Inhibition, Symptom and Anxiety

I. A Definition of Inhibition and Symptom

Our usage of speech permits us, in the description of pathological phenomena, to differentiate between symptoms and inhibitions, but not much value is attributed to this distinction. If cases of illness did not come to us of whom we must say that they show only inhibitions and no symptoms, and if we did not know how they came about, we should hardly be interested in discriminating between inhibition and symptom.

These two do not flourish on the same soil. Inhibition has a special relationship to function and does not necessarily indicate something pathological, for one may call the restrictions of a function inhibition of the same. Symptoms, on the other hand, signify indications of disease processes. So also may inhibition be a symptom of disease. The usage of language, then, is such that it speaks of inhibition where there is an unusual variation of the same or a new performance. In many cases it is left to one’s discretion to emphasize the positive or negative side of a pathological process, and designate the result as a symptom or an inhibition. This, in all truth, is not interesting and the question with which we begin this thesis is shown to bear little fruit.

As inhibition is evidently so intimately connected with function, one may arrive at the idea of studying the different ego functions, in respect to which forms of disturbance of the same are expressed in the individual neurotic functions. For this comparative study we choose: the sexual function, eating, locomotion and occupation.

(a) The sexual function is subject to very manifold disturbances, the majority of which show the character of simple inhibitions. These may be comprehended under the head of psychic impotence. The status of normal sexual function presupposes a very complicated course, and disturbance may come about in every part. The principal stations for inhibition in men are: the turning aside of the libido at the beginning of the process (psychic frigidity); the absence of physical preparation (erection); the shortening of the act (precocious ejaculation—which may equally be described as a positive symptom); the holding back of the same (lack of ejaculation); and the absence of the psychic effect (pleasure in the orgasm). Other disturbances result from the association of the function with special conditions of perverse or fetichistic nature.

One cannot long escape the recognition of a relationship between inhibition and angst.^[1] Many inhibitions are palpably a renunciation of function because in the exercise of the latter fear is developed. Direct fear of the sexual function is frequent in women. We associate it with hysteria, and also with the defensive symptom of nausea, which set in originally as a supplementary reaction to the passively experienced sexual act and appear later at the mental image of the same. A great number of compulsive behaviors are also shown as precautions and assurance against sexual experience and are therefore of phobic nature.

One does not get far in the comprehension of these matters and at most one remarks only that very different procedures are applied in the disturbance of the functions: (1) The mere absence of libido, which seems the soonest to manifest itself, which we call a pure inhibition. (2) The impairment in the execution of the function. (3) The aggravation of the same by special conditions and the modification by deviation to other objectives. (4) The prevention by safety measures. (5) The interruption through development of fear so far as its addition cannot be hindered, and finally (6), a supplementary one which protests against the disturbance and would make what has happened undone if the function could be carried out.

(b) The most common disturbance of the nutritive function is anorexia through withdrawal of the libido. Also aggravation of the appetite is often seen—a compulsion to eat motivated by fear of starving has been but little studied. As a hysterical refusal of food is the symptom of vomiting, refusal of food through fear belongs to psychotic states (delusion of poisoning).

(c) Locomotion is inhibited in many neurotic conditions through disinclination to walk and weakness on walking, while hysterical inhibition is manifested by motor palsy of the locomotor apparatus or else by some special abolition of function like abasia. Especially characteristic are difficulties of locomotion through the interposition of definite conditions, through the non-fulfilment of which fear arises (phobias).

(d) Inhibition of one’s occupational activities, which comes so often to treatment as an isolated symptom, shows diminished desire for work or poor execution or reaction phenomena, as exhaustion (vertigo, vomiting) when continuation of the occupation is forced. Hysteria forces the cessation of labor through engendering organ and functional paralyses, the existence of which cannot be conjoined with execution. The compulsive neuroses disturb work through continuous diversion and through loss of time in the interpolated delays and repetitions.

We could extend this survey over other functions but could not expect to attain more thereby. We have not gone beyond the surface phenomena. Hence we resolve to take a view which makes the conception of an inhibition no longer very enigmatical. Inhibition is the expression of a functional limitation of the ego, which can come about from very different causes.

Many of the mechanisms of this renunciation of function and a general tendency to the same are well known to us. It is easy to recognize this tendency in the specialized inhibitions. If piano playing, writing and even walking are subject to neurotic inhibitions, analysis shows us the reason for the same in an over-strong erotisation of the organs involved—the fingers and the feet. We have gained the view in general that the ego function of an organ is injured if its erogeneity, its sexual significance, increases. It then behaves—if one dare make a scurrilous comparison—like a cook who will no longer work at the fireside because the man of the house enters into love relations with her. If writing which consists in letting ink flow from a tube on a piece of white paper, has assumed the symbolic significance of coitus; or when walking has become a symbolic substitute for stamping on Mother Earth, then both writing and walking will be prohibitive because it is as if one would carry out some forbidden sexual transaction. The ego renounces this function proper to it in order not to be compelled to undertake a new repression, in order to avoid a conflict with the It.

Other inhibitions follow obviously in the service of self-punishment—frequently in connection with professional activities. The ego dare not do certain things because it will use them in a manner disapproved of by the more strict super-ego. In turn the ego renounces these functions in order not to engage in a conflict with the super-ego.

The general inhibitions of the ego follow another and simple mechanism. When the ego is claimed by a psychic task of particular difficulty,—through an affliction, a grand affect-suppression, through the necessity of holding down a constantly increasing sexual fancy,—it is so deprived of disposable energy that it must retrench its supply in many directions like a speculator who has tied up his money in his enterprises. An instructive example of such an intensive general inhibition of brief duration was observed by me in a compulsive patient who fell into a paralyzing weariness of one or several days’ duration on occasions which should obviously have led to an outbreak of rage. Beginning here there must be found a way to the comprehension of general inhibition through which the depressive states and the most severe of these, melancholy, characterize themselves.

In conclusion, one may say of the inhibitions that they are restrictions of the ego functions either from prudence or impoverishment of energy. It is easy to recognize now wherein inhibition differs from symptom; for symptom can be nothing more than a process within or connected with the ego.

II. Symptom Formation

The main features of symptom formation have long been studied and have been expressed, it is to be hoped, in an impregnable manner. The symptom is a sign and substitute of a suppressed impulse-gratification, the result of a repressive process. The repression proceeds from the ego, which, perchance in the service of the super-ego, will not coöperate in an instinct investment incited by the It. The ego through the repression makes it possible for the idea, which was the carrier of the unamiable striving, to become shut off from consciousness. Analysis often demonstrates that it remains as an unconscious formation. Thus far it is clear, but presently the unsolved difficulties begin.

Our previous descriptions of the process in repression have emphasized the result of the shutting off from consciousness, but in other respects we have left matters open to doubt. The question arises, what is the fate of the impulse activated in the It which aims at gratification? The answer is an indirect one and runs as follows: through the process of repression the anticipated desire for gratification is changed to pain. One would then confront the problem of how pain could be the result of the instinct gratification. We hope to explain the situation by the definite statement that the intentional course of the stimulus in the It fails to take place because of repression, while the ego succeeds in inhibiting or diverting the same. Then the riddle unfolds of affect-transformation by repression. We have, however, confessed to the ego that it can express so far reaching an influence on the processes in the It and we should learn to understand in what way this astounding unfolding of power becomes possible.

I believe that this influence belongs to the ego as a result of its intimate associations with the perceptive system, which indeed constitutes its very nature and is the basis of its differentiation from the It. The function of this system, which we have called the perceptive-conscious, is bound up with the phenomenon of consciousness; it receives excitations not only from without but also from within and by means of pleasure-pain sensations which it attains therefrom it attempts to direct all of the courses of the psychic happenings in accordance with the pleasure principle. We imagine the ego as good as powerless against the It, but when it strives against an instinctive process in the It, it needs only to give the signal of pain in order to attain its objective through the almost omnipotent factor of the pleasure principle. When we contemplate this situation by itself for the moment we may illustrate it by an example from another sphere of activity. A certain clique resists a measure which meets with the inclinations of the mass of the people. This minority then usurps the press, manipulates through it the sovereign “public opinion” and pushes matters in such a way that the planned measure does not go through.

Other questions now arise. Where does the energy originate which brings about the pain signal? Here an idea shows us the way the defence of an unwished for process within may follow the pattern of a defence against an external irritant, where the ego takes the same path against internal as it does against external danger. If the danger is from without, the organized being takes flight and then first of all withdraws from the perception of danger; later it is recognized that a more efficacious means is to effectuate such muscular actions that the perception of danger becomes impossible, even when it is not denied; in other words, to withdraw from the region of danger. One such effort at flight is equivalent to repression. The ego withdraws the (preconscious) investment from the instinct representation to be repressed and applies it for the disengagement of displeasure (anxiety). The problem of how anxiety arises from repression may be no simple one and in any case one has the right to hold fast to the idea that the ego is the chief place of anxiety and to reject the earlier notion that the investment energy of fixation of the repressed incitation becomes automatically changed to anxiety. If I formerly so expressed myself I was giving it a phenomenological and not a metapsychological presentation.

From what has been said a new question comes up. How is it economically possible that a mere withdrawal and conducting off—as in the retreat of a preconscious ego-investment—could engender disinclination or fear, which according to our presuppositions can result only from enhanced investment? My reply is that this causation is not to be explained economically. Anxiety is not newly engendered in repression but is reproduced as an affective state after a present memory picture. With a further inquiry as to the origin of this anxiety—as of affects in general—we abandon the undisputed psychological territory and enter the borderland of physiology. Affective states are incorporated into the soul life as precipitates of archaic traumatic experiences and are awakened in like situations as memory symbols. I mean that I am not in error in making them equivalent to the late and isolated hysterical attacks, and to be regarded as their normal prototypes. In mankind and the creatures related to him the act of parturition appears to be the first individual anxiety experienced to give the characteristic traits of the expression of an anxiety affect. We are not, however, to overestimate this connection and in its recognition are not to overlook the fact that an affect symbol is a biological necessity for a situation of peril and at all events must be obtained. I also hold that it is unjustified to assume that in every outbreak of anxiety something occurs in the soul life which reproduces the birth situation. It is not at all certain whether the hysterical attacks which are originally such traumatic reproductions maintain this character permanently.

Elsewhere I have deduced that most repressions with which we have to do therapeutically are cases of after-repression, which presuppose the existence of archaic repressions exerting their attractive influence on a newer situation. Of this background and forestage of repression too little is known. One comes easily into the danger of overestimating the rôle of the super-ego in repression.

At present we are unable to judge whether the appearance of the super-ego creates the border between primeval repression and late repression. The first—very intensive—outbursts of anxiety do at any rate follow upon the differentiation of the super-ego. It is plausible throughout that quantitative factors, such as the excessive strength of the excitation and the breach in the stimulus protection, are the first occasions of the primary repression.

Mention of protection from excitation reminds us like a catchword that repressions appear in two different situations—first, when an unpleasant instinctive stimulus is awakened by an external perception, and second, when the latter occurs from internal provocation. We will return later to this difference. Stimulus protection is afforded only against external irritation, not from internal instinctive demands.

As long as we study the attempt at flight of the ego we remain far from symptom formation. The symptom arises from the instinct stimulus which is encroached on by the repression. When the ego attains its objective, through the pain signal, of keeping under the instinct stimulus, we learn nothing as to how this is brought about. We only learn from cases which are to be termed more or less unsuccessful repressions.

In general, then, it is so presented that despite the repression the instinct stimulus has found a substitute, but this is strongly blighted, displaced and inhibited. It is no longer recognizable as a satisfaction. When it consummated, no feeling of pleasure accompanies it. For this reason the consummation has assumed the character of a compulsion. But in this lowering of the course of satisfaction to the symptom, the repression shows its power in another respect. The substitution process is withheld from removal by the motor actions and even when this is unsuccessful it must exhaust itself in the alteration of its own body and cannot encroach on the outer world; it is forbidden it to transform itself into activity. We understand that in suppression the ego works under the influence of external reality and on that account shuts off the result of the process of substitution from this reality.

The ego dominates the access to consciousness as also the transition to action against the external world; in repression its power is employed in both directions. The instinct object is adapted to sense one side, and the impulse prompting to the other side of its expression of force. It is now permissible to ask how this recognition of the power of the ego coincides with the description outlined of the position of the same ego in my study “The Ego and the It.” We have therein depicted the dependence of the ego on the It and the super-ego and unmasked its weakness and readiness to anxiety toward both and its superiority, which has been built up laboriously. This judgment has since found a strong echo in psychoanalytic literature. Numerous voices emphasize urgently the weakness of the ego against the It, of the rational against the demoniacal in us, and are ready to make this proposition into a foundation for a psychoanalytic view of the universe. Should not the insight into the mode of action of repression be the very thing to hold the analyst back from so extreme a partisan designation?

I am not at all for the fabrication of world contemplations. One may leave such to philosophers who by their own confession cannot make life’s journey practicable without such a Baedeker, which gives information about all things. Let us humbly take upon ourselves the contumely with which the philosophers look down upon us from the standpoint of their indigence. Since we, too, cannot deny our narcistic pride, we will seek our comfort in the venture that all of these life pilots soon age, that it is just our shortsighted restricted work in miniature which makes necessary their new editions, and that even the most modern of these Baedekers are essays to replace old catechism, so convenient and complete. We know exactly how little light science has hitherto diffused over the riddle of this world; all the noise of the philosophers can change nothing, only a patient continuation of the work which subordinates everything to one demand for certainty, can effect slowly the transformation. If the wanderer sings in the dark, he denies his anxiety but this does not make him see more clearly.

III. The Ego

To return to the problem of the ego: the appearance of contradiction is due to the fact that we take abstractions too rigidly and out of a complicated state of affairs look at first one, then another side alone. The separation of the ego from the It seems justified. It is forced on us by definite conditions. But on the other hand, the ego and It are identical, the ego is only a differentiated part of the same It. If in thought we place this fragment against the whole, or if there is a true dissension between the two, the weakness of this ego is manifest. But if the ego remains bound to the It and cannot be divided from it, its strength is manifest. The relation between the ego and super-ego is similar; in many situations the two flow together; mostly we can only distinguish between them when there is tension, a conflict, between them. For the case of repression this fact will be decisive, that the ego is an organization, the It is not. The ego is the organized part of the It. It would be quite unjustified if one should imagine that the ego and It are two unlike camps of warriors; in repression the ego seeks to repress a fragment of the It. but the remainder of the It comes to the rescue and measures its strength with that of the ego. This may often happen although it is certainly not the initial situation of repression; as a rule the instinct to be repressed is isolated. If the act of repression has shown us the strength of the ego, it bears witness of its weakness and for the fact that the individual instincts of the It cannot be influenced. For the process which has become a symptom through repression maintains its existence outside of the ego organization and independently of it. And not only this alone but all of its offshoots enjoy the same right, one may say the extraterritoriality. And where it comes together associatively with the portions of the ego organization, it may be asked whether these did not draw it to themselves and gain ground with this addition at the expense of the ego. A comparison long a favorite with us regards the symptom as a foreign body which ceaselessly maintains phenomena of irritation and reaction in the tissues in which it has embedded itself. It does indeed happen that the defensive battle against the unpleasant instinct is shut off through the symptom formation; as far as we can see this is possible in hysterical conversion, but usually the course is different—after the first act of repression there follows a tedious or never ending after-play; the fight against the instinct finds its continuation in the fight against the symptom.

