Introductory lectures on psycho-analysis

The best-known productions of phantasy have already been met by us; they are called day-dreams, and are imaginary gratifications of ambitious, grandiose, erotic wishes, dilating the more extravagantly the more reality admonishes humility and patience. In them is shown unmistakably the essence of imaginary happiness, the return of gratification to a condition in which it is independent of reality’s sanction. We know that these day-dreams are the kernels and models of night-dreams; fundamentally the night-dream is nothing but a day-dream distorted by the nocturnal form of mental activity and made possible by the nocturnal freedom of instinctive excitations. We are already familiar with the idea that a day-dream is not necessarily conscious, that unconscious day-dreams also exist; such unconscious day-dreams are therefore just as much the source of night-dreams as of neurotic symptoms.

The significance of phantasy for symptom-formation will become clear to you in what follows. We said that under privation the Libido regressively invests the positions it had left, but to which nevertheless some portions of its energy had remained attached. We shall not retract or correct this statement, but we shall have to interpolate a connecting-link in it. How does the Libido find its way back to these fixation-points? Now the objects and channels which have been forsaken by the Libido have not been forsaken in every sense; they, or their derivatives, are still retained to some degree of intensity in the conceptions of phantasy. The Libido has only to withdraw on to the phantasies in order to find the way open to it back to all the repressed fixations. These phantasies had enjoyed a certain sort of toleration; no conflict between them and the Ego had developed, however sharp an opposition there was between them, as long as a certain condition was preserved—a condition of a quantitative nature, now disturbed by the return of the Libido-stream on to the phantasies. By this accession, the investment of the phantasies with energy becomes so much augmented that they become assertive and begin to press towards realization; then, however, conflict between them and the Ego becomes unavoidable. Although previously they were preconscious or conscious, now they are subject to repression from the side of the Ego and are exposed to the attraction exerted from the side of the Unconscious. The Libido travels from the phantasies, now unconscious, to their sources in the Unconscious—back to its own fixation-points again.

The return of the Libido on to phantasy is an intermediate step on the way to symptom-formation which well deserves a special designation. C. G. Jung has coined for it the very appropriate name of INTROVERSION, but inappropriately he uses it also to describe other things. We will adhere to the position that introversion describes the deflection of the Libido away from the possibilities of real satisfaction and its excessive accumulation upon phantasies previously tolerated as harmless. An introverted person is not yet neurotic, but he is in an unstable condition; the next disturbance of the shifting forces will cause symptoms to develop, unless he can yet find other outlets for his pent-up Libido. The unreal character of neurotic satisfaction and the disregard of the difference between phantasy and reality are already determined by the delay at this stage of introversion.

You will doubtless have noticed that in these last remarks I have introduced a new factor into the concatenation of the ætiological chain—namely, the quantity, the magnitude of the energies concerned; we must always take this factor into account as well. A purely qualitative analysis of the ætiological conditions does not suffice; or, to put it in another way, a purely dynamic conception of these processes is insufficient, the economic aspect is also required. We have to realize that the conflict between the two forces in opposition does not break out until a certain intensity in the degree of investment is reached, even though the substantive conditions have long been in existence. In the same way, the pathogenic significance of the constitutional factor is determined by the preponderance of one of the component-instincts in excess over another in the disposition; it is even possible to conceive disposition as qualitatively the same in all men and only differentiated by this quantitative factor. No less important is this quantitative factor for the capacity to withstand neurotic illness; it depends upon the amount of undischarged Libido that a person can hold freely suspended, and upon how large a portion of it he can deflect from the sexual to a non-sexual goal in sublimation. The final aim of mental activity, which can be qualitatively described as a striving towards pleasure and avoidance of pain, is represented economically in the task of mastering the distribution of the quantities of excitation (stimulus-masses) present in the mental apparatus, and in preventing the accumulation of them which gives rise to pain.

I set out to tell you as much as this about symptom-formation in the neuroses. Yes, but I must not neglect to mention once more that everything said to-day relates only to symptom-formation in hysteria. Even the obsessional neurosis shows great differences, although the essentials are the same. The ‘counter-charges’ from the Ego against the demands made by instincts for satisfaction, mentioned already in connection with hysteria, are more strongly marked in the obsessional neurosis and govern the clinical picture in the form of what we call ‘reaction-formations.’ Similar and more extensive deviations still are found in the other neuroses, in which field researches into the mechanisms of symptom-formation are not yet complete in any direction.

Before you leave to-day I should like to direct your attention for a moment to a side of phantasy-life of very general interest. There is, in fact, a path from phantasy back again to reality, and that is—art. The artist has also an introverted disposition and has not far to go to become neurotic. He is one who is urged on by instinctive needs which are too clamorous; he longs to attain to honour, power, riches, fame, and the love of women; but he lacks the means of achieving these gratifications. So, like any other with an unsatisfied longing, he turns away from reality and transfers all his interest, and all his Libido too, on to the creation of his wishes in the life of phantasy, from which the way might readily lead to neurosis. There must be many factors in combination to prevent this becoming the whole outcome of his development; it is well known how often artists in particular suffer from partial inhibition of their capacities through neurosis. Probably their constitution is endowed with a powerful capacity for sublimation and with a certain flexibility in the repressions determining the conflict. But the way back to reality is found by the artist thus: He is not the only one who has a life of phantasy; the intermediate world of phantasy is sanctioned by general human consent, and every hungry soul looks to it for comfort and consolation. But to those who are not artists the gratification that can be drawn from the springs of phantasy is very limited; their inexorable repressions prevent the enjoyment of all but the meagre day-dreams which can become conscious. A true artist has more at his disposal. First of all he understands how to elaborate his day-dreams, so that they lose that personal note which grates upon strange ears and become enjoyable to others; he knows too how to modify them sufficiently so that their origin in prohibited sources is not easily detected. Further, he possesses the mysterious ability to mould his particular material until it expresses the ideas of his phantasy faithfully; and then he knows how to attach to this reflection of his phantasy-life so strong a stream of pleasure that, for a time at least, the repressions are out-balanced and dispelled by it. When he can do all this, he opens out to others the way back to the comfort and consolation of their own unconscious sources of pleasure, and so reaps their gratitude and admiration; then he has won—through his phantasy—what before he could only win in phantasy: honour, power, and the love of women.

After such a difficult piece of work as we got through in our last lecture I shall leave the subject for a time and turn to my audience.

For I know that you are dissatisfied. You imagined that Introductory Lectures on Psycho-Analysis would be something quite different. You expected illustrations from life instead of theories; you will tell me that the story of the two children, on the ground-floor and in the mansion, revealed something of the causation of neurosis to you, except that it ought to have been an actual fact instead of an invention of my own. Or you will say that, when at the beginning I described two symptoms to you (not also imaginary, let us hope), and unfolded the solution of them and their connection with the lives of the patients, it threw some light on the meaning of symptoms, and you had hoped I would continue in the same way. Instead of doing so I gave you long-drawn-out and very obscure theories which were never complete, and to which I was constantly adding something; I dealt with conceptions which I had not yet introduced to you; I let go of descriptive explanation and took up the dynamic aspect and dropped this again for a so-called economic one; made it difficult for you to understand how many of these technical terms mean the same thing and are only exchanged for one another on account of euphony; I let vast conceptions, such as those of the pleasure and reality principles, and the inherited residue of phylogenetic development, appear, and then instead of explaining anything to you I let them drift away before your eyes out of sight.

