Selected papers on hysteria and other psychoneuroses · Sigmund Freud
CHAPTER X. HYSTERICAL FANCIES AND THEIR RELATIONS TO BISEXUALITY.[57]
The delusional formations of paranoiacs containing the greatness and sufferings of their own ego, which manifest themselves quite typically in almost monotonous forms are universally familiar. Furthermore, through numerous communications we became acquainted with the peculiar organizations by means of which certain perverts put into operation their sexual gratifications, be it in fancy or reality. On the other hand it may sound rather novel to some to hear that quite analogous psychic formations regularly appear in all psychoneuroses, especially in hysteria, and that these so called hysterical fancies show important relations to the causation of the neurotic symptoms. Of the same source and of the normal prototype are all these fantastic creations, so called reveries of youth, which have already gained a certain consideration in the literature, though not a sufficient one.[58] They are perhaps equally frequent in both sexes; in girls and women they seem to be wholly of an erotic nature, while in men they are of an erotic or ambitious nature. Yet even in men the significance of the erotic moment is not to be put in the second place, for on examining more closely the reveries of men we generally learn that all these heroic acts are accomplished, that all these successes are acquired in order to please a woman and to be preferred to other men.[59] These fancies are wish gratifications which emanate from privation and longing. They are justly named “day dreams” for they give the key for the understanding of night dreams in which the nucleus of the dream formation is produced by just such complicated, disfigured day fancies which are misunderstood by the conscious psychic judgment.[60]
These day dreams are garnished with great interest, are cautiously nurtured, and coyly guarded, as if they were numbered among the most intimate estates of personality. On the street, however, the day dreamer can be readily recognized by a sudden, as if absent minded smile, by talking to himself, or by a running-like acceleration of his gait wherein he designates the acme of the imaginary situation. All hysterical attacks which I have been thus far able to examine proved to be such involuntary incursions of day dreams. Observation leaves no doubt that such fancies may exist as unconscious or conscious and whenever they become unconscious they may also become pathogenic, that is, they may express themselves in symptoms and attacks. Under favorable conditions it is possible for consciousness to seize such unconscious fancies. One of my patients whose attention I have called to her fancies narrated that once while in the street she suddenly found herself in tears, and rapidly reflecting over the cause of her weeping the fancy became clear to her. She fancied herself in delicate relationship with a piano virtuoso familiar in the city, but whom she did not know personally. In her fancy she bore him a child (she was childless), and he then deserted her, leaving her and her child in misery. At this passage of the romance she burst into tears.
The unconscious fancies are either from the first unconscious, having been formed in the unconscious, or what is more frequently the case they were once conscious fancies, day dreams, and were then intentionally forgotten, merging into the unconscious by “repression.” Their content then either remained the same or underwent a transformation, so that the present unconscious fancy represents a descendant of the once conscious one. The unconscious fancy stands in a very important relation to the sexual life of the person, it is really identical with that fancy which helped it towards sexual gratification during a period of masturbation. The masturbating act (in the broader sense the onanistic) then consisted of two parts, the evocation of the fancy, and the active performance of self gratification at the height of the same. This combination is familiarly in itself a soldering.[61] Originally this action was a purely auto-erotic undertaking for the pleasure obtained from a certain so called erogenous part of the body. Later this action blended with a wish presentation from the sphere of the object loved, and served for a partial realization of the situation in which this fancy culminated. If, then, the person forgoes in this manner the masturbo-fantastic gratification, the action remains undone, the fancy, however, changes from a conscious to an unconscious one. If no other manner of sexual gratification occurs, if the person remains abstinent and does not succeed in sublimating his libido, that is, in diverting the sexual excitement to a higher aim, we then have the conditions for the refreshment of the unconscious fancy; it grows exuberantly and with all the force of the desire for love at least a fragment of its content becomes a morbid symptom.
