So where did I get the idea of this conversion in the first place? From my study of the ‘actual’ neuroses,23 undertaken long before we learned to differentiate between processes in the ego and processes in the id. I found that attacks of fear and a generalized state of apprehensiveness are precipitated by certain sexual practices such as coitus interruptus, frustrated arousal and enforced abstinence – in other words, whenever sexual excitement is inhibited, checked or deflected before it has achieved gratification. Since sexual excitement is the manifestation of libidinal drive-impulses, it did not seem rash to suppose that disruptions of this kind have the effect of converting the libido into fear. And this observation is still valid today. Then again, it cannot be denied that the libido of the id-processes suffers disruption instigated by the repression; accordingly it may still be right to suppose that when repression takes place, fear is produced by the libido-cathexis of the drive-impulses. But how are we to reconcile this conclusion with our other conclusion that the fear present in phobias is an ego-fear,24 that it arises in the ego, that it does not emerge from the repression but causes the repression? This appears to be a contradiction, and one that is not easy to resolve. It is no simple task to reduce these two sources of fear to a single one. One might attempt to do so by hypothesizing that in situations such as coitus interruptus, arousal without gratification or enforced abstinence, the ego senses danger, and responds to this danger with fear; but this supposition gets us nowhere. On the other hand, it seems that our analysis of the phobias in question cannot be faulted. Non liquet25 is the only possible verdict!
V
Our aim was to study symptom-formation and the ego's secondary battle against the symptom, but in choosing phobias we clearly didn't strike lucky. The fear that is such a predominant feature in this particular condition now seems to me to be an unnecessary complication that obscures the issue. There are plenty of neuroses that exhibit no signs of fear. True conversion hysteria26 is one such: we encounter not the slightest tinge of fear in even its gravest symptoms. This fact alone ought to warn us not to posit too close a connection between fear and symptom-formation. In all other respects phobias are so closely akin to conversion hysterias that I have thought it right to regard the former as a sub-group of the latter, under the heading ‘fear-hysteria’. But no one has yet been able to say what circumstances determine whether a particular case takes the form of a conversion hysteria or a phobia; in other words, no one has fathomed the circumstances that lead to the development of fear in cases of hysteria.
The most common symptoms of conversion hysteria – motor paralyses, contractures, involuntary actions or energy-discharges,27 pains, hallucinations – are either permanently established or intermittent cathexis processes, and this circumstance confronts us with yet more difficulties in our attempts to find an explanation. We don't really know a great deal about these symptoms. Through psychoanalysis we can discover which particular disrupted excitation process they are substituting for. It mostly transpires that they themselves are part and parcel of this process, rather as if its entire energy were focused on this one element. Thus, for instance, the patient's pain turns out to have been present in the situation in which the repression first occurred; his hallucinations started out as actual perceptions; his motor paralysis arose as a means of defence against an action that was supposed to be carried out at that same juncture, but was inhibited; his contracture is usually the displacement of a muscle innervation that was meant to happen then, but in some other part of the body; his spasms are the outward mark of an explosion of affect that has escaped the control normally exercised by his ego. There is a quite remarkable variation in the sensations of unpleasure that accompany the appearance of these symptoms. In the case of permanent symptoms that are displaced onto motor activity, such as paralyses and contractures, there are generally no such sensations at all: the ego behaves in their regard as though entirely uninvolved. In the case of intermittent symptoms and those relating to the sensory sphere, marked sensations of unpleasure are usually experienced, which in respect of pain symptoms can intensify to an extreme degree. It is very difficult in the midst of this multiplicity to establish which particular factor makes for such disparities, and yet allows us to see how they all hang together. We also find little trace in conversion hysteria of the ego's battle against the symptom once it has actually formed. Only when the sensitivity to pain of a particular part of the body has turned into a symptom is it enabled to play a dual role. When this part of the body is touched externally, the pain symptom manifests itself just as surely as it does when the pathogenic situation it represents is associatively activated internally, whereupon the ego takes precautionary measures to prevent the symptom from being aroused through external perception. We are clearly incapable of fathoming the origins of the peculiar obscurity that attaches to symptom-formation – but this gives us a good reason to abandon this unfruitful terrain without delay.
