480

with this. On the other hand the analysis of the phobias which we
have undertaken seems not to admit of a justification. It is not clear.

V

We will study the symptom formation and the secondary combat
of the ego against the symptom but we have frankly made no for-
tunate selection among the phobias. The fear which dominates in
the picture of this affection appears to us now as a complication which
veils the subject matter. There are neuroses in abundance in which
no fear is shown. The genuine conversion hysteria is of this sort,
and its severest symptoms are found with no admixture of fear.
This fact must warn us that we must not adhere too closely to the
relations between fear and symptom formation. Otherwise con-
version hysteria stands so close to the phobias that I have held myself
justified in grouping the latter with “fear hysterias.” But no one
has as yet been able to give the condition which differentiates between
them or whether a case assumes the form of a conversion hysteria
or a phobia. Nor has any one explored the reasons for develop-
ment of fear in hysteria.

The commonest symptoms of conversion hysteria—a motor paraly-
sis, contracture, involuntary action or discharge, a pain, a hallucina-
tion—are either permanently established or intermittent investment
processes, the explanation of which prepares new difficulties. One
really knows but little of such symptoms. Through analysis one
may learn what disturbed course of excitement they replace. Mostly
it results that they themselves have a part in these, as if the total
energy had been concentrated on a fragment. Pain was present in
the situation in which the repression fell; hallucination was at the
time a perception; motor palsy was a defense against action which
should have been carried out in that situation but was inhibited;
contracture is usually a displacement for a muscular innervation
intended at the time at another place; the convulsive attack an expres-
sion of an affective outbreak which has withdrawn itself from the
normal control of the ego. Changeable in a striking manner is the
feeling of disinclination which accompanies the appearance of the
symptoms. In the permanent symptoms displaced as to motility, as
palsies and contractures, this is mostly absent; the ego behaves against
these as if non-participating. In the intermittent cases and in symp-
toms of the sensory sphere, these sensations of pain are as a rule
distinct and in the case of pain the symptoms may increase to
an excessive degree. It is very difficult in this manifoldness to find
the factor which makes such differences possible and which can

481

explain them in unit fashion. Even the battle of the ego against
the once formed symptom is but little in evidence in conversion
hysteria. Only when the sensitiveness to pain in some region of the
body has become a symptom will this be placed in position to play
a double rôle. The pain symptom appears just as certainly when this
locality is touched from without, as when the pathogenic situation
which represents it is associatively activated from within, and the
ego grasps precautionary rules in order to hold back the awakening
of symptoms through external perception. Whence originates the
special opaqueness of symptom formation in conversion hysteria we
cannot guess, but it gives us a motive to leave promptly a field
so unfertile.

We turn now to compulsion neurosis in the expectation that here
we can learn more about symptom formation. The symptoms of
compulsion neurosis are in general of two kinds and of opposite
tendencies. They are either prohibitions, precautions, expiations–
hence negative in nature–or, contrariwise, they are substitute gratifi-
cations, very often in symbolic clothing. Of these two groups the
negative, defensive, punitive, is the older and with the duration of
the disease the gratifications which mock at all defense take the
upper hand. It is a triumph of symptom formation when it succeeds
in fusing the prohibition with gratification; so that the originally
defensive command or prohibition obtains the significance of a grati-
fication; whereby often very artificial methods of combination are
claimed. In this performance an inclination to synthesis shows
itself which we have already conceded to the ego. In extreme cases
the patient effects that most of his symptoms have acquired the exact
opposite of their original significance, a testimony of the power
of ambivalence, which, we know not why, plays so great a rôle
in compulsive neuroses. In the crudest cases the symptom is
two stage–that is, upon the action which executes a certain instruc-
tion there follows immediately a second, which abolishes the first
or makes it regressive if it does not dare to carry out the opposite.

Two impressions are at once derived from this fugacious survey
of compulsive symptoms. The first, which is maintained in constant
warfare against the repressed which applies itself more and more
to the disfavor of the repressing forces, and the second, that the ego
and super-ego play a specially large part in the symptom formation.