Why did I not begin the introduction to the study of the neuroses with what you all know of nervousness, a thing that has long roused your interest, or with the peculiar nature of nervous persons, their incomprehensible reactions to human intercourse and external influences, their excitability, their unreliability, and their inability to do well in anything? Why not lead you step by step from an explanation of the simple everyday forms of nervousness to the problems of the enigmatic extreme manifestations?

Indeed, I cannot deny any of this or say that you are wrong. I am not so much in love with my powers of presentation as to imagine that every blemish in it is a peculiar charm. I think myself that I might with advantage to you have proceeded differently, and, indeed, such was my intention. But one cannot always carry through a reasoned scheme; something in the material itself often intervenes and takes possession of one and turns one from one’s first intentions. Even such an ordinary task as the arrangement of familiar material is not entirely subject to the author’s will; it comes out in its own way and one can but wonder afterwards why it happened so and not otherwise.

One of the reasons probably is that my theme, an introduction to psycho-analysis, no longer covers this section dealing with the subject of the neuroses. The introduction to psycho-analysis lies in the study of errors and of dreams; the theory of neurosis is psycho-analysis itself. I do not think that in such a short time I could have given you any knowledge of the material contained in the theory of the neuroses except in this very concentrated form. It was a matter of presenting to you in their proper context the sense and meaning of symptoms, together with the external and internal conditions and mechanisms of symptom-formation. This I attempted to do; it is more or less the core of what psycho-analysis is able to offer to-day. In conjunction with it there was much to be said about the Libido and its development, and something about that of the Ego. You were already prepared by the preliminary lectures for the main principles of our method and for the broad aspects involved in the conceptions of the Unconscious and of repression (resistance). In one of the following lectures you will learn at what point the work of psycho-analysis finds its organic continuation. So far I have not concealed from you that all our results proceed from the study of one single group only of nervous disorders—namely, the transference neuroses; and even so I have traced out the mechanism of symptom-formation only in the hysterical neurosis. Though you will probably have gained no very thorough knowledge and have not retained every detail, yet I hope that you have acquired a general idea of the means with which psycho-analysis works, the problems it has to deal with, and the results it has to offer.

I have ascribed to you a wish that I had begun the subject of the neuroses with a description of the neurotic’s behaviour, and of the ways in which he suffers from his disorder, protects himself against it, and adapts himself to it. This is certainly a very interesting subject, well worth studying, and not difficult to treat; nevertheless there are reasons against beginning with this aspect. The danger is that the Unconscious will be overlooked, the great importance of the Libido ignored, and that everything will be judged as it appears to the patient’s own Ego. Now it is obvious that his Ego is not a reliable and impartial authority. The Ego is after all the force which denies the existence of the Unconscious and has subjected it to repressions; how then can we trust its good faith where the Unconscious is concerned? That which has been repressed consists first and foremost of the repudiated claims of the sexuality; it is perfectly self-evident that we shall never learn their extent and their significance from the Ego’s view of the matter. As soon as the nature of repression begins to dawn upon us we are advised not to allow one of the two contending parties, and certainly not the victorious one, to be judge in the dispute. We are forewarned against being misled by what the Ego tells us. According to its evidence it would appear to have been the active force throughout, so that the symptoms arise by its will and agency; we know that to a large extent it has played a passive part, a fact which it then endeavours to conceal and to gloss over. It is true that it cannot always keep up this pretence—in the symptoms of the obsessional neurosis it has to confess to being confronted by something alien which it must strenuously resist.

It is certainly plain sailing enough for anyone who does not heed these warnings against taking the falsifications of the Ego at their face-value; he will escape all the opposition which psycho-analysis has to encounter in accentuating the Unconscious, sexuality, and the passivity of the Ego. He can agree with Alfred Adler that the “nervous character” is the cause of the neurosis, instead of the result; but he will not be in a position to account for a single detail of symptom-formation or a single dream.

You will ask: May it not be possible to do justice to the part played by the Ego in nervousness and in symptom-formation without absolutely glaring neglect of the other factors discovered by psycho-analysis? I reply: Certainly it must be possible, and some time or other it will be done; but the work which lies at hand for psycho-analysis is not suited for a beginning at this end. One can, no doubt, predict the point at which this task also will be included. There are neuroses, called by us the narcissistic neuroses, in which the Ego is far more deeply involved than in those we have studied; analytic investigation of these disorders will enable us to estimate impartially and reliably the share taken by the Ego in neurotic disease.

One of the relations the Ego bears to its neurosis is, however, so conspicuous that it was quite appreciable from the beginning. It never seems to be absent; but it is most clearly discernible in a form of disorder which we are far from understanding, the traumatic neurosis. You must know that in the causation and mechanism of all the various different forms of neurosis the same factors are found at work over and over again, only that in one type this factor and in another type that factor is of greatest significance in symptom-formation. It is just the same as with the personnel of a theatrical company, where every member plays a special type of part—hero, confidant, villain, etc; each of them will choose a different piece for his own benefit-performance. Hence, the phantasies which are transformed into the symptoms are nowhere so manifest as in hysteria; the ‘counter-charges’ or reaction-formations of the Ego dominate the picture in the obsessional neurosis; the mechanism which in dreams we called ‘secondary elaboration’ is the prominent feature in the delusions of paranoia, and so on.

In the traumatic neuroses, especially in those arising from the terrors of war, we are particularly impressed by a self-seeking, egoistic motive, a straining towards protection and self-interest; this alone perhaps could not produce the disease, but it gives its support to the latter and maintains it once it has been formed. This tendency aims at protecting the Ego from the dangers which led by their imminence to the outbreak of illness; nor does it permit of recovery until a repetition of the dangers appear to be no longer possible, or until some gain in compensation for the danger undergone has been received.

The Ego takes a similar interest in the origin and maintenance of all the other forms of neurosis; we have said already that the symptom is supported by the Ego because one side of it offers a satisfaction to the repressing Ego-tendency. More than this, a solution of the conflict by a symptom-formation is the most convenient one, most in accordance with the pleasure-principle; for it undoubtedly spares the Ego a severe and painful piece of internal labour. There are indeed cases in which the physician himself must admit that the solution of a conflict by a neurosis is the one most harmless and most tolerable socially. Do not be astonished to hear then that the physician himself occasionally takes sides with the illness which he is attacking. It is not for him to confine himself in all situations in life to the part of fanatic about health; he knows that there is other misery in the world besides neurotic misery—real unavoidable suffering—that necessity may even demand of a man that he sacrifice his health to it, and he learns that such suffering in one individual may often avert incalculable hardship for many others. Therefore, although it may be said of every neurotic that he has taken ‘flight into illness,’ it must be admitted that in many cases this flight is fully justified, and the physician who has perceived this state of things will silently and considerately retire.

