THE AMERICAN

JOURNAL OF PSYCHOLOGY

Founded by G. Stanley Hall in 1887

Vol. XXI APRIL, 1910 No. 2

THE ORIGIN AND DEVELOPMENT OF
PSYCHOANALYSIS¹

By PROF. Sigmund Freud (Vienna)

FIRST LECTURE

Ladies and Gentlemen: It is a new and somewhat embar-
rassing experience for me to appear as lecturer before students
of the New World. I assume that I owe this honor to the
association of my name with the theme of psychoanalysis, and
consequently it is of psychoanalysis 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.

Granted that it is a merit to have created psychoanalysis,
it is not my merit. I was a student, busy with the passing of
my last examinations, when another physician of Vienna, Dr.
Joseph Breuer,² made the first application of this method to
the case of an hysterical girl (1880–82). We must now ex-
amine the history of this case and its treatment, which can be
found in detail in ‘Studien über Hysterie,’ later published
by Dr. Breuer and myself.³

But first one word. I have noticed, with considerable satis-
 

¹Lectures delivered at the Celebration of the Twentieth Anniversary
of the opening of Clark University, Sept., 1909; translated from the
German by Harry W. Chase, Fellow in Psychology, Clark University,
and revised by Prof. Freud.

²Dr. Joseph Breuer, born 1842, corresponding member of the
“Kaiserliche Akademie der Wissenschaften,” is known by works on
respiration and the physiology of the sense of equilibrium.

³“Studien über Hysterie,” 1895, Deuticke, Vienna. Second edi-
tion, 1909. Parts of my contributions to this book have been trans-
lated into English by Dr. A. A. Brill, of New York. (“Selected
Papers on Hysteria and other Psychoneuroses, by S. Freud.”)

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FREUD

faction, that the majority of my hearers do not belong to the
medical profession. Now do not fear that a medical education
is necessary to follow what I shall have to say. We shall now
accompany the doctors a little way, but soon we shall take
leave of them and follow Dr. Breuer on a way which is quite
his own.

Dr. Breuer’s patient was a girl of twenty-one, of a high de-
gree 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 seriously. She had a severe
paralysis of both right extremities, with anæsthesia, and at
times the same affection of the members of the left side of the
body; disturbance of eye-movements, and much impairment
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,” of confusion,
delirium, alteration of her whole personality. These states
will later claim our attention.

When one hears of such a case, one does not need to be a
physician to incline to the opinion that we are concerned here
with a serious injury, probably of the brain, for which there is
little hope of cure and which will probably lead to the early death
of the patient. The doctors will tell us, however, that in one
type of cases with just as unfavorable symptoms, another, far
more favorable opinion is justified. When one finds such a
series of symptoms in the case of a young girl, whose vital
organs (heart, kidneys), are shown by objective tests to be nor-
mal, but who has suffered from strong emotional disturbances,
and when the symptoms differ in certain finer characteristics
from what one might logically expect, in a case like this the
doctors are not too much disturbed. They consider that there
is present no organic lesion of the brain, but that enigmatical
state, known since the time of the Greek physicians as hys-
teria, which can simulate a whole series of symptoms of various
diseases. They consider in such a case that the life of the
patient is not in danger and that a restoration to health will
probably come about of itself. The differentiation of such an
hysteria from a severe organic lesion is not always very easy.
But we do not need to know how a differential diagnosis of
this kind is made; you may be sure that the case of Breuer’s
patient was such that no skillful physician could fail to diag-
nose an hysteria. We may also add a word here from the
history of the case. The illness first appeared while the

183

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.

So far it has seemed best to go with the doctors, but we
shall soon part company with them. You must not think that
the outlook of a patient with regard to medical aid is essen-
tially 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.¹⁾ Accordingly, with the recognition
of the disease as hysteria, little is changed in the situation of
the patient, but there is a great change in the attitude of the
doctor. We can observe that he acts quite differently toward
hystericals than toward patients suffering from organic dis-
eases.

