Freud - Complete Works (433 page)

   The importance in the causation
of illness which must be ascribed to
quantity
of libido is
in satisfactory agreement with two main theses of the theory of the
neuroses to which psycho-analysis has led us: first, the thesis
that the neuroses are derived from the conflict between the ego and
the libido, and secondly, the discovery that there is no
qualitative
distinction between the determinants of health
and those of neurosis, and that, on the contrary, healthy people
have to contend with the same tasks of mastering their libido -
they have simply succeeded better in them.

Types Of Onset Of Neurosis

2564

   It remains to say a few words on
the relation of these types to the facts of observation. If I
survey the set of patients on whose analysis I am at the moment
engaged, I must record that not one of them is a pure example of
any of the four types of onset. In each of them, rather, I find a
portion of frustration operating alongside of a portion of
incapacity to adapt to the demands of reality; inhibition in
development, which coincides, of course, with inflexibility of
fixations, has to be reckoned with in all of them, and, as I have
already said, the importance of quantity of libido must never be
neglected. I find, indeed, that in several of these patients their
illness has appeared in successive waves, between which there have
been healthy intervals, and that each of these waves has been
traceable to a different type of precipitating cause. Thus the
erection of these four types cannot lay claim to any high
theoretical value; they are merely different ways of establishing a
particular pathogenic constellation in the mental economy - namely
the damming-up of libido, which the ego cannot, with the means at
its command, ward off without damage. But this situation itself
only becomes pathogenic as a result of a quantitative factor; it
does not come as a novelty to mental life and is not created by the
impact of what is spoken of as a ‘cause of
illness’.

   A certain
practical
importance may readily be allowed to these types of onset. They are
to be met with in their pure form, indeed, in individual cases; we
should not have noticed the third and fourth types if they had not
in some subjects constituted the sole precipitating causes of the
illness. The first type keeps before our eyes the extraordinarily
powerful influence of the external world, and the second the no
less important influence - which opposes the former one - of the
subject’s peculiar individuality. Pathology could not do
justice to the problem of the precipitating factors in the neuroses
so long as it was merely concerned with deciding whether those
affections were of an ‘endogenous’ or
‘exogenous’ nature. It was bound to meet every
observation which pointed to the importance of abstinence (in the
widest sense of the word) as a precipitating cause with the
objection that other people tolerate the same experiences without
falling ill. If, however, it sought to lay stress on the peculiar
individuality of the subject as being the essential factor decisive
between illness and health, it was obliged to put up with the
proviso that people possessing such a peculiarity can remain
healthy indefinitely, just so long as they are able to retain that
peculiarity. Psycho-analysis has warned us that we must give up the
unfruitful contrast between external and internal factors, between
experience and constitution, and has taught us that we shall
invariably find the cause of the onset of neurotic illness in a
particular psychical situation which can be brought about in a
variety of ways.

2565

CONTRIBUTIONS TO A DISCUSSION ON MASTURBATION

(1912)

2566

Intentionally left blank

2567

CONTRIBUTIONS TO A DISCUSSION ON MASTURBATION

I

INTRODUCTION

It is never the aim of the discussions in the
Vienna Psycho-Analytical Society to remove diversities or to arrive
at conclusions. The different speakers, who are held together by
taking a similar fundamental view of the same facts, allow
themselves to give the sharpest expression to the variety of their
individual opinions without any regard to the probability of
converting any of their audience who may think otherwise. There may
be many points in these discussions which have been misstated and
misunderstood, but the final outcome, nevertheless, is that every
one has received the clearest impression of views differing from
his own and has communicated his own differing views to other
people.

   The discussion on masturbation,
of which actually only fragments are published here, lasted for
several months and was conducted on the plan of each speaker in
turn reading a paper, which was followed by an exhaustive debate.
Only the actual papers are included in the present publication, and
not the debates, which were highly stimulating and in which the
differing opinions were expressed and defended. This pamphlet would
otherwise have attained dimensions which would certainly have stood
in the way of its being widely read and proving effective.

   The choice of the topic calls for
no apologies in these days when an attempt is at last being made to
subject the problems of man’s sexual life to a scientific
examination. Numerous repetitions of the same thoughts and
assertions were unavoidable: they are, of course, the signs of
agreement between the speakers. As regards the many divergences in
their views, it can no more be an editor’s task to harmonize
them than it is to attempt to hide them. It is to be hoped that the
reader’s interest will be repelled neither by the repetitions
nor by the contradictions.

