Chapter XVII: Part 17

In my opinion, therefore, the question how far the quite justifiable distinction between sexual and self-preservative instincts is to be carried has not much importance for psycho-analysis, nor is psycho-analysis competent to deal with it. From the biological point of view there are certainly various indications that the distinction is important. For the sexual function is the only function of a living organism which extends beyond the individual and secures its connection with its species. It is undeniable that the exercise of this function does not always bring advantage to the individual, as do his other activities, but that for the sake of an exceptionally high degree of pleasure he is involved by this function in dangers which jeopardize his life and often enough exact it. Quite peculiar metabolic processes, different from all others, are probably required in order to preserve a portion of the individual’s life as a disposition for posterity. And finally, the individual organism that regards itself as first in importance and its sexuality as a means like any other to its own satisfaction is from a biological point of view only an episode in a series of generations, a short-lived appendage to a germplasm which is endowed with virtual immortality, comparable to the temporary holder of an entail that will survive his death.

We are not concerned with such far-reaching considerations, however, in the psycho-analytic elucidation of the neuroses. By means of following up the distinction between the sexual and the Ego-instincts we have gained the key to comprehension of the group of transference neuroses. We were able to trace back their origin to a fundamental situation in which the sexual instincts had come into conflict with the self-preservative instincts, or—to express it biologically, though at the same time less exactly—in which the Ego in its capacity of independent individual organism had entered into opposition with itself in its other capacity as a member of a series of generations. Such a dissociation perhaps only exists in man, so that, taken all in all, his superiority over the other animals may come down to his capacity for neurosis. The excessive development of his Libido and the rich elaboration of his mental life (perhaps directly made possible by it) seem to constitute the conditions which give rise to a conflict of this kind. It is at any rate clear that these are the conditions under which man has progressed so greatly beyond what he has in common with the animals, so that his capacity for neurosis would merely be the obverse of his capacity for cultural development. However, these again are but speculations which distract us from the task in hand.

Our work so far has been conducted on the assumption that the manifestations of the sexual and the Ego-instincts can be distinguished from one another. In the transference neuroses this is possible without any difficulty. We called the investments of energy directed by the Ego towards the object of its sexual desires ‘Libido,’ and all the other investments proceeding from the self-preservative instincts its ‘interest’; and by following up the investments with Libido, their transformations, and their final fates, we were able to acquire our first insight into the workings of the forces in mental life. The transference neuroses offered the best material for this exploration. The Ego, however,—its composition out of various organizations with their structure and mode of functioning—remained undiscovered; we were led to believe that analysis of other neurotic disturbances would be required before light could be gained on these matters.

The extension of psycho-analytic conceptions on to these other affections was begun in early days. Already in 1908 K. Abraham expressed the view after a discussion with me that the main characteristic of dementia præcox (reckoned as one of the psychoses) is that in this disease _the investment of objects with Libido is lacking_. (_The Psycho-Sexual Differences between Hysteria and Dementia Præcox_). But then the question arose: what happens to the Libido of dementia patients when it is diverted from its objects? Abraham did not hesitate to answer that it is turned back upon the Ego, and that _this reflex reversion of it is the origin of the delusions of grandeur in dementia præcox_. The delusion of grandeur is in every way comparable to the well-known overestimation of the object in a love-relationship. Thus we came for the first time to understand a feature of a psychotic affection by bringing it into relation to the normal mode of loving in life.

I will tell you at once that these early views of Abraham’s have been retained in psycho-analysis and have become the basis of our position regarding the psychoses. We became slowly accustomed to the conception that the Libido, which we find attached to certain objects and which is the expression of a desire to gain some satisfaction in these objects, can also abandon these objects and set the Ego itself in their place; and gradually this view developed itself more and more consistently. The name for this utilization of the Libido—NARCISSISM—we borrowed from a perversion described by P. Näcke, in which an adult individual lavishes upon his own body all the caresses usually expended only upon a sexual object other than himself.

Reflection then at once disclosed that if a fixation of this kind to the subject’s own body and his own person can occur it cannot be an entirely exceptional or meaningless phenomenon. On the contrary, it is probable that this _narcissism_ is the universal original condition, out of which _object-love_ develops later without thereby necessarily effecting a disappearance of the narcissism. One also had to remember the evolution of object-Libido, in which to begin with many of the sexual impulses are gratified on the child’s own body—as we say, auto-erotically—and that this capacity for auto-erotism accounts for the backwardness of sexuality in learning to conform to the reality-principle. Thus it appeared that auto-erotism was the sexual activity of the narcissistic phase of direction of the Libido.

