64 AN OUTLINE OF PSYCHOANALYSIS

Fifth Lecture

Ladies and Gentlemen: With the discovery of infan-
tile sexuality and the tracing back of the neurotic symp-
toms to erotic impulse-components we have arrived at
several unexpected formule for expressing the nature and
tendencies of neurotic diseases. We see that the individual
falls ill when in consequence of outer hindrances or inner
lack of adaptability the satisfaction of the erotic needs in
the sphere of reality is denied. We see that he then flees
to sickness, in order to find with its help a surrogate satis-
faction for that denied him. We recognize that the symp-
toms of illness contain fractions of the sexual activity of
the individual, or his whole sexual life, and we find in the
turning away from reality the chief tendency and also the
chief injury of the sickness. We may guess that the re-
sistance of our patients against the cure is not a simple
one, but is composed of many motives. Not only does the
ego of the patient strive against the giving up of the re-
pression by which it has changed itself from its original
constitution into its present form, but also the sexual
impulses may not renounce their surrogate satisfaction so
long as it is not certain that they can be offered anything
better 1n the sphere of reality.

The flight from the unsatisfying reality into what we
call, on account of its biologically injurious nature, dis-
ease, but which is never without an individual gain in
pleasure for the patient, takes place over the path of
regression, the return to earlier phases of the sexual life,
when satisfaction was not lacking. This regression is.
seemingly a twofold one, a temporal, in so far as the libido
or erotic need falls back to a temporally earlier stage of
development, and a formal, since the original and primitive
psychic means of expression are applied to the expression
of this need. Both sorts of regression focus in childhood
and have their common point in the production of an in-
fantile condition of sexual life.

The deeper you penetrate into the pathogenic of neu-

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ORIGIN AND DEVELOPMENT 65

rotic diseases, the more the connection of neurvses vith
other products of human mentality, even the most valu-
able, will be revealed to you. You will be reminded that
we men, with the high claims of our civilization and under
the pressure of our repressions, find reality generally quite
unsatisfactory and so keep up a life of fancy in which we
love to compensate for what is lacking in the sphere of
reality by the production of wish-fulfillments. In these
phantasiec ‘s often contained very much of the particular
constitutional essence of personality and of its tendencies,

_ repressed in real life. The energetic and successful man

is he who succeeds by dint of labor in transforming his.
wish fancies into reality. Where this is not successful in
consequence of the resistance of the outer world and the _
weakness of the individual, there begins the turning away
from reality. The individual takes refuge in his satisfy-
ing world of fancy. Under certain favorable. conditions
it still remains possible for him to find another connecting
link between these fancies and reality, instead of perma-
nently becoming a stranger to it through the regression
into the infantile. If the individual who 1s displeased with
reality is in possession of that artistic talent which is still a
psychological riddle, he can transform his fancies into
artistic creations. So he escapes the fate of a neurosis and
wins back his connection with reality by this round-about
way.'® Where this opposition to the real world exists, but
this valuable talent fails or proves insufficient, it 1s un-
avoidable that the libido, following the origin of the fan-
cies, succeeds by means of regression in revivifying the.
infantile wishes and so producing a neurosis. The neu-.
rosis takes, in our time, the place of the cloister, in which
were accustomed to take refuge all those whom life had
undeceived or who felt themselves too weak for life. Let
me give at this point the main result at which we have
arrived by the psychoanalytic investigation of neurotics,

-18Cf. Rank, Otto, Der Künstler, Ausätze zu einer Sexual-
Psychologie, 56 pp. Heller & Co., Wien, 1907.

66 AN OUTLINE OF PSYCHOANALYSIS

namely, that neuroses have no peculiar psychic content of
their own, which is not also to be found in healthy states;
or, as C. G. Jung has expressed it, neurotics fall ill of the
same complexes with which we sound people struggle. It
depends on quahtitative relationships, on the relations of
the forces wrestling with each other, whether the struggle .
leads to health, to a neurosis, or to compensatory over-
functioning (Ueberleistung).

