Зигмунд Фрейд - A General Introduction to Psychoanalysis

Discussions of this sort, gentlemen, are bound to be somewhat dry. To render them more vivid and impressive, let us return to clinical illustrations. You know that hysteria and compulsion–neurosis are the two chief factors in the group of transference neuroses. In hysteria, libidinous return to primary, incestuous sexual objects is quite regular, but regression to a former stage of sexual organization very rare. In the mechanism of hysteria suppression plays the chief part. If you will permit me to supplement our previous positive knowledge of this neurosis by a constructive suggestion, I could describe the state of affairs in this manner: the union of the partial instincts under the domination of the genitals is accomplished, but its results encounter the opposition of the fore–conscious system which, of course, is bound up with consciousness. Genital organization, therefore, may stand for the unconscious but not for the fore–conscious. Through this rejection on the part of the fore–conscious, a situation arises which in certain aspects is similar to the condition existing before the genitals had attained their primacy. Of the two libido regressions, the regression to a former stage of sexual organization is by far the more conspicuous. Since it is lacking in hysteria and our entire conception of the neuroses is still too much dominated by the study of hysteria which preceded it in point of time, the meaning of libido regression became clearer to us much later than that of repression. Let us be prepared to widen and change our attitude still more when we consider other narcistic neuroses besides compulsion–neurosis and hysteria in our discussion.

In contrast to this, regression of libido in compulsion–neurosis turns back most conspicuously to the earlier sadistico–anal organization, which accordingly becomes the most significant factor expressed by the symptoms. Under these conditions the love impulse must mask itself as a sadistic impulse. The compulsion idea must therefore be reinterpreted. Isolated from other superimposed factors, which though they are not accidental are also indispensable, it no longer reads: "I want to murder you"; rather it says "I want to enjoy you in love." Add to this, that simultaneously regression of the object has also set in, so that this impulse is invariably directed toward the nearest and dearest persons, and you can imagine with what horror the patient thinks of these compulsion ideas and how alien they appear to his conscious perception. In the mechanism of these neuroses, suppression, too, assumes an important part, which it is not easy to explain in a superficial discussion of this sort. Regression of the libido without suppression would never result in neurosis but would finally end in perversion. This makes it obvious that suppression is the process most characteristic of neurosis, and typifies it most perfectly. Perhaps I shall at some future time have the opportunity of presenting to you our knowledge of the mechanism of perversions and then you will see that here also things do not work themselves out as simply as we should best like to construe them.

You will most readily reconcile yourself with these elucidations of fixation and regression, when you consider them as a preface to the investigation of the etiology of neuroses. Towards this I have only advanced a single fact: that people become neurotically ill when the possibility of satisfying their libido is removed, ill with "denial," as I expressed myself, and that their symptoms are the substitutes for the denied gratification. Of course, that does not mean that every denial of libidinous satisfaction makes every person neurotic, but merely that in all cases known of neurosis, the factor of denial was traceable. The syllogism therefore cannot be reversed. You also understand, I trust, that this statement is not supposed to reveal the entire secret of the etiology of neurosis, but only emphasizes an important and indispensable condition.

Now, we do not know, in the further discussion of this statement, whether to emphasize the nature of denial or the individuality of the person affected by it. Denial is very rarely complete and absolute; to cause a pathological condition, the specific gratification desired by the particular person in question must be withheld, the certain satisfaction of which he alone is capable. On the whole there are many ways of enduring abstinence from libidinous gratification without succumbing to a neurosis by reason thereof. Above all we know of people who are able to endure abstinence without doing themselves injury; they are not happy under the circumstances, they are filled with yearning, but they do not become ill. Furthermore, we must take into consideration that the impulses of the sex instinct are extraordinarily plastic , if I may use that term in this connection. One thing may take the place of the other; one may assume the other's intensity; if reality refuses the one gratification, the satisfaction of another may offer full compensation. The sexual impulses are like a network of communicating channels filled with fluids; they are this in spite of their subjugation to the primacy of the genitals, though I realize it is difficult to unite these two ideas in one conception. The component impulses of sexuality as well as the total sexual desire, which represents their aggregate, show a marked ability to change their object, to exchange it, for instance, for one more easily attainable. This displacement and the readiness to accept substitutes must exert powerful influences in opposition to the pathological effect of abstinence. Among these processes which resist the ill effects of abstinence, one in particular has won cultural significance. Sexual desire relinquishes either its goal of partial gratification of desire, or the goal of desire toward reproduction, and adopts another aim, genetically related to the abandoned one, save that it is no longer sexual but must be termed social. This process is called "sublimation," and in adopting this process we subscribe to the general standard which places social aims above selfish sexual desires. Sublimation is, as a matter of fact, only a special case of the relation of sexual to non–sexual desires. We shall have occasion to talk more about this later in another connection.

Now your impression will be that abstinence has become an insignificant factor, since there are so many methods of enduring it. Yet this is not the case, for its pathological power is unimpaired. The remedies are generally not sufficient. The measure of unsatisfied libido which the average human being can stand is limited. The plasticity and freedom of movement of libido is by no means retained to the same extent by all individuals; sublimation can, moreover, never account for more than a certain small fraction of the libido, and finally most people possess the capacity for sublimation only to a very slight degree. The most important of these limitations clearly lies in the adaptability of the libido, as it renders the gratification of the individual dependent upon the attainment of only a very few aims and objects. Kindly recall that incomplete development of the libido leaves extensive and possibly even numerous libido fixations in earlier developmental phases of the processes of sexual organization and object–finding, and that these phases are usually not capable of affording a real gratification. You will then recognize libido fixation as the second powerful factor which together with abstinence constitutes the causative factors of the illness. We may abbreviate schematically and say that libido fixation represents the internal disposing factor, abstinence the accidental external factor of the etiology of neurosis.

I seize the opportunity to warn you of taking sides in a most unnecessary conflict. In scientific affairs it is a popular proceeding to emphasize a part of the truth in place of the whole truth and to combat all the rest, which has lost none of its verity, in the name of that fraction. In this way various factions have already separated out from the movement of psychoanalysis; one faction recognizes only the egoistic impulses and denies the sexual, another appreciates the influence of objective tasks in life, but ignores the part played by the individual past, and so on. Here is occasion for a similar antithesis and subject for dispute: are neuroses exogenous or endogenous diseases, are they the inevitable results of a special constitution or the product of certain harmful (traumatic) impressions; in particular, are they called forth by libido fixation (and the sexual constitution which goes with this) or through the pressure of forbearance? This dilemma seems to me no whit wiser than another I could present to you: is the child created through the generation of the father or the conception of the mother? Both factors are equally essential, you will answer very properly. The conditions which cause neuroses are very similar if not precisely the same. For the consideration of the causes of neuroses, we may arrange neurotic diseases in a series, in which two factors, sexual constitution and experience, or, if you wish, libido–fixation and self–denial, are represented in such a way that one increases as the other decreases. At one end of the series are the extreme cases, of which you can say with full conviction: These persons would have become ill because of the peculiar development of their libido, no matter what they might have experienced, no matter how gently life might have treated them. At the other end are cases which would call forth the reversed judgment, that the patients would undoubtedly have escaped illness if life had not thrust certain conditions upon them. But in the intermediate cases of the series, predisposing sexual constitution and subversive demands of life combine. Their sexual constitution would not have given rise to neurosis if the victims had not had such experiences, and their experiences would not have acted upon them traumatically if the conditions of the libido had been otherwise. Within this series I may grant a certain preponderance to the weight carried by the predisposing factors, but this admission, too, depends upon the boundaries within which you wish to delimit nervousness.