We turn now to obsessional neurosis, in the expectation that we shall learn rather more here about symptom-formation. The symptoms of obsessional neurosis are generally of two kinds, which tend in opposite directions. They consist on the one hand in prohibitions, precautions, penances – i.e. they are negative in nature; on the other hand, and in sharp contrast, they consist in surrogate gratifications, very often in symbolic guise. Of these two groups, it is the negative, defensive, punitive one that arises first; as the illness proceeds, however, the gratifications proliferate markedly, mocking all efforts to fight them off. It is a particular triumph of symptom-formation when it manages to merge the prohibition element into the gratification element, so that the injunction or prohibition originally active as a defence mechanism ends up itself taking on the character of a gratification – a process in which highly artificial associative pathways are frequently called upon. This achievement displays the proclivity to synthesis that we have already noted in the ego. In extreme cases the patient gets to the point where the great majority of his symptoms not only have their original significance, but also a directly contrary one – clear evidence of how powerful the ambivalence is that plays such a major role in obsessional neurosis (though we do not yet know why). In very extreme cases the symptom shows two distinct phases: an action having been carried out in accordance with some particular precept, a second immediately follows that cancels or reverses the first, without as yet daring to effect its complete opposite.
This very brief overview of obsessional symptoms gives rise to two distinct impressions. The first is that a constant battle is being waged here against whatever has been repressed – a battle in which the forces of repression are driven ever further back; the second is that the ego and super-ego are involved in the symptom-formation process to a particularly marked degree.
Obsessional neurosis may be the most interesting and most rewarding object of scrutiny within the purview of psychoanalysis – but as a problem it none the less remains unresolved. If we aim to delve deeper into its essence, then we have to acknowledge that we cannot yet manage without continued recourse to shaky assumptions and unproven conjectures. Obsessional neurosis presumably arises out of exactly the same circumstance as hysteria does, namely the imperative need to fight off the libidinal demands of the Oedipus complex. Moreover, the nethermost layer of every obsessional neurosis appears to consist of hysterical symptoms that were formed at a very early stage. Its subsequent development, however, is decisively altered by a constitutional factor. The genital organization of the libido turns out to be weak and insufficiently resistant. Thus when the ego commences its defensive battle, the first success it achieves is that the genital organization (of the phallic phase) is wholly or partially forced back to the earlier sadistic-anal phase. This regression remains a determining influence on everything that ensues.
Another possibility also merits consideration. Perhaps the real factor causing the regression is not constitutional but temporal. On this hypothesis the regression is made possible not because the genital or
ganization of the libido is too puny in its development, but because the ego's defensive response begins too early, while the sadistic phase is still in full flourish. I would not venture to come to a definite decision on this point either – but it is not a supposition that is supported by psychoanalytical observation. On the contrary, the latter tends to show that by the time the shift towards obsessional neurosis occurs, the phallic stage has already been attained. Furthermore, this neurosis sets in at a later age than hysteria does (that is, in the second period of childhood, following the onset of the latency period). Indeed in one case that I was able to study, in which the disorder developed at a particularly late stage, it became very clear that it was a specific impairment of the patient's previously unscathed genital life that created the conditions conducing to regression and the emergence of his obsessional neurosis.28
The metapsychological explanation of regression appears to me to lie in a ‘de-mergence’ of drives, in the elimination of those erotic components that supervened at the beginning of the genital phase and thereby compounded the destructive cathexes of the sadistic phase.29