The unconscious fancies are then the nearest psychical first steps of a whole series of hysterical symptoms. The hysterical symptoms are nothing other than unconscious fancies brought to light by “conversion,” and insofar as they are somatic symptoms they are frequently enough taken from the spheres of the sexual feelings and motor innervations which originally accompanied the former still conscious fancies. In this way the disuse of onanism is really made retrograde, and the final aim of the whole pathological process, the restoration of the primary sexual gratification, though it never becomes perfect, in a manner always achieves a certain approximation. The interest of him who studies hysteria turns directly from the symptoms to the fancies from which the former originate. The technique of psychoanalysis gives the means of finding out from the symptoms the unconscious fancies, and then of bringing them back to the patient’s consciousness. In this way it was found that the unconscious fancies of hysterics perfectly correspond in content to the consciously performed gratification situations of perverts. Those who lack examples of such nature need only recall the historical managements of the Roman Caesars whose frenzies were naturally only conditioned by the unrestricted fullness of the fancy creators. The delusional formations of paranoiacs are of the same nature, they are fancies which directly become conscious, and which are borne by the masochistic-sadistic components of the sexual impulse. Complete counterparts of these can also be found in certain unconscious fancies of hysterics. It is a familiar, practically significant fact that hysterics express their fancies not as symptoms but in conscious realization, and in this way they feign and commit murders, assaults, and sexual aggressions.
All that can be found out about the sexuality of the psychoneurotic can be ascertained by the psychoanalytic examination which leads from the obtrusive symptoms to the hidden unconscious fancies; herein, too, is the fact, the communication of which will be put in the foreground of this short preliminary publication. Probably in view of the difficulties which prevent the effort of the unconscious fancies from expressing themselves, the relation between the fancies to the symptoms is not simple but rather manifoldly complicated.[62] As a rule, that is, in a fully developed and a long standing neurosis, a symptom does not correspond to an individual unconscious fancy, but to a number of such, and indeed it is not arbitrary but in lawful combination. To be sure in the beginning of the disease all these complications are not developed. For the sake of general interest I pass over the connection of this communication and insert a series of formulæ which strive to progressively exhaust the nature of hysteria. They do not contradict one another but correspond partly to more complete and sharper conceptions, and partly to the use of different points of view. 1. The hysterical symptom is the memory symbol of certain efficacious (traumatic) impressions and experiences. 2. The hysterical symptom is the compensation by conversion for the associative return of the traumatic experience.
3. The hysterical symptom—like all other psychic formations—is the expression of a wish realization. 4. The hysterical symptom is the realization of an unconscious fancy serving as a wish fulfilment. 5. The hysterical symptom serves as a sexual gratification, and represents a part of the sexual life of the individual (corresponding to one of the components of his sexual impulse). 6. The hysterical symptom, in a fashion, corresponds to the return of the sexual gratification which was real in infantile life but had been repressed since then. 7. The hysterical symptom results as a compromise between two opposing affects or impulse incitements, one of which strives to bring to realization a partial impulse, or a component of the sexual constitution, while the other strives to suppress the same. 8. The hysterical symptom may undertake the representation of diverse unconscious non-sexual incitements, but can not lack the sexual significance. It is the seventh among these determinations which expresses most exhaustively the essence of the hysterical symptom as a realization of an unconscious fancy, and it is the eighth which properly designates the significance of the sexual moment. Some of the preceding formulæ are contained as first steps in this formula.
9. An hysterical symptom is the expression, on the one hand, of a masculine, and on the other hand of a feminine unconscious sexual fancy. I expressly observe that I am unable to adjudge to this axiom the similar general validity that I claimed for the other formulæ. As far as I can see it is met neither in all symptoms of a single case, nor in all cases. On the contrary it is not difficult to find cases in which the contrary sexual emotions have found separate symptomatic expression, so that the symptoms of hetero- and homosexuality can be as sharply distinguished from each other as the fancies hidden behind them. Nevertheless, the relation claimed in the ninth formula occurs frequently enough, and wherever it is found it is of sufficient significance to merit a special formulation. It seems to me to signify the highest stage of complexity to which the determination of hysterical symptoms can reach, and can only be expected in a long standing neurosis and where a great amount of organization has occurred.[63]
The demonstrable bisexual significance of hysterical symptoms occurring in many cases is indeed an interesting proof for the assertion formulated by me that the supposed bisexual predisposition of man can be especially recognized in psychoneurotics by means of psychoanalysis.[64] Quite an analogous process from the same sphere is that in which the masturbator in his conscious fancies attempts to live through in his imagination the fancied situations of both the man and the woman. Other counterparts are found in certain hysterical crises in which the patients play both rôles lying at the basis of sexual fancies; thus, for example, one of the cases under my observation presses his garments to his body with one arm (as woman), and with the other arm he attempts to tear them off (as man). This contradictory simultaneity determines most of the incomprehensibility of the situation otherwise so plastically represented in the attack, and is excellently suited for the concealment of the effective unconscious fancy. In psychoanalytical treatment it is very important to be prepared for the bisexual significance of a symptom. It should not be at all surprising or misleading when a symptom remains apparently undiminished in spite of the fact that one of its sexual determinants is already solved. Perhaps it is still supported by the unsuspected contrary sexual. Furthermore, during the treatment of such cases we can observe how the patient makes use of this convenience. During the analysis of the one sexual significance he continually switches his thoughts into the sphere of the contrary significance just as if onto a neighboring track.
