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his unconscious, making use of the transferences for this purpose, and relying on the patient's desire for recovery as the main motive for carrying through the analysis. The rate at which this task was carried through was determined mainly by the varying psychical constellations of the patient, and so with few exceptions—such as, for example, the help derived from a general knowledge of symbolism-was largely independent of the analyst. Now it has long been observed that the patient's psychical constellation, on which the progress and duration of the analysis depends, fluctuates greatly according to both internal and external factors, and studies have been made of these varying mental states and the circumstances influencing them. It became clear, for instance, that the efforts made by the patient to carry through the analysis vary with his need of mental health and thus are usually greater in proportion to his suffering. Partial recovery from the symptoms, therefore, with consequent relief of suffering, or, again, an access of happiness from a changed external situation, very often has the effect of diminishing the patient's efforts in the analysis, so that, however glad the analyst may be of such happenings on other grounds, he has good reason to fear their delaying influence on the course of the analysis. Too much comfort, happiness, or satisfaction of any sort can on occasion be detrimental to the interests of the analysis by lowering the tension of the energy at the patient's disposal for carrying out the work needed of him, and it becomes a question whether in certain cases it may not be advantageous artificially to keep this tension up to a desirable height by deliberately forbidding the patient to indulge in various outlets for his pent-up feelings. It should be remarked that this applies to the outlets which afford an unconscious relief far more than to conscious enjoyments, and, further, particular stress should be laid on veiled forms of libidinous satisfaction, as Ferenczi (3) has well pointed out, the importance of libidinous impulses as the driving forces in the neuroses being a matter well recognised by all psycho-analysts. For this reason Freud (4) has formulated the rule that "the analytic treatment should be carried out, so far as possible, in a state of abstinence.” By this he naturally does not mean abstinence from all pleasure, nor even abstinence from sexual indulgence, but only that in the situation there should always be a certain element of deprivation, one which would be removed by the success of the treatment.

In addition to the series of didactic articles he has published on the regular technique (5) Freud has pointed out respects in which 'active' deviations from this may be made according to the type of case (4).


Thus he suggests that with an obsessional neurotic one should proceed until the idea of the analysis itself has become involved in the obsessional structure and then play off this obsession against the illness. Again he remarks that one can never cure a severe case of hysterical phobia if one allows the patient to shield himself entirely from the danger of an anxiety attack by means of the phobia; when the analysis is not making progress the patient should be got to expose himself to such an attack, of course of a mild order, when his analytic impulses will be strengthened and suitable material will be brought out. Mention should also be made of a series of technical points raised by Ferenczi (6), the most valuable being a criticism of Freud's “golden rule” relating to the freedom of associations where he discusses the ways in which the patient may exploit and misuse this.

An extraordinary casuistic study of infantile sexuality which Freud has recently published (7) is of interest for both treatment and aetiology. In the light of the material there presented he discusses at great length the validity of the ultimate constructions made towards the end of a complete analysis. One is often compelled to infer a primordial scene (Urscene) in the patient's early life--in this case it was at the age of eighteen months—the later effects of which have been of decisive pathogenic importance, but the memory of which can no longer be recalled through any technical device. In some cases this primordial scene corresponds with a real occurrence, in others with a pure phantasy, and Freud raises the question whether such a phantasy, of which a typical example is the overhearing of parental coitus, must always have been based on some kind of individual experience or can be the product of inherited predisposition; he inclines towards the latter view. Altogether of late he has devoted much attention to clarifying the psycho-analytic theory of the aetiology of the psychoneuroses. Following on his essay entitled “Neurotic types of falling ill," which was published before the war(8), he has discussed the subject fully in his recent introductory lectures on psycho-analysis (9). He sees the course of events somewhat as follows: partly as the result of a deprivation in the outer world, the libido seeks other outlets and tends to regress to earlier stages of development, especially to the points of its ‘fixation' in childhood. These fixation-points are determined partly by inherited predisposition, partly by infantile experiences or phantasies; the libido finds its way back to them via unconscious phantasies in which they are still represented. If nothing but this regression takes place the result is a sexual perversion. If, however, as is so often the case, the form of sexual activity


corresponding with the fixation-point is not in accord with the standards of the later ego-ideal, there arises a state of conflict between the two, in which the former is repressed and prevented from entering consciousness or from finding any kind of motor expression; this is the second, or internal deprivation. The wish in question is then subject to the mechanisms characteristic of the unconscious, displacement, condensation, etc., and can reach expression, like the wishes of a dream, only after undergoing such distortion as renders them unrecognisable in consciousness. The relative importance of the three main factors, the deprivation, infantile experiences, and inherited predisposition, Freud conceives to be variable and mutually interchangeable, thus laying stress on a new element in his theory which he terms the economic' one as distinguished from the dynamic' one. The same applies to the relative strength of the forces appertaining to the self and the sexual impulses respectively, and he points out how important for the origin of the psychoneuroses is the relative development of each of these two sets of impulses, the extent to which it is parallel in both, and so on.



