Freud - Complete Works (73 page)

   Now let us turn to the other
objection, which is based precisely on an acknowledgement of the
frequency of infantile sexual experiences and on the observed fact
that many people who remember scenes of that kind have
not
become hysterics. Our first reply is that the excessive frequency
of an aetiological factor cannot possibly be used as an objection
to its aetiological significance. Is not the tubercle bacillus
ubiquitous and is it not inhaled by far more people than are found
to fall ill of tuberculosis? And is its aetiological significance
impaired by the fact that other factors must obviously be at work
too before the tuberculosis, which is its specific effect, can be
evoked? In order to establish the bacillus as the specific
aetiology it is enough to show that tuberculosis cannot possibly
occur without its playing a part. The same doubtless applies to our
problem. It does not matter if many people experience infantile
sexual scenes without becoming hysterics, provided only that all
the people who become hysterics have experienced scenes of that
kind. The area of occurrence of an aetiological factor may be
freely allowed to be wider than that of its effect, but it must not
be narrower. Not everyone who touches or comes near a smallpox
patient develops smallpox; nevertheless infection from a smallpox
patient is almost the only known aetiology of the disease.

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424

   It is true that if infantile
sexual activity were an almost universal occurrence the
demonstration of its presence in every case would carry no weight.
But, to begin with, to assert such a thing would certainly be a
gross exaggeration; and secondly, the aetiological pretensions of
the infantile scenes rest not only on the regularity of their
appearance in the anamneses of hysterics, but, above all, on the
evidence of there being associative and logical ties between those
scenes and the hysterical symptoms - evidence which, if you were
given the complete history of a case, would be as clear as daylight
to you.

   What can the other factors be
which the ‘specific aetiology’ of hysteria still needs
in order actually to produce the neurosis? That, Gentlemen, is a
theme in itself, which I do not propose to enter upon. To-day I
need only indicate the point of contact at which the two parts of
the topic - the specific and the auxiliary aetiology - fit into one
another. No doubt a considerable quantity of factors will have to
be taken into account. There will be the subject’s inherited
and personal constitution, the inherent importance of the infantile
sexual experiences, and, above all, their number: a brief
relationship with a strange boy, who afterwards becomes
indifferent, will leave a less powerful effect on a girl than
intimate sexual relations of several years’ standing with her
own brother. In the aetiology of the neuroses quantitative
preconditions are as important as qualitative ones: there are
threshold-values which have to be crossed before the illness can
become manifest. Moreover, I do not myself regard this aetiological
series as complete; nor does it solve the riddle of why hysteria is
not more common among the lower classes. (You will remember, by the
way, what a surprisingly large incidence of hysteria was reported
by Charcot among working-class
men
). I may also remind you
that a few years ago I myself pointed out a factor, hitherto little
considered, to which I attribute the leading role in provoking
hysteria after puberty. I then put forward the view that the
outbreak of hysteria may almost invariably be traced to a
psychical conflict
arising through an incompatible idea
setting in action a
defence
on the part of the ego and
calling up a demand for repression. What the circumstances are in
which a defensive endeavour of this kind has the pathological
effect of actually thrusting the memory which is distressing to the
ego into the unconscious and of creating a hysterical symptom in
its place I was not able to say at that time. But to-day I can
repair the omission.
The defence achieves its purpose of
thrusting the incompatible idea out of consciousness if there are
infantile sexual scenes present in the (hitherto normal) subject in
the form of unconscious memories, and if the idea that is to be
repressed can be brought into logical or associative connection
with an infantile experience of that kind
.

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   Since the ego’s efforts at
defence depend upon the subject’s total moral and
intellectual development, the fact that hysteria is so much rarer
in the lower classes than its specific aetiology would warrant is
no longer entirely incomprehensible.

   Let us return once again,
Gentlemen, to the last group of objections, the answering of which
has led us such a long way. We have heard and have acknowledged
that there are numerous people who have a very clear recollection
of infantile sexual experiences and who nevertheless do not suffer
from hysteria. This objection has no weight; but it provides an
occasion for making a valuable comment. According to our
understanding of the neurosis, people of this kind
ought
not
to be hysterical at all, or at any rate, not hysterical as a result
of the scenes which they consciously remember. With our patients,
those memories are never conscious; but we cure them of their
hysteria by transforming their unconscious memories of the
infantile scenes into conscious ones. There was nothing that we
could have done or needed to do about the fact that they have had
such experiences. From this you will perceive that the matter is
not merely one of the existence of the sexual experiences, but that
a psychological precondition enters in as well. The scenes must he
present as
unconscious memories
; only so long as, and in so
far as, they are unconscious are they able to create and maintain
hysterical symptoms. But what decides whether those experiences
produce conscious or unconscious memories - whether that is
conditioned by the content of the experiences, or by the time at
which they occur, or by later influences - that is a fresh problem,
which we shall prudently avoid. Let me merely remind you that, as
its first conclusion, analysis has arrived at the proposition that
hysterical symptoms are derivatives of memories which are
operating unconsciously
.