The compulsive neurosis is probably the most interesting and most
gratifying object of analytical investigation although as yet it is an
unconquered problem. If we will penetrate deeply into its nature
we must confess that uncertain assumptions and unproved surmises
cannot yet be dispensed with. The exit situation of the compulsive

482

neurosis is probably no other than that of hysteria, the necessary
defense against the libidinous claims of the Oedipus complex. In
every compulsive neurosis we seem to find a lower stratum of
precociously formed hysterical symptoms. Then, however, the fur-
ther formation is decidedly altered by a constitutional factor. The
genital organization of the libido shows itself as weakly and too
little resistant. When the ego begins its defensive striving its first
result is that the genital organization (phallic phase) regresses wholly
or in part to an earlier sadistic-anal stage. This fact of regression
remains a determinant of all that follows. One may draw yet
another possibility into consideration. Perhaps the regression is
not the consequence of a constitutional but a time factor. Hence
it is not endowed with power because the genital organization of
the libido is weak, but because the effort of the ego is premature, set
in during the bloom of the sadistic phase. I do not trust myself to
make a final decision upon this point, but analytical observation is
not favorable to this supposition. Rather does it show that in the
turn to compulsive neurosis the phallic stage has already been
reached. The time of life for the outbreak of this neurosis is also
later than for hysteria (the second childhood period after the ter-
mination of the latent period) and in a case of very late development
of this affection which I could cite, it was clearly shown that a real
depreciation of the hitherto intact genital life created the condition
for the regression and the origin of the compulsive neurosis.^*

The metapsychologic explanation of the regression is to be sought
in a mixture of impulses, in the separation of an erotic component
which appeared at the onset of the genital phase in the destructive
investments of the sadistic phase.

The conquest of the regression signifies the first result of the ego
in the defensive fight against the libido claims. We distinguish here
the general tendency of the defense from the repression, which
is only one of the defensive mechanisms. Perhaps still more clearly
than in normal and hysterical cases one recognizes in the compulsive
neurosis the castration complex as the motive of defense. We now
find ourselves at the beginning of the latency period, which is charac-
terized by the fall of the Oedipus complex, the creation or consoli-
dation of the super-ego, and the erection of an ethical and esthetic
shrine in the ego. These processes in compulsive neuroses go over
the normal measure. For the destruction of the Oedipus complex
the regressive degradation of the libido is added, the super-ego is
especially rigid and unamiable, and the ego develops in obedience

^*See Disposition to Compulsive Neurosis, Collected Papers in German,
Vol. V.

483

to the super-ego reaction pictures of conscience, sympathy and purity.
With inexorable and not always successful rigidity, the temptation
to the continuation of early infantile onanism is tabooed; it now
leans upon regressive sadistic-anal ideas but represents the uncon-
quered portion of the phallic organization. There is here an internal
contradiction, so that in the very interest of preservation of manhood
(castration fear) every activity of manhood is hindered but even
this contradiction is only exaggerated in the compulsive neurosis and
adheres already to the normal mode of removing the Oedipus com-
plex. As every excess carries in itself the germ to a self-uplift, this
holds good also in compulsion neuroses since the very repressed
onanism forces itself in the form of compulsive actions to an ever-
increasing approximation to gratification.

The reaction formations in the ego of the compulsive neurotic,
which we recognize as exaggerations of the normal character, we
may class as a new mechanism of defense along with repression
and regression. In hysteria it seems to be absent or far weaker.
Retrospectively, we gain the presumption that it is distinguished as
a defense process of hysteria. It seems that it limits itself to sup-
pression as the ego turns away from the unpleasant prompting,
leaving it to its course in the unconscious and takes no further part
in its fate. This cannot be entirely or exclusively correct, for we
know the case where the hysterical symptom simultaneously signi-
fied the fulfilment of a demand for punishment from the super-ego;
but it may describe a general character of the behavior of the ego
in hysteria.

One may simply receive it as a fact that in the compulsive neuroses
so strict a super-ego is formed that the fundamental trait of this
affection is libido regression; and one may seek to associate it with
the character of the super-ego. In fact the super-ego which springs
from the It cannot withdraw itself from the regression and mixture
of impulses which proceeds from the latter. It would not be sur-
prising if it were not on its own part harder, more punitive and
less amiable than when the development is normal.

During the period of latency the defense of the attempt at onanism
seems to be treated as the chief task. This combat generates a series
of symptoms which recur in typical fashion in the most dissimilar
kinds of people and bear in general the character of a ceremonial.
It is to be much lamented that these have not yet been collected and
systematically analyzed; as the earliest performances of the neurosis
they would shed light over the mechanism here involved in symptom
formation. They already show the traits which will appear so fatally
in the later severe affection; the disposal of the behaviors which later

484

will be carried out as if automatically-going to sleep, washing,
dressing, walking, the tendency to repetition and waste of time.
Why this happens so is still not at all intelligible but the sublimation
of anal erotic components plays a distinct rôle thereby.