Ladies and gentlemen, I have still withheld from you the
most remarkable experience which corroborates our as-
sumptions of the ‘sexual impulse-forces of neurotics.
Every time that we treat a neurotic psychoanalytically,
there occurs in him the so-called phenomenon of transfer
(Uebertragung), that is, he applies to the person of the
- physician a great amount of tender emotion, often mixed
with enmity, which has no foundation in any real relation,
and must be derived in every respect from the old wish-
fancies of the patient which have become unconscious.
Every fragment of his emotive life, which can no longer
be called back into memory, 1s accordingly lived over by
the patient in his relations to the physician, and only by
such a living of them over in the “transfer” is he con-
vinced of the existence and the power of these unconscious
sexual excitations. The symptoms, which, to use a simile
from chemistry, are the precipitates of earlier love experi-
ences (in the widest sense), can only be dissolved in the
higher temperature of the experience of transfer and
transformed into other psychic products. The physician
plays in this reaction, to use an excellent expression of
S. Ferenczi,?® the role of a catalytic ferment, which tem-
porarily attracts to itself the affect which has become free
in the course of the process.

The study of transfer can also give you the key to the
understanding of hypnotic suggestion, which we at first
used with our patients as a technical means of investiga-
tion of the unconscious. Hypnosis showed itself at that

19 Ferenczi, S., Introjektion und Uebertragung, Jahrbuch f.
Psycho-anal. u. Psychopath. Forschungen. Bd. I, H. 2, 1900.

ORIGIN AND DEVELOPMENT 67

time to be a therapeutic help, but a hindrance to the scien-
tific knowledge of the real nature of the case, since it

cleared away the psychic resistances from a certain field,
cnly to pile them up in an unscalable wall at the boundaries
of this field. You must not think that the phenomenon of
transfer, about which I can unfortunately say only toc
little here, is created by the influence of the psychoanalytic
treatment. The transfer arises spontaneously in all human
elations and in the relations of the patient to the physi-
Man; it is everywhere the especial bearer of therapeutic

_ influences, and it works the stronger the less one knows

of its presence. Accordingly psychoanalysis does not cre-
ate it, it merely discloses it to consciousness, and avails
itself of it, in order to direct the psychic processes to the
wished-for goal. But I cannot leave the theme of transfer
without stressing the fact that this phenomenon is of
decisive importance to convince not only the patient, but
also the physician. I know that all my adherents were
first convinced of the correctness of my views through
their experience with transfer, and I can very well con-
ceive that one may not win such a surety of judgment so
long as he makes no psychoanalysis, and so has not himself
observed the effects of transfer.

Ladies and gentlemen, I am of the opinion that there
are, on the intellectual side, two hindrances to acknowledg-
ing the value of the psychoanalytic viewpoint: first, the
fact that we are not accustomed to reckon with a strict
determination of mental life, which holds without excep-
tion, and, second, the lack of knowledge of the peculiarities ©
through which unconscious mental processes differ from
these conscious ones with which we are familiar. One
of ihe most widespread resistances against the work of
psychoanalysis with patients as with persons in health
reduces to the latter of the two moments. One is afraid
of doing harm by psychoanalysis, one is anxious about
calling up into consciousness the repressed sexual impulses
of the patient, as though there were danger that they could

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68 AN OUTLINE OF PSYCHOANALYSIS rs

overpower the higher ethical strivings and rob him of his.

cultural acquisitions. One can see that the patient has
sore places in his soul life, but one is afraid to touch them,
lest his suffering be increased. We may use this analogy.
It is, of course, better not to touch diseased places when
one can only cause pain. But we know that the surgeon
does not refrain from the investigation and reinvestigation
of the seat of illness, if his invasion has as its aim the
restoration of lasting health. Nobody thinks of blaming
him for the unavoidable difficulties of the investigation
or the phenomena of reaction from the operation, if these
only accomplish their purpose, and gain for the patient a
final cure by temporarily making his condition worse. The
case is similar in psychoanalysis; it can lay claim to the
same things as surgery; the increase of pain which takes
place in the patient during the treatment is very much less
than that which the surgeon imposes upon him, and espe-
cially negligible in comparison with the pains of serious
illness. But the consequence which is feared, that of a dis-
turbance of the cultural character by the impulse which has
been freed from repression, is wholly impossible. In rela-
tion to this anxiety we must consider what our experiences
have taught us with certainty, that the somatic and mental
power of a wish, if once its repression has not succeeded,
is incomparably stronger when it is unconscious than when
it is conscious, so that by being made conscious it can only
be weakened. The unconscious wish cannot be influenced,
is free from all strivings in the contrary direction, while
the conscious is inhibited by those wishes which are also
conscious and which strive against it. The work of
psychoanalysis accordingly presents a better substitute, in
the service of the highest and most valuable cultural
strivings, for the repression which has failed.