This secondary defensive fight shows us two faces with contradictory expressions. On one hand the ego is notified through its nature to undertake something which we must estimate as an attempt at restoration or expiation. The ego is an organization, it rests upon free intercourse and the possibility of reciprocally influencing among all of its components. Its desexualized energy announces its origin in the effort towards union and unification and this urge to synthesis always increases with the strength which the ego develops. It therefore becomes intelligible that the ego also tries to abolish the strangeness and isolation of the symptom, using for this purpose all possibilities to bind it to itself and by such bands to incorporate it into its organization. We know that such an effort already influences the act to symptom formation. A classical example thereof is furnished by those hysterical symptoms which become transparent to us as a compromise between the requirement for gratification and the requirement for punishment. As fulfillment of a demand of the super-ego such symptoms have from the first a part in the ego while on the other hand they indicate positions of the repressed and breaches in the ego organization; they are, so to speak, border stations with mixed investments. Whether all primary hysterical symptoms are so constructed demands careful investigation. In further course the ego so behaves as if conducted by deliberation. The symptom is once there and cannot be removed. It must make friends with the situation and draw the greatest amount of benefit from it. An adaptation takes place with the ego-foreign fragment of the inner world which is represented through the symptom, as otherwise normally the ego brings to pass in the real outer world. There is never a lack of occasions. The existence of symptoms may bring with itself a certain inhibition of function with which one may soothe a demand of the super-ego or refuse a claim of the external world. The symptom is gradually entrusted with the representation of more important interests, it receives a value for self assertion, adheres more intimately to the ego and becomes more indispensable to it. Only in quite rare cases can the process be likened to the presence of a foreign body after a wound has healed. One may also exaggerate the importance of this secondary adaptation to the symptom in saying that the ego has created the symptom in order to derive benefit from it. This is just as true or false as when one presents the opinion that war-injured soldiers have allowed their legs to be shot off in order to live without work on their invalid pensions.

Other symptom formations, such as compulsion neurosis and paranoia, gain a high value for the ego, not because they are of advantage to it but because they bring a narcistic gratification which is indispensable. The system formations of the compulsive neurotic flatter his self love through the delusion that he is specially pure and conscientious and is better than other human beings. The delusional formations of paranoia open to the acumen and phantasy of these patients a field of activity which is not readily replaced. From all of these mentioned relations there results what is known as the (secondary) disease gain of the neurosis. There ensues the effort of the ego to incorporate the symptom into itself and strengthen the fixation of the latter. If we then make the attempt to furnish aid of analysis to the ego in its fight against the symptom, we find that these placable connections between the ego and symptom efficacious on the part of the resistance. It is not made easy for us to solve these. Both procedures which the ego applies against the symptom stand actually in opposition to each other.

The other procedure has a less friendly aspect and continues the direction of the repression. It seems, however, that we should not burden the ego with the reproach of futility. The ego is ready to be peaceable and would like to incorporate the symptom and take it into its ensemble. The disturbance proceeds from the symptom, which is the proper substitute and derivative of the repressed prompting. The latter rôle is played further, in that the urge for gratification is constantly renewed and so prompts the ego to again give the pain signal and come to its defense. The secondary defensive fight against the symptom is many sided and plays itself on different stages, serving itself with manifold means. We will state little if we do not take the individual cases of symptom formation as an object of investigation. By so doing we shall find occasion to go into the problem of anxiety which we have long spied lurking in the background. It would seem desirable to start out with the symptoms created by the hysterical neuroses, for we are not yet prepared for the presuppositions of symptom formation in the compulsive neuroses, paranoia, and other neuroses.

IV. Infantile Zoöphobia

Our first consideration will be that of infantile hysterical animal fear; for example, the typical case of horse fear of the five year old “Little Hans” (in Volume VIII of my collected papers published in German). Even the first glimpse allows us to recognize that the relations of a genuine case of neurotic disease are much more complicated than would be anticipated in our imagination as long as we work with abstractions. Some work must be devoted to orientation—which suppressed prompting, what symptom equivalent, what motive for suppression becomes recognizable.

The boy refused to go out in the street because of his fear of horses. This is the raw material. What is the symptom? Development of anxiety, selection of a feared object, renunciation of free mobility, or several such in combination? What gratification is given up? Why must he go without it? The case is not enigmatical. The incomprehensible fear of the horse is a symptom of incapacity for walking in the street, a phenomenon of inhibition, a limitation which is enjoined on the ego in order not to awaken the fear symptom. One sees straightway the correctness of the explanation of the last point and will leave this inhibition out of consideration in further discussion. But the first fugacious acquaintance with the case does not teach us to recognize the actual expression of the supposititious symptoms. As shown by further inquiry it had to do not with an indefinite fear of a horse, but a definite anxious expectation that the horse would bite him. It is true that this content sought to withdraw itself from consciousness and to replace it with an indefinite phobia in which only the fear and the object remain. Is this content the nucleus of the symptom?

We get no further so long as we do not draw the entire psychic situation of the child into consideration as is revealed with analytical work in general. In the Oedipus situation to the father we find jealousy and enmity although the boy loved him heartily aside from conditions in which the mother came into consideration. In other words there was an ambivalence conflict—well founded love with not less justified hate, both directed against the same person. His phobia must result from an effort to solve this conflict. Such ambivalence conflicts are very common and we know another typical ending. In this one of the two instincts which strive together, usually the tender one, greatly strengthened, causes the other to disappear. Only the excess and the compulsive character of the tenderness betray it, as this situation is not the only one present, and it is constantly on its guard to hold its opponent in subjugation and allows us to construe a procedure which we describe as repression through reaction formation in the ego. Cases like that of little Hans show nothing of such reaction formation; evidently there are different ways which lead out of an ambivalence conflict.

In the meantime we have learned something with certainty. The instinct stimulus which lies beneath the repression is a hostile impulse against the father. The analysis gives us the proofs, because it traces the origin of the idea of the biting horse. Hans had seen a horse fall, and had also seen a playmate fall and hurt himself when they were playing horse. This gave us the right to construe a wish impulse of Hans’s which meant that the father might fall and injure himself. References to an observed departure allowed us to assume that the wish for the removal of the father had found a less timid expression. Such a wish, however, is equivalent to the intention to remove him himself, with the murderous stimulus of the Oedipus complex.

From this repressed instinct stimulus there leads up to now no way to a substitute for what we suppose to be hippophobia. Suppose we simplify the situation of the boy by clearing away the infantile factor and ambivalence. There is, perhaps, a young man servant who is enamored of the mistress and who rejoices in certain kindnesses on that account on her part. Suppose that he hates the stronger master of the house and would like to have him removed. The most natural consequence of this situation would be that he fears the revenge of the master, so that there develops a sense of fear—quite analogous to the phobia of the little boy for the horse. That is to say, we cannot designate the fear in this phobia as symptom; if the boy who loves his mother would show fear of his father we should have no right to impute to him a neurosis, a phobia. We have here a quite comprehensible affective reaction. That which would make a neurosis out of this is another trait and this only, the substitution of the horse for the father. This displacement produces something which has claim to the name of symptom. It is that other mechanism which permits the solution of the ambivalence conflict without the aid of a reaction formation. It is made possible or easier through the circumstance that the inborn traces of totemistic modes of thinking in this tender age are still readily animated. The cleft between human and animal is not yet recognized, certainly less emphasized than later. The adult, admired yet feared, still stands in a series with the larger animal, which man envies in many ways and of which he must be warned because the beast can be a source of danger. The ambivalence conflict is not decided on the same person but is as if circumvented, as one palms off one of his own promptings as that of a substitute man. Thus far we see clearly, but in another point analysis of the phobia of the boy has brought a complete disillusionment. The disguise in which the symptom formation exists is not at all undertaken as the representative (ideational content) of the instinct prompting to be repressed, but is quite different therefrom, which corresponds only to a reaction on the essentially unpleasant. Our anticipation would find a gratification sooner if the small Hans had developed in place of a phobia an inclination to mistreat the horse, to beat it, or had announced the wish to see it fall and hurt itself, perhaps to die in convulsions (making a riot with its legs). Something of the sort did develop during the analysis but it did not stand long prominent in the neurosis. Something there is not in order, either in our comprehension of the repression or in our definition of a symptom. One thing strikes us naturally at once: if little Hans had really shown this demeanor toward the horse, the character of the shocking, aggressive instinct stimulus would not be at all altered by the repression, only the object would be changed.

It is quite certain that there are cases of repression which do not perform more than this; but in the genesis of the phobia in little Hans more happened. As to how much more may be divined in another fragment of the analysis.

We have already heard that little Hans gave as the content of his phobia the idea of being bitten by the horse. Later we have had a glimpse into the genesis of another case^[2] of animal phobia in which a wolf was the animal feared with likewise the significance of a father substitute. At the conclusion of a dream which made the analysis transparent there developed in this boy the fear of being devoured by a wolf like one of the seven kids in the fable. That the father of little Hans demonstrably had played horse with him had certainly been a determinant for the choice of the animal to be feared. Likewise, it was at least made probable that the father of my Russian (who was not analyzed until the third decade of his life) had also in play imitated a wolf and jokingly threatened to eat the boy. Since then I have found a third case in a young American in whom indeed no zoöphobia had developed but this very omission aids in clearing up the other cases. His sexual excitation had been kindled by a child’s fanciful history which was read to him, about an Arabian chief who pursued a man consisting of an edible substance (the gingerbread man) in order to devour him. He identified himself with this edible man while the chieftain was readily recognizable as a substitute for the father and this fancy was the first substratum of his autoerotic activity. The idea of being devoured by his father is typical archaic child property; the analogies from mythology (Chronos) and from animal life are well known.

Despite these explanations the content of this idea is so strange to us that we could impute it to the child only with incredulity. We do not even know whether he really meant what he seemed to be saying and do no understand how he can be the subject of a phobia. Analytic experience, however, gives the requisite information and teaches us that the notion of being eaten by the father is the regressive degraded expression of a passive tender excitation which wishes to be loved by the father as an object in the sense of genital eroticism. The follow-up history of the case leaves no doubt as to the correctness of this interpretation. The genital striving does indeed betray nothing more of its tender intention if expressed in the speech of the vanquished transition phase of the oral to the sadistic libido organization. Does it have to do further with nothing more than a substitution of the representative through a regressive expression, or is there a genuine regressive degradation of the genitally directed striving in the It? It is not so easy to decide. The clinical history of the Russian wolf man speaks quite decidedly for the last named possibility for he himself behaved badly after the deciding dream—vexatiously and sadistically—and soon after developed a proper compulsion neurosis. In any case we gain the insight that the suppression is not the sole means which stands at the command of the ego for the rejection of an unpleasant impulse prompting. When he succeeds in bringing the impulse to regression he has injured it fundamentally with greater energy than was possible through its repression. Indeed, it often happens that the regression originally forced follows the repression.

The subject matter with the wolf man, and that somewhat simpler in the case of little Hans incite various other considerations but already we gain two unexpected glimpses. There is no doubt that in these phobias the repressed instinct is hostile to the father. One may say this was repressed through the process of transformation into the opposite; in place of aggression toward the father, the aggression—revenge—of the father is directed toward one’s own person. As without this, such an aggression is rooted in the sadistic libido phase, it needs only to be degraded to the oral stage, indicated by Hans through the fear of being bitten, in the Russian carried out crudely by the fear of being devoured. Moreover the analysis established beyond all doubt that at the same time another instinct yielded to repression, the opposite of a tender passive excitation for the father, which had already reached the level of the genital (phallic) libido organization. The latter indeed seems more important for the end result of the process of repression; it experiences a further reaching regression and maintains the determining influence on the content of the phobia. Where we have investigated only a repression of impulse, we must recognize the coincidence of two such processes; both of the promptings—sadistic aggression against the father and a tender passive situation to him—form a contrasting pair. Still more: when we properly evaluate the history of little Hans we recognize that through the formation of his phobia the tender object-investment of the mother is also abolished, the content of phobia betraying nothing of this. In the case of Hans—it is much less distinct in the Russian—there is only a process of repression, which concerns almost all of the components of the Oedipus complex, the hostile as well as the tender incitation toward the father and the tender incitation toward the mother.

These complications are not wished for by us who desire to study only simple cases of symptom formation and with this intention we have applied ourselves only to the earliest and apparently most transparent neuroses of childhood. In place of a single repression we found a cumulation of such and in addition had to do with a regression. Perhaps we have increased the confusion when we treat our two disposable cases of zoöphobia alike—that of little Hans and the wolf man. Now certain differences occur to us. Only in the case of little Hans can we say with precision that through his phobia he disposed of both chief excitations of the Oedipus complex, the aggressive attitude against the father and the over tender one toward the mother; the tender feeling for the father is certainly obvious and plays its rôle in the repression of its opposite, but it is neither demonstrable that it was strong enough to provoke the repression nor that it was afterwards abolished. Hans seems to have been a normal child with a so-called positive Oedipus complex. It is possible that the elements which we missed were also coöperative but we could not point them out, the material even of our most thorough analyses is defective and our documentation imperfect. In the Russian the defect is in another place; its relation to the female object is disturbed by a precocious seduction; the passive, feminine side is strongly cultivated in him and the analysis of the wolf dream reveals little of intentional aggression against the father. Therefore the proofs are undoubted that the repression concerns the passive, tender situation to the father. Here also other factors may have actively participated, but such do not appear. If despite this distinction in the two cases, which almost approximates an antithesis, the end result of the phobia is almost the same, the explanation must come to us from another side; it comes from the second result of our little comparative study. We believe the motif for repression in both cases is known and we see its rôle corroborated through the course which was taken by the development of the two children. In both cases it is the same, the fear of threatened castration. Out of castration fear little Hans gave up his aggression toward the father; his fear that the horse would bite him can easily be completed—the horse would bite off his genitals, castrate him. But out of castration fear the little Russian renounced the wish to be loved by the father as a sexual object, for he had understood that such a relation had the presupposition that his genitals would be sacrificed—the organs which distinguished him from woman. Both forms of the Oedipus complex, the normal and active like the inverted, are shattered at the castration complex. The fear idea of the Russian, that of being devoured by the wolf, does not contain any hint of castration; it had through oral regression removed itself too far from the phallic phase, but the analysis of the dream makes every other proof superfluous. It is a complete triumph of suppression that in the text of the phobia there is no further hint of castration.