To put it briefly, we formed an idea of the relation between the Ego-Libido and the object-Libido which I can illustrate to you by a comparison taken from zoology. Think of the simplest forms of life consisting of a little mass of only slightly differentiated protoplasmic substances. They extend protrusions which are called pseudopodia into which the protoplasm overflows. They can, however, again withdraw these extensions of themselves and reform themselves into a mass. We compare this extending of protrusions to the radiation of Libido on to the objects, while the greatest volume of Libido may yet remain within the Ego; we infer that under normal conditions Ego-Libido can transform itself into object-Libido without difficulty and that this can again subsequently be absorbed into the Ego.

With the help of these conceptions it is now possible to explain a whole series of mental states, or, to express it more modestly, to describe in terms of the Libido-theory conditions that belong to normal life; for instance, the mental attitude pertaining to the conditions of “being in love,” of organic illness, and of sleep. Of the condition of sleep we assumed that it is founded upon a withdrawal from the outer world and a concentration upon the wish to sleep. We found that the nocturnal mental activity which is expressed in dreams served the purpose of the wish to sleep, and, moreover, that it was governed exclusively by egoistic motives. In the light of the Libido-theory we may carry this further and say that sleep is a condition in which all investments of objects, the libidinal as well as the egoistic, are abandoned and withdrawn again into the Ego. Does not this shed a new light upon the recuperation afforded by sleep and upon the nature of fatigue in general? The likeness we see in the condition which the sleeper conjures up again every night to the blissful isolation of the intra-uterine existence is thus confirmed and amplified in its mental aspects. In the sleeper the primal state of the Libido-distribution is again reproduced, that of absolute narcissism, in which Libido and Ego-interests dwell together still, united and indistinguishable in the self-sufficient Self.

Two observations are in place here. First, how is the concept ‘narcissism’ distinguished from ‘egoism’? In my opinion, narcissism is the libidinal complement of egoism. When one speaks of egoism one is thinking only of the _interests_ of the person concerned, narcissism relates also to the satisfaction of his libidinal needs. It is possible to follow up the two separately for a considerable distance as practical motives in life. A man may be absolutely egoistic and yet have strong libidinal attachments to objects, in so far as libidinal satisfaction in an object is a need of his Ego: his egoism will then see to it that his desires towards the object involve no injury to his Ego. A man may be egoistic and at the same time strongly narcissistic (i.e. feel very little need for objects), and this again either in the form taken by the need for direct sexual satisfaction, or in those higher forms of feeling derived from the sexual needs which are commonly called “love,” and as such are contrasted with “sensuality.” In all these situations egoism is the self-evident, the constant element, and narcissism the variable one. The antithesis of egoism, “altruism,” is not an alternative term for the investment of an object with Libido; it is distinct from the latter in its lack of the desire for sexual satisfaction in the object. But when the condition of love is developed to its fullest intensity altruism coincides with the investment of an object with Libido. As a rule the sexual object draws to itself a portion of the Ego’s narcissism, which becomes apparent in what is called the ‘sexual overestimation’ of the object. If to this is added an altruism directed towards the object and derived from the egoism of the lover, the sexual object becomes supreme; it has entirely swallowed up the Ego.

I think you will find it a relief if, after these scientific phantasies, which are after all very dry, I submit to you a poetic description of the ‘economic’ contrast between the condition of narcissism and that of love in full intensity. I take it from a dialogue between Zuleika and her lover in Goethe’s _Westöstliche Divan_:—

ZULEIKA:

The slave, the lord of victories,
The crowd, with single voice, confess
In sense of personal being lies
A child of earth’s true happiness.
There’s not a life he need refuse
If his true self he does not miss:
There’s not a thing he cannot lose
If he remains the man he is.

HÂTEM:

So it is held! so well may be!
But down a different track I come
Of all the bliss earth holds for me
I in Zuleika find the sum.
Does she expend her being on me,
Myself grows to myself of cost;
Turns she away, then instantly
I to my very self am lost.
And then with Hâtem all were over;
Though yet I should but change my state;
Swift, should she grace some happy lover,
In him I were incorporate.[52]

The second observation is an amplification of the theory of dreams. The way in which a dream originates is not explicable unless we assume that what is repressed in the Unconscious has acquired a certain independence of the Ego, so that it does not subordinate itself to the wish for sleep and maintains its investments, although all the object-investments proceeding from the Ego have been withdrawn for the purpose of sleep. Only this makes it possible to understand how it is that this unconscious material can make use of the abrogation or diminution in the activities of the censorship which takes place at night, and that it knows how to mould the day’s residue so as to form a forbidden dream-wish from the material to hand in that residue. On the other hand, some of the resistance against the wish to sleep and the withdrawal of Libido thereby induced may have its origin in an association already in existence between this residue and the repressed unconscious material. This important dynamic factor must therefore now be incorporated into the conception of dream-formation which we formed in our earlier discussions.

