Page:Freud - Selected papers on hysteria and other psychoneuroses.djvu/141

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THE DEFENSE NEURO-PSYCHOSES.
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prove by any clinico-psychological analysis. Perhaps it would be more correct to say that these are not really processes of a psychic nature but physical processes of which the psychic result so presents itself that the expressions " separation of the idea from its affect and false connection of the latter," seem actual occurrences.

Besides the cases evincing in turn the sexual unbearable idea and the obsession we find a series of others in which there are simultaneously obsessions and painfully accentuated sexual ideas. It will not do very well to call the latter "sexual obsessions"; they lack the essential character of obsessions in proving themselves fully justified, whereas the painfulness of the ordinary obsession is a problem for the doctor as well as the patient. From the amount of insight that could be obtained in such cases, it seems that we deal here with a continued defense against sexual ideas which are constantly renewed, a work heretofore not accomplished.

As long as the patients are aware of the sexual origin of their obsessions they often conceal them. If they complain they generally express surprise that this affect underlies the symptoms, at being afraid, and at having certain impulses, etc. To the experienced physician, however, the affect appears justified and intelligible; he finds the striking part only in the connection of such an affect with an idea unworthy of it. In other words the affect of the obsession appears to him as one dislocated or transposed, and if he has accepted the observations here laid down he can in a great many cases of obsessions attempt a retranslation into the sexual.

Any idea which either through its character may be combinable with an affect of such quality or which bears a certain relation to the unbearable by virtue of which it seems fit as a substitute for the same, may be used for the secondary connection of the freed affect. Thus, for example, freed anxiety, the sexual origin of which can not be recalled, attaches itself to the common primary phobias of man for animals, thunderstorms, darkness, etc., or to things which are unmistakably in some way associated with the sexual, such as urination, defecation, pollutions and infections.

The advantage gained by the ego in the transposition of the affect for the purpose of defense is considerably less than in the hysterical conversion of psychic excitement into somatic innerva-