 an hour late in administering 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 action of the 
 woman who wore black in the summer time was 
 
184 MORBID FEARS AND COMPULSIONS 
 
 in part conditioned in this wise. Another example 
 is that of a salesman whose business it was to 
 secure 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 him?" 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: "I've 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), was 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 hand 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 
 commissions 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 bath 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- 
 tion, 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 inferior- 
 ity, and this 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 of 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 uncleanness of whatever origin 
 
188 MORBID FEARS AND COMPULSIONS 
 
 is replaced by the notion of physical uncleanness 
 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. 
 
 Still 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- 
 ful 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 
 she 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 understanding. 
 
 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 FEAES 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 cure 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 bad 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, unconsciously 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 MOEBID FEAES AND COMPULSIONS 
 
 ticular man of that type. The woman who was 
 converted to Christian Science and " hated " all 
 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. 1 This obsession had origin in a death 
 wish against one particular Jew, namely, the pa- 
 tient's father. 
 
 (f) TRANSFERENCE 
 
 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 under 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 
 
 i "Psychoanalysis" Chapter on the Compulsion Neurosis. 
 
TRANSFERENCE 193 
 
 of the identification nor as a rule 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 much 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 MOBBID 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 which 
 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 clear 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, 
 
TRANSFERENCE 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 I deserved. The diffi- 
 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 acimit 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 MOKBID 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 
 partly by the actual facts of the present. That I 
 was so fortunate as to find in X. an equally 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. But 
 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, 1 have shown 
 
 i Pawlow "Investigation of the Higher Nervous Functions." 
 Watson "The Place of the Conditioned Reflex in Psychology" 
 
 Psychological Review, Vol. XXIII, No. 2. 
 
 Lashley "Human Salivary Reflex and its Use in Psychology" 
 
 Psychological Review, Vol. VII, No. 6. 
 
TRANSFERENCE 197 
 
 that when the primary stimulus 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 MOEBID FEAES 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 pattern. 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 but 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 by 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 transferred 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 CEdipus 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. 1 As he has boldly stated, a 
 sexual preference becomes active at a very early 
 
 i The paragraphs here quoted are from Freud's "Interpretation 
 of Dreams," Chapter V. I have made some changes in their 
 original order. 
 
TRANSFERENCE 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 us 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 MOKBID FEARS AND COMPULSIONS 
 
 greater must have been his impatience, as desig- 
 nated successor, to obtain the mastery himself 
 after his father 's death. Even in our own middle- 
 class family the father is accustomed to aid the 
 development of the germ of hatred which naturally 
 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 fiction 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. Wells in "Ann Veronica" has given expression to the 
 father complex in the following words of his character Capes: 
 "1 don't believe there is any strong natural affection 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 true. There are senti- 
 mental and traditional deferences and reverences, I know, be- 
 tween father and son, but that is just exactly what prevents the 
 developing of an easy friendship. Father-worshiping sons are 
 abnormal and they are no good. . . ." 
 
TRANSFERENCE 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, and 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 these 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 
 
 successor. '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 
 
TRANSFEEENCE 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- 
 ence, 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 almost 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 
 first impulse towards liberty and first feelings of 
 injustice have been directed against the oppressor. 
 The parents say that the children do not agree, 
 and cannot 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 MOEBID FEAES AND COMPULSIONS 
 
 develop simultaneously 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 
 
TRANSFERENCE 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 certain time the maternal instincts of the 
 girl will be excited towards the helpless new-born 
 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 
 
 i 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 (Edipus complex consists, 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 (conscious 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 MOEBID FEAES 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 
 
 CEdipus complex in the infantile form but with the addition of 
 new contributions from the beginning adult sexuality. 
 
 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. Such 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 father may thus be loved while the father-imago remains 
 invested with the full measure of infantile hate. Mutatis 
 mutandis the same may be said in regard to the mother-imago 
 and mother love. 
 
TRANSFERENCE 207 
 
 actual sum of peculiarities or total make-up of 
 this person, but is also partly determined by that 
 one 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, 1 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. E. B. Holt. ("The Freudian Wish.") 
 
208 MORBID FEARS 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 closely a woman tends to 
 coincide with the unconscious mother imago the 
 more is she likely to be loved, while toward those 
 who fail to recall 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- 
 
TRANSFERENCE 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. 1 In 
 the normal course of things the (Edipus (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 family, 
 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 
 
 iSuch statements as that a patient "hates his father" or "is 
 in love with his mother" have been used rather carelessly by 
 some psychoanalytic 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 MOEBID FEAES AND COMPULSIONS 
 
 what was said in the first chapter in regard to 
 the processes of the Unconscious being unoriented 
 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. II) 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 clearly 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 
 
 like a river; blue is like the sky. In the same way, 
 to our unconscious thinking, Miss Jones is not 
 beautiful, 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 overbearingness 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 example, a wealthy young 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 
 soul devoted to him. The explanation is that 
 
212 MOEBID FEAES 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 vague 
 similarities in appearance, caused an unconscious 
 identification with his mother (a sense not merely 
 of is like but of is), 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. 
 
 Eeactions 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!" 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- 
 
FATHER 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 countenance and for- 
 bidding mien had half consciously impressed 
 him. With 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 is 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 
 
214 MOEBID FEARS 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 unconsciously 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 right. ' ' 1 
 
 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 contain 
 instances of transference. For example the girl suffering 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 love 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 transference from 
 the father. 
 
MOTHER COMPLEX 215 
 
 attracted by comparatively ignorant servant girls 
 or nurse maids older than himself, and as a rule 
 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 surroundings and was a man of unusual 
 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 under their care, 
 and quite unreasonably 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 as the most wonderful, pure and angelic of 
 all the women that had ever lived. When he 
 
216 MOEBID FEAES 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 unthinkingly 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. 1 
 
 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 
 
 i He was best satisfied when in his relations with these women 
 the earlier practices were reproduced, perferring them to inter- 
 course, though often feeling some hesitation in stating this 
 preference. 
 
218 MOEBID 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 longings 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 
 
TRANSFERENCE 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. 1 
 
 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. 
 
 i See Ferenczi : Introjection and Transference, Chapter II of 
 his "Contributions to Psychoanalysis." 
 
CHAPTER V 
 
 THE NEUBOSIS AS A WHOLE 
 
 ANEUEOSIS, especially when it suddenly 
 breaks out in a person previously in 
 seeming good health, has the appearance 
 of something bizarre, foreign and devoid of all 
 continuity with the rest of the individual's men- 
 tal life. No data within the reach of his con- 
 sciousness serve satisfactorily to explain 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 foreign, 
 
 220 
 
FAILURE OF REPRESSION 221 
 
 nor a neoplastic excrescence which develops on its 
 surface, 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 affectivity or action are normally un- 
 der the control of the f oreconscious 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 through. 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 foreconscious. 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 certain forms of psychosis) nor do 
 
222 MORBID FEARS AND COMPULSIONS 
 
 those of the Unconscious 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 all 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, * * the 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. " J 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- 
 
 i "Bruchstttck ciner Hysterienanalyse," Samml. kl. Schr. z. 
 Neurosenl. II. 
 
224 MORBID FEAES AND COMPULSIONS 
 
 plained on other grounds. But 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 form, 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 showed what it was doing and how it did 
 manifest itself. Nobody has ever done this or 
 apparently ever 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't, 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 dexterities 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 clearly, 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 similar 
 disguises exist unpenetrated. 
 
 When I say that the doctor's own blindness 
 

 226 MORBID FEAES AND COMPULSIONS 
 
 rather than any real absence of the sexual factor 
 was responsible for the cases reported as excep- 
 tions to Freud >s rule, I intended no reproach to 
 these men, for I believe that they are thoroughly 
 sincere. The reproach, if there is any, belongs 
 not to them but 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? 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- 
 
 i Adolf Meyer: A Discussion of Some Fundamental Issues in 
 Freud's Psychoanalysis, State Hospitals Bulletin,, Vol. II, No. 
 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. TJie 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 is 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 
 
 i Some years ago a prominent neurologist said tome: "Freud's 
 theory that the neuroses depend upon unsatisfied sexual wishes 
 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 views. 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 conscious desire for intercourse 
 is responsible for the neurosis. In fact the presence of a well 
 developed desire of that character instead of indicating that a 
 woman was likely to develop a neurosis would more reasonably 
 
228 MOEBID FEAES AND COMPULSIONS 
 
 But 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, afs Freud expresses it, 
 is the negative of the perversion. 1 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 
 
 signify that she would not. It is the unconscious and repressed 
 /sexual wishes of the patient which furnish the neurosis with its 
 motive power. The desire for intercourse is only a small part of 
 sexuality, 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 chronic 
 masturbators. 
 
 i Freud : "Selected Papers on Hysteria and Other Psychoneu- 
 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 cause 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 
 technically known as "fixation." James points 
 out a phenomenon which he calls "the inhibition 
 of instincts by habit." "When objects of a cer- 
 tain class elicit from an animal a certain sort of 
 reaction," he writes, "it 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 sea-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 FEAES AND COMPULSIONS 
 
 ... A habit, once grafted on an instinctive tend- 
 ency, restricts the range of the tendency itself, 
 and keeps us 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 
 class. 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 many ways, or through any one of a num- 
 
 i William James : "Principles of Psychology," Vol. II, page 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. 1 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- 
 
 i Compare what has already been said concerning the condi- 
 tioned reflex, in the section on Transference, page 197. 
 
232 MORBID FEAES AND COMPULSIONS 
 
 tile holophilic activities, nevertheless there is 
 some object-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. 1 This 
 unconscious portion of the libido has a directing 
 
 i We must not be confused by such cases 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 "will 
 not afterward react on any other specimen of a certain class." 
 It seems rather the reverse of such inhibition and as if habit, 
 instead of limiting the numbers of a class to which the individual 
 would react, had abnormally increased them. The case is only 
 an apparent contradiction to the rule. Psychologically the pa- 
 tient was not reacting to different 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, stern manner, etc.) to touch off the reaction. The possi- 
 bilities of reacting to a waiter, an hotel clerk or a conductor 
 were ignored. 
 
FIXATION 233 
 
 influence in the 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. 1 
 
 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 ferashf 
 
 Does the grass clothe a new-built wall? 
 
 Is she under thirty the woman who holds a boy in her thrall ? 
 KUDYARD KIPLING: "Certain Maxima of Hafiz." 
 
 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 
 
 The Ladies. 
 
 Many of this writer's stories give good pictures of object-selec- 
 tion dominated by the mother complex. 
 
234 MOEBID FEABS AND COMPULSIONS 
 
 them, he is satisfied with her, and relatively indif- 
 ferent to others for an indefinite period. In other 
 words, his sexual ideal is quite inclusive 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 difficult 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 pervejse ; 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 consciousness in such 
 forms as neurotic symptoms and dreams. 1 
 
 i 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, fundamentally? Jung has said: "In a certain 
 sensitiveness," 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 
 _haie too soon. His holophilic feelings possess almost adult 
 intensity while, in years and in his modes of reaction, he is still 
 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 qualitative 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 intense, 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 MORBID FEAES AND COMPULSIONS 
 
 The practical element in the question of fixation 
 is that the points at which fixation occurs 
 (whether they be fixation in respect to ob- 
 ject or in respect to aim) are loci minoris 
 resistentice in the synthesis of the holophilic 
 impulses. 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 menaces 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 child may be worn more deeply in the 
 neurotic through being more often traversed. All this, again, 
 does not mean very much. 
 
KEGRESSION 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! 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 in her grave for years, assisted thereto by 
 unfeeling abuse received at the hands of the 
 wailer. 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 diseon- 
 gruity with 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 FEAES AND COMPULSIONS 
 
 the old paths left by earlier real or attempted dis- 
 charge is not merely one from the present back to 
 the past, 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- 
 tasies of gratification; first perhaps to conscious 
 ones, but shortly it regresses still further to phan- 
 tasies which are unconscious. The phantasies 
 thus re-activated are either those which were once 
 
INTROVERTED LIBIDO 239 
 
 conscious, in the form of some of the masturbatic 
 phantasies of puberty, which were later forgotten, 
 or those which had been formed in the Uncon- 
 scious 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. 1 
 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. 
 
 i Any given symptom is ordinarily a condensation product cor- 
 responding to the attempted realization of several unconscious 
 phantasies, not all 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 caused 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 
 express the same trends. Masturbation is normal or abnormal 
 in youth according to whether it expresses normal or abnormal 
 wish constellations. 
 
 Cp. Freud: Hysterical Fancies and Their Relation to Bisex- 
 uality in "Selected Papers on Hysteria and Other Psychoneuroses," 
 Chapter IX. 
 
240 MOKBID FEAES AND COMPULSIONS 
 
 But the neurosis is not only an attempt to grat- 
 ify, after the manner of the old hallucinatory 
 method, wishes belonging to the Unconscious 
 which are returning from repression. It may also 
 serve to secure gratification for other and even 
 conscious wishes and not through essentially phan- 
 tastic but through real means. The first form of 
 wish fulfillment Freud calls the primary function 
 of the neurosis, the latter its secondary function. 
 For, at least in any cases of long standing, the 
 neurotic uses 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 the 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 perception 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 MORBID FEARS 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) tendencies. 
 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 degree 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. 1 
 
 "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 : Ueber die neurotischen Erkrankungstypen, Zentral- 
 blatt f. Psychoan. Bd. II., 1912, pages 297-302. 
 
DEPRIVATION 243 
 
 may send a substitute for the lost possibility of 
 satisfaction, than by the physician. 
 
 "In this type, which includes 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 FEARS AND COMPULSIONS 
 
 vidual, turns 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 unconscious 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, 1 the 
 libido can revert further, find infantile channels 
 by way of regression and strive toward the aims 
 corresponding with them. 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 2 school. Here the indi- 
 vidual becomes ill not as a result of a change in 
 the external world, which has put deprivation in 
 
 1 Formulierungen uber die zwei Prinzipien des psychischen 
 Gcschehens, Jahrb. f. Psychoanalyse, Bd. III. 
 
 2 Jung: Die Bedeutung des Vaters filr das Schicksal des Em- 
 eelnen, Jahrb. f. Psychoanalyse, 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 difficulties. 
 
 "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 FEAES AND COMPULSIONS 
 
 to autoerotism, for real object love ; a girl who lias 
 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 
 
INTROVERSION 247 
 
 second type reduces to a special case of depriva- 
 tion. In it not every form of satisfaction by 
 reality is withheld, but 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 back 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 ill 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 FEAES 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 role 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. Such 
 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 they 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 neuroses 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 pathogenic 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 illness 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 FEARS AND COMPULSIONS 
 
 taught us regularly to find the cause of the neu- 
 rotic 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. 1 
 
 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. 2 It occurs on occasions where a 
 normal person would either feel no fear at all or 
 
 *The word anxiety, as used in psychoanalytic writing, has 
 about the same significance as the German word Angst, i.e., an 
 intense fear. The words fear and anxiety are, however, often used 
 interchangeably. 
 
 2 Jones : "Pathology of Morbid Anxiety" in his Papers on Psy- 
 choanalysis. 
 
MORBID FEAK 253 
 
 else a less intense one. An additional fact is that 
 normal fears are usually 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 superficial 
 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 attack of morbid fear is not, as the 
 patient may think, the cause 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 MOEBID FEAES AND COMPULSIONS 
 
 other. Nevertheless, the more we become ac- 
 quainted with the facts relating to the situation, 
 the less improbable all this seems. 
 
 Let us ask what an emotion is, and see if this 
 does not throw some light on the question. An 
 emotion, one might 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 excited 
 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 
 Crile writes: " There is (in emotion) a specific 
 stimulation or inhibition of every organ and tissue 
 in the body, in accordance with the role 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 circulation 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. ' ' 1 The organism 
 
 i Crile: "Man, an Adaptive Mechanism." 
 
EMOTION 255 
 
 is like a car which, with throttle open, spark ad- 
 vanced and engine racing, throbs and trembles 
 with liberated energy, while the clutch 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 fatigue 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, characteristic 
 changes 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. 1 
 
 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- 
 
 i William James : "Principles of Psychology," Vol. I, page 450. 
 
