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Willard, C. (1939). Internationale Zeitschrift für Psychoanalyse. Psychoanal. Rev., 26(1):108-129.
Psychoanalytic Electronic Publishing: Internationale Zeitschrift für Psychoanalyse

(1939). Psychoanalytic Review, 26(1):108-129

Internationale Zeitschrift für Psychoanalyse

C. Willard

(Vol. 22, No. 1)

1.   Nunberg, H. Homosexuality, Magic, and Aggression.

2.   Payne, S. M. The Conception of Femininity.

3.   Sterba, R. Psychic Trauma and Management of the Transference.

4.   Bálint, A. The Management of the Transference on the Basis of Ferenczi's Experience.

5.   Benedek, T. The Overvalued Idea and Its Relation to Drug Addiction.

6.   Almásy, E. The Psychoanalysis of Amentia-Like Cases.

1.   Nunberg, H. Homosexuality, Magic and Aggression. The homosexual act represents a triumph over the male—the father. In making a woman of his male sexual partner the homosexual feels himself male—able to possess the mother. This serves as a compensation for injured narcissism and as a fortification of the ego. Through fulfillment of the homosexual wishes an increase of self-consciousness arises, an infantile feeling of omnipotence and with it a feeling that a magic power streams from the personality. It is well known that overvaluation of the ego is characteristic of paranoia and also that homosexuality has significance in paranoia. Another characteristic which these two disturbances have in common is aggression. By comparison of various homosexual cases (non-psychotic) in his experience Nunberg found that the aggression is not expressed merely in the choice of object, but that it is a general characteristic of this type. On many sides the view is held that the relation between paranoia and homosexuality is disproved by

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deeper criticism, because the paranoid projects, the homosexual does not. It is true that projection is one of the most prominent characteristics of paranoia, but Nunberg finds that this mechanism also plays an important role in homosexuality, especially in certain types where the object is chosen on the model of the mother-love. In the case which Nunberg has selected for detailed description the patient projects his ideal; he wishes to be a big, strong man. He loves this ideal and seeks it in the outer world. That he succeeds from time to time in finding this ideal in reality probably protects him from paranoia. The feature which distinguishes this case from paranoia is the difference in the final results of the projection. The projected sadism in paranoia receives a negative sign with a resulting masochism in the paranoic. In Nunberg's patient the sign of the projected ideal remains unchanged. In other words, while in paranoia the aggression is turned against the ego, in Nunberg's case this process of direction against self and this change of sign took place only to a very slight degree.

2.   Payne, S. M. The Conception of Femininity. See Psychoanalytic Review later.

3.   Sterba, R. Psychic Trauma and the Management of the Transference. Sterba's article is a brief account of Ferenczi's work in its last form, and of his views on “active technique.” In this technique the aim is to produce an increase of emotional tension, so that the deeply hidden emotions are not only revealed but relived. This repetition in the presence of the physician renders these emotions more accessible and makes it possible to bring them under control. The danger of this process is that a resistance may arise to the analyst. To avoid this Ferenczi advises an attitude of “unfailing good will” on the analyst's part. Provocative aggression should be met with unbounded and unchanging patience, honesty, and firmness. When under this treatment, the attitude of the patient becomes more trusting he begins to demand tenderness and love; naive confidences are made, which should be encouraged according to the “relaxation” principle. However to obtain a maximal emotional reaction more than a receptive kindliness is necessary. The ego of the patient, falling to a deep infantile level is troubled by an adult attitude on the part of the analyst, and he therefore, like the patient, should descend to the infantile situation, treating the patient with the understanding tenderness of a mother. An example from Ferenczi's practice is cited. The results of this treatment, confusion of speech, paresthesias, spasms, trance-like conditions, Ferenczi designated “bodily symptoms of memory.” Through this “neocatharsis” the importance of the original trauma in producing the neuroses becomes apparent anew. In later writings Ferenczi seems to regard the trauma as the sole cause of the neuroses. He says “it is impossible to overvalue the importance of the trauma, particularly the sexual trauma, as the causative agent in producing

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neuroses.” The trauma, especially the sexual, is not the result of a traumaphile sensitiveness in the child with neurotic diathesis; it results from real mismanagement, mistaken, moody, tactless even cruel treatment in childhood, at the hands of adults. For Ferenczi the significance of the trauma is so great that the instinctive components as causes of neuroses sink into insignificance. In view of the mutual dependence of theory and technique to which Freud called attention in 1922, it is not surprising that this new application of the catharsis should again place emphasis on the trauma as the cause of neuroses. Further application of Ferenczi's methods should lead to new discoveries in the direction of the mutual dependence of theory and technique.

4.   Bálint, A. The Management of the Transference on the Basis of Ferenczi's Experience. Ferenczi was an individualist and therefore he never founded a school at Budapest, in the sense of establishing a uniform program of work for his students. He made as little use of the seminar and control analysis as possible and his teachings consisted principally in communicating his experiments and ideas, which he varied from time to time, then permitting his pupils to adopt those which they could or would. Ferenczi was influenced to this course by his dissatisfaction with therapeutic results in general. He traced many of the failures or partial successes to the management of the transference. Bálint sets forth Ferenczi's principles in this regard. By most careful attention to all that the patient says, certain seemingly minor phenomena come to the foreground and reveal the opinions, feelings, and criticisms of the patient in regard to the analyst and the role which the peculiarities and limitations of the analyst play in the procedure. It is not sufficient to merely interpret the fact that the patient has a critical attitude because he once had the same attitude toward the parents; the criticism should be examined for any possible actual and real content. It may soon be discovered that while the attitude is merely a repetition of that formerly held towards the parents, the content is taken from certain qualities in the analyst. Here a form of activity is indicated—an activity which seems unavoidable in the analytic situation. The enormous weight given to every omission, the sensitiveness of every shade of tone, to every gesture, is not something newly called into existence by the analytic situation; it is a direct derivative of the observant attitude which is natural to all children. If the analyst does not pay attention to patient's criticisms the same mistakes are made as in the childhood situations where the adults held themselves always blameless. The patient with the analyst, like the child with the parent, is ever on the alert to discover hypocrisies, and patients, like children, have an uncanny divination, an almost paranoid suspicion of the smallest details. The great problem of managing the transference is to establish rapport with the child in the patient, a direct contact, not an indirect one by means of interpretation. Interpretation may, even after years of effort, lead to an empty repetition

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of infantile situations, instead of to an emotional realization of them. Ferenczi has understood the child with its needs, its helplessness, its dependence, better than any other perhaps. Like the intuition of the child, that of the patient is not applied to reality generally. The libido with which the child invests the object world is not exactly narcissistic, it is rather egoistic, best expressed by the terms “passive object love.” The recommendation has been made (Bibring) that in cases where the character of the analyst leads to such an exact reproduction of the pathogenic infantile situation as to render progress impossible, a change of analyst should take place. Bálint believes that this fruitless repetition of the traumatic infantile situation arises not from unalterable qualities of the analyst, but rather from non-application of what Ferenczi calls “elasticity.” The concept of the passivity of the analyst stands in need of modification; preserving silence and doing nothing cannot be considered as inactivity. Under certain conditions silence may really be an invitation to speech. The attitude of the analyst to the patient is always behavior, therefore activity and management of the transference always implies activity on the part of the analyst.

