Freud - Complete Works (693 page)

Inhibitions, Symptoms And Anxiety

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   These are unwelcome
complications, considering that we only set out to study simple
cases of symptom-formation due to repression, and with that
intention selected the earliest and to all appearances, most
transparent neuroses of childhood. Instead of a single repression
we have found a collection of them and have become involved with
regression into the bargain. Perhaps we have added to the confusion
by treating the two cases of animal phobia at our disposal -
‘ Little Hans’ and the ‘Wolf Man’ - as
though they were cast in the same mould. As a matter of fact,
certain differences between them stand out. It is only with regard
to ‘Little Hans’ that we can say with certainty that
what his phobia disposed of were the two main impulses of the
Oedipus complex - his aggressiveness towards his father and his
over-fondness for his mother. A tender feeling for his father was
undoubtedly there too and played a part in repressing the opposite
feeling; but we can prove neither that it was strong enough to draw
repression upon itself nor that it disappeared afterwards.
‘Hans’ seems, in fact, to have been a normal boy with
what is called a ‘positive’ Oedipus complex. It is
possible that the factors which we do not find were actually at
work in him, but we cannot demonstrate their existence. Even the
most exhaustive analysis has gaps in its data and is insufficiently
documented. In the case of the Russian the deficiency lies
elsewhere. His attitude to female objects had been disturbed by an
early seduction and his passive, feminine side was strongly
developed. The analysis of his wolf-dream revealed very little
intentional aggressiveness towards his father, but it brought
forward unmistakable proof that what repression overtook was his
passive tender attitude to his father. In his case, too, the other
factors may have been operative as well; but they were not in
evidence. How is it that, in spite of these differences in the two
cases, almost amounting to an antithesis, the final outcome - a
phobia - was approximately the same? The answer must be sought in
another quarter. I think it will be found in the second fact which
emerges from our brief comparative examination. It seems to me that
in both cases we can detect what the motive force of the repression
was and can substantiate our view of its nature from the line of
development which the two children subsequently pursued. This
motive force was the same in both of them. It was the fear of
impending castration. ‘Little Hans’ gave up his
aggressiveness towards his father from fear of being castrated. His
fear that a horse would bite him can, without any forcing, be given
the full sense of a fear that a horse would bite off his genitals,
would castrate him. But it was from fear of being castrated, too,
that the little Russian relinquished his wish to be loved by his
father, for he thought that a relation of that sort presupposed a
sacrifice of his genitals - of the organ which distinguished him
from a female. As we see, both forms of the Oedipus complex, the
normal, active form and the inverted one, came to grief through the
castration complex. The Russian boy’s anxiety-idea of being
devoured by a wolf contained, it is true, no suggestion of
castration, for the oral regression it had undergone had removed it
too far from the phallic stage. But the analysis of his dream
rendered further proof superfluous. It was a triumph of repression
that the form in which his phobia was expressed should no longer
have contained any allusion to castration.

Inhibitions, Symptoms And Anxiety

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   Here, then, is our unexpected
finding: in both patients the motive force of the repression was
fear of castration. The ideas contained in their anxiety - being
bitten by a horse and being devoured by a wolf - were substitutes
by distortion for the idea of being castrated by their father. This
was the idea which had undergone repression. In the Russian boy the
idea was an expression of a wish which was not able to subsist in
the face of his masculine revolt; in ‘Little Hans’ it
was the expression of a reaction in him which had turned his
aggressiveness into its opposite. But the
affect
of anxiety,
which was the essence of the phobia, came, not from the process of
repression, not from the libidinal cathexes of the repressed
impulses, but from the repressing agency itself. The anxiety
belonging to the animal phobias was an untransformed fear of
castration. It was therefore a realistic fear, a fear of a danger
which was actually impending or was judged to be a real one. It was
anxiety which produced repression and not, as I formerly believed,
repression which produced anxiety.

   It is no use denying the fact,
though it is not pleasant to recall it, that I have on many
occasions asserted that in repression the instinctual
representative is distorted, displaced and so on, while the libido
belonging to the instinctual impulse is transformed into anxiety.
But now an examination of phobias, which should be best able to
provide confirmatory evidence, fails to bear out my assertion; it
seems, rather, to contradict it directly. The anxiety felt in
animal phobias is the ego’s fear of castration; while the
anxiety felt in agoraphobia (a subject that has been less
thoroughly studied) seems to be its fear of sexual temptation - a
fear which, after all, must be connected in its origins with the
fear of castration. As far as can be seen at present, the majority
of phobias go back to an anxiety of this kind felt by the ego in
regard to the demands of the libido. It is always the ego’s
attitude of anxiety which is the primary thing and which sets
repression going. Anxiety never arises from repressed libido. If I
had contented myself earlier with saying that after the occurrence
of repression a certain amount of anxiety appeared in place of the
manifestation of libido that was to be expected, I should have
nothing to retract to-day. The description would be correct; and
there does undoubtedly exist a correspondence of the kind asserted
between the strength of the impulse that has to be repressed and
the intensity of the resultant anxiety. But I must admit that I
thought I was giving more than a mere description. I believed I had
put my finger on a metapsychological process of direct
transformation of libido into anxiety. I can now no longer maintain
this view. And, indeed, I found it impossible at the time to
explain how a transformation of that kind was carried out.