 The state of tension or tonus, which, according to the channels 
 along which it is expressed, is either emotion or action, is the 
 physiological equivalent of what in Freudian psychology is spoken 
 of as the unconscious wish. 
 
SEXUAL EMOTION 257 
 
 ness which is primarily sexual 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 must be felt as fear and 
 what are the exact details of the process. We 
 have to be content with knowing that this relation- 
 ship, 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 FEAES AND COMPULSIONS 
 
 include the accumulations of internal secretions 
 of the sexual glands, and the stimuli represented 
 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-specific elements would be changes in the 
 blood content and in the sympathetic-autonomic 
 balance, much the same as those 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. 1 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-sexual exertion such as attack or flight, and 
 this very likely is accompanied by corresponding 
 
 i This does not mean that the individual need be continuously 
 conscious of sexual desire. 
 
ANXIETY STATES 259 
 
 changes in the sympathetic-autonomic balance. It 
 is not then difficult to imagine that this accumula- 
 tion and these changes in the involuntary nervous 
 system which have so much in common with the 
 states of preparedness from which come the 
 afferent reports known as anger and fear, 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. 1 
 
 Certainly the clinical facts are in accord with 
 this hypothesis. In 1895 Freud wrote a paper 
 describing a condition which had formerly been 
 classed as one of the varieties of " Neurasthenia " 
 which he named Anxiety Neurosis. 2 The symp- 
 toms were (1) general irritability and hyperes- 
 
 1 It cannot be advanced as an objection to this hypothesis that 
 if a damming up of the libido can cause fear it also ought to 
 cause anger, for the reason that, in certain cases, it does cause 
 anger (or at least an over intense reaction to what in normal 
 persons would cause but slight irritation). The constant state 
 of irritability, exasperation or ill temper (in short, of chronic 
 anger) which is manifest in some nervous people is so familiar 
 as hardly to require comment. Why a damming up of the libido 
 should more frequently cause fear than anger is a question that 
 cannot yet be answered more than to say that conditions of in- 
 hibition or repression which are usually in part responsible for 
 the damming up are surely closely allied to fear; while anger 
 more nearly coincides with the freer or self-assertive state of 
 mind that leads to or goes with an adequate sexual outlet. 
 
 2 Veber die Berechtigung von der Neurasthenic einen beatimm- 
 ten Symptomen-lcomplex ala "Angstneurose" dbzutrennen. Brill's 
 translation appears in "Selected Papers on Hysteria and Other 
 Psychoneuroses. 
 
260 MORBID FEAES AND COMPULSIONS 
 
 thesia, (hyperacusis, insomnia, etc.), (2) anxious 
 expectation, fearfulness, worry, with perhaps 
 occasional severe attacks or seizures of intense 
 anxiety, and (3) somatic symptoms such as dis- 
 turbances of heart action, attacks of dyspnoea, 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 
 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 clearly the presence of the endocrine fac- 
 tors and correlated disturbances of the sympa- 
 thetic nervous system. 1 The condition of general 
 irritability (i. e. of lowered threshold and too 
 
 i Freud has pointed out the resemblance of the physical ac- 
 companiments of the anxiety attacks to those of sexual excite- 
 ment rapid heart action, hurried breathing, perspiration, dry- 
 ness of the mouth, involuntary muscular contractions, etc. They 
 also resemble those of angry excitement. 
 
ANGER AND HATE 261 
 
 ready response to all sorts of stimuli) 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- 
 
 i Quoted by Cannon. 
 
262 MOBBID FEAKS 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, undergo 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, 
 must 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 suffice, will next over- 
 flow into the less habitual ones. ' ' 1 '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 
 
 iH. Spencer: "Essays, Scientific, Political," etc., quoted by Dar- 
 win in his "Expression of the Emotions." 
 
FEAR 263 
 
 for itself an unnatural one. It "must expend 
 itself somewhere. " * 
 
 So much for the physiological aspects of the 
 question. Let us 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 rhinoceros, 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. 2 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 even attempt to explain on a physiological basis 
 why morbid fear attaches itself to certain special objects and not 
 to others. 
 
 2 As Crile points out, 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 skunk, however, whose chief means of 
 protection is its odor; the porcupine, defended by its quills; the 
 turtle, protected by its shell; the lion and the elephant, secure 
 in their superior strength, show little if any fear. 
 
264 MOEBID FEARS AND COMPULSIONS 
 
 Morbid fear has origin from conditions that are 
 internal. This seems to us something entirely 
 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. 1 
 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. 2 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-fulfillment, which from 
 the point of view of the individual's conscious and 
 
 i Compare Freud's "Triebe und Triebschicksale," Int. Zeitschr. 
 f. arzt. Psychoanalyse, Vol. Ill, 1915. 
 2L. c. 
 
FEAR AND DESIRE 265 
 
 foreconscious trends, are repugnant and would 
 cause displeasure, is treated like other sources 
 of displeasure, as something external and hos- 
 tile, 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 FEAES AND COMPULSIONS 
 
 the danger arising from an abnormal condition- 
 the damming up of the libido to a point where it 
 breaks through f oreconscious 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 Krafft-Ebing, 
 Nystrom, Eohleder, Kisch, 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 excite- 
 ment. ' ' Oh, ' ' she cried, " I Ve had such an experi- 
 ence ! Just now as I was coming home through a 
 dark and lonely street I saw a Man! And, My 
 Goodness, how I did run ! ' ' 
 
 "You don't say so !" returned one of the board- 
 ers, looking up with an expression of sympathetic 
 interest, ' ' and did you catch him, Miss Antique 1 9 ' 
 
 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. 2 
 
 We have offered two explanations of the origin 
 of neurotic fear from dammed up desire, a physio- 
 
 iSee H. Ellis: "Sex and Society." 
 
 2 Fielding and Dickens, among other writers, show a keen 
 Insight into defensive reactions of about this sort. 
 
FEAR AND DESIKE 267 
 
 logical and a psychological 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 role 
 in the formation of the symptoms conflicts which, 
 
268 MOEBID FEAES 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. 1 
 
 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 
 
 i Cf . Jones : "The Relation Between the Anxiety Neurosis and 
 Anxiety Hysteria," Journal of Abnormal Psychology, Vol. VIII, 
 1913. 
 
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 PSYCHOLOGY OF THE COMPULSION 
 NEUROSIS 
 
 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 rule 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 neurologists, 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 decided misnomer. For most of these con- 
 ditions are not, strictly speaking, nervous 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 English 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 compulsion (or obses- 
 sional) neurosis. We shall begin 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 kill 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 did?" 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 this other woman 
 out of her mind. She had 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 MOEBID FEAES AND COMPULSIONS 
 
 variously as compulsive ideas, fixed ideas or ob- 
 sessions. 
 
 An intelligent young 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 spell 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 1? 
 What is it?" To use or to hear the word "My" 
 has a similar effect. "Who is My?" she has to 
 ask herself. "My is not my body or I wouldn't 
 say 'my hands.' It's not my mind or I wouldn't 
 say 'my 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!" 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, Grubelsucht.) 
 
 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 look 
 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 
 corner, etc." Before beginning each of these 
 actions she would have to count ten. These are 
 cases 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 
 
274 MORBID FEAES 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 
 T think, to fear or to act in a certain 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- 
 I 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 lie read, but his feeling in the matter 
 was altogether excessive in proportion to the like- 
 lihood of his receiving any serious 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 
 gloom. 
 
 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 J 
 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, in\ 
 short, that the affects must have some other 
 source than that represented by the ideas to which] 
 they are attached. But if in pursuance of this 
 
276 MOKBID FEABS AND COMPULSIONS 
 
 hypothesis we ask of a patient: "Is there any- 
 thing in your life that troubles you, or that could 
 give rise to the strong emotions of which you 
 complain ?" he replies: "No, nothing at all. If 
 I could only get this terrible fear out of my mind, 
 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 conclude 
 either that the patient is lying or that he does 
 not know. 
 
 But with these last words Tie 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. 1 In 
 other words, to seek to explain the phenomena 
 
 i This 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- 
 sciousness. 
 
 Such a word as "Unconscious" or "Subcon- 
 scious" as applied to mental processes for niost 
 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 MOEBID FEAES AND COMPULSIONS 
 
 " Stokes thinks he is in love with Miss Ehodes, 
 but I'm sure he isn't. It's really her money he's 
 marrying her for, but he doesn't know it." And 
 what does such a statement imply, if not that 
 Stokes is swayed by a powerful motive of which 
 he is not vividly conscious? Who has not made 
 remarks containing similar implications? 
 
 Even the physician quoted above, who does not 
 "believe 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 
 
PARTIAL REPRESSION 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 work? We had a hint of the 
 answer to such 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. For in the mam.JJh.ese- impulses 
 (and their representing ideas) are of such a kind 
 as to be repugnant to his conscious personality 
 and contrary to, or out of accord with, the trends 
 of his ethical self. The lack of knowledge is a 
 result of the automatic censorship exercised by 
 consciousness and the foreconscious, an effect 
 of repression. 
 
 But, as has been many times indicated, the 
 fact that a wish is out of consciousness does not 
 mean 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- 
 sion. The repressed elements in such a case are 
 
280 MORBID FEAES AND COMPULSIONS 
 
 neither completely excluded from consciousness 
 nor have they wholly free entrance into it. What 
 happens is that the repressed forces again mani- 
 fest themselves in consciousness, not, however in 
 their original, but 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) which 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 
 
 In conversion hysteria the ideational elements 
 remain repressed (unconscious) while the energic 
 element (the libido) is employed in somatic in- 
 nervation, sensory or motor, excitor or inhibitory, 
 producing a purely bodily symptom (a pain, 
 anaesthesia, spasm, paralysis or the like). The 
 locus, thus over-innervated, is found, on analysis 
 of the case, to bear a definite relation 1 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 
 us, 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 un- 
 
 i Freud: "Sammlung Kleiner Schreften," Vol. II, Chapter I. 
 
282 MOEBID FEARS AND COMPULSIONS 
 
 successful. The idea-content of the repressed 
 presentation is withheld from consciousness and 
 remains repressed. But the activation energy 
 (the libido) goes fully 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 unpleasant, 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 fifiei 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 
 the fact that this wish : energy is attached in con- 
 
SUBSTITUTE ACTIVITIES 283 
 
 sciousness to some new idea-content, is, in other 
 words, directed to a substitute, 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, like 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 r 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 ac- 
 
284 MORBID FEAES AND COMPULSIONS 
 
 companiment but also produces a transformation 
 of the wish energy into anxiety. We have then 
 a compulsive fear. Indeed it is not difficult to 
 imagine such a thing occurring 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 cloth, 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 ? 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 woman, at least, is not 
 
SELF EEPROACH 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 careful to emphasize in the second 
 chapter, the role of the foreconscious is not a 
 purely passive one, or limited to the screening 
 out 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 almost 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 MOEBID FEAES AND COMPULSIONS 
 
 ethico-esthetic part of the self and corresponds 
 to the repressing forces. The following is a good 
 example. 
 
 A young professional man, unmarried, began to 
 suffer from compulsive self-reproachres 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 his 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 REPROACH 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 still 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 FEARS AND COMPULSIONS 
 
 was wrong in the things he had done, or explain 
 why he felt guilty and reproached himself. I 
 should add that there was apparently nothing in 
 his life that should give occasion for such feelings 
 of guilt, 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 EEPROACH 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. 1 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 
 
 i This was before the beginning of the European War. 
 
290 MOKBID FEARS AND COMPULSIONS 
 
 his desire to take back the hat and the check 
 book, etc. and was responsible for his lack of 
 complete 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 
 over compensation 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, conscientious 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 conscious personality. 1 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 
 
 i The words "conscious personality" as used in this book mean 
 the combined tendencies of the foreconscious and conscious 
 systems. 
 
REPRESSED 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 nearly 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 MOEBID FEAES AND COMPULSIONS 
 
 life is lived coincidently with an undercurrent of 
 impulses of anger, hate, hostility, and revenge and 
 their corresponding phantasies. To compensate 
 for this substratum of hostile trends the conscious 
 qualities of love, sympathy, considerateness and 
 scrupulousness are developed often to an unusual 
 extent and participate in the task of maintaining 
 the repression. 
 
 The period of apparent normality, but really of 
 successful repression, which succeeds upon the 
 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 foreconscious 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 sin- 
 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. 
 
/I 
 
 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 unconscious 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 aboulia, 
 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 
 
294 MOEBID FEAES AND COMPULSIONS 
 
 i 
 
 of outlet, somewhat in the manner that the cur- 
 rent of blood, after ligation of an artery, tends to 
 swell the smaller branches and establish a col- 
 lateral circulation. Thus we find large amounts 
 of energy discharging, or attempting to discharge, 
 through channels represented by mental or motor 
 activities of so little intrinsic dignity and im- 
 portance as to be entirely out of accord with such 
 great expenditures. These collaterals, tapping 
 the store of energy corresponding to the impulses 
 of love and hate denied expression elsewhere, are 
 those strange phenomena which clinically we know 
 as compulsions. Sometimes they give expression 
 to a hostile impulse, sometimes to a tender one, 
 but the rule is that the activity which becomes 
 compulsive is one of a sort to give to the hostile 
 and tender impulses a more or less simultaneous 
 discharge, and thus represents a sort of comprom- 
 ise between them. 
 
 The compulsions are then, as was said earlier, 
 substitute activities and come about through dis- 
 placement. But the energy which is displaced is 
 that derived from impulses of love and hate which 
 have reciprocally inhibited one another. Depend- 
 ing on the extent to which thinking has replaced 
 action, we have compulsive thinking or " ideas" 
 (obsessions) instead of compulsive actions in the 
 narrow sense. Whether the compulsive activi- 
 ties take the form of imperative wishes, impulses, 
 doubts, etc., or that of fears depends on whether 
 the original energic content retains more or less 
 its true form or is transformed by the repression 
 into anxiety or some similar emotion. 
 
SECONDARY DEFENSE 295 
 
 In the majority of cases there develop the so- 
 called * 'measures of secondary defense." They 
 are activities which occur after there has been a 
 failure of repression, and have the appearance 
 of being directed against the symptoms them- 
 selves. 
 
 For instance a person with a compulsive fear 
 often has some formula or prayer which he re- 
 peats, or some gesture or rite which he performs 
 in order to prevent the feared occurrence from 
 taking place. But the measures of secondary de- 
 fense are not sharply marked off, either clinically 
 or psychologically, from the primary symptoms. 
 For the secondary defensive action is usually 
 found upon analysis to have received some of its 
 motivation from the very impulses causing the 
 primary symptom and against which it is in- 
 tended to defend. For example a young man who 
 suffered from an obsession that he was notice- 
 ably effeminate in appearance conceived the idea 
 that by injecting himself with testicular extract 
 he might gain a more virile and masculine aspect. 
 This obsession, apart from the hostile elements 
 in its motivation, was mainly dependent upon a 
 repressed homosexual trend. Thus the measure 
 which was intended to do away with the appear- 
 ance of effeminacy (which was a projection, a sub- 
 stitution of an outer for the repressed inner per- 
 ception of homosexual tendencies) was one sym- 
 bolic of a coitus, in which the patient, in the 
 feminine role, received the semen of the male. 
 
 A typical occurrence in the compulsion neurosis 
 is that of "two-sided compulsive acts," where a 
 
296 MORBID FEARS 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 individual. Freud gives 
 the following example. 1 His patient, a young 
 officer, 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. 
 
 Cases 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 
 
 i "Bemerkungen iiber einen Fall Zwangsneurose," Jahrbuch f . 
 psychoan. u. psychopath. Forsch. Bd. I., Hft. 2, 1909. 
 
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 autoerotic 
 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." 1 
 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 antithesis "masculine-feminine" as distinguished from 
 "active-passive" does not exist until the genital zones become the 
 prime foci of sexual reference. 
 