5.   Benedek, T. The Overvalued Idea and its Relation to Drug Addiction. See Psychoanalytic Review later.

6.   Almásy, E. The Psychoanalysis of Amentia-like Cases. As the diagnosis of amentia in psychiatry is somewhat indefinite Almásy limits the subject to amentia-like conditions. Three cases are described at length and a study is made of the dynamic relation between the instinctive demands and the deprivations revealed in these cases. In the hallucinosis of the second case a triumph of the wish over the deprivation is obvious at the first glance. The deprivation here was not from without, it came from the super-ego of the patient. In the first and third cases, on the other hand, real persons played a secondary prohibitive rôle, and for a long time there was no irreconcilable contradiction between the force of the instinctive demand and the prohibition. According to Freud's view a psychosis arises from a conflict of the ego and reality; as result of this conflict the ego admits the energies of the Id. The withdrawal from the environment is the first step in the psychotic condition and proceeds in such a way that reality actually present or preserved in memory is no longer perceived or the perception remains ineffective. This withdrawal is not always complete. The second step in the psychosis consists in replacing the outer world by the over-determined Id drives. Freud does not explain the manner in which the ego accomplishes the withdrawal from the environment. Almásy finds that this becomes possible through peculiar conditions of the ego. Usually the ego in the adult is a rigid system, stark in the sense that it renounces adherence to the external world only with great difficulty. In the cases here described, however, a quite unusual plasticity and elasticity of the ego was discovered.

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In order to understand this plasticity it is necessary to become oriented in the developmental history of the ego, as described in Ferenczi's fundamental work—long before the psychoanalytic concept of the ego was adopted. The sense of reality evolves only gradually from the infantile to the adult level. Fixation at an early level or regression may then be assumed to explain the possibility of detachment from reality. Almásy believes that acute amentias throw light on the psychic economy. They permit an extensive and extreme mobilization of the Id drives—in short an “abreaction.” This abreaction involves a rapid descent and extreme investment of the Id energies and thus brings about a condition where the ego can resume connection with the exterior world, as the ego is no longer so strongly assailed by the Id energies. A therapeutic outlook is suggested. Perhaps with deeper knowledge of the ego structure it may be possible to render the ego more elastic and to cure chronic neuroses and functional psychoses by inducing artificial amentias.

(Vol. 22, No. 2)

1.   Mueller-Braunschweig, C. The Girl's First Object Investment in Relation to Penis Envy and Femininity.

2.   Riviere, J. Jealousy as a Defense Mechanism.

3.   Lampl-De Groot, J. Inhibition and Narcissism.

4.   Laforgue, R. Exceptions to the Fundamental Analytical Principle.

5.   Wittels, F. A Type of Woman with Three-fold Love Life.

6.   Bergler, E. Comments on Compulsion Neurosis.

7.   Dreyfuss, D. K. The Significance of the Psychic Trauma in Epilepsy.

1.   Mueller-Braunschweig, C. The Girl's First Object Investment in Relation to Penis Envy and Femininity. Mueller-Braunschweig notes that homosexuality in women is always essentially a regression to the behavior of the girl to her first love object of the same sex. In the development of the boy there is no analogy to this situation. The first relation of the boy to an object of the same sex, to the father, is one of admiring identification. In the beginning the relation of the girl to the mother is one of intense love, both physical and in the form of tenderness, not merely simple identification. Although at first disguised by pregenital features and having an infantile character, it is really an object love from the moment of birth on. Mueller—Braunschweig seeks to show the various bearings of the original situation on feminine development, particularly on penis envy, feeling that current explanations of these phases are insufficient. He believes that primarily the little girl is not discontented with her lot because she discovers that she is without penis, but because she finds herself at a disadvantage in comparison with the

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boy in her first relation to the mother and realizes that this relation can never be complete, adequate, heterosexual, that she can never be the complementing sexual pole with accompanying tensions and satisfactions. Mueller-Braunschweig believes that this is the source of the feeling of inferiority in women, the obstinate wish to be a boy, and of the penis envy. His understanding is that the anatomical form has less to do with narcissistic investment and disturbances of genital nature generally, than has a specific genito-sexual function in relation to an object toward which, in the girl there is a feeling of inadequacy. Penis envy can be rightly understood only if the fact is taken into consideration that there is a rivalry between the sexes for love of the first object. To assume that the cause of the girl's passionate envy is the optical comparison of her organ with that of the boy sounds grotesque; the reason must be sought in a more fundamental element, deeply imbedded in the instincts. When first the girl becomes conscious of the difference in the sexes—and this consciousness comes, whether she had ever seen the little boy's genitals or not—she feels as though she has been cheated, that the sexual relation to the mother is less complete than that of the boy. The presence of a boy, a brother or another boy, though she never sees his genitals, fortifies this feeling or inadequacy and inferiority. To meet a possible objection that according to this view the genital level is supposed to be present from the very beginning he explains that in the girl, as well as in the boy, from the very start, even in the pregenital phase, genitality is present as a partial drive within the polymorphous infantile sexuality. He believes that the heterosexual attraction, assumed as a basic principle in development, an ultimate fact given phenomenologically, must be extended to the pregenital stage, and finds that this view is supported by biological and somatological observations. In this connection he discusses several more or less loosely associated developmental phenomena, for example, the significance of the object relation and primary genitality in the pregenital phase: a phallic attitude toward the object accompanies this entire phase, the situation during the period of pregenital primacy, being that, in the girl, there is an adaptation to an inadequate object, in the boy, an incestuous attachment to an adequate object, which results in the narcissistic attitude in one sex and the attitude of defense in the other. The turning of the girl from the mother to the father is facilitated by hate arising from various sources, but these are only aids and the fundamental impetus is the growing disappointment with the inadequate partner and increasing heterosexual attraction by the father. The existence of the negative Œdipus complex in the same sense as it exists in boys is questioned. The rôle of the clitoris is discussed and Mueller-Braunschweig finds that the investment of this organ corresponds to that of the penis, notwithstanding evidence against an exact anatomical paralellism. In explaining frigidity in women, or a specific tendency to frigidity, he notes that the female child has early incentive to withhold

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investment of the vagina connected with fear of oncoming genitality. Advancing biological speculation he holds that the woman with her double genital formation represents a significant survival of the original hermaphroditic stage from which the two sexes have differentiated, the male differentiating in a dominant manner, the female more ambiguously. Even in the mother's body the male element finds heterosexual polar equilibrium, while equilibrium with the female fetus in the mother's body is established only by emphasis of a male factor. The little girl's idea that the mother possesses a penis arises from the effort to establish polar equilibrium, the little girl emphasizes the mother's male element and produces the phantasy of the mother's penis; or she emphasizes the female element in the mother and fancies that she has a penis.