The first psycho-analytic contribution to this subject was Freud's article in 1908 on the anal character. The importance of this has been increasingly recognised of late years and recently I published a review (10) of what is now known of the respects in which the anal-erotic sensations of the infant influence character traits in later life; I was able to show that the extent and the manifoldness of this influence are far greater than anyone who has not investigated it could imagine. In an earlier work (11) I discussed the curiously close relation subsisting between hate and anal-erotism in both the normal and, more especially, in the obsessional neurosis, and Freud (12) has expressed the view that this combination is characteristic of a certain stage in normal sexual development which he terms the ‘pregenital' stage because it antedates that in which the primacy of the genital zone is established. When, as is far from rare in adult life, there is a tendency to regression in the direction of this level of development, corresponding changes are manifested in the person's character. Abraham has further shewn (13) that there exists a still earlier pregenital stage of development, which, from the prominent part played in it by the buccal zone, he calls the ‘oral' or 'cannibalistic' one; fixations or regressions in connexion with this stage also can be accompanied by typical character changes,


Freud has made a second contribution to this subject in an essay entitled “Some character types from psycho-analytic work” (14). He describes here three types. The persons of the first type are distinguished by their making special claims to be treated as “exceptions. It is true that we should all like to be treated by our environment as exceptions, as individuals to whom the strict rules of life should not apply as they have to with mere other people, and who should be granted special privileges in obtaining pleasure and in being spared the bitter demands of necessity. The people in question, however, not only desire this, but seriously maintain that they have an actual right to expect such special treatment on the part of their environment and of fate, and this characteristic is at times so highly developed as to render its possessor impervious to argument and quite unable to see either the unreasonableness or the impossibility of their demands. Freud illustrates the type by the example of Richard III, and states that in all the patients of the kind he has analysed he has been able to trace the origin of the character trait to a painful event in infantile life regarding which they knew themselves to be innocent and which they looked upon as an unjust injury; they then go through life claiming compensation for this in the form of exceptional treatment. It is probable that much of the specially privileged position claimed by women, and accorded to them, is the result of the idea that they were unjustly deprived of an important part of the body in early life, and the bitterness of so many daughters against their mothers is due in the last resort to the reproach that they were brought into the world as girls and not boys.

The second type, which Freud illustrates by analysis of Macbeth and Ibsen's Rosmersholm, he designates as “those who are broken by success.” The subjects of this type display the peculiar reaction of breaking, usually in the form of a severe psychoneurosis, just when they attain the success for which they have long hoped and striven, thus presenting a curious paradox to the rule that a neurosis follows on some deprivation or disappointment. It is not hard, however, to solve the paradox. In the commoner cases an external deprivation leads to the internal deprivation which is the essential precursor of the neurosis, while in these rarer cases the internal deprivation alone suffices and is brought into play by the realisation of what had previously been treated by the ego as a harmless phantasy. As is well known, conscience often passes a very different judgement on the mere wish for a given action and the putting this into force in real life.

The third type Freud terms “the criminal from guilty conscience.” The persons of this type are not guilty because they have committed a forbidden act, but commit the forbidden act because they feel guilty, obtaining thereby a relief of this feeling. They displace their feeling of guilt on to the relatively mild offence, and ease their conscience by undergoing penance in the form of the punishment they provoke. Naturally the original sense of guilt had an older source, probably always arising ultimately from the Oedipus complex. It is an interesting question to ask how many actual criminals belong to this class, excluding of course those who have no scruples of conscience, and one might add that Freud's contribution throws some light on the curious fascination for the forbidden which most educators have observed.

Freud has continued his series of publications entitled “Contributions to the psychology of love," and I will refer only to the one that appeared during the war, on the subject of virginity. It is primarily an investigation of the curious fact, observed in many savage tribes, that the defloration of a woman is carefully entrusted to some other man than the future husband. After giving an account of the accompanying features of the rite, and the hypotheses that have attempted to account for it, he brings it into relation with the various reactions that psychoanalysis discovers in regard to the act of defloration. On the one hand this is often followed by a very special and lasting attachment to the man who performed the act, this being particularly marked when an unduly great resistance against sexuality had previously existed and is overcome by the first act or acts; a similar kind of ‘sexual dependence' may sometimes be observed with men who had previously been impotent. At the other extreme are women who never love, and may even hate, the men who deflowered them; they are often, however, quite capable of forming a deep attachment to another man, which is a psychological reason why many widows make successful second marriages. In between these extremes are two instructive types of neurotic reaction; in one of these, where the mechanism resembles that of the obsessional neurosis, both attitudes can coexist, namely love and hate; the other, by far the commoner, is the well-known hysterical anaesthesia or frigidity, where the hostility acts by neutralising and inhibiting sexual love. Freud enumerates four grounds for the hostility in question which is so likely to be aroused by the first act of intercourse, and considers that the deepest and most important is the “envy of the penis” that most girls experience to a greater or lesser extent, and which always lies behind the wish to be a boy. The hostility thus aroused may

lead to a desire for revenge on the man who finally and definitely made them

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