CURIOSITY IMPULSE 299 
 
 stinate (anal-erotic traits) though during the 
 period of sexual functioning they had shown no 
 such characteristics. 1 Thus, as he says, such 
 characteristics, 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 tumultuous 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 
 compulsion 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- 
 
 * Freud : "Die Disposition zur Zwangsneurose," Int. Zeitschr. 
 f. Aerztliche Psychoanalyse, Vol. I, No. 6, 1913. Cp. Freud: 
 "Charakter und Anal-Erotik," Sammlung kleiner Schriften zur 
 Neurosenlehre, Bd. II or Brill: Anal-Eroticism and Character 
 in his book on "Psychoanalysis." 
 
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 : "Bemerkungen liber einen Fall Zwangsneurose," Jalir- 
 buch fur psychoan. u. psychopath. Forschungen, Vol. I, 1909. 
 
SUPERSTITION 301 
 
 exist along side, and in spite of their mate- 
 rialistic convictions. As Freud expresses it, 
 they are superstitious and at the same time not 
 superstitious, 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 lie 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." 1 
 
 The superstition of these patients is related to 
 and based largely on a belief (unformulated and 
 
 iLc. 
 
302 MOEBID FEAES AND COMPULSIONS 
 
 in the main unconscious) in the omnipotence 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 
 neuroses and in many normal persons. How such 
 a belief arises has been ably discussed by 
 Ferenczi and need not be considered here. 1 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 role 
 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) amnesia. 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- 
 
 i Ferenczi: "Contributions to Psychoanalysis," Chapter VIII, 
 tr. by Ernest Jones. 
 
DISPLACED REPROACH 303 
 
 sides in the psychic process which we must 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." 1 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 
 skin department, which is next door, and stopped 
 me. 
 
 "Doctor," she said, "is there any one in your 
 department who knows how to hypnotize?" 
 
 "Yes," I replied, "why do you ask?" 
 
 "Because I want to stop smoking cigarettes, 
 
304 MOEBID FEAES AND COMPULSIONS 
 
 and I can't. I thought maybe if I could be 
 hypnotized it would help me. I've got to stop. 
 The things are killing me." 
 
 "All right," I said, "come in and we'll see 
 what can be done," and, sitting down, I began to 
 take the usual routine history. 
 
 "Your age?" 
 
 "Twenty-five." 
 
 "Occupation!" 
 
 "I am a prostitute." 
 
 "What diseases have you had?" 
 
 "I've had gonorrhea and syphilis. I'm being 
 treated for syphilis now in the skin department." 
 
 "Do you drink?" 
 
 "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 day?" (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 * killing' 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 EEPROACH 305 
 
 really makes you feel blue and worried, and you 
 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, because I never felt 
 this way until I began to smoke them." 
 
 "How long ago did you begin the sort of life 
 you are now leading?" 
 
 "Five years ago. I was a perfectly straight 
 girl up to then." 
 
 "But that's just the time you began to smoke 
 cigarettes, isn't it?" 
 
 "Yes, that's right," she admitted. 
 
 "But," I asked, "since you began to smoke 
 cigarettes and to do these other things at just the 
 same time, how do you know which it is that makes 
 you feel badly? Being a prostitute and having 
 gonorrhea and syphilis might much more easily 
 cause a girl to feel blue and worried than smok- 
 ing a few cigarettes. Don't you think it possi- 
 ble that some of these other things and not the 
 smoking are the real reasons why you do not feel 
 well?" 
 
 "No," she said, "I see what you mean, but I 
 don't agree with you. Somebody else might 
 worry about such things, but I never do. Old 
 E. E. Morse never bothers me. If I could 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 could 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 FEARS AND COMPULSIONS 
 
 patient had made the "correct confession" 1 
 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 ttye 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 them. 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." 
 
 "All 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. 
 
 i Without doubt the "confession" was incomplete. 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 activities, 
 which, being more pleasurable, 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. ' ' l 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: "Allgemeines tiber den hysterischen Anfalle"; Samm- 
 lung kleiner Schriften zur Neurosenlehre, Bd. II. 
 
CHAPTER VII 
 
 A CASE OF COMPULSION NEUEOSIS 
 
 (THE CASE or 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 in 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 
 
 303 
 
A COMPULSION NEUROSIS 309 
 
 it shows that the confessions of the patient were 
 not " suggested " by the psychoanalyst. It con- 
 firms the correctness of some of Freud's con- 
 clusions as to the mechanism of neurotic disturb- 
 ances, 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. 
 
 PART I. HISTORICAL 
 (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 1" 
 
 This obsession had appeared in July, 1910, ten 
 months earlier, when she was madly infatuated 
 
310 MORBID FEAES AND COMPULSIONS 
 
 with a young 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 
 to 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 
 
 upon 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 
 innocent 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. 1 But this, she 
 
 i Physicians are often consulted by neurotic patients contem- 
 plating matrimony who express some more or less vague fear that 
 they may be impotent, or have syphilis, or suffer from some other 
 ill which would render marriage inadvisable. They wish to be ex- 
 amined and assured that their fears are groundless, 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 wish that such were the case 
 (showing that the individual in question is really of two minda 
 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 ought not to marry, although 
 not 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 COMPULSIONS 
 
 replied, was impossible. All 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. 
 
 (b) 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. Cf. Jones, "Der Stellungsnahme des Aerztes zur den 
 Aktual Konflikten," Internationale Zeitschrift fur Aerztliche Psy- 
 choanalyse, Vol. Ill, 1915. 
 
A COMPULSION "NEUROSIS 313 
 
 toms other than to cause temporary exacerbation 
 of her fears just before it. 
 
 During 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 MORBID 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, but thought 
 "it was from worrying about something. " 
 
 Physical examination was practically negative. 
 The patient was well nourished, 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 born in a small village in Russia. 
 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 family, 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 NEUEOSIS 315 
 
 place in a department store where she worked up 
 to the year she was married. 
 
 Stella's education, begun in Europe 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 sequelae of this visit are 
 of so much importance that I must take up the his- 
 tory of these matters in considerable detail. 
 
316 MORBID FEAES AND COMPULSIONS 
 
 In the early summer of 1910 Stella went to a 
 country boarding house for her vacation. There 
 she 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 NEUROSIS 317 
 
 it did not come. On the contrary, Max maintained 
 a most inflexible 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 
 
318 MOEBID FEAES AND COMPULSIONS 
 
 summer, and, when she confided her condition to 
 her cousin Eose, the latter immediately suggested 
 magic as a way of inducing in Max a like state of 
 mind, and ultimately bringing about a wedding. 
 Eose, 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 Eose was continually tell- 
 ing, and at first refused to have anything to do 
 with magic and fortune tellers. 
 
 Some days later, however, when Stella had ac- 
 companied Eose, who had some eye trouble, to 
 what we will call St. Christopher's Clinic, she said 
 suddenly as they were walking home, "Eose, I 
 think I would like to go to a fortune teller after 
 all." 
 
 This suggestion Eose 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 MdhosJief, 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. 
 Eose 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- 
 ess. 
 
A COMPULSION 'NEUROSIS 319 
 
 Soon Rose returned in great excitement. ' * lie '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 "you 
 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 he 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 FEARS AND COMPULSIONS 
 
 "I can do everything!" he cried boastfully. 
 "For me all kinds of Kishef (magic) are easy!" 
 
 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 Eose ; ' ' now I know 
 I can marry Max. ' ' N 
 
 There followed two days of joyful expectation. 
 Stella and Eose 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 Eose'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 NEUROSIS 321 
 
 visit 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, though, 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 Eose. ' ' Why should 
 you worry about how you get him as long as you do 
 get him! You're too honest! You make me 
 sick!" 
 
 This matter was soon dropped and Eose went 
 on to tell 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 Eose. "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 '11 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. "Oh!" she cried, 
 "isn't that awful! I can't have a man's days' 
 shortened for my pleasure ! I can't have him lose 
 his life on my account. ' ' 
 
 "You are so stupid," replied Eose in great con- 
 tempt ; ' ' why should you care ! I wouldn 't let the 
 
322 MOEBID FEARS 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 
 words, "if Max has magic done to him he'll be 
 weak and sickly all the rest of his life," the ter- 
 rific fear had come upon her that the Mahoshef 
 was exerting magic upon Tier 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 him she did not want the young 
 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, finally, 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 clinic 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 began 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 young 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 would 
 say so/' 
 
324 MOEBID FEARS AND COMPULSIONS 
 
 And to this highly abstract proposition, which 
 Stella apparently found to be quite as unassail- 
 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 him 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 much 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 NEUKOSIS 325 
 
 fear suddenly returned and she was as sick as 
 ever. 
 
 The revival of the obsession occurred under the 
 following circumstances. 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, maybe the Mahoshef 
 can do magic 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 MORBID FEARS AND COMPULSIONS 
 
 She gave him her history, telling him particu- 
 larly of her great fear that she ought 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 was 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 
 acquaintances 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 NEUROSIS 327 
 
 magic on her and that she would 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 Kishef 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 'in 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 it? Is it a scientific 
 fact that there can't be any? There were great 
 men in the Bible, and Shakespeare was a great 
 man, but they believed in magic and witches how 
 do you know they were wrong ? If such bright men 
 believed in those things there must be some truth 
 in them it makes me afraid I think the Mdho- 
 shef has power over me," etc. 
 
328 MORBID 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 corner 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 which 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 Eose and the 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 civil 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 Kishef 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 all 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 MORBID 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 would 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, 1 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 NEUROSIS 331 
 
 death. What finer example could be desired of 
 "that 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? 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) Preliminary 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 FEAES AND COMPULSIONS 
 
 about the reawakening, and thus cause the neuro- 
 sis. From such 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? The case explains itself! 
 
 The psychoanalyst, however, would see in this 
 history many points that call for extensive and 
 careful 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 which 
 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 in 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? 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. 1 Such a position was once 
 occupied by Max, later by Barney. We may there- 
 fore infer that some sort of emotional conflict 
 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 
 at 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 or 
 wholly unconscious, to some new love-object, 
 against whom there are no particular conscious 
 
 i "Analytical Psychology," p. 129. Aa a matter of fact the per- 
 sons to whom Stella stood in 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 
 >of her adjustment to her parents is one that for the moment we 
 need not consider, although we shall take it up later. 
 
334 MOEBID FEARS AND COMPULSIONS 
 
 resistances, 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 unknown 
 way, Tie 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. 1 
 
 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 mean, of course, that all her seeming love for 
 Max had this origin merely that a part of it did, particularly at 
 first. 
 
A COMPULSION NEUROSIS 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. "Oh," she would say, "he was so 
 refined ! How I loved him ! 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 Liebe 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 FEARS AND COMPULSIONS 
 
 In full accord with this conclusion 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 I 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. 1 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 example, a man develops a neurotic symptom which 
 apparently causes him to be unable to continue his business, we 
 are likely to find upon analysis that for some reason the man 
 wanted to give up his business, 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 thus 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. ANALYTIC 
 (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 you?" 
 
 But, after a few moments, she began to talk 
 about her mother. 
 
 "My mother," she said, "is 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 FEAES 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. 
 "What!" she cried excitedly, "do you mean that 
 I hate my mother, that I want her to die f ' ' 
 
 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. 
 
 ' l Oh, 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 NEUROSIS 339 
 
 She answered that she could 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 FEAES AND COMPULSIONS 
 
 for the fright he had given her. "Why can't you 
 leave me alone !" she said indignantly. "Don't 
 ever do that to me again! I've had enough of 
 your nonsense. ' ' 
 
 "Can't a father kiss his own daughter I" 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- 
 ter? 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. Stella 
 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 entertain 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 
 
 occur. The opposed feelings in these cases are 
 not as a rule simultaneously conscious. The hate 
 is usually confined more or less successfully to the 
 unconscious, 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. 
 
 (b) The Separation-Complex 
 
 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 MOKBID FEARS 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. 1 
 
 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. 
 
 i 1 should, perhaps, state at this point that this and similar 
 questions that came up in the analysis I submitted to Stella in 
 the hope that she would answer them. It was quite useless, 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 maintained that she 
 had married Barney for love alone, whereas at other times her 
 own admission, as well as many other indications, showed that 
 this explanation was entirely incorrect. 
 
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, 
 "1 think 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?" 
 
 "Yes," she answered rather reluctantly and 
 would say nothing more. 
 
 I kept on questioning her and finally brought to 
 light, first, that Barney suffered from ejaculatio 
 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 MORBID FEARS AND COMPULSIONS 
 
 Stella's presence, that in all probability lie was 
 sterile and would remain so. This was very 
 painful to Stella, for, as she then told me, she 
 was extremely anxious 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 
 you?" 
 
 "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 NEUROSIS 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; but, when he is me'an, I hope he 
 will die right away. Usually, 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 communication 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 MOEBID FEAKS 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," etc. 
 
 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," etc., 
 and thus she never got to the point of putting her 
 plan into execution. 1 
 
 i This element of her fear, namely, that by means of the history 
 at the Broadway Clinic it would be proved that she was insane, 
 etc., is what I had in mind particularly when, in the introduction, 
 
A COMPULSION NEUROSIS 347 
 
 Two sets 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 
 cared 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 displacement as shown 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 MOEBID 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 made 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 anything 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 NEUROSIS 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 
 showed 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 friends, 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 clothes 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. "Koped him in!"; she would 
 cry. " A nice remark for a friend to make ! The 
 mean, low, false thing! Could any decent per- 
 son say a thing like that? 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. 1 
 
 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 
 
 i Page 423. 
 
352 MORBID FEAES AND COMPULSIONS 
 
 only the truth that hurts. ' ' But, having come to 
 such a conclusion, I was no better off than before, 
 for, 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 him, 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 financially. Third, 
 we have reached 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 NEUEOSIS 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 5 s relations with Barney and take up another 
 matter which at first seems to have no connection 
 with the first. Stella had been coming to me some 
 considerable time when one day she said suddenly, 
 "Doctor, the Kishef 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 MOEBID FEAES 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- 
 culty 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 NEUROSIS 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." 1 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. 
 
 i Craziness in the head. 
 
356 MOEBID FEAES 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 ruptured accidentally during ex- 
 amination. Such a certificate, somewhat am- 
 biguously worded, she did finally receive. 
 
 The assault obsession lasted without abatement 
 for some eight or nine months, but then it gradu- 
 ally cleared up. After this it reappeared oc- 
 casionally even up to the time the Kishef 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 Eose, the same 
 cousin who was connected with the Kishef incident. 
 To Eose she did not speak frankly, however. 
 
A COMPULSION NEUROSIS 357 
 
 Eose 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 FEAES 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. 1 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. 
 
 i The relation between the obsession and a wish on Stella's part 
 to be masturbated by her father will be referred to again in con- 
 nection with the analysis of the Kishef obsession, where at the 
 same time the significance of Stella's repeated visits to doctors 
 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 MOEBID FEARS AND COMPULSIONS 
 
 day phantasies having such a content. That the 
 wish to be pregnant was uppermost in Stella's 
 mind on that particular 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 part 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. 1 
 
 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 much 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 
 
 i An additional fact in regard to the delay of this period will 
 be produced later. Page 387. 
 
A COMPULSION NEUROSIS 361 
 
 she did not take advantage of this opportunity to 
 gratify her desires in a normal way by marrying 
 him will 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 Resistance 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 MORBID FEAES 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 which 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 COMPULSION NEUROSIS 363 
 
 of over a year she had not done so to the best of 
 my recollection. I immediately 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 
 / can't 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 sound, 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 
 about 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, 
 "couldn't 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 so?" 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 COMPULSION NEUROSIS 365 
 
 premature ejaculation. Yet the view that she as- 
 cribed to all three of us some sexual weakness was 
 difficult to accept, for by what conceivable process 
 of reasoning could she have formed any opinion 
 in regard to the sexual power of Max and myself? 
 Furthermore, 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 that 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 FEABS AND COMPULSIONS 
 
 tion of the mystery. Stella began to manifest a 
 considerable anxiety about 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 about my diet. These remarks usually ended 
 in her laughing at herself and saying that, since 
 I was a doctor, I must think her very presumptu- 
 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 will 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 COMPULSION NEUROSIS 367 
 
 hence, when Stella saw a drop of blood upon my 
 lip there could 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 meaning of the word (Connor) and so ap- 
 pear in her consciousness attached to the thought 
 that I was an Irishman? 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 
 had 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 MORBID FEAES AND COMPULSIONS 
 
 ite advances and did not ask her to marry Mm. 
 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 understand. 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 Rose's remark concerning Max, "he'll 
 be weak and sickly all the rest of his life," should 
 have had such 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 Rose'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 Rose's prediction that he w.ould 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 NEUROSIS 369 
 
 which resulted in her wishing that if she married 
 him his life would be short. 
 