But let us continue our discussion without regard to these exceptional cases. In the ordinary way it is apparent that by flight into neurosis the Ego gains a certain internal ‘advantage through illness,’ as we call it; under certain conditions a tangible external advantage, more or less valuable in reality, may be combined with this. To take the commonest case of this kind: a woman who is brutally treated and mercilessly exploited by her husband fairly regularly takes refuge in a neurosis, if her disposition admits of it. This will happen if she is too cowardly or too conventional to console herself secretly with another man, if she is not strong enough to defy all external reasons against it and separate from her husband, if she has no prospect of being able to maintain herself or of finding a better husband, and last of all, if she is still strongly attached sexually to this brutal man. Her illness becomes her weapon in the struggle against him, one that she can use for her protection, or misuse for purposes of revenge. She can complain of her illness, though she probably dare not complain of her marriage; her doctor is her ally; the husband who is otherwise so ruthless is required to spare her, to spend money on her, to grant her absence from home and thus some freedom from marital oppression. Whenever this external or ‘accidental’ advantage through illness is at all pronounced, and no substitute for it can be found in reality, you need not look forward very hopefully to influencing the neurosis by your therapy.

You will now say that what I have just told you about the ‘advantage through illness’ is all in favour of the view I have rejected, namely, that the Ego itself desires the neurosis and creates it. But just a moment! Perhaps it means merely this: that the Ego is pleased to accept the neurosis which it is in any case unable to prevent, and that if there is anything at all to be made out of it it makes the best of it. This is only one side of the matter. In so far as there is advantage in it the Ego is quite happy to be on good terms with a neurosis, but there are also disadvantages to be considered. As a rule it is soon apparent that by accepting a neurosis the Ego has made a bad bargain. It has paid too heavily for the solution of the conflict; the sufferings entailed by the symptoms are perhaps as bad as those of the conflict they replace, and they may quite probably be very much worse. The Ego wishes to be rid of the pain of the symptoms, but not to give up its advantage through illness; and that is just what it cannot succeed in doing. It appears therefore that the Ego was not quite so actively concerned in the matter throughout as it had thought, and we will keep this well in mind.

If, as physicians, you have much to do with neurotics, you will soon cease to expect that those who complain most bitterly of their illness will be most ready to accept your help and make least difficulty—quite the contrary. You will at all events easily understand that everything which contributes to the advantage through illness reinforces the resistance arising from the repressions, and increases the therapeutic difficulties. And there is yet another kind of advantage through illness, one which supervenes later than that born with the symptom, so to speak. When such a mental organization as the disease has persisted for a considerable time it seems finally to acquire the character of an independent entity; it displays something like a self-preservative instinct; it forms a kind of pact, a modus vivendi, with the other forces in mental life, even with those fundamentally hostile to it, and opportunities can hardly fail to arise in which it once more manifests itself as useful and expedient, thus acquiring a secondary function which again strengthens its position. Instead of taking an example from pathology let us consider a striking illustration in everyday life. A capable working-man earning his living is crippled by an accident in the course of his employment; he can work no more, but he gets a small periodical dole in compensation and learns how to exploit his mutilation as a beggar. His new life, although so inferior, nevertheless is supported by the very thing which destroyed his old life; if you were to remove his disability you would deprive him for a time of his means of subsistence, for the question would arise whether he would still be capable of resuming his former work. When a secondary exploitation of the illness such as this is formed in a neurosis we can range it alongside the first and call it a ‘secondary advantage through illness.’

I should like to advise you in a general way not to underestimate the practical importance of the advantage through illness, and yet not to be too much impressed by its theoretical significance. Apart from the exceptions previously recognized, this factor always reminds one of the illustrations of “Intelligence in Animals” by Oberländer in Fliegende Blätter. An Arab is riding a camel along a narrow path cut in the side of a steep mountain. At a turn in the path he suddenly finds himself confronted by a lion ready to spring at him. There is no escape; on one side the abyss, on the other the precipice; retreat and flight are impossible; he gives himself up for lost. Not so the camel. He takes one leap with his rider into the abyss—and the lion is left a spectator. The remedies provided by neurosis avail the patient no better as a rule; perhaps because the solution of the conflict by a symptom-formation is after all an automatic process which may show itself inadequate to meet the demands of life, and involves man in a renunciation of his best and highest powers. The more honourable choice, if there be a choice, is to go down in fair fight with destiny.

I still owe you a further explanation of my motive in not taking ordinary nervousness as my starting-point. Perhaps you think I avoided doing so because it would have been more difficult to bring in evidence of the sexual origin of the neuroses in that way; but in this you would be mistaken. In the transference neuroses the symptoms have to be submitted to interpretation before we arrive at this; but in the ordinary forms of what are called the ACTUAL NEUROSES the ætiological significance of the sexual life is a crudely obvious fact which courts notice. I became aware of it more than twenty years ago, as one day I began to wonder why, when we examine nervous patients, we so invariably exclude from consideration all matters concerning their sexual life. Investigations on this point led to the sacrifice of my popularity with my patients, but in a very short time my efforts had brought me to this conclusion: that no neurosis—actual neurosis, I meant—is present where sexual life is normal. It is true that this statement ignores the individual differences in people rather too much, and it also suffers from the indefinite connotation inseparable from the word “normal”; but as a broad outline it has retained its value to this day. At that time I got so far as to be able to establish particular connections between certain forms of nervousness and certain injurious sexual conditions; I do not doubt that I could repeat these observations to-day if I still had similar material for investigation. I noticed often enough that a man who contented himself with some kind of incomplete sexual satisfaction, e.g. with manual masturbation, would suffer from a definite type of actual neurosis, and that this neurosis would promptly give way to another form if he adopted some other equally unsatisfactory form of sexual life. I was then in a position to infer the change in his mode of sexual life from the alteration in the patient’s condition; and I learnt to abide stubbornly by my conclusions until I had overcome the prevarications of my patients and had compelled them to give me confirmation. It is true that they then thought it advisable to seek other physicians who would not take so much interest in their sexual life.

It did not escape me at that time either that sexuality was not always indicated as the cause of a neurosis; one person certainly would fall ill because of some injurious sexual condition, but another because he had lost his fortune or recently sustained a severe organic illness. The explanation of these variations was revealed later, when insight was obtained into the interrelationships suspected between the Ego and the Libido; and the further this subject was explored the more satisfactory became our insight into it. A person only falls ill of a neurosis when the Ego loses its capacity to deal in some way or other with the Libido. The stronger the Ego the more easily can it accomplish this task; every weakening of the Ego, from whatever cause, must have the same effect as an increase in the demands of the Libido; that is, make a neurosis possible. There are yet other and more intimate relations between the Ego and the Libido, which I shall not go into now as we have not yet come to them in the course of our discussions. The most essential and most instructive point for us is that the fund of energy supporting the symptoms of a neurosis, in every case and regardless of the circumstances inducing their outbreak, is provided by the Libido, which is thus put to an abnormal use.

