Page:Freud - Selected papers on hysteria and other psychoneuroses.djvu/148

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PAPERS ON HYSTERIA AND OTHER PSYCHONEUROSES.

mechanism of the real neurasthenia which remains after such a separation.

I call this symptom-complex"anxiety neurosis" (Angstneurose) because the sum of its components can be grouped around the main symptom of anxiety, because each individual symptom shows a definite relation to anxiety. I believed that I was original in this conception of the symptoms of anxiety neurosis until an interesting lecture by E. Hecker[1] fell into my hands. In this lecture I found the description of the same interpretation with all the desired clearness and completeness. To be sure, Hecker does not separate the equivalents or rudiments of the attack of anxiety from neurasthenia as I intend to do; but this is apparently due to the fact that neither here nor there has he taken into account the diversity of the etiological determinants. With the knowledge of the latter difference every obligation to designate the anxiety neurosis by the same name as the real neurasthenia disappears, for the only object of arbitrary naming is to facilitate the formulation of general assertions.

I. Clinical Symptomatology of Anxiety Neurosis.

What I call "anxiety neurosis" can be observed in complete or rudimentary development, either isolated or in combination with other neuroses. The cases which are in a measure complete, and at the same time isolated, are naturally those which especially corroborate the impression that the anxiety neurosis possesses clinical independence. In other cases we are confronted with the task of selecting and separating from a symptom-complex which corresponds to a "mixed neurosis," all those symptoms which do not belong to neurasthenia, hysteria, etc., but to the anxiety neurosis.

The clinical picture of the anxiety neurosis comprises the following symptoms:

1. General Irritability.—This is a frequent nervous symptom, common as such to many nervous states. I mention is here be-

  1. E. Hecker, Über larvierte und abortive Angstzustände bei Neurasthenie, Centralblatt für Nervenheilkunde, December, 1893.—Anxiety is made particularly prominent among the chief symptoms of neurasthenia by Kaan, Der neurasthenische Angstafifekt bei Zwangsvorstellungen und der primordiale Grübelzwang, Wien, 1893.