 Sixth, the idea that Stella was "too 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, then, 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 har- 
 
370 MOBBID FEARS AND COMPULSIONS 
 
 monious with the facts that have been brought out, 
 but it enables us to explain very readily many 
 previously baffling things things which, it seems 
 to me, could be explained by no other hypothesis. 
 For these reasons I felt perfectly justified in look- 
 ing on it not as a mere hypothesis but as an expo- 
 sition of actual fact. 1 
 
 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 sick ! " 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- 
 
 iMy belief was that Stella in some way knew that Max and 
 Barney had tuberculosis in the latter case independently of the 
 doctor'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 conclusions 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 
 that 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 MORBID 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 what 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: 
 ' 1 1 've been awfully sick, Doctor. Last night I had 
 a terrible attack of fear the worst I ever had, I 
 think." 
 
 "What were you afraid of!" I asked. 
 
 ' ' Of 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 such terrible 
 fear." 
 
 She went on with her usual complaints, "I'll 
 never get well," "I'm lost," "I have no future," 
 etc., but I interrupted her by asking: "Don't you 
 
A COMPULSION NEUROSIS 373 
 
 know what made you afraid? What happened to 
 bring on the attack? " 
 
 "That 1*11 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 
 say was, * ' That I '11 never tell you ! ' ' 
 
 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 time. * 
 
 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 
 
 i 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 overcome them by explaining them, 
 rather than, so to speak, by using force. 
 
374 MORBID FEARS AND COMPULSIONS 
 
 keep back after all the embarrassing things I have 
 told you?" 
 
 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 out of the room for a 
 few minutes. When I came back she said, "Well, 
 doctor, I've been thinking it over and I've made 
 up my mind. I know I shouldn't take up your 
 time unless I let you know everything. At last 
 I'm going to tell you my secret." 
 
 4 'Well," I asked, "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. 1 
 
 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 
 
 i It was on account of her lung trouble that Stella had to leave 
 school at an early age rather than, as she stated at first, that her 
 mother "needed her to help with the house work." Page 315. 
 
A COMPULSION NEUROSIS 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 
 sanitarium. 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 displacement which 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 made in 
 
376 MOEBID FEAES 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 KisJief. 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 shall 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. 1 
 
 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 
 
 i The fact that Ida died of tuberculosis did not dispel Stella's 
 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 jusfc 
 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 MORBID FEABS 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 would 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 
 paying 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 NEUROSIS 379 
 
 exaggeration " Among the Jews on the East Side, 
 it could 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 true, 
 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 
 again, practically every one of her acquaintances 
 would know it, she would be branded as a consump- 
 
382 MORBID FEAES 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? 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. But as a matter of fact she was unwilling 
 to have the question settled. In her inmost self 
 she was practically certain that her lungs would 
 not be found normal, and she was not disposed to 
 exchange what opportunity 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 earlier, she had a wish to return to her for- 
 mer relations with 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 have reenforced 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? 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? If somo 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 taking 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 fact, 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 giv- 
 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 children, to say 
 nothing of the best of food to keep up her strength 
 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 us now consider just what this happening 
 was. What, in other words, was the relation of 
 the obsession 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 ! 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 FEAES AND COMPULSIONS 
 
 the paternal finger. Her fear, then, was a fear of 
 temptation, and expressed a wish to be robbed of 
 her virtue, 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 NEUROSIS 387 
 
 had come 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 Eose 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 FEAES 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 "has never 
 been touched") but the ambiguity of the word 
 "touch" allowed her to discharge her impulse to 
 tell, but without disclosing just what had occurred. 
 This obsession lasted some months. Fortu- 
 nately Stella was 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 Stella'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 inexplicable. 
 Thus, I was able eventually to discover the reason 
 for her sudden infatuation for Max and to answer 
 
A COMPULSION NEUROSIS 389 
 
 the extremely baffling 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 in 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. 1 
 
 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 
 
 i With the knowledge of tuberculosis 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 was certain, 
 nevertheless. 
 
390 MORBID FEAES AND COMPULSIONS 
 
 was a consumptive, but she also told me that even 
 before she married him she was convinced 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. 1 
 Now, it may be added, that sometime earlier in 
 the analysis Stella told me she first felt that she 
 wanted to marry Barney just 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 while 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 suspicion 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 first visit to me Stella said, in re- 
 sponse to my suggestion that she put off her marriage for a time, 
 that neither her own nor her husband's parents would listen to 
 any proposal of delay. As we have learned, quite the reverse was 
 true, at least so far as Stella's parents were concerned. They not 
 only would have been glad to have her put off this marriage, but 
 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 MOEBID FEAES AND COMPULSIONS 
 
 tive rest from her work in the store, to build up 
 her health, 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 NEUROSIS 393 
 
 child the tendency to develop a fixation that 
 would form a permanent obstacle to normal trans- 
 ference is of course very great. In fact, 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 numerous 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 that 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 MORBID FEAES AND COMPULSIONS 
 
 The prime object of her vacation in the country 
 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 FEAES AND COMPULSIONS 
 
 from Eose 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 Eose had 
 said to Stella, "You are so much in love with Max 
 that you'll make yourself sick worrying about him. 
 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 Eose that this 
 was so without being at all satisfied that she had 
 succeeded, although Eose did not dispute the point 
 and pretented to be convinced. 
 
 When, then, at their first visit to the Mahoshef, 
 Eose, having preceded her into his presence, re- 
 turned crying, "He knew what your trouble was 
 right away!" Stella, demonstrating the truth of 
 her own proverb, "Auf dem Gonef brennt die 
 Hiittel, ' ' 1 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 Eose might have given him 
 some hint of her history, for, knowing that Eose 
 was suspicious and feeling sure that she had not 
 
 i On the thief the hat burns. 
 
A COMPULSION NEUROSIS 397 
 
 succeeded in convincing her that she had never 
 had the disease, Stella thought it not unlikely that 
 Eose, shrewdly suspecting that the problem of 
 tuberculosis was worrying her a good deal, had 
 communicated this suspicion to the Mahoshef with 
 the kindly intention of giving him every possible 
 advantage. The vague 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 reenforced by 
 the wonder tales which Eose 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 Eose 
 
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 cure Max and me of tuberculosis 
 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 Eose two days later 
 Stella said, "I had rather get him in the 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 guilt about marry- 
 ing, no matter what her past history had been. 
 When, then, Eose 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 Eose can believe a thing so foolish as that, 
 how can I put any confidence in her when she tells 
 me that the Mahoshef has such wonderful powers? 
 What a fool I have been to think he could cure 
 tuberculosis ! " 1 
 
 i Probably the essential nature of these thoughts is that orig- 
 
A COMPULSION NEUROSIS 399 
 
 It was natural, then, that when a moment later 
 Eose said, "Do you 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 
 long?" 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 Eose ; 
 he will always be weak and sickly if he has magic 
 done to him and if he doesn't have it done to 
 him! 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." 1 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, 
 so 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)/ 9 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- 
 
 inally they were wordless, although I am here obliged to express 
 them in words. 
 
 iThis 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 MOEBID 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 sputum, 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 knew 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, 
 for, 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 
 a euphemistic phrase with which to make the ad- 
 mission. To say, "I 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 
 fortune teller's Kishef" appeared in Stella's con- 
 
402 MOEBID FEAES AND COMPULSIONS 
 
 sciousness as something unmotivated, strange, and 
 foreign to the rest of her thoughts in short, as 
 an obsession because it was there construed lit- 
 erally, rather than in the figurative sense in which 
 her unconscious employed it. The reason for this 
 misconstruction and misunderstanding was, as I 
 have tried to show, her reluctance to realize and 
 admit a painful fact. 
 
 The emotional accompaniments which made this 
 obsession so compelling did not all have origin 
 in the way just described. As we shall see, once 
 the obsession started, the affects belonging to 
 other painful thoughts were transferred to it, and 
 at the same time ree'nf orcement was received from 
 certain wishes which however manifested them- 
 selves in the shape of fear. 
 
 One displacement came about as follows : Since 
 Eose had never even seen Max and could have had 
 no reason for supposing him tubercular, her re- 
 mark, "He will be weak and sickly all the rest of 
 his life," etc., might well have startled Stella by 
 its uncanny accuracy. Naturally she thought 
 something like this: "What a coincidence! It is 
 almost as if that she-devil Eose were reading my 
 mind." But, since Stella's thinking was habitu- 
 ally done in a mixture of Yiddish and English, 
 the place of the phrase "that she-devil" was taken 
 in her mind by another phrase, viz., "that Mach- 
 seveh," "Machseveh" being a feminine form of 
 what would in English correspond to "rascal" or 
 ' ' devil. ' ' But it so happens that the word ' ' Mach- 
 seveh" is not only used to denote a rascally per- 
 son but signifies also a witch in short, "Mach- 
 
A COMPULSION NEUROSIS 403 
 
 seven," a witch, is the feminine of "Mahoshef," 
 a magician or wizard. Furthermore, the powers 
 which a Mahoshef and Machseveh are reputed to 
 possess include not only those of making love 
 matches and curing diseases but also that of read- 
 ing minds telepathy is thus a variety of Kishef 
 so Stella's reflection "Rose is guessing my 
 thoughts" naturally took the form "That Mach- 
 seveh (that she-devil, Rose) is doing Kishef to 
 me," a phrase which, but for the mere difference 
 of masculine and feminine word forms , is identical 
 with the wording of her obsession. It is easy to 
 understand, then, how affects arising from dis- 
 agreeable thoughts with which Rose was con- 
 nected, especially such thoughts as could be figura- 
 tively expressed in terms of Kishef, could become 
 displaced in Stella's consciousness via "Machse- 
 veh" to "Mahoshef" and thus merge with the 
 already existing fear of the fortune teller. 
 Such a substitution of the fortune teller for Rose 
 was further facilitated by the fact already pointed 
 out that Stella suspected that Rose had made a 
 confidant of him ; that is, she could say, "Whatever 
 Rose knows, he knows. To tell Rose a thing is the 
 same as telling it to the Mahoshef. ' ' 1 
 
 i There can be introduced here the explanation of Stella's anger 
 upon discovering that Rose and the Mahoshef were already ac- 
 quainted at the time of their first visit to him. We have already 
 seen that Stella suspected at the time of this visit that Rose had 
 told him of her tuberculosis. This suspicion was strengthened 
 when he said to her, "I can do everything!" and when he at- 
 tempted to sell her medicine, for she wondered if this did not 
 mean he was hinting that he knew of her lung trouble and that 
 he would try to help her if she cared to be frank with him. The 
 discovery some days later that Rose had known the Mahoshef 
 
404 MOEBID FEARS AND COMPULSIONS 
 
 The thoughts from which affective displacement 
 came about by this route arose as follows. Not 
 only did Eose 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 that, 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 Rose had 
 betrayed her. For the fact that Rose had seen fit to conceal this 
 acquaintance indicated a certain duplicity on her 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 Rose 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 corresponds 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 fact, for she believed that 
 she 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 him 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 ! " l But it is clear that though Stella 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 Eose 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, 
 Kose will look upon me as a murderess." And, 
 as we have just shown, Eose, in Stella's opinion, 
 would be right in thinking her a murderess. Here 
 
 i After she married Barney and it 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 FEARS AND COMPULSIONS 
 
 again Eose, though through wrong premises, 
 would reach a correct 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, "Rose will be right if she thinks I am a, 
 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 
 "Rose 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. 1 
 
 But still another group of ideas came to be rep- 
 resented in Stella's consciousness by her fear of 
 the Mahoshef. Not only in the two connections 
 just spoken of but in still another Rose had seemed 
 to divine what Stella was thinking; for as has al- 
 ready been said, Stella thought that Rose guessed 
 that she was worrying about tuberculosis. She 
 felt sure that when they discussed the matter of 
 
 i Compare the discussion of thing-ideas and word-ideas in Chap- 
 ter IV. 
 
A COMPULSION NEUROSIS 407 
 
 hemorrhages Rose, though pretending to be im- 
 pressed by her protestations, was really not at all 
 convinced that Stella had never had the disease. 
 And Rose's warning, "If you worry so about Max, 
 T. B. will come back on you* ' had made Stella won- 
 der if Rose 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 Stella thought it not improbable 
 that if Rose 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 
 
 i It is perhaps true that Stella's grounds for thinking that Rose 
 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 
 eecret, 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 1 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 shortly 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 ill this wish was a totally unconscious one. Phenom- 
 ena of this sort are well known under the term, "the projection 
 of a reproach," and that the existence of this mechanism is well 
 recognized is evidenced by such familiar phrases as: "A guilty 
 conscience needs no accuser." "The wicked flee when no man pur- 
 Bueth." To some extent, then, Stella's thought that Rose and the 
 Mahoshef knew she had tuberculosis depended upon a projection 
 
408 MORBID FEARS AND COMPULSIONS 
 
 At any rate, for Rose to guess that Stella was 
 having a relapse for in fact Stella was fat and 
 looked perfectly well was remarkable enough to 
 be expressed in terms of mind reading or divina- 
 tion. Hence, whatever affects belonged to the 
 idea i l That I have tuberculosis is known to others ' ' 
 could be displaced in Stella's consciousness to the 
 idea ' i The Mahoshef is doing magic to me. ' ' 
 
 This point, that magic meant among other things 
 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 Rose 
 also, because she thought Rose 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 history was there on file, and he might have 
 seen it or have learned of her story from some of 
 
 of the repressed thought "7 know I have it." This thought, "I 
 know I have tuberculosis," then, contributed to the obsession 
 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 know 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 
 kribws 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. 1 It is not unreasonable to conclude, then, 
 
 i Freud Paychoanalytische Bemerkungen liber einen autobi- 
 ographisch beschriebenen Fall von Paranoia. Jahrbuch ftir Psy- 
 
410 MORBID FEAES 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 would seem that 
 he must have stood as a representative of some 
 one whom she really did love. 1 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 Kishef 
 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 Forschungen, Bd. Ill, 
 Hft. 1, 1912. 
 
 i This line of reasoning has brought us to a conclusion 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 NEUROSIS 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 forces, reenf orced by the conflicts 
 arising out of the tuberculosis 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 still 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- 
 
412 MORBID FEAES 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 " playing doctor." 
 They examined one another, 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. 1 
 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." 
 
 iThis same idea of playing doctor obviously had to do with 
 the assault obsession. Her repeated visits to physicians at that 
 time signified among other things a wish 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 "doctor" 
 she really wanted, she would not go to for the purpose directly. 
 
A COMPULSION NEUROSIS 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 
 wishes 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 yielding to the temptation to have 
 
414 MOEBID FEARS AND COMPULSIONS 
 
 sexual intercourse. 1 Furthermore, she had often 
 said to herself that a girl who through such a 
 stroke of ill fortune as having tuberculosis was 
 deprived of an opportunity to secure the advan- 
 tages of marriage was on the 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 Eose, 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 it." 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 wish-fulfillment in 
 the sense that it represented various excuses for 
 doing as she pleased, particularly in matters of 
 sex. 
 
 i That the temptation was a real one is 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 rale 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 
 small" there was always an impulse to think "I 
 have no chance of getting a good husband, there 
 is no use in my being good hence 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 FEAES AND COMPULSIONS 
 
 the eventual sexual outlet it would represent, but 
 pleasing in so far as she desired an excuse for 
 returning to her father and for gaining a sexual 
 outlet 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 that 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 NEUROSIS 417 
 
 matically resisted whatever tendency she had to 
 make the transfer of libido that would result 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 give 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 MOEBID FEAES AND COMPULSIONS 
 
 poor she used as an excuse for not making the 
 best of things after he became an invalid. 1 
 
 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 determinant 
 than the one just mentioned. When the obsession first developed 
 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 
 Harry Thaw and stated (incorrectly, but Stella did not know 
 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 thought 
 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 slie 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 FEARS AND COMPULSIONS 
 
 Lehmann to Barney. I did not understand why 
 she married Barney until the following informa- 
 tion came to light. Lehmann went South in the 
 fall of 1910 and expected to return in January. 
 Later he 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 #eek 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 active 
 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 sanitarium, 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! 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 I'll 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 primarily to the 
 
422 MOEBID FEARS AND COMPULSIONS 
 
 events which had led her to believe that the Leh- 
 manns had learned of her malady. 
 