Certain conditions—organic illness, painful accesses of stimulation, an inflammatory condition of an organ—have clearly the effect of loosening the Libido from its attachment to its objects. The Libido which has thus been withdrawn attaches itself again to the Ego in the form of a stronger investment of the diseased region of the body. Indeed, one may venture the assertion that in such conditions the withdrawal of the Libido from its objects is more striking than the withdrawal of egoistic interests from their concerns in the outer world. This seems to lead to a possibility of understanding hypochondria, in which some organ, without being perceptibly diseased, becomes in a very similar way the subject of a solicitude on the part of the Ego. I shall, however, resist the temptation to follow this up, or to discuss other situations which become explicable or capable of exposition on this assumption of a return of the object-Libido into the Ego; for I feel bound to meet two objections which I know have all your attention at the moment. First of all, you want to know why when I discuss sleep, illness, and similar conditions, I insist upon distinguishing between Libido and ‘interests,’ sexual instincts and Ego-instincts, while the observations are satisfactorily explained by assuming a single uniform energy which is freely mobile, can invest either object or Ego, and can serve the purposes of the one as well as of the other. Secondly, you will want to know how I can be so bold as to treat the detachment of the Libido from its objects as the origin of a pathological condition, if such a transformation of object-Libido into Ego-Libido—or into Ego-energy in general—is a normal mental process repeated every day and every night.

The answer is: Your first objection sounds a good one. Examination of the conditions of sleep, illness, and falling in love would probably never have led to a distinction between Ego-Libido and object-Libido, or between Libido and ‘interests.’ But in this you omit to take into account the investigations with which we started, in the light of which we now regard the mental situations under discussion. The necessity of distinguishing between Libido and ‘interests,’ between sexual and self-preservative instincts, has been forced upon us by our insight into the conflict from which the transference neuroses arise. We have to reckon with this distinction henceforward. The assumption that object-Libido can transform itself into Ego-Libido, in other words, that we shall also have to reckon with an Ego-Libido, appears to be the only one capable of solving the riddle of what are called the narcissistic neuroses, e.g. dementia præcox, or of giving any satisfactory explanation of their likeness to hysteria and obsessions and differences from them. We then apply what we have found undeniably proved in these cases to illness, sleep, and the condition of intense love. We are at liberty to apply them in any direction and see where they will take us. The single conclusion which is not directly based on analytical experience is that Libido is Libido and remains so, whether it is attached to objects or to the Ego itself, and is never transformed into egoistic ‘interests’ and vice versa. This statement, however, is another way of expressing the distinction between sexual instincts and Ego-instincts which we have already critically examined, and which we shall hold to from heuristic motives until such time as it may prove valueless.

Your second objection too raises a justifiable question, but it is directed to a false issue. The withdrawal of object-Libido into the Ego is certainly not pathogenic; it is true that it occurs every night before sleep can ensue, and that the process is reversed upon awakening. The protoplasmic animalcule draws in its protrusions and sends them out again at the next opportunity. But it is quite a different matter when a definite, very forcible process compels the withdrawal of the Libido from its objects. The Libido that has then become narcissistic can no longer find its way back to its objects, and this obstruction in the way of the free movement of the Libido certainly does prove pathogenic. It seems that an accumulation of narcissistic Libido over and above a certain level becomes intolerable. We might well imagine that it was this that first led to the investment of objects, that the Ego was obliged to send forth its Libido in order not to fall ill of an excessive accumulation of it. If it were part of our scheme to go more particularly into the disorder of dementia præcox I would show you that the process which detaches the Libido from its objects and blocks the way back to them again is closely allied to the process of repression, and is to be regarded as a counterpart of it. In any case you would recognize familiar ground under your feet when you found that the preliminary conditions giving rise to these processes are almost identical, so far as we know at present, with those of repression. The conflict seems to be the same and to be conducted between the same forces. Since the outcome is so different from that of hysteria, for instance, the reason can only lie in some difference in the disposition. The weak point in the Libido-development in these patients is found at a different phase of the development; the decisive fixation which, as you will remember, enables the process of symptom-formation to break out is at another point, probably at the stage of primary narcissism, to which dementia præcox finally returns. It is most remarkable that for all the narcissistic neuroses we have to assume fixation-points of the Libido at very much earlier phases of development than those found in hysteria or the obsessional neurosis. You have heard, however, that the concepts we have elicited from the study of the transference neuroses also suffice to show us our bearings in the narcissistic neuroses, which are in practice so much more severe. There is a very wide community between them; fundamentally they are phenomena of a single class. You may imagine how hopeless a task it is for anyone to attempt to explain these disorders (which properly belong to psychiatry) without being first equipped with the analytic knowledge of the transference neuroses.