Here we have unexpected results. In both cases the motif of repression is the fear of castration; the content of the fear of being bitten by the horse and of being devoured by the wolf are substitutions, disguised, for the content of being castrated by the father. In the Russian it was the expression of a wish which could not exist if manhood were rebelled against; in Hans it was the expression of a reaction which aggression transformed to the opposite. But the fear affect of the phobia which makes up its nature, does not originate in the process of repression, nor from the libidinous fixations of the suppressed impulses but from that which is repressed. The fear in the zoöphobia is the untransformed castration fear, hence a true fear, fear of an actually threatened or actually judged danger. Here the fear makes the repression, not, as I once thought, the reverse.

It is not pleasant to think thus but it does not help to deny it. I have often represented the proposition that through repression the representative of the impulse is disguised, displaced, etc., the libido of the prompting being transformed into fear. Investigation of the phobias which before all should be called on to prove this proposition, not only did not confirm but seemed rather to contradict directly. The fear of the zoöphobias is the castration fear of the ego, that of the less fundamentally studied agoraphobia seems to be fear of temptation, which must cohere genetically with castration fear. Most phobias as far as we can see to-day go back to fear of the ego of the claims of the It. Here the fear situation of the ego is the primary one and the incentive to repression. The fear never comes forth from the libido. If I formerly pleased to say, after the repression appears a mass of fear in place of the expected expression of the libido, I have nothing to take back to-day. The description is correct and between the force of the prompting to be repressed and the intensity of the resulting fear the correspondence which I asserted doubtless exists. But I confess that I believe I gave more than a mere description, in assuming that I had recognized the metapsychological process of a direct transformation of the libido into fear. This I cannot to-day maintain. Nor was I formerly able to explain how this came to pass.

Whence did I draw the idea of this transformation? At a time when it was still not possible for us to distinguish between processes of the ego and processes of the It—from the study of actual neuroses—I found that definite sexual practices such as coitus interruptus, frustrated excitation, enforced abstinence, generated outbreaks of fear and a general predisposition to fears—always therefore when the course of sexual gratification was inhibited, delayed or diverted. As sexual excitement is the expression of libidinous promptings it does not seem venturesome to assume that libido is changed to fear through the influence of such disturbances. Now this observation holds good to-day. On the other hand it cannot be denied that the libido of the It processes experiences a disturbance through the incitement of the repression; it may be still better to say that fear arises in the repression from the libido investment of the instinct stimulus. But how may we harmonize this result with the other, that the fear of the phobias is an ego fear—originating in the ego, not produced by repression but producing the repression? This seems a contradiction and is not readily solved. The reduction of both origins of fear to one single fear is not readily carried through. One may try it with the assumption that the ego in the situation of the disturbed coitus, the interrupted excitement, the abstinence, scents danger, to which it reacts with fear. But nothing can be done with this. On the other hand the analysis of the phobias which we have undertaken seems not to admit of a justification. It is not clear.

V. Symptom Formation and the Secondary Defense of the Ego

We will study the symptom formation and the secondary combat of the ego against the symptom but we have frankly made no fortunate selection among the phobias. The fear which dominates in the picture of this affection appears to us now as a complication which veils the subject matter. There are neuroses in abundance in which no fear is shown. The genuine conversion hysteria is of this sort, and its severest symptoms are found with no admixture of fear. This fact must warn us that we must not adhere too closely to the relations between fear and symptom formation. Otherwise conversion hysteria stands so close to the phobias that I have held myself justified in grouping the latter with “fear hysterias.” But no one has as yet been able to give the condition which differentiates between them or whether a case assumes the form of a conversion hysteria or a phobia. Nor has any one explored the reasons for development of fear in hysteria.

The commonest symptoms of conversion hysteria—a motor paralysis, contracture, involuntary action or discharge, a pain, a hallucination—are either permanently established or intermittent investment processes, the explanation of which prepares new difficulties. One really knows but little of such symptoms. Through analysis one may learn what disturbed course of excitement they replace. Mostly it results that they themselves have a part in these, as if the total energy had been concentrated on a fragment. Pain was present in the situation in which the repression fell; hallucination was at the time a perception; motor palsy was a defense against action which should have been carried out in that situation but was inhibited; contracture is usually a displacement for a muscular innervation intended at the time at another place; the convulsive attack an expression of an affective outbreak which has withdrawn itself from the normal control of the ego. Changeable in a striking manner is the feeling of disinclination which accompanies the appearance of the symptoms. In the permanent symptoms displaced as to motility, as palsies and contractures, this is mostly absent; the ego behaves against these as if non-participating. In the intermittent cases and in symptoms of the sensory sphere, these sensations of pain are as a rule distinct and in the case of pain the symptoms may increase to an excessive degree. It is very difficult in this manifoldness to find the factor which makes such differences possible and which can explain them in unit fashion. Even the battle of the ego against the once formed symptom is but little in evidence in conversion hysteria. Only when the sensitiveness to pain in some region of the body has become a symptom will this be placed in position to play a double rôle. The pain symptom appears just as certainly when this locality is touched from without, as when the pathogenic situation which represents it is associatively activated from within, and the ego grasps precautionary rules in order to hold back the awakening of symptoms through external perception. Whence originates the special opaqueness of symptom formation in conversion hysteria we cannot guess, but it gives us a motive to leave promptly a field so unfertile.

We turn now to compulsion neurosis in the expectation that here we can learn more about symptom formation. The symptoms of compulsion neurosis are in general of two kinds and of opposite tendencies. They are either prohibitions, precautions, expiations—hence negative in nature—or, contrariwise, they are substitute gratifications, very often in symbolic clothing. Of these two groups the negative, defensive, punitive, is the older and with the duration of the disease the gratifications which mock at all defense take the upper hand. It is a triumph of symptom formation when it succeeds in fusing the prohibition with gratification; so that the originally defensive command or prohibition obtains the significance of a gratification; whereby often very artificial methods of combination are claimed. In this performance an inclination to synthesis shows itself which we have already conceded to the ego. In extreme cases the patient effects that most of his symptoms have acquired the exact opposite of their original significance, a testimony of the power of ambivalence, which, we know not why, plays so great a rôle in compulsive neuroses. In the crudest cases the symptom is two stage—that is, upon the action which executes a certain instruction there follows immediately a second, which abolishes the first or makes it regressive if it does not dare to carry out the opposite.

Two impressions are at once derived from this fugacious survey of compulsive symptoms. The first, which is maintained in constant warfare against the repressed which applies itself more and more to the disfavor of the repressing forces, and the second, that the ego and super-ego play a specially large part in the symptom formation.

The compulsive neurosis is probably the most interesting and most gratifying object of analytical investigation although as yet it is an unconquered problem. If we will penetrate deeply into its nature we must confess that uncertain assumptions and unproved surmises cannot yet be dispensed with. The exit situation of the compulsive neurosis is probably no other than that of hysteria, the necessary defense against the libidinous claims of the Oedipus complex. In every compulsive neurosis we seem to find a lower stratum of precociously formed hysterical symptoms. Then, however, the further formation is decidedly altered by a constitutional factor. The genital organization of the libido shows itself as weakly and too little resistant. When the ego begins its defensive striving its first result is that the genital organization (phallic phase) regresses wholly or in part to an earlier sadistic-anal stage. This fact of regression remains a determinant of all that follows. One may draw yet another possibility into consideration. Perhaps the regression is not the consequence of a constitutional but a time factor. Hence it is not endowed with power because the genital organization of the libido is weak, but because the effort of the ego is premature, set in during the bloom of the sadistic phase. I do not trust myself to make a final decision upon this point, but analytical observation is not favorable to this supposition. Rather does it show that in the turn to compulsive neurosis the phallic stage has already been reached. The time of life for the outbreak of this neurosis is also later than for hysteria (the second childhood period after the termination of the latent period) and in a case of very late development of this affection which I could cite, it was clearly shown that a real depreciation of the hitherto intact genital life created the condition for the regression and the origin of the compulsive neurosis.^[3]

The metapsychologic explanation of the regression is to be sought in a mixture of impulses, in the separation of an erotic component which appeared at the onset of the genital phase in the destructive investments of the sadistic phase.

The conquest of the regression signifies the first result of the ego in the defensive fight against the libido claims. We distinguish here the general tendency of the defense from the repression, which is only one of the defensive mechanisms. Perhaps still more clearly than in normal and hysterical cases one recognizes in the compulsive neurosis the castration complex as the motive of defense. We now find ourselves at the beginning of the latency period, which is characterized by the fall of the Oedipus complex, the creation or consolidation of the super-ego, and the erection of an ethical and esthetic shrine in the ego. These processes in compulsive neuroses go over the normal measure. For the destruction of the Oedipus complex the regressive degradation of the libido is added, the super-ego is especially rigid and unamiable, and the ego develops in obedience to the super-ego reaction pictures of conscience, sympathy and purity. With inexorable and not always successful rigidity, the temptation to the continuation of early infantile onanism is tabooed; it now leans upon regressive sadistic-anal ideas but represents the unconquered portion of the phallic organization. There is here an internal contradiction, so that in the very interest of preservation of manhood (castration fear) every activity of manhood is hindered but even this contradiction is only exaggerated in the compulsive neurosis and adheres already to the normal mode of removing the Oedipus complex. As every excess carries in itself the germ to a self-uplift, this holds good also in compulsion neuroses since the very repressed onanism forces itself in the form of compulsive actions to an ever-increasing approximation to gratification.

The reaction formations in the ego of the compulsive neurotic, which we recognize as exaggerations of the normal character, we may class as a new mechanism of defense along with repression and regression. In hysteria it seems to be absent or far weaker. Retrospectively, we gain the presumption that it is distinguished as a defense process of hysteria. It seems that it limits itself to suppression as the ego turns away from the unpleasant prompting, leaving it to its course in the unconscious and takes no further part in its fate. This cannot be entirely or exclusively correct, for we know the case where the hysterical symptom simultaneously signified the fulfilment of a demand for punishment from the super-ego; but it may describe a general character of the behavior of the ego in hysteria.

One may simply receive it as a fact that in the compulsive neuroses so strict a super-ego is formed that the fundamental trait of this affection is libido regression; and one may seek to associate it with the character of the super-ego. In fact the super-ego which springs from the It cannot withdraw itself from the regression and mixture of impulses which proceeds from the latter. It would not be surprising if it were not on its own part harder, more punitive and less amiable than when the development is normal.

During the period of latency the defense of the attempt at onanism seems to be treated as the chief task. This combat generates a series of symptoms which recur in typical fashion in the most dissimilar kinds of people and bear in general the character of a ceremonial. It is to be much lamented that these have not yet been collected and systematically analyzed; as the earliest performances of the neurosis they would shed light over the mechanism here involved in symptom formation. They already show the traits which will appear so fatally in the later severe affection; the disposal of the behaviors which later will be carried out as if automatically—going to sleep, washing, dressing, walking, the tendency to repetition and waste of time. Why this happens so is still not at all intelligible but the sublimation of anal erotic components plays a distinct rôle thereby.

Puberty makes a decisive section in the development of a compulsion neurosis. The genital organization broken up in childhood now sets in with great energy. We know, moreover, that the sexual development of childhood also prescribes the direction in the beginning of the puberty years. Hence on the one hand the aggressive promptings of the early period are again awakened, on the other hand there is a more or less large share of new libidinous stirrings—in bad cases the whole of them—which strike out paths prescribed by regression, and appear as aggressive and destructive purposes. As a result of this disguise of the erotic strivings and the strong reaction-formations in the ego, the warfare against sexuality is carried further under the ethical flag. The ego, amazed, strives against cruel and violent demands sent up by the It into the consciousness and has no inkling that it is fighting erotic wishes, among them such that otherwise would escape its own criticism. The over strict super-ego persists the more energetically in the repression of sexuality which has assumed—to it—such repulsive forms. Thus the conflict in compulsive neurosis becomes intensified in two directions—the defender is intolerant and the defended has become unendurable; both through the influence of one factor, libido regression.

One could find a contradiction against many of our presuppositions in the fact that the unpleasant compulsive idea is conscious. But there is no doubt that previously it has gone through the process of repression. In the majority the actual text of the aggressive instinct is not known to the ego. A large block of analytic labor is required to make it conscious. What gets through to consciousness is in most cases only a disguised substitute, either of a blurred, dreamy vagueness or is made unrecognizable through an absurd disguise. If the repression has not gnawed at the content of the aggressive prompting it has certainly removed the concomitant affect character. So the aggression does not appear to the ego as an impulse but, as the patient says, as a bare thought content that should leave one cold. The noteworthy fact is, however, that this is not the case.

The affect spared by the perception of the compulsive thought comes especially to view at another place. The super-ego behaves as if no suppression had taken place, as if the aggressive prompting were known to it in its proper text and with full affect character; and it treats the ego on a basis of this presupposition. The ego, which knows itself to be blameless, must feel a sense of guilt and bear a responsibility which it knows not how to explain. The riddle herewith given to us is, however, not so great as it at first seems. The behavior of the super-ego is intelligible throughout, the contradiction in the ego shows us only that it has, by means of repression, closed itself against the It while it remains accessible to the influence of the super-ego.^[4] The further question, why the ego does not seek to withdraw from the tormenting criticism of the super-ego, disposes of the fact that this really does happen in a large series of cases. There are compulsive neuroses entirely without sense of guilt; as far as we understand, the ego has spared itself the perception of the same through a new series of symptoms, expiations and restrictions to self-punishment. These symptoms signify, however, simultaneous gratifications of masochistic promptings which have likewise drawn strength through regression.

The manifold phenomena of compulsive neurosis are so great that even by much effort we have failed to give a coherent synthesis of all their variations. We have striven to make prominent the typical relations, always with the concern to survey irregularities of no less importance.

I have already described the general tendency of symptom formation in compulsive neuroses. It is to procure more room for substitute-gratifications at the expense of renunciation. The same symptoms which indicate the original limitations of the ego assume later—thanks to the indication of the ego to synthesis—those of gratification, and it is obvious that the last significance gradually becomes the more practicable. An extremely restricted ego which has shown that its gratifications are sought in the symptoms becomes the result of these processes, which approaches more and more the complete failure of the initial defensive striving. The displacement of the relations of the energy in favor of gratification can lead to the dreaded end of paralysis of will on the part of the ego, which for each decision finds almost as strong an impulse on one side as on the other. The hyper-acute conflict between the it and the super-ego which dominates the affection at the beginning and after may so spread itself that none of the arrangements of the ego, incapable of communication, can avoid being drawn into this conflict.