2.   Riviere, J. Jealousy as a Defense Mechanism. See Psychoanalytic Review later.

3.   Lampi-De Groot, J. Inhibition and Narcissism. Lampl-de Groot discusses the course of various different psychic processes which produce the same condition in the ego and lead to the same result—limitation of effective expression of the personality. Masturbation, inhibited sexual activities, excessive indulgence and disturbances of potency are considered in this connection. Too free discharge of instinctive drives leads to certain disturbances in the ego, and the same disturbances result from inhibition of discharge. In other words the impression is gained that there is an optimal balance between instinctive drives and the ego. A discharge in excess of an optimal quantity causes a “poisoning,” a paralysis of the ego; it is flooded in such manner that the previously existing function is damaged. This effect is analogous to that of a poisonous drug which only in a definite quantity is beneficial. On the other hand where the indulgence of the instinctive drive is less than the optimum there is a similar deleterious influence, in analogy with the action of certain substances, a definite quantity of which is necessary to produce any effect. Whether or not the optimal release of tension occurs depends on two factors. The first is the absolute intensity of the instinct. If this intensity is increased by normal physical processes (puberty, menopause, disease), the result will be inundation of the ego and disturbances of its function. If the absolute intensity is always below a certain level an absence of normal developmental capacity may be assumed. The second factor is the intensity relative to the strength of the ego. If a certain intensity is opposed to a relatively weak ego, the ego is inundated just as where there is an absolute increase of intensity. If the ego has sufficient strength to resist admission of a greater quantity than is requisite to normal functioning the optimal condition is attained. If the ego overshoots the mark and represses the instinct too vigorously there is again disturbance of function. To the exertion of this force the ego is pushed by the effort (1) to avoid a conflict with the

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super-ego (from feeling of guilt, uneasiness of conscience), or (2) to avoid a wound to narcissism. Now the problem involves not merely the strength of the ego and the intensity of the drive; a new factor emerges—a topical one, the point of attack of the instinctive drive. This factor may again be compared with a somatic condition. Many poisons have selective action (e.g. on the anterior region of the brain, the heart muscle) leaving other parts uninjured. Thus it may happen that a certain instinctive impulse can be coped with if a certain definite part of the ego is not attacked, for example the relation of the ego to its superego, or at a point where the narcissism is specially endangered. It would seem that an unharmed libidinous investment of the ego is the first and most important condition for psychic health. However the narcissism should not be rigid and immovable (as in the psychose). The ego should always have at its disposal the quantity of free-floating energy necessary for normal relations with the environment. This condition fulfilled, an uninjured narcissism assures an inner and outer freedom and independence, by which alone the highest effectiveness of the personality can be attained.

4.   Laforgue, R. Exceptions to the Fundamental Analytical Principle. Laforgue discusses what is called the fundamental principle of psychoanalysis which requires that, during the analysis, patients should communicate every thought that occurs to them and conceal nothing of any sort. Laforgue maintains that the analyst is often forced to depart from this principle, or, at least, not to follow it literally, as rigid application would at times be attended by resistances and difficulties in the transference. Tact always plays an important role in the means used to induce the patient to follow the guiding line of the analyst. This tact involves not only an understanding of the problems of the patient, but also his heart. It is an attitude toward human needs and is not conditioned solely by intellectual principles (mostly overrated); it is a quality of sympathy. When all these factors are taken into consideration it is found that there should be considerable elasticity in the application of the fundamental principle. It must not be applied as an orthodox law. However it cannot be denied that entire disregard of it may render the analysis so difficult that the treatment has to be abandoned. This, however, is a rare exception, more likely to be met with in the psychoses than in the neuroses.

5.   Wittels, F. A Type of Woman With Three-fold Love Life See Psychoanalytic Review later.

6.   Bergler, E. Comments on Compulsion Neuroses. Bergler describes the case of a woman, fifty-eight years of age, who for many years had suffered from a compulsion neurosis. As result of her manifold compulsions centering about the recurring thought of a certain man, almost a complete stranger, she finally arrived at a condition where she

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was compelled to go through such endless rituals to avoid the compulsive thought that she was incapable of social adaptation, had to be dressed and undressed like a child and, finally, placed in an institution. The differential diagnosis between delirium of compulsion of neurotic character and paranoid schizophrenia could be made only with difficulty. On the basis of this case Bergler calls attention to a feature often not sufficiently recognized in patients suffering from compulsion neurosis—the narcissistic pleasure-gain. The compulsion neurotic feels a constant necessity to reduce the super-ego ad absurdum, provoking it to silly impositions in order to prove the moral independence of the ego. This tendency to discredit the super-ego is usually regarded as a defense against too stern regulations but it is also motivated by the narcissism. The self contradiction in the psychic principles or laws involved in this disturbance are not merely, as is often assumed, due to ambivalence, but are expressions of a striving for narcissistic pleasure-gain, and the clumsiness by which absurdity of the super-ego is demonstrated is typical of the disorder: the more clumsy and simple the error into which the super-ego falls, the greater the triumph of the unconscious factor in the ego. Compulsion neurotics are constantly meeting with situations which satisfy their narcissism by confirming their omnipotence of thought. Connected with this is the characteristic of creating “gullible amazement.” Through all these peculiarities self contradiction in the psychic laws (Federn), clumsiness of expression and the bringing about of gullible wonder narcissism proceeds to victory. The content and form of the compulsions are determined, not only by laws which arise from fear that the compulsions will fail of effect, but also by the striving for narcissistic pleasure-gain, which is in part playful, but is always on an early infantile level.