Puberty makes a decisive section in the development of a com-
pulsion neurosis. The genital organization broken up in childhood
now sets in with great energy. We know, moreover, that the sexual
development of childhood also prescribes the direction in the begin-
ning of the puberty years. Hence on the one hand the aggressive
promptings of the early period are again awakened, on the other
hand there is a more or less large share of new libidinous stirrings–
in bad cases the whole of them–which strike out paths prescribed
by regression, and appear as aggressive and destructive purposes.
As a result of this disguise of the erotic strivings and the strong
reaction-formations in the ego, the warfare against sexuality is car-
ried further under the ethical flag. The ego, amazed, strives against
cruel and violent demands sent up by the It into the consciousness
and has no inkling that it is fighting erotic wishes, among them such
that otherwise would escape its own criticism. The over strict super-
ego persists the more energetically in the repression of sexuality
which has assumed–to it–such repulsive forms. Thus the conflict
in compulsive neurosis becomes intensified in two directions–the
defender is intolerant and the defended has become unendurable;
both through the influence of one factor, libido regression.

One could find a contradiction against many of our presupposi-
tions in the fact that the unpleasant compulsive idea is conscious.
But there is no doubt that previously it has gone through the process
of repression. In the majority the actual text of the aggressive
instinct is not known to the ego. A large block of analytic labor
is required to make it conscious. What gets through to conscious-
ness is in most cases only a disguised substitute, either of a blurred,
dreamy vagueness or is made unrecognizable through an absurd
disguise. If the repression has not gnawed at the content of the
aggressive prompting it has certainly removed the concomitant affect
character. So the aggression does not appear to the ego as an im-
pulse but, as the patient says, as a bare thought content that should
leave one cold. The noteworthy fact is, however, that this is not
the case.

The affect spared by the perception of the compulsive thought
comes especially to view at another place. The super-ego behaves
as if no suppression had taken place, as if the aggressive prompting
were known to it in its proper text and with full affect character;
and it treats the ego on a basis of this presupposition. The ego,

485

which knows itself to be blameless, must feel a sense of guilt and
bear a responsibility which it knows not how to explain. The riddle
herewith given to us is, however, not so great as it at first seems.
The behavior of the super-ego is intelligible throughout, the contra-
diction in the ego shows us only that it has, by means of repression,
closed itself against the It while it remains accessible to the influence
of the super-ego.^* The further question, why the ego does not
seek to withdraw from the tormenting criticism of the super-ego,
disposes of the fact that this really does happen in a large series
of cases. There are compulsive neuroses entirely without sense of
guilt; as far as we understand, the ego has spared itself the percep-
tion of the same through a new series of symptoms, expiations and
restrictions to self-punishment. These symptoms signify, however,
simultaneous gratifications of masochistic promptings which have
likewise drawn strength through regression.

The manifold phenomena of compulsive neurosis are so great that
even by much effort we have failed to give a coherent synthesis of
all their variations. We have striven to make prominent the typical
relations, always with the concern to survey irregularities of no
less importance.

I have already described the general tendency of symptom forma-
tion in compulsive neuroses. It is to procure more room for substi-
tute-gratifications at the expense of renunciation. The same symp-
toms which indicate the original limitations of the ego assume later–
thanks to the indication of the ego to synthesis–those of gratification,
and it is obvious that the last significance gradually becomes the
more practicable. An extremely restricted ego which has shown
that its gratifications are sought in the symptoms becomes the result
of these processes, which approaches more and more the complete
failure of the initial defensive striving. The displacement of the
relations of the energy in favor of gratification can lead to the dreaded
end of paralysis of will on the part of the ego, which for each deci-
sion finds almost as strong an impulse on one side as on the other.
The hyper-acute conflict between the it and the super-ego which domi-
nates the affection at the beginning and after may so spread itself
that none of the arrangements of the ego, incapable of communica-
tion, can avoid being drawn into this conflict.

VI

During this conflict one may observe two symptom-forming activi-
ties of the ego which deserve particular interest because they are

^*Compare Reik, Impulse to Confess and Punishment Need, 1925.