 In the light of our knowledge of the motives 
 which led Stella to marry Barney and of the cir- 
 cumstances 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 
 she 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 ill (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 because she herself had been 
 false. If she had been a true friend to the girl, 
 she would not have married her brother under cir- 
 cumstances 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 girl 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 
 ehe 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 
 
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. 
 
 Conclusion 
 
 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 Kishef 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 MORBID FEARS AND COMPULSIONS 
 
 At this point the analysis was interrupted and 
 I have done no work of any consequence on the 
 case since. As soon as Stella told me that she had 
 had tuberculosis 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 tu- 
 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 anaemia in her blood examination 
 to suggest that she was tubercular. The anos- 
 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 neurologist. 
 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 MOEBID FEARS AND COMPULSIONS 
 
 told Barney of her tubercular 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 i. 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. 1 
 
 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.) 
 
CHAPTEE VIII 
 
 THE PSYCHOLOGY OF ANXIETY HYSTEBIA 
 
 *|^ /FORBID fears of psychoneurotic origin 
 |%/| (i. e., those not belonging to psychoses, 
 JL v JL to toxic deliria, etc.) come under the 
 headjdther of the compulsion neurosis or of anxi- 
 ety hysteria. The latter term, as we have said 
 before, now includes the condition called the anxi- 
 ety neurosis, i.'e., those cases in which the physical 
 factors are in the foreground in causing the dam- 
 ming up of the libido. 
 
 Anxiety hysteria is the commonest of all the 
 psychoneuroses. It may occur at any time of 
 life, 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 and the physical 
 accompaniments thereof^ These fear symptoms 
 
 430 
 
PHOBIA AND PANIC 431 
 
 may be divided into two sorts, the "phobia" and 
 the "panic." 
 
 For instance, 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 
 some 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 
 sees 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 FEAKS AND COMPULSIONS 
 
 A third patient has a phobia of knives. If 
 she sees a sharp knife, she becomes afraid that 
 she may use it to injure herself or some other 
 person. She cannot go into a butcher shop, a 
 hardware store or any other place where she is 
 likely to see knives or other sharp instruments 
 exposed. She will not be left alone in her house 
 until she is assured that the carving knife, scis- 
 sors, 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_^spe^ial^features of anxiejtvjiyjsteria 
 are then thelrtta^ ^ 
 
 serves to keep the individual away from such sit- 
 uations as lead to the development of the panic, 
 'and the ideational element the notion of_what it 
 is that is feared. In addition to these typical 
 symptoms the patient also suffers in varying de- 
 grees from minor ones such as restlessness, in- 
 digestion, flatulence, insomnia, 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 
 
 i 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 won't 
 have insomnia or depression or nervousness or whatever it is 
 you may be suffering 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 thejrelation of the typical symp- 
 toms to the processes of the Unconsg^ojis and 
 what are the mechanisms by which they are 
 
 formed? The fear, the impulse to run away froi 
 something, is conditioned, as was said before, by 
 a damming up of libido which threatens to break 
 through the repression. What the patient Tears 
 is his own unconscious sexual impulses. But in 
 place of the ideas corresponding to these impulses 
 the iv appear in his consciousness some substi- 
 tute ideas, bearing, to be sure, a certain relation 
 to the repressed ones, but generally referring 
 to some possible external danger. The inner 
 menace is represented through projection by an 
 outer one, and, by taking care to avoid this outer 
 one, the patient is really attempting to escape 
 from a part of himself. The essential process 
 of the symptom formation is that of a displace- 
 ment of the anxiety affects into which the re- 
 pressed libido has been converted. 
 
 There 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, Cy, 
 whar ye goin'?" 
 
 "I'm a goin' down to the village to get drunk, " 
 replied Cyrus, gloomily, "and, Gosh, how I dread 
 it!" 
 
 pression and then you'll be cheerful." For, generally speaking, 
 "worry" is not a cause of the neurotic state, but a symptom of 
 it. The worry which these writers would regard as a cause of 
 insomnia, nervousness and so on, is really a morbid anxiety 
 which, in common with the insomnia, depression and other symp- 
 toms in the case, results primarily from conflicts, resistances, and 
 a damming up of the libido. 
 
434 MORBID FEARS AND COMPULSIONS 
 
 This story impresses us as funny, for we are not 
 accustomed to think of people looking with dread 
 upon the fulfillment of their own wishes. We 
 should be tempted to say to the farmer: "Well, 
 if that's the way you feel about getting drunk, why 
 do you do it! You don't have to get drunk if you 
 don't want to." Yet such a remark would show 
 a lack of appreciation of the situation. For Cy 
 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 don't 
 want it" just as if the wish for it had suddenly 
 evaporated. 
 
 The wishes which give rise to the neurosis are 
 those which behave 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 fulfillment and of 
 the existence of other wishes incompatible with 
 
FEAR AND DESIRE 435 
 
 their being fulfilled. The individual fears them 
 as he might fear bad 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. This would be a very real and reason- 
 able fear caused by desire. 
 
 Now let us go further and imagine that through 
 
436 MOEBID FEAES AND COMPULSIONS 
 
 some miraculous process his craving for drink is 
 transferred from consciousness to the Uncon- 
 scious, 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 bill, he might very well experience a sense 
 of uneasiness, of impending evil, of fear, without 
 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 villainous 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 me!" And we can imagine that this 
 
FEAE AND DESIRE 437 
 
 rationalization is accepted as the true explanation, 
 particularly as the evil looking alcoholic might 
 become connected in the farmer's mind with the 
 unconscious 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 
 his dailgefs.and he would develop phobias concern- 
 ing places 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 MORBID FEARS 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, somejDf 
 the libido of the wish-presentations, breaking 
 through the repression, is drawn off as anxiety, 
 while their idea-content remains repressed. At 
 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 energy of the wishes escap- 
 ing repression is in other words displaced to a 
 substitute idea, which ordinarily corresponds to 
 some object or situation in the external world. 
 Attacks of anxiety may then be brought on in two 
 ways, one by an increase of the unconscious libido 
 tensions and the other by stimuli proceeding from 
 the feared object corresponding to the substitute 
 idea. The feared object is often a substitute for 
 the 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 
 to the limitations which the phobias impose, he is 
 not totally free from anxiety. Flights from the 
 external stimuli of the substitute idea have no in- 
 fluence upon those attacks of anxiety which de- 
 
FEAR AND DESIRE 439 
 
 velop through 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! 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 conscious idea of having protec- 
 tion against the attacks of evil 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 traits 
 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, such as we spoke of in connection with 
 the compulsion neurosis, has not been as well 
 worked out for the hysterical conditions. 
 
440 MORBID FEARS AND COMPULSIONS 
 
 To supplement what has been said as to the 
 mechanisms 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' 7 ) coming upon her from behind 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 all 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 certain 
 house at night and had passed through a door at 
 the bottom of the stairway. This door slammed 
 
FEAR AND DESIRE 441 
 
 behind her before she had opened the outer one. 
 Thus she was for a few moments shut in the entry- 
 way between the two doors as if in a very small 
 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 back 
 (inner) door to choke her. Concerning the door 
 in front of her she felt no fear whatever. 
 
 Immediately after telling me this, she made a 
 rather suggestive slip of speech. She was speak- 
 ing in German, and used the words von dem Hin* 
 terer (from the behind, i. e. the gluteal regions) 
 when she had intended to say von hintern (from 
 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 born from the rectum. 
 Also she reproduced a great number of memories 
 of phantasies of anal coitus, wishes for which ahe 
 had even consciously experienced, at least momen- 
 tarily, during most of her married life. As we 
 already know, her great desire for children was 
 left ungratified through the sterility of her hus- 
 band. These wishes for children, expressed in the 
 form of anal birth phantasies, together with anal 
 erotic desires, formed the basis for her phobias 
 Of the truth of this statement little further evi- 
 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 back part, back entrance, 
 back opening or back passage. 
 
442 MOEBID FEAES AND COMPULSIONS 
 
 The idea of the "dead soul" or ghost, which was 
 to come from behind to choke her, has the follow- 
 ing explanation. 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 born 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 the breath or soul leaves the body, in like 
 manner stands for conception, in which a new soul 
 enters it. 1 
 
 What Stella really was afraid of was, then, her 
 own wishes for children, and for what amounted 
 
 i The representation of an idea by its opposite is a common oc- 
 currence in symptom and dream formation. It is on about the 
 same principle that a Negro is called "Snowball" or a fat man 
 nicknamed "Skinny." 
 
FEAR AND DESIRE 443 
 
 to a perverse method of getting them, anal coitus, 
 which was one of her early conceptions of the 
 sexual 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 aesthetic 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. 
 
CHAPTER IX 
 
 A CASE OF ANXIETY HYSTEBIA 
 (THE CASE OF MISS SUNDEKLAND) 
 
 THIS patient was an unmarried girl of 
 twenty, born 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 
 struck 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 kind 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 girl's 
 
AN ANXIETY HYSTERIA 447 
 
 first attack occurred 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 "spookiness" 
 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 you?" "No," I replied, 
 * * what do you mean ? " " 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 MOEBID FEARS AND COMPULSIONS 
 
 she disliked very much and that she hoped they 
 would not marry. After this there was a pause, 
 and then she laughed, 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 crazy 
 about him ! I could love him to death ! " 
 
 Then followed a still longer pause, after which 
 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." Eather 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 clean and straight person, this 
 did not lessen her aversion to him. 
 
 These bits of information, which I have re- 
 corded, though at first glance seemingly irrelevant 
 and disconnected, are when carefully 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 
 
 Further, 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. 1 
 
 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. 
 
 i "Diaguostische Assoziationsstudien," Bd. I, Beitrag VIII. 
 
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 MOEBID FEAES AND COMPULSIONS 
 
 long-nosed, gray dog, which was trying to bite her, 
 while she endeavored to prevent it by holding his 
 mouth shut with her hands. The dog finally did 
 bite her somewhere in the thigh. She saw a little 
 blood flowing from the wound, and then her body 
 began to swell up to a great size, and she awoke 
 terrified. 
 
 This is evidently a sexual dream. Its symbol- 
 ism is very typical. Young 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 symbolism that is famil- 
 iar from the Bible, wherein the word "thigh" is 
 often used when another part of the body is meant. 
 In 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 HYSTERIA 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. l 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 
 
 i Before this, she said, she had had no knowledge of sexual 
 relations and had not known how children came into existence. 
 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 vague 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 
 she 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 MOEBID FEAES 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- 
 cited man, for as shown by her associations she 
 had thought of men under such circumstances 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 said 
 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, 
 * ' My ! How I 'd like to be that dog I ' ' 
 
 Our 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 possessed 
 
456 MOEBID FEARS AND COMPULSIONS 
 
 a strong sexual attraction for her. But we can 
 easily interpret her aversion, dislike, etc., as cor- 
 responding to the struggle in the dream against 
 the dog and to her efforts to hold his mouth shut. 
 ("To 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 the 
 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 liking 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 HYSTERIA 457 
 
 my conclusions, 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 wrong. 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 MOEBID FEARS AND COMPULSIONS 
 
 that this something not uncommonly proved to be 
 the recollection of some definite sexual experience. 
 As soon as I made this remark, I saw from the 
 girPs 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, ashamed, 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 HYSTERIA 459 
 
 to experience sensations of an unmistakable char- 
 acter, she suddenly pushed the girl from her in 
 anger and shame, protesting that they could never 
 he 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 Ieucorrho3al 
 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. 2 
 
 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. 
 
 2 One usually has to give such assurances but can not rely upon 
 them to remove the patient's self-reproach entirely. If the emo- 
 
460 MORBID FEARS AND COMPULSIONS 
 
 At the next visit 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. 1 
 
 tion is strong it is dispelled only when the patient recalls and 
 connects with it the corrective experiences of childhood out of 
 which arose the ego-ideal specification or resistance applying to 
 the immediate cause of the sense of guilt. 
 
 1 It is to be seen that the resistances which began when the 
 
AN ANXIETY HYSTERIA 461 
 
 In connection with our discussion of the homo- 
 sexual experience, the girl remarked that ever 
 since it she had felt a certain resentment toward 
 her parents for not warning her that such things 
 could 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 
 warnings she had heeded, and made friends only 
 with 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 experi- 
 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 
 
 things sexual. In other words, such apparent ig- 
 norance as hers ordinarily denoted not a real ig- 
 norance of sex matters but rather an early ac- 
 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 other 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 back 
 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 which 
 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 HYSTERIA 463 
 
 resis, 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- 
 nected 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 FEAES 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. 
 
 In 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 begged 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 with her hands. "What were you 
 doing V 9 I asked. "I was making a flower," she 
 replied. "And what had you in mind!" 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 else? What comes to your 
 mind I " " Nothing, ' ' she replied ; " I don 't think 
 of anything 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 heart, and this, with occasional dyspno3a, 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 ac- 
 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 FEARS AND COMPULSIONS 
 
 ance at nearly every place they went, on account 
 of which they had to keep moving. In speaking of 
 this the young 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 young bride, a 
 phantasy, in other words, that she had run 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 category. 
 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 HYSTERIA 467 
 
 myself without her having to ask a direct question. 
 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 other 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 consciously with regard to me, had pre- 
 viously taken place unconsciously in regard to 
 some other person who for the time being I rep- 
 
468 MOEBID FEAES 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 them. 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 , 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 illness, 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 that 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 close, 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 
 took her to this room, and submitted to the caress 
 
470 MOEBID FEAES AND COMPULSIONS 
 
 with very little protest. On the whole she quite 
 enjoyed the experience. She bad 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 occasionally. 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, general 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 
 relapse 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 
 similia similibus 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 MOEBID FEAES 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 she 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 which had 
 operated to produce her neurosis. This is her 
 dream. 
 
 "I was riding on a train or subway car. 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 King James II. 
 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 material loss that 
 might 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 FEAES 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 pick 
 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 the 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 mean? Asked to associ- 
 ate, the patient remarked, "A key is something 
 you use when you want to get into things Yes- 
 terday my mother 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 associations, 
 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 other 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. 1 
 
 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 office 
 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 fate, after setting out to join the German 
 Army, or, as we know it, after taking up medical 
 
 iThe "Secondary function" of neurotic illness. See Freud's 
 "Sammlung Kleiner Schriften Zur Neurosenlehre," Bd. II. 
 
476 MORBID FEAES 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 does 
 this mean? 
 
 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 
 II 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 fulfillment. She feared that if 
 she got well she would have to go back 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 suggested 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 almost 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 FEAES AND COMPULSIONS 
 
 him. In spite of all I could do she had not yet ap- 
 peared to be able to overcome the feeling that sex 
 was essentially sinful. Though now admitting 
 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 gynaecologist. 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 could 
 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 treatment. 
 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. E. 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 "plenty of cracked ice and exercise. " 
 
AN ANXIETY HYSTERIA 479 
 
 While reading she kept glancing at the clock, the 
 idea being that at a certain time the doctor's office 
 hour would 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 
 gynaecologist 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 MOEBID 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. The 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 run 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. 1 
 
 It is clear 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 clock, 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 MOEBID FEARS 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 making 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 erotic book which, 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 role 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. 
 