7.   Dreyfuss, D. K. The Significance of Psychic Trauma in Epilepsy. Dreyfuss notes that studies which seek to explain epilepsy on organic basis should be brought in line with material on the psychopathological side. From a few hypnotic sessions the writer was able to study some of the mechanisms of the disease. He describes a case K. From the nature of the attacks and the history of the case the opinion of physicians was divided, as to whether the disturbance was of organic origin, result of a fall or a case of genuine epilepsy. From accounts of witnesses the accident was of minor importance, though the patient insisted that he had received a serious head injury. When the patient came to the observation of the writer he had been subject to fits for years. They recurred every night and lasted sometimes for two hours. As soon as a certain contact with the patient was established, Dreyfuss discontinued the medicines the patient had been taking under former physicians and began hypnotic treatment. The sessions were all much of the same character; After a period of about 15 minutes the patient jerked back as if from fright and then fell into a stupor so deep that it was almost impossible to obtain any reactions. The nightly epileptic fits continued in exaggerated

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form and the patient gave up the treatment even when hope of final benefit was extended. Dreyfuss was of the opinion that the treatment was abandoned because the loosening of traumatic material had released too much anxiety. There were indications of an earlier trauma, probably connected with castration fear, which had been reinforced by the accident. Dreyfuss decided that the case was one of genuine epilepsy. There were several possibilities which presented themselves. The accident itself may have been due to a first fit—a latent convulsive tendency having received a sudden impetus (apposition), or a latent epileptic “disposition” may have become manifest during a neurosis following the accident. The impression was gained that hypnosis is too active a process for therapeutic use in epilepsy. There is danger of overstrong reactions which, while making unconscious material easily accessible, at the same time releases too much anxiety. Hypnosis would have to be limited to recent cases of unmistakably traumatic origin (Simmel) where the symptoms have not become imbedded in the personality (Reich). On the other hand it seems advisable, as Stekel and Reich have recommended, to subject epileptic patients to analytic treatment through which the resistances may be overcome systematically and reactions of anxiety are not threatened to the same degree. However it is not impossible that, during an analysis, hypnosis may sometimes find a place. In discussing the symptoms of epilepsy and especially the fit, Dreyfuss calls attention to a parallel with manic-depressive disturbances. In both instances there is an intolerable surplus of sadism. The tension between super-ego and ego is the depressive phase is compared to the psychic and motor paralyses in epilepsy; the manic phase, with the psychic and motor excitement of the fit. The greater brutality of the epileptic actions and the deeper regression in the stupor, are confirmatory of the view that there is fixation at an earlier developmental level than in manic-depressive disturbances. These hypotheses do not conflict with Reich's assumption that the central mechanism of the epileptic attack is of the nature of an extragenital orgasm, a libidinous overinvestment of the muscle system as result of accumulations of vegetative energy. Dreyfuss believes that vegetative accumulation and motor-aggressive possibility of expression stand to each other in inverse ratio. In the free intervals the vegetative accumulation increases and when an intolerable amount is reached a discharge takes place in the fit, a view reconcilable with Reich's if the extragenital orgasm is regarded as a discharge on a very early narcissistic libido level. From observation of the confused states Dreyfuss is inclined with Ferenczi to trace sleep, dreams and epilepsy to a common origin, regarding them as regressions to the same libido level. Differences may be explained by assuming that the demands of the unconscious are responded to by different reactions of the ego instance. In regard to the birth trauma as the cause of epilepsy (Pierre Marie, Schwarz) he believes that a bad beginning would prepare the way for later vulnerability to trauma and for the establishment of fixations.

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(Vol. 22, No. 3)

1.   Jones, E. In Memory of M. D. Eder (1866-1936).

2.   Fenichel, O. The Symbolic Equation, Girl-Phallus.

3.   Reich, A. Clinical Contribution to the Understanding of the Paranoid Personality.

4.   Rotter-Kertesz, L. Deep Psychological Background of Incestuous Fixation.

5.   Hermann, I. Clining Fast-Seeking Afield.

6.   Clinical Contributions:

(a)  Jacobssohn, E. Development of the Wish for a Child in Woman.

(b)  Gerö, G. Construction of Depression.

1.   Jones, E. In Memory of M. D. Eder. Jones gives a sketch of Eder's life and a bibliography of his writings with dates and places of publication.

2.   Fenichel, O. The Symbolic Equation, Girl-Phallus. In a previous analysis of a case of transvestitism Fenichel found that the phantasy at the foundation of this perversion was a girl with phallus. The patient phantasied this phallic girl to satisfy wishes to be a woman and yet to avoid the intense fear of castration. Ceding to the perverse practice it was as though the patient said to the love object “Love me as the mother (or sister) is loved, but I do not lose my penis thereby.” It seems probable that the meaning of the actions in transvestitism generally is a compromise between wishes to be a woman and opposing fears of castration, or, as the castration fear is a result of the high narcistic value set on the person's own phallus, between the wish to be a woman and the narcistic pride in the sexual organ. The exhibitionistic behavior of such persons has a double meaning “I will make myself seen and admired because of my penis” and “I will make myself admired and loved as a pretty girl.” Through the narcissistic investment of the sexual organ the whole body becomes penis and the equivalents stand: I = my whole body = a girl = the little one = penis. In the little girl the process is somewhat different; she identifies herself with the penis in the effort to overcome penis envy. The formula here is “I have incorporated the penis and am myself the penis” the oral sadistic wishes, at one time directed to the male sex organ, leading reactively to the identification. The analyses of several women are cited to show this connection. Phantasies on this pattern reappear as the motif of numerous sagas and myths. The protecting little women who accompany powerful men in adventure, the mascot, dwarfs, charms, talismen, the “little double” may all be recognized as phallus figures. Mignon, the youngest daughter of King Lear, the little daughter of King Nicolo are further examples. Freud finds that for the male a woman rescued represents the mother and a usual interpretation of