   It has been our purpose on this
occasion to show the direction into which the study of the problem
of masturbation has been forced by the emergence of the
psycho-analytic method of approach. How far we have succeeded in
that purpose will appear from our readers’ applause, or
perhaps still more clearly from their disapproval.

VIENNA
,
Summer
1912

Contributions To A Discussion On Masturbation

2568

II

CONCLUDING REMARKS

GENTLEMEN
, - The older members of
this group will be able to recall that some years ago we made a
previous attempt at a collective discussion of this kind - a
‘symposium’, as our American colleagues call it - on
the subject of masturbation. At that time the opinions expressed
showed such important divergences that we did not venture to lay
our proceedings before the public. Since then the same group,
together with some newcomers, having been uninterruptedly in touch
with observed facts, and having had a constant interchange of ideas
with one another, have so far clarified their views and arrived at
common ground that the venture which we previously abandoned now no
longer seems so rash. I really have an impression that the points
on which we are agreed in connection with masturbation are now
firmer and more deep-going than the disagreements - though these
undeniably exist. Some of the apparent contradictions are only the
result of the many different directions from which you have
approached the subject, whereas in fact the opinions in question
may quite well find a place alongside one another.

   With your permission I will set
before you a summary of the points on which we seem to be agreed or
divided.

   We are all
agreed
, I
feel,

   (
a
) on the importance of
the phantasies which accompany or represent the act of
masturbation,

   (
b
) on the importance of
the sense of guilt, whatever its source may be, which is attached
to masturbation, and

   (
c
) on the impossibility
of assigning a qualitative determinant for the injurious effects of
masturbation. (On this last point agreement is not unanimous.)

  
Unresolved differences of
opinion
have appeared

   (
a
) in respect to a denial
of a somatic factor in the effects of masturbation,

   (
b
) in respect to a
general denial of the injurious effects of masturbation,

   (
c
) with regard to the
origin of the sense of guilt, which some of you wish to attribute
directly to lack of satisfaction, while others adduce social
factors in addition, or the attitude of the subject’s
personality at the moment, and

   (
d
) with regard to the
ubiquity of masturbation in children.

   Lastly, significant
uncertainties
exist

   (
a
) as to the mechanism of
the injurious effects of masturbation, if there are any, and

   (
b
) as to the aetiological
relation of masturbation to the ‘actual neuroses’.

   As regards the majority of the
points of controversy among us, we have to thank the challenging
criticisms of our colleague Wilhelm Stekel, based on his great and
independent experience. There is no doubt that we have left very
many points over to be established and clarified by some future
band of observers and enquirers. But we may console ourselves with
the knowledge that we have worked honestly and in no narrow spirit,
and that in so doing we have opened up paths along which later
research will be able to travel.

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2569

   You must not expect much from my
own contributions to the questions we are concerned with. You are
aware of my preference for the fragmentary treatment of a subject,
with emphasis on the points which seem to me best established. I
have nothing new to offer - no solutions, only a few repetitions of
things I have already maintained, a few words in defence of these
old assertions against attacks made upon them by some of you, and
in addition, a few comments which must inevitably force themselves
on anyone listening to your papers.

   I have, as you know, divided
masturbation according to the subject’s age into (1)
masturbation in infants, which includes all auto-erotic activities
serving the purpose of sexual satisfaction, (2) masturbation in
children, which arises directly out of the preceding kind and has
already become fixed to certain erotogenic zones, and (3)
masturbation at puberty, which is either continuous with childhood
masturbation or is separated from it by the period of latency. In
some of the accounts which I have heard you give, full justice has
not quite been done to this temporal division. The ostensible unity
of masturbation, which is fostered by the customary medical
terminology, has given rise to some generalizations where a
differentiation according to the three periods of life would have
been better justified. It has been a matter for regret, too, that
we have not been able to pay as much attention to female as to male
masturbation; female masturbation, I believe, is deserving of a
special study and in its case it is particularly true that a
special emphasis lies on the modifications in it that arise in
relation to the subject’s age.

   I come now to the objections
raised by Reitler to my teleological argument in favour of the
ubiquity of masturbation in infancy. I admit that this argument
must be abandoned. If one more edition of my
Three Essays on the
Theory of Sexuality
is called for, it will not contain the
sentence under attack. I will renounce my attempt at guessing the
purposes of Nature and will content myself with describing the
facts.

