Freud - Complete Works (68 page)

II

THE NATURE AND MECHANISM OF OBSESSIONAL
NEUROSIS

   Sexual experiences of early
childhood have the same significance in the aetiology of
obsessional neurosis as they have in that of hysteria. Here,
however, it is no longer a question of sexual
passivity
, but
of acts of aggression carried out with pleasure and of pleasurable
participation in sexual acts - that is to say, of sexual
activity
. This difference in the aetiological circumstances
is bound up with the fact that obsessional neurosis shows a visible
preference for the male sex.

  
¹
(
Footnote added
1924:) This section
is dominated by an error which I have since repeatedly acknowledged
and corrected. At that time I was not yet able to distinguish
between my patients’ phantasies about their childhood years
and their real recollections. As a result, I attributed to the
aetiological factor of seduction a significance and universality
which it does not possess. When this error had been overcome, it
became possible to obtain an insight into the spontaneous
manifestations of the sexuality of children which I described in my
Three Essays on the Theory of Sexuality
(1905
d
).
Nevertheless, we need not reject everything written in the text
above. Seduction retains a certain aetiological importance, and
even to-day I think some of these psychological comments are to the
point.

Further Remarks On The Neuro-Psychoses Of Defence

389

   In all my cases of obsessional
neurosis, moreover, I have found a
substratum of hysterical
symptoms
which could be traced back to a scene of sexual
passivity that preceded the pleasurable action. I suspect that this
coincidence is no fortuitous one, and that precocious sexual
aggressivity always implies a previous experience of being seduced.
However, I can as yet give no definitive account of the aetiology
of obsessional neurosis; I only have an impression that the
decision as to whether hysteria or obsessional neurosis will arise
on the basis of traumas in childhood depends on
chronological
circumstances in the development of the
libido.

   The nature of obsessional
neurosis can be expressed in a simple formula.
Obsessional
ideas
are invariably transformed
self-reproaches
which
have re-emerged from
repression
and which always relate to
some
sexual
act that was performed with pleasure
in
childhood
. In order to elucidate this statement it is necessary
to describe the typical course taken by an obsessional
neurosis.

   In a first period - the period of
childhood immorality - the events occur which contain the germ of
the later neurosis. First of all, in earliest childhood, we have
the experiences of sexual seduction that will later on make
repression possible; and then come the acts of sexual aggression
against the other sex, which will later appear in the form of acts
involving self-reproach.

   This period is brought to a close
by the advent of sexual ‘maturation’, often itself
unduly early. A self-reproach now be comes attached to the memory
of these pleasurable actions; and the connection with the initial
experience of passivity makes it possible - often only after
conscious and remembered efforts - to repress them and to replace
them by a
primary symptom of defence
. Conscientiousness,
shame and self-distrust are symptoms of this kind, with which the
third period begins - the period of
apparent
health, but
actually, of successful defence.

Further Remarks On The Neuro-Psychoses Of Defence

390

   The next period, that of the
illness, is characterized by
return of the repressed
memories
- that is, therefore, by the failure of the defence.
It is not certain whether the awakening of those memories occurs
more often accidentally and spontaneously or as a result of current
sexual disturbances, as a kind of by-product of them. The
re-activated memories, however, and the self reproaches formed from
them never re-emerge into consciousness unchanged: what become
conscious as obsessional ideas and affects, and take the place of
the pathogenic memories so far as conscious life is concerned, are
structures in the nature of a
compromise
between the
repressed ideas and the repressing ones.

   In order to describe clearly and
with probable accuracy the processes of repression, the return of
the repressed and the formation of pathological compromise-ideas,
one would have to make up one’s mind to quite definite
assumptions about the substratum of psychical events and of
consciousness. So long as one seeks to avoid this, one must be
content with the following remarks which are intended more or less
figuratively. There are two forms of obsessional neurosis,
according to whether what forces an entrance into consciousness is
solely the
mnemic content
of the act involving
self-reproach, or whether the self-reproachful
affect
connected with the act does so as well.

   The first form includes the
typical obsessional ideas, in which the content engages the
patient’s attention and, as an affect, he merely feels an
indefinite unpleasure, whereas the only affect which would be
suitable to the obsessional idea would be one of self-reproach. The
content of the obsessional idea is distorted in two ways in
relation to the obsessional act of childhood. First, something
contemporary is put in the place of something past; and secondly,
something sexual is replaced by something analogous to it that is
not sexual. These two alterations are the effect of the inclination
to repress, still in force, which we will ascribe to the
‘ego’. The influence of the re-activated pathogenic
memory is shown by the fact that the content of the obsessional
idea is still in part identical with what has been repressed or
follows from it by a logical train of thought. If, with the help of
the psycho-analytic method, we reconstruct the origin of an
individual obsessional idea, we find that from a single current
impression two different trains of thought have been set going. The
one which has passed by way of the repressed memory proves to be as
correctly logical in its structure as the other, although it is
incapable of being conscious and insusceptible to correction. If
the products of the two psychical operations do not tally, what
takes place is not some sort of logical adjustment of the
contradiction between them; instead, alongside of the
normal
intellectual outcome, there comes into consciousness, as a
compromise between the resistance and the
pathological
intellectual product, an obsessional idea which appears absurd. If
the two trains of thought lead to the
same
conclusion, they
reinforce each other, so that an intellectual product that has been
arrived at normally now behaves, psychologically, like an
obsessional idea.
Wherever a neurotic obsession emerges in the
psychological sphere, it comes from repression
. Obsessional
ideas have, as it were, a compulsive psychical currency, not on
account of their intrinsic value, but on account of the source from
which they derive or which has added a contribution to their
value.

