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Volume 16


Volume XVI: 
Introductory Lectures on Psycho-Analysis (Part III)

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XVI: Psycho-analysis and psychiatry.
The psychoanalytic view of the phenomena of neurosis is presented. Some patients do not close the doors between the waiting room and the office. This happens only when the waiting room is empty, not full. This action is not a matter of chance but has a motive, a sense and an intention. It has a place in an assignable mental context. A case history is presented of a woman suffering from delusions of jealousy. The patient actually was in love with her son-in-law. This love was not conscious; but it remained in existence and, even though it was unconscious, it exercised a severe pressure. Some relief had to be looked for. The easiest mitigation was offered by the mechanism of displacement which plays a part so regularly in the generating of delusional jealousy. The phantasy of her husband’s unfaithfulness acted as a cooling compress on her burning wound. Psychoanalysis showed that the delusion ceased to be absurd or unintelligible, it had a sense, it had good motives and it fitted into the context of an emotional experience of the patient’s. The delusion was necessary, as a reaction to an unconscious mental process, and it was to this connection that it owed its delusional character and its resistance to every logical and realistic attack. The fact that the delusion turned out to be a jealous one and not one of another kind was unambiguously determined by the experience that lay behind the illness.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neurosis (1917).
Lecture XVII: The sense of symptoms.
The sense of neurotic symptoms was first discovered by Josef Breuer. Obsessional neurosis is shown in the patient’s being occupied with thoughts in which he is in fact not interested, in his being aware of impulses in himself which appear very strange to him and in his being led to actions, the performance of which, give him no enjoyment, but which it is quite impossible for him to omit. Two examples of the analysis of an obsessional symptom are presented. The first patient is a lady, nearly 30 years of age, who suffered from the most severe obsessional manifestations. She ran from her room into another neighboring one, took up a particular position there beside a table that stood in the middle, rang the bell for her housemaid, sent her on some indifferent errand or let her go without one, and then ran back into her own one. The obsessional action appeared to have been a representation, a repetition, of a significant scene; that of her wedding night. The second patient was a 19-year-old girl. She developed a sleep ceremonial as follows: the big clock in her room was stopped, all the other clocks or watches in the room were removed, and her tiny wrist watch was not allowed inside her bedside table. The patient gradually came to learn that it was a symbol of the female genitals that clocks were banished from her equipment for the night.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XVIII: Fixation to traumas-The unconscious.
The closest analogy to the behavior of neurotics is afforded by illnesses which are produced by war, traumatic neuroses. The traumatic neuroses give a clear indication that a fixation at the moment of the traumatic accident lies at their root. These patients regularly repeat the traumatic situation in their dreams. The existence of unconscious mental processes is revealed in the obsessional behavior of neurotics. These patients are not aware of the link between their obsessional behavior and the precipitating circumstance. The sense of the symptoms is regularly unconscious. There is an inseparable relation between this fact of the symptoms being unconscious and the possibility of their existing. Symptoms are never constructed from conscious processes; as soon as the unconscious processes concerned have become conscious, the symptom must disappear. The task of psychoanalysis is to make conscious everything that is pathogenically unconscious. Its task is to fill up all the gaps in the patient’s memory, to remove his amnesias.

