Illuminate. Discover. Change.

Volume 7

Volume VII:
A Case of Hysteria, Three Essays on Sexuality, and Other Works (1901 – 1905)

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Fragment of an analysis of a case of hysteria: (1953) Editor’s note.
The Fragment of an Analysis of a Case of Hysteria was published in October and November, 1905; however, the greater part of it was written in January 1901. On October 14, 1900, Freud told Fliess that he had recently begun work with a new patient, an 18-year-old girl. Her treatment came to an end some 3 months later. The analysis was grouped around 2 dreams and contained solutions of hysterical symptoms and considerations on the sexual organic basis of the whole condition. Three times in his later writings, Freud assigned his treatment of Dora to the wrong year, to 1899 instead of 1900. Dora was born in 1882, her father was ill in 1888, bed wetting appeared in 1889 and dyspnea in 1890. Her father’s detached retina occurred in 1892 and in 1894, her father had his confusional attack and visited Freud. April 1902 was Dora’s last visit to Freud.

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Fragment of an analysis of a case of hysteria (1905).
Prefatory remarks.
Prefatory remarks to a Fragment of an Analysis of a Case of Hysteria are presented. If it is true that the causes of hysterical disorders are to be found in the intimacies of the patients’ psychosexual life, and that hysterical symptoms are the expression of their most secret and repressed wishes, then the complete elucidation of a case of hysteria involves the revelation of those intimacies and the betrayal of those secrets. Freud believes it is the physician’s duty to publish what he believes he knows of the causes and structure of hysteria, and it becomes cowardice to neglect doing so, as long as he can avoid causing direct personal injury to the patient concerned. Some ways in which Freud overcame some of the technical difficulties in drawing up the report of this case history are presented. The material which elucidated the case was grouped around 2 dreams and the treatment covered only 3 months and was not carried through to its appointed end, but was broken off at the patient’s request when it reached a certain point.

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Fragment of an analysis of a case of hysteria (1905).
Chapter I: The clinical picture.
The family of the 18-year-old girl (Dora), who is the patient, included her parents and a brother who was 1-1/2 years her senior. Her father was the dominating figure in the family, owing to his intelligence and character as much as to the circumstances of his life. His daughter was very tenderly attached to him, and for that reason her critical powers, which developed early, took all the more offense at many of his actions and peculiarities. Her affection for him was further increased by the many severe illnesses which he had since her sixth year. The patient had begun to develop neurotic symptoms at the age of 8 and became subject at that time to chronic dyspnea with occasional episodes in which the symptom was very much aggravated. Freud first saw her when she was 16 at which time she was suffering from a cough and from hoarseness. The experience with Herr K., his making love to her and the insult to her honor which was involved seem to provide the psychical trauma which Breuer and Freud declared to be the indispensable prerequisite for the production of a hysterical disorder. Thus there are 3 symptoms, disgust, sensation of pressure on the upper part of the body, and the avoidance of men engaged in affectionate conversation, all derived from this single experience. Next considered were her motives for being ill. The relation between Dora and her father, Herr K. and Frau K. and the relation between Dora’s father and Frau K. were the primary contributors to Dora’s hysteria. It was concluded that no one can undertake the treatment of a case of hysteria until he is convinced of the impossibility of avoiding the mention of sexual subjects, or unless he is prepared to allow himself to be convinced by experience.

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Fragment of an analysis of a case of hysteria (1905).
Chapter II: The first dream.
Dora’s first dream which keeps recurring is presented:

“A house was on fire.” My father was standing beside my bed and woke me up. I dressed quickly. Mother wanted to stop and save her jewel case; but Father said, ‘I refuse to let myself and 2 children be burnt for the sake of your jewel case.’ We hurried downstairs, and as soon as I was outside I woke up.”

Freud’s task was to establish the relation between the events at L. (the place where the scene with Herr K. had taken place) and the recurrent dreams which she had had there. Jewel case was interpreted as a means of expressing the female genitals. The dream interpreted as an intention which Dora carried with her into her sleep was repeated each night until the intention had been carried out; and it reappeared years later when an occasion arose for forming an analogous intention. The intention might have been consciously expressed in words as these: “I must fly from this house, for I see that my virginity is threatened here; I shall go away with my father, and I shall take precautions not to be surprised while I am dressing in the morning.” The dream was a reaction to a fresh experience of an exciting nature; and this experience must have revived the memory of the only previous experience which was at all analogous to it. The latter was the scene of the kiss in Herr K.’s place of business, when she had been seized with disgust.