VI. The Undoing and Isolation Mechanisms in Compulsion Neurosis

During this conflict one may observe two symptom-forming activities of the ego which deserve particular interest because they are evidently substitutes for repression and therefore their technic and tendency can already be elucidated. Perhaps we should also understand this auxiliary and substitute technic as a proof that the carrying through of correct suppression will meet with difficulties. If we consider that in compulsive neuroses the ego is so much more the scene of symptom formation than in hysteria; that this ego holds fast tenaciously to its relationship to reality and consciousness and thereby summons all of its intellectual resources; and that the thought activity seems overfixed and erotised, such variations of suppression are perhaps brought nearer.

The two suggested technics are the undoing and the isolation. The former has a large field of application and extends far back. It is negative magic, so to speak; it does not will the consequences of an event (impression, experience) through motor symbolism but itself “blows this away.” With the choice of this last expression it is indicated what rôle this technic plays not only in the neurosis, but also in magic actions, folk customs and religious ceremonials. In the compulsion neurosis one encounters the undoing first in the two-stage symptoms where the second action abolishes the first as if it had not happened, where in reality both stages occurred. The compulsive-neurotic ceremonial has its second root in the intention of the undoing. The first is the prevention, the foresight that something definite shall not happen, not repeat itself. This distinction is easy to grasp; the precautionary measures are rational, the abolitions through undoing are irrational, magical in nature. Naturally one must suppose that this second root is the older, originating in the animistic situation to the external world. Its shading into the normal finds the attempt at undoing in the resolution to treat an event as if it had not yet happened, but then one undertakes nothing against it or bothers either with the event or its consequences; while in the neurosis one even abolishes the past and seeks to repress motivistically. The same tendency may also give the explanation of the so frequent compulsion to repetition in the neurosis, in the execution of which many intentions are found together which reciprocally antagonize one another. What does not happen in this fashion, as it should have happened in accord with the wish, is made undone in another way through repetition, where all the motives appear to tarry in these repetitions. In the further course of the neurosis the tendency is often unveiled to make a traumatic experience undone, as a symptom-forming motive of the first rank. We receive so unexpected a glimpse into a new motor technic of defense, or as we might say with a little inexactness, of repression.

The other sort of new technic to be described is that of isolation which is peculiar to compulsive neuroses. It is likewise in relation to the motor sphere and consists as follows: after an unpleasant event and also after any personal activity significant in the sense of a neurosis, a pause is interpolated in which nothing is to happen, no perception made nor action carried out. This at first strange behavior soon betrays to us its relation to repression. We know that it is possible in hysteria to allow a traumatic impression to fall into amnesia. In compulsive neurosis this does not often succeed; the experience is not forgotten but is laid bare by its affect and its associative relations are repressed or interrupted; so that it stands as if isolated and is not reproduced in the course of thought activity. The effect of this isolation is the same as in repression with amnesia. This technic is therefore reproduced in the isolation of compulsive neurosis but is also strengthened motor wise in the magic intention. What is thus held apart is exactly that which associatively belongs to it, the motor isolation is to give a guarantee for the interruption of the connection in thought. A pretext for this procedure of the neurosis is given by the normal process of concentration. What seems significant to us as an impression, as a task, is not to be disturbed through the simultaneous claims of other thought achievements or activities. But even in the normal the concentration is applied not only to the indifferent and not pertinent but before all to hold aloof the unsuitable opposite. As the most disturbing is felt what had originally belonged to it but had been torn asunder in the development of progress—for example, the expressions of ambivalence of the father complex in the relationship to God or the promptings of the excretory organs in the excitement of love. Hence normally the ego has a great task of isolation to perform in the direction of the course of thought and we know that in the exercise of the analytic technic, we must educate the ego to renounce at times this otherwise justifiable function.

We have all had the experience that it is especially difficult for the compulsive neurotic to follow the psychoanalytic principle. Probably as a result of the high tension of the conflict between the super-ego and the It the ego is more watchful, more seriously aware of its isolations. During the labor of thinking it has too much to defend, the mixture of unconscious fancies, the expression of ambivalent strivings. It dare not let itself go, and it finds itself constantly in readiness to fight. It supports this compulsion to concentration and isolation through magical acts of isolation, which as symptoms become so striking and practically so significant, but are naturally worthless per se and have the character of ceremonials.

As, however, it seeks to hinder associations, combination in thought, it follows one of the oldest and most fundamental commands of compulsion neurosis, the tabu of contact. If one puts to himself the question why the avoidance of contact and infection plays so great a rôle in the neurosis and brings such complicated systems into content, one finds the answer that contact, bodily contact, is the nearest goal both as to aggressive and tender object fixation. The Eros wishes the contact, for it strives for union and abolition of the distance between the ego and the love object. But also destruction—which before the invention of weapons used at a distance could only come from near by—must presuppose bodily contact, the application of the hand. To touch a woman is in speech usage a euphemism for her utilization as a sex object. Not to touch the penis is the text of the prohibition against autoerotic satisfaction. As the compulsive neurosis at the beginning follows the erotic contact and then after regression the contact is masked as aggression, there is nothing else to be forbidden in so high a degree, nothing so suited to become the central point of a system of prohibition. Isolation is abolition of the possibility of contact, a thing to withdraw from every contact and if the neurotic isolates even an impression or an activity through a pause, he gives us to understand symbolically that he will not allow the thoughts of it to come into associative contact with other thoughts.

So far our investigations extend into the subject of symptom formation. It hardly repays us to resume them. They are poor in result and remain unfinished; they have in fact brought us little that we did not know before. Symptom formation in other affections besides phobias, conversion hysteria and compulsion neurosis for the sake of comparison, promises nothing—too little is known of them. Even from the comparison of these three neuroses there arises a difficult task which cannot be put off. In all three the destruction of the Oedipus complex is the exit; in all, we assume, castration fear is the motif of the ego striving. But only in the phobias does such fear come to the surface, is admitted. What becomes of the fear in the two other affections, how has the ego spared itself this fear? The problem becomes more difficult when we think of the above mentioned possibility that the fear emerges in the course of disturbed libido investment by a sort of agitation. Further, does it stand fast that castration fear is the sole motif of repression (or defense)? If one thinks of the neuroses of women, one must doubt it, for as surely the castration complex may be found in them, one can hardly speak of castration fear in the proper sense if castration is already completed.

VII. A Further Consideration of Infantile Zoöphobia

Let us return to the infantile zoöphobias, for we understand them better than all of the others. Here the ego must intercede against a libidinous object investment of the It (that of the positive or negative Oedipus complex) because it has understood that to yield brings with it the danger of castration. This we have already discussed and still find occasion to clear up a doubt which remains from the first discussion. Are we to assume with little Hans (hence in the case of a positive Oedipus complex), that it is the tender emotion toward the mother, or the aggressive one against the father which produces the defense of the ego? Practically this seems indifferent, especially as the two promptings condition each other, but a theoretic interest associates itself in the question because only a tender current toward the mother can count as purely erotic. The aggressive is essentially dependent on the destructive impulse and we have always believed that in the neurosis the ego defends itself against the claims of the libido, not of the other impulses. We see in fact that in the formation of the phobia the tender mother association has vanished and is radically removed through repression, while the symptom (substitute) formation has completed itself with the aggressive prompting. In the case of the wolf man the matter is more simple, the repressed prompting is actually an erotic one, the feminine situation to the father, and with this completes itself in the symptom formation.

It is to be deplored that after so much work we find still further difficulties in the comprehension of the fundamental relations, but we have undertaken to simplify nothing and to conceal nothing. If we could not see clearly we would at least see keenly the obscurities. That which stands in our way here is evidently a lack of symmetry in the development of our knowledge of the impulses. First, we had the organization of the libido from the oral past, the sadistic-anal to the genital, and hereby ranked these components of the sex impulse equally. Later it appears to us that sadism is the representative of another, the impulse opposite to Eros. The new comprehension of the two groups of impulses seems to rupture the former construction of the successive phases of libido organization. But we do not need to discover anew the helpful information from these difficulties, for these have long been tendered us and mean that we hardly ever have to do with pure impulses but always with the alloys of both impulses in varying proportions. The sadistic object investment also has a claim to be treated as libidinous; the organization of the libido does not need to be revised, the aggressive prompting against the father can with the same claim be the object of repression as the tender one for the mother. In any case we place the material for later discussion of this possibility to one side, for repression is a process which has a particular relation to the genital organization of the libido. The ego grasps after other modes of defense when it must defend itself against the libido at other stages of organization, and we proceed. A case like that of little Hans permits us no decision; here an aggressive prompting is removed by repression but only after the genital organization has already been reached.

This time we will not allow the relation to fear to escape our attention. We said that as the ego recognizes the danger of castration it gives the fear signal and by means of the pleasure-pain principle inhibits in a manner not understood the threatening investment process in the It. Simultaneously the phobia formation is completed. The castration fear receives another object and a disguised expression (bitten by a horse, devoured by a wolf in place of being castrated by the father). The substitute formation has two manifest advantages, first, that it evades an ambivalent conflict, for the father is at the same time an object of love; and second, that it permits the ego to stop the development of fear. The fear in the phobia is especially a facultative one and appears only when its object is the subject of perception. This is entirely feasible, for only then is the fear situation at hand. From an absent father one need not fear even castration. Now when one cannot get the father out of the way the fear always shows itself and when it will. If the father is replaced by an animal, he needs only a glimpse, can keep out of the animal’s way and thus be free from danger and fear. Little Hans contracted his ego and produced an inhibition; he would not go out in order not to see horses. The little Russian had it still more convenient. It was hardly any self denial for him to avoid taking up a certain picture-book. If his bad sister did not hold up before him this image of the wolf he could feel secure from this fear.

I have formerly ascribed to fear the character of a projection, as I replaced an internal prompting of danger by an external perceptive danger. This brings the advantage that man can protect himself against external danger by flight and by avoidance of the perception, while flight cannot protect from an internal danger. My observation was not faulty but it remains superficial. The impulse is not a danger in itself but only because it brings with it a true external danger, that of castration. So at the basis of a phobia one external danger is replaced by another. That the ego in a phobia can withdraw the fear by flight or inhibition agrees very well with the notion that fear is an affect signal only and that the economic situation is not really changed.

The fear in a zoöphobia is also an affective reaction of the ego to danger; the danger which is signalled being that of castration. There is no other difference from ordinary fear which the ego expresses in danger situations save that the content remains unknown and is made conscious only by disguising it.

The same comprehension will, I believe, hold good for the fears of adults even if the material which the neurosis elaborates is much more abundant and there are additional factors in symptom formation. At bottom it is the same thing. The agoraphobe lays a limitation on his ego in order to escape a danger from impulse. The danger lies in the temptation to yield to his erotic desires, as a result of which he again as in childhood, conjures up the fear of castration or something analogous. As an example I cite the case of a young man who became an agoraphobe because he feared he would yield to the attractions of prostitutes and catch syphilis as a punishment.

I well know that many cases show a complicated structure and that many others can empty repressed promptings into a phobia, but these are only auxiliary and have for the most part set themselves at a later period in association with the nucleus of the neurosis. The symptoms of agoraphobia become complicated thereby, so that the ego does not content itself with renouncing something; instead it adds something to deprive the situation of danger. This addendum is usually a regression into child years (in extreme cases into the uterus, into the time in which it was protected from the dangers which now menace it) and appears as a condition under which renunciation can be omitted. Hence the agoraphobe can walk the streets when, like a little child, he is accompanied by some one in whom he confides. The same regard may also permit him to go out alone when he does not exceed a certain distance from his home and does not go into neighborhoods which are unfamiliar to him and where he is unknown to people. In the choice of these determinants he shows the influence of infantile factors which dominate him through his neurosis. Quite unequivocal but without the element of infantile regression is the fear of being alone, which is founded on the fear that one will yield to the temptation of solitary onanism. The condition of infantile regression is naturally the chronological removal from childhood.

The phobia as a rule originates when under certain circumstances—on the street, on the railway, when alone—a first attack of fear is experienced. Fear is then banished but invariably asserts itself when conditions of protection cannot be controlled. The mechanism of the phobia does good service as a means of defense and shows a great inclination to stability. A continuation of the defensive fight, which is now directed against the symptom, often but not necessarily enters.

What we have learned about fears in connection with phobias remains of utility in the compulsive neuroses. It is not difficult to reduce the situation of the compulsive neurosis to that of a phobia. The motif of all later symptom formation is evidently the fear of the ego of its super-ego. The hostility of the super-ego is the danger situation from which the ego must withdraw itself. Here there is no sign of a projection, the danger is throughout interiorized. But if we ask ourselves what the ego fears from its super-ego, the notion is forced upon us that the punishment of the latter is a continuation of the castration punishment. As the super-ego is really the father who has been depersonalized, so the fear of the threatened castration by the father becomes transformed into indefinite social fears, of fear of conscience. But this fear is hidden, the ego withdraws itself from it while at the same time it carries out the commands, precautions and expiations laid upon it. When it is prevented there develops an extremely penible discomfort which to the patient is the equivalent of fear. Hence our result runs as follows: Fear is a reaction to the danger situation and is spared if the ego does something to avoid the situation or withdraw from it. One might say that the symptoms are created in order to avoid dangerous situations which are signalized by fear development. This danger in the cases hitherto discussed was the danger of castration or of something derived from it.

If fear is the reaction of the ego to danger, we come nearer to comprehending the traumatic neurosis which so often follows an experience with danger to life as a direct consequence of life-fear or death-fear with setting aside of the dependencies of the ego and of castration. This has happened in connection with most of the observers of traumatic neuroses during the last war, and it was triumphantly announced that now we have proofs that imperilling the impulse to self-preservation can cause a neurosis without any participation of sexuality and without regard to the complicated assumptions of psycho-analysis. It is, in fact, extremely unfortunate that there is not a single utilizable example of an analysis of a traumatic neurosis. Not because of the contradiction of the etiological significance of sexuality—for this has long ago been abolished by the introduction of narcism which brings the libidinous fixation of the ego in a series with the object investments and emphasizes the libidinous nature of self-preservation—but because through the absence of these analyses we have neglected a most valuable opportunity to draw decisive conclusions over the relation between fear and symptom formation. From all that we know of the structure of the simpler neuroses of daily life it is highly improbable that a neurosis can occur only through the objective fact of peril without participation of the deeper unconscious strata of the psychic apparatus. In the unconscious, moreover, there is nothing at hand which can give content to our conception of the destruction of life. Castration can be visualized through the daily experience of parting with the intestinal contents and through the loss of the maternal breast through weaning; but anything like death has never been experienced, or if so, like a swoon, has left no trace behind which could be demonstrated. Therefore I hold fast to the supposition that death-fear is to be comprehended as an analogue of castration fear and that the situation upon which the ego reacts is the abandonment by the protecting super-ego—the power of fate—whereby the assurance against all danger has an end. Besides, there comes into consideration that in the experiences which lead to traumatic neurosis external protection from irritation is broken through and over-large quantities of excitation appear in the psychic apparatus; so that the second possibility is present that not only does fear fail to signalize the affect but the situation is newly generated from the economic conditions.