The picture formed by the symptoms of dementia præcox, incidentally a very variable one, is not determined exclusively by the symptoms arising from the forcing of the Libido back from the objects and the accumulation of it as narcissism in the Ego. Other phenomena occupy a large part of the field, and may be traced to the efforts made by the Libido to reach its objects again, which correspond therefore to attempts at restitution and recovery. These are in fact the conspicuous, clamorous symptoms; they exhibit a marked similarity to those of hysteria, or more rarely of the obsessional neurosis; they are nevertheless different in every respect. It seems that in dementia præcox the efforts of the Libido to get back to its objects, that is, to the mental idea of its objects, do really succeed in conjuring up something of them, something that at the same time is only the shadow of them—namely, the verbal images, the words, attached to them. This is not the place to discuss this matter further, but in my opinion this reversed procedure on the part of the Libido gives us an insight into what constitutes the real difference between a conscious and an unconscious idea.

This has now brought us into the field where the next advances in analytic work are to be expected. Since the time when we resolved upon our formulation of the conception of Ego-Libido, the narcissistic neuroses have become accessible to us; the task before us was to find the dynamic factors in these disorders, and at the same time to amplify our knowledge of mental life by a comprehension of the Ego. The psychology of the Ego, at which we are aiming, cannot be founded upon data provided by our own self-perceptions; it must be based, as is that of the Libido, upon analysis of the disturbances and disintegrations of the Ego. We shall probably think very little of our present knowledge of the fate of the Libido, gained from the study of the transference neuroses, when that further, greater work has been achieved. But as yet we have not got very far towards it. The narcissistic neuroses can hardly be approached at all by the method which has availed for the transference neuroses; you shall soon hear why this is. With these patients it always happens that after one has penetrated a little way one comes up against a stone wall which cannot be surmounted. You know that in the transference neuroses, too, barriers of resistance of this kind are met with, but that it is possible bit by bit to pull them down. In the narcissistic neuroses the resistance is insuperable; at the most we can satisfy our curiosity by craning our necks for a glimpse or two at what is going on over the wall. Our technique will therefore have to be replaced by other methods; at present we do not know whether we shall succeed in finding a substitute. There is no lack of material with these patients; they bring forward a great deal, although not in answer to our questions; at present all we can do is to interpret what they say in the light of the understanding gained from the study of the transference neuroses. The agreement between the two forms of disease goes far enough to ensure us a satisfactory start with them. How much we shall be able to achieve by this method remains to be seen.

There are other difficulties, besides this, in the way of our progress. The narcissistic disorders and the psychoses related to them can only be unriddled by observers trained in the analytic study of the transference neuroses. But our psychiatrists do not study psycho-analysis and we psycho-analysts see too little of psychiatric cases. We shall have to develop a breed of psychiatrists who have gone through the training of psycho-analysis as a preparatory science. A beginning in this direction is being made in America, where several of the leading psychiatrists lecture on psycho-analytic doctrines to their students, and where medical superintendents of institutions and asylums endeavour to observe their patients in the light of this theory. But all the same it has sometimes been possible for us here to take a peep over the wall of narcissism, so I will now proceed to tell you what we think we have discovered in this way.

The disease of paranoia, a chronic form of systematic insanity, has a very uncertain position in the attempts at classification made by present-day psychiatry. There is no doubt, however, that it is closely related to dementia præcox; I have in fact proposed that they should both be included under the common designation of _paraphrenia_. The forms taken by paranoia are described according to the content of the delusion, e.g. delusions of grandeur, of persecution, of jealousy, of being loved (erotomania), etc. We do not expect attempts at explanation from psychiatry; as an example, an antiquated and not very fair example, I grant, I will tell you the attempt which was made to derive one of these symptoms from another, by means of a piece of intellectual rationalization: The patient who has a primary tendency to believe himself persecuted draws from this the conclusion that he must necessarily be a very important person and therefore develops a delusion of grandeur. According to our analytic conception, the delusion of grandeur is the direct consequence of the inflation of the Ego by the Libido withdrawn from the investment of objects, a secondary narcissism ensuing as a return of the original early infantile form. In the case of delusions of persecution, however, we observed things which led us to follow up a certain clue. In the first place we noticed that in the great majority of cases the persecuting person was of the same sex as the persecuted one; this was capable of a harmless explanation, it is true, but in certain cases which were closely studied it appeared that the person of the same sex who had been most beloved while the patient was normal became the persecutor after the disease broke out. A further development of this becomes possible through the well-known paths of association by which a loved person may be replaced by someone else, e.g. the father by masters or persons in authority. From these observations, which were continually corroborated, we drew the conclusion that persecutory paranoia is the means by which a person defends himself against a homosexual impulse which has become too powerful. The conversion of the affectionate feeling into the hate which, as is well-known, can seriously endanger the life of the loved and hated object then corresponds to the conversion of libidinal impulses into anxiety, which is a regular result of the process of repression. As an illustration I will quote the last case I had of this type. A young doctor had to be sent away from the place where he lived because he had threatened the life of the son of a university professor there who had previously been his greatest friend. He imputed superhuman power and the most devilish intentions to this friend; he was to blame for all the misfortunes which had occurred in recent years to the family of the patient and for all his ill-luck in public and in private. This was not enough, however; the wicked friend and his father, the professor, had caused the war and brought the Russians over the border; he had ruined his life in a thousand ways; our patient was convinced that the death of this criminal would be the end of all evil in the world. And yet his old love for him was still so strong that it had paralysed his hand when he had an opportunity of shooting his enemy at sight. In the short conversation which I had with the patient it came to light that this intimate friendship between the two men went right back to their school-days; on at least one occasion it had passed beyond the boundaries of friendship, a night spent together had been the occasion of complete sexual intercourse. The patient had never developed any of the feeling towards women that would have been natural at his age with his attractive personality. He had been engaged to a handsome, well-connected girl, but she had broken off the engagement because her lover was so cold. Years after, his disease broke out at the very moment when he had for the first time succeeded in giving full sexual gratification to a woman; as she encircled him in her arms in gratitude and devotion he suddenly felt a mysterious stab of pain running like a sharp knife round the crown of his head. Afterwards he described the sensation as being like that of the incision made at a post-mortem to bare the brain; and as his friend was a pathological anatomist he slowly came to the conclusion that he alone could have sent him this woman as a temptation. Then his eyes began to be opened about the other persecutions of which he had been the victim by the machinations of his former friend.