Now I must point out to you the decisive difference between the symptoms of the actual neuroses and those of the psychoneuroses, with the first group of which (the transference neuroses) we have hitherto been so much occupied. In both the actual neuroses and the psychoneuroses the symptoms proceed from the Libido; that is, they are abnormal ways of using it, substitutes for satisfaction of it. But the symptoms of an actual neurosis—headache, sensation of pain, an irritable condition of some organ, the weakening or inhibition of some function—have no ‘meaning,’ no signification in the mind. Not merely are they manifested principally in the body, as also happens, for instance with hysterical symptoms, but they are in themselves purely and simply physical processes; they arise without any of the complicated mental mechanisms we have been learning about. They really are, therefore, what psychoneurotic symptoms were for so long held to be. But then, how can they be expressions of the Libido which we have come to know as a force at work in the mind? Now, really, the answer to that is very simple. Let me resurrect one of the very first objections ever made against psycho-analysis. It was said that the theories were an attempt to account for neurotic symptoms by psychology alone and that the outlook was consequently hopeless, since no illness could ever be accounted for by psychological theories. These critics were pleased to forget that the sexual function is not a purely mental thing, any more than it is merely a physical thing. It affects bodily life as well as mental life. Having learnt that the symptoms of the psychoneuroses express the mental consequences of some disturbance in this function, we shall not be surprised to find that the actual neuroses represent the direct somatic consequences of sexual disturbances.

Clinical medicine gives us a useful hint (recognized by many different investigators) towards comprehension of the actual neuroses. In the details of their symptomatology, and also in the peculiarity by which all the bodily systems and functions are affected together, they exhibit an unmistakable similarity with pathological conditions resulting from the chronic effect or the sudden removal of foreign toxins—i.e. with states of intoxication or of abstinence. The two groups of affections are brought still closer together by comparison with conditions like Basedow’s disease^[49] that have also been found to result from poisoning, not, however, from poisons derived externally, but from such as arise in the internal metabolism. In my opinion these analogies necessitate our regarding the neuroses as the effects of disturbances in the sexual metabolism, due either to more of these sexual toxins being produced than the person can dispose of, or else to internal and even mental conditions which interfere with the proper disposal of these substances. Assumptions of this kind about the nature of sexual desire have found acceptance in the mind of the people since the beginning of time; love is called an “intoxication,” it can be induced by “potions”—in these ideas the agency at work is to some extent projected on to the outer world. We find occasion at this point to remember the erotogenic zones, and to reflect upon the proposition that sexual excitation may arise in the most various organs. Beyond this the subject of ‘sexual metabolism’ or the ‘chemistry of sexuality’ is an empty chapter: we know nothing about it, and cannot even determine whether to assume two kinds of sexual substances, to be called ‘male’ and ‘female,’ or to content ourselves with one sexual toxin as the agent of all the stimuli effected by the Libido. The edifice of psycho-analytic doctrine which we have erected is in reality but a superstructure, which will have to be set on its organic foundation at some time or other; but this foundation is still unknown to us.

As a science psycho-analysis is characterized by the methods with which it works, not by the subject-matter with which it deals. These methods can be applied without violating their essential nature to the history of civilization, to the science of religion, and to mythology as well as to the study of the neuroses. Psycho-Analysis aims at and achieves nothing more than the discovery of the unconscious in mental life. The problems of the actual neuroses, in which the symptoms probably arise through direct toxic injury, offer no point of attack for psycho-analysis; it can supply little towards elucidation of them and must leave this task to biological and medical research. Now perhaps you understand better why I chose this arrangement of my material. If I had intended an Introduction to the Study of the Neuroses it would undoubtedly have been correct to begin with the simple forms of (actual) neuroses and proceed from them to the more complicated psychical disorders resulting from disturbances of the Libido. I should have had to collect from various quarters what we know or think we know about the former, and about the latter psycho-analysis would have been introduced as the most important technical means of obtaining insight into these conditions. An Introduction to Psycho-Analysis was what I had undertaken and announced, however; I thought it more important to give you an idea of psycho-analysis than to teach you something about the neuroses; and therefore the actual neuroses which yield nothing towards the study of psycho-analysis could not suitably be put in the foreground. I think too that my choice was the wiser for you, since the radical axioms and far-reaching connections of psycho-analysis make it worthy of every educated person’s interest; the theory of the neuroses, however, is a chapter of medicine like any other.

However, you are justified in expecting that we should take some interest in the actual neuroses; their close clinical connection with the psychoneuroses even necessitates this. I will tell you then that we distinguish three pure forms of actual neurosis: neurasthenia, anxiety-neurosis and hypochondria. Even this classification has been disputed; the terms are certainly all in use, but their connotation is vague and unsettled. There are some medical men who are opposed to all discrimination in the confusing world of neurotic manifestations, who object to any distinguishing of clinical entities or types of disease, and do not even recognize the difference between actual neuroses and psychoneuroses; in my opinion they go too far, and the direction they have chosen does not lead to progress. The three kinds of neurosis named above are occasionally found in a pure form; more frequently, it is true, they are combined with one another and with a psychoneurotic affection. This fact need not make us abandon the distinctions between them. Think of the difference between the science of minerals and that of ores in mineralogy: the minerals are classified individually, in part no doubt because they are frequently found as crystals, sharply differentiated from their surroundings; the ores consist of mixtures of minerals which have indeed coalesced, not accidentally, but according to the conditions at their formation. In the theory of the neuroses we still understand too little of the process of their development to formulate anything similar to our knowledge of ores; but we are certainly working in the right direction in first isolating from the mass the recognizable clinical elements, which are comparable to the individual minerals.

A noteworthy connection between the symptoms of the actual neuroses and the psychoneuroses adds a valuable contribution to our knowledge of symptom-formation in the latter; the symptom of the actual neurosis is frequently the nucleus and incipient stage of the psychoneurotic symptom. A connection of this kind is most clearly observable between neurasthenia and the transference neurosis known as conversion-hysteria, between the anxiety-neurosis and anxiety-hysteria, but also between hypochondria and forms of a neurosis which we shall deal with later on, namely, paraphrenia (dementia præcox and paranoia). As an example, let us take an hysterical headache or backache. Analysis shows that by means of condensation and displacement it has become a substitutive satisfaction for a whole series of libidinal phantasies or memories; at one time, however, this pain was real, a direct symptom of a sexual toxin, the bodily expression of a sexual excitation. We do not by any means maintain that all hysterical symptoms have a nucleus of this kind, but it remains true that this very often is so, and that all effects (whether normal or pathological) of the libidinal excitation upon the body are specially adapted to serve the purposes of hysterical symptom-formation. They play the part of the grain of sand which the oyster envelopes in mother-of-pearl. The temporary signs of sexual excitation accompanying the sexual act serve the psychoneurosis in the same way, as the most suitable and convenient material for symptom-formation.

There is a similar process of special diagnostic and therapeutic interest. In persons who are disposed to be neurotic without having yet developed a neurosis on a grand scale, some morbid organic condition—perhaps an inflammation, or an injury—very commonly sets the work of symptom-formation in motion; so that the latter process swiftly seizes upon the symptom supplied by reality, and uses it to represent those unconscious phantasies that have only been lying in wait for some means of expression. In such a case the physician will try first one therapy and then the other; will either endeavour to abolish the organic foundation on which the symptom rests, without troubling about the clamorous neurotic elaboration of it; or will attack the neurosis which this opportunity has brought to birth, while leaving on one side the organic stimulus which incited it. Sometimes one and sometimes the other procedure will be found justified by success; no general rules can be prescribed for mixed cases of this kind.

