Introductory lectures on psycho-analysis

I said that conversion into anxiety, or better, discharge in the form of anxiety, was the immediate fate of Libido which encounters repression; I must add that it is not the only or the final fate of it. In the neuroses, processes take place which are intended to prevent the development of anxiety, and which succeed in so doing by various means. In the phobias, for instance, two stages in the neurotic process are clearly discernible. The first effects the repressions and conversion of the Libido into anxiety, which is then attached to some external danger. The second consists in building up all those precautions and safeguards by which all contact with this externalized danger shall be avoided. Repression is an attempt at flight on the part of the Ego from the Libido which it feels to be dangerous; the phobia may be compared to a fortification against the outer danger which now stands for the dreaded Libido. The