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the protecting maiden phantasy is that it is a reversal of the phantasy of men who rescue women, but this theory leaves many features of the “maiden rescuer” unexplained, for example her diminutiveness and her weakness which stand in such contrast to her magic power. The question arises whether penis significance does not attach to all these female figures. Freud's understanding of Cordelia in Lear as representing the goddess of death does not contradict this view; the goddess of death is a magic omnipotent being to whom the much greater and more powerful father is subjected and this goddess is allied with phallic figures by the quality of magic omnipotence. Mignon figures have been exhaustively studied in psychoanalytic literature from the male point of view. In describing Goethe's Mignon, Sarasin indicates a narcissistic object choice. From the context of the story of Mignon masculine traits are apparent which represent the poet himself. Other analyses of such little fragile maidens and of the infantile wife leave no doubt that these indicate a narcissistic choice of object. These love objects always represent the man himself who phantasies himself as a girl, and the mechanism of choice is that which Freud describes for a certain sort of male homosexuals. The same mechanism is probably at the root of pedophilia. Fenichel observes that in phantasies indicating this object choice there is usually another homosexual figure, a big man, a father figure, and the idea of mutual rescuing appears. The little woman is rescued naturally by the man, the man by the woman through magic. Through the study of a case Fenichel traces the connection between phallus and clown, and with grotesque comedy generally. The schema is: “I wish to exhibit myself, but fear to be ridiculed, so I will exhibit myself in such a way as to excite amazement at my power.” That the exhibition is phallic is revealed in the traditional dress of the clown. The “wonder child” shows a similar mechanism. Swift's Gulliver among the Lilliputians is described in this connection. Finally the phantasy of the phallic maiden is found to have close relationship with a form of perversion hitherto little understood—sex slavery. The slaves are inseparably bound to the person by whom they are appropriated. Some forms of animal love also fall into this category, where the love for the animal representing the phallus, goes so far as to be almost identical with the love of a man for a cherished child wife chosen on the narcissistic pattern. Fenichel notes that always, wherever the symbolic equivalent holds body = penis, this equation rests on a pre-genital history. The phallic maiden, in general, is not only a penis, but besides, child excrement (the contents of the mother's body) and milk. It is an introject which is again projected. The penis is the last element in the series of introjections and projections and this last element is the one to which Fenichel directs attention.

3.   Reich, A. Clinical Contributions to the Understanding of the Paranoid Personality. Reich brings material confirmatory of the views of Freud, Tausk and, above all, Abraham, on paranoia. Her case is

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interesting from the fact that the deep layers which must usually be reconstructed from meager fragments by means of complicated interpretations were openly revealed, expressed verbally understandable without translation. The patient was a schizophrenic twenty years of age. The onset of the disease, following the bite of a dog, became apparent for the first time while he was awaiting treatment in the Pasteur institute. When he was placed in an institution, the first impressions were that he was an orderly, friendly, somewhat studious youth, but in a short time an unnatural responsiveness in conversation and empty laughter showed that he was utterly callous to all friendliness. His attempts at sociability were of short duration and he then sought complete isolation, lost in phantasies with now and then periods of wild and unrestrained aggression. He expressed freely and in unambiguous words his cannibalistic and coprophagic desires. After strong resistances were overcome he described homosexual phantasies—that his weaker phallus came into contact with the strong phallus of the father which had the form of excrement. With the lowering of the object to this early level there was also a regression of the ego and withdrawal of libido from real objects which rendered it possible to regard the sexual organ as the entire object and to see all objects as terribly altered or, as the patient expressed it, “to make man excrement.” The object producing anxiety was the father, who, however, presented properties characteristic of skybalum. Abraham has explained the mechanism by which the condensation of the whole body into a part takes place, namely through introjection of the desired organ in place of an object lost and a reproduction of the introjected part in the outer world. Reich remarks that the mechanism, with the aid of which the introjected object is again projected, is proscribed somatically; what is taken in orally is ejected anally. At times the patient's world seemed quite normal but as soon as libidinous investment took place the horrible transformations declared themselves. As soon as sexual excitement reaches a certain height the castration anxiety overcomes him. As defence against this anxiety he does not seek expression in an object libidinous drive of genital or anal character; there is regression to the oral level with tendency to devour, particularly the phallus or excrement of the father. The real object has ceased to exist and excrement as the persecutor is the projected result—projection of an introject. By a new act of devouring the patient seeks to annihiliate and at the same time to win the pursuer. In the regression causal relations are abandoned and are replaced by a primitive process, magical, prelogical thinking. The ego loses all power to test reality and the world is remade on the model of the ego and the instincts of the personality are ascribed to the environment. The law of talion reigns, according to which the fear of being devoured is changed to the wish to devour. The act of introjection remained an unsublimated form of satisfaction. Projected as pursuer a pseudo-super-ego appears to the boy as a ghastly figure of terror. Analysis of the patient had not been completed, but he had formed

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sexual attachments, had become able to invest parts of the body other than the sexual organ with libido; his anxiety, which reached the highest point in fear of damage at ejaculation, had diminished. Under the positive transference which the analyst was careful to give an asexual character, he was beginning to learn that there was an objective world and that it was not destructive.

4.   Rotter-Kertesz, L. Deep Psychological Background of Incestuous Fixation. Rotter-Kertesz describes four cases, three men and one woman. Two of the men came to analysis because of impotence and the third, a young man of twenty-five because of extreme introversion. He developed a long ambivalence conflict when he wished to form an attachment with a young girl, because of his utter dependence on his family. The woman, the fourth case, suffered from castration fears connected with the trauma of weaning and separation from the mother. This early s trauma and the fear of castration was reflected in every situation in which a part of the body was removed, as when teeth were abstracted or tonsils removed, confirming the view that the separation of children from the parents is experienced as a tearing away of a part of the children's own body. In this woman patient the incestuous fixation was revealed as an archaic imprint in the unconscious, a survival of an experience perhaps at the deepest, certainly at the earliest levels of her psychic existence. The essential factor in the mechanism is that the nursling regards the mother as forming part of an inseparable unity with itself, two-in-one, as in the fetal condition. This dual unity, this two-in-one is not an investment of an object, nor is it an identification with introjection. The primitive ego and the environment are amalgamated into a dual unity, well designated by the term two-in-one. Hoffmann treats of this same theme (See Psychoanal. Rev., Vol. 24, page 312) but his material presents another aspect of the subject, the persistence of the wish for union with the object. Rotter-Kertesz describes patients mirroring the fear of separation. The dreams, phantasies and anxieties of her patients showed that at the time of this dual unity and at the level of consciousness belonging to this level, the concept “alone” has not the same significance as it has in conscious thinking. At the primitive level, it is equivalent to being torn in pieces, maimed, castrated, being merely a part; essentially at that level alone means not whole. Against separation from the mother the child struggles with all the means at its command; it clings with mouth, hands, excrement; it seeks again and again to reestablish the close contact with the body of the mother. Later the same struggle for contact is carried on by means of vision and hearing. If the child is obliged to give up somatic contact it endeavors untiringly to remain in psychic touch. Thus the child is driven toward identification and introjection and it does not rest until it has united, once for all and inseparably, the parents with its own ego and has set up in its soul-structure the mother-child or mother-family unity.