You will certainly have judged the information that I gave you in the last lecture about ordinary nervousness as the most fragmentary and most inadequate of all my accounts. I know that it was; and I expect that nothing surprised you more than that I made no mention of the ‘anxiety’ which most nervous people complain of and themselves describe as their most terrible burden. Anxiety or dread can really develop tremendous intensity and in consequence be the cause of the maddest precautions. But in this matter at least I wished not to cut you short; on the contrary, I had determined to put the problem of nervous anxiety to you as clearly as possible and to discuss it at some length.

Anxiety (or dread)^[50] itself needs no description; everyone has personally experienced this sensation, or to speak more correctly this affective condition, at some time or other. But in my opinion not enough serious consideration has been given to the question why nervous persons in particular suffer from anxiety so much more intensely, and so much more altogether, than others. Perhaps it has been taken for granted that they should; indeed, the words “nervous” and “anxious” are used interchangeably, as if they meant the same thing. This is not justifiable, however; there are anxious people who are otherwise not in any way nervous and there are, besides, neurotics with numerous symptoms who exhibit no tendency to dread.

However this may be, one thing is certain, that the problem of anxiety is a nodal point, linking up all kinds of most important questions; a riddle, of which the solution must cast a flood of light upon our whole mental life. I do not claim that I can give you a complete solution; but you will certainly expect psycho-analysis to have attacked this problem too in a different manner from that adopted by academic medicine. Interest there centres upon the anatomical processes by which the anxiety condition comes about. We learn that the medulla oblongata is stimulated, and the patient is told that he is suffering from a neurosis in the vagal nerve. The medulla oblongata is a wondrous and beauteous object; I well remember how much time and labour I devoted to the study of it years ago. But to-day I must say I know of nothing less important for the psychological comprehension of anxiety than a knowledge of the nerve-paths by which the excitations travel.

One may consider anxiety for a long time without giving a thought to nervousness. You will understand me at once when I describe this form of anxiety as Real Anxiety, in contrast to neurotic anxiety. Now real anxiety or dread appears to us a very natural and rational thing; we should call it a reaction to the perception of an external danger, of an injury which is expected and foreseen; it is bound up with the reflex of flight, and may be regarded as an expression of the instinct of self-preservation. The occasions of it, i.e. the objects and situations about which anxiety is felt, will obviously depend to a great extent upon the state of the person’s knowledge and feeling of power regarding the outer world. It seems to us quite natural that a savage should be afraid of a cannon or of an eclipse of the sun, while a white man who can handle the weapon and foretell the phenomenon remains unafraid in the same situation. At other times it is knowledge itself which inspires fear, because it reveals the danger sooner; thus a savage will recoil with terror at the sight of a track in the jungle which conveys nothing to an ignorant white man, but means that some wild beast is near at hand; and an experienced sailor will perceive with dread a little cloud on the horizon because it means an approaching hurricane, while to a passenger it looks quite insignificant.

The view that real anxiety is rational and expedient, however, will on deeper consideration be admitted to need thorough revision. In face of imminent danger the only expedient behaviour, actually, would be first a cool appraisement of the forces at disposal as compared with the magnitude of the danger at hand, and then a decision whether flight or defence, or possibly attack, offered the best prospect of a successful outcome. Dread, however, has no place in this scheme; everything to be done will be accomplished as well and probably better if dread does not develop. You will see too that when dread is excessive it becomes in the highest degree inexpedient; it paralyses every action, even that of flight. The reaction to danger usually consists in a combination of the two things, the fear-affect and the defensive action; the frightened animal is afraid and flees, but the expedient element in this is the ‘flight,’ not the ‘being afraid.’

One is tempted therefore to assert that the development of anxiety is never expedient; perhaps a closer dissection of the situation in dread will give us a better insight into it. The first thing about it is the ‘readiness’ for danger, which expresses itself in heightened sensorial perception and in motor tension. This expectant readiness is obviously advantageous; indeed, absence of it may be responsible for grave results. It is then followed on the one hand by a motor action, taking the form primarily of flight and, on a higher level, of defensive action; and on the other hand by the condition we call a sensation of ‘anxiety’ or dread. The more the development of dread is limited to a flash, to a mere signal, the less does it hinder the transition from the state of anxious readiness to that of action, and the more expediently does the whole course of events proceed. The anxious readiness therefore seems to me the expedient element, and the development of anxiety the inexpedient element, in what we call anxiety or dread.

I shall not enter upon a discussion whether the words anxiety, fear, fright, mean the same or different things in common usage. In my opinion, anxiety relates to the condition and ignores the object, whereas in the word fear attention is directed to the object; fright does actually seem to possess a special meaning—namely, it relates specifically to the condition induced when danger is unexpectedly encountered without previous anxious readiness. It might be said then that anxiety is a protection against fright.

It will not have escaped you that a certain ambiguity and indefiniteness exists in the use of the word ‘anxiety.’ It is generally understood to mean the subjective condition arising upon the perception of what we have called ‘developed’ anxiety; such a condition is called an affect. Now what is an affect, in a dynamic sense? It is certainly something very complex. An affect comprises first of all certain motor innervations or discharges; and, secondly, certain sensations, which moreover are of two kinds—namely, the perceptions of the motor actions which have been performed, and the directly pleasurable or painful sensations which give the affect what we call its dominant note. But I do not think that this description penetrates to the essence of an affect. With certain affects one seems to be able to see deeper, and to recognize that the core of it, binding the whole complex structure together, is of the nature of a repetition of some particular very significant previous experience. This experience could only have been an exceedingly early impression of a universal type, to be found in the previous history of the species rather than of the individual. In order to be better understood I might say that an affective state is constructed like an hysterical attack, i.e. is the precipitate of a reminiscence. An hysterical attack is therefore comparable to a newly-formed individual affect, and the normal affect to a universal hysteria which has become a heritage.

Do not imagine that what I am telling you now about affects is the common property of normal psychology. On the contrary, these conceptions have grown on the soil of psycho-analysis and are only indigenous there. What psychology has to say about affects—the James-Lange theory, for instance—is utterly incomprehensible to us psycho-analysts and impossible for us to discuss. We do not however regard what we know of affects as at all final; it is a first attempt to take our bearings in this obscure region. To continue, then: we believe we know what this early impression is which is reproduced as a repetition in the anxiety-affect. We think it is the experience of birth—an experience which involves just such a concatenation of painful feelings, of discharges of excitation, and of bodily sensations, as to have become a prototype for all occasions on which life is endangered, ever after to be reproduced again in us as the dread or ‘anxiety’ condition. The enormous increase in stimulation effected by the interruption of the renewal of blood (the internal respiration) was the cause of the anxiety experience at birth—the first anxiety was therefore toxically induced. The name Angst (anxiety)—angustiæ, Enge, a narrow place, a strait—accentuates the characteristic tightening in the breathing which was then the consequence of a real situation and is subsequently repeated almost invariably with an affect. It is very suggestive too that the first anxiety state arose on the occasion of the separation from the mother. We naturally believe that the disposition to reproduce this first anxiety condition has become so deeply ingrained in the organism, through countless generations, that no single individual can escape the anxiety affect; even though, like the legendary Macduff, he ‘was from his mother’s womb untimely ripped’ and so did not himself experience the act of birth. What the prototype of the anxiety condition may be for other animals than mammals we cannot say; neither do we know what the complex of sensations in them is which is equivalent to fear in us.