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.

But there is another motive in this action. The physician,
who through his studies has learned so much that is hidden from
the laity, can realize in his thought the causes and alterations
of the brain disorders in patients suffering from apoplexy or
dementia, a representation which must be right up to a certain
point, for by it he is enabled to understand the nature of each
symptom. But before the details of hysterical symptoms, all
his knowledge, his anatomical-physiological and pathological
education, desert him. He cannot understand hysteria. He
is in the same position before it as the layman. And that is
not agreeable to any one, who is in the habit of setting such a
high valuation upon his knowledge. Hystericals, accordingly,
tend to lose his sympathy; he considers them persons who
overstep the laws of his science, as the orthodox regard here-
tics; he ascribes to them all possible evils, blames them for
exaggeration and intentional deceit, “simulation,” and he
punishes them by withdrawing his interest.

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. Probably this was
easier for him on account of those superior qualities of the
patient’s mind and character, to which he bears witness in his
account of the case.

His sympathetic observation soon found the means which

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.

184

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 themselves 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
expressed in the “absence” was a consequence of the excita-
tions 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 cleans-
ing of the soul more could be accomplished than a tempo-
rary 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, pro- vided 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 suffer- ing from hydrophobia. Obviously 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 disliked, 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 conventions the patient had remained silent. Now,

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ORIGIN AND DEVELOPMENT OF PSYCHOANALYSIS

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 with the glass at
her lips. The symptom thereupon vanished permanently.”¹

Permit me to dwell for a moment on this experience. No one
had ever cured an hysterical symptom by such means before,
or had come so near understanding its cause. This would be
a pregnant discovery 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 inves-
tigated 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 experiences, 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, “determined” (determiniert) by the scene whose mem-
ory 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 traumata 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.

You will of course want to hear me speak of other examples
of the causation of hysterical symptoms beside this of inability
to drink on account of the disgust caused by the dog drinking
from the glass. I must, however, if I hold to my programme,
limit myself to very few examples. Breuer relates, for in-
stance, that his patient’s visual disturbances could be traced
back to external causes, in the following way. “The patient,
with tears in her eyes, was sitting by the sick-bed when her
father suddenly asked her what time it was. She could not
see distinctly, strained her eyes to see, brought the watch near
her eyes so that the dial seemed very large (macropia and
strabismus conv.), or else she tried hard to suppress her tears,
so that the sick man might not see them.”²

All the pathogenic impressions sprang from the time when

¹“Studien über Hysterie,” 2d edition, p. 26.

²Studien über Hysterie,” 2d edition, p. 31.

186

she shared in the care of her sick father. “Once she was
watching at night in the greatest anxiety for the patient, who
was in a high fever, and in suspense, for a surgeon was ex-
pected from Vienna, to operate on the patient. Her mother
had gone out for a little while, and Anna sat by the sick-bed,
her right arm hanging over the back of her chair. She fell into
a revery and saw a black snake emerge, as it were, from the
wall and approach the sick man as though to bite him. (It
is very probable that several snakes had actually been seen in
the meadow behind the house, that she had already been
frightened by them, and that these former experiences fur-
nished the material for the hallucination.) She tried to drive
off the creature, but was as though paralyzed. Her right
arm, which was hanging over the back of the chair, had
“gone to sleep,” become anasthetic and paretic, and as she
was looking at it, the fingers changed into little snakes with
deaths-
heads. (The nails.) Probably she attempted to drive
away the snake with her paralyzed right hand, and so the
anesthesia and paralysis of this member formed associations
with the snake hallucination. When this had vanished, she
tried in her anguish to speak, but could not. She could not
express herself in any language, until finally she thought of
the words of an English nursery song, and thereafter she
could think and speak only in this language.”¹⁾ When the
memory of this scene was revived in hypnosis the paralysis of
the right arm, which had existed since the beginning of the
illness, was cured and the treatment ended.