Now what is the fate of the wishes which have becoi:e
free by psychoanalysis, by what means shall they be made
harmless for the life of the individual? There are severai

ways. The general consequence is, that the wish is con-

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ORIGIN AND DEVELOPMENT 69

sumed during the work by the correct mental activity of

those better tendencies which are opposed to it. The re-
pression is supplanted by a condemnation carried through
with the best means at one’s disposal. This is possible,
since for the most part we have to abolish only the effects
of earlier developmental stages of the ego. The individual
for his part only repressed the useless impulse, because
at that time he was himself still incompletely organized
and weak; in his present maturity and strength he can,
perhaps, conquer without injury to himself that which is
inimical to him. A second issue of the work of psycho-
analysis may be that the revealed unconscious impulses
can now arrive at those useful applications which, in the
case of undisturbed development, they would have found
earlier. The extirpation of the infantile wishes is not at
all the ideal aim of development. The neurotic has lost,
by his repressions, many sources of mental energy whose
contingents would have been very valuable for his char-
acter building and his life activities. We know a far more
purposive process of development, the so-called sublima-
tion (Sublimirung), by which the energy of infantile wish-
excitations is not secluded, but remains capable of applica-
tion, while for the particular excitations, instead of be-
coming useless, a higher, eventually no longer sexual, goal
is set up. The components of the sexual instinct are
especially distinguished by such a capacity for the sublima-
tion and exchange of their sexual goal for one more remote
and socially more valuable. To the contributions of the
energy won in such a way for the functions of our mental
life we probably owe the highest cultural consequences.
A repression taking place at an early period excludes the

~ sublimation of the repressed impulse; after the removal

of the repression the way to sublimation is again free.
We must not neglect, also, to glance at the third of the
possible issues. A certain part of the suppressed libidinous
excitation has a right to direct satisfaction and ought to
find it in life. The claims of our civilization make life too

70 AN OUTLINE OF PSYCHOANALYSIS

hard for the greater part of humanity, and so further the
aversion to reality and the origin of neuroses, without pro-
ducing an excess of cultural gain by this excess of sexual
repression. We ought not to go so far as to fully neglect
the original animal part of our nature, we ought not to
forget that the happiness of individuals cannot be dis-
pensed with as one of the aims of our culture. The plas-
ticity of the sexual-components, manifest in their capacity
for sublimation, may cause a great temptation to accom-
plish greater culture-effects by a more and more far reach-
ing sublimation. But just as little as with our machines
we expect to change more than a certain fraction of the
applied heat into useful mechanical work, just as little
ought we to strive to separate the sexual impulse in its
whole extent of energy from its peculiar goal. This can-
not succeed, and if the narrowing of sexuality is pushed too
far it will have all the evil effects of a robbery.

I do not know whether you will regard the exhortation
with which I close as a presumptuous one. I only venture
the indirect presentation of my conviction, if I relate an
old tale, whose application you may make yourselves.
German literature knows a town called Schilda, to whose
inhabitants were attributed all sorts of clever pranks. The
wiseacres, so the story goes, had a horse, with whose pow-
ers of work they were well satisfied, and against whom
they had only one grudge, that he consumed so much ex-
pensive oats. They concluded that by good management
they would break him of this bad habit, by cutting down
his rations by several stalks each day, until he had learned
to do without them altogether. Things went finely for a
while, the horse was weaned to one stalk a day, and on the
next day he would at last work without fodder. On the
morning of this day the malicious horse was found dead;
the citizens of Schilda could not understand why he had
died. We should be inclined to believe that the horse had
starved, and that without a certain ration of oats no work
could be expected fram an animal.

en Warn