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5.   Hermann, I. Clinging Fast—Seeking Afield. Hermann here describes a pair of opposites, adhering and cleaving, hitherto neglected in analytic work, and discusses their relation to sadism and masochism. In this connection she first discusses (1) the erotogenicity of the hand and (2) the relation of mother and suckling in apes. The child when nursing grasps with the hand and clings to the breast and these manifestations seem to form a part of nursing as essential as sucking itself. Young apes during the first months after birth cling to the mother with both fore and hind paws. Neurological studies of the grasping reflex are cited in proof of the instinctual drive to cling. The drives to seek afield or separate as connected with shock, anxiety and the castration complex are then brought into line with neurological observations. In the fear reaction the embracing reflex is brought into play. It is found that the same reflexes, in general outline, are manifested in states of contented grasping and in shock or separation; the object to which they are directed is always the same—the mother for the purpose of clinging to her or to find her when separation takes place. In connection with these facts a psychoanalytic explanation of anxiety is given: Essentially anxiety is the feeling of being abandoned in disaster; its expression is a seeking for help (a seeking for the mother). In explaining castration anxiety in keeping with this pattern the writer notes that the nursling and the mother in the early-ego form a whole, not symbolically, but actually; the trauma of separation from the mother is experienced as a loss of part of the self. In every expression of the castration complex Hermann sees the separation from the mother as the primary factor, the loss of the genitals, at the genital level, being a secondary factor. In analysis, in the phantasies, cover memories, the wish to separate, to wander, it is evident that there is a continual seeking for an object. When all the facts are correlated, biological, neurological and psychoanalytical, the writer feels justified in assuming that clinging and seeking afield are expressions of instinctive partial drives of the libido. The wish to separate, to tear one's self away, seems reactive in character, just as, for example, cleanliness is a reaction to anal erotism. The relation of the drive to cling and sadism is revealed in the behavior of the hand in seizing, in overpowering, gaining possession. Masochistic pleasure, on the other hand is closely interwoven with the castration complex and through this with that reaction to the clinging tendency which finds expression in the drive to dissolve relations. In this connection she notes self-mutilation. In masochism as a trait of character the wish to separate, to wander, occupies the foreground and is a reaction to the early trauma of separation. Freud finds that the masochistic attitude is infantile, but behind this attitude the effort is hidden to become, after the masochistic deed, adult, independent.

6.   Jacobssohn, E. Clinical Contributions: (a) Development of the Wish for a Child in Woman. A little girl was analyzed intermittently from her third to her fifth year and insight into many interesting phases of the

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female sexual life of early childhood was gained. An early pregenital wish for a child, at first directed to the mother and only assuming heterosexual character in the (Edipus phase, was discovered. Three stages of the unfolding of the wish were observed. From the second to the third year there was great attachment to the mother, strong oral tendency and identification with the child in the mother's body. From the third to the fourth year the oral sadistic drive directed against the mother led to oral penis phantasies, a bisexual attitude and receptive genital wishes to gain possession of the penis. Fourth to fifth year, the equivalent child-penis was established and there was a transformation of the receptive genital (urethral) wish to gain possession of the father's penis as well as of the anal and phallic urethral tendencies in relation to the mother, into a distinct heterosexual Œdipus drive and a wish for a child.

(b) Gerö, G. Construction of Depression. Gerö gives results of the analysis in two cases of neurotic depression. These cases (one man and one woman) stopped short of being melancholia and both showed oral erotism and aggression. When the oral wishes were brought to consciousness genital sensations declared themselves. In the man the mother was the object of both oral and genital drives. In the woman when the oral wishes were rendered conscious there were genital sensations directed to the father.

(Vol. 22, No. 4)

1.   Brierly, M. Affect in Theory and Practice.

2.   Bálint, Michael. Eros and Aphrodite.

3.   Isakower, Otto. Psychopathology of Falling Asleep.

4.   Hann-Kende, Fanny. On Transference and Counter-Transference.

5.   Riviere, Joan. On the Genesis of Psychical Conflict in Earliest Infancy.

6.   Waelder, Robert. Problem of Psychical Conflict in Earliest Infancy.

7.   7. EIDELBERG, LUDWIG. The Genesis of Agoraphobia and Writers Cramp.

1.   Brierly, M. Affect in Theory and Practice. In considering affects we have not only a tension of instinct and object to deal with, but also a tension between “egos” and conditions within them. Federn defines affect as arising between two ego boundaries which border on each other, the affects being different according to the nature of the instinctive investment of the ego at these boundaries, but he is obliged to go beyond this in the case of certain affects, especially anxiety, which he concedes originates within the ego. According to Brierly the affects, in general, fall better into a theory of the ego nucleus, than into an ego boundary theory. In practice it cannot be too clearly kept in mind that in working with affects one is dealing with living psychic energies. The transference relation is always an affective one and it is not enough to arrange and explain the affects according to the instinct-object relations. The process of cure consists in a constant modification of the superego

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and practically this change involves getting rid of transference anxiety and transference ambivalance, by a progressive libidinization of the feeling of hate. A logical theory is useful but the analyst does not work with theories. He works with living feelings of dynamic force and theories of affects must be based on knowledge gained from practical experience.

2.   Bálint, M. Eros and Aphrodite. In classical times there were two deities symbolizing love. One, Aphrodite, probably belonging to the group Istar-Astarte-Isis, is a mother image. She is represented as a young and beautiful woman who constantly arouses love and is for the most part in love herself. She had nothing to do with morality, had many lovers and several husbands. She lived a full sexual life, not always with the same partner, but when she loved she abandoned herself completely to passion. The other love deity is Eros, a mighty character, yet a child. He is sportive, impudent, good-for-nothing—a rascal. Ethnologists see in him the symbol of the penis, but for the psychoanalysts this is of less importance than the fact that he is not a man. He always accompanies Aphrodite, but as her companion, never as her partner. He plays only, but in playing accomplishes the most difficult tasks. He is a child but more powerful than a man. A favorite representation is the triumphal procession of Eros, in which Zeus in chains and laughing follows the triumphal car. For the Greeks then the phenomena of love fall into two groups, to each of which belongs a separate concept and divinity. A similar division of the love-life is made by Freud in his Three Contributions—fore-pleasure and end-pleasure. Since then this distinction has been generally recognized in psychoanalysis. Bálint finds, however, that this distinction has not been sufficiently emphasized. The end-pleasure is tacitly regarded as a more developed, more complicated form of pleasure, but not as essentially different from fore-pleasure. Even Ferenczi who has called attention to genitality as a separate form of his partial drives, considers, in his amphimixis theory, end-pleasure as a simple summation of fore-pleasure mechanisms. This assumption seems problematic to Bálint and he is of the opinion that fore-pleasure and end-pleasure, though related, are essentially different sorts of experience. He finds support of this view in the well known fact that end-pleasure and anxiety are so closely connected, in the sense that end-pleasure renders the adult immune to anxiety, a fact referred to in Freud's earliest writings. Though it might seem that in perversions genitality loses the leading rôle and that the entire sexuality is organized under partial drives as primary, yet this is only part of the truth. While here partial drives occupy the foreground it is the excitement which outweighs all else and this excitement is finally released in genital end-pleasure. Fore-pleasure erotism is neither male nor female and is experienced by both sexes in the same manner, has the same goal, often the same object, in short is essentially sexless. The mechanisms which lead to fore-pleasure are very simple, usually in the form of caresses, stroking, tickling, licking, etc.

