Page:The International Journal of Psycho-Analysis II 1921 1.djvu/37

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PSYCHO-ANALYTICAL OBSERVATIONS ON TIC 29

memory-traces in the unconscious for things, that refer to the libido objects (persons). In consequence of the incessant reciprocal associative linking-up of the memory-systems of "the thing" and of "the ego" (body), the pathogenic psychic material of the hysteric can use the associated physical memory material as a means ot expression. That is the explanation of the so-called "physical approach" which Breuer and Freud remarked on in reference to the very first analysed cases of hysteria. In the celebrated case of the patient "Anna" the hysterical paralysis of the arm was traced back to the fact that in a most critical moment when contend- ing tendencies came into conflict, her arm was inadvertently left hanging over the back of the chair and had "gone to sleep". In similar manner a tear that obscured her sight was the cause ol Macropsia which developed later. The accidental catarrh of a patient of Freud's (Doi;a) was the finely graduated means of express- ing the most complicated love emotions under the mask of a "nervous cough". Thus in conversion-hysteria the object memories repressed by psychic energy are used to reinforce and finally to 'materialise the ego (body) memories associated with them This is the mechanism of the "leap from the mental to the physical" in the formation of hysterical symptoms.

In Tic on the contrary, traumatic ego (body) memory forces itself spontaneously to the fore on every occasion that offers. One could say that Tic and Catatonia are in reality ego-hysterias. Or expressed in the terminology of the libido theory : the hysterical conversion-symptoms are expressions of (genital) object love, clothed in the form of auto-erotism, while the tics and catatonias are auto- erotism which has to some extent adopted genital qualities.^

Finally we must also compare the motor expressions of obsess- ive actions. We know through Freud, that these actions are psychic protective measures with the object of guarding against

> See in this connection the following passage from the important work of Nunberg on the catatonic attack (Internationale Zeitsckrift fur Psycho- analyse, 1920, Bd. V, S. 49). "In conclusion I should like to refer to the many singularly striking similarities between catatonic and hysteric attacks, as, for instance, the 'dramatisation' and Angst. There is, however, this difiference between them, namely, that while in Hysteria we are concerned with a Libido-charge of an object, in Catatonia a Libido-charge of an organ takes place."

Also, the perversions of adults are of course "genitalised" auto-erotism (Perversion is indeed the "Positive of Hysteria").