Footnote 12: We are unable to distinguish in this preliminary contribution what there is new in this content and what can be found in such other authors as Moebius and Strümpel who present similar views on hysteria. The greatest similarity to our theoretical and therapeutical accomplishments we accidentally found in some published observations of Benedict which we shall discuss hereafter. Footnote 13: The German abreagiren has no exact English equivalent. It will therefore be rendered throughout the text by “ab-react,” the literal meaning is to react away from or to react off. It has different shades of meaning, from defense reaction to emotional catharsis, which can be discerned from the context. Footnote 14: As an example of the technique mentioned above, that is, of investigating in a non-somnambulic state or where consciousness is not broadened, I will relate a case which I analyzed recently. I treated a woman of thirty-eight who suffered from an anxiety neurosis (agoraphobia, fear of death, etc.). Like many patients of that type she had a disinclination to admit that she acquired this disease in her married state and was quite desirous of referring it back to early youth. She informed me that at the age of seventeen when she was in the street of her small city she had the first attack of vertigo, anxiety, and faintness, and that these attacks recurred at times up to a few years ago when they were replaced by her present disease. I thought that the first attacks of vertigo, in which the anxiety was only blurred, were hysterical and decided to analyze the same.
All she knows is that she had the first attack when she went out to make purchases in the main street of her city.—“What purchases did you wish to make?”—“Various things, I believe it was for a ball to which I was invited.”—“When was the ball to take place?”—“I believe two days later.”—“Something must have happened a few days before this which excited you, and which made an impression on you.”—“But I don’t know, it is now twenty-one years.”—“That does not matter, you will recall it. I will exert some pressure on your head and when I stop it you will either think of or see something which I want you to tell me.” I went through this procedure, but she remained quiet.—“Well, has nothing come into your mind?”—“I thought of something, but that can have no connection with it.”—“Just say it.”—“I thought of a young girl who is dead, but she died when I was eighteen, that is, a year later.”—“Let us adhere to this. What was the matter with your friend?”—“Her death affected me very much, because I was very friendly with her.
A few weeks before another young girl died, which attracted a great deal of attention in our city, but then I was only seventeen years old.”—“You see, I told you that the thought obtained under the pressure of the hands can be relied upon. Well now, can you recall the thought that you had when you became dizzy in the street?”—“There was no thought, it was vertigo.”—“That is quite impossible, such conditions are never without accompanying ideas. I will press your head again and you will think of it. Well, what came to your mind?”—“I thought, ‘now I am the third.’”—“What do you mean?”—“When I became dizzy I must have thought, now I will die like the other two.”—“That was then the idea, during the attack you thought of your friend, her death must have made a great impression on you.”—“Yes, indeed, I recall now that I felt dreadful when I heard of her death, to think that I should go to a ball while she lay dead, but I anticipated so much pleasure at the ball and was so occupied with the invitation that I did not wish to think of this sad event.” (Notice here the intentional repression from consciousness which caused the reminiscences of her friend to become pathogenic.) The attack was now in a measure explained, but I still needed the occasional moment which just then provoked this recollection, and accidentally I formed a happy supposition about it.—“Can you recall through which street you passed at that time?”—“Surely, the main street with its old houses, I can see it now.”—“And where did your friend live?”—“In the same street. I had just passed her house and was two houses farther when I was seized with the attack.”—“Then it was the house which you passed that recalled your dead friend, and the contrast which you then did not wish to think about that again took possession of you.”