But how about those cases in which the persecutor is of a different sex from that of the persecuted one, and which appear therefore to contradict our explanation of this disease as a defence against homosexual Libido? Some time ago I had an opportunity of examining a case of the kind, and behind the apparent contradiction I was able to elicit a confirmation. A young girl imagined herself persecuted by a man with whom she had twice had intimate relations; actually she had first of all cherished the delusion against a woman who could be recognized to be a mother-substitute. Not until after the second meeting with him did she make the advance of transferring the delusional idea from the woman to the man; so that in this case also the condition that the sex of the persecutor is the same as that of the victim originally held good also. In her complaint to the lawyer and the doctor the patient had not mentioned the previous phase of her delusion and this gave rise to an apparent contradiction of our theory of paranoia.

The homosexual choice of object is originally more closely related to narcissism than the heterosexual; hence, when a strong unwelcome homosexual excitation suffers repudiation, the way back to narcissism is especially easy to find. I have so far had very little opportunity in these lectures of speaking about the fundamental plan on which the course of the love-impulse during life is based, so far as we know it; nor can I supplement it now. I will only select this to tell you: that the choice of object, the step forward in the development of the Libido which comes after the narcissistic stage, can proceed according to two types. These are: either _the narcissistic type_, according to which, in place of the Ego itself, someone as nearly as possible resembling it is adopted as an object; or _the anaclitic type_ (_Anlehnungstypus_)[53] in which those persons who became prized on account of the satisfactions they rendered to the primal needs in life are chosen as objects by the Libido also. A strong Libido-fixation on the narcissistic type of object-choice is also found as a trait in the disposition of manifest homosexuals.

You will remember that in the first lecture given this session I described to you a case of delusional jealousy in a woman. Now that we have so nearly reached the end you will certainly want to know how we account for a delusion psycho-analytically. I have less to say about it than you would expect, however. The inaccessibility of delusions to logical arguments and to actual experience is to be explained, as it is with obsessions, by the connection they bear to the unconscious material which is both expressed by, and held in check by, the delusion or the obsession. The differences between the two are based on the topographical and dynamic differences in the two affections.

As with paranoia, so also with melancholia (under which, by the way, very different clinical types are classified), it has been possible to obtain a glimpse into the inner structure of the disorder. We have perceived that the self-reproaches with which these sufferers torment themselves so mercilessly actually relate to another person, to the sexual object they have lost or whom they have ceased to value on account of some fault. From this we concluded that the melancholic has indeed withdrawn his Libido from the object, but that by a process which we must call ‘narcissistic identification’ he has set up the object within the Ego itself, projected it on to the Ego. I can only give you a descriptive representation of this process, and not one expressed in terms of topography and dynamics. The Ego itself is then treated as though it were the abandoned object; it suffers all the revengeful and aggressive treatment which is designed for the object. The suicidal impulses of melancholics also become more intelligible on the supposition that the bitterness felt by the diseased mind concerns the Ego itself at the same time as, and equally with, the loved and hated object. In melancholia, as in the other narcissistic disorders, a feature of the emotional life which, after Bleuler, we are accustomed to call _ambivalence_ comes markedly to the fore; by this we mean a directing of antithetical feelings (affectionate and hostile) towards the same person. It is unfortunate that I have not been able to say more about ambivalence in these lectures.