484 MOEBID FEAES AND COMPULSIONS 
 
 Densmore appealed more strongly to the passion- 
 ate side of her nature than any one else that she 
 had ever known, she felt that that sort of an ap- 
 peal was not right, and that she should care for a 
 man in a "spiritual way" only. Even marriage, 
 to her mind, failed to legitimatize physical sexual- 
 ity, and she continually argued that the fact that 
 
 Mr. D inspired "lustful" feelings in her was 
 
 the very reason she ought to keep away from him. 
 I pointed out, of course, that the impulses she was 
 trying to suppress were something perfectly nor- 
 mal and possessed by everybody, and that the sort 
 of love she thought she ought to have was really 
 an infantile sexuality. Her conviction that sex- 
 uality was essentially wrong and debasing was 
 traced in various ways to earlier experiences par- 
 ticularly with regard to her parents for instance, 
 it was pointed out that when her parents had con- 
 cealed their sexuality from her she had assumed 
 that it did not exist and had based her ideal of 
 what she ought to be on this false assumption, ad- 
 hering to it in the face of the information she 
 gained at fourteen that all parents had intercourse 
 and that such was the way children came to exist. 
 Instead of viewing this information as evidence 
 that her sexual idea needed modification and that 
 there was nothing inherently disgraceful about 
 having sexual desire and gratifying it, she had re- 
 pressed the information that might have served to 
 correct her false notions and persisted in clinging 
 to them in spite of it. In these and other ways 
 effort was made to overcome her pathological 
 resistance against her sexuality but without meet- 
 
AN ANXIETY HYSTERIA 485 
 
 ing with any pronounced success. She continued 
 to assert that everything sexual was repugnant 
 to her, and that though she did have sexual feel- 
 ings she could not accept the view that they were 
 normal and inevitable. It seemed to me at times 
 however, that she was more nearly convinced than 
 she was ready to admit. 
 
 At length there occurred the following dream 
 which marked a definite change in her attitude. 
 She saw flying in the sky an enormous bird, which 
 mounted higher and higher, and upon which she 
 looked with feelings of awe and wonder but not 
 of fear. She tried to point out this wonderful 
 sight to her mother, who stood by, but the latter, 
 as if blind or stupefied, failed to look where the 
 bird was and kept repeating "I can't see it, I 
 can't see it." After a time, however, her mother 
 was induced to look in the right direction and said 
 "Oh, yes, I do see it after all." In the dream she 
 felt much surprise that she had so much difficulty 
 in making her mother see the bird, for it seemed 
 so plainly in sight and impossible to overlook. 
 
 As we began the analysis of the dream the pati- 
 ent said, "I don't know what the bird could repre- 
 sent. I've never seen anything like it. It seemed 
 to me so wonderful and amazing." Here she 
 paused, and when I asked her what she had in 
 mind she replied "I've thought Nature wonder- 
 ful and amazing too." She meant by this, as she 
 at length explained, reproduction and all it sig- 
 nified. The bird therefore could be regarded as a 
 symbol of reproduction. 1 On the day preceding 
 
 iThe bird is a familiar penis symbol cf. Jones' paper, Die 
 
486 MOEBID FEAES AND COMPULSIONS 
 
 the dream we had spoken of the biological mean- 
 ing of the sex instinct 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 Jater 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 "to look in the right direc- 
 tion," or in other words, she finally became will- 
 ing to see the sexual life as something fine 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 singularly 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 
 
 Empfangnis der Jungfrau Maria durch das Ohr. Jahrbuch der 
 Psychoanalyse 1914. Also, children are told that babies are 
 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. 1 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), 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 that 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. 
 
 i Another element in the life of these young people also affected 
 her, as we shall hear later. 
 
488 MORBID FEAES 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 getting 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 marry 
 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 
 
 i She had no definite information as to what were the grounds 
 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. Densmore. 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 family, 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 MOEBID FEAES AND COMPULSIONS 
 
 namely, that when a person is vacillating between 
 two divergent courses and can not bring himself 
 to give up 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. 1 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 partly the result of her 
 experience with her rich employer. The foreigner was a substi- 
 tute for him. 
 
492 MOEBID FEAES AND COMPULSIONS 
 
 to exaggerate the significance of a divorce having 
 
 occurred in Mr. D 's family and to persuade 
 
 herself that he might be cruel. 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 , then there would be that much 
 
 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. 1 
 
 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 hence 
 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. 2 
 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 1 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 MOEBID 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 ac- 
 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-erotic 
 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 involuntarily 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 for 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 
 
 THE THEORY AND MECHANISM OP THE 
 PSYCHOANALYTIC CUBE 
 
 IF the reader has closely followed the preced- 
 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 
 transference, 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 in- 
 
 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, Brewer 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 MORBID FEARS AND COMPULSIONS 
 
 meantime had been neglected, there was developed 
 the so-called cathartic method of treatment. 
 They came to the conclusion 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 
 
PRESENT 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 well? How 
 does this cure him? 
 
 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 it? 
 
EXPLANATION OF CUBE 501 
 
 As a matter of fact, 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 him? 
 
 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 fully 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 MOEBID FEAES AND COMPULSIONS 
 
 what more elaborate than those usually given, 
 though I cannot claim that it adds anything really 
 new to them. In attempting to set it forth I wish, 
 first of all, to emphasize, and to ask the reader to 
 bear in mind throughout, that, in point of view of 
 effect, the overcoming of resistance and the filling 
 out of gaps of memory are identical, or at least 
 inseparable. The filling out of memory gaps re- 
 quires the overcoming of resistances; the over- 
 coming of resistance requires gaps of memory to 
 be filled 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? 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 unhappiness. 
 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 
 ones, those restraints which have the similar ef- 
 fect in the neurotic are endogenous and psychic 
 ones. The prisoner may struggle 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) 1 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 
 
 i The sense of guilt which may be a large contributor to the 
 neurotic's misery is by no means invariably perceived by him as 
 guilt. More often it is so subject to displacement or distortion as 
 to be regarded by him as some other sort of unpleasant feeling. 
 
ORIGIN OF RESISTANCES 505 
 
 the demands of civilized existence. Rather the 
 analysis makes practical the establishing of a 
 minimum of non-fulfilled wishes and a maxi- 
 mum of wish fulfillment by making it possible for 
 the patient to satisfy J)yjway of subUm^tionjnany 
 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, 
 
506 MORBID FEARS AND COMPULSIONS 
 
 upon the unconscious. 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 functionings 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. 2 
 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- 
 
 iThis 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. 
 
 2 J. B. Watson: Behavior, Chap. VI. 
 
ORIGIN OF RESISTANCES 507 
 
 tween habit and instinct is, then, that of origin. 1 
 In instinct the " pattern " (the number and local- 
 ization of the different reflex arcs involved) and 
 the " order " (the temporal relations of the un- 
 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 behaviorisms 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 functionings 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. c. That which the behaviorists and which Freud would 
 call instinctive is about the same. Freud, however, uses the term 
 instinct as the heading for large groups of tendencies, while the 
 term impulse or wish applies to the subdivisions of the group. 
 The behaviorists would call instinctive these or even finer sub- 
 divisions. I trust it is clear 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 FEAES 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. 1 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 foreconscious 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. 
 
 i The term "complex" does not quite coincide either with in- 
 stinct or with habit. Most complexes have an instinctive 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 psychoanalytic standpoint as belonging 
 to the unconscious. 
 
SIGNIFICANCE OF HABIT 509 
 
 After the dog has pricked his mouth a f ew 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 as 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?" 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 FEAES AND COMPULSIONS 
 
 habit is involved, if we employ terms only of the 
 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. 1 Their significance cannot be expressed 
 without historical references. The question 
 "What is he doing?" cannot, when it is a case of 
 habit, be answered satisfactorily without bring- 
 ing in terms of the past experiences which .were 
 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 still 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 it." 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 ways 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 still watching over him; AS IF your orig- 
 
 i Naturally I am thinking in this connection only of sensori- 
 motor habits not of the sort which depend on some artificially 
 produced changes in the chemistry of the body such as occur with 
 the morphine or tobacco habit. 
 
SIGNIFICANCE OF HABIT 511 
 
 inal system of rewards and punishments were 
 still in force. 1 To be sure he will soon cease to 
 interpret his own behavior in any such light. 
 When the habits that you 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. 2 
 
 i Many 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." 
 
 2 1 know very well how difficult it is for one to recognize in 
 himself the functioning 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 
 Borne similar reason. The people of this country, for instance, 
 
512 MORBID FEAES AND COMPULSIONS 
 
 But we are rapidly becoming in danger of losing 
 sight of the questions that we set out to answer: 
 What is a resistance? and why is it that the psy- 
 choanalytic cure results from the overcoming of 
 resistances f In reality we have not wandered so 
 far from these questions as perhaps might seem. 
 And at the same time we have been getting into 
 a position from which we can consider, with some 
 prospect of answering it, the other question: 
 Why is it that the patient becomes cured by the 
 filling out of the gaps in his memory? 
 
 Whenever in the foregoing discussion I have 
 used the word "habit," I might perhaps just as 
 
 feel that it is "wrong" for a girl to come unchaste to her hus- 
 band, little realizing that what they think or feel in this matter 
 is infinitely more dependent upon the influence of environment 
 or, in other words, upon habit, than upon whatever Tightness or 
 wrongness may really inhere in the question. They would say 
 that a girl self evidently "ought to be" chaste, and that their 
 opinions and feelings in the matter depend upon the actual merits 
 of the case and not upon habit and training. By way of con- 
 trast, then, I might mention that there are regions where just the 
 opposite opinions prevail and just the opposite habits are de- 
 veloped. In Japan, for instance, at least in certain quarters, 
 it is considered a moral disgrace for a woman to come to her 
 husband uninitiated and untrained in matters of sex, and for 
 this reason the young woman is prepared for marriage by spend- 
 ing a certain time in public brothels, where, in intercourse with 
 strangers, she gains the experience in sexual affairs, without 
 which, in the Japanese opinion, no girl is fitted to be a good wife. 
 And just as an American girl not only thinks but feels it to be 
 a disgrace if her chastity is violated (that is, she would ex- 
 perience the reflex efferent discharge producing the subjective 
 feeling of guilt, a purely automatic and reflex functioning) so, 
 presumably, the Japanese girl would, through an opposite sort 
 of training, show the same reflex response under directly opposite 
 conditions, that is, if she came to her marriage without having 
 had extensive sexual experience. 
 
HABIT AND RESISTANCE 513 
 
 well have said "resistance," or even " complex, " 
 in most instances. For whether one says habit or 
 resistance, that which is thought of is the same. 
 The two words correspond to different ways of 
 thinking of it. The habit, which reduces to arcs 
 and reflexes, coincides with the purely objective 
 point of view ; the resistance, which is analyzable 
 into ideas, memories, impulses or wishes, takes 
 into account subjective factors. 
 
 What I have desired to bring out is that the 
 full significance of a habit, and consequently of a 
 repression resistance (with the exception of those 
 repression resistances which are purely instinc- 
 tive, and these perhaps are never overcome, even 
 in the most thoroughgoing analysis), can be ex- 
 pressed only by employing terms of past expe- 
 rience. The action, thought or feeling which, in a 
 given individual, results when there is touched off 
 one of those acquired integrations which we may 
 call interchangeably habit or resistance, occurs in 
 general as if he were surrounded by and reacting 
 to the same conditions or objects which originally 
 called forth this response. It is a question of the 
 same principle as that with which we are already 
 familiar from the discussion of the conditioned 
 reflex (in the section on transference) namely, 
 that a small part of the stimuli corresponding to 
 an original sensory pattern may serve to excite 
 the whole original motor pattern and efferent dis- 
 charge may, in short, cause the individual to 
 react as if the whole ensemble of external factors 
 from which proceeded the stimuli for the original 
 sensory excitations were still present and still giv- 
 
514 MORBID FEAES AND COMPULSIONS 
 
 ing off stimuli. The question, What is he doing? 
 when acquired organized responses are involved 
 (habit or resistance] cannot be fully answered 
 without reciting the history of the experiences 
 which produced the integrations now functionat- 
 ing. 
 
 Now in the case of the dog in whom there has 
 been built up, by the use of pins, a habit or re- 
 sistance which inhibits his original tendency to 
 mouthe 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 things, 
 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. 1 In answering the ques- 
 tion, What is he doing? 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 
 
 iThis way of expressing the facts is quite permissible even 
 though we may know that the dog is incapable of "thinking," 
 in any ordinary human sense, anything of the kind. 
 
SIGNIFICANCE OF KESISTANCE 515 
 
 our 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 individual's 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 habit 
 is responsible. This, apparently, is what cures 
 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, 1 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. ' 2 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: Ethics, page 9. 
 
 2 Angell : Psychology, page 59. 
 
OVERCOMING RESISTANCES 517 
 
 process repeats itself over and over." The 
 analysis is exactly the reverse of this. By it, 
 consciousness, which had "betaken itself else- 
 where" is brought back to the points at which 
 "responses which have become themselves auto- 
 matic, 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 MOEBID FEAES AND COMPULSIONS 
 
 fects split off by the dissection." 1 With one re- 
 sistance, 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-fulfillment, 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 ham. 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 
 
 i Ferenczi, "Contributions to Psychoanalysis," p. 34. He con- 
 tinues, "In a technically correct psycho-analysis the bond thus 
 formed is only a loose one, the interest of the patient being led 
 back as soon as possible to its original, covered-over sources and 
 brought into permanent connection with them." 
 
EXAMPLE OF HABIT 519 
 
 why he so reacted to ham, he would say it is be- 
 cause ham is Trdfe 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 MOEBID FEARS 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 might 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 MEMORIES 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 i. e. that what 
 originally caused him to avoid those things called 
 Trafe was that he was scolded and punished by 
 his father when he did not. 1 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. 2 
 
 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 
 
 1 Of course the history of the integration of the habit could not 
 be as simple as this, but what I have said is sufficient for our 
 immediate purposes. 
 
 2 This fear belongs to the foreconscioua rather than to the 
 unconscious proper. 
 
522 MOEBID FEAES 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 indi- 
 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 could 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 
 women. 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 MORBID FEARS AND COMPULSIONS 
 
 acknowledge that on the one hand she was far 
 from frigid, 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. But at any rate, and, as it seemed 
 to him, in consequence of his lack of full sexual 
 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 his 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 -distrust 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 
 old, 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 MORBID FEAES AND COMPULSIONS 
 
 interest in his mother. There were probably a 
 large number of as yet unremembered 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 inhibit 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 intellectually 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 given up his religion, 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 FEAES AND COMPULSIONS 
 
 planation, 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 negative 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 
 
 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 which was diagnosed had yet to be cured. 
 
 How then was this old habit or integration 
 which still continued to functionate eventually 
 broken up? Obviously the integration was pro- 
 duced by, and the continued habit was an effect 
 of, certain earlier experiences which we would in- 
 clude under the head of "training." The num- 
 ber of individual experiences which had been in- 
 strumental in forming 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 profoundest 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 built up. They have, in one way 
 or another, to be recalled. The individual is, as 
 
530 MORBID FEAES AND COMPULSIONS 
 
 it were, taken back in memory to the original sit- 
 uations, allowed to review them in the light of 
 new knowledge and to start from them afresh in 
 such a way as to form new integrations better 
 adapted to the demands of adult existence than 
 were the old. 
 
 One could, then, divide the analytic work, on 
 theoretical grounds, into two parts: the diag- 
 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- 
 ysis. 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 analytic treatment 
 would be really endless. In the case of Miss 
 
EEMEMBEKING 531 
 
 S 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 distintegrative living-over- 
 again of the earlier complex-producing experi- 
 ences accomplished? Apparently in two essen- 
 tially different ways, the one by the patient's di- 
 rectly recalling these past experiences, the other 
 by his re-living them in the form of transference. 1 
 
 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 hypnotic analysis first used by Breuer and 
 Freud this taking of the patient back to earlier experiences 
 seemed much simpler than it does now. It was suggested to the 
 patient that he was in this or that situation and he was then 
 required to describe it and his feelings in detail. The most un- 
 fortunate feature of this otherwise very desirable method of 
 procedure is that the physician does not always know what 
 situations he should make the patient go back to, and that to 
 some, against which the patient has strong resistances because 
 they are in some way painful, he cannot be made to go back in 
 spite of all suggesting. 
 