Still I was not satisfied, perhaps there was something else which provoked or strengthened the hysterical disposition in a hitherto normal girl. My suppositions were directed to the menstrual indisposition as an appropriate moment, and I asked, “Do you know when during that month you had your menses?”—She became indignant: “Do you expect me to know that? I only know that I had them then very rarely and irregularly. When I was seventeen I only had them once.”—“Well let us enumerate the days, months, etc., so as to find when it occurred.”—She with certainty decided on a month and wavered between two days preceding a date which accompanied a fixed holiday.—Does that in any way correspond with the time of the ball?—She answered quietly: “The ball was on this holiday. And now I recall that I was impressed by the fact that the only menses which I had had during the year occurred just when I had to go to the ball. It was the first invitation to a ball that I had received.” The combination of the events can now be readily constructed and the mechanism of this hysterical attack readily viewed. To be sure the result was gained after painstaking labor. It necessitated on my side full confidence in the technique and individual directing ideas in order to reawaken such details of forgotten experiences after twenty-one years in a sceptical and awakened patient. But then everything agreed.
Footnote 15: A better description of this peculiar state in which one knows something and at the same time does not know it, I could never obtain. It can apparently be understood only if one has found himself in such a state. I have at my disposal a very striking recollection of this kind which I can vividly see. If I make the effort to recall what passed through my mind at that time my output seems very poor. I saw at that time something which was not at all appropriate to my expectations, and what I saw did not in the least divert me from my definite purpose, whereas this perception ought to have done away with my purpose. I did not become conscious of this contradiction nor did I remark the affect of the repulsion to which it was undoubtedly due that this perception did not attain any psychic validity. I was struck with that form of blindness in seeing eyes, which one admires so much in mothers towards their daughters, in husbands towards their wives, and in rulers towards their favorites. Footnote 16: It will be shown that, notwithstanding, I erred. Footnote 17: Die Abwehr-Neuropsychosen, Neurologisches Centralblatt, 1 June, 1894. Footnote 18: I can neither exclude nor prove that this pain, especially of the thighs, was of a neurasthenic nature.
Footnote 19: To my surprise I once discovered that such subsequent ab-reaction—through other impressions than nursing—may form the content of an otherwise enigmatic neurosis. It was the case of a pretty girl of nineteen, Miss Matilda H. whom I first saw with an incomplete paralysis of the legs, and months afterward I was again called because her character had changed. She was depressed and tired of living, entertaining lack of consideration for her mother, and was irritable and inapproachable. The whole picture of the patient did not seem to me to be that of an ordinary melancholia. She could easily be put into a somnambulic state, and I made use of this peculiarity to impart to her each time commands and suggestions to which she listened in her profound sleep and responded with profuse tears, but which, however, caused but little change in her condition. One day while hypnotized she became talkative and informed me that the reason for her depression was the breaking of her betrothal many months before. She stated that on closer acquaintance with her fiance the things displeasing to her and her mother became more and more evident. On the other hand, the material advantages of the engagement were too tangible to make the decision of a rupture easy, thus, both of them hesitated for a long time.
I had under my observation another case in which a contracture of the masseters made it impossible for the artist to sing. The young lady in question through painful experiences in the family was forced to go on the stage. While in Rome rehearsing, in great excitement she suddenly perceived the sensation of being unable to close her opened mouth and sank fainting to the floor. The physician who was called closed her jaws forcibly, but the patient since that time was unable to open her jaws more than a finger’s breadth and had to give up her newly chosen profession. When she came under my care many years later, the motives for that excitement were apparently over for some time, for massage in a light hypnosis sufficed to open her mouth widely. The lady has since sung in public. Footnote 22: But perhaps spinal neurasthenic? Footnote 23: See Studien über Hysterie, p. 57, footnote. Footnote 24: l. c. Footnote 25: The literal translation of Auftreten is to press down by treading. Footnote 26: In conditions of profounder psychic changes we apparently find a symbolic stamp (mark) of the more artificial usage of language in the form of emblematic pictures and sensations. There was a time in Mrs. Cäcilie M. during which every thought was changed into an hallucination, and which solution frequently afforded great humor. She at that time complained to me of being troubled by the hallucination that both her physicians, Breuer and I, were hanged in the garden on two nearby trees. The hallucination disappeared after the analysis revealed the following origin: The evening before Breuer refused her request for a certain drug. She then placed her hopes on me but found me just as inflexible. She was angry at both of us, and in her affect she thought, “They are worthy of each other, the one is a pendant of the other!”
