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Thorner, H.A. (1939). Clinical: Otto Fenichel. 'The Conception of Trauma in Present Day Psycho-Analytical Theory of Neuroses.' Internationale Zeitschrift für Psycho-analyse, Vol. XXIII, Part 3, pp. 439-459.. Int. J. Psycho-Anal., 20:186-187.
Psychoanalytic Electronic Publishing: Clinical: Otto Fenichel. 'The Conception of Trauma in Present Day Psycho-Analytical Theory of Neuroses.' Internationale Zeitschrift für Psycho-analyse, Vol. XXIII, Part 3, pp. 439-459.
(1939). International Journal of Psycho-Analysis, 20:186-187
A neurosis is fundamentally a discharge of accumulated excitation which the ego either rejects, or of which it is not aware. Excitation can be accumulated by an increased influx in the time-unit (traumatic neurosis), or by a diminished discharge as a result of fear of the external world, or of command of the super-ego (psycho-neurosis). There is a particular link between neurosis and anxiety. Anxiety is a signal of threatening danger. The term 'danger' means that the ego considers a certain situation a potentially traumatic one. The signal, i.e. the anxiety, might increase to such an extent that the presumed danger turns into a trauma. The increase of the anxiety-reaction is due to chronic inhibition of discharge which leads to damming up of libido. The signal might thus fail, and the danger necessitate a defence against anxiety. Referring to traumatic neuroses the author mentions two types of traumata: external and internal ones. The importance of impulses as a source of danger is discussed. This danger is twofold: the external world might interfere, or the apparatus which provides satisfaction might fail. The author quotes the work of Melanie Klein and other English workers who maintain that the small child is inevitably exposed to traumatic situations. By remembering situations in which impulses were not satisfied the ego becomes hostile to these impulses, and suppresses them in order to avoid a similar frustration. The defence against impulses, however, is not explained by reducing it to the occasion when it first occurred. It is one of the achievements of psycho-analytical research that neuroses result from later experiences. Anna Freud, in speaking of a primary hostility of the ego against impulses, means, according to the author, a similar mechanism. It is based on memory-traces of traumatic situations which occurred at a time when the apparatus which provides satisfaction was not yet fully developed, and failed. The author rejects these hypotheses, as he cannot see any reason why a human being should have such an anxiety once the apparatus providing satisfaction is fully developed. A further step is that the fear of internal sensations is interpreted as 'introjected bad objects'. The author gives a number of examples of anxiety and discusses them in their connection with trauma. Overwhelming excitation is the main object of fear, as under its pressure the ego threatens to break down. Reich points
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out that orgasm consists of two phases, a voluntary and an involuntary one. The latter phase is experienced in these cases as a breakdown of the ego, and thus pleasure turns into pain and anxiety. If we were to assume a primary hostility we would have to ask how the fear of a breakdown in the ego is normally overcome. The author, however, is inclined to assume that a normal person is capable of orgasm, and the question would then not be how this normal state arises, but what events make an individual incapable of experiencing orgasm as pleasure. Two events are possible which can produce such an incapacity: (1) Real or projected prohibitions will create defences against impulses, and block the normal path of discharge. (2) Traumata produce greater quantities of excitation than endogene impulses. Infantile traumata are capable of emphasizing later prohibitions and vice versâ.
The distinction between traumatic neurosis and psycho-neurosis is only relative. A traumatic neurosis is never isolated from conflicts of impulses while a psycho-neurosis accumulates impulses on account of anxiety. Anxiety offers a link to traumatic neurosis because it is a judgment anticipating a danger, a sort of memory of a passed traumatic situation. Furthermore there are mixed cases which have traces of a traumatic neurosis and of a psycho-neurosis. These cases are particularly difficult. A trauma experienced with comparatively little co-operation of impulses will only be revived when the particular situation is repeated, and usually disappears after some time. If, however, the trauma is linked up with sexual excitation the neurosis cannot heal spontaneously as the traumatic conflict is revived by the sexual impulse which physiologically increases at intervals. The patient finds himself involved in a vicious circle as long as the sexual excitation appears as a danger.
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Thorner, H.A. (1939). Clinical. Int. J. Psycho-Anal., 20:186-187