THE ORIGIN AND DEVELOPMENT OF
PSYCHO-ANALYSIS!

Five Lectures delivered at the Celebration of
the Twentieth Anniversary of Clark
University, Worcester, Mass. in September

1909

First Lecture. Ladies and Gentlemen, —Itis a new and
somewhat embarrassing experience for me to appcar
as lecturer before students of the New World. I
assume that I owe this honour to the association of
my name with the theme of psycho-analysis, and
consequently it is of psycho-analysis that I shall aim
to speak. I shall attempt to give you in very brief
form an historical survey of the origin and further
development of this new method of research and
cure

I was a student, busy with the passing of my last
examinations, when another physician of Vienna,
Dr. Joseph Breuer [was experimenting with methods
of treating hysterical patients (1880-2) ]. . . . Dr.
Breuer's patient was a girl of twenty-one, of a high
degree of intelligence. She had developed in the
course of her two years’ illness a series of physical and
mental disturbances which well deserved to be taken

1 [This first appeared in the American Journal of ア -
chology, 1910, XXI, ii, 181-218, later in G.S. iv, 349-406.
It was published in German under the title 'Ueber
Psychoanalyse’, by Verlag F. Deuticke, Leipzig u. Wien,
and grateful acknowledgments are made to this firm, to
the Internationaler Psychoanalytischer Verlag and to
the Editor of the Am. 7. Psych. for permission to print

these extracts. Trans. by Harry W. Chase, revised by
author.]

3

4 THE ORIGIN OF PSYCHO-ANALYSIS 1910

seriously. She had a severe paralysis of both right
extremities, with anesthesia, and at times the same
affection of the members of the left side of the body;
disturbance of eye-movements, and much impair-
ment of vision; difficulty in maintaining the position
of the head, an intense Tussis nervosa, nausea when
she attempted to take nourishment, and at one time
for several weeks a loss of the power to drink, in spite
of tormenting thirst. Her power of speech was also
diminished, and this progressed so far that she could
neither speak nor understand her mother tongue;
and, finally, she was subject to states of * absence ら
of confusion, delirium, alteration of her whole per-
sonality. These states will later claim our attention.
. The illness first appeared while the patient
was caring for her father, whom she tenderly loved,
during the severe illness which led to his death, a task
which she was compelled to abandon because she
herself fell ill. . . .

You must not think that the outlook of a patient
with regard to medical aid is essentially bettered
when the diagnosis points to hysteria rather than to
organic disease of the brain. Against the serious brain
diseases medical skill is in most cases powerless, but
also in the case of hysterical affections the doctor
can do nothing. He must leave it to benign nature,
when and how his hopeful prognosis will be realized.
Accordingly with the recognition of the disease as
hysteria, little is changed in the situation of the

1 I know that this view no longer holds to-day, but in
the lecture I take myself and my hearers back to the time
before 1880. If things have become different since that
time it has been largely due to the work the history of
which I am sketching.

1910 THE ORIGIN OF PSYCHO-ANALYSIS 5

patient, but there is a great change in the attitude of
the doctor. We can observe that he acts quite dif-
ferently toward hystericals than toward patients
suffering from organic diseases. He will not bring
the same interest to the former as to the latter, since
their suffering is much less serious and yet seems to
set up the claim to be valued just as seriously. . . ・
Now Dr. Breuer did not deserve this reproach in
this case; he gave his patient sympathy and interest,
although at first he did not understand how to help
her. ‥ . His sympathetic observation soon found
the means which made the first help possible. It had
been noticed that the patient, in her states of
* absence’, of psychic alteration, usually mumbled
over several words to herself. These seemed to
spring from associations with which her thoughts
were busy. The doctor, who was able to get these
words, put her in a sort of hypnosis and repeated
them to her over and over, in order to bring up any
associations that they might have. The patient
yielded to his suggestion and reproduced for him
those psychic creations which controlled her thoughts
during her ‘absences’, and which betrayed them-
selves in these single spoken words. These were
fancies, deeply sad, often poetically beautiful, day
dreams we might call them, which commonly took
as their starting point the situation of a girl beside
the sick bed of her father, Whenever she had related
a number of such fancies, she was, as it were, freed
and restored to her normal mental life. This state of
health would last for several hours, and then give
place on the next day to a new “ absence ', which was
removed in the same way by relating the newly
created fancies. It was impossible not to get the
impression that the psychic alteration which was

6 THE ORIGIN OF PSYCHO-ANALYSIS 1910

expressed in the ` absence “ was a consequence of the
excitations originating from these intensely emotional
fancy-images. The patient herself, who at this time
of her illness strangely enough understood and spoke
only English, gave this new kind of treatment the
name "talking cure’, or jokingly designated it as
* chimney sweeping ".