In forcing a regression to occur, the ego scores its first success in its campaign of defence against the demands of the libido. It is expedient here for us to draw a distinction between ‘defence’, as a more generalized activity, and ‘repression’, which is just one amongst the various mechanisms that the defence process makes use of. It is perhaps even clearer to us in cases of obsessional neurosis than in normal and hysterical cases that the driving force behind the defence process is the castration complex, its target the busy pretensions of the Oedipus complex. We are dealing here with the beginning of the latency period, which is characterized by the dissolution of the Oedipus complex, the creation or consolidation of the super-ego, and the erection of ethical and aesthetical barriers in the ego. In obsessional neurosis, these processes carry on well beyond the norm: in addition to the destruction of the Oedipus complex there is also regressive debasement of the libido; the super-ego becomes particularly harsh and unbending; and the ego in its obedience to the super-ego produces strong reaction-formations in the shape of conscientiousness, compassion and cleanliness. The temptation to carry on with early infantile masturbation is renounced and reviled with implacable severity, albeit not always with success – masturbation that now draws on regressive (sadistic-anal) imaginings, but none the less represents that portion of phallic organization that remains unbeaten and unbowed. There is an inherent contradiction in the fact that for the very purpose of safeguarding masculinity (castration fear), every least hint of masculine activity is forestalled; but this contradiction, too, is already part and parcel of the normal routine for getting rid of the Oedipus complex, and is remarkable in obsessional neurosis only for its excessiveness. The axiom that excess always bears within it the seeds of its own dissolution is borne out not least by obsessional neurosis, in that the suppressed masturbation forces its way in the guise of obsessional acts ever closer to gratification.
The reaction-formations that take place in the ego of obsessional neurotics, which we have identified as exaggerated versions of normal character-formation, may reasonably be described as a new defence mechanism by comparison with regression and repression. They appear to be absent or very much weaker in hysteria. Looking back, then, we can make a conjecture as to what constitutes the distinguishing feature of the defence process in hysteria: it appears to confine itself to repression, in that the ego turns away from the disagreeable drive-impulse, leaves it to run its course in the unconscious, and takes no further part in its destiny. True, this cannot be wholly and invariably correct, for of course we know of cases where a hysterical symptom simultaneously represents the fulfilment of a call for punishment pronounced by the super-ego; but it may serve to describe a general characteristic of the ego's behaviour in cases of hysteria.
One can either simply accept it as a fact that the super-ego takes on such a harsh form in obsessional neurosis, or else one can suppose that the fundamental trait of this disorder is libido regression, and then attempt to posit a connection between this and the severity exhibited by the super-ego. It is certainly the case that the super-ego, which itself derives from the id, cannot just ignore the regression and the de-mergence of drives that have occurred there. It would scarcely be surprising if the super-ego for its part did not become harsher, colder, more pitiless than it is when there is normal development.
During the latency period, fighting off the temptation to masturbate appears to be treated as the paramount task. This battle produces a whole range of symptoms that recur in typical form even in very different individuals, and are by and large ritualistic in character. It is very much to be regretted that they have not yet been catalogued and systematically analysed: as the earliest by-products of neurosis they would be likely to shed more light than anything else on the mechanism of symptom-formation involved here. Even at this early stage they exhibit signs of the traits that will come to the fore in such a dire way once the illness becomes severe: the tendency to repeat and dwell on things becomes apparent; and ordinary, everyday activities - going to bed, washing and dressing, going from A to B – reflect their influence in the form of habits that are later to become practically automatic. Why this happens is by no means fully understood as yet; but the sublimation of anal-erotic components clearly plays a role in it.