It may perhaps interest you to know how it was possible to arrive at such an idea as this—that birth is the source and prototype of the anxiety affect. Speculation had least of all to do with it; on the contrary, I borrowed a thought from the naïve intuitive mind of the people. Many years ago a number of young house-physicians, including myself, were sitting round a dinner-table, and one of the assistants at the obstetrical clinic was telling us all the funny stories of the last midwives’ examination. One of the candidates was asked what it meant when the meconium (child’s excreta) was present in the waters at birth, and promptly replied: “That the child is frightened.” She was ridiculed and failed. But I silently took her part and began to suspect that the poor unsophisticated woman’s unerring perception had revealed a very important connection.

Now let us turn to neurotic anxiety; what are the special manifestations and conditions found in the anxiety of nervous persons? There is a great deal to be described here. First of all, we find a general apprehensiveness in them, a ‘free-floating’ anxiety, as we call it, ready to attach itself to any thought which is at all appropriate, affecting judgements, inducing expectations, lying in wait for any opportunity to find a justification for itself. We call this condition ‘expectant dread’ or ‘anxious expectation.’ People who are tormented with this kind of anxiety always anticipate the worst of all possible outcomes, interpret every chance happening as an evil omen, and exploit every uncertainty to mean the worst. The tendency to this kind of expectation of evil is found as a character-trait in many people who cannot be described as ill in any other way, and we call them ‘overanxious’ or pessimistic; but a marked degree of expectant dread is an invariable accompaniment of the nervous disorder which I have called anxiety-neurosis and include among the actual neuroses.

In contrast to this type of anxiety, a second form of it is found to be much more circumscribed in the mind, and attached to definite objects and situations. This is the anxiety of the extraordinarily various and often very peculiar phobias. Stanley Hall, the distinguished American psychologist, has recently taken the trouble to designate a whole series of these phobias by gorgeous Greek titles; they sound like the ten plagues of Egypt, except that there are far more than ten of them. Just listen to the things that can become the object or content of a phobia: darkness, open air, open spaces, cats, spiders, caterpillars, snakes, mice, thunder, sharp points, blood, enclosed places, crowds, loneliness, crossing bridges, travelling by land or sea, and so on. As a first attempt to take one’s bearings in this chaos we may divide them into three groups. Many of the objects and situations feared are rather sinister, even to us normal people, they have some connection with danger; and these phobias are not entirely incomprehensible to us, although their intensity seems very much exaggerated. Most of us, for instance, have a feeling of repulsion upon encountering a snake. It may be said that the snake-phobia is universal in mankind. Charles Darwin has described most vividly how he could not control his dread of a snake that darted at him, although he knew that he was protected from it by a thick plate of glass. The second group consists of situations that still have some relation to danger, but to one that is usually belittled or not emphasized by us; most situation-phobias belong to this group. We know that there is more chance of meeting with a disaster in a railway train than at home—namely, a collision; we also know that a ship may sink, whereupon it is usual to be drowned; but we do not brood upon these dangers and we travel without anxiety by train and boat. Nor can it be denied that if a bridge were to break at the moment we were crossing it we should be hurled into the torrent, but that only happens so very occasionally that it is not a danger worth considering. Solitude too has its dangers, which in certain circumstances we avoid, but there is no question of never being able to endure it for a moment under any conditions. The same thing applies to crowds, enclosed spaces, thunderstorms, and so on. What is foreign to us in these phobias is not so much their content as their intensity. The anxiety accompanying a phobia is positively indescribable! And we sometimes get the impression that neurotics are not really at all fearful of those things which can, under certain conditions, arouse anxiety in us and which they call by the same names.

There remains a third group which is entirely unintelligible to us. When a strong full-grown man is afraid to cross a street or square in his own so familiar town, or when a healthy well-developed woman becomes almost senseless with fear because a cat has brushed against her dress or a mouse has scurried through the room, how can we see the connection with danger which is obviously present to these people? With this kind of animal-phobia it is no question of an increased intensity of common human antipathies; to prove the contrary, there are numbers of people who, for instance, cannot pass a cat without attracting and petting it. A mouse is a thing that so many women are afraid of, and yet it is at the same time a very favourite pet name;^[51] many a girl who is delighted to be called so by her lover will scream with terror at the sight of the dainty little creature itself. The behaviour of the man who is afraid to cross streets and squares only suggests one thing to us—that he behaves like a little child. A child is directly taught that such situations are dangerous, and the man’s anxiety too is allayed when he is led by someone across the open space.

The two forms of anxiety described, the ‘free-floating’ expectant dread and that attached to phobias, are independent of each other. The one is not the other at a further stage; they are only rarely combined, and then as if fortuitously. The most intense general apprehensiveness does not necessarily lead to a phobia; people who have been hampered all their lives by agoraphobia may be quite free from pessimistic expectant dread. Many phobias, e.g. fear of open spaces, of railway travelling, are demonstrably acquired first in later life; others, such as fear of darkness, thunder, animals, seem to have existed from the beginning. The former signify serious illness, the latter are more of the nature of idiosyncrasies, peculiarities; anyone exhibiting one of these latter may be suspected of harbouring others similar to it. I must add that we group all these phobias under anxiety-hysteria, that is, we regard them as closely allied to the well-known disorder called conversion-hysteria.

The third form taken by neurotic anxiety brings us to an enigma; there is no visible connection at all between the anxiety and the danger dreaded. This anxiety occurs in hysteria, for instance, accompanying the hysterical symptoms; or under various conditions of excitement in which, it is true, we should expect some affect to be displayed, but least of all an anxiety-affect; or without reference to any conditions, incomprehensible both to us and to the patient, an unrelated anxiety-attack. We may look far and wide without discovering a danger or an occasion which could even be exaggerated to account for it. These spontaneous attacks show therefore that the complex condition which we describe as anxiety can be split up into components. The whole attack can be represented (as a substitute) by a single intensively developed symptom—shuddering, faintness, palpitation of the heart, inability to breathe—and the general feeling which we recognize as anxiety may be absent or may have become unnoticeable. And yet these states which are termed ‘anxiety-equivalents’ have the same clinical and ætiological validity as anxiety itself.

Two questions arise now: Is it possible to bring neurotic anxiety, in which such a small part or none at all is played by danger, into relation with ‘real anxiety,’ which is essentially a reaction to danger? And, how is neurotic anxiety to be understood? We will at present hold fast to the expectation that where there is anxiety there must be something of which one is afraid.

Clinical observation yields various clues to the comprehension of neurotic anxiety, and I will now discuss their significance with you.