There is also, besides the narcissistic, an hysterical form of identification which has long been known to us. I wish it were possible to make the differences between them clear to you in a few definite statements. I can tell you something of the periodic and cyclic forms of melancholia which will interest you. It is possible in favourable circumstances—I have twice achieved it—to prevent the recurrence of the condition, or of its antithesis, by analytic treatment during the lucid intervals between the attacks. One learns from this that in melancholia and mania as well as other conditions a special kind of solution of a conflict is going on, which in all its pre-requisites agrees with those of the other neuroses. You may imagine how much there remains for psycho-analysis to do in this field.

I also told you that by analysis of the narcissistic disorders we hoped to gain some knowledge of the composition of the Ego and of its structure out of various faculties and elements. We have made a beginning towards this at one point. From analysis of the delusion of observation we have come to the conclusion that in the Ego there exists a faculty that incessantly watches, criticizes, and compares, and in this way is set against the other part of the Ego. In our opinion, therefore, the patient reveals a truth which has not been appreciated as such when he complains that at every step he is spied upon and observed, that his every thought is known and examined. He has erred only in attributing this disagreeable power to something outside himself and foreign to him; he perceives within his Ego the rule of a faculty which measures his actual Ego and all his activities by an _Ego-ideal_, which he has created for himself in the course of his development. We also infer that he created this ideal for the purpose of recovering thereby the self-satisfaction bound up with the primary infantile narcissism, which since those days has suffered so many shocks and mortifications. We recognize in this self-criticizing faculty the Ego-censorship, the ‘conscience’; it is the same censorship as that exercised at night upon dreams, from which the repressions against inadmissible wish-excitations proceed. When this faculty disintegrates in the delusion of being observed, we are able to detect its origin and that it arose out of the influence of parents and those who trained the child, together with his social surroundings, by a process of identification with certain of these persons who were taken as a model.

These are some of the results yielded by the application of psycho-analysis to the narcissistic disorders. They are still not very numerous, and many of them still lack that sharpness of outline which cannot be achieved in a new field until some degree of familiarity has been attained. All of them have been made possible by employing the conception of Ego-Libido, or narcissistic Libido, by means of which we can extend the conclusions established for the transference neuroses on to the narcissistic neuroses. But now you will put the question whether it is possible for us to bring all the disorders of the narcissistic neuroses and of the psychoses into the range of the Libido-theory, for us to find the libidinal factor in mental life always and everywhere responsible for the development of disease, and for us never to have to attribute any part in the causation to the same alteration in the functions of the self-preservative instincts. Well now, it seems to me that decision on this point is not very urgent, and above all that the time is not yet ripe for us to make it; we may leave it calmly to be decided by advance in the work of science. I should not be astonished if it should prove that the capacity to induce a pathogenic effect were actually a prerogative of the libidinal impulses, so that the theory of the Libido would triumph all along the line from the actual neuroses to the severest psychotic form of individual derangement. For we know it to be characteristic of the Libido that it refuses to subordinate itself to reality in life, to Necessity. But I consider it extremely probable that the Ego-instincts are involved secondarily and that disturbances in their functions may be necessitated by the pathogenic affections of the Libido. Nor can I see that the direction taken by our investigations will be invalidated if we should have to recognize that in severe psychosis the Ego-instincts themselves are primarily deranged; the future will decide—for you, at least.

Let me return for a moment to anxiety, in order to throw light upon the one obscure point we left there. We said that the relation between anxiety and Libido, otherwise so well defined, is with difficulty harmonized with the almost indisputable assumption that real anxiety in the face of danger is the expression of the self-preservative instincts. But how if the anxiety-affect is provided, not by self-interest on the part of the Ego-instincts, but by the Ego-Libido? The condition of anxiety is after all invariably detrimental; its disadvantage becomes conspicuous when it reaches an intense degree. It then interferes with the action that alone would be expedient and would serve the purposes of self-preservation, whether it be flight or self-defence. Therefore if we ascribe the affective component of real anxiety to the Ego-Libido, and the action undertaken to the Ego-preservative instincts, every theoretical difficulty will be overcome. You will hardly maintain seriously that we run away _because_ we perceive fear? No, we perceive fear _and_ we take to flight, out of the common impulse that is roused by the perception of danger. Men who have survived experiences of imminent danger to life tell us that they did not perceive any fear, that they simply acted—for instance, pointed their gun at the oncoming beast—which was undoubtedly the best thing they could do.