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   It may be asked how I arrived at
this idea of transformation in the first instance. It was while I
was studying the ‘actual neuroses’, at a time when
analysis was still a very long way from distinguishing between
processes in the ego and processes in the id. I found that
outbreaks of anxiety and a general state of preparedness for
anxiety were produced by certain sexual practices such as
coitus
interruptus
, undischarged sexual excitation or enforced
abstinence - that is, whenever sexual excitation was inhibited,
arrested or deflected in its progress towards satisfaction. Since
sexual excitation was an expression of libidinal instinctual
impulses it did not seem too rash to assume that the libido was
turned into anxiety through the agency of these disturbances. The
observations which I made at the time still hold good. Moreover, it
cannot be denied that the libido belonging to the id-processes is
subjected to disturbance at the instigation of repression. It might
still be true, therefore, that in repression anxiety is produced
from the libidinal cathexis of the instinctual impulses. But how
can we reconcile this conclusion with our other conclusion that the
anxiety felt in phobias is an ego anxiety and arises in the ego,
and that it does not proceed out of repression but, on the
contrary, sets repression in motion? There seems to be a
contradiction here which it is not at all a simple matter to solve.
It will not be easy to reduce the two sources of anxiety to a
single one. We might attempt to do so by supposing that, when
coitus is disturbed or sexual excitation interrupted or abstinence
enforced, the ego scents certain dangers to which it reacts with
anxiety. But this takes us nowhere. On the other hand, our analysis
of the phobias seems to admit of no correction.
Non
liquet
.

Inhibitions, Symptoms And Anxiety

4270

V

   We set out to study the formation
of symptoms and the secondary struggle waged by the ego against
symptoms. But in picking on the phobias for this purpose we have
clearly made an unlucky choice. The anxiety which predominates in
the picture of these disorders is now seen as a complication which
obscures the situation. There are plenty of neuroses which exhibit
no anxiety whatever. True conversion hysteria is one of these. Even
in its most severe symptoms no admixture of anxiety is found. This
fact alone ought to warn us against making too close a connection
between anxiety and symptom-formation. The phobias are so closely
akin to conversion hysteria in every other respect that I have felt
justified in classing them alongside of it under the name of
‘anxiety hysteria’. But no one has as yet been able to
say what it is that determines whether any given case shall take
the form of a conversion hysteria or a phobia - has been able, that
is to say, to establish what determines the generating of anxiety
in hysteria.

   The commonest symptoms of
conversion hysteria - motor paralyses, contractures, involuntary
actions or discharges, pains and hallucinations - are cathectic
processes which are either permanently maintained or intermittent.
But this puts fresh difficulties in the way. Not much is actually
known about these symptoms. Analysis can show what the disturbed
excitatory process is which the symptoms replace. It usually turns
out that they themselves have a share in that process. It is as
though the whole energy of the process had been concentrated in
this one part of it. For instance, it will be found that the pains
from which a patient suffers were present in the situation in which
the repression occurred; or that his hallucination was, at that
time, a perception; or that his motor paralysis is a defence
against an action which should have been performed in that
situation but was inhibited; or that his contracture is usually a
displacement of an intended innervation of the muscles in some
other part of his body; or that his convulsions are the expression
of an outburst of affect which has been withdrawn from the normal
control of the ego. The sensation of unpleasure which accompanies
the appearance of the symptoms varies in a striking degree. In
chronic symptoms which have been displaced on to motility, like
paralyses and contractures, it is almost always entirely absent;
the ego behaves towards the symptoms as though it had nothing to do
with them. In intermittent symptoms and in those concerned with the
sensory sphere, sensations of unpleasure are as a rule distinctly
felt; and in symptoms of pain these may reach an extreme degree.
The picture presented is so manifold that it is difficult to
discover the factor which permits of all these variations and yet
allows a uniform explanation of them. There is, moreover, little to
be seen in conversion hysteria of the ego’s struggle against
the symptom after it has been formed. It is only when sensitivity
to pain in some part of the body constitutes the symptom that that
symptom is in a position to play a dual role. The symptom of pain
will appear no less regularly whenever the part of the body
concerned is touched from outside than when the pathogenic
situation which it represents is associatively activated from
within; and the ego will take precautions to prevent the symptom
from being aroused through external perceptions. Why the formation
of symptoms in conversion hysteria should be such a peculiarly
obscure thing I cannot tell; but the fact affords us a good reason
for quitting such an unproductive field of enquiry without
delay.

Inhibitions, Symptoms And Anxiety

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   Let us turn to the obsessional
neuroses in the hope of learning more about the formation of
symptoms. The symptoms belonging to this neurosis fall, in general,
into two groups, each having an opposite trend. They are either
prohibitions, precautions and expiations - that is, negative in
character - or they are, on the contrary, substitutive
satisfactions which often appear in symbolic disguise. The
negative, defensive group of symptoms is the older of the two; but
as illness is prolonged, the satisfactions, which scoff at all
defensive measures, gain the upper hand. The symptom-formation
scores a triumph if it succeeds in combining the prohibition with
satisfaction so that what was originally a defensive command or
prohibition acquires the significance of a satisfaction as well;
and in order to achieve this end it will often make use of the most
ingenious associative paths. Such an achievement demonstrates the
tendency of the ego to synthesize, which we have already observed.
In extreme cases the patient manages to make most of his symptoms
acquire, in addition to their original meaning, a directly contrary
one. This is a tribute to the power of ambivalence, which, for some
unknown reason, plays such a large part in obsessional neuroses. In
the crudest instance the symptom is diphasic: an action which
carries out a certain injunction is immediately succeeded by
another action which stops or undoes the first one even if it does
not go quite so far as to carry out its opposite.

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