Footnote 27: E. Hecker, Centralblatt für Nervenheilkunde, Dec., 1893. Footnote 28: See Breuer und Freud, Studien über Hysterie. Deuticke, Leipzig und Wien, 1895, p. 15. Footnote 29: See Breuer und Freud, Studien über Hysterie. Deuticke, Leipzig und Wien, 1895, p. 106. Footnote 30: See Breuer und Freud, Studien über Hysterie. Deuticke, Leipzig und Wien, 1895, p. 15. Footnote 31: As mentioned in the preface the author has long since discarded this pressure procedure.—Translator’s note. Footnote 32: See Breuer und Freud, Studien über Hysterie. Deuticke, Leipzig und Wien, 1895, p. 85. Footnote 33: l. c., p. 15. Footnote 34: See Breuer und Freud, Studien über Hysterie. Deuticke, Wien und Leipzig, 1895, p. 28. Footnote 35: See Breuer und Freud, Studien über Hysterie. Deuticke, Leipzig und Wien, 1895, p. 55. Footnote 36: État mental des hystériques, Paris, 1893 and 1894. Quelques définitions récentes de l’hystérie, Arch. de Neurol., 1893, XXXV-VI. Footnote 37: Oppenheim: Hysteria is an exaggerated expression of emotion. But the “expression of emotion” represents that amount of psychic excitement which normally experiences conversion. Footnote 38: Strümpel: The disturbance of hysteria lies in the psycho-physical, there where the physical and psychical are connected with each other. Footnote 39: Janet, in the second chapter of his spirited essay “Quelques definitions,” etc., has treated the objection that the splitting of consciousness belongs also to the psychoses and the so called psychaesthenia, but in my opinion he has not satisfactorily solved it. It is essentially this objection which urged him to call hysteria a form of degeneration. But through no characteristic is he able to separate sufficiently the hysterical splitting of consciousness from the psychopathic, etc.
Footnote 40: The group of typical phobias, for which agoraphobia is a prototype, cannot be reduced to the psychic mechanisms here developed. Furthermore the mechanism of agoraphobia deviates in one decisive point from that of the real obsessions and from phobias based on such. Here there is no repressed idea from which the affect of fear has been separated. The fear of this phobia has another origin. Footnote 41: E. Hecker, Über larvierte und abortive Angstzustände bei Neurasthenie, Centralblatt für Nervenheilkunde, December, 1893.—Anxiety is made particularly prominent among the chief symptoms of neurasthenia by Kaan, Der neurasthenische Angstaffekt bei Zwangsvorstellungen und der primordiale Grübelzwang, Wien, 1893. Footnote 42: Die Abwehr-Neuropsychosen, Neurol. Centralbl., 1894, Nr. 10 u. 11. Footnote 43: Obsession et phobies, Révue neurologique, 1895. Footnote 44: Moebius, Neuropathologische Beiträge, 1894, 2. Heft. Footnote 45: Peyer, Die nervösen Affektionen des Darmes, Wiener Klinik, Jänner, 1893. Footnote 46: Freud, Abwehr-Neuropsychosen. Footnote 47: Neurologisches Centralblatt, 1896, Nr. 10. Footnote 48: I myself surmise that the so frequently fabricated assaults of hysterical persons are obsessional confabulations emanating from the memory traces of infantile traumas. Footnote 49: In an article on the anxiety neurosis (Neurologisches Centralblatt, 1895, Nr. 2) I stated that “an anxiety neurosis which can almost typically be combined with hysteria can be evoked in maturing girls at the first encounter with the sexual problem.” I know today that the occasion in which such virginal anxiety breaks out does not really correspond to the first encounter with sexuality, but that in such persons there was in childhood a precedent experience of sexual passivity which memory was awakened at the “first encounter.”
Text from Project Gutenberg, public domain in the United States.