532 MORBID FEAES AND COMPULSIONS 
 
 the development of their symptoms, they will not 
 only remember and relate much that they had 
 known to be important at the time of its occur- 
 rence, but also many things the importance of 
 which had previously escaped them and is now 
 recognized for the first time. A good deal of this 
 material, which we could consider as belonging to 
 the unconscious, 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. 1 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, percep- 
 tion of connections and relations all 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 as 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 I 
 realize that I have been thinking, unconsciously. 
 
 Yet on spontaneous memory alone one can never 
 
 iCf. Freud's Weitere Rataohlage, Int. Zeit. f. Arzt. Psychoa. 
 II, 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. I mean by this that 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- 
 uation. 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 FEARS 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 be 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" (i. 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 
 
TRANSFERENCE 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 under 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 
 watching 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 MOEBID FEARS AND COMPULSIONS 
 
 tie boy! Suppose you told this to the doctor! 
 He would give you hell ! He might refuse to treat 
 you if you did not stop it at once ! ' ' 
 
 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 
 it?" the patient had thought, "What business is it 
 of his? Am I not a man and can I not do as I 
 please, without running to him and confessing?" 
 And then at other times he would think: "Why 
 should I be afraid to tell him? Suppose he does 
 criticize me, he is not God. Why should I care? 
 He is no better than I. Very likely he'd do the 
 same thing if he got the chance !" 
 
 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, ' * the 
 doctor is very friendly with his lady patients! 
 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 
 
TRANSFERENCE RESISTANCE 537 
 
 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 curiosity 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 wife? 
 How did I get along with her? 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 everything 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 FEAES 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 con- 
 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 you," he 
 thought, "confess to the doctor how nosey you 
 have been? He would never forgive you! He 
 never talks of his own affairs, and that should 
 have warned you how he would resent any one's 
 prying into them! 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 
 corner of his privacy; that you had suspected 
 him of immorality with his women patients! 
 Suppose he were to discover some of these things 
 from one of your dreams. He would be furi- 
 ous!" 
 
 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 might 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 fragmentarily, 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 off an unconsciously 
 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 MOEBID FEAES AND COMPULSIONS 
 
 transference phenomena and reproductions of the 
 long-forgotten past. What he had experienced 
 with me was really a living over again of unre- 
 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 did this in their bedrooms every night. 
 In the midst of the proceedings the little girl's 
 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 young 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 
 own? Was his mother that way too? And did 
 married people really do at night what the little 
 girl said they did? 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 " playing," 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 MOEBID FEAES AND COMPULSIONS 
 
 alert to find out 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 
 conscious memory, so that when he was later told 
 about intercourse, he was sure his mother would 
 not do such a " dirty thing." It is easy to see, 
 however, that his transference curiosity about my 
 sexual 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 OF INHIBITION 543 
 
 factors, and the why of its continued operation. 
 It became clear to him that an important constit- 
 uent of this habit or inhibition was an uncon- 
 scious J fear, on the one hand, of punishment from 
 the father, 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 
 
 i Strictly speaking, foreconacious. 
 
544 MOEBID FEAES 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 
 could 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 little 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 clearly 
 
ANALYSIS OF INHIBITION 545 
 
 that, as he had at first surmised, the doubts, re- 
 sistances 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. In 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 MOEBID FEAES AND COMPULSIONS 
 
 autonomousness and independence of action and 
 rendered assimilable with the results of adult ex- 
 perience and the requirements of adult 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 UNDESTANDING 547 
 
 not have either the effect of bringing to his con- 
 sciousness 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 FEAES AND COMPULSIONS 
 
 It is clear, 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 travelers 
 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 
 especially 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 RE-EDUCATION 549 
 
 common sense. 1 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 
 adult, 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- 
 
 i 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, unconsciously 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 per- 
 fectly 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. NOW jreally the pur- 
 pose of .psychoanalysis is practically identical with 
 that of moral instruction and moral codes (if 
 viewed according to their basic significance), 
 jaamely, the highest welfare of the individual as 
 a member of the social group, the best possible 
 adaptation of himself to his environment. 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 but 
 
ANALYTIC RE-EDUCATION 551 
 
 failed. The analysis does not seek to overcome 
 morality but rather certain moral inhibitions or 
 habits which have outlived their usefulness, 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' 9t 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 undertaken 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- 
 
 i Dewey and Tufts, Ethics, p. 173. 
 
552 MOEBID FEARS AND COMPULSIONS 
 
 tempted, as Hinkle remarks, "by lowering the in- 
 stinct, and seeing in it something vile or un- 
 clean, something unspeakable and unholy. In- 
 stead of destroying the power of sexuality this 
 struggle has only warped and distorted, injured 
 and mutilated the expression; for not without 
 destruction of the individual can these fundamen- 
 tal instincts be destroyed. Life itself has needs 
 and imperiously demands expression through the 
 forms created. All nature answers to this freely 
 and simply except man. His failure to recognize 
 himself as an instrument through which life is 
 coursing and the demands of which must be 
 obeyed, is the cause of his misery " 1 Ignorant 
 and too rigorous early repressive training, bad 
 family influences, or unnatural ideals establish in 
 the child such habits "of feeling and believing 
 about actions" that when he becomes an adult 
 he can not without pain and horror see himself as 
 he actually is. Tendencies which are innate and 
 inevitable become sources for the development of 
 tormenting affects of guilt; energies 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 social 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, Introduction to Jung's Psychology of the Un- 
 conscious, p. xlii. 
 
ANALYTIC EE-EDUCATION 553 
 
 individual's psychic household, which whenever 
 he gets a glimpse of them, 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 
 by teaching him new standards as by unteaching 
 old, erroneous and distorted ones. 
 
BIBLIOGRAPHY! 
 CHAPTER I 
 
 Ellis, H. Autoerotism ; Analysis of the Sexual Im- 
 pulse; Love and Pain; Erotic Symbolism; Sexual 
 Inversion, in the Studies in the Psychology of Sex, 
 F. A. Davis Co. 
 
 Freud, S. Three Contributions to the Sexual The- 
 ory, 2d Edition, translated by A. A. Brill, The 
 Journal of Nervous and Mental Disease Monograph 
 Series, No. 7. 
 
 Triebe und Triebshicksale, Internationale Zeit- 
 schrift fur drztliche Psychoanalyse, Vol. III., 1915. 
 Beitrage zur Psychologic des Liebeslebens II., 
 Jahrbuch fur psychoanalytische und psychopath- 
 ologische Forschungen, Bd. IV., Hft. I., 1912. 
 Ueber Infantile Sexualtheorien, Sammlung Tdevner 
 Schriften zur Neurosenlehre, Bd. II., S. Karger, 
 Berlin. 
 
 The Origin and Development of Psychoanalysis, 
 American Journal of Psychology, Vol. XXI., No. 
 2, 1910. 
 
 Analyse der Phobie eines fiinfjahrigen Knaben, 
 Jdhrbuch fur Psychoanalytische und Psychopathol- 
 ogische Forschungen, Bd. I, Hft. 1, 1909. 
 
 Frink, H. W. -The Sexual Theories Formed in Early 
 Childhood, and Their Role in the Psychoneuroses, 
 New York Medical Journal, November 15, 1915. 
 
 Hug-Hellmuth, H. von. Aus den Seelenleben dea 
 Kindes, F. Deuticke, Vienna. 
 
 Jones, E. Die Empfangnis der Jungfrau Maria durch 
 
 555 
 
556 BIBLIOGRAPHY 
 
 das Ohr, Jdhrbuch der Psychoanalyse, Bd. 6, 
 
 1914. 
 Jung, C. J. Experiences Concerning the Psychic Life 
 
 of the Child, Analytical Psychology, translated 
 
 by Constance Long, Moffat, Yard & Co. 
 Moll, A. The Sexual Life of the Child, Macmillan 
 
 Co. 
 Reitler, JR. Eine infantile Sexualtheorie und ihre 
 
 Beziehung zur Selbstmordsymbolik. Zentralblatt 
 
 fur Psychoanalyse, Bd. II, Hft. 2, 1912. 
 Watson, J. B. Behavior, Henry Holt & Co. 
 
 CHAPTER II 
 
 Freud, S. Das Unbewusste, Internationale Zeitschrift 
 fur Arztliche Psychoanalyse, Bd. III., Hft. 4-5, 
 1915. 
 
 De Verdrangung, Ibid., Hft. 3. 
 Zur Einfiihrung des Narzissmus, Jahrbuch der 
 Psychoanalyse, Bd. VI., 1915. 
 Einige Bemerkungen iiber den Begriff des Unbe- 
 wussten in der Psychoanalyse, Internationale Zeit- 
 schrift fur Arztliche Psychoanalyse, Bd. I., Hft. 2, 
 1913. 
 
 The Interpretation of Dreams, Chapter VII., The 
 Macmillan Co. 
 
 The Psychopathology of Everyday Life, Macmil- 
 lan Co. 
 
 Frink, H. W. What is a Complex? Journal of the 
 American Medical Association, Vol. LXIL, p. 897. 
 
 Hart, B. The Conception of the Subconscious, Jour- 
 nal of Abnormal Psychology, Vol. IV., No. 6, 1910. 
 "The Psychology of Insanity," Cambridge University 
 Press. 
 
 Holt, E. B. The Freudian Wish, Henry Holt & Co. 
 
BIBLIOGRAPHY 557 
 
 Jones, E. The Significance of the Unconscious in 
 Psychopathology, Review of Neurology and Psy- 
 chiatry, Vol. XII., No. 11, 1914. 
 
 Pfister, O. The Psychoanalytic Method, Part I, Moffat, 
 Yard & Co. 
 
 Putnam, J. J. Human Motives, Little, Brown & Co. 
 
 CHAPTER III 
 
 Abraham, K. Dreams and Myths, Nervous and Men- 
 tal Disease Monograph Series, No. XV. 
 
 Bleuler, E. Das autistiche Denken, Jahrbuch fur 
 psychoanalytische und psychopathologische For- 
 schungen, Bd. IV., Hft. I., 1912. 
 
 Brill, A. A. Dreams, Chapter II. of Psychoanalysis, 
 W. B. Saunders Co. 
 
 Ferenczi, S. The Psychological Analysis of Dreams, 
 and Stages in the Development of the Sense of 
 Reality, Chapters III. and VII. of Contributions 
 to Psychoanalysis, Richard G. Badger. 
 
 Freud, S. Formulierung iiber die zwei Prinzipien des 
 psychischen Geschehens, Jahrbuch fur .psycho- 
 analytische und psychopathologische Forschungen, 
 Bd. III., Hft. 1, 1911. 
 The Interpretation of Dreams. 
 On Dreams, The Rebman Co. 
 
 Die Handhabung der Traumdeutung in der Psycho- 
 analyse, Zentralblatt fur Psychoanalyse, Bd. II, 
 Hft. 3, 1912. 
 
 Jones, E. Freud's Theory of Dreams, Chapter XV 
 of Papers on Psychoanalysis, William Wood & Co. 
 
 Jung, C. G. Concerning Two Kinds of Thinking, 
 Chapter I., of The Psychology of the Unconscious, 
 Moffat Yard & Co. 
 
558 BIBLIOGRAPHY; 
 
 CHAPTER IV 
 
 Ferenczi S. Introjeetion and Transference, Chap. II. of 
 Contributions to Psychoanalysis. 
 
 Freud, S. The Psyehopathology of Everyday Life, Mac- 
 
 millan Co. 
 
 The Interpretation of Dreams, Chap. V. 
 Zur Dynamik der Ubertragung, Zentralblatt fiir Psy- 
 choanalyse, Vol. II., 1912. 
 
 [Tones, E. Papers on Psychoanalysis, Chapters I., III., 
 XII., XIX., and XX. 
 
 Jung, C. G. The Significance of the Father in the Des- 
 tiny of the Individual, Chapter III., Analytical Psy- 
 chology, Moffat, Yard & Co. 
 
 Pfister, 0. The Psychoanalytic Method. 
 
 Rank, 0. Das Inzest-Motiv in Dichtung und Sage, 
 Deuticke, Vienna. 
 
 Watson, J. B. Behavior. 
 
 CHAPTER V 
 
 Brill, A. A. Psychoanalysis, W. B. Saunders Co. 
 
 Cannon, W. B. Bodily Changes in Pain, Hunger, Fear 
 and Rage, Appletons. 
 
 Crile, G. W. Man, an Adaptive Mechanism, Macmillan 
 Co. 
 
 Darwin, C. The Expression of the Emotions in Man 
 and Animals, D. Appleton & Co. 
 
 Ellis, H. The Problem of Sexual Abstinence, Chapter 
 VI. of Sex in Relation to Society, Vol. VI. of the 
 Studies in the Psychology of Sex, F. A. Davis Co. 
 
 Ferenczi, S. Introjeetion and Transference, in his Con- 
 tributions to Psychoanalysis, Richard G. Badger. 
 
 Freud S. Selected Papers on Hysteria and other Psy- 
 choneuroses, Nervous and Mental Disease Mono- 
 graph Series. 
 
BIBLIOGRAPHY 559 
 
 Frink, H. W. The Freudian Conception of the Psycho- 
 neuroses, Medical Record, Nov. 29, 1913. 
 
 Hitschmann, E. Preud's Theories of the Neuroses, 
 Moffat, Yard & Co. 
 
 Jones, E. The Pathology of Morbid Anxiety, in his 
 
 Papers on Psychoanalysis. 
 
 The Relation between the Anxiety Neurosis and 
 Anxiety Hysteria, Journal of Abnormal Psychology, 
 Vol. VIIL, No. 1, 1913. 
 
 Jung, C. G. Analytical Psychology, Moffat, Yard & Co. 
 
 Seif, L. Zur Psychopathologie der Angst, Interna- 
 tionale Zeitschrift fur drztliche 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 iiber einen Fall Zwangsneu- 
 rose, Jahrb. f. psychoanal. u. psychopath. Forsch., 
 Bd. I, Hft. 2, 1909. 
 Die Disposition zur Zwangsneurose, Int. Zeit. f. a. 
 
 Psychoanalyse, Bd. I, 1913. 
 
 Das Unbewusste, Int. Zeit. f. a. P.A., Bd. Ill, 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. f. psy- 
 choanal. u. psychopath. Forsch., Bd. IV, 1912. 
 Hass und Anal-erotik in der Zwangsneurose, ibid., 
 Bd. I, 1913. 
 
560 BIBLIOGRAPHY 
 
 CHAPTER VIII 
 
 Freud, S. Analyse der Phobic eines fiinfjahrigen 
 Knaben, Jahrb. f. psychoanal. u. psychopath 
 Forsch., Bd. I, Hft. 1, 1909. 
 
 Die Verdrangung, Int. Zeit. f. a. P.A. Bd. Ill, 1915. 
 Das Unbewussten, ibid. 
 
 Ubnes, E, The Relation between the Anxiety Neurosis 
 and Anxiety Hysteria, Journal of Abnormal Psy- 
 chology, Vol. VIII, No. 1, 1913. 
 
 Stekel, W. Nervose Angstzustande und ihre Behand- 
 lungen, Urban & Schwartzenberg, Berlin. 
 
 CHAPTER X 
 
 Burrow, T. The Meaning of Psychoanalysis, Journal 
 
 of Abnormal Psychology, Vol. XII, No. 1, 1917. 
 Conceptions and Misconceptions in Psychoanalysis, 
 Journal of the American Medical Association, Vol. 
 LXVIII, Feb. 3, 1917. 
 
 Dewey and TuftsEthics, Henry Holt & Co. 
 Ellis, H. Sexual Education, Chapter II, of Sex In Re- 
 lation to Society, Sixth Volume of the Studies in 
 the Psychology of Sex. 
 