Puberty marks a decisive watershed in the development of obsessional neurosis. The process of genital organization broken off earlier in childhood now reasserts itself with tremendous force. We know, however, that the pattern of sexual development in early childhood also determines the direction that things take in this new beginning represented by the pubertal period. Thus on the one hand the aggressive impulses of infancy awaken afresh, and on the other hand a pretty substantial proportion of the new libidinal impulses – in severe cases all of them – are obliged to follow the paths already marked out by the regression process, and to emerge as aggressive and destructive tendencies. Because of this camouflaging of the person's erotic urges, and because of the powerful reaction-formations that occur in the ego, the battle against sexuality is now waged under the banner of ethics. The ego recoils aghast from the cruel and violent demands transmitted to its consciousness from the id, without realizing that in so doing it is actually fighting off erotic desires, including some to which under normal circumstances it would have raised no objection. The hyper-severe super-ego insists even more emphatically on the suppression of this sexuality because of the fact that it has assumed such repellent forms. The conflict thus proves to be doubly exacerbated in obsessional neurosis: the forces doing the fighting off become even more intolerant, while the forces needing to be fought off become even more intolerable. Both developments are the result of a single factor: the regression of the libido.
One might consider a number of our suppositions to be contradicted by the very fact that the disagreeable notion informing the obsession ever enters consciousness in the first place. There can be no doubt, however, that before doing so it has first gone through the process of repression. In most cases the ego is completely oblivious of the real purport of the aggressive drive-impulse, and a good deal of psychoanalytical work is required in order to make the patient aware of it. As a rule, the only thing that manages to make its way into consciousness is a deformed surrogate that is either blurred and dreamlike in its lack of definition, or so absurdly disguised as to be unrecognizable. Even if the repression has not gnawed away at the actual content of the aggressive drive-impulse, it will certainly have got rid of the attendant element of affect. The ego accordingly perceives the aggression not as an active impulse, but as patients tend to say as a mere ‘thought’, something that ought to have no effect whatever on the emotions. What is most extraordinary is that this is not in fact the case. For the affect that is kept out of the picture as regards the subject's perception of the notion behind his obsession does make its appearance after all but in a different location. The
super-ego behaves as if no repression had taken place, as if it were familiar with both the precise purport and the whole affective nature of the aggressive impulse, and treats the ego on the basis of these assumptions. On the one hand the ego knows itself to be guiltless, but on the other hand it necessarily experiences guilt-feelings and a sense of blame that it simply cannot explain. The puzzle that this confronts us with is not as big as it first seems, however. The behaviour of the super-ego is altogether understandable; as for the contradiction within the ego, it simply proves to us that it has shut itself off from the id by means of the repression, while remaining entirely open to any influences emanating from the super-ego.30 The further question as to why the ego does not similarly abstract itself from the torment of the super-ego's criticism becomes otiose once we realize that this does indeed happen in a great number of cases. Furthermore, there are obsessional neuroses that exhibit no guilty conscience at all: the ego has avoided all cognizance of it, so we believe, by summoning up a whole new set of symptoms, penances and self-punishing restrictions. At the same time, however, these symptoms represent the gratification of masochistic drive-impulses, which the regression process has likewise served to reinforce.
Obsessional neurosis displays such enormous diversity in its manifestations that no amount of effort has ever succeeded in producing a coherent synthesis of all its variations. Our one aim is to identify connections and correlations typical of the disorder, yet we are worried all the time lest we overlook other recurrent features that are no whit less important.
I have already described the general tendency characteristic of symptom-formation in obsessional neurosis. It amounts to giving ever more scope for surrogate gratification, hence ever less scope for refusal.31 Thanks to the ego's proclivity to synthesis, the same symptoms that originally signified restrictions subsequently also acquire the significance of gratifications, and it is clear that this latter role gradually becomes the more influential of the two. An extremely restricted ego that is entirely dependent on symptoms for its gratification: that is the eventual result of this process, which gets ever closer to marking the total failure of what began as a defensive battle. This shift in the balance of forces in favour of gratification can lead ultimately to the dreaded phenomenon of a complete paralysis of will in the ego, which, when facing any kind of decision, experiences almost as strong an impetus from the one side as from the other. The unduly fierce conflict between the id and the super-ego that dominates the disorder from the outset can proliferate to such an extent that all activities of the ego – itself quite incapable of mediating between the two – are irresistibly drawn into it.
Beyond the Pleasure Principle and Other Writings Page 23