Introductory lectures on psychoanalysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XIX: Resistance and repression.
When we undertake to restore a patient to health, to relieve him of the symptoms of his illness, he meets us with a violent and tenacious resistance, which persists throughout the whole length of the treatment. In psychoanalytic therapy, we instruct the patient to put himself into a state of quiet, unreflecting self-observation, and to report whatever internal perceptions he is able to make in the order to which they occur to him. One hardly comes across a single patient who does not make an attempt at reserving some region or other for himself so as to prevent the treatment from having access to it. Some patients put up intellectual resistances. The patient also knows how to put up resistances, without going outside the framework of the analysis, the overcoming of which is among the most difficult of technical problems. Instead of remembering, he repeats attitudes and emotional impulses from his early life which can be used as a resistance against the doctor and the treatment by means of what is known as transference. If the patient is a man, he usually extracts this material from his relation to his father, into whose place he fits the doctor. The pathogenic process which is demonstrated by resistance is called repression. It is the precondition for the construction of symptoms. Symptoms are a substitute for something that is held back by repression. Neurotic symptoms are substitutes for sexual satisfactions.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XX: The sexual life of human beings.
The sexual life of human beings is discussed. By means of careful investigations we have come to know groups of individuals whose sexual life deviates from the usual picture of the average. Only members of their own sex can rouse their sexual wishes. They are called homosexuals or inverts. This class of perverts behave to their sexual object in approximately the same way as normal people do to theirs. There is a long series of abnormal people whose sexual activity diverges more and more widely from what seems desirable to a sensible person. They are divided into those in whom, like the homosexuals, the sexual object has been changed, and others in whom the sexual aim is what has primarily been altered. Neurotic symptoms are substitutes for sexual satisfaction. Of the many symptomatic pictures in which obsessional neurosis appears, the most important turn out to be those provoked by the pressure of excessively strong sadistic sexual impulses. Psychoanalytic research has had to concern itself with the sexual life of children. This is because the memories and associations arising during the analysis of symptoms in adults regularly led back to the early years of childhood. The first area of sexual interest in a baby is the mouth. The next erotogenic zone is the anus. A sign of maturity is the passing of sexual interest to the genitals.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXI: The development of the libido and the sexual organizations.
The development of the libido and of the sexual organizations are discussed. The sexual life of children cannot be doubted from the third year of life onwards: at about that time the genitals already begin to stir; a period of infantile masturbation, of genital satisfaction, sets in. From about the sixth to the eighth year of life onwards, we can observe a halt and retrogression in sexual development, which, in cases where it is most propitious culturally, deserves to be called a period of latency. The majority of experiences and mental impulses before the start of the latency period fall victim to infantile amnesia. The task for psychoanalysis is to bring this forgotten period back into memory. From the third year of life, a child’s sexual life shows much agreement with an adult’s. A kind of loose organization which might be called pregenital exists before that. During this earlier phase, what stands in the forefront are not the genital component instincts but the sadistic and anal ones. The sadistic anal organization is the immediate forerunner of the phase of genital primacy. The turning point of the sexual development is the subordination of all the component sexual instincts under the primacy of the genitals. Erotic desires become focused upon the parent of the opposite sex, in association with the murderous wish to do away with all rivals, in the Oedipus complex.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neurosis (1917).
Lecture XXII: Some thoughts on development and regression-Aetiology.
The libidinal function goes through a lengthy development before it can be enlisted in the service of reproduction. A development of this kind involves 2 dangers: inhibition and regression. There are 2 kinds of regressions: a return to the objects first cathected by the libido which are of an incestuous nature; and a return of the sexual organization as a whole to earlier stages. Repression is the process by which an act which is admissible to consciousness, one which belongs to the preconscious system, is made unconscious. In hysteria, there is a regression to an earlier stage of the sexual organization. The chief part in the mechanism of hysteria is played by repression. In obsessional neurosis, it is the regression of the libido to the preliminary stage of the sadistic anal organization that is the most striking fact and the one which is decisive for what is manifested in symptoms. The meaning of psychical conflict can be adequately expressed by saying that for an external frustration to become pathogenic an internal frustration must be added to it. Another factor in the etiology of the neuroses, the tendency to conflict, is as much dependent on the development of the ego as on that of the libido. The transition from the pleasure principle to the reality principle is one of the most important steps forward in the ego’s development.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXIII: The paths to the formation of symptoms.
Psychical (or psychogenic) symptoms and psychical illness are acts that are detrimental, or at least useless, to the subject’s life as a whole, often complained of by him as unwelcome and bringing unpleasure or suffering to him. The main damage they do resides in the mental expenditure which they themselves involve and in the further expenditure that becomes necessary for fighting against them. Neurotic symptoms are the outcome of a conflict which arises over a new method of satisfying the libido. The path to perversion branches off sharply from that to neurosis. The libido’s escape under conditions of conflict is made possible by the presence of fixations. The regressive cathexis of these fixations leads to the circumvention of the repression and to a discharge of the libido, subject to the conditions of a compromise being observed. The libido finds the fixations which it requires in order to break through the repressions in the activities and experiences of infantile sexuality, in the abandoned component trends, in the objects of childhood which have been given up. The symptoms create a substitute for the frustrated satisfaction by means of a regression of the libido to earlier times. Among the occurrences which recur again and again in the youthful history of neurotics are: observation of parental intercourse, seduction by an adult, and threat of being castrated. The libido’s retreat to phantasy is an intermediate stage on the path to the formation of symptoms and it seems to call for a special name. Jung called it introversion.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXIV: The common neurotic state.
One of the ways in which the ego is related to its neurosis is most clearly recognizable in traumatic neurosis. In traumatic neuroses, and particularly in those brought about by the horrors of war, we are unmistakably presented with a self-interested motive on the part of the ego, seeking for protection and advantage, a motive which cannot create the illness by itself but which assents to it and maintains it when once it has come about. The ego takes a similar interest in the development and maintenance of the neurosis in every other case. In average circumstances, we recognize that by escaping into a neurosis the ego obtains a certain internal gain from illness. The symptoms of the actual neuroses, intracranial pressure, sensations of pain, a state of irritation in an organ, and weakening or inhibition of a function have no sense, no psychical meaning. They are not only manifested predominantly in the body but they are also themselves entirely somatic processes, in the generating of which all the complicated mental mechanisms are absent. There are 3 pure forms of actual neuroses: neurasthenia, anxiety neurosis, and hypochondria.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXV: Anxiety.
The problem of anxiety is discussed. Realistic anxiety is rational and expedient. It calls for drastic revision. The first thing about it is preparedness for the danger, which manifests itself in increased sensory attention and motor tension. The preparedness for anxiety seems to be the expedient element in anxiety, and the generation of anxiety the inexpedient one. In the anxiety manifested by neurotics, there is a general apprehensiveness, a kind of freely floating anxiety which is ready to attach itself to any idea that is in any way suitable, which influences judgment, selects what is to be expected, and lies in wait for any opportunity that will allow it to justify itself. This is called expectant anxiety or anxious expectation. A second form of anxiety is bound psychically and attached to particular objects or situations. This is the anxiety of phobias. In the third of the forms of neurotic anxiety, the connection between anxiety and a threatening danger is completely lost to view. Anxiety may appear in hysteria as an accompaniment to hysterical symptoms, or in some chance condition of excitement; or it may make its appearance, divorced from any determinants and equally incomprehensible to us and to the patient, as an unrelated attack of anxiety. There is a connection between sexual restraint and anxiety states. The deflection of the libido from its normal employment, which causes the development of anxiety, takes place in the region of somatic processes.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXVI: The libido theory and narcissism.
The libido theory and narcissism are discussed. Sexuality is the single function of the living organism which extends beyond the individual and is concerned with his relation to the species. The cathexes of energy which the ego directs towards the objects of its sexual desires are termed libido; all the others, which are sent out by the self-preservative instincts, are called interest. In 1908, Karl Abraham pronounced the main characteristic of schizophrenia to be that in it the libidinal cathexis of objects was lacking. In a sleeper, the primal state of distribution of the libido is restored, total narcissism, in which libido and ego interest, still united and indistinguishable, dwell in the self-sufficing ego. Narcissism is the libidinal complement to egoism. When we speak of egoism, we have in view only the individual’s advantage; when we talk of narcissism we are also taking his libidinal satisfaction into account. Object choice, the step forward in the development of the libido which is made after the narcissistic stage, can take place according to 2 different types: either according to the narcissistic type, where the subject’s own ego is replaced by another one that is as similar as possible, or according to the attachment type, where people who have become precious through satisfying the other vital needs are chosen as objects by the libido as well.

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Introductory lectures on psycho-analysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXVII: Transference.
Transference is discussed. By carrying what is unconscious on into the conscious, we lift the repression, we remove the preconditions for the formation of symptoms. The repression must be gotten rid of, after which the substitution of the conscious material for the unconscious can proceed smoothly. The resistance is removed by discovering it and showing it to the patient. The anticathexis or the resistance does not form part of the unconscious but of the ego. The patient, who ought to want nothing else but to find a way out of his distressing conflicts, develops a special interest in the person of the doctor. For a time, relations with him become very agreeable. But then, difficulties arise in the treatment. The patient behaves as though he were outside the treatment and as though he had not made an agreement with the doctor. The cause of the disturbance is that the patient has transferred on to the doctor intense feelings of affection which are justified neither by the doctor’s behavior nor by the situation that has developed during the treatment. Transference can appear as a passionate demand for love or in more moderate forms; the libidinal desire can be toned down into a proposal for an inseparable, but ideally nonsensual, friendship. With his male patients, the doctor comes across a form of expression of the transference which is hostile or negative. The transference is necessary in order for a cure.

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Introductory lectures on psychoanalysis (1916-17).
Part III. General theory of the neuroses (1917).
Lecture XXVIII: Analytic therapy.
Analytic theory is discussed. Direct suggestion is suggestion aimed against the manifestation of the symptoms; it is a struggle between your authority and the motives for the illness. Experience shows that in renouncing direct suggestion we are not giving up anything of irreplaceable value. Hypnotic treatment seeks to expose and get rid of something. An analytic treatment demands from both doctor and patient the accomplishment of serious work, which is employed in lifting internal resistances. Through the overcoming of these resistances the patient’s mental life is permanently changed, is raised to a high level of development, and remains protected against fresh possibilities of falling ill. A neurotic is incapable of enjoyment and of efficiency, the former because his libido is not directed toward any real object and the latter because he is obliged to employ a great deal of his available energy on keeping his libido under repression and on warding off its assaults. He would become healthy if the conflict between his ego and his libido came to an end and if his ego had his libido again at its disposal. The therapeutic task consists, in freeing the libido from its present attachments, which are withdrawn from the ego, and in making it once more serviceable to the ego. The therapeutic work falls into 2 phases: 1) all the libido is forced from the symptoms into the transference and concentrated there; and 2) the struggle is waged around this new object and the libido is liberated from it.

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Introductory lectures on psycho-analysis (1916-17).
Index of parapraxes.
An index of parapraxes is presented. The source of each parapraxis is given where it is other than Freud himself. The 6 parapraxes include: bungled and symptomatic actions, errors; forgetting intentions, lost objects; forgetting names; misreadings; slips of the pen and misprints; and slips of the tongue. In addition to Freud, the sources include: Brill, Maeder, Bernard Shaw, Jones, Dattner, Jung, Lichtenberg, Crown Prince, Stekel, Reitler, Meringer and Mayer, Rank, Constable, Lattman, Schiller and Graf.

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Introductory lectures on psycho-analysis (1916-1917).
Index of dreams.
An index of dreams is presented. The subject matter of the dreams includes a trip across Lake Aussee, a black-edged visiting card, 2 rows of boys, a brother in a box, a brown dachshund, a shop in Cairo, the English Channel, a basket of cherries, church and landscape, church bells, a clock man, broken crockery, a customs officer, a dead daughter, an exhumed father, an extensive view, God in a paper cocked hat, a kiss in an automobile, love services, a low hanging chandelier, a murderer in a railway train, a mustard plaster, an officer in a red cap, Orvieto wine, a piano that needs tuning, pulling a woman from behind a bed, the shape of a table, sleigh bells, strawberries, 3 theater tickets, 2 black trunks, 2 sisters, and an uncle smoking a cigarette.

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Introductory lectures on psycho-analysis (1916-17).
Index of symbols.
An index of 139 symbols is presented. They include: apples, balloons, beheading, blossoms, books, bottles, boxes, breaking, bushes, cases, castle, cavities, chapels, chests, churches, citadel, city, climbing, cloaks, clothes, crafts, cupboards, daggers, dancing, departure, doors, emperor and empress, falling, fishes, flame, flowers, flying, foot, fortress, fountains, gardens, gates, gliding, hammers, hand, hats, head, hearth, hills, hollows, horseshoe, house, instruments, jewels, keys, knives, ladders, landscape, limbs, linen, materials, mouth, mushroom, mussels, neckties, ovens, overcoats, paper, peaches, pencils, piano playing, pig, pillow, pistols, pits, playing, plough, pockets, posts, receptacles, reptiles, revolvers, riding, rifles, rocks, rooms, sabres, ships, shoes, sliding, staircases, steps, sticks, sweets, tables, three, tools, train journey, treasure, trees, trunks, umbrellas, underclothing, uniforms, vermin, water, windows, wood, and zeppelins.

Abstracts of the Standard Edition of 
the Psychological Works of Sigmund Freud

Carrie Lee Rothgeb, Editor

 

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