When, a number of years later, I began to use Breuer’s re-
searches and treatment on my own patients, my experiences
completely coincided with his. In the case of a woman of
about forty, there was a tic, a peculiar smacking noise which
manifested itself whenever she was laboring under any excite-
ment, without any obvious cause. It had its origin in two
experiences which had this common element, that she at-
tempted to make no noise, but that by a sort of counter-
will this noise broke the stillness. On the first occasion, she had
finally after much trouble put her sick child to sleep, and she
tried to be very quiet so as not to awaken it. On the second
occasion, during a ride with both her children in a thunder-
storm the horses took fright, and she carefully avoided any
noise for fear of frightening them still more.²⁾ I give this ex-
 

¹⁾“Studien über Hysterie,” 2d edition, p. 30.

²⁾Loc cit., 2d ed. pp. 43–46. A selection from this book, augmented
by several later treatises on hysteria, lies before me, in an English
translation by Dr. A. A. Brill, of New York. It bears the title “Se-
lected Papers on Hysteria and other Psychoneuroses,” 1909. [No. 4
of the Nervous and Mental Disease Monograph Series, New York.]

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ORIGIN AND DEVELOPMENT OF PSYCHOANALYSIS

ample instead of many others which are cited in the “Studien
über Hysterie.”

Ladies and gentlemen, 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.

A comparison with other memory symbols from other sources
will perhaps enable us better to understand this symbolism.
The memorials and monuments with which we adorn our
great cities, are also such memory symbols. If you walk
through London you will find before one of the greatest rail-
way stations of the city a richly decorated Gothic pillar—
“Charing Cross.” One of the old Plantagenet kings, in the
thirteenth century, caused the body of his beloved queen
Eleanor to be borne to Westminster, and had Gothic crosses
erected at each of the stations where the coffin was set down.
Charing Cross is the last of these monuments, which preserve
the memory of this sad journey.¹ In another part of the city,
you will see a high pillar of more modern construction, which
is merely called “the monument.” This is in memory of the
great fire which broke out in the neighborhood in the year
1666, and destroyed a great part of the city. These monu-
ments are memory symbols like the hysterical symptoms; so
far the comparison seems justified. But what would you say
to a Londoner who to-day stood sadly before the monument to
the funeral of Queen Eleanor, instead of going about his busi-
ness with the haste engendered by modern industrial condi-
tions, or rejoicing with the young queen of his own heart?
Or to another who before the “Monument” bemoaned the
burning of his loved native city, which long since has arisen
again so much more splendid than before?

Now hystericals and all neurotics behave like these two un-
practical Londoners, not only in that they remember the
painful experiences of the distant past, but because they are
still strongly affected by them. They cannot escape from the
past and neglect present reality in its favor. This fixation of
the mental life on the pathogenic 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 corre-

¹Or rather the later copy of such a monument. The name “Char-
ing” is itself, as Dr. E. Jones tells me, derived from the words
“chère reine.”

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FREUD

sponded 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 behavior. I concede
this: there is nothing abnormal in the fixation of feeling on
the trauma shown by Breuer’s patient. But in other cases,
like that of the tic that I have mentioned, the occasions for
which lay ten and fifteen years back, the characteristic of this
abnormal clinging to the past is very clear, and Breuer’s
patient would probably have developed it, if she had not come
under the “cathartic treatment” such a short time after the
traumatic experiences and the beginning of the disease.