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The reaction in adults is correspondingly simple, smiling, laughing, crying out. All this is closely allied to the comic—an amusement. The end-pleasure, on the contrary, is deathly earnest, dramatic, often tragic (many animals die in the first orgasm). Bálint presents a scheme of differences in these two forms of experience. Fore-pleasure: from birth, always at hand, relatively simpler mechanism, no special organ, always connected with all the ego function, sexless, no pronounced termination, is a diversion, a play. End-pleasure: developed later in life, periodicity, absolute limits, very complicated mechanism, specific organ, independent system closely connected with perpetuation of the race, special organ for pleasure gain, two sexually different forms, orgasm a definite termination, immunizes against anxiety, is earnest. The writer brings biological evidence in support of his view. Fore-pleasure is continuously existent from the simplest form of life on: it is uninterruptedly and inseparably connected with all bodily functions (for example, taking nourishment, digestion, excretion, sensory perception, exercise of muscles, etc.). It is therefore an original function of the body, the soma. End-pleasure, the orgasm, on the contrary, seems to have been acquired at a relatively late phylogenetic period. During the entire life a character of strangeness seems to attach to it. It seems probable that the body was originally asexual, anorgastic, though erotic, experiencing only fore-pleasure and that only in the course of phylogenesis, sexual differentiation and end-pleasure made their appearance. It is recognized that man, like all other vertebrates, consists of two different systems, the diploid and the haploid germ cells and it must certainly be significant that the period of end-pleasure coincides generally with the time when the haploid cells are found to be present. In examining these relations Bálint is forced to the conclusion that the function of procreation, orgasm, individualization, and death make their appearance simultaneously in phylogenetic history, develop in parallel manner and must therefore probably be explained as related, none of these functions being an original property of life itself or of the soma. For the soul also fore-pleasure, of the two, seems to have less strangeness, seems less dangerous, less forced. This accounts for the frequent regression to this level. By psychologists fore-pleasure has been usually (Ferenczi) considered as connected with a moderate degree of excitement, the orgastic function with greater. The genital function, however, is little fitted to produce extreme excitement as the end-satisfaction occurs so promptly and is followed by reaction, contentment and feeling of well-being. Two opposite tendencies, then, are active in the organism, one originating in the time before the pleasure principle, the pattern of which is Ferenczi's autonomy tendency. The other is of much later origin with more pronounced psychic factor. These considerations lead directly to the ego psychology and render less mystifying the fact that the sexual life is taken as the paradigm of psychic conditions. In childhood too great fore-pleasure, fondling, etc., or too great deprivation bring harm to the

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labile libido equilibrium. The child who as yet possesses no outlet for discharge of the excitement reacts in panic, either in a clonic or tonic spasm. These modes of action are carried over into adult life as disturbances of potency and in psychic reactions. The difference between fore-pleasure and end-pleasure is of much deeper significance than has hitherto been assumed.

3.   Isakower, O. Psychopathology of Falling Asleep. Isakower notes similarities and contrasts between the phenomena of falling asleep, the aura in the epileptic attack, the experience of deja vu and traumatic amnesia. In falling asleep the ego withdraws interest from the object-investment. This occurs gradually. The changes in distribution of investment are naturally connected with changes within the ego itself, characterized by two processes: falling apart of various elements of the ego and loss of differentiation. The loss of differentiation seems to take place later than the dissociation of the ego-parts. As result of this redistribution, energy goes from perception and from the conscious and critical system to the body ego. The body ego thus flooded with libido is further altered so that boundaries are lost and it becomes confluent with the environment. Perceptions become feelings on definite parts of the body and are at the same time, localized as processes in the outer world, or, more exactly immediately on the zones where the body meets the outer world, principally the mouth (including respiratory tracts), and the hand. Other zones on the skin surface, merged with each other, are unified with the mouth zone. The expression “I am all mouth” fits the situation. In the beginning this regressive process is marked by swings back and forth between the changed body-ego and the perceptive system from which investment is being gradually withdrawn. Certain processes of the sensory apparatus are temporarily more strongly invested leading to such phenomena as entoptic and entotic hynogogic experiences. As noted by Freud perception is always an active process closely allied with motor intention, evident in the manner in which the nursling opens the mouth at optical stimulus and grasps the breast with the hands. An example of the relation of activity and perception is found in the vestibular apparatus where the stimuli from the outer world are grasped by consciousness in an almost vanishing degree, but are responded to by most important alterations in the body. Evidence of revival of early sense impressions are traceable in motor responses in falling asleep, indicating nursing at the mother's breast, relaxation of repletion etc. Not the mother but the breast is the object at this level. The hand makes movements as though kneading and feelings in the mouth indicate sensation of thirst as in the nursling. Other descriptions reveal features belonging to birth processes or intrauterine situations. As in retrograde amnesia, where the inhibitive processes reach far beyond the painful or traumatic events which have given rise to repression, the regressive tendency, as tendency, extends to former experiences generally. As in the

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waking state, in deja vu the tendency to revive extends to events which have never before been experienced, so in sleep, where the object investments have become labile, this perseverating tendency to revive earlier attitudes extends to all psychic factors. These withdrawals of investment and changes in the ego-regions do not take place without friction. The disintegration of the elements of the ego, the loss of differentiation in falling asleep, in fevers, in certain intoxications, especially those producing confusion, cause a weakening of the ego, more particularly of the superior elements; the repressed instinctive wishes endowed with es-libido offer impulses and, to avoid conflict, these are clothed with conscious qualities. The rebirth phantasies and the intrauterine phantasies belong to the resulting phenomena, but Isakower emphasizes that only a complete regression of the ego permit these long abandoned objects to be relived in halluncinatory form. All these phenomena, he finds, are of great importance in confirmation of the view that the primary attitudes of the organism are revived.

