463

INHIBITION, SYMPTOM AND ANXIETY

SIGMUND FREUD

I

Our usage of speech permits us, in the description of pathological
phenomena, to differentiate between symptoms and inhibitions, but
not much value is attributed to this distinction. If cases of illness
did not come to us of whom we must say that they show only inhi-
bitions and no symptoms, and if we did not know how they came
about, we should hardly be interested in discriminating between inhi-
bition and symptom.

These two do not flourish on the same soil. Inhibition has a
special relationship to function and does not necessarily indicate
something pathological, for one may call the restrictions of a func-
tion inhibition of the same. Symptoms, on the other hand, signify
indications of disease processes. So also may inhibition be a symp-
tom of disease. The usage of language, then, is such that it speaks
of inhibition where there is an unusual variation of the same or a
new performance. In many cases it is left to one's discretion to
emphasize the positive or negative side of a pathological process, and
designate the result as a symptom or an inhibition. This, in all truth,
is not interesting and the question with which we begin this thesis is
shown to bear little fruit.

As inhibition is evidently so intimately connected with function,
one may arrive at the idea of studying the different ego functions,
in respect to which forms of disturbance of the same are expressed
in the individual neurotic functions. For this comparative study we
choose: the sexual function, eating, locomotion and occupation.

(a) The sexual function is subject to very manifold disturbances,
the majority of which show the character of simple inhibitions.
These may be comprehended under the head of psychic impotence.
The status of normal sexual function presupposes a very complicated
course, and disturbance may come about in every part. The princi-
pal stations for inhibition in men are: the turning aside of the libido
at the beginning of the process (psychic frigidity); the absence of
physical preparation (erection); the shortening of the act (pre-
cocious ejaculation–which may equally be described as a positive
symptom); the holding back of the same (lack of ejaculation); and
the absence of the psychic effect (pleasure in the orgasm). Other
disturbances result from the association of the function with special
conditions of perverse or fetichistic nature.

464

One cannot long escape the recognition of a relationship between
inhibition and angst.^* Many inhibitions are palpably a renunciation
of function because in the exercise of the latter fear is developed.
Direct fear of the sexual function is frequent in women. We as-
sociate it with hysteria, and also with the defensive symptom of
nausea, which set in originally as a supplementary reaction to the
passively experienced sexual act and appear later at the mental
image of the same. A great number of compulsive behaviors are
also shown as precautions and assurance against sexual experience
and are therefore of phobic nature.

One does not get far in the comprehension of these matters and
at most one remarks only that very different procedures are applied in
the disturbance of the functions: (1) The mere absence of libido,
which seems the soonest to manifest itself, which we call a pure
inhibition. (2) The impairment in the execution of the function.
(3) The aggravation of the same by special conditions and the
modification by deviation to other objectives. (4) The prevention
by safety measures. (5) The interruption through development of
fear so far as its addition cannot be hindered, and finally (6), a
supplementary one which protests against the disturbance and would
make what has happened undone if the function could be carried out.

(b) The most common disturbance of the nutritive function is
anorexia through withdrawal of the libido. Also aggravation of the
appetite is often seen—a compulsion to eat motivated by fear of
starving has been but little studied. As a hysterical refusal of food is
the symptom of vomiting, refusal of food through fear belongs to
psychotic states (delusion of poisoning).

(c) Locomotion is inhibited in many neurotic conditions through
disinclination to walk and weakness on walking, while hysterical in-
hibition is manifested by motor palsy of the locomotor apparatus or

^*Contrary to ordinary usage the German word angst in this article is
in many instances rendered fear in place of anxiety, the last being the equivalent
given in psychoanalytic glossaries. The reader can himself substitute the word
anxiety for fear whenever the latter occurs in the text. The reason for pre-
ferring fear to anxiety is that the latter is too mild a term, suggesting little
more than worry or solicitude to the casual reader. The German word angst
has no exact equivalent in English, for it can denote any affective state between
anxiety and the most extreme terror, as in the term todesangst for mortal fear.
That the affective state implied is fear is shown in several ways, as the Greek
phobia, which connotes fear, is equivalent in sense and is rendered by
angstzustand or fear state. The word anxiety would not serve as an equivalent
for phobia, which may indicate a condition of extreme fear. It has been sug-
gested that the German word angst be left untranslated in the English text,
much as the word anlage is left untranslated as having no exact English equiva-
lent. This idea meets with our approval but until this is done we prefer to
make use of fear as well as anxiety. The idea of rendering angst as fear or
anxiety at the option of the translator, according to the context, has been
tested but is not entirely satisfactory. [Editor.]