(a) It is not difficult to see that expectant dread or general apprehensiveness stands in intimate relation to certain processes in the sexual life—let us say, to certain modes of Libido-utilization. The simplest and most instructive case of this kind arises in people who expose themselves to what is called frustrated excitation, i.e. when a powerful sexual excitation experiences insufficient discharge and is not carried on to a satisfying termination. This occurs, for instance, in men during the time of an engagement to marry, and in women whose husbands are not sufficiently potent, or who perform the sexual act too rapidly or incompletely with a view to preventing conception. Under these conditions the libidinal excitation disappears and anxiety appears in place of it, both in the form of expectant dread and in that of attacks and anxiety-equivalents. The precautionary measure of coitus interruptus, when practised as a customary sexual régime, is so regularly the cause of anxiety-neurosis in men, and even more so in women, that medical practitioners would be wise to enquire first of all into the possibility of such an ætiology in all such cases. Innumerable examples show that the anxiety-neurosis vanishes when the sexual malpractice is given up.

So far as I know, the fact that a connection exists between sexual restraint and anxiety conditions is no longer disputed, even by physicians who hold aloof from psycho-analysis. Nevertheless I can well imagine that they do not neglect to invert the connection, and to put forward the view that such persons are predisposed to apprehensiveness and consequently practise caution in sexual matters. Against this, however, decisive evidence is found in the reactions in women, in whom the sexual function is essentially passive, so that its course is determined by the treatment accorded by the man. The more ‘temperament,’ i.e. the more inclination for sexual intercourse and capacity for satisfaction, a woman has, the more certainly will she react with anxiety manifestations to the man’s impotence or to coitus interruptus; whereas such abuse entails far less serious results with anæsthetic women or those in whom the sexual hunger is less strong.

Sexual abstinence, which is nowadays so warmly recommended by physicians, of course only has the same significance for anxiety conditions when the Libido which is denied a satisfactory outlet is correspondingly insistent, and is not being utilized to a large extent in sublimation. Whether or not illness will ensue is indeed always a matter of the quantitative factor. Even apart from illness, it is easy to see in the sphere of character-formation that sexual restraint goes hand in hand with a certain anxiousness and cautiousness, whereas fearlessness and a boldly adventurous spirit bring with them a free tolerance of sexual needs. However these relations may be altered and complicated by the manifold influences of civilization, it remains incontestible that for the average human being anxiety is closely connected with sexual limitation.

I have by no means told you all the observations which point to this genetic connection between Libido and anxiety. There is, for instance, the effect upon anxiety states of certain periods of life, such as puberty and the menopause, in which the production of Libido is considerably augmented. In many states of excitement too, the mingling of sexual excitation with anxiety may be directly observed, as well as the final replacement of the libidinal excitation by anxiety. The impression received from all this is a double one; first, that it is a matter of an accumulation of Libido, debarred from its normal utilization; and secondly, that the question is one of somatic processes only. How anxiety develops out of sexual desire is at present obscure; we can only ascertain that desire is lacking and anxiety is found in its place.

(b) A second clue is obtained from analysis of the psychoneuroses, in particular, of hysteria. We have heard that anxiety frequently accompanies the symptoms in this disease, and that unattached anxiety may also be chronically present or come to expression in attacks. The patients cannot say what it is they fear; they link it up by unmistakable secondary elaboration to the most convenient phobias: of dying, of going mad, of having a stroke, etc. When we subject to analysis the situation in which the anxiety, or the symptom accompanied by anxiety, arose, we can as a rule discover what normal mental process has been checked in its course and replaced by a manifestation of anxiety. To express it differently: we construe the unconscious process as though it had not undergone repression and had gone through unhindered into consciousness. This process would have been accompanied by a particular affect and now we discover, to our astonishment, that this affect, which would normally accompany the mental process through into consciousness, is in every case replaced by anxiety, no matter what particular type it had previously been. So that when we have a hysterical anxiety condition before us, its unconscious correlative may be an excitation of a similar character, such as apprehension, shame, embarrassment; or quite as possibly a ‘positive’ libidinal excitation; or an antagonistic, aggressive one, such as rage or anger. Anxiety is thus general current coin for which all the affects are exchanged, or can be exchanged, when the corresponding ideational content is under repression.

(c) A third observation is provided by patients whose symptoms take the form of obsessive acts, and who seem to be remarkably immune from anxiety. When we restrain them from carrying out their obsessive performances, their washing, their ceremonies, etc., or when they themselves venture an attempt to abandon one of their compulsions, they are forced by an appalling dread to yield to the compulsion and to carry out the act. We perceive that the anxiety was concealed under the obsessive act and that this is only performed to escape the feeling of dread. In the obsessional neurosis, therefore, the anxiety which would otherwise ensue is replaced by the symptom-formation; and when we turn to hysteria we find a similar relation existing—as a consequence of the process of repression either a pure developed anxiety, or anxiety with symptom-formation, or, symptom-formation without anxiety. In an abstract sense, therefore, it seems correct to say that symptoms altogether are formed purely for the purpose of escaping the otherwise inevitable development of anxiety. Thus anxiety comes to the forefront of our interest in the problems of the neuroses.

We concluded from our observations on the anxiety-neurosis that the diversion of the Libido away from its normal form of utilization, a diversion which releases anxiety, took place on the basis of somatic processes. The analyses of hysterical and obsessional neuroses furnish the additional conclusion that a similar diversion with a similar result can follow from opposition on the part of psychical agents (Instanzen). We know as much as this, therefore, about the origin of neurotic anxiety; it still sounds rather indefinite. But for the moment I know of no path which will take us further. The second task we undertook, that of establishing a connection between neurotic anxiety (abnormally utilized Libido) and ‘real anxiety’ (which corresponds with the reaction to danger), seems even more difficult to accomplish. One would think there could be no comparison between the two things, and yet there are no means by which the sensations of neurotic anxiety can be distinguished from those of real anxiety.

The desired connection may be found with the help of the antithesis, so often put forward, between the Ego and the Libido. As we know, the development of anxiety is the reaction of the Ego to danger and the signal preparatory to flight; it is then not a great step to imagine that in neurotic anxiety also the Ego is attempting a flight, from the demands of its Libido, and is treating this internal danger as if it were an external one. Then our expectation, that where anxiety is present there must be something of which one is afraid, would be fulfilled. The analogy goes further than this, however. Just as the tension prompting the attempt to flee from external danger is resolved into holding one’s ground and taking appropriate defensive measures, so the development of neurotic anxiety yields to a symptom-formation, which enables the anxiety to be ‘bound.’

Our difficulty in comprehension now lies elsewhere. The anxiety which signifies the flight of the Ego from its Libido is nevertheless supposed to have had its source in that Libido. This is obscure, and we are warned not to forget that the Libido of a given person is fundamentally part of that person and cannot be contrasted with him as if it were something external. It is the question of the topographical dynamics of anxiety-development that is still obscure to us—what kind of mental energies are being expended and to what systems do they belong? I cannot promise you to answer this question also; but we will not neglect to follow up two other clues, and in so doing will again summon direct observation and analytic investigation to aid our speculation. We will turn to the sources of anxiety in children, and to the origin of the neurotic anxiety which is attached to phobias.