The doctor soon hit upon the fact that through
such cleansing of the soul more could be accom-
plished than a temporary removal of the constantly
recurring mental ‘clouds’. Symptoms of the
disease would disappear when in hypnosis the patient
could be made to remember the situation and the
associative connections under which they first
appeared, provided free vent was given to the
emotions which they aroused. “There was in the
summer a time of intense heat, and the patient had
suffered very much from thirst; for, without any
apparent reason, she had suddenly become unable to
drink. She would take a glass of water in her hand,
but as soon as it touched her lips she would push it
away as though suffering from hydrophobia. Obvi-
ously for these few seconds she was in her absent
state. She ate only fruit, melons and the like in order
to relieve this tormenting thirst. When this had been
going on about six weeks, she was talking one day in
hypnosis about her English governess, whom she dis-
liked, and finally told, with every sign of disgust,
how she had come into the room of the governess,
and how that lady's little dog, that she abhorred,
had drunk out of a glass. Out of respect for the con-
ventions the patient had remained silent. Now, after
she had given energetic expression to her restrained
anger, she asked for a drink, drank a large quantity
of water without trouble and woke from hypnosis

1910 THE ORIGIN OF PSYCHO-ANALYSIS 7

with the glass at her lips. The symptom thereupon
vanished permanently’.

Permit me to dwell for a moment on this experi-
ence. No one had ever cured an hysterical symptom
by such means before, or had come so near under-
standing its cause. This would be a pregnant dis-
covery if the expectation could be confirmed that still
other, perhaps the majority of symptoms, originated
in this way and could be removed by the same
method. Breuer spared no pains to convince himself
of this and investigated the pathogenesis of the
other more serious symptoms in a more orderly way.
Such was indeed the case; almost all the symptoms
originated in exactly this way, as remnants, as
precipitates, if you like, of affectively toned experi-
ences, which for that reason we later called * psychic
traumata '. The nature of the symptoms became
clear through their relation to the scene which caused
them. They were, to use the technical term, * deter-
mined’ by the scene whose memory traces they
embodied, and so could no longer be described as
arbitrary or enigmatical functions of the neurosis.

Only one variation from what might be expected
must be mentioned. It was not always a single
experience which occasioned the symptom, but
usually several, perhaps many similar, repeated
tråumata co-operated in this effect. It was necessary
to repeat the whole series of pathogenic memories in
chronological sequence, and of course in reverse
order, the last first and the first last. It was quite
impossible to reach the first and often most essential
trauma directly, without first clearing away those
coming later. . . . 3

When, a number of years later, I began to use
Breuer’s researches and treatment on my own
p

8 THE ORIGIN OF PSYCHO-ANALYSIS 1910

patients, my experiences completely coincided with
his.... If you will permit me to generalize, as is
indispensable in so brief a presentation, we may
express our results up to this point in the formula:
Our hysterical patients suffer from reminiscences. Their
symptoms are the remnants and the memory symbols
of certain (traumatic) experiences . . . they cannot
escape from the past and neglect present reality in its
favour. This fixation of the mental life on the patho-
genic traumata is an essential, and practically a most
significant characteristic of the neurosis. I will
willingly concede the objection which you are
probably formulating as you think over the history
of Breuer’s patient. All her traumata originated at
the time when she was caring for her sick father,
and her symptoms could only be regarded as
memory symbols of his sickness and death. They
corresponded to mourning, and a fixation on thoughts
of the dead so short a time after death is certainly
not pathological, but rather corresponds to normal
emotional behaviour. I concede this: there is nothing
abnormal in the fixation of feeling on the trauma ・
shown by Breuer's patient. . . .
We have so far only explained the relation of the
hysterical symptoms to the life history of the patient;
now by considering two further factors which Breuer
observed, we may get a hint as to the processes of the
beginning of the illness and those of the cure. With
regard to the first, it is especially to be noted that
Breuer’s patient in almost all pathogenic situations
had to suppress a strong excitement, instead of giving
vent to it by appropriate words and deeds. In the
little experience with her governess's dog, she
suppressed, through regard for the conventions, all
manifestations of her very intense disgust. While she