We have so far only explained the relation of the hysterical
symptoms to the life history of the patient; now by consider-
ing two further moments 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 situa-
tions had to suppress a strong excitement, instead of giving
vent to it by appropriate words and deeds. In the little ex-
perience with her governess’ dog, she suppressed, through
regard for the conventions, all manifestations of her very in-
tense disgust. While she was seated by her father’s sick bed,
she was careful to betray nothing of her anxiety and her pain-
ful depression to the patient. When, later, she reproduced
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 quantity which may become in-
creased, derived and displaced. So we are forced to the con-
clusion that the patient fell ill because the emotion developed
in the pathogenic situation was prevented from escaping nor-
mally, and that the essence of the sickness lies in the fact that
these “imprisoned” (dingeklemmt) emotions undergo a series
of abnormal changes. In part they are preserved as a lasting
charge and as a source of constant disturbance in psychical
life; in part they undergo a change into unusual bodily innerva-
tions and inhibitions, which present themselves as the physical
symptoms of the case. We have coined the name “hysterical

189

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 emo-
tions.” Hysterical conversion exaggerates this part of the
course of a mental process which is emotionally colored; it
corresponds to a far more intense emotional expression, which
finds outlet by new paths. If a stream flows in two channels,
an overflow 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 psy-
chological 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 con-
sciousness a great part in determining the characteristics of
the disease. His patient showed many sorts of mental states,
conditions of “absence,” confusion and alteration of charac-
ter, besides her normal state. In her normal state she was
entirely ignorant of the pathogenic scenes and of their con-
nection 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 possi-
ble, after considerable difficulty, to recall those scenes to her
memory, and by this means of recall the symptoms 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
phenomena, 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. Cases of such a sort, known as “double
personality” (“double conscience”), occasionally appear spon-
taneously. If in such a division of personality conscious-
ness remains constantly bound up with one of the two
states, this is called the conscious mental state, and the
other the unconscious. In the well-
known phenomena of so-
called post-hypnotic suggestion, in which a command given in
hypnosis is later executed in the normal state as though by an
imperative suggestion, we have an excellent basis for under-
standing how the unconscious state can influence the con-
scious, although the latter is ignorant of the existence of the
former. In the same way it is quite possible to explain the
facts in hysterical cases. Breuer came to the conclusion that
the hysterical symptoms originated in such peculiar mental
states, which he called “hypnoidal states.” (hypnoide Zus-
tände.) Experiences of an emotional nature, which occur dur-

190

Freud

ing such hypnoidal states easily become pathogenic, since such
states do not present the conditions for a normal draining off of
the emotion of the exciting processes. And as a result there
arises a peculiar product of this exciting process, that is, the
symptom and this is projected like a foreign body into the
normal state. The latter has, then, no conception of the sig-
nificance of the hypnoidal pathogenic situation. Where a
symptom arises, we also find an amnesia, a memory gap, and
the filling of this gap includes the removal of the conditions
under which the symptom originated.

I am afraid that this portion of my treatment will not seem
very clear, but you must remember that we are dealing here
with new and difficult views, which perhaps could not be
made much clearer. This all goes to show that our knowl-
edge in this field is not yet very far advanced. Breuer’s idea
of the hypnoidal states has, moreover, been shown to be sur-
perfluous and a hindrance to further investigation, and has been
dropped from present conceptions of psychoanalysis. 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 moment.

You have probably also felt, and rightly, that Breuer’s in-
vestigations gave you only a very incomplete 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 dis-
trustful, had any one offered you at the beginning of his
observations 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

Ladies and Gentlemen: At about the same time that Breuer
was using the “talking-cure” with his patient, M. Charcot
began in Paris, with the hystericals of the Salpetrière, those
researches which were to lead to a new understanding of the
disease. These results were, however, not yet known in
Vienna. But when about ten years later Breuer and I pub-
lished our preliminary commuication on the psychic mechan-
ism of hysterical phenomena, which grew out of the cathartic
treatment of Breuer’s first patient, we were both of us under
the spell of Charcot’s investigations. We made the pathogenic
experiences of our patients, which acted as psychic traumata,
equivalent to those physical traumata whose influence on
hysterical paralyses Charcot had determined; and Breuer’s
hypothesis of hypnoidal states is itself only an echo of the fact