TWENTY-SEVENTH LECTURE
TRANSFERENCE

Now that we are coming to the end of our discussions you will feel a certain expectation which must not be allowed to mislead you. You are probably thinking that I surely have not led you through all these complicated mazes of psycho-analysis only to dismiss you at the end without a word about the therapy, upon which after all the possibility of undertaking psycho-analytic work depends. As a matter of fact I could not possibly leave out this aspect of it; for some of the phenomena belonging to it will teach you a new fact, without knowledge of which you would be quite unable to assimilate properly your understanding of the diseases we have been studying.

I know you do not expect directions in the technique of practising analysis for therapeutic purposes; you only want to know in a general way by what means the psycho-analytic therapy works and to gain a general idea of what it accomplishes. And you have an undeniable right to learn this; nevertheless I am not going to tell you—I am going to insist upon your finding it out for yourselves.

Think for a moment! You have already learnt everything essential, from the conditions by which illness is provoked to all the factors which take effect within the diseased mind. Where is the opening in all this for therapeutic influence? First of all there is the hereditary disposition,—we do not often mention it because it is so strongly emphasized in other quarters and we have nothing new to say about it. But do not suppose that we underestimate it; as practitioners we are well aware of its power. In any event we can do nothing to change it; for us also it is a fixed datum in the problem, which sets a limit to our efforts. Next, there is the influence of the experiences of early childhood, which we are accustomed in analysis to rank as very important; they belong to the past, we cannot undo them. Then there is all that unhappiness in life which we have included under ‘privation in reality,’ from which all the absence of love in life proceeds—namely, poverty, family strife, mistaken choice in marriage, unfavourable social conditions, and the severity of the demands by which moral convention oppresses the individual. There is indeed a wide opening for a very effective treatment in all this; but it would have to follow the course of the dispensations of Kaiser Joseph in the Viennese legend—the benevolent despotism of a potentate before whose will men bow and difficulties disappear! But who are we that we can exert such beneficence as a therapeutic measure? Poor as we are and without influence socially, with our living to earn by our medical practice, we are not even in a position to extend our efforts to penniless folk, as other physicians with other methods can do; our treatment takes too much time and labour for that. But perhaps you are still clinging on to one of the factors put forward, and believe you see an opening for our influence there. If the conventional restrictions imposed by society have had a part in the privations forced upon the patient, the treatment could give him the courage and even directly advise him to defy these obstacles, and to seize satisfactions and health for himself at the cost of failing to achieve an ideal which, though highly esteemed, is after all often set at naught by the world. Health is to be won by “free living,” then. There would be this blot upon analysis, to be sure, that it would not be serving general morality; what it gave to the individual it would take from the rest of the world.

But now, who has given you such a false impression of analysis? It is out of the question that part of the analytic treatment should consist of advice to “live freely”—if for no other reason because we ourselves tell you that a stubborn conflict is going on in the patient between libidinal desires and sexual repression, between sensual and ascetic tendencies. This conflict is not resolved by helping one side to win a victory over the other. It is true we see that in neurotics asceticism has gained the day; the result of which is that the suppressed sexual impulses have found a vent for themselves in the symptoms. If we were to make victory possible to the sensual side instead, the disregarded forces repressing sexuality would have to indemnify themselves by symptoms. Neither of these measures will succeed in ending the inner conflict; one side in either event will remain unsatisfied. There are but few cases in which the conflict is so unstable that a factor like medical advice can have any effect upon it, and these cases do not really require analytic treatment. People who can be so easily influenced by physicians would have found their own way to that solution without this influence. After all, you know that a young man living in abstinence who makes up his mind to illicit sexual intercourse, or an unsatisfied wife who seeks compensation with a lover, does not as a rule wait for the permission of a physician, still less of an analyst, to do so.

In considering this question people usually overlook the essential point of the whole difficulty—namely, that the pathogenic conflict in a neurotic must not be confounded with a normal struggle between conflicting impulses all of which are in the same mental field. It is a battle between two forces of which one has succeeded in coming to the level of the preconscious and conscious part of the mind, while the other has been confined on the unconscious level. That is why the conflict can never have a final outcome one way or the other; the antagonists meet each other as little as the whale and the polar bear in the well-known story. An effective decision can be reached only when they confront each other on the same ground. And, in my opinion, to accomplish this is the sole task of the treatment.

Besides this, I can assure you that you are quite misinformed if you imagine that advice and guidance concerning conduct in life forms an integral part of the analytic method. On the contrary, so far as possible we refrain from playing the part of mentor; we want nothing better than that the patient should find his own solutions for himself. To this end we expect him to postpone all vital decisions affecting his life, such as choice of career, business enterprises, marriage or divorce, during treatment and to execute them only after it has been completed. Now confess that you had imagined something very different. Only with certain very young or quite helpless and defenceless persons is it impossible to keep within such strict limitations as we should wish. With them we have to combine the positions of physician and educator; we are then well aware of our responsibility and act with the necessary caution.

