Freud - Complete Works (34 page)

Studies On Hysteria

170

   If, therefore, there are a large
number of characteristic hysterical phenomena which we cannot
suppose to be ideogenic, it would seem right to limit the
application of Moebius’s thesis. We shall not define as
hysterical those pathological phenomena which are caused by ideas,
but only assert that a great number of hysterical phenomena,
probably more than we suspect to-day, are ideogenic. But the
fundamental pathological change which is present in every case and
enables ideas as well as non-psychological stimuli to produce
pathological effects lies in an abnormal excitability of the
nervous system.¹ How far this excitability is itself of
psychical origin is another question.

   Yet even though only some of the
phenomena of hysteria are ideogenic, nevertheless it is precisely
they that may be described as the specifically hysterical ones, and
it is the investigation of them, the discovery of their psychical
origin, which constitutes the most important recent step forward in
the theory of the disorder. The further question then arises: ho do
these phenomena come about? What is their ‘psychical
mechanism’?

   This question requires a quite
different answer in the case of each of the two groups into which
Moebius divides ideogenic symptoms. Those pathological phenomena
which correspond in their content to the instigating idea are
relatively understandable and clear. If the idea of a heard voice
does not merely cause it to echo faintly in the ‘inward
ear’, as it does in healthy people, but causes it to be
perceived in a hallucinatory manner as a real, objective acoustic
sensation, this may be equated with familiar phenomena of normal
life - with dreams - and is quite intelligible on the hypothesis of
abnormal excitability. We know that with every voluntary movement
it is the idea of the result to be achieved which initiates the
relevant muscular contraction; and it is not very hard to see that
the idea that this contraction is impossible will impede the
movement (as happens in paralysis by suggestion).

   The situation is otherwise with
those phenomena which have no logical connection with the
determining idea. (Here, too, normal life offers parallels, as, for
instance, blushing for shame.) How do they arise? Why does an idea
in a sick man evoke one particular entirely irrational movement or
hallucination which does not in any way correspond to it?

  
¹
Attributed by Oppenheim to
‘instability of the molecules’. It may be possible at a
later stage to replace the very vague statement in the text above
by a more precise and significant formula.

Studies On Hysteria

171

   In our ‘Preliminary
Communication’ we felt able to say something about this
causal relation on the basis of our observations. In our exposition
of the subject, however, we introduced and employed without apology
the concept of ‘excitations which flow away or have to be
abreacted’. This concept is of fundamental importance for our
theme and for the theory of the neuroses in general, and it seems
to demand and to deserve a more detailed examination. Before I
proceed to this, I must ask to be forgiven for taking the reader
back to the basic problems of the nervous system. A feeling of
oppression is bound to accompany any such descent to the
‘Mothers’.

   But any attempt at getting at the
roots of a phenomenon inevitably leads in this way to basic
problems which cannot be evaded. I hope therefore that the
abstruseness of the following discussion may be viewed with
indulgence.

(2)  INTRACEREBRAL TONIC EXCITATIONS -
AFFECTS

(A)

   We know two extreme conditions of
the central nervous system: a clear waking state and dreamless
sleep. A transition between these is afforded by conditions of
every degree of decreasing clarity. What interests us here is not
the question of the purpose of sleep and its physical basis (its
chemical or vasomotor determinants) but the question of the
essential distinction between the two conditions.

   We can give no direct information
about the deepest, dreamless sleep, for the very reason that all
observations and experiences are excluded by the state of total
unconsciousness. But as regards the neighbouring condition of sleep
accompanied by dreams, the following assertions can be made. In the
first place, when in that condition we intend to make voluntary
movements - of walking, speaking, etc. - this does not result in
the corresponding contractions of the muscles being voluntarily
initiated, as they are in waking life. In the second place, sensory
stimuli are perhaps perceived (for they often make their way into
dreams) but they are not apperceived, i.e. do not become conscious
perceptions. Again, ideas that emerge do not, as in waking life,
activate all the ideas which are connected with them and which are
present in potential consciousness; a great number of the latter
remain unexcited. (For instance, we find ourselves talking to a
dead person without remembering that he is dead.) Furthermore,
incompatible ideas can be present simultaneously without mutually
inhibiting each other, as they do in waking life. Thus, association
is defective and incomplete, We may safely assume that in the
deepest sleep this severance of connections between the psychical
elements is carried still further and becomes total.

Studies On Hysteria

172

   On the other hand, when we are
fully awake every act of will initiates the corresponding movement;
sense-impressions become conscious perceptions; and ideas are
associated with the whole store present in potential consciousness.
In that condition the brain functions as a unit with complete
internal connections.

   We shall perhaps only be
describing these facts in other words if we say that in sleep the
paths of connection and conduction in the brain are not traversable
by excitations of the psychical elements ( ? cortical cells),
whereas in waking life they are completely so traversable.

   The existence of these two
different conditions of the paths of conduction can, it seems, only
be made intelligible if we suppose that in waking life those paths
are in a state of tonic excitation (what Exner calls
‘intercellular tetanus’), that this intracerebral
excitation is what determines their conductive capability, and that
the diminution and disappearance of that excitation is what sets up
the state of sleep.

   We ought not to think of a
cerebral path of conduction as resembling a telephone wire which is
only excited electrically at the moment at which it has to function
(that is, in the present context, when it has to transmit a
signal). We ought to liken it to a telephone line through which
there is a constant flow of galvanic current and which can no
longer be excited if that current ceases. Or better, let us imagine
a widely-ramified electrical system for lighting and the
transmission of motor power; what is expected of this system is
that simple establishment of a contact shall be able to set any
lamp or machine in operation. To make this possible, so that
everything shall be ready to work, there must be a certain tension
present throughout the entire network of lines of conduction, and
the dynamo engine must expend a given quantity of energy for this
purpose. In just the same way there is a certain amount of
excitation present in the conductive paths of the brain when it is
at rest but awake and prepared to work.¹

   This view of the matter is
supported by the fact that merely being awake, without doing any
work, gives rise to fatigue and produces a need for sleep. The
state of waking in itself causes a consumption of energy.

  
¹
I may perhaps venture here to indicate
briefly the notion on which the above statements are based. We
usually think of the sensory nerve cells as being passive receptive
organs. This is a mistake. For the mere existence of a system of
associative fibres proves that these sensory nerve-cells also send
out excitation into the nerve-fibres. If excitation from two
sensory cells flows into a nerve-fibre that connects them - whether
per continuitatem
or
per contiguitatem
- then a state
of tension must exist in it. This state of tension has the same
relation to the excitation flowing away in, for instance, a
peripheral motor fibre as hydrostatic pressure has to the living
force of flowing water or as electric tension has to an electric
current. If all the nerve-cells are in a state of mean excitation
and are exciting their nerve-processes, the whole immense network
forms a single reservoir of ‘nervous tension’. Apart
then from a potential energy which lies quiescent in the chemical
substance of the cell and an unknown form of kinetic energy which
is discharged when the fibres are in a state of excitation, we must
assume the existence of yet another quiescent state of nervous
excitation: tonic excitation or nervous tension.

Studies On Hysteria

173

   Let us imagine a man in a state
of intense expectation, which is not, however, directed to any
particular sensory field. We then have before us a brain which is
quiescent but prepared for action. We may rightly suppose that in
such a brain all the paths of conduction are at the maximum of
their conductive capability - that they are in a state of tonic
excitation. It is a significant fact that in ordinary language we
speak of such a state as one of tension. Experience teaches us what
a strain this state is and how fatiguing, though no actual motor or
psychical work is performed in it.

   This is an exceptional state,
which, precisely on account of the great consumption of energy
involved, cannot be tolerated for long. But even the normal state
of being wide awake calls for an amount of intracerebral excitation
varying between limits that are not very widely separated. Every
diminishing degree of wakefulness down to drowsiness and true sleep
is accompanied by correspondingly lower degrees of excitation.

   When the brain is performing
actual work, a greater consumption of energy is no doubt required
than when it is merely
prepared
to perform work. (In just
the same way the electrical system described above by way of
comparison must cause a greater amount of electrical energy to flow
into the conducting lines when a large number of lamps or motors
are switched into the circuit.) Where functioning is normal no more
energy is liberated than is immediately employed in activity. The
brain, however, behaves like one of those electrical systems of
restricted capability which are unable to produce both a large
amount of light and of mechanical work at the same time. If it is
transmitting power, only a little energy is available for lighting,
and
vice versa
. Thus we find that if we are making great
muscular efforts we are unable to engage in continuous thought, or
that if we concentrate our attention in one sensory field the
efficiency of the other cerebral origins is reduced - that is to
say, we find that the brain works with a varying but limited amount
of energy.

   The non‑uniform
distribution of energy is no doubt determined by what Exner calls
‘facilitation by attention’ - by an increase in the
conductive capability of the paths in use and a decrease in that of
the others; and thus in a working brain the ‘intracerebral
tonic excitation’, too, is non‑uniformly
distributed.¹

  
¹
The conception of the energy of the central
nervous system as being a quantity distributed over the brain in a
changing and fluctuating manner is an old one. ‘La
sensibilite’, wrote Cabanis, ‘semble e comporter
à la manière d’une fluide dont la
quantité totale est déterminée et qui, toutes
les fois qu’il se jette en plus grande abonds ance dans un de
ses canaux, diminue proportionellement dans le autres.’
(Quoted from Janet, 1894, 277.) [‘Sensibility seems to behave
like a fluid whose total quantity is fixed and which, whenever it
pours into one of its channels in greater abundance, becomes
proportionally less in the others.’]

Studies On Hysteria

174

   We wake up a person who is
sleeping - that is, we suddenly raise the quantity of his tonic
intracerebral excitation - by bringing a lively sensory stimulus to
bear upon him. Whether alterations in the blood-circulation in the
brain are essential links here in the causal chain, and whether the
blood-vessels are directly dilated by the stimulus, or whether the
dilatation is a consequence of the excitation of the cerebral
elements - all this is undecided. What is certain is that the state
of excitation, entering through a gateway of the senses, spreads
over the brain from that point, becomes diffused and brings all the
paths of conduction into a state of higher facilitation.

   It is still not in the least
clear, of course, how
spontaneous
awakening occurs - whether
it is always one and the same portion of the brain that is the
first to enter a state of waking excitation and the excitation then
spreads from there, or whether sometimes one and sometimes another
group of elements acts as the awakener. Nevertheless spontaneous
awakening, which, as we know, can take place in complete quiet and
darkness without any external stimulus, proves that the development
of energy is based on the vital process of the cerebral elements
themselves. A muscle remains unstimulated, quiescent, however long
it has been in a state of rest and even though it has accumulated a
maximum of tensile force. This is not so with the cerebral
elements. We are no doubt right in supposing that during sleep the
latter regain their previous condition and gather tensile force.
When this has happened to a certain degree, when, as we may say, a
certain level has been reached, the surplus flows away into the
paths of conduction, facilitates them and sets up the intracerebral
excitation of the waking state.