mistakes of a journeyman. Such suggestions only redound to the discredit of those who make them. Ever since then patients have been examined by every possible means from which suggestion could be absolutely excluded. And still the associations described by Freud have been proved to be true in principle. We are thus obliged in the first place to regard many of these shocks of early childhood as phantoms, while other traumata have objective reality. With this knowledge, at first somewhat confusing, the etiological importance of the sexual trauma in childhood declines, as it seems now quite irrelevant whether the trauma really took place or not. Experience teaches us that phantasy can be, so to speak, of the same traumatic value as real shock. In the face of such facts, every physician who treats hysteria will recall cases where the neurosis has indeed been provoked by violent traumatic impressions. This observation is only in apparent contradiction with our knowledge, already referred to, of the unreality of traumatic events in childhood. We know perfectly well that many persons suffer shocks in childhood or in adult life who nevertheless get no neurosis. Therefore the trauma has, ceteris paribus, no absolute etiological importance, but owes its efficacy to the nature of the soil upon which it falls.
The Predisposition for the Trauma
No neurosis will grow on an unprepared soil where no germ of neurosis is already existing; the trauma will pass by without leaving any permanent and effective mark. From this simple consideration it is pretty clear that, to make it really effective, the patient must meet the shock with a certain internal predisposition. This internal predisposition is not to be understood as meaning that totally obscure hereditary predisposition of which we know so little, but as a psychological development which reaches its apogee and its manifestation at the moment, and even through, the trauma.
I will show you first of all by a concrete case the nature of the trauma and its psychological predisposition. A young lady suffered from severe hysteria after a sudden fright. She had been attending a social gathering that evening and was on her way home at midnight, accompanied by several acquaintances, when