 Freud, S. Weitere Ratschlage zur Technik der Psycho- 
 analyse, Nos. I, II, and III, Int. Zeit. f. d. Psycho- 
 analyse, Bd. I, II, and III, 1913-15. 
 Uber "wilde" Psychoanalyse, Zentralblatt f. Psycho- 
 analyse, Bd. I, 1911. 
 Origin and Development of Psychoanalysis, American 
 
 Journal of Psychology, Vol. XXI, No. 2, 1910. 
 History of the Psychoanalytic Movement, Psycho- 
 
 analytic Review, Vol. Ill, No. 1, 1916. 
 Beitrage zur Psychologic des Liebenslebens, II. i 
 
BIBLIOGEAPHY 561 
 
 Uber die allgemeinste Erniedrigung des Liebesle- 
 
 bens Jahrbuch f. psychoanal. u. psychopath. 
 
 Forsch, Bd. IV, Hft. I, 1912. 
 Holt, E. B. The Freudian Wish. 
 Jones, E. The Therapeutic Action of Psychoanalysis, 
 
 Chapter XIV of Papers on Psychoanalysis. See 
 
 also Chapters XIX and XX. 
 MacCurdy, J. T. The Ethics of Psychoanalysis, Johns 
 
 Hopkins Medical Bulletin, 1915. 
 Reik, T. Einige Bemerkungen zur Lehre vom Wider- 
 
 stande, Int. Zeit. f. a. Psychoanalyse, Bd. Ill, 1915. 
 Watson, J. B. Behavior. 
 
INDEX 
 
 Aboulia, 293 
 
 Abreaction, 498 
 
 Activation energy, 43 
 
 Active and passive, 298 
 
 Active and passive partial im- 
 pulses, 12 
 
 Affect and idea in compulsion, 
 274 
 
 Affect really a conscious sen- 
 sory perception of a bodily 
 state, 145 n. 
 
 Affect-sum, 280 
 
 Affects, strangulated, 498 
 
 Affectivity least controlled by 
 foreconscious, 75 
 
 Aggressive tendency, 12, 20 
 
 Aim and object of holophilic 
 impulses, 230 
 
 Allerotic phenomena, 15 
 
 Ambivalence, 297 
 
 Amphi erotic, 16 
 
 Analysis, a brief, 83-88 
 
 Anger, 261 
 
 Antivivisectionism, 136 
 
 Anxiety, 55, 252 n. 
 
 Anxiety Neurosis, 259 
 
 Anxiety Hysteria, 280 
 
 commonest of all psychoneu- 
 roses, 430 
 
 ANXIETY HYSTERIA, THE PSY- 
 CHOLOGY OF, 430 
 
 ANXIETY HYSTERIA, A CASE OF, 
 444 
 
 Association, random, the de- 
 scendant of the repressed, 
 84 
 relevancy of the apparently 
 
 irrelevant, 87 
 free, method of, 102 
 
 Attention, 93 
 
 Autoerotism, 14 
 
 Behavior, explicit and implicit, 
 
 507 
 
 Behaviorists, 506 
 Bisexual tendency, 16 
 
 Cannon, 255 
 Cathartic method, 498 
 Censor, 48, 61 
 
 activity of, same as that of 
 conscience, 62 
 
 a second, between forecon- 
 conscious and conscious 
 systems, 82 
 Chivalry, 138 
 
 Christian Science, 132, 133 n. 
 Cloaca theory of birth, 24 
 Coitus, 21 
 
 children's view of, 26 
 Compensation, 126 
 Complex, 38, 508 n. 
 
 doctrine of, 499 
 
 Zurich doctrine of, 244 
 Compulsion Neurosis, 148, 280 
 COMPULSION NEUBOSIS, PSY- 
 CHOLOGY OF, 270 
 COMPULSION NEUROSIS, A CASE 
 
 OF, 308 
 
 Compulsive acts, two-sided, 295 
 Compulsive doubt, 273 
 Compulsive fear, 272 
 Compulsive ideas, 272, 294 
 Compulsive self-reproach, 286, 
 
 303 
 
 Compulsive thinking, 272 
 Condensation, 109 
 Conditioned reflex, 197 
 Confession, 306 
 
 Confessions of patient not sug- 
 gested, 309 
 Conflict, 51 
 Conscience, 49 
 
 563 
 
564 
 
 INDEX 
 
 "Contagion" theory of impreg- 
 nation, 28 
 
 Conversion hysteria, 281 
 
 Counter-activation, 76 
 
 Crile, 254 
 
 Curiosity impulse, 12, 13, 18 
 
 Curiosity impulse in compul- 
 sion neurosis, 299 
 
 Day- dreaming, 90 
 Defense and distortion mechan- 
 isms, 132 
 Deprivation, 242 
 Descendants of the repressed, 
 
 75,81 
 use of, in dream analysis, 
 
 103 
 
 Desire and fear, 266 
 Diagnostic and disintegrative 
 parts of analytic work, 530 
 Disguise of wish-fulfillment, 
 
 107 
 
 Disintegrative and diagnostic 
 
 parts of analytic work, 530 
 
 Displacement, 78, 113, 143, 433 
 
 diffuse, 155 
 Distortion, 107 
 amount of, governed by 
 amount of repression, 108 
 mechanisms, 182 
 Doubt, compulsive, 273 
 Dramatization, 117 
 DEEAM, PSYCHOLOGY OP THE, 
 
 89 
 
 Dream, the imaginary fulfill- 
 ment of a wish, 96 
 representation in, is indirect, 
 
 97 
 symbolism of, analogous to 
 
 that of cartoons, 97 
 manifest content of, 105 
 latent content of, 106 
 a compromise between two 
 opposed psychic streams, 
 108 
 
 function of, 121 
 the via regia to the under- 
 
 Dream, Continued 
 
 standing of the uncon- 
 scious, 122 
 
 analysis of, in psychothera- 
 peutics, 122 
 
 Education, 17 n., 548 
 
 Educative function of psycho- 
 analysis, 549 
 
 Ego- ideal, 53 
 
 is not merely intellectual but 
 
 dynamic, 60 
 is largely foreconscious, 61 
 
 Electra complex, 15 
 
 Ellis, H., 266 
 
 Emotion a state of prepared- 
 ness for action, 254 
 
 End pleasure, 15 
 
 Energy of sexual wishes not 
 easy to repress, 79 
 
 Energy of compulsive symp- 
 tom misplaced, 282 
 
 Erogenous zones, 9 
 
 Esthetic forces, fore-runners of, 
 16 
 
 Ethical forces, the fore-run- 
 ners of, 16 
 
 Exhibitionism, 13, 17 
 
 Father complex, 211 
 Fear, difference between nor- 
 mal and morbid, 252, 263 
 morbid, defined, 265 
 is converted desire, 122 
 Feminism, 135 
 Ferenczi, 16, 302 
 Fixation, 230 
 Fixed ideas, 272 
 Foreconscious, 41 
 Foreconscious system, seat of 
 
 ego-ideal, 61 
 
 Foreconscious like a screen be- 
 tween Unconscious and 
 consciousness, 71 
 like a theatrical manager, 73 
 imperfectly controls affect- 
 ivity, 75 
 
INDEX 
 
 565 
 
 Foreconscious, Continued 
 largely made up of descend- 
 ants of the repressed, 81 
 not all content of, eligible 
 for consciousness, 82 
 
 Fore-pleasure, 15 
 
 Free association, method of, 
 102 
 
 Freud quoted, 92, 95 n., 210, 
 242, 296 
 
 Genius and neurosis, 136 
 Guilt, sense of, 503, 504 
 
 distortion of sense of, 504 n. 
 
 Habit and instinct compared, 
 506 
 
 Habit, significance of, 508, 513 
 equivalent to resistance or 
 complex, 513 
 
 Habits that function indefi- 
 nitely, 520 
 
 Habits of thought and feeling, 
 522 
 
 Hallucinatory satisfaction of 
 wishes, 91, 96 
 
 Hate, 261 
 
 Hippocrates, 1 
 
 Holophilic, definition of term, 
 5n. 
 
 Homophilic tendency, 16 
 
 Homosexual, 16 
 
 Hunger, 3 
 
 Hysteria, 1 
 
 Hysterical vomiting, 10 
 
 Idea and affect in compulsion, 
 274 
 
 Ideas, compulsive or fixed, 272 
 
 Ideas but not energy of sexual 
 wishes confined to uncon- 
 scious, 79 
 
 Identification, 167 
 
 Imago, 207 
 
 Infantile sexuality, 3-21 
 
 Infantile sexual theories, 21, 
 
 80 
 fading of, 27 
 
 Inferiority feeling, 168 
 Inhibitory tendencies, 17 
 Instinct a creator of tensions, 
 
 70 
 Instinct and habit compared, 
 
 506 
 
 Integrations, changes in, 547 
 Introjection, 155, 167 
 Introversion, 238 
 
 James, William, 230, 256 
 Jones, Ernest, 40, 252, 268 
 
 Kissing, 10 
 
 Kleptomania, 152 
 
 Knowing, intellectual, vs. re- 
 living, 546 
 
 no ordinary kind of, cures 
 the patient, 547 
 
 Latency period, 16, 19 
 Latent content of dream, 106 
 Latent memories, 32 
 Libido, 6, 14, 51 
 Looking and showing impulses, 
 
 13 
 Lynching, 140 
 
 Manifest content of dream, 105 
 Masculine and feminine, 298 
 Masochism, 13 
 Masochistic-sadistic impulse, 
 
 12, 17, 18 
 
 Masturbation, 20, 239 n. 
 MECHANISMS OF PSYCHOPATH- 
 
 OLOGICAL MANIFESTATIONS, 
 
 124 
 Mechanisms of psychoanalytic 
 
 cure, 496 
 Mind not to be defined as only 
 
 consciousness, 34 
 Morbid fear defined, 265 
 Morbid fear, two origins for, 
 
 267 
 
 Narcissism, 52 
 Neurasthenia, 270, 430 
 
566 
 
 INDEX 
 
 Neurosis, a pre- Freudian view 
 of, 2 
 
 Neurosis a partial failure of 
 repression, 122, 279 
 
 NEUROSIS AS A WHOLE, 220 
 
 Neurosis the negative of the 
 perversion, 228 
 
 Neurosis, primary and second- 
 ary function of, 240 
 
 Neurotic symptoms, are uncon- 
 scious mechanisms, 124 
 
 Neurotic, the, has learned to 
 love too soon, 235 n. 
 
 Neurotic unable to shake off 
 habits of childhood, 520 
 
 Neurotic's greater tendency to 
 form fixations, 235 n. 
 
 Nightmares, 122 
 
 Object love, 19 
 
 Obsessions, 272 
 
 Obsessive fear, 272 
 
 (Edipus complex, 15, 16, 205 n., 
 209 
 
 Omnipotence of thought, 302 
 
 Oral-erotic, 10 
 
 "Order" and "pattern" of in- 
 stinct reflexes, 507 
 
 Over-compensation, 130, 290 
 
 Over-determination in neurosis, 
 229 
 
 Panic, 431 
 
 Paranoia, 55 
 
 Partial impulses, 12 
 
 Passive tendency, 20 
 
 "Pattern" and "order" of in- 
 stinct reflexes, 507 
 
 Penis complex, 185 
 
 Penis theory, 24 
 
 Periods, three, of human sex- 
 ual development, 8 
 
 Perversions, 13, 21 
 
 Phobia, 271, 431 
 
 Pleasure-sucking, 10 
 
 Pleasure thinking, 89 
 
 Pleasure thinking the more 
 primitive, 91 
 
 Polymorphous-perverse, 13 
 
 Pre-inhibitory period, 8 
 
 Primacy of genital zone, 19 
 
 Projection, 155 
 
 Projection ordinarily a defense 
 mechanism, 156 
 
 Psychasthenia, 271 
 
 Psychoanalysis, educative func- 
 tion of, 549 
 
 dissolves certain moral inhi- 
 bitions, 550 
 
 PSYCHOANALYTIC CUBE, THE- 
 ORY AND MECHANISM OF, 
 496 
 
 Psychoanalytic cure, theory of, 
 neglected by writers, 501 
 
 Psychoanalytic technique, 84 
 changes in, 497 
 
 PSYCHOLOGY OF ANXIETY HYS- 
 TERIA, 430 
 
 PSYCHOLOGY OF COMPULSION 
 NEUROSIS, 270 
 
 Psychoneuroses, 21 
 
 are more serious failures of 
 of the foreconscious to 
 control, 75 
 
 Rapport, 103 n. 
 Rationalization, 40, 175, 511 
 
 n. 2 
 
 Rationalization of anxiety, 436 
 Reality thinking, 89 
 belongs to higher psychic 
 
 systems, 90 
 an experimental paying out 
 
 of accumulated tensions, 
 
 94 
 
 goal of, is utility, 94 
 Re-enactment of what cannot 
 
 be remembered, 533 
 Regression, 236, 244, 299 
 Regression is from present to 
 
 past and from real to 
 
 imaginary, 238 
 Repressed, descendants of, 75, 
 
 81, 103 
 
INDEX 
 
 567 
 
 Repression, 45 
 
 a protective mechanism, 49 
 
 brought about by forecon- 
 scious, 61 
 
 failure of, 75 
 
 failure of, a condition of neu- 
 rosis, 221 
 
 primarily affects ideas, 144 
 Resistance, 47 
 
 overcoming of, identical with 
 filling of memory gaps, 
 502, 517 
 
 origin of, 505 
 
 might be called habit, 508 
 Retention of feces, 9 
 
 Sadism, 13 
 
 in antivivisectionism and 
 
 chivalry, 137 n. 
 in lynching, 140 
 unconscious, causes compul- 
 sive self-reproach, 290 
 repressed, 291 
 Sadistic-masochistic impulse, 
 
 12, 18 
 
 Sadistic perversion, 141 
 Sadistic impulse in compulsion 
 
 neurosis, 300 
 Secondary defense measures, 
 
 295, 307 
 
 Secondary elaboration, 121 
 Secondary function of the neu- 
 rosis, 307 
 
 Self-reproach, compulsive, 286 
 Sexual, the term, 3 
 Sexual emotion, 257 
 Sexual factor in neurosis, 223, 
 
 309 
 
 Sexual ideal in neurotics, 234 
 Sexual instinct, 2 
 development of, in education, 
 
 548 
 
 Sexual investigation, 22 
 Sexuality, human, three phases 
 
 of, 8 
 effort to overcome, 551 
 
 SEXUAL SYNTHESIS, 1 
 
 Sexual theories, infantile, 21 
 
 Small penis complex, 185 
 
 Subconscious, 277 
 
 Sublimation, 19 
 
 Sublimation 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 
 
 Symptoms, neurotic, 124, 277 
 
 Synthesis, sexual, 1 
 
 THEORY AND MECHANISM OF 
 THE PSYCHOANALYTIC 
 
 CUBE, 496 
 Thing-ideas, 145 
 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, 
 
 500 
 
 as a re-living of complex- 
 producing experiences, 531 
 phenomena, 540 
 Trauma, psychic, 498 
 
 UNCONSCIOUS, THE, 30 
 Unconscious is primitive, 66 
 Unconscious has no regard for 
 
 reality, 66 
 
 Unconscious is infantile, 66 
 Unconscious is unoriented in 
 
 time, 67 
 
 Unconscious is instinctive, 68 
 Unconscious contains no inhi- 
 bition, no negation, no con- 
 flict, 70 
 
568 
 
 INDEX 
 
 Unconscious has free access to 
 motility only in major 
 psychoses, 76 
 
 Unconscious habits, 521, 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, 235 
 
 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 foreconscious, 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 
 
FOTTRTFFTV F>AV 
 
 PERIOD 
 
 ALL BOOKS MAY BE RECALLED AFTER 7 DAYS 
 pi IP AS STAMPED BELOVV 
 
 FORMNO. DDO. 50m. 11/94 
 
 UNIVERSITY OF CAUKKNIA. BERKELEY 
 BERKELEY, CA 94720 
 
U.C. BERKELEY LIBRARIES 
 
 MMlM 
 Q 
 
 /T 
 
 UNIVERSITY OF CALIFORNIA LIBRARY 
 
 -. , ^' ,