4.   Hann-Kende, F. On Transference and Counter-Transference. Hann-Kende notes that the counter-transference is a libidinous process to which literature has devoted little attention. Ferenczi, principally in those writings dealing with the technical problems of psychoanalysis, has mentioned the great dangers latent in the counter-transference and Freud sees in the control of the counter-transference one of the principal functions of the analyst. Ferenczi writes that the psychoanalyst can no longer approach the patient according to the dictates of his heart, with mildness and sympathy or with sternness and severity, and wait until the soul of the patient accommodates itself to the character of the analyst. A twofold task is imposed on the analyst: on the one hand to observe the patients, test their communications, trace unconscious connections, and, on the other, to master his own attitude. Hann-Kende believes that the management of the counter-transference is perhaps the most difficult task of the analyst. The counter-transference is one side of the transference situation. The unconscious trends of the analyst, his libidinous and destructive tendencies, were for the most part brought to his consciousness during his own analysis, and in part have been sublimated. Certain memory traces, however, remain stored in the foreconscious and possess dynamic force in the transference situation and may interfere with that atmosphere free of affect, that fundamental tone, which is indispensable for a successful analysis. Every further analysis, even after the analyses made under control, to a certain extent adds to the analyst's understanding of himself and brings additional memory traces to consciousness. When the transference and the counter-transference can be brought into equilibrium and the basic tone takes the leading role, the counter transference will not be an obstacle to the success of the analysis, but rather an aid.

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5.   Riviere, J. On the Genesis of Psychical Conflict in Earliest Infancy. See Psychoanalytic Review later.

6.   Waelder, R. The Problem of Psychic Conflict in Earliest Infancy. Waelder offers comments on Riviere's article, noting that her work presents the problem in a strikingly clear manner. He then describes divergencies in theory which have prevailed concerning conflicts in early infancy, considering certain points upon which there is universal agreement and avoiding polemic discussion. Melanie Klein and her colleagues have described a series of phantasies which are met with in the analyses of adults as well as in older children. She has continued work in a direction which had already been taken by psychoanalysis, following the pioneer work of Abraham. This enrichment of the knowledge of psychoanalysis was very acceptable and in this connection it is to be noted that Madame Klein very early grasped and elaborated a concept outlined by Freud in the Ego and the Id, namely that the aggression of the superego does not come entirely from without, but is in part the person's own aggression directed against himself. But here doubts arise. One hesitates to believe that there is a definite and prescribed series of phantasies which can be weakened or intensified by reality and which to a certain degree are always active; that an extreme aggression expressed in the first years of life is ubiquitous; so that later psychoses are explicable through modes of reaction belonging to the very first periods of normal development (one seems more justified in seeking their origin at a later period, in the third or fourth year when fixations from the first two years yield determinants). In short one would hesitate to say that there are sufficient data at hand to permit any inferences of experiences in the earliest infancy with certainty or any details with scientific precision. Nevertheless this quest in the shadowy past has been undertaken with the result that much else which is indispensable to psychoanalysis and which is really accessible has been neglected. To clarify these problems all sides of the question must be proved on abundant material. Constant repetition of assertions and contradictions based on experience in individual cases will scarcely be fruitful. Psychoanalysis has a dialectic structure. The poles of this dialectic are phantasy and reality, biology and environment, constitution and experience, transference and real relations, Id and Ego. Those works which depend on certain concepts of the earliest infantile life seem to approach one extreme only, while the majority of analysts following Freud's footsteps, hold to a middle course.

7.   Eidelberg, L. The Genesis of Agoraphobia and Writer's Cramp. Eidelberg describes a case in full. The symptoms consisted of fear of going on the street, a conversion symptom in the form of a rush of blood to the head, certain optical symptoms as though the rows of houses were lengthened, dizziness and uncertainty, and writer's cramp in both hands. The instinctive wishes disclosed by the analysis were: exhibitionism, wish for the female sex rôle, death wish. The exhibitionistic wish was

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illustrated in a memory from the fifth year of life when the patient playing with his brothers and sisters pretended he was a cow being milked, his penis representing the udder. Punishment followed this escapade, connected with castration fear. The patient had great fear of an apoplectic fit. Eidelberg is unable to say whether this anxiety stood in direct, causal connection with the conversion symptom, the rush of blood to the head, or whether the anxiety arose independently. In the analyses of other patients who have conversion symptoms it is found that these arise without anxiety, so that in this case it must be assumed either that this conversion is of different form or that the anxiety is unconnected with the conversion. In the early history aggression was discovered as a source of anxiety. Projected, the aggression took on a paranoia-like color, as a constant fear of attack from a pursuer. The most important memory which became conscious in the analysis was that of a scene with a cat. The cat had followed the patient and he was overcome with great fear when the cat, driven into a corner, made a spring at him. Characteristically his fear was of injury to his eyes, plainly connected with castration fear and a logical consequence of his scoptophilia and exhibitionism. At that time the patient realized that his own aggression in cornering the cat could become dangerous for himself and he understood how, by a reversal, the pursuer might become the pursued. A kataphobia was averted by identification with the cat, one evidence of which was a peculiar slinking gait like that of a cat. This pithiatism stamped the identification as of hysterical rather than of narcissistic nature. H. Deutsch has shown that in agoraphobia a self-punishing identification with the hated object takes place and that the hysterical form arises at a higher level than the narcissistic, is transitory and susceptible of correction. The first point was fully demonstrated in this case, and, notwithstanding the fact that the patient's difficulties had persisted for twenty years and could not therefore be regarded as transitory, the writer believes that the identification was hysterical, in keeping with Freud's view that in this form of identification the object continues to exercise an influence, recognizable usually in certain isolated actions and innervations. Few analyses of writer's cramp have been published. Here the disturbance signified that the hand had been sexualized and in female sense. In the history a homosexual episode with a friend of the patient's foster father revealed the feminine sexual trend. The writer's cramp signified not merely “I do not need the woman as I can satisfy myself with the hand,” but also “I do not need the woman for I am myself a woman and by means of the hand can live without my female wishes.” The hand symbolized a female sexual organ and the pencil or pen took the role of the penis. Doubtless in the genesis of this agoraphobia aggression played a central role. The death wish “He shall go away” (die), when projected became “I shall go away” (die). The agoraphobia was established as a defence against the inacceptable aggressive tendencies, to create the impression that the patient himself was afraid of an aggression.

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Article Citation

Willard, C. (1939). Internationale Zeitschrift für Psychoanalyse. Psychoanal. Rev., 26(1):108-129

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