1. The Disposition to Compulsion Neurosis.—Before the problem of why anybody has a can be settled, the more special problem of why anybody has just the special he does have must probably be solved. We distinguish in this connection what one brings with him and what happens to him, i. e., constitutional and accidental causes. The first thesis maintains that the ground for the determining of the lies wholly in the disposition and is independent of the pathologically acting experience. If we seek an origin of this disposition our is turned to the of the psychical functions, above all the sexual function, but also different important ego functions, and we have to acknowledge that this is not always so perfect that the whole function progresses without any hitches. Where a part of this function stops at any we have a so-called “ point” to which the function can regress in case of disease due to any outer disturbance.
1 Paper read before the psychoanalytic congress in Munich, 1913.
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Our dispositions are hence inhibitors of .
The order in which the principal forms of psychoneuroses are the time at which these diseases appear in life. can be observed in earliest ; the manifests itself usually given: , , , Dementia Præcox, corresponds (on the whole, if not absolutely exactly) with usually in the second period of (6 to 8, on); the two others come first after and up to maturity. These two last affections have for the first time proved accessible since our investigations. The characteristics peculiar to both, megalomania, the turning from the world of , and the difficulties of , force us to the conclusion that the disposing takes place before the establishment of , and hence has to be sought in the of and . These late appearing forms thus go back to the very earliest inhibitions and fixations.
Freud tells of the case of a patient, whom he had studied for a long time, whose went through an unusual . The began, after a traumatic experience, as a mere , and kept this for a year. One day, however, it changed suddenly into a of the severest .
The patient, till her illness, was a happy, almost completely satisfied wife. She wished children, from motives of an infantile wish , and became sick when she learned that she could have no children by her exclusively beloved husband. The with which she reacted to this of her desires, corresponded, as she soon learned herself to understand, to the refusal to give in to temptations to -building which she had carried on since . She did everything now not to let her husband know why she was sick. But it is not without good ground maintained that every man possesses in his own an instrument with which he can understand of another. The man knew, without confession or explanation, what the of his wife meant, was hurt, without showing it, and reacted on his side neurotically, by refusing, for the first time, sexual intercourse. Immediately thereafter he went away on a trip; his wife believed him to be permanently impotent and produced the first on the day of his expected return.
The content of her consisted in a painful washing and purifying and the greatest efforts to protect herself against bad things, hence a against anal
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eroticism and sadistic tendencies. In such forms her sexual need had to express itself after her genital life had been lost through the impotence of her husband.
In the first theory of the only the of was distinguished. The analysis of has made it necessary to insert the of . And now we see the necessity of adding another , in which the partial impulses are unified to an , that either the own person or another, but taking place before the primacy of the genital zones have been established. The partial impulses which rule the organization of the sexual life are principally the anal erotic and the sadistic.
The sexual life of the patient began in the earliest with sadistic phantasies. After their came an unusually long latent period during which she had a highly moralistic without awakening to any female sexual sensations. With an early marriage began a normal sexual activity as a happy wife, which continued a number of years till the first great of her desires brought about the . With the depreciation of the genital life her sexual life sank back to the infantile of .
The idea of a sexual organization is incomplete in two directions. First, it does not take account of the of other partial impulses than and anal-erotic. Second, the stages of the ego impulses are very little known.
The author hazards the guess that the disposition to a lies in a premature antedating the .
2. The Psychopathology of a Case of Phobia.—The was of church steeples and towers. This, according to the author, was found to be really of bells ringing.
After trying the “so-called psychoanalytic method,” unsuccessfully, the author employed and discovered that the ringing of bells was associated with a period of anxious waiting while her mother was being operated on, and her subsequent The “setting” that gave “meaning” to chimes was , hence the emotion.
(For the same case in English see the Journal of Abnormal Psychology, Vol. VIII, No. 4, 1913.)
3. Stuttering, and its Treatment by Psychoanalysis.—The from of certain thought tendencies is the principal factor in stuttering. The retardation of function in the larynx and
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mouth mechanism goes back to the desire not to speak. Many normal people stutter in certain situations,—the maiden when wooed, a witness in court, if his answer will likely incriminate himself or another. The author maintains that trouble with the tongue, teeth, mouth, or larynx never causes stuttering even though it may hinder clear articulation.
The author reports the analysis of two cases. The first is that of a man of thirty-two years who had stuttered from . From the age of ten he was sent to a special school and had seen many physicians in England and on the Continent without gaining any lasting benefit. The patient had suffered from with a chronic eczema which began on the scrotum and anus and later spread to the thighs and arms. He also had suffered from a from the ear which was cured when he was eighteen. He felt from early that he was a sickly and unlucky boy. He felt that his father did not treat him as well as he did his sisters, and hurt, would withdraw into himself. At the age of eight this turning from his little world was so strong that repeatedly at night he would console himself by saying, “Come to me all ye who are weary and heavy laden.”
He had, however, unusual interest in, and esteem for, his father. His father stuttered. Father and son had difficulty with certain of the same sounds. One of these was the sound of 1. In this connection the patient remembered an incident connected with his . He remembered that when he was about four and a half he threw down a little girl by the name L. L., with whom he played, and looked at her genitals. He was surprised to note the difference between the sexes. He felt that he had done wrong and could not speak the name of the girl's mother. The author wishes to make it clear, however, that the stuttering is not due to this or that psychic , but to deeper trends and resistances which this hides.
These trends are his feelings for his father. He would like to be his father's lover. Love between mother and child conies first, but if at an unusually early age the father begins to play the principle role then there arises a against everything learned from the mother, even against speech.
Scatological phantasies and anal eroticism played a large role in the patient's life.
The patient had no ideal feelings for women. He regarded them merely as dirty animals necessary for man's health. At the age of twenty-one he had his first sexual relations with a woman. He felt no in the act and did it only for his health, he said.
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Psychic , and anal eroticism, together with the overpowering influence of the father, were the elements which placed the patient in a false position in life and formed the roots of his stuttering.
With a successful ending of the the stuttering vanished.