You must not be led away by my eagerness to defend myself against the accusation that in analytic treatment neurotics are encouraged to “live a free life” and conclude from it that we influence them in favour of conventional morality. That is at least as far removed from our purpose as the other. We are not reformers, it is true; we are merely observers; but we cannot avoid observing with critical eyes, and we have found it impossible to give our support to conventional sexual morality or to approve highly of the means by which society attempts to arrange the practical problems of sexuality in life. We can demonstrate with ease that what the world calls its code of morals demands more sacrifices than it is worth, and that its behaviour is neither dictated by honesty nor instituted with wisdom. We do not absolve our patients from listening to these criticisms; we accustom them to an unprejudiced consideration of sexual matters like all other matters; and if after they have become independent by the effect of the treatment they choose some intermediate course between unrestrained sexual licence and unconditional asceticism, our conscience is not burdened whatever the outcome. We say to ourselves that anyone who has successfully undergone the training of learning and recognizing the truth about himself is henceforth strengthened against the dangers of immorality, even if his standard of morality should in some respect deviate from the common one. Incidentally, we must beware of overestimating the importance of abstinence in affecting neurosis; only a minority of pathogenic situations due to privation and the subsequent accumulation of Libido thereby induced can be relieved by the kind of sexual intercourse that is procurable without any difficulty.

So you cannot explain the therapeutic effect of psycho-analysis by supposing that it permits patients free sexual indulgence; you must look round for something else. I think that one of the remarks I made while I was disposing of this conjecture on your part will have put you on the right track. Probably it is the substitution of something conscious for something unconscious, the transformation of the unconscious thoughts into conscious thoughts, that makes our work effective. You are right; that is exactly what it is. By extending the unconscious into consciousness the repressions are raised, the conditions of symptom-formation are abolished, and the pathogenic conflict exchanged for a normal one which must be decided one way or the other. We do nothing for our patients but enable this one mental change to take place in them; the extent to which it is achieved is the extent of the benefit we do them. Where there is no repression or mental process analogous to it to be undone there is nothing for our therapy to do.

The aim of our efforts may be expressed in various formulas—making conscious the unconscious, removing the repressions, filling in the gaps in memory; they all amount to the same thing. But perhaps you are dissatisfied with this declaration; you imagined the recovery of a nervous person rather differently, that after he had been subjected to the laborious process of psycho-analysis he would emerge a different person altogether, and then you hear that the whole thing only amounts to his having a little less that is unconscious and a little more that is conscious in him than before. Well, you probably do not appreciate the importance of an inner change of this kind. A neurotic who has been cured has really become a different person, although at bottom of course he remains the same—that is, he has become his best self, what he would have been under the most favourable conditions. That, however, is a great deal. Then when you hear of all that has to be done, of the tremendous exertion required to carry out this apparently trifling change in his mental life, the significance attached to these differences between the various mental levels will appear more comprehensible to you.

I will digress a moment to enquire whether you know what ‘a causal therapy’ means? This name is given to a procedure which puts aside the manifestations of a disease and looks for a point of attack in order to eradicate the cause of the illness. Now is psycho-analysis a causal therapy or not? The answer is not a simple one, but it may give us an opportunity to convince ourselves of the futility of such questions. In so far as psycho-analytic therapy does not aim immediately at removing the symptoms it is conducted like a causal therapy. In other respects you may say it is not, for we have followed the causal chain back far beyond the repressions to the instinctive predispositions, their relative intensity in the constitution, and the aberrations in the course of their development. Now suppose that it were possible by some chemical means to affect this mental machinery, to increase or decrease the amount of Libido available at any given moment, or to reinforce the strength of one impulse at the expense of another—that would be a causal therapy in the literal sense, and our analysis would be the indispensable preliminary work of reconnoitring the ground. As you know, there is at present no question of any such influence upon the processes of the Libido; our mental therapy makes its attack at another point in the concatenation, not quite at the place where we perceive the manifestations to be rooted, but yet comparatively far behind the symptoms themselves, at a place which becomes accessible to us in very remarkable circumstances.

What then have we to do in order to bring what is unconscious in the patient into consciousness? At one time we thought that would be very simple; all we need do would be to identify this unconscious matter and then tell the patient what it was. However, we know already that that was a short-sighted mistake. Our knowledge of what is unconscious in him is not equivalent to his knowledge of it; when we tell him what we know he does not assimilate it _in place of_ his own unconscious thoughts, but _alongside_ of them, and very little has been changed. We have rather to regard this unconscious material topographically; we have to look for it in his memory at the actual spot where the repression of it originally ensued. This repression must be removed, and then the substitution of conscious thought for unconscious thought can be effected straightaway. How is a repression such as this to be removed? Our work enters upon a second phase here; first, the discovery of the repression, and then the removal of the resistance which maintains this repression.