Further Remarks On The Neuro-Psychoses Of Defence

391

   A second form of obsessional
neurosis comes about if what has forced its way to representation
in conscious psychical life is not the repressed mnemic content but
the likewise repressed self-reproach. The affect of self-reproach
can, by means of some mental addition, be transformed into any
other unpleasurable affect. When this has happened there is no
longer anything to prevent the substituted affect from becoming
conscious. Thus
self-reproach
(for having carried out the
sexual act in childhood) can easily turn into
shame
(in case
some one else should find out about it), into
hypochondriacal
anxiety
(fear of the physical injuries resulting from the act
involving the self-reproach), into
social anxiety
(fear of
being punished by society for the misdeed), into
religious
anxiety
, into
delusions of being noticed
(fear of
betraying the act to other people), or into
fear of
temptation
(a justified mistrust of one’s own moral
powers of resistance), and so on. In addition, the mnemic content
of the act involving self-reproach may be represented in
consciousness as well, or it may remain completely in the
background - which makes diagnosis much more difficult. Many cases
which, on a superficial examination, seem to be common
(neurasthenic) hypochondria, belong to this group of
obsessional
affects
; what is known as ‘periodic neurasthenia’
or ‘periodic melancholia’ seems in particular to
resolve itself with unexpected frequency into obsessional affects
and obsessional ideas - a discovery which is not a matter of
indifference therapeutically.

Further Remarks On The Neuro-Psychoses Of Defence

392

   Besides these compromise
symptoms, which signify the return of the repressed and
consequently a collapse of the defence that had been originally
achieved, the obsessional neurosis constructs a set of further
symptoms, whose origin is quite different. For the ego seeks to
fend off the derivatives of the initially repressed memory, and in
this defensive struggle it creates symptoms which might be classed
together as ‘
secondary defence
’. These are all
of them ‘
protective measures
’, which have
already done good service in the fight against obsessional ideas
and obsessional affects. If these aids in the defensive struggle
genuinely
succeed in once more repressing the symptoms of
the return which have forced themselves on the ego, then the
obsession is transferred to the protective measures themselves and
creates a third form of ‘obsessional neurosis’-
obsessional actions
. These actions are never primary; they
never contain anything but a defence - never an aggression. A
psychical analysis of them shows that, in spite of their
peculiarity, they can always be fully explained by being traced
back to the obsessional memories which they are fighting
against.¹

  
¹
To take a single example only. An
eleven-year-old boy had in an obsessional way instituted the
following ceremonial before going to bed. He did not go to sleep
until he had told his mother in the minutest detail all the
experiences he had had during the day; there must be no bits of
paper or other rubbish on the carpet in his bedroom in the evening;
his bed had to be pushed right up against the wall, three chairs
had to be placed in front of it, and the pillows had to lie in a
particular way. In order to go to sleep he was obliged first to
kick both his legs out a certain number of times and then lie on
his side. This was explained in the following manner. Years before,
a servant-girl who put the nice looking boy to bed had taken the
opportunity of lying down on him and abusing him sexually. When,
later on, this memory was aroused in him by a recent experience, it
manifested itself in his consciousness in a compulsion to perform
the ceremonial I have described above. The meaning of the
ceremonial was easy to guess and was established point by point by
psycho-analysis. The chairs were placed in front of the bed and the
bed pushed against the wall in order that nobody else should be
able to get at the bed; the pillows were arranged in a particular
way so that they should be differently arranged from how they were
on that evening; the movements with his legs were to kick away the
person who was lying on him; sleeping on his side was because in
the scene he had been lying on his back; his circumstantial
confession to his mother was because, in obedience to a prohibition
by his seductress, he had been silent to his mother about this and
other sexual experiences; and, finally, the reason for his keeping
his bedroom floor clean was that neglect to do so had been the
chief reproach that he had so far had to hear from his
mother.

Further Remarks On The Neuro-Psychoses Of Defence

393

   Secondary defence against the
obsessional ideas may be effected by a forcible diversion on to
other thoughts with a content as contrary as possible. This is why
obsessional brooding
, if it succeeds, regularly deals with
abstract and
suprasensual
things; because the ideas that
have been repressed are always concerned with
sensuality
. Or
else the patient tries to make himself master of each of his
obsessional ideas singly by logical work and by having recourse to
his conscious memories. This leads to
obsessional thinking
,
to a
compulsion to test things
and to
doubting mania
.
The advantage which perception has over memory in such tests at
first causes the patient, and later compels him, to collect and
store up all the objects with which he has come into contact.
Secondary defence against obsessional
affects
leads to a
still wider set of protective measures which are capable of being
transformed into obsessional acts. These may be grouped according
to their purpose:
penitential
measures (burdensome
ceremonials, the observation of numbers),
precautionary
measures (all sorts of phobias, superstition, pedantry, increase of
the primary symptom of conscientiousness); measures to do with
fear of betrayal
(collecting scraps of paper,
seclusiveness), or to ensure
numbing
(dipsomania). Among
these obsessional acts and obsessional impulses, phobias, since
they circumscribe the patient’s existence, play the greatest
part.