1910 THE ORIGIN OF PSYCHO-ANALYSIS 9

was seated by her father's sick bed, she was careful
to betray nothing of her anxiety and her painful
depression to the patient. When, later, she repro-
duced the same scene before the physician, the
emotion which she had suppressed on the occurrence
of the scene burst out with especial strength, as
though it had been pent up all along. The symptom
which had been caused by that scene reached its
greatest intensity while the doctor was striving to
revive the memory of the scene, and vanished after it
had been fully laid bare. On the other hand,
experience shows that if the patient is reproducing
the traumatic scene to the physician, the process has
no curative effect if, by some peculiar chance, there
is no development of emotion. It is apparently these
emotional processes upon which the illness of the
patient and the restoration to health are dependent.
We feel justified in regarding * emotion ? as a quan-
tity which may become increased, derived and dis-
placed. So we are forced to the conclusion that the
patient fell ill because the emotion developed in the
pathogenic situation was prevented from escaping
normally, and that the essence of the sickness lies in
the fact that these “ imprisoned * emotions undergo a
series of abnormal changes. In part they are preserved
as a lasting charge and as a source of constant dis-
turbance in psychical life; in part they undergo a
change into unusual bodily innervations and inhibi-
tions, which present themselves as the physical
symptoms of the case. We have coined the name
* hysterical conversion “ for the latter process. Part
of our mental energy is, under normal conditions,
conducted off by way of physical innervation and
gives what we call * the expression of emotions”.
Hysterical conversion exaggerates this part of the

10 THE ORIGIN OF PSYCHO-ANALYSIS 1910

course of a mental process which is emotionally
coloured; it corresponds to a far more intense
emotional expression, which finds outlet by new
paths. If a stream flows in two channels, an over-
flow of one will take place as soon as the current in
the other meets with an obstacle.

You see that we are in a fair way to arrive at a
purely psychological theory of hysteria, in which we
assign the first rank to the affective processes. A
second observation of Breuer compels us to ascribe
to the altered condition of consciousness a great part
in determining the characteristics of the disease. His
patient showed many sorts of mental states, condi-
tions of “absence”, confusion and alteration of
character, besides her normal state. In her normal
state she was entirely ignorant of the pathogenic
scenes and of their connection with her symptoms.
She had forgotten those scenes, or at any rate had
dissociated them from their pathogenic connection.
When the patient was hypnotized, it was possible,
after considerable difficulty, to recall those scenes to
her memory, and by this means of recall the symp-
toms were removed. It would have been extremely
perplexing to know how to interpret this fact, if
hypnotic practice and experiments had not pointed
out the way. Through the study of hypnotic phenom-
ena, the conception, strange though it was at first,
has become familiar, that in one and the same
individual several mental groupings are possible,
which may remain relatively independent of each
other, ‘know nothing’ of each other, and which
may cause a splitting of consciousness along lines
which they lay down. . . . In the same way it is
quite possible to explain the facts in hysterical cases.
Breuer came to the conclusion that the hysterical

1910 THE ORIGIN OF PSYCHO-ANALYSIS 11

symptoms originated in peculiar mental states,
which he called ` hypnoidal states’. ... Later I
shall at least suggest what other influences and
processes have been disclosed besides that of the
hypnoidal states, to which Breuer limited the causal
factor.

You have probably also felt, and rightly, that
Breuer’s investigations gave you only a very incom-
plete theory and insufficient explanation of the
phenomena which we have observed. But complete
theories do not fall from Heaven, and you would
have had still greater reason to be distrustful had
anyone offered you at the beginning of his observa-
tions a well-rounded theory, without any gaps; such
a theory could only be the child of his speculations
and not the fruit of an unprejudiced investigation of
the facts.

Second Lecture. ... The great French observer
[Charcot], whose student I was during the years
1885-6, had no natural bent for creating psychological
theories. His student, P. Janet, was the first to
attempt to penetrate more deeply into the psychic
processes of hysteria, and we followed his example
when we made the mental splitting and the dissocia-
tion of personality the central points of our theory.
Janet propounds a theory of hysteria which draws
upon the principal theories of heredity and degenera-
tion which are current in France. According to his
view hysteria is a form of degenerative alteration of
the nervous system, manifesting itself in a congenital
“weakness ” of the function of psychic synthesis. . . .

When I undertook to continue on my own account
the investigations begun by Breuer I soon came to
another view of the origin of hysterical dissociation
(or splitting of consciousness). . . . The cathartic