Apprehensiveness is very common among children, and it is difficult enough to decide whether it is real or neurotic anxiety. Indeed the very value of this distinction is called in question by the attitude of children themselves. For on the one hand we are not surprised that children are afraid of strangers, of strange objects and situations, and we account for this reaction to ourselves very easily by reflecting on their weakness and ignorance. Thus we ascribe to the child a strong tendency to real anxiety and should regard it as only practical if this apprehensiveness had been transmitted by inheritance. The child would only be repeating the behaviour of prehistoric man and of primitive man to-day who, in consequence of his ignorance and helplessness, experiences a dread of anything new and strange, and of much that is familiar to him, none of which any longer inspires fear in us. It would also correspond to our expectations if the phobias of children were at least in part such as might be attributed to those primeval periods of human development.

On the other hand, it cannot be overlooked that children are not all equally apprehensive, and that the very children who are more than usually timid in the face of all kinds of objects and situations are just those who later on become neurotic. The neurotic disposition is therefore betrayed, amongst other signs, by a marked tendency to real anxiety; apprehensiveness rather than nervousness appears to be primary; and we arrive at the conclusion that the child, and later the adult, experiences a dread of the strength of his Libido, simply because he is afraid of everything. The derivation of anxiety from the Libido itself would then be discarded; and investigation of the conditions of real anxiety would logically lead to the view that the consciousness of personal weakness and helplessness—inferiority, as A. Adler calls it—when it is able to maintain itself into later life is the final cause of neurosis.

This sounds so simple and plausible that it has a claim on our attention. It is true that it would involve shifting the point of view from which we regard the problem of nervousness. That such feelings of inferiority do persist into later life—together with a disposition to anxiety and symptom-formation—seems so well established that much more explanation is required when, in an exceptional case, what we call ‘health’ is the outcome. But what can be learnt from the close observation of apprehensiveness in children? The small child is first of all afraid of strange people; situations become important only on account of the people concerned in them, and objects always much later. But the child is not afraid of these strange people because he attributes evil intentions to them, comparing their strength with his weakness, and thus recognizing in them a danger to his existence, his safety, and his freedom from pain. Such a conception of a child, so suspicious and terrified of an overpowering aggressivity in the world, is a very poor sort of theoretical construction. On the contrary, the child starts back in fright from a strange figure because he is used to—and therefore expects—a beloved and familiar figure, primarily his mother. It is his disappointment and longing which are transformed into dread—his Libido, unable to be expended, and at that time not to be held suspended, is discharged through being converted into dread. It can hardly be a coincidence too that in this situation, which is the prototype of childish anxiety, the condition of the primary anxiety state during birth, a separation from the mother, is again reproduced.

The first phobias of situations in children concern darkness and loneliness; the former is often retained throughout life; common to both is the desire for the absent attendant, for the mother, therefore. I once heard a child who was afraid of the darkness call out: “Auntie, talk to me, I’m frightened.” “But what good will that do? You can’t see me;” to which the child replied: “If someone talks, it gets lighter.” The longing felt in the darkness is thus transformed into fear of the darkness. Far from finding that neurotic anxiety is only secondary and a special case of real anxiety, we see on the contrary that there is something in the small child which behaves like real anxiety and has an essential feature in common with neurotic anxiety—namely, origin in undischarged Libido. Of genuine ‘real anxiety’ the child seems to bring very little into the world. In all those situations which can become the conditions of phobias later, on heights, on narrow bridges over water, in trains and boats, the small child shows no fear—the less it knows the less it fears. It is much to be wished that it had inherited more of these life-preserving instincts; the task of looking after it and preventing it from exposing itself to one danger after another would have been very much lightened. Actually, you see, a child overestimates his powers, to begin with, and behaves without fear because he does not recognize dangers. He will run along the edge of the water, climb upon the window-sill, play with sharp things and with fire, in short, do anything that injures him and alarms his attendants. Since he cannot be allowed to learn it himself through bitter experience, it is entirely due to training that real anxiety does eventually awake in him.

Now if some children embrace this training in apprehensiveness very readily, and then find for themselves dangers which they have not been warned against, it is explicable on the ground that these children have inherently a greater amount of libidinal need in their constitution than others, or else that they have been spoiled early with libidinal gratifications. It is no wonder if those who later become nervous also belong to this type as children; we know that the most favourable circumstance for the development of a neurosis lies in the inability to tolerate a considerable degree of pent-up Libido for any length of time. You will observe now that here the constitutional factor, which we have never denied, comes into its own. We protest only when others emphasize it to the exclusion of all other claims, and when they introduce the constitutional factor even where according to the unanimous findings both of observation and of analysis, it does not belong, or only plays a minor part.

Let us sum up the conclusions drawn from the observation of apprehensiveness in children: Infantile dread has very little to do with real anxiety (dread of real danger), but is, on the other hand, closely allied to the neurotic anxiety of adults. It is derived like the latter from undischarged Libido, and it substitutes some other external object or some situation for the love-object which it misses.

Now you will be glad to hear that the analysis of phobias has little more to teach us than we have learnt already. The same thing happens in them as in the anxiety of children; Libido that cannot be discharged is continuously being converted into an apparently ‘real’ anxiety, and so an insignificant external danger is taken as a representative of what the Libido desires. The agreement between the two forms of anxiety is not surprising; for infantile phobias are not merely prototypes of those which appear later in anxiety-hysteria, but they are a direct preliminary condition and prelude of them. Every hysterical phobia can be traced back to a childish dread, of which it is a continuation, even if it has a different content and must be called by a different name. The difference between the two conditions lies in their mechanism. In order that the Libido should be converted into anxiety in the adult it is no longer sufficient that the Libido should be momentarily unable to be utilized. The adult has long since learned to maintain such Libido suspended, or to apply it in different ways. But, when the Libido is attached to a mental excitation which has undergone repression, conditions similar to those in the child, in whom there is not yet any distinction between conscious and unconscious, are re-established; and by a regression to the infantile phobia a bridge, so to speak, is provided by which the conversion of Libido into anxiety can be conveniently effected. As you will remember, we have treated repression at some length, but in so doing we have been concerned exclusively with the fate of the idea to be repressed; naturally, because this was easier to recognize and to present. But we have so far ignored the question of what happened to the affect attached to this idea, and now we learn for the first time that it is the immediate fate of the affect to be converted into anxiety, no matter what quality of affect it would otherwise have been had it run a normal course. This transformation of affect is, moreover, by far the more important effect of the process of repression. It is not so easy to present to you; for we cannot maintain the existence of unconscious affects in the same sense as that of unconscious ideas. An idea remains up to a point the same, whether it is conscious or unconscious; we can indicate something that corresponds to an unconscious idea. But an affect is a process involving a discharge of energy, and it is to be regarded quite differently from an idea; without searching examination and clarification of our hypotheses concerning mental processes, we cannot tell what corresponds with it in the Unconscious—and that cannot be undertaken here. However, we will preserve the impression we have gained, that the development of anxiety is closely connected with the unconscious system.