Through the last remark that the ego through its regularly repeated loss of objects is prepared for castration, we have obtained a new conception of fear. Having regarded it hitherto as the affect signal of danger, it now appears to us often in connection with castration danger as the reaction to a loss, a separation. While many things may speak against this conclusion, as is at once apparent, a very noteworthy agreement must strike us. The first fear experience of mankind is birth, and this signifies objectively separation from the mother, which may be likened to castration of the mother (according to the equation child equals penis). Now it would be very gratifying if fear should be repeated at every subsequent separation as a symbol of separation; but unfortunately another valuation of this agreement stands in the way, for subjectively birth is not experienced as a separation from the mother, for to the narcistic fetus the mother is quite unknown as a separate object. Another consideration will be that the affect reaction to a separation is known and that we feel pain and grief but not anxiety or fear. Indeed, we recall that we have not understood why grief should be so painful.

VIII. An Analysis of Fear

It is time to reflect. We seek obviously for insight into the nature of fear, for an “either—or” which will separate truth from error. This, however, is difficult, for fear itself is not easily comprehended. Hitherto we have attained nothing but contradictions between which no choice is possible. I now propose something different. Without bias we will assemble everything which may be said of fear and at the same time give up the expectation of a close synthesis.

Fear or anxiety in the first place is something felt and we call it an affective state, although we do not know what an affect is. As a feeling it obviously is of the painful type but this does not exhaust its quality. Not every painful sensation is fear, for there are others (tensions, pain, grief), so that as a painful quality fear must have something special. We may ask: Is it possible to comprehend differences between these various painful affects? From the sensation of fear we can always deduce something. Its pain has a special note and while we cannot prove this it is probable and would not be striking. From this peculiar quality so difficult to isolate we note the fear of certain somatic sensations which we refer to different organs. We are not interested here in the physiology of fear and will be satisfied to isolate individual representatives of this sensation and the most frequent and evident have to do with the respiratory organs and the heart. They are to us proofs that the motor innervation (discharge processes) take part in the totality of fear. Hence the analysis of the fear stage gives us (1) a specific pain character; (2) a discharge reaction; and (3) perception of the same. Points 2 and 3 at once give us a distinction between fear on the one hand and grief and pain.

In the two latter there is no motor expression; where they are at hand they separate themselves distinctly not as constituents of the whole but as consequents or reactions. Fear is then a special state of pain with discharge reactions along definite paths. According to our general views we shall believe that fear is based on increased excitation which on the one hand gives it its character of pain and on the other relieves itself through discharge. But this purely physiological comprehension will hardly suffice. We are tempted to assume the existence of a historical factor which unites the sensations with the innervations. In other words, the state of fear is the reproduction of an experience which contains the conditions of an increase of irritation and leads off along certain paths whereby the pain of fear receives its specific character. As such a visualized experience birth in mankind presents itself, and therefore we are inclined to see in a fear state a reproduction of the birth trauma.

At the same time we have not maintained that fear is an exception in this respect as compared with other affective states. We believe that other affects are also reproductions of old experiences which are important to life and perhaps preindividual, and we adduce them as general, typical, congenital hysterical attacks in comparison with late and individually acquired attacks of hysterical neurosis, the genesis and importance of which have through analysis become distinct. Naturally it would be very desirable to be able to carry this notion out for a series of other affects in a demonstrable fashion but at present we are far removed from this prospect.

Reference of fear back to the birth trauma must defend itself against objections which are close at hand. Fear is probably a reaction experienced by all animals although only the mammals experience labor and it is questionable whether the latter is a trauma with them. There is therefore fear without the prototype of birth. But this objection is outside the limits between biology and psychology. Just because fear has a biologically indispensable function to fulfil, as a reaction to the condition of danger it may be arranged in different fashions for different creatures. We do not therefore know whether in the creatures far removed from man there is the same content in sensations and innervations as in mankind. This does not, however, prevent fear from being a prototype of the birth process in man. If this be the structure and origin of fear, a further question is, What is its function? Under what circumstances is it reproduced? The answer seems near at hand and convincing. Fear is a reaction to a state of danger and is reproduced regularly when such a state reappears.

There is something else to note. The innervation of the original fear state was probably characterized by feeling and was purposeful, quite as with the muscle actions of the first hysterical attack. If one would explain the hysterical attack one need only to seek the situation in which the movements concerned were part of an authorized action. So probably during labor the direction of the innervation upon the respiratory organs prepares the activity of the lungs, the acceleration of the heart-beat works against the poisoning of the blood. This efficiency naturally fails in the later reproduction of the fear state as an affect, as it is also missed in the repeated hysterical seizure. If, then, the individual engages in a new situation of danger it can readily become unsuitable to answer by a fear state, the reaction to a former danger, in place of that of the now adequate reaction. The utility again appears when the danger situation is recognized as approaching and as signalized by the outbreak of fear. The fear can then be disposed of through suitable measures. Hence two possibilities separate themselves in the appearance of fear: one, unsuitable, in a new situation of danger, and the other suitable for signalling and preventing danger.

But what is a danger? In the act of birth there exists an objective danger to the preservation of life; we know what it imports in reality, but psychologically it tells us nothing. The danger from birth has as yet no psychic content. We certainly may not presuppose that the fetus has any kind of knowledge that it is in danger of annihilation. The fetus can do no more than perceive a wholesale disturbance in the economy of its narcistic libido. Large quantities of excitations penetrate to it and generate a new series of unpleasant situations; many organs are forced to heightened fixations constituting a prelude to the soon to begin object-investments. What among these find evaluation as a characteristic of a danger situation?

Unfortunately we know far too little of the psychic comprehension of the new-born to answer this question directly. I cannot even concede the utility of the above depiction. It is easy to say that the new-born will repeat the fear affect in all situations which recall to it the event of birth. However, the decisive point remains, what is recalled, and how.

Hardly anything remains but to study the occasions in which the nursling or older child shows itself to be prepared for fear. In his book on the birth trauma, Rank^[5] makes an energetic effort to demonstrate the relations of the earliest phobias of the child to the impression of the event of birth, but I do not regard this as fortunate.

One may make two objections to this view: First, that it rests on a presupposition that the infant has definite sense impressions, especially those of a visual nature, received during birth and renewed in memory of the birth trauma, thus producing the fear reaction. This assumption is fully unproved and devoid of probability, and it is not credible that the child at birth has anything beyond tactile and general sensibility. If it later shows fear of small animals as they vanish into holes or emerge from the same, Rank explains this reaction through the perception of an analogy which, however, could not become striking to a child. Second, Rank, in the evaluation of this later fear situation according to the requirement of the recollection of the happy intrauterine life or of its traumatic interruption, leaves the door open to any kind of arbitrary interpretation. Individual cases of child fear are directly opposed to the application of Rank’s principle. If the infant is brought into darkness and solitude we should expect that it would accept this restoration of the intrauterine situation as gratification. If the fact that it reacts to this very situation with fear is referred back to the recollection of the disturbance of its happiness by birth one can no longer ignore the forced character of the interpretation.

I must draw the conclusion that the earliest child phobias do not permit of a direct transference to the impression made by the act of birth, and thus far they have withdrawn themselves from explanation. A certain predisposition to fear is unmistakable in the nursling. It is not at its worst directly after birth, to decrease slowly, but appears during psychic evolution and persists through a certain period of childhood. When such early phobias extend beyond this period they awake the suspicion of a neurotic disturbance, although their relationship to the later distinct neuroses of childhood is obscure.

Only a few cases of the expression of child fear are intelligible to us and we must limit ourselves to them. When the child is alone, in the dark, and when it finds a stranger in place of its mother, all three states reduce themselves to one condition, absence of the loved and longed for person. But from here on the way to understanding fear and to reconciling the contradictions which seem associated, is free.

The memory picture of the person longed for is certainly intense, probably at first hallucinatorily fixed. But this has no consequence and now it appears as if this longing changes to fear. There is exactly the impression as if this fear is the expression of perplexity, as if the undeveloped creature knew nothing better than to start with this yearning fixation. The fear appears as a reaction to missing the object and there is forced on us the analogy that castration fear has also the content of separation from a highly prized object and that the original fear (the primary fear of birth) arises from separation from the mother.

The next consideration leads to the emphasis of the loss of the object. If the nursling longs to behold the mother it is only because it knows from experience that she satisfies all its requirements without delay. The situation which it evaluates as fear and against which it would be assured is one of unsatisfaction, the increase in the requirement tension, against which it is powerless. I mean that from this point of view on, everything is arranged; the situation of unsatisfaction attains a painful height from the mass of stimulus and does not find itself overmastered by psychic employment or discharge. For the nursling this must be analogous to the experience of birth, the repetition of the danger situation. Common to both is the economic disturbance through the increase of the mass of stimulation demanding discharge.

This factor is the essential nucleus of the danger. In both cases the fear reaction appears, having shown itself already in the nursling as useful, since the direction of the discharge upon the respiratory and vocal musculature summons the mother, just as formerly the lung activity did away with internal irritation. From its birth the child does not need to maintain more than this characterization of danger.

With the experience that an external object comprehended through perception can make an end to the dangerous warning situation, the content of danger now displaces itself from the economic situation to its condition, the loss of the object. To miss the mother is now the danger at the appearance of which the child gives the fear signal, even before the economic situation has appeared. This transformation signifies the first great advance in the impulse toward self-preservation and at the same time it includes the transition from the automatically unwilled new origin of fear to its intentional reproduction as the signal of danger.

In both respects, as an automatic phenomenon and as a rescuing signal, fear shows itself as the product of the psychic helplessness of the nursling which is the self-evident counterpart of its biological helplessness. The striking coincidence that birth fear as well as nursling fear recognize the condition of separation from the mother needs no psychological explanation. It is explained biologically simply enough from the fact that the mother has soothed all the demands of the child before birth and partly continues to do so after delivery. Intrauterine life and earliest childhood represent far more of a continuum than the striking censure of the act of birth allows us to believe. The psychic mother-object replaces to the child the biological fetal situation. We must therefore not forget that in intrauterine life the mother was no object and that at that time there was no object.

It is easily seen that in this connection there is no room for reacting off the birth trauma and that another function of fear as a signal for avoiding danger is not to be found. The fear condition of the loss of the object carries us still further. The next transformation of fear, the castration fear which develops in the phallic phase, is a fear of separation bound to the same condition. The danger here is separation from the genitals. A thought train from Ferenczi which seems fully justified allows us to recognize distinctly the line of the connection with the former content of the danger situation. The high narcistic valuation of the penis can rest on this, that the possession of this organ contains the danger of a reunion with the mother (mother substitute) in the act of coitus. Deprivation of this member is as good as a fresh separation from the mother, thus again indicating an unpleasurable requirement tension (as in birth) to be delivered helpless. This requirement, the increase of which is feared, is, however, only a specialized one, that of the genital libido, and is no longer an optional one as in the nursing period. I add here that the fancy of return within the mother’s womb is the substitute coitus of the impotent (inhibited by the castration threat). In Ferenczi’s sense one may say that the individual who will allow himself to represent the return into the womb with his genital organ, replaces this organ regressively by his entire person.

The progress in the development of the child, the increase of its independence, the acute separation of his psychic apparatus in several instances, the appearance of new needs cannot remain without influence on the content of the danger situation. We have followed this transformation from the loss of the mother object to castration and see the next step caused by the might of the super-ego. With the depersonalization of the parental instance, from which one fears the castration, the danger becomes more definite. Castration fear develops into conscience fear and social fear. It is now no longer easy to say what is feared. The formula of separation, exclusion from the herd, applies only to that later portion of the super-ego which has developed from leaning upon social prototypes, and not to the nucleus of the super-ego, which corresponds to an introjected parental instance. More generally expressed, it is the anger, the punishment of the super-ego, the loss of love from that side which the ego values as danger and answers with the fear signal. As the last transformation of this fear of the super-ego is the fear of death (life), fear of the projection of the super-ego into the power of destiny as it appears.

Formerly I placed a certain value on the presentation that it is the fixation withdrawn in repression which the application experiences as conducting off the fear. This view now seems to me hardly worth while. The difference lies here, that formerly I believed that fear always arose automatically through an economic process, while the present conception of fear as a signal intended to influence the pleasure-pain factor makes us independent of this economic compulsion. There is, of course, nothing to be said against the assumption that the ego utilizes this very energy which is set free in the diversion of repression to arouse the affect, but it becomes unimportant with what portion of the energy this takes place.

Another proposition which I have expressed now demands retesting in the light of our new comprehension. This is the assertion that the ego is the actual seat of fear.

In my opinion this will be shown to be correct. We have no occasion to impute to the super-ego any kind of an expression of fear. If, however, one speaks of a fear of the It there is no contradiction implied but one must correct a clumsy expression. Fear is an affective state which naturally can be felt only by the ego. The It cannot have fear like the ego; it has no organization and is unable to judge a danger situation. On the other hand, it is a frequent occurrence for processes to be prepared or completed in the It which give occasion to the ego for the development of fear. In fact, the probably earliest repressions with the majority of the later ones are motivated through fear of the ego towards individual processes in the It. We differentiate here, again with good reason, the two processes which occur in the It. One activates the danger situation for the ego and moves it to give the fear signal for inhibition; and the other prepares in the It a situation analogous to the birth trauma, in which it comes automatically to a fear reaction. The two are brought nearer to each other when one emphasizes that the second corresponds to the first and original danger situation; the first, however, is one of the later ones derived from its fear conditions. Or, referred to affections which actually occur, that the second process is realized in the etiology of the actual neuroses while the first remains characteristic for the psychoneuroses.

We now see that we do not need to depreciate former communications but merely to bring them into association with the more recent. It is not to be denied that in abstinence, or abusive disturbance in the course of sexual excitement, resulting in a diversion of the same from its psychic elaboration, fear may originate directly from the libido; that is, that condition of helplessness of the ego against an over great requirement tension is produced, which as in birth proceeds from fear development. We see that upon the foundation of these actual neuroses psychoneuroses may easily develop; that is to say, the ego makes an effort to spare the fear, which it has learned to keep for a time in suspense and bind it by symptom formation. Probably analysis of the traumatic war neuroses, which term indeed comprises very different affections, would show that a number of these share the characteristics of actual neuroses.