465

else by some special abolition of function like abasia. Especially
characteristic are difficulties of locomotion through the interposition
of definite conditions, through the non-fulfilment of which fear arises
(phobias).

(d) Inhibition of one’s occupational activities, which comes so often
to treatment as an isolated symptom, shows diminished desire for
work or poor execution or reaction phenomena, as exhaustion (vertigo,
vomiting) when continuation of the occupation is forced. Hysteria
forces the cessation of labor through engendering organ and func-
tional paralyses, the existence of which cannot be conjoined with
execution. The compulsive neuroses disturb work through continu-
ous diversion and through loss of time in the interpolated delays and
repetitions.

We could extend this survey over other functions but could not
expect to attain more thereby. We have not gone beyond the surface
phenomena. Hence we resolve to take a view which makes the con-
ception of an inhibition no longer very enigmatical. Inhibition is
the expression of a functional limitation of the ego, which can come
about from very different causes.

Many of the mechanisms of this renunciation of function and a
general tendency to the same are well known to us. It is easy to
recognize this tendency in the specialized inhibitions. If piano play-
ing, writing and even walking are subject to neurotic inhibitions,
analysis shows us the reason for the same in an over-strong erotisa-
tion of the organs involved–the fingers and the feet. We have
gained the view in general that the ego function of an organ is in-
jured if its erogeneity, its sexual significance, increases. It then
behaves–if one dare make a scurrilous comparison–like a cook
who will no longer work at the fireside because the man of the house
enters into love relations with her. If writing which consists in
letting ink flow from a tube on a piece of white paper, has assumed
the symbolic significance of coitus; or when walking has become a
symbolic substitute for stamping on Mother Earth, then both writing
and walking will be prohibitive because it is as if one would carry
out some forbidden sexual transaction. The ego renounces this
function proper to it in order not to be compelled to undertake a
new repression, in order to avoid a conflict with the It.

Other inhibitions follow obviously in the service of self-punish-
ment–frequently in connection with professional activities. The
ego dare not do certain things because it will use them in a manner
disapproved of by the more strict super-ego. In turn the ego re-
nounces these functions in order not to engage in a conflict with
the super-ego.

466

The general inhibitions of the ego follow another and simple
mechanism. When the ego is claimed by a psychic task of particu-
lar difficulty,–through an affliction, a grand affect-suppression,
through the necessity of holding down a constantly increasing sexual
fancy,–it is so deprived of disposable energy that it must retrench
its supply in many directions like a speculator who has tied up his
money in his enterprises. An instructive example of such an in-
tensive general inhibition of brief duration was observed by me in
a compulsive patient who fell into a paralyzing weariness of one or
several days’ duration on occasions which should obviously have led
to an outbreak of rage. Beginning here there must be found a way
to the comprehension of general inhibition through which the de-
pressive states and the most severe of these, melancholy, characterize
themselves.

In conclusion, one may say of the inhibitions that they are re-
strictions of the ego functions either from prudence or impoverish-
ment of energy. It is easy to recognize now wherein inhibition
differs from symptom; for symptom can be nothing more than a
process within or connected with the ego.

II

The main features of symptom formation have long been studied
and have been expressed, it is to be hoped, in an impregnable manner.
The symptom is a sign and substitute of a suppressed impulse-grati-
fication, the result of a repressive process. The repression proceeds
from the ego, which, perchance in the service of the super-ego, will
not coöperate in an instinct investment incited by the It. The ego
through the repression makes it possible for the idea, which was
the carrier of the unamiable striving, to become shut off from
consciousness. Analysis often demonstrates that it remains as an
unconscious formation. Thus far it is clear, but presently the un-
solved difficulties begin.

Our previous descriptions of the process in repression have em-
phasized the result of the shutting off from consciousness, but in
other respects we have left matters open to doubt. The question
arises, what is the fate of the impulse activated in the It which aims
at gratification? The answer is an indirect one and runs as follows:
through the process of repression the anticipated desire for gratifica-
tion is changed to pain. One would then confront the problem of
how pain could be the result of the instinct gratification. We hope
to explain the situation by the definite statement that the intentional
course of the stimulus in the It fails to take place because of repres-