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426

   (
c
) Our view then is that
infantile sexual experiences are the fundamental precondition for
hysteria, are, as it were, the
disposition
for it and that
it is they which create the hysterical symptoms, but that they do
not do so immediately, but remain without effect to begin with and
only exercise a pathogenic action later, when they have been
aroused after puberty in the form of unconscious memories. If we
maintain this view, we shall have to come to terms with the
numerous observations which show that a hysterical illness may
already make its appearance in childhood and before puberty. This
difficulty, however, is cleared up as soon as we examine more
closely the data gathered from analyses concerning the chronology
of the infantile experiences. We then learn that in our severe
cases the formation of hysterical symptoms begins - not in
exceptional instances, but, rather, as a regular thing - at the age
of eight, and that the sexual experiences which show no immediate
effect invariably date further back, into the third or fourth, or
even the second year of life. Since in no single instance does the
chain of effective experiences break off at the age of eight, I
must assume that this time of life, the period of growth in which
the second dentition takes place, forms a boundary line for
hysteria, after which the illness cannot be caused. From then on, a
person who has not had sexual experiences earlier can no longer
become disposed to hysteria; and a person who
has
had
experiences earlier, is already able to develop hysterical
symptoms. Isolated instances of the occurrence of hysteria on the
other side of this boundary line (that is,
before
the age of
eight) may be interpreted as a phenomenon of precocious maturity.
The existence of this boundary-line is very probably connected with
developmental processes in the sexual system. Precocity of somatic
sexual development may often be observed, and it is even possible
that it can be promoted by too early sexual stimulation.

   In this way we obtain an
indication that a certain
infantile
state of the psychical
functions, as well as of the sexual system, is required in order
that a sexual experience occurring during this period shall later
on, in the form of a memory, produce a pathogenic effect. I do not
venture as yet, however, to make any more precise statement on the
nature of this psychical infantilism or on its chronological
limits.

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427

   (
d
) Another objection
might arise from exception being taken to the supposition that the
memory
of infantile sexual experiences produces such an
enormous pathogenic effect, while the actual experience itself has
none. And it is true that we are not accustomed to the notion of
powers emanating from a mnemic image which were absent from the
real impression. You will moreover notice the consistency with
which the proposition that symptoms can only proceed from memories
is carried through in hysteria. None of the later scenes, in which
the symptoms arise, are the effective ones; and the experiences
which
are
effective have at first no result. But here we are
faced with a problem which we may very justifiably keep separate
from our theme. It is true that we feel impelled to make a
synthesis, when we survey the number of striking conditions that we
have come to know: the fact that in order to form a hysterical
symptom a defensive effort against a distressing idea must be
present, that this idea must exhibit a logical or associative
connection with an unconscious memory through a few or many
intermediate links, which themselves, too, remain unconscious at
the moment, that this unconscious memory must have a sexual
content, that its content must be an experience which occurred
during a certain infantile period of life. It is true that we
cannot help asking ourselves how it comes about that this memory of
an experience that was innocuous at the time it happened, should
posthumously produce the abnormal effect of leading a psychical
process like defence to a pathological result, while it itself
remains unconscious.

   But we shall have to tell
ourselves that this is a purely psychological problem, whose
solution may perhaps necessitate certain hypotheses about normal
psychical processes and about the part played in them by
consciousness, but that this problem may be allowed to remain
unsolved for the time being, without detracting from the value of
the insight we have so far gained into the aetiology of hysterical
phenomena.

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428

III

   Gentlemen, the problem, the
approaches to which I have just formulated, concerns the
mechanism
of the formation of hysterical symptoms. We find
ourselves obliged, however, to describe the
causation
of
those symptoms without taking that mechanism into account, and this
involves an inevitable loss of completeness and clarity in our
discussion. Let us go back to the part played by the infantile
sexual scenes. I am afraid that I may have misled you into
over-estimating their power to form symptoms. Let me, therefore,
once more stress the fact that every case of hysteria exhibits
symptoms which are determined, not by infantile but by later, often
by recent, experiences. Other symptoms, it is true, go back to the
very earliest experiences and belong, so to speak, to the most
ancient nobility. Among these latter are above all to be found the
numerous and diverse sensations and paraesthesias of the genital
organs and other parts of the body, these sensations and
paraesthesias being phenomena which simply correspond to the
sensory content of the infantile scenes, reproduced in a
hallucinatory fashion, often painfully intensified.

   Another set of exceedingly common
hysterical phenomena - painful need to urinate, the sensation
accompanying defaecation, intestinal disturbances, choking and
vomiting, indigestion and disgust at food - were also shown in my
analyses (and with surprising regularity) to be derivatives of the
same childhood experiences and were explained without difficulty by
certain invariable peculiarities of those experiences. For the idea
of these infantile sexual scenes is very repellent to the feelings
of a sexually normal individual; they include all the abuses known
to debauched and impotent persons, among whom the buccal cavity and
the rectum are misused for sexual purposes. For physicians,
astonishment at this soon gives way to a complete understanding.
People who have no hesitation in satisfying their sexual desires
upon children cannot be expected to jib a finer shades in the
methods of obtaining that satisfaction; and the sexual impotence
which is inherent in children inevitably forces them into the same
substitutive actions as those to which adults descend if they
become impotent. All the singular conditions under which the
ill-matched pair conduct their love-relations - on the one hand the
adult, who cannot escape his share in the mutual dependence
necessarily entailed by a sexual relationship, and who is yet armed
with complete authority and the right to punish, and can exchange
the one role for the other to the uninhibited satisfaction of his
moods, and on the other hand the child, who in his helplessness is
at the mercy of this arbitrary will, who is prematurely aroused to
every kind of sensibility and exposed to every sort of
disappointment, and whose performance of the sexual activities
assigned to him is often interrupted by his imperfect control of
his natural needs - all these grotesque and yet tragic
incongruities reveal themselves as stamped upon the later
development of the individual and of his neurosis, in countless
permanent effects which deserve to be traced in the greatest
detail. Where the relation is between two children, the character
of the sexual scenes is none the less of the same repulsive sort,
since every such relationship between children postulates a
previous seduction of one of them by an adult. The psychical
consequences of these child-relations are quite extraordinarily
far-reaching; the two individuals remain linked by an invisible
bond throughout the whole of their lives.