As we presented the development of the different danger situations from the original birth prototype, it is far from our intention to maintain that every later fear condition merely sets the predecessor out of power. The progress of ego development contributes indeed to the depreciation of the former fear situation and shoves it aside, so that one may say that a certain fear condition must be assigned as adequate to a definite age of development. The danger of psychic helplessness fits in with the time of life of the immaturity of the ego, just as the danger of loss of the object belongs to the early years of childhood, the castration danger to the phallic stage, and fear of the super-ego to the period of latency. But it can also happen that all these danger situations and fear conditions coexist side by side and can cause the ego to react with fear at periods later than those adequate or that several of them may step into activity simultaneously. Possibly closer relations may exist between the actual danger situation and the form of the subsequent neurosis.^[6]

In an earlier portion of these investigations we came upon the importance of the castration danger in more than one neurotic affection, and we imparted the warning not to overemphasize this factor, for it might not work out in the neuroses to which women are known to be more predisposed. We now see that we are not in danger if we explain castration fear as the sole motif for the defensive processes which lead to the neurosis. In another place I have explained how the development of the little girl is directed by the castration complex to a tender object fixation. It is exactly in women that the danger situation of the loss of the object appears to be the most efficacious. We may adduce the small modification in their fear condition, that it is no longer a matter of missing or of the real loss of the object but of the loss of love by reason of the object. As it is certain that hysteria has a great affinity for femaleness as the compulsive neurosis has for maleness, the presumption would be that the fear condition of the loss of love plays a rôle in hysteria which is analogous to that of castration threat in the phobias, and the fear of the super-ego in the compulsive neuroses.

IX. The Relation Between Symptom Formation and Fear Development

What now remains is the treatment of the relations between symptom formation and fear development. Two opinions on this point seem widely diffused. The first calls the fear itself a symptom of the neurosis, the other believes in a much more intimate relation between the two. According to this, all symptom formation is undertaken in order to escape fear; the symptoms bind the psychic energy that otherwise would be led off as fear, so that fear is the basic phenomenon and chief problem of the neurosis.

The at least partial justification of this second view is shown by striking examples. When one has accompanied an agoraphobe into the street and then leaves him to himself he produces in him an attack of fear. If one hinder a compulsive neurotic from washing his hands after a contact, he becomes the prey of an almost unbearable fear. It is therefore clear that the conditions of being accompanied and of washing had the intention and also the result of preventing fear.

In this sense every inhibition which the ego lays on itself may be called a symptom. As we have referred the fear development to the danger situation we would prefer to say that the symptoms have been formed to withdraw the ego from the danger situation. If symptom formation is prevented the danger actually appears, that is, a situation results which is analogous to birth, in which the ego finds itself helpless against the constantly growing claim of the impulse—the earliest and most primitive of the fear conditions. For our view the relationship between fear and symptom is less close than has been assumed because we have interpolated between the two elements the danger situation. We might add supplementarily that fear development introduces symptom formation, yes, that it is a necessary presupposition of the same; for if the ego would not arouse the pleasure-pain factor by fear development, then it would not obtain the power of holding back the danger threatening process prepared in the It. Here the tendency is unmistakable of limiting itself to the smallest mass of fear development, to use fear only to give the signal; otherwise one would obtain the pain which is threatened by the impulse process but would feel it only where there would be no result according to the intention of the pleasure principle, which, however, happens often enough in the neuroses.

The symptom formation, then, has the actual result of abolishing the danger situation. It has two sides, one which is hidden from us and prepares in the It that alteration by means of which the ego is withdrawn from danger, while the other, turned toward us, shows what is created at the place of the influenced impulse process—the formation of the substitute.

We should, however, express ourselves more correctly if we ascribed to the defensive process what we have just said of the symptom formation and apply the term symptom formation as a synonym of substitute formation. It now seems clear that the defensive process is analogous to flight, through which the ego withdraws itself from danger which threatens from without, that it represents an attempt at flight from an impulse danger. The criticisms against this comparison will aid us in a further explanation. First let it be objected that loss of the object (loss of love in connection with the object) and the threat of castration are likewise dangers which threaten from without, like a beast of prey, hence not danger from impulses. But the case is not the same. The wolf will probably attack us wherever we may happen to encounter him; but the beloved person will not withdraw love and castration will not menace us if we do not nourish within us definite feelings and intentions. So if these instinct stimuli become conditions of external danger and thereby themselves dangerous we can combat the external danger by measures against internal dangers. In the zoöphobias the danger seems to be felt as a purely external danger and also in the symptom there is experienced a displacement externally. In the compulsive neurosis the danger is far more interiorized, the share of the fear of the super-ego, the social fear, is represented by an internal substitution for an external danger, while the other share, the fear of conscience, is throughout endopsychic.

A second objection is that in attempt at flight from a threatened external danger we do nothing more than increase the space between us and the danger. We do not place ourselves in defense against the danger, do not seek to change anything in the same, as in the other cases, when we charge on the wolf with a cudgel or shoot at him with a gun. The defense process, however, seems to do more than what corresponds to flight. It attacks the threatening course of the process, somehow represses it, diverts its aim and thereby renders it powerless. This objection seems absolute, we must take it into account. We think it would be as if there were defense processes which one could with justice compare to an effort at flight, because the ego defends itself much more actively in others and undertakes energetic counter-efforts. If the comparison of the defense with flight is not disturbed through the circumstance that the ego and the It impulse are parts of the same organization, not detached instances like the wolf and the child, every kind of behavior of the ego must influence the impulse process to change it.

Through the study of fear conditions we must look at the behavior of the ego in defense in a so-to-speak rational clarification. Every danger situation corresponds to a certain period of life or phase of development of the psychic apparatus and seems justified for it. The early child nature is actually not equipped to master psychically the large quantities of excitation which reach it from without. At a certain period of life it is actually of the most importance that the persons on which it depends do not withdraw their tender care. When the boy feels the powerful father as his rival for the mother, becomes aware of his aggressive inclinations against him and his sexual intentions toward the mother, he has the right to fear him and the fear of punishment can through phylogenetic strengthening be expressed as castration fear. With his entry into social relations fear of the super-ego, conscience, necessity, the omission of these factors, become the source of severe conflicts and dangers. But just here a new problem is added. Suppose we attempt to replace for a time the fear affect through another, the pain affect. We hold it as normal throughout that the girl of four years cries painfully when she breaks her doll, at six years when her teacher rebukes her, at sixteen when her sweetheart loses interest in her, at twenty-five when she buries her child. All of these pain conditions have their time relationship and afterwards become void, except the last which persist through life. It would startle us if the girl as wife and mother would weep over damage to some trifle, although the neurotic behaves in just this way. In their psychic apparatus all instances for the mastery of irritation have long been completed within wide limits; they are sufficiently grown up to be able to satisfy most of their needs; they have long known that castration is no longer utilized as a punishment, nevertheless they behave as if the old danger situations still persist, and hold fast to all former fear conditions.

The answer to this will turn out to be somewhat prolix. It will above all have to sift the facts. In a large number of cases the old fear conditions will actually fall out after they have caused neurotic reactions. The phobias of little children—of being alone, darkness and strangers, which may be termed almost normal—mostly pass off in later years and are outgrown, as we say of many other disturbances of childhood. The so numerous animal phobias have the same fate, and many of the conversion hysterias of childhood years find no later continuity. Ceremonial in the latent period is an uncommonly frequent occurrence; only a very slight percentage of these cases develop later into a full compulsion neurosis. The child neuroses—as far as our experience extends among the city children of the white race which is subjected to the high requirements of culture—are regular episodes of development although there is still too little attention granted them. One misses the signs of childhood neurosis not at all in an adult neurotic, while by no means do all of the children who show them become neurotics later. Hence in the course of ripening, fear conditions must be given up and danger situations have lost their significance. Moreover, it happens that some of these danger situations preserve themselves in later times so that their fear condition is modified with time. In this way castration fear is preserved under the mask of syphiliphobia after one has experienced that castration is no longer the punishment for allowing full play to sexual lusts although freedom of impulse threatens severe affections. Other fear conditions are not especially doomed to perish but accompany man through life, as fear of the super-ego. The neurotic is differentiated from the normal by the fact that he immoderately heightens the reaction to these dangers. Again, no sufficient protection is offered even to adulthood that the original traumatic situations may not return; there should be a limit for every man beyond which his psychic apparatus fails to master the disposal of the importunate amounts of excitation.

These small corrections cannot possibly have the determination to shake the fact that is here discussed, the fact that so many individuals remain infantile in their behavior to danger and do not overcome ancient fear conditions. To dispute this would be to deny the fact of neurosis, for such persons are called neurotics. But how is this possible? Why are not all neuroses episodes of development which are concluded with the attainment of the next phase? Whence the element of permanence in these reactions to danger? Whence the advantage which the fear affect seems to enjoy over all other affects that it alone calls forth reactions which separate themselves as abnormal from the others and oppose themselves as unsuitable to the stream of life? In other words we unexpectedly find ourselves once more in the presence of the so often put vexed question, whence comes the neurosis, what it its final, its special motif? After decades of analytical investigation this problem looms before us, as unsolved as in the beginning.

X. Theoretical Considerations of the Birth Trauma

Fear is the reaction to danger. However, one can not reject the idea that it is connected with the nature of danger if the fear affect can force an exceptional situation in the psychic economy. But dangers are in general human and the same for all individuals; what we need and do not have at our disposal is a factor which makes intelligible to us the selection of the individual who can subject the fear affect despite its strangeness to the normal psychic management, or determines who must fail at this task. I see before me two efforts to uncover such a factor; it is comprehensible that all such efforts may expect a sympathetic reception for they promise redress for a tormenting need. Both of these attempts supplement each other because they attack the problem from opposite sides. The first was undertaken more than ten years ago by Alfred Adler, who maintained—reduced to its inmost nucleus—that in those individuals who are unable to master the task imposed by danger, their organ inferiority makes the difficulties too great. If the maxim simplex sigillum veri is true one must greet such a solution as a redemption. But on the contrary the criticism of the past decade has proven conclusively the complete insufficiency of this explanation, which moreover puts itself outside of the entire superstructure of facts uncovered by psychoanalysis.

The second essay was undertaken in 1923 by Otto Rank in his book “The Birth Trauma.” It would be unjust to place it on a par with Adler’s effort save in the connection made above, for it rests on the foundation of psychoanalysis and continues its course of thought and should be recognized as a legitimate effort toward the solution of the analytic problem. In the relation given between the individual and danger, Rank diverts from the organ weakness of the individual and towards the variable intensity of the danger. Birth is the first danger situation and the economic disturbance produced by it is the prototype of the fear reaction. We have already followed the line of development which unites this first danger situation and fear condition with all later ones and have seen that all preserve something in common, for all in a certain sense indicate separation from the mother—at first only in a biological respect, later in the sense of the direct loss of the object, and finally in the indirect loss of the same. The discovery of this great association is the undisputed service of the Rank construction. Now the birth situation concerns the individual with a difference in intensity; with the severity of the trauma there is a variation in the violence of the fear reaction and, according to Rank, the initial volume of the fear development should determine whether the individual will or will not acquire mastery—whether he is to become normal or neurotic. The criticism of the whole Rank conception is not our task here—only the test of its utility for the solution of our problem. The formula of Rank’s that neurotics are those who cannot react off the over-strong birth trauma is in theory vulnerable in a high degree. We do not know just what is meant by the reacting off of a trauma. If understood literally one comes to the untenable conclusion that the neurotic is the nearer well the more frequently and intensely he can reproduce the fear affect. Because of this contradiction with reality I have in due course given up the theory of reacting off which plays so great a rôle in catharsis. Emphasis of the variable strength of the birth trauma leaves no room for justifiable etiological claim of the hereditary constitution. This is, of course, an organic factor which behaves toward the constitution as a contingency, and is itself dependent on many influences which may be called contingent, as from timely assistance in labor.

The Rank doctrine has left constitutional as well as phylogenetic factors out of consideration altogether. If one will prepare space for the significance of the constitution, perhaps through a modification of the same, it would be much more to the point to know how prolifically the individual reacts to the variable intensity of the birth trauma. Thus one deprives the theory of its significance and restricts the newly introduced factor to an accessory rôle. The decision as to the fate of the neurosis lies, then, in another and again an unknown territory.

The fact that mankind has the birth process in common with other mammals and at the same time has the preference of a particular disposition to neuroses over the other mammals will hardly attune favorably with the Rank theory. The chief objection, however, remains that it is in the air and does not rest on an assured foundation. There have been no good studies as to whether severe and protracted labor coincides unmistakably with the development of neurosis and if children thus born show the phenomena of early infantile fears longer or more strongly than others. If one could show that precipitate labors which were easy for the mother might possibly possess the significance of severe traumas for the child, the demand would still remain that labors which lead to asphyxia must allow the alleged consequences to be recognized with certainty. It appears an advantage to the Rank etiology that it supplies a factor which is accessible to testing with the material of experiment, but as long as such a trial has never yet been actually undertaken it is impossible to judge of the value.

On the other hand I cannot join in the opinion that the Rank theory opposes the etiological significance of the sexual impulse hitherto recognized in psychoanalysis; for this refers only to the relation of the individual to the danger situation and fortunately leaves open the supposition that whoever cannot master the original dangers must also fail in the later developing sexual situations and thereby be forced into a neurosis.

I therefore do not believe that the Rank essay has brought to us the answer to the question of the foundation of the neurosis and I think it cannot yet be decided, no matter how great the contribution to the subject it may comprise. If the investigations over the influence of severe labor on the disposition to neurosis fall out negative, this contribution must be valued but slightly. It is to be lamented that the need for a tangible and uniform final cause of nervousness still remains unsatisfied. The ideal case after which the physician probably longs to-day should be the bacillus which can be isolated and cultured pure and of which inoculation into a given individual will cause the disease in question. Or, to be less fanciful, the presentation of a chemical substance the exhibition of which may both produce and abolish definite neuroses. But probability speaks against such solutions of the problem.

Psychoanalysis leads to less simple and less satisfactory information. I have here to repeat only what has long been known and have nothing new to add. If the ego succeeds in protecting itself against a dangerous impulse, for example, by the process of repression, it has indeed inhibited and injured this portion of the It but has at the same time given up a portion of its own independence and renounced some of its own sovereignty. This follows from the nature of repression which is an attempt at flight. The repressed content is now “free as a bird,” excluded from the great organization of the ego, subjected only to the laws that reign in the realm of the unconscious. If the danger situation alters, so that the ego has no motif to repel a new impulse analogous to the repressed content, the consequences of the ego limitation are obvious. The course of the more recent prompting completes itself under the influence of automatism—I prefer to say of the compulsion to repetition—it wanders the same way as the former repressed content as if the conquered danger situation still persisted. The fixing factor of the repression is therefore the repetition compulsion of the unconscious It which normally is abolished only by the freely mobile function of the ego. Now it may at times succeed to the ego to recapture the repression which it itself had arranged and to regain its influence over the prompting and to direct the course of the new prompting in the direction of the altered danger situation. The fact is that this so often fails of success, that it cannot make its repressions regressive. Quantitative relations may be authoritative for the outcome of this combat and in many cases we gain the impression that the decision is compulsive; the regressive attraction of the repressed instinct and the strength of repression are so great that the more recent prompting can only follow the repetition compulsion. In other cases we perceive the contribution of another play of force; the attraction of the repressed prototype is fortified through repulsion from the side of the actual difficulties which are opposed by the different course of the more recent promptings.

