The Collected Works of Sigmund Freud. Sigmund Freud

mate may for many years have been lacking in that sufficient sexual capacity which the well-preserved woman needs for her satisfaction. We have learned by experience to know that those very men whose faithfulness is thus placed beyond a doubt are most gentle in their treatment of their wives and unusually forbearing toward their nervous complaints. Furthermore, the fact that it was just the young husband of a daughter who became the object of her abnormal infatuation is by no means insignificant. A strong erotic attachment to the daughter, which in the last analysis leads back to the mother’s sexual constitution, will often find a way to live on under such a disguise. May I perhaps remind you in this connection that the relationship between mother and son-in-law has seemed particularly delicate since all time and is one which among primitive peoples gave rise to very powerful taboos and avoidances.³⁷ It often transgresses our cultural standards positively as well as negatively. I cannot tell you of course which of these three factors were at work in our case; whether two of them only, or whether all of them coöperated, for as you know I did not have the opportunity to continue the analysis beyond two hours.

      I realize at this point, ladies and gentlemen, that I have been speaking entirely of things for which your understanding was not prepared. I did this in order to carry through the comparison of psychiatry and psychoanalysis. May I now ask one thing of you? Have you noticed any contradiction between them? Psychiatry does not apply the technical methods of psychoanalysis, and neglects to look for any significance in the content of the obsession. Instead of first seeking out more specific and immediate causes, psychiatry refers us to the very general and remote source — heredity. But does this imply a contradiction, a conflict between them? Do they not rather supplement one another? For does the hereditary factor deny the significance of the experience, is it not rather true that both operate together in the most effective way? You must admit that there is nothing in the nature of psychiatric work which must repudiate psychoanalytic research. Therefore, it is the psychiatrists who oppose psychoanalysis, not psychiatry itself. Psychoanalysis stands in about the same relation to psychiatry as does histology to anatomy. The one studies the outer forms of organs, the other the closer structure of tissues and cells. A contradiction between two types of study, where one simplifies the other, is not easily conceivable. You know that anatomy today forms the basis of scientific medicine, but there was a time when the dissection of human corpses to learn the inner structure of the body was as much frowned upon as the practice of psychoanalysis, which seeks to ascertain the inner workings of the human soul, seems proscribed today. And presumably a not too distant time will bring us to the realization that a psychiatry which aspires to scientific depth is not possible without a real knowledge of the deeper unconscious processes in the psychic life.

      Perhaps this much-attacked psychoanalysis has now found some friends among you who are anxious to see it justify itself as well from another aspect, namely, the therapeutic side. You know that the therapy of psychiatry has hitherto not been able to influence obsessions. Can psychoanalysis perhaps do so, thanks to its insight into the mechanism of these symptoms? No, ladies and gentlemen, it cannot; for the present at least it is just as powerless in the face of these maladies as every other therapy. We can understand what it was that happened within the patient, but we have no means of making the patient himself understand this. In fact, I told you that I could not extend the analysis of the obsession beyond the first steps. Would you therefore assert that analysis is objectionable in such cases because it remains without result? I think not. We have the right, indeed we have the duty to pursue scientific research without regard to an immediate practical effect. Some day, though we do not know when or where, every little scrap of knowledge will have been translated into skill, even into therapeutic skill. If psychoanalysis were as unsuccessful in all other forms of nervous and psychological disease as it is in the case of the obsession, it would nevertheless remain fully justified as an irreplaceable method of scientific research. It is true that we would then not be in a position to practice it, for the human subjects from which we must learn, live and will in their own right; they must have motives of their own in order to assist in the work, but they would deny themselves to us. Therefore let me conclude this session by telling you that there are comprehensive groups of nervous diseases concerning which our better understanding has actually been translated into therapeutic power; moreover, that in disturbances which are most difficult to reach we can under certain conditions secure results which are second to none in the field of internal therapeutics.

37. Compare S. Freud, Totem and Taboo, 1913.

      SEVENTEENTH LECTURE

       GENERAL THEORY OF THE NEUROSES

       THE MEANING OF THE SYMPTOMS

       Table of Contents

      In the last lecture I explained to you that clinical psychiatry concerns itself very little with the form under which the symptoms appear or with the burden they carry, but that it is precisely here that psychoanalysis steps in and shows that the symptom carries a meaning and is connected with the experience of the patient. The meaning of neurotic symptoms was first discovered by J. Breuer in the study and felicitous cure of a case of hysteria which has since become famous (1880–82). It is true that P. Janet independently reached the same result; literary priority must in fact be accorded to the French scholar, since Breuer published his observations more than a decade later (1893–95) during his period of collaboration with me. On the whole it may be of small importance to us who is responsible for this discovery, for you know that every discovery is made more than once, that none is made all at once, and that success is not meted out according to deserts. America is not named after Columbus. Before Breuer and Janet, the great psychiatrist Leuret expressed the opinion that even for the deliria of the insane, if we only understood how to interpret them, a meaning could be found. I confess that for a considerable period of time I was willing to estimate very highly the credit due to P. Janet in the explanation of neurotic symptoms, because he saw in them the expression of subconscious ideas (idées inconscientes) with which the patients were obsessed. But since then Janet has expressed himself most conservatively, as though he wanted to confess that the term “subconscious” had been for him nothing more than a mode of speech, a shift, “une façon de parler,” by the use of which he had nothing definite in mind. I now no longer understand Janet’s discussions, but I believe that he has needlessly deprived himself of high credit.

      The neurotic symptoms then have their meaning just like errors and the dream, and like these they are related to the lives of the persons in whom they appear. The importance of this insight into the nature of the symptom can best be brought home to you by way of examples. That it is borne out always and in all cases, I can only assert, not prove. He who gathers his own experience will be convinced of it. For certain reasons, however, I shall draw my instances not from hysteria, but from another fundamentally related and very curious neurosis concerning which I wish to say a few introductory words to you. This so-called compulsion neurosis is not so popular as the widely known hysteria; it is, if I may use the expression, not so noisily ostentatious, behaves more as a private concern of the patient, renounces bodily manifestations almost entirely and creates all its symptoms psychologically. Compulsion neurosis and hysteria are those forms of neurotic disease by the study of which psychoanalysis has been built up, and in whose treatment as well the therapy celebrates its triumphs. Of these the compulsion neurosis, which does not take that mysterious leap from the psychic to the physical, has through psychoanalytic research become more intimately comprehensible and transparent to us than hysteria, and we have come to understand that it reveals far more vividly certain extreme characteristics of the neuroses.

      The chief manifestations of compulsion neurosis are these: the patient is occupied by thoughts that in reality do not interest him, is moved by impulses that appear alien to him, and is impelled to actions which, to be sure, afford him no pleasure, but the performance of which he cannot possibly resist. The thoughts may be absurd in themselves or thoroughly indifferent to the individual, often they are absolutely childish and in all cases they are the result of strained thinking, which exhausts the patient, who surrenders