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Fragment of an analysis of a case of hysteria (1905).
Chapter III: The second dream.
A few weeks after the first dream, a second dream occurred. Dora was wandering about alone in a strange town, and saw streets and squares. The wandering about was overdetermined and led back to one of the exciting causes from the day before. Dora returned to her own house and found a note from her mother saying that since she had left home without her parents’ knowledge, the mother had not wanted to write and say her father was ill. Now he was dead, and Dora could come if she liked. This was interpreted as revenge against her father. The fact that she asked a certain question, “Where is the station?” nearly a hundred times in her dream led to another cause of the dream which was related to the previous evening. The thick wood near the station in her dream was interpreted as a symbolic geography of sex. There lay concealed behind the first situation in the dream a phantasy of defloration, the phantasy of a man seeking to force an entrance into the female genitals. It was concluded that incapacity for meeting a real erotic demand is one of the most essential features of a neurosis and that neurotics are dominated by the opposition between reality and phantasy. If what they long for most intensely in their phantasies is presented to them in reality, they flee from it; and they abandon themselves to their phantasies most readily where they need no longer fear to see them realized.

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Fragment of an analysis of a case of hysteria (1905).
Chapter IV: Postscript.
The theory of hysteria does not by any means fail to point out that neuroses have an organic basis, though it does not look for that basis in any pathological anatomical changes, and provisionally substitutes the conception of organic functions for the chemical changes which we should expect to find but which we are at present unable to apprehend. Sexuality does not simply intervene on one single occasion, at some point in the working of the processes which characterize hysteria, but it provides the motive power for every single symptom, and for every single manifestation of a symptom. The symptoms of the disease are nothing else than the patient’s sexual activity. During psychoanalytic treatment, the formation of new symptoms is invariably stopped. But the productive powers of the neurosis are by no means extinguished; they are occupied in the creation of a special class of mental structures, for the most part unconscious, to which the name of transference may be given. Transferences are new editions or facsimiles of the impulses and phantasies which are aroused and made conscious during the progress of the analysis; however, they replace some earlier person by the person of the physician.

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Three essays on the theory of sexuality:
Editor’s note (1953) and prefaces (1909-1920).
Freud’s Three Essays on the Theory of Sexuality stand beside his Interpretation of Dreamsas his most momentous and original contributions to psychoanalytic knowledge. The history of Freud’s concern with the subject can be followed in detail. Clinical observations of the importance of sexual factors in the causation, first, of anxiety neurosis and neurasthenia, and later, of the psychoneuroses, were what first led Freud into a general investigation of the subject of sexuality. His first approaches, during the early nineties, were from the physiological and chemical standpoints. In the preface to the third edition, Freud makes a few remarks intended to prevent misunderstandings and expectations that cannot be fulfilled. It must be emphasized that the exposition is based entirely upon everyday medical observation, to which the findings of psychoanalytic research should lend additional depth and scientific significance. Throughout the entire work the various factors are placed in a particular order of precedence: preference is given to the accidental factors, while disposition is left in the background, and more weight is attached to onto-genesis than to phylogenesis. In the preface to the fourth edition, Freud states that some of the contents of the book, its insistence on the importance of sexuality in all human achievements and the attempt it makes at enlarging the concept of sexuality, have from the first provided the strongest motives for the resistance against psychoanalysis.

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Three essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations:
(1). Deviations in respect of the sexual object.
a.) Inversion b.) Sexually immature persons and animals as sexual objects.
Sexual aberrations are discussed. The person from whom sexual attraction proceeds is called the sexual object and the act towards which the instinct tends is called the sexual aim. Some deviations in respect of the sexual object are presented. The behavior of inverts (people with ‘contrary sexual feelings,’ such as homosexuals) varies greatly in several respects: 1) They may be absolute inverts; 2) they may be amphigenic inverts, that is psychosexual hermaphrodites, or: 3) they may be contingent inverts. The earliest assessments regarded inversion as an innate indication of nervous degeneracy. The attribution of degeneracy in this connection is open to the objections which can be raised against the indiscriminate use of the word in general. Innateness is only attributed to the first class of inverts. The existence of the 2 other classes is difficult to reconcile with the hypothesis of the innateness of inversion. The nature of inversion is explained neither by the hypothesis that it is innate nor by the alternative hypothesis that it is acquired. The facts of anatomy lead us to suppose that an originally bisexual physical disposition has, in the course of evolution, become modified into a unisexual one, leaving behind only a few traces of the sex that has become atrophied. The theory of psychical hermaphroditism presupposes that the sexual object of an invert is the opposite of that of a normal person. No one single aim can apply in cases of inversion. Sexual instinct and the sexual object are merely close together: sexual instinct is independent of its object and its origin is not likely due to its object’s attractions. Cases in which sexually immature persons (children) are chosen as sexual objects and cases of sexual intercourse with animals are judged as sporadic aberrations. It is concluded that under a great number of conditions and in surprisingly numerous individuals, the nature and importance of the sexual object recedes into the background. What is essential and constant in the sexual instinct is something else.

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Three Essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations.
(2). Deviations in respect of the sexual aim.
a). Anatomical extensions. b). Fixation of preliminary sexual aims.
Some deviations of the sexual aim are presented. Per-versions are sexual activities which either extend, in an anatomical sense, beyond the regions of the body that are designed for sexual union, or linger over the intermediate relations to the sexual object which should normally be traversed rapidly on the path towards the final sexual aim. The use of the mouth as a sexual organ is regarded as a perversion if the lips (or tongue) of one person are brought into contact with the genitals of another, but not if the mucous membranes of the lips of both of them come together. Where the anus is concerned it becomes still clearer that it is disgust which stamps that sexual aim as a perversion. Unsuitable substitutes, called fetishes, (such as hair, piece of clothing, etc.) for the sexual object are discussed. Every external or internal factor that hinders or postpones the attainment of the normal sexual aim will evidently lend support to the tendency to linger over the preparatory activities and to turn them into new sexual aims that can take the place of the normal one. Pleasure in looking (scopophilia) becomes a perversion if it is restricted exclusively to the genitals, or if it is concerned with the overriding of disgust, or if, instead of being preparatory to the normal sexual aim, it supplants it. The most common and the most significant of all the perversions is the desire to inflict pain (sadism) upon the sexual object, and its reverse (masochism). The roles of passivity and activity in sadism and masochism are discussed in view of the fact that in this perversion both forms are habitually found in the same individual.

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Three essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations.
(3). The perversions in general.
The perversions in general are discussed. In the majority of instances, the pathological character in a perversion is found to lie not in the content of the new sexual aim but in its relation to the normal. If a perversion, instead of appearing merely alongside the normal sexual aim and object, supplants it completely and takes its place in all circumstances, so that the perversion has the characteristics of exclusiveness and fixation, then we shall be justified in regarding it as a pathological symptom. The sexual instinct has to struggle against certain mental forces which act as resistances, of which shame and disgust are the most prominent. Some perversions are only made intelligible if we assume the convergence of several motive forces.

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Three essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations.
(4). The sexual instinct in neurotics.
The sexual instinct in neurotics is discussed. The only means of obtaining information about the sexual life of persons known as psychoneurotics is through psychoanalytic investigation. Experience shows that these psychoneuroses, hysteria, obsessional neuroses, neurasthenia, schizophrenia, and paranoia, are based on sexual instinctual forces. The removal of the symptoms of hysterical patients by psychoanalysis proceeds on the supposition that those symptoms are substitutes for a number of emotionally cathected mental processes, wishes and desires, which, by the operation of a special psychical procedure (repression), have been prevented from obtaining discharge in psychical activity that is admissible to consciousness. The findings of psychoanalysis show that symptoms represent a substitute for impulses the sources of whose strength is derived from the sexual instinct. In the case of anyone who is predisposed to hysteria, the onset of his illness is precipitated when he finds himself faced by the demands of a real sexual situation. Between the pressure of the instinct and his antagonism to sexuality, illness offers escape. The sexual instinct of psychoneurotics exhibits all the aberrations and manifestations of abnormal sexual life. The unconscious mental life of all neurotics shows inverted impulses, fixation of their libido upon persons of their own sex. In any fairly marked case of psychoneurosis it is unusual for only a single one of the perverse instincts to be developed.

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Three essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations.
(5). Component instincts and erotogenic zones.
The component instincts and erotogenic zones are discussed. An instinct is provisionally understood to be the psychical representative of an endosomatic, continuously flowing source of stimulation, as contrasted with a stimulus, which is set up by single excitations coming from without. Excitations of 2 kinds arise from the somatic organs, based upon differences of a chemical nature. One of these kinds of excitation is specifically sexual, and the organ concerned is the erotogenic zone of the sexual component instinct arising from it. The part played by the erotogenic zones is immediately obvious in the case of those perversions which assign a sexual significance to the oral and anal orifices. In hysteria these parts of the body and the neighboring tracts of mucous membrane become the seat of new sensations and of changes in innervation in just the same way as do the actual genitalia under the excitations of the normal sexual processes. In obsessional neurosis, what is striking is the significance of those impulses which create new sexual aims and seem independent of erotogenic zones. In scopophilia and exhibitionism the eye corresponds to an erotogenic zone, while in the case of those components of the sexual instinct which involve pain and cruelty the same role is assumed by the skin.

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Three essays on the theory of sexuality (1905).
Chapter I: The sexual aberrations.
(6). Reasons for the apparent preponderance of perverse sexuality in the psychoneuroses.
(7). Intimation of the infantile character of sexuality.
Most psychoneurotics fall ill only after the age of puberty as a result of the demands made upon them by normal sexual life, or illnesses of this kind set in later when the libido fails to obtain satisfaction along normal lines. In both cases the libido behaves like a stream whose main bed has become blocked and it proceeds to fill up collateral channels which may hitherto have been empty. Thus what appears to be the strong tendency of psychoneurotics to perversion may be collaterally determined and must be collaterally intensified. Different cases of neurosis may behave differently: in one case the preponderating factor may be the innate strength of the tendency to perversion, in another it may be the collateral increase of that tendency owing to the libido being forced away from a normal sexual aim and sexual object. Neurosis will always produce its greatest effects when constitution and experience work together in the same direction. The disposition to perversions is itself of no great rarity but must form a part of what passes as the normal constitution. It is debatable whether the perversions go back to innate determinants or arise owing to chance experiences. There is something innate lying behind the perversions but it is something innate in everyone, though as a disposition it may vary in its intensity and may be increased by the influences of actual life. The postulated constitution, containing the germs of all the perversions, will only be demonstrable in children, even though in them it is only with modest degrees of intensity that any of the instincts can emerge. Thus a formula emerges which states that the sexuality of neurotics has remained in, or has been brought back to, an infantile state.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality:
(1). The period of sexual latency in childhood and its interruptions.
Infantile amnesia, which turns everyone’s childhood into something like a prehistoric epoch and conceals from him the beginnings of his own sexual life, is responsible for the fact that no importance is attached to childhood in the development of sexual life. The period of sexual latency in childhood and its interruptions are discussed. The germs of sexual impulses are already present in the newborn child and these continue to develop for a time, but are then overtaken by a progressive process of suppression; this in turn is itself interrupted by periodical advances in sexual development or may be held up by individual peculiarities. The sexual life of children usually emerges in a form accessible to observation around the third or fourth year of life. It is during the period of total or only partial latency that the mental forces which later impede the course of the sexual instinct are built up. Powerful components are acquired for every kind of cultural achievement by the diversion of sexual instinctual forces from sexual aims and their direction to new ones, a process called sublimation. The same process plays a part in the development of the individual and its beginning is in the period of sexual latency of childhood. Interruptions of the latency period are discussed.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality.
(2). The manifestations of infantile sexuality.
The manifestations of infantile sexuality are discussed. Thumbsucking (or sensual sucking) is regarded as an example of the sexual manifestations of childhood. Thumbsucking appears in early infancy and may continue into maturity, or even persist all through life. A grasping instinct may appear and may manifest itself as a simultaneous rhythmic tugging at the lobes of the ears or a catching hold of some part of another person for the same purpose. Sensual sucking involves a complete absorption of the attention and leads either to sleep or even to a motor reaction in the nature of an orgasm. The behavior of a child who indulges in thumbsucking is determined by a search for some pleasure which has already been experienced and is now remembered. To begin with, sexual activity attaches itself to functions serving the purpose of self-preservation and does not become independent of them until later. The 3 essential characteristics of an infantile sexual manifestation are: 1) at its origin it attaches itself to one of the vital somatic functions; 2) it has as yet no sexual object, and is thus autoerotic; and 3) its sexual aim is dominated by an erotogenic zone.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality.
(3). The sexual aim of infantile sexuality.
The sexual aim of infantile sexuality is discussed. An erotogenic zone is a part of the skin or mucous membrane in which stimuli of a certain sort evoke a feeling of pleasure possessing a particular quality. A rhythmic character must play a part among the special conditions which produce the pleasure. There are predestined erotogenic zones; however, any other part of the skin or mucous membrane can take over the functions in that direction. Thus the quality of the stimulus has more to do with producing the pleasurable feeling than has the nature of the part of the body concerned. A child who indulges in sensual sucking searches about his body and chooses some part of it to suck, a part which is afterwards preferred by him by force of habit. A precisely analogous tendency to displacement is also found in the symptomatology of hysteria; here repression affects most of all the actual genital zones and these transmit their susceptibility to stimulation to other erotogenic zones which then behave exactly like genitals. The sexual aim of the infantile instinct consists in obtaining satisfaction by means of an appropriate stimulation of the erotogenic zone which has been selected in one way or another. This satisfaction must have been previously experienced in order to have left behind a need for its repetition. A sexual aim consists in replacing the projected sensation of stimulation in the erotogenic zone by an external stimulus which removes that sensation by producing a feeling of satisfaction.

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Three essays on the theory of sexuality (1905). Chapter
II: Infantile sexuality.
(4). Masturbatory sexual manifestations.
Masturbatory sexual manifestations are discussed. The anal zone is well suited by its position to act as a medium through which sexuality may attach itself to other somatic functions. The intestinal disturbances which are so common in childhood see to it that this zone does not lack intense excitations. The masturbation of early infancy seems to disappear after a short time, but at some point of childhood (usually before the fourth year) the sexual instinct belonging to the genital zone usually revives and persists for a time until it is once more supressed or it may continue without interruption. The sexual excitation returns, either as a centrally determined tickling stimulus which seeks satisfaction in masturbation, or as a process in the nature of nocturnal emission which, like the nocturnal emissions of adult years, achieves satisfaction without the help of any action by the subject. The reappearance of sexual activity is determined by internal causes and external contingencies, both of which can be guessed at in cases of neurotic illness from the form taken by their symptoms. Under the influence of seduction, children can become polymorphously perverse, and can be led into all possible kinds of sexual irregularities. This shows that an aptitude for them is innately present in their disposition. Infantile sexual life, in spite of the preponderating dominance of erotogenic zones, exhibits components which involve other people as sexual objects. Such are the instincts of scopophilia, exhibitionism and cruelty. The cruel component of the sexual instinct develops in childhood even more independently of the sexual activities that are attached to erotogenic zones. The impulse of cruelty arises from the instinct for mastery and appears at a period of sexual life at which the genitals have not yet taken over their later role. It then dominates a phase of sexual life which is described as a pregenital organization.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality.
(5). The sexual researches of childhood.
At about the same time as the sexual life of children reaches its first peak, between the ages of 3 and 5, the children begin to show signs of the activity which may be ascribed to the instinct for knowledge or research. Its activity corresponds to a sublimated manner of obtaining mastery, while it also makes use of the energy of scopophilia. A male child believes that a genital like his own is to be attributed to everyone he knows, and he cannot make its absence tally with his picture of these other people. This conviction is energetically maintained by boys; is obstinately defended against the contradictions which soon result from observation; and is only abandoned after severe internal struggles (the castration complex). The substitutes for the penis which they feel is missing in women play a great part in determining the form taken by many perversions. When girls see that boys’ genitals are formed differently from their own, they are ready to recognize them immediately and are overcome by envy for the penis. Children’s theories of birth are discussed as is their sadistic view of sexual intercourse. The sexual theories of children are, in general, reflections of their own sexual constitution. In spite of their grotesque errors, the theories show more understanding of sexual processes than children are given credit for.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality.
(6). The phases of development of the sexual organization.
Infantile sexual life is essentially autoerotic and its individual component instincts are disconnected and independent of one another in their search for pleasure. The study of the inhibitions and disturbances of the process of development of the sexual organization enables us to recognize abortive beginnings and preliminary stages of a firm organization of the component instincts. The name pregenital is given to organizations of sexual life in which the genital zones have not yet taken over their predominant part. The first of these is the oral organization. A second pregenital phase is that of the sadistic anal organization. In this stage sexual polarity and an extraneous object are observable but organization and subordination to the reproductive function are still absent. This form of sexual organization can persist throughout life and can permanently attract a large portion of sexual activity. The opposing pairs of instincts (activity and passivity) are developed to an equal extent and are described by the term ambivalence. It is concluded that the whole of the sexual currents have become directed towards a single person in relation to whom they seek to achieve their aims, this then being the closest approximation possible in childhood to the final form taken by sexual life after puberty. It may be regarded as typical of the choice of an object that the process is diphasic, that is, that it occurs in 2 waves. The first of these begins between the ages of 2 and 5, and is brought to a halt or to a retreat by the latency period. The second wave starts with puberty and determines the final outcome of sexual life.

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Three essays on the theory of sexuality (1905).
Chapter II: Infantile sexuality.
(7). The sources of infantile sexuality.
Sexual excitation arises: 1) as a reproduction of a satisfaction experienced in connection with other organic processes; 2) through appropriate peripheral stimulation of erotogenic zones; and 3) as an expression of certain instincts. Sexual excitation can also be produced by rhythmic mechanical agitation of the body. Stimuli of this kind operate in 3 different ways: on the sensory apparatus of the vestibular nerves, on the skin, and on the deeper parts. Children feel a need for a large amount of active muscular exercise and derive extraordinary pleasure from satisfying it. In many people, the infantile connection between romping and sexual excitation is among the determinants of the direction subsequently taken by their sexual instinct. All comparatively intense affective processes, including even terrifying ones, infringe upon sexuality, a fact which may incidentally help to explain the pathogenic effect of emotions of that kind. Concentration of the attention upon an intellectual task and intellectual strain in general produce a concomitant sexual excitation in many young people as well as adults. The same pathways along which sexual disturbances infringe upon the other somatic functions also perform another important function in normal health; they serve for the attraction of sexual instinctual forces to aims that are other than sexual, that is to say, for the sublimation of sexuality.

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Three essays on the theory of sexuality (1905).
Chapter III: The transformations of puberty.
(1). The primacy of the genital zones and the fore-pleasure.
With the arrival of puberty, changes set in which are destined to give infantile sexual life its final, normal shape. A normal sexual life is only assured by an exact convergence of the affectionate current and the sensual current both being directed towards the sexual object and sexual aim. The new sexual aim in men consists in the discharge of the sexual products. The most striking of the processes at puberty has been picked upon as constituting its essence: the manifest growth of the external genitalia. Stimuli can impinge on it from 3 directions: from the external world by means of the excitation of the erotogenic zones, from the organic interior, and from mental life, which is a storehouse for external impressions and a receiver for internal excitations. All three types of stimuli produce sexual excitement. The erotogenic zones are used to provide a certain amount of pleasure by being stimulated in the way appropriate to them. This pleasure then leads to an increase in tension which in its turn is responsible for producing the necessary motor energy for the conclusion of the sexual act. The penultimate stage of that act is once again the appropriate stimulation of an erotogenic zone by the appropriate object; and from the pleasure yielded by this excitation the motor energy is obtained, this time by a reflex path, which brings about the discharge of the sexual substances.

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Three essays on the theory of sexuality (1905).
Chapter III: The transformations of puberty.
(2). The problem of sexual excitation.
The problem of sexual excitation is discussed. We remain in complete ignorance both of the origin and of the nature of the sexual tension which arises simultaneously with the pleasure when erotogenic zones are satisfied. A certain degree of sexual tension is required for the excitability of the erotogenic zones. The accumulation of the sexual substances creates and maintains sexual tension; the pressure of these products upon the walls of the vesicles containing them might be supposed to act as a stimulus upon a spinal center, the condition of which would be perceived by higher centers and would then give consciousness to the familiar sensation of tension. Observations on castrated males seem to show that sexual excitation can occur to a considerable degree independently of the production of the sexual substances. It seems probable that special chemical substances are produced in the interstitial portion of the sex glands; these are then taken up in the blood stream and cause particular parts of the central nervous system to be charged with sexual tension. It is concluded that substances of a peculiar kind arise from sexual metabolism.

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Three essays on the theory of sexuality (1905).
Chapter III: The transformations of puberty.
(3). The libido theory.
The libido theory is discussed. Libido is defined as a quantitatively variable force which could serve as a measure of processes and transformations occurring in the field of sexual excitation. The idea of a quantity of libido is presented and the mental representation of it is given the name of ego libido. The production, increase or diminution, distribution and displacement of it should afford us possibilities for explaining the psychosexual phenomena observed. This ego libido is, however, only conveniently accessible to analytic study when it has been put to the use of cathecting sexual objects, that is, when it has become object libido. It should be the task of a libido theory of neurotic and psychotic disorders to express all the observed phenomena and inferred processes in terms of the economics of the libido. In contrast to object libido, ego libido is described as narcissistic libido. Narcissistic or ego libido seems to be the great reservoir from which the object cathexes are sent out and into which they are withdrawn once more; the narcissistic libidinal cathexis of the ego is the original state of things, realized in earliest childhood, and is merely covered by the later extrusions of libido, but in essentials persists behind them.

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Three essays on the theory of sexuality (1905).
Chapter III: The transformations of puberty
(4). The differentiation between men and women.
The differentiation between men and women is discussed. It is not until puberty that the sharp distinction is established between the masculine and feminine characters. From that time on, this contrast has a more decisive influence than any other upon the shaping of human life. The development of the inhibitions of sexuality takes place in little girls earlier and in the face of less resistance than in boys. The autoerotic activity of the erotogenic zones is, however, the same in both sexes. The leading erotogenic zone in female children is located at the clitoris, and is thus homologous to the masculine genital zone of the glans penis. Puberty, which brings about so great an accession of libido in boys, is marked in girls by a fresh wave of expression, in which it is precisely clitoral sexuality that is affected. When erotogenic susceptibility to stimulation has been successfully transferred by a woman from the clitoris to the vaginal orifice, it implies that she has adopted a new leading zone for the purpose of her later sexual activity. A man retains his leading zone unchanged from childhood.

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Three essays on the theory of sexuality (1905).
Chapter III: The transformations of puberty.
(5). The finding of an object.
The processes at puberty establish the primacy of the genital zones; and in a man, the penis, which has now become capable of erection, presses forward insistently towards the new sexual aim, penetration into a cavity in the body which excites his genital zone. Simultaneously on the psychical side the process of finding an object, for which preparations have been made from earliest childhood, is completed. All through the period of latency children learn to feel for other people who help them in their helplessness and satisfy their needs. Their love is modeled after and a continuation of, their relation as sucklings to their mother. Children behave as though their dependence on the people looking after them were in the nature of sexual love. Anxiety in children is originally an expression of the fact that they are feeling the loss of the person they love. The barrier against incest is maintained by the postponing of sexual maturation until the child can respect the cultural taboo upheld by society. The sexual life of maturing youth is almost entirely restricted to indulging in phantasies. When incestuous fantasies are overcome, detachment from parental authority is completed. The closer one comes to the deeper disturbances of psychosexual development, the more unmistakably the importance of incestuous object choice emerges. In psychoneurotics, a large portion or the whole of their psychosexual activity in finding an object remains in the unconscious as a result of their repudiation of sexuality. Even a person who has avoided an incestuous fixation of his libido does not entirely escape its influence. One of the tasks implicit in object choice is that it should find its way to the opposite sex.

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Three essays on the theory of sexuality (1905).
The onset of sexual development in human beings occurs in 2 phases. This appears to be one of the necessary conditions of the aptitude of men for developing a higher civilization, but also of their tendency to neurosis. It is not rare to find perversions and psychoneuroses occurring in the same family, and distributed between the 2 sexes in such a way that the male members of the family are positive perverts, while the females, are negative perverts, that is, hysterics. This is good evidence of the essential conditions which exist between the 2 disorders. If an abnormal relationship between all the different dispositions persists and grows stronger at maturity, the result can only be a perverse sexual life. If the genital zone is weak, the combination, which is required to take place at puberty, is bound to fail, and the strongest of the other components of sexuality will continue its activity as a perversion. If in the course of development some of the components which are of excessive strength in the disposition are submitted to the process of repression, the excitations concerned continue to be generated as before; but they are prevented by psychical obstruction from attaining their aim and are diverted into numerous other channels until they find their way to expression as symptoms. Sublimation enables excessively strong excitations arising from particular sources of sexuality to find an outlet and use in other fields, so that an increase in psychical efficiency results from a disposition which in itself is perilous.

Three essays on the theory of sexuality (1905).
Appendix: List of writings by Freud dealing predominantly or largely with sexuality.
A list of writings by Freud dealing predominantly or largely with sexuality is presented. References to sexuality are to be found in a large majority of Freud’s writings. This list of 33 writings comprises those which are more directly concerned with the subject. They date from 1898 to 1940 and include: Sexuality in the Etiology of the Neuroses; The Sexual Enlightenment of Children; Character and Anal Erotism; Contributions to a Discussion on Masturbation; The Disposition to Obsessional Neurosis; On Narcissism: an Introduction; On the Transformation of Instincts, with Special Reference to Anal Erotism; The Taboo of Virginity; The Infantile Genital Organization; The Economic Problem of Masturbation; The Dissolution of the Oedipus Complex; Fetishism; Libidinal Types; and Splitting of the Ego in the Process of Defense.

1904A 7/249
Freud’s psycho-analytic procedure (1904).
Freud’s psychotherapeutic procedure, described as psychoanalysis, is an outgrowth of the cathartic method. The cathartic method presupposed that the patient could be hypnotized, and was based on the widening of consciousness that occurs under hypnosis. Its aim was the removal of the pathological symptoms. The cathartic method renounced suggestion; Freud gave up hypnosis as well and found a substitute for hypnosis in the associations of his patients. Freud insisted that the patients include everything that comes into their heads when they discuss their case history. Freud noticed that gaps (amnesias) appeared in the patient’s memory thus making up the determining factor of his entire theory. If the patient is urged to fill the gaps discomfort occurs when the memory really returns. From this Freud concludes that the amnesias are the result of a process which he calls repression and the motive for which he finds in feelings of unpleasure. The psychical forces which have brought about this repression can be detected in the resistance which operates against the recovery of the lost memories. The factor of resistance has become a cornerstone of his theory. The greater the resistance, the greater the distortion of the repressed psychical phenomena. Freud developed the art of interpretation which takes on the task of extracting repressed thoughts from unintentional ideas. The work of interpretation is applied not only to the patient’s ideas but also to his dreams. The therapeutic procedure remains the same for all the various clinical pictures that may be presented in hysteria and all forms of obsessional neurosis. The qualifications that are required for anyone who is to be beneficially affected by psychoanalysis include: periods of psychically normal condition, natural intelligence, and ethical development.

1905A 7/257
On psychotherapy (1905).
On Psychotherapy was delivered as a lecture before the Wiener medizinisches Doktorenkollegium on December 12, 1904. Psychotherapy is not a modern method of treatment. The majority of primitive and ancient medical methods must be classed under the head of psychotherapy. Certain diseases, in particular, the psychoneuroses, are far more readily accessible to mental influences than to any other form of medication. The many ways and means of practicing psychotherapy that lead to recovery are good. Several thoughts are presented concerning psychotherapy. 1) This method is often confused with hypnotic treatment by suggestion. There is the greatest possible degree of antithesis between these 2 techniques. Suggestion is not concerned with the origin, strength and meaning of morbid states but superimposes a suggestion hopefully capable of restraining the pathogenic idea. Analysis concerns itself with the genesis of the morbid symptoms and its function is to bring out factors during analysis. 2) The technique of searching for the origins of an illness and removing its manifestations is not easy and can not be practiced without training. 3) The analytic investigation and probing do not indicate speedy results and resistance can result in unpleasantness; however, all the effort of psychoanalytic therapy seems worthwhile when we consider that it has made a large number of patients who were permanently unfit for existence, fit for existence. 4) The indications or contraindications for psychoanalysis are that a patient should have a reasonable degree of education and a fairly reliable character, a normal mental condition, and be less than 50 yrs. old. Psychoanalysis should not be attempted when speedy removal of dangerous symptoms is required. 5) No injury to the patient is to be feared when the treatment is conducted with comprehension. 6) It is concluded that this therapy is based on the recognition that unconscious ideas, or the unconsciousness of certain mental processes, are the direct cause of the morbid symptoms. Psychoanalytic treatment may, in general, be conceived of as a re-education in overcoming internal resistances. Freud’s last comment is to advise against recommending sexual activity in psychoneuroses.

1906A 7/271
My views on the part played by sexuality in the aetiology of the neuroses (1906).
The part played by sexuality in the etiology of the neuroses is discussed. Originally, Freud’s theory related only to the clinical pictures comprised under the term neurasthenia including neurasthenia proper and anxiety neurosis. With more experiences, it was discovered that the cause of lifelong hysterical neuroses lies in what are in themselves the trivial sexual experiences of early childhood. A number of phantasies of seduction are explained as attempts at fending off memories of the subject’s own sexual activity (infantile masturbation). The importance of sexuality and of infantilism are stressed. The patient’s symptoms constitute his sexual activity, which arise from the sources of the normal or perverse component instincts of sexuality. The etiology of the neuroses comprises everything which can act in a detrimental manner upon the processes serving the sexual function. The most important are the noxae which affect the sexual function itself; next are every other type of noxa and trauma which, by causing general damage to the organism, may lead secondarily to injury to its sexual processes. The onset of illness is the product of a summation of etiological factors and the necessary total of these factors can be completed from any direction.

1905B 7/283
Psychical (or mental) treatment (1905).
Psychical treatment denotes treatment taking its start in the mind, treatment (whether of mental or physical disorders) by measures which operate upon the human mind. Foremost among such measures is the use of words, and words are the essential tool of mental treatment. There is a large number of patients, suffering from disorders of greater or less severity, whose disorders and complaints make great demands on the skill of their physicians, but in whom no visible or observable signs of a pathological process can be discovered. One group of these patients are distinguished by the copiousness and variety of their symptoms (which are influenced by excitement). In this case, the illness is of the nervous system, as a whole and is called “nervousness” (neurasthenia or hysteria). The affects are often sufficient in themselves to bring about both diseases of the nervous system accompanied by manifest anatomical changes and also diseases of other organs. States of illness that are already present can be considerably influenced by violent affects. The processes of volition and attention are also capable of exercising a profound effect on somatic processes and of playing a large part in promoting or preventing physical illnesses. The mental state of expectation puts in motion a number of mental forces that have the greatest influence on the onset and cure (such as faith or miracle cure) of physical diseases. The use of hypnosis and the knowledge gained from it are discussed. By means of hypnosis the mind can increase its control over the body and the physician can cause changes in the patient’s waking state by posthypnotic suggestion. Disadvantages of hypnosis include the damage it can cause and the patient’s dependence on the physician.

1942A 7/305
Psychopathic characters on the stage (1942).
Psychopathic characters on the stage are discussed. The purpose of drama is to reveal sources of pleasure or enjoyment in our emotional life. In this respect the prime factor is the process of getting rid of one’s own emotions; the consequent enjoyment corresponds to the relief produced by a thorough discharge and to an accompanying sexual excitation. The spectator’s enjoyment is based on illusion; it is someone other than himself who is acting and suffering on the stage, and it is only a game, which can not damage his personal security. Drama seeks to explore emotional possibilities and give an enjoyable shape even to forebodings of misfortune. Suffering of every kind is the subject matter of drama, and from this suffering it promises to give the audience pleasure. The other precondition of this art form is that it should not cause suffering to the audience but should compensate for the sympathetic suffering which is aroused. People are acquainted with mental suffering principally in connection with the circumstances in which it is acquired; accordingly, dramas dealing with it require some event out of which the illness shall arise and they open with an exposition of this event. The event must involve conflict and must include an effort of will together with resistance. Religious drama, social drama, and drama of character differ essentially in the terrain on which the action that leads to the suffering is fought out. Psychological and psychopathological drama are discussed next. Hamlet is distinguished with reference to 3 characteristics. 1) The hero is not psychopathic, but only becomes psychopathic in the course of the play. 2) The repressed impulse is one of those which are similarly repressed in all of us; this repression is shaken up by the situation in the play. 3) The impulse that is struggling into consciousness is never given a definite name so that in the spectator the process is carried through with his attention averted, and he is in the grip of his emotions instead of taking stock of what is happening. A certain amount of resistance is saved in this way. It is concluded that the neurotic instability of the public and the dramatist’s skill in avoiding resistances and offering forepleasures can alone determine the limits set upon the use of abnormal characters on the stage.

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

Carrie Lee Rothgeb, Editor


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