That this is the origin of the investment of the repression and the maintenance of the no longer actual danger situation, finds its proof in the modest although theoretically hardly overestimable fact of analytic therapy. If we furnish aid to the ego in the analysis which will enable it to abolish its repressions it regains power over the repressed It and can allow the impulses to run their course as if the old danger situations no longer existed. What we thus attain is in harmony with other powers of our medical performance. As a rule our therapy must be satisfied with bringing about the good result more rapidly, more trustworthily and with little outlay, which under favorable conditions might have come about spontaneously.

The previous considerations teach us that there are quantitative relations which are not directly visible, comprehended only through inference, which decide whether the old danger situation is held fast, whether the repressions of the ego are maintained, and whether or not there is a continuation of the child neuroses. Of the factors which take part in the causation of the neuroses, which have created the conditions under which the psychic forces measure themselves with another, there are three which become conspicuous for our comprehension—one biologic, one phylogenetic and one purely psychologic. The first mentioned is the long drawn out helplessness of the small human child. The intrauterine existence of man seems relatively shorter than that of most of the animals and he is sent into the world less apt. As a result the influence of the external world is strengthened, the differentiation of the ego from the It is precociously promoted, the dangers of the outer world are increased in importance and the value of the object, which can alone protect from these dangers and replace the lost intrauterine life, is greatly enhanced. This biologic factor prepares the first danger situation and creates the need to be loved which will never more leave the human subject.

The second, phylogenetic, factor is only inferred by us; a very notable fact of libido development has forced us to assume it. We find that the sexual life of mankind is not developed steadily from beginning to maturity, as in most of the nearest related animals, but that after an early bloom up to the fifth year it experiences an energetic interruption, after which it again becomes prominent with puberty and annexes itself to the infantile fractions. We think that something important to the destiny of mankind must have happened which this interruption of sexual development has left behind as a historical precipitate. The pathogenic significance of this factor is apparent from the fact that most of the impulse claims of this infantile sexuality are treated by the ego as dangers and repulsed, so that the later sexual stirrings of puberty, which should be normal to the ego, are in danger of subjugation to the attraction of infantile prototypes and follow these in repression. Here we abut against the most direct etiology of the neuroses. It is noteworthy that the early contact with the claims of sexuality works upon the ego in the same manner as precocious contact with the external world.

The third or psychologic factor is to be found in the incompleteness of our psychic apparatus which is connected with its differentiation into the ego and It, hence in the last analysis it goes back to the influence of the external world. Through regard for the dangers of reality the ego is forced to oppose itself against certain promptings of the It and to treat them as dangers. The ego, however, cannot defend itself against inner promptings so efficaciously as against a fragment of alien reality. Itself intimately connected with the It, it can only defend itself against the danger of the impulse while contracting its own organization and allows itself to fall into symptom formation as a substitute for its injury of the impulse. If the crowding of the repulsed impulse is then renewed there result for the ego all of the difficulties which we know as the neurotic affection.

I must believe that our insight into the nature and causation of the neuroses cannot go further at present.

XI. Addenda

In the course of these discussions various themes have been touched upon which it was necessary to pass over for the time being and which should now be assembled in order to maintain attention to the part of the book to which they have claim.

Modifications of Views Previously Expressed

Resistance and Counter-investment

It is an important bit of the theory of repression that it does not present a solitary process but requires a persistent outlay. When the latter fails the repressed impulse, which receives the continuous influx from its sources, will the next time strike out in the same path from which it had been forced; the repression would be carried to its termination or must be repeated indefinitely. Hence there follows from the continuous nature of the prompting the demand upon the ego in order to assure its defense reaction through a permanent outlay. This action for the protection of the repression is that which we feel in the therapeutic activity as resistance, and resistance presupposes what I have designated as counter-fixation. Such counter-fixation is tangible in compulsion neurosis and appears here as ego alteration, as reaction formation in the ego, through strengthening of that situation which is the antithesis of the repressing impulse direction (sympathy, conscientiousness, purity). These reaction formations of the compulsive neurosis are always exaggerations of normal character traits developed in the period of latency. It is far more difficult to demonstrate counter-investment in hysteria although according to theoretic expectation it ought to be equally indispensable. Here likewise there is a certain amount of ego alteration unmistakable, through reaction formation, in many relations so striking that they force themselves on the attention as the chief symptom of the condition. In such a fashion, for example, is the ambivalence conflict of hysteria solved; the hate toward a loved person is held down through an excess of tenderness for him and anxiety about him. One must, however, make prominent a distinction against the compulsive neurosis where such reaction formations do not show the general nature of character traits but restrict themselves to quite special relations. The hysterical woman, for example, who treats with excessive tenderness the children which fundamentally she hates does not on the whole become more ready for love than other women nor more tender toward other children. The reaction formation in hysteria holds tenaciously to a definite object and does not elevate itself to a general disposition of the ego. For the compulsive neurosis this generalization is characteristic—the loosening of object relations and the displacement of the choice of object.

Another kind of counter-investment seems more suitable to the peculiarity of hysteria. The repressed prompting can become activated from two sides (newly invested), first, through a strengthening of the impulse from its inner sources of excitation; second, from without through perception of the object which the prompting desires. Hysterical counter-investment is now by preference directed outward and toward the dangerous perception and assumes the form of a special vigilance which avoids situations through contraction of the ego, in which the perception must appear and which makes it able to draw the attention from this perception should the latter come up. French authors (Laforgue) have recently designated this performance of hysteria through the special term “scotomisation.” Still more striking than in hysteria is this technic of counter-investment in the phobias, where the interest concentrates itself in removing itself further and further from the possibility of the dreaded perception. The contrast in the direction of the counter-fixation between hysteria and the phobias on the one hand and compulsion neurosis on the other seems significant even if it is not absolute. The assumption lies near at hand that between the repression and the external counter-investment, as between the regression and the internal counter-investment (ego alteration through reaction formation), there exists an intimate connection. The repulse of the dangerous perception is, moreover, a general task of the neuroses. Different commands and prohibitions are to serve the same intent. We have already on one occasion made ourselves clear that the resistance, which we have to overcome in the analysis, is furnished by the ego which holds fast to its counter-investment. The ego finds it difficult to apply its attention to perceptions and ideas, the avoidance of which it has previously made a precept, or to recognize as its own, strivings which form a complete antithesis to those believed to be his own. Our struggle against the resistance in the analysis is based on such a conception of the same. We make the resistance conscious where—so often because of association with the repressed content—it is unconscious; we oppose to it logical arguments, when or after it has become conscious, and promise to the ego advantages and bonuses if it renounces the resistance. Hence there is nothing either to doubt or to justify in respect to the resistance of the ego. On the other hand it must be asked whether this alone covers the subject matter which is opposed to us in the analysis. We have the experience that the ego always finds new difficulties in making the repressions regressive, even after it has conceived the purpose of giving up the resistance and has designated the phase of arduous effort—which follows such a praise-worthy intention—as that of “working through.” It now lies at hand to recognize the dynamic factor which makes such “working through” necessary and intelligible. It can hardly be otherwise than that after abolition of the ego resistance the power of the repetition compulsion, the attraction of the unconscious prototypes of the repressed impulse process, is to be overcome and there is nothing to say against it if one will designate this factor as the resistance of the unconscious. We should not allow such corrections to vex us; they are desired if they further our understanding a bit and there is nothing to be deplored if in place of refuting they enrich what has been said before, restricting perhaps a general consideration and broadening a comprehension which is too narrow.

It is not to be assumed that through this correction we have gained a complete summary of the kinds of resistance encountered in analysis. We note rather that we have five kinds of resistance to antagonize which proceed from all three sides, to wit, from the ego, the super-ego and the It, the ego being the source of three of the forms shown to differ in their dynamics. The first of these three ego resistances is the repression resistance already treated, concerning which there is but little to say that is new. From this is distinguished the resistance of transference which is of like nature but in an analysis causes other and far more important phenomena, for it succeeds in originating a relation to the analytical situation or person of the analyst and with this a repression which is recalled with difficulty becomes again freshly animated. Another ego resistance although of quite different nature is that which proceeds from the gain of the disease and is founded on the interrelation of the symptoms in the ego. It corresponds to the striving against the renunciation of a gratification or a relief. The fourth kind of resistance—that of the It—we have made responsible just now for the necessity of “working through.” The fifth resistance, that of the super-ego, is the latest to be recognized; it is the most obscure but is not always the weakest and seems to spring from the sense of guilt or need of punishment; it opposes itself to every analytic effort and later also to cure through analysis.

Fear from Transformation of the Libido

The notion of fear represented in this essay is removed a bit from that which hitherto seemed justified. Formerly I regarded fear as a general reaction of the ego under the conditions of unpleasure and sought on each occasion to justify its appearance economically. I assumed, sustained by the investigation of the actual neuroses, that the libido (sexual excitation) which was refused or not employed by the ego, found a direct discharge in the form of fear. One cannot overlook the fact that these different determinations do not go well together, at least do not necessarily follow from one another. Moreover, there resulted the apparently intimate relation between fear and libido, which again does not harmonize with the general character of fear as an unpleasure reaction.

The objection to this comprehension proceeds from the tendency to make the ego the sole abiding place of fear and was also one of the consequences of the arrangement of the psychic apparatus sought in “The Ego and It.” To the former comprehension it lay near at hand to regard the libido of the repressed impulse as the source of the fear; according to the later one the ego should be responsible for this fear—either ego fear or impulse (It) fear. As the ego works with desexualized energy, in the innovation the intimate connection between fear and the libido is loosened. I hope to succeed at least to make this contradiction clear, to draw the outlines of uncertainty sharply.

Rank’s admonition that the fear affect, as I myself once maintained, is a consequence of the birth process and a repetition of the situation then lived through, necessitates a new examination of the fear problem. With his own comprehension of birth as a trauma, of the fear condition as a discharge reaction, every renewed fear affect as an attempt to react off the trauma completely, I cannot go further. There results the compulsion to go back to it, from the fear reaction to the danger situation. With the introduction of this factor new viewpoints come up for consideration. Labor becomes a prototype for all later danger situations which result under the new conditions of the altered form of existence and the progressive psychic development. Its own significance, however, becomes contracted upon this prototype relation. The fear felt at birth now becomes the prototype of an affect condition which must share the fate of other affects. It is reproduced, either automatically in situations which were analogous to its original situations, as inappropriate forms of reaction, after it had been appropriate in the first danger situation. Or the ego obtains power over this affect and reproduces it itself, serves itself with it as a warning of danger and as a means of rousing the pleasure-pain mechanism. The biologic significance of the fear affect came into its own, since fear is recognized as the general reaction to the situation of danger. The rôle of the ego as the seat of fear was confirmed, since the function was conceded to the ego of reproducing the fear affect according to its requirements. To fear were directed in later life two kinds of modes of origin; one involuntary, automatic, always economically justified whenever a danger analogous to birth had been produced; the other, produced by the ego when such a situation only threatened, in order to further its avoidance. In this second case the ego submitted to the fear like an inoculation, in which through a weakened outbreak of disease one escapes an unweakened one. The danger situation, as it were, has an unmistakable tendency to restrict the painful experience to a suggestion, a signal. How the different situations of danger develop one after another and yet remain genetically combined has already been set forth in detail. Perhaps we may succeed in penetrating a little further into the comprehension of fear if we attack the problem of the relations between neurotic fear and actual fear.

The formerly asserted direct transposition of the libido to fear has now become less significant to our interest, if we take into consideration that we have several kinds to distinguish between. The fear which the ego provokes as a signal does not come into account, and further, not in all of the danger situations which move the ego to the introduction of a repression. The libidinous investment of the repressed prompting experiences (as one sees most distinctly in conversion hysteria) another application than transposition into and discharge as fear. Nevertheless we shall in the further discussion of the danger situation come upon that kind of fear development which ought probably to be judged otherwise.

Repression and Defense

In connection with the discussions of the fear problem I have an idea—or more modestly expressed a terminus—to take up which served me exclusively at the beginning of my studies thirty years ago and which afterwards I was compelled to abandon. I refer to the process of defense.^[7] I replaced it later with that of repression, the relationship between the two remaining undetermined. I now think that we gain something by harking back to the old idea of defense if at the same time one settles the issue that the general designation for all the technics shall be defense, of which the ego serves itself in conflicts which may lead to neurosis; while repression remains the name of a definite method of defense which must first be better known to us as a result of the course of our investigations.

A simple terminological innovation will also become justified, and should be the expression of a new mode of consideration or an amplification of our views. The resumption of the idea of defense, and the contraction of the notion of repression bears reckoning of only one fact long known to us but with a gain in importance through certain new findings. Our first experiences with repression and symptom formation were gained from hysteria; we saw that the perception content of exciting experiences, the ideation content of pathogenic thought formations were forgotten and their reproduction excluded from memory, and have therefore recognized in this shutting out from consciousness the chief character of hysterical repression. Later we studied the compulsion neurosis and found that in this affection the pathogenic event had not been forgotten. It remained conscious but was, however, isolated in a manner which as yet could not be visualized; so that about the same result was produced as in hysteria. The difference, however, is large enough to justify our opinion that the process, by means of which the compulsive neurosis removed an impulse claim, could not be the same as hysteria. Further investigations have taught us that in the compulsion neurosis under the influence of ego striving a regression of the impulses to an earlier phase of libido was obtained, which did not make repression superfluous but evidently acted in the same direction as a repression. We have seen further that the counter-investment which also is presumptive in hysteria, plays a particularly large rôle in ego protection in compulsion neurosis as a reactive ego alteration.

Our attention is called to a procedure of “isolation” the technic of which we cannot yet give, which procures a directly sympathetic expression, and to another procedure which may be termed magical, that of “undoing,” which without doubt is of a rebuffing tendency, but has no longer any resemblance to the process of repression. These experiences are reason enough to reinstate the old conception of defense, which can comprehend all of these processes having a common tendency—protection of the ego against impulse claims—and to comprise repression as a special case of the same. The importance of this nomenclature is heightened if one contemplates the possibility that a deepening of our studies might yield an intimate connection between special forms of defense and definite affections—for example between repression and hysteria. Our anticipation is directed further to the possibility of another significant dependence. It can easily be that before the sharp sundering of the ego from the It, before the completion of the super-ego the psychic apparatus used another method of defense than after attaining these stages of organization.

Supplement to Fear

The fear affect shows certain traits the investigation of which promises further enlightenment. Fear has an unmistakable relation to expectation; one is afraid of something. There adheres to it a character of indetermination and absence of an object. The correct use of language itself changes the name to fright when an object is present. Fear has further in addition to its relation to danger another to neurosis, with the explanation of which we have expended much effort. The question arises, why are not all fear reactions neurotic, and why are so many recognized as normal? Finally the difference between real and neurotic fear demands a basic critique. Let us start with the last mentioned task. Our progress consisted in the falling back of the fear reaction upon the danger situation. If we suppose the same alteration to be present in the problem of real fear the solution would be easy. Real danger is a danger which we know, real fear is fear of such a known danger. Neurotic fear is fear of danger of which we know nothing. Hence neurotic danger must first be sought and analysis shows us it is an impulse danger. As we bring into consciousness this danger which is unknown to the ego the difference between real and neurotic fear is effaced and we may treat the last like the first.

In real danger we develop two reactions: the affective, or fear outburst, and the protective behavior. Presumably the same happens in impulse danger. We see the suitable coöperation of both reactions when one gives the signal for the institution of the other; but we also see the unsuitable type of response, that of fear paralysis, in which one gains ground at the expense of the other.

There are instances in which the characters of real and neurotic fear are commingled. The danger is known and real but the fear reaction is unnaturally great, greater than it should be in our judgment and in this excess the neurotic element is betrayed. But these instances for the most part contribute nothing new, and analysis shows that the known real danger is connected with an unknown impulsive danger.

We progress further when we refuse to be satisfied with referring the fear to the danger. What is the nucleus, the significance of the danger situation? Evidently the estimation of our strength in comparison with its size, the confession of our helplessness against it—material helplessness against real danger, psychic helplessness in the case of impulse danger. Our judgment here is guided by actual experience and whether this errs in the estimate is immaterial for the result. Suppose we term such an experienced situation of helplessness a traumatic one; we then have good reason for separating the traumatic situation from the danger situation.

It is now important to prove for ourselves if such a traumatic situation is not merely waited for but is foreseen, expected. The situation in which the condition for such expectation is contained is called the danger situation in which the fear signal is given. For example, I expect that a situation of helplessness will result, or the present situation reminds me of a formerly experienced traumatic experience. Hence I anticipate that this trauma will behave as if it were already there as long as there is time to divert it. Fear is therefore on the one hand the expectation of a trauma, and on the other a mitigated repetition of the same. Both characters which have struck us in connection with fear have therefore a different origin. Their relation to expectation belongs to the danger situation, their indefinite character and absence of object to the traumatic situation of helplessness, which is anticipated in the danger situation.

According to the development of the series, fear—danger—helplessness (trauma), we can sum up. The danger situation is a known, recollected, expected situation of helplessness. Fear is the original reaction to the helplessness in the trauma which is then later reproduced in the danger situation as a signal for help. The ego, which has passively lived through the trauma, now repeats actively a weakened reproduction of the same in order to be able to direct its course actively. We know the child behaves thus in all painful impressions since they are reproduced in play. In going over in this manner from passive to active it seeks to master psychically its life impressions. If this is to be the sense of a reacting off of the trauma, no one could further object to it. The decisive point, however, is the first displacement of the fear reaction from its origin in the situation of helplessness upon its expectation, the danger situation. Then follow the further displacements from the danger itself to the condition of the danger, the loss of object and the modifications already mentioned.

The “spoiling” of the little child has the unwished for consequence that the danger of the loss of the object—the object as protection against all the situations of helplessness—is increased toward all other dangers. It favors the reserve in childhood, which is proper to the physical and psychical helplessness.

Hitherto we have had no occasion to consider real fear otherwise than neurotic fear. We know the difference—real fear threatens from an external object, and neurotic fear from an impulse claim. In as far as this last is something real, neurotic fear may be recognized as founded on real fear. We have understood that the appearance of a particularly intimate relationship between fear and neurosis goes back to the fact that the ego, with the aid of the fear reaction of the impulse danger, defends itself as in actual external danger; that this direction of the defense activity runs into the neurosis because of the imperfection of the psychic apparatus. We have also gained the conviction that the impulse claim often becomes dangerous (inwardly) only because its gratification would bring about an external danger, because the internal danger represents an external one.

On the other hand the external danger (real) must have found an interiorization if it is to be significant for the ego; it must have recognized its relation to an experienced situation of helplessness.^[8] An instinctive perception of externally threatening danger seems not to be given to mankind or at least only in a very modest degree. Little children incessantly do things which bring their lives in peril and exactly for this reason cannot dispense with the protecting object. In relation to the traumatic situation against which man is helpless, external and internal danger, real danger and impulse claim, come together. In one case the ego may experience a pain which will not let up; in another case a stagnation of desire which can find no satisfaction; the economic situation is the same in both cases and the motor helplessness finds its expression in the psychic helplessness.

The enigmatic phobias of early childhood again deserve mention. Some of these, as fear of being alone, of the dark and of strangers we can understand as reactions to the danger of the loss of object. For others, as fear of small animals, thunder, etc., the information offers itself that they may be atrophied residues of a congenital preparation for real dangers which is so distinctly developed in other animals. Purposeful for mankind is only that portion of this archaic inheritance as is related to loss of the object. If such child phobias fix themselves, become strengthened and persist into late years of life, analysis shows that the content has set itself in association with impulse claims and is representative also of internal dangers.

Anxiety, Pain and Grief

There is so little pertaining to the psychology of the feelings that the ensuing halting observations should raise a claim for indulgence in judgment. We must say that anxiety becomes a reaction to the danger of loss of object. Now we already know one such reaction on object loss which we call sorrow. But when does it come to one, when to the other? For sorrow, with which we have already been occupied (Grief and Melancholy in my Collected Papers), one trait remains quite obscure, and that is its peculiarly painful quality. It seems to us self evident that separation from an object is painful, but the problem is complicated further. When does separation from the object mean anxiety, when grief and when pain? We say at once that there is no prospect at hand of replying to these questions. We shall be content to find certain demarcations and certain hints.

Our starting point may again be the one situation which we believe we understand, that of the nursling who in place of its mother sees a stranger. It then shows anxiety which we have interpreted as due to the danger of object loss. But it is doubtless more complicated and merits a more thorough discussion. There is no doubt as to the anxiety of the nursling, but the facial expression and the reaction of crying allow us to assume that it also feels pain. It seems as if certain things coalesce which later become separate again. It cannot distinguish between the momentary absence and permanent loss. If the mother once goes out of its sight its behavior is as if it would never more behold her and not until after several consolatory experiences does it learn that such a vanishing of the mother will be followed by her reappearance. The mother ripens this experience, so important for the child, when she plays the game of “peek-aboo,” hiding her face for a moment and then showing it again to the great joy of the child. The child can then feel longing which is not accompanied by despair.

The situation in which it misses the mother is the consequence of its misconception, it is no danger situation but a traumatic one, or rather it is traumatic if at this moment it feels a need that the mother should satisfy; it turns itself to danger situations when the need is not actual. The first anxiety condition which the ego itself introduces is therefore that of the loss of perception which is placed on a par with that of the loss of the object. A loss of love does not yet come into consideration. Later experience teaches that the object may remain at hand yet become bad for the child, and now the loss of love on the part of the object becomes a new and much more constant danger and fear condition.

The traumatic situation of missing the mother yields in one decisive point from the traumatic situation of birth. At that time there was no object present that could be missed. Anxiety remained the sole reaction which could occur. Since then repeated situations of gratification have formed the object of the mother, so that now in case of need it experiences an intense fixation which may be termed as yearning. The reaction of pain is related to this innovation and hence pain is the peculiar reaction to loss of the object as fear is to danger which the loss brings with it, in further displacement of the danger of loss of object itself. Nor do we know much of pain. The only sure content is the fact that pain—at first and as a rule—originates when a stimulus which attacks the periphery breaks through the apparatus for protecting against stimuli and acts like a continuous prompting against the otherwise efficacious muscle actions which remain powerless to withdraw the irritant from the irritated place. If the pain does not go forth from the surface but from an internal organ the situation is not at all changed; it is only that a bit of internal periphery replaces the external. The child has obviously an opportunity to go through such experiences of pain which are independent of its need experiences. This condition of origin of pain seems, however, to possess but little similarity with loss of the object and moreover the essential factor of peripheral irritation in the yearning situation of the child is fully lost. Nevertheless it cannot be irrational that language has shaped the notion of internal, psychic pain and placed the sensations of object loss quite on a par with physical pain.

In physical suffering there arises a high fixation—which may be termed narcistic—on the painful area which continues to increase and acts, so to speak, as evacuating upon the ego. It is known that in pain in the internal organs we acquire spatial and other ideas of such portions of the body which are not otherwise represented in conscious ideation. Further, the noteworthy fact that the most intense physical pains cannot develop if the mind is diverted by some other interest (we should not say that one remains unconscious of the pain), finds its explanation in the concentration of the fixation on the psychic representative of the painful area of the body. Now the analogy in this point seems to lie in the fact that it permits the transference of the painful sensation to the psychic province. The intensive yearning fixation, steadily augmenting because uncontrollable, of the missed (lost) object, forms the same economic conditions as the pain-fixation of injured portions of the body and makes it possible to look off from the peripheral conditionhood of bodily pain. The transition from physical to psychical pain correspond to the transformation of narcistic to object fixation: The object idea, highly fixed from need, plays the rôle of the body region fixed by growth stimulation. The continuity and uninhibitable character of the fixation process brings about the same condition of psychic helplessness. If the then arising sensation of unpleasure bears the character of pain which cannot be more approximately described than as specific, instead of expressing itself in the reaction form of anxiety, it lies at hand to make a factor responsible for it which otherwise would play but a small rôle in explanation; this is the high level of the fixation and combination relations upon which these processes which lead to the sensation of unpleasure perfect themselves.

We know still another emotional reaction to the loss of the object—sorrow. Its explanation, however, is not difficult. Sorrow originates under the influence of testing reality, which demands categorically that man must separate himself from the object because it no longer exists. This affect must now perform the labor of carrying out the retreat from the object in all situations in which the object was the subject of high fixation. The painful character of this separation unites itself to the explanation just given through the unfulfillable yearning fixation of the object during the reproduction of the situations in which the binding to the object is to be loosed.

NOTES

Contrary to ordinary usage the German word angst in this book is in many instances rendered fear in place of anxiety, the last being the equivalent given in psychoanalytic glossaries. The reader can himself substitute the word anxiety for fear whenever the latter occurs in the text. The reason for preferring fear to anxiety is that the latter is too mild a term, suggesting little more than worry or solicitude to the casual reader. The German word angst has no exact equivalent in English, for it can denote any affective state between anxiety and the most extreme terror, as in the term todeasangst for mortal fear. That the affective state implied is fear is shown in several ways, as the Greek phobia, which connotes fear, is equivalent in sense and is rendered by angstzustand or fear state. The word anxiety would not serve as an equivalent for phobia, which may indicate a condition of extreme fear. It has been suggested that the German word angst be left untranslated in the English text, much as the word anlage is left untranslated as having no exact English equivalent. This idea meets with our approval but until this is done we prefer to make use of fear as well as anxiety. The idea of rendering angst as fear or anxiety at the option of the translator, according to the context, has been tested but is not entirely satisfactory. [L. P. C.]↩︎
See History of an Infantile Neurosis (Vol. VIII of Collected Papers in German).↩︎
See Disposition to Compulsive Neurosis, Collected Papers in German, Vol. V.↩︎
Compare Reik, Impulse to Confess and Punishment Need, 1925.↩︎
Otto Rank. Birth Trauma and Its Importance for Psychoanalysis. Psychoanalytic Bibliothek, XV, 1921.↩︎
Since the distinction between the ego and It our interest in the problems of suppression must experience a new animation. Hitherto we had been satisfied to take into account the aspects of the process applied to the ego, the shutting off from consciousness and from motility and the substitute (symptom) formation. For the suppressed prompting itself we assumed it to remain indefinitely long and unchanged in the unconscious. Now our interest became directed to the fate of the repressed and we had the foreboding that such an unchanged and inalterable continuity is not self-evident and perhaps not even customary. The original prompting is in any case inhibited through the repression and diverted from its aim. But does the portion in the unconscious remain intact and does it show itself resistant towards the changing and depreciating influences of life? Do the old wishes, which analysis showed formerly to exist, persist? The answer seems near at hand and to be trustworthy. The repressed old wishes must persist in the unconscious, for we find their derivatives, the symptoms, still active. But such an answer is not sufficient; it allows no decision to be made between the two possibilities, whether the old wish merely acts through its derivatives to which all its energy of fixation has been transferred or whether in addition the wish itself persists as such. If it had been its fate to be exhausted in the fixation of its derivatives, there remains a third possibility that in the course of the neurosis it is reanimated by regression, however unseasonable this may seem at present. One does not need to regard these speculations as idle; much of the phenomena of the morbid as well as the normal in the psychic life seems to demand such questioning. In my studies of the decline of the Oedipus complex I have called attention to the difference between the bare repression and the actual elevation of an old wish.↩︎
See The Defense Neuroses, collected papers in German, Vol. I.↩︎
It may occur often enough that in a danger situation which is rightly recognized as such, a small amount of impulse fear is added to real fear. The impulse claim, from the gratification of which the ego shrinks, would then be of a masochistic nature, a destructive prompting directed against oneself. Possibly this addition explains the reason why the fear reaction is excessive, unsuitable and paralyzing. The height phobias (window, steeple, precipice) may have this origin; their secret feminine significance is related to masochism.↩︎

1.	The Objective and Subjective Development of the Ego (Clark)	$1.00
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8.	Inhibition, Symptom and Anxiety (S. Freud)	2.50
9.	The Book of the It (Georg Groddeck), ready October, 1927	3.50

The Project Gutenberg eBook of Inhibition, symptom and anxiety

Inhibition, Symptom and Anxiety

CONTENTS

Preface

I. A Definition of Inhibition and Symptom

II. Symptom Formation

III. The Ego

IV. Infantile Zoöphobia

V. Symptom Formation and the Secondary Defense of the Ego

VI. The Undoing and Isolation Mechanisms in Compulsion Neurosis

VII. A Further Consideration of Infantile Zoöphobia

VIII. An Analysis of Fear

IX. The Relation Between Symptom Formation and Fear Development

X. Theoretical Considerations of the Birth Trauma

XI. Addenda

Modifications of Views Previously Expressed

Resistance and Counter-investment

Fear from Transformation of the Libido

Repression and Defense

Supplement to Fear

Anxiety, Pain and Grief

NOTES

Inhibition, Symptom and Anxiety

CONTENTS

Preface

I. A Definition of Inhibition and Symptom

II. Symptom Formation

III. The Ego

IV. Infantile Zoöphobia

V. Symptom Formation and the Secondary Defense of the Ego

VI. The Undoing and Isolation Mechanisms in Compulsion Neurosis

VII. A Further Consideration of Infantile Zoöphobia

VIII. An Analysis of Fear

IX. The Relation Between Symptom Formation and Fear Development

X. Theoretical Considerations of the Birth Trauma

XI. Addenda

Modifications of Views Previously Expressed

Resistance and Counter-investment

Fear from Transformation of the Libido

Repression and Defense

Supplement to Fear

Anxiety, Pain and Grief

Monograph Series of the Psychoanalytic Institute

A New Journal of Psychoanalysis