   Another remark of Reitler’s
is, I think, significant and important. This was to the effect that
certain arrangements in the genital apparatus which are peculiar to
human beings seem to tend towards preventing sexual intercourse in
childhood. Here, however, my doubts arise. The occlusion of the
female sexual orifice and the absence of an
os penis
which
would assure erection are, after all, directed only against actual
coition, not against sexual excitations in general. Reitler seems
to me to take too anthropomorphic a view of the way in which Nature
pursues her aims - as though it were a question of her carrying
through a single purpose, as is the case with human activity. But
so far as we can see, in natural processes a whole number of aims
are pursued alongside one another, without interfering with one
another. If we are to speak of Nature in human terms, we shall have
to say that she appears to us to be what, in the case of men, we
should call inconsistent. For my part, I think Reitler should not
attach so much weight to his own teleological arguments. The use of
teleology as a heuristic hypothesis has its dubious side: in any
particular instance one can never tell whether one has hit upon a
‘harmony’ or a ‘disharmony’. It is the same
as when one drives a nail into the wall of a room: one cannot be
certain whether one is going to come up against lath and plaster or
brick-work.

Contributions To A Discussion On Masturbation

2570

   On the question of the relation
of masturbation and emissions to the causation of so-called
‘neurasthenia’, I find myself like many of you, in
opposition to Stekel, and, subject to a limitation which I shall
mention presently, I maintain, as against him, my former views. I
see nothing that could oblige us to abandon the distinction between
‘actual neuroses’ and psychoneuroses, and I cannot
regard the genesis of the symptoms in the case of the former as
anything but toxic. Here Stekel really seems to me greatly to
overstretch psychogenicity. My view is still what it was in the
first instance, more than fifteen years ago: namely, that the two
‘actual neuroses’ - neurasthenia and anxiety neurosis
(and perhaps we ought to add hypochondria proper as a third
‘actual neurosis’) - provide the psychoneuroses with
the necessary ‘somatic compliance’; they provide the
excitatory material, which is then psychically selected and given a
‘psychical coating’, so that, speaking generally, the
nucleus of the psychoneurotic symptom - the grain of sand at the
centre of the pearl - is formed of a somatic sexual manifestation.
This is clearer, it is true, of anxiety neurosis and its relation
to hysteria than it is of neurasthenia, into which no careful
psycho-analytic investigations have yet been made. In anxiety
neurosis, as you have often been able to convince yourselves, it is
at bottom a small fragment of undischarged excitation connected
with coition which emerges as an anxiety symptom or provides the
nucleus for the formation of a hysterical symptom.

   Stekel shares with many
non-psycho-analytic writers an inclination to reject the
morphological differentiations which we have made within the jumble
of the neuroses and to lump them all together under one heading -
under psychasthenia, perhaps. We have often contradicted him on
this, and have held fast to our expectation that the
morphologico-clinical differences will prove valuable as
indications that have not yet been understood of essentially
distinct processes. When he - justly - points out to us that he has
regularly found the same complexes present in what are termed
neurasthenics as in other neurotics, his argument fails to meet the
point at issue. We have long known that the same complexes and
conflicts are to be looked for, too, in all normal and healthy
people. In fact, we have grown accustomed to attributing to every
civilized human being a certain amount of repression of perverse
impulses, a certain amount of anal erotism, of homosexuality and so
on, as well as a piece of father-complex and mother-complex and of
other complexes besides - just as in the chemical analysis of an
organic substance we have every hope of finding certain elements:
carbon, oxygen, hydrogen, nitrogen and a trace of sulphur. What
distinguishes organic substances from one another is the relative
amounts of these elements and the way in which the links between
them are constituted. In the same way, in the case of normal and
neurotic people what is in question is not whether these complexes
and conflicts
exist
but whether they have become pathogenic
and, if so, by means of what mechanisms they have become so.

Contributions To A Discussion On Masturbation

2571

   The essence of the theories about
the ‘actual neuroses’ which I have put forward in the
past and am defending to-day lies in my assertion, based on
experiment, that their symptoms, unlike psychoneurotic ones, cannot
be analysed. That is to say, the constipation, headaches and
fatigue of the so-called neurasthenic do not admit of being traced
back historically or symbolically to operative experiences and
cannot be understood as substitutes for sexual satisfaction or as
compromises between opposing instinctual impulses, as is the case
with psycho-neurotic symptoms (even though the latter may perhaps
have the same appearance). I do not believe it will be possible to
upset this assertion by the help of psycho-analysis. On the other
hand I will grant to-day what I was unable to believe formerly -
that an analytic treatment can have an indirect curative effect on
‘actual’ symptoms. It can do so either by enabling the
current noxae to be better tolerated, or by enabling the sick
person to escape from the current noxae by making a change in his
sexual régime. These would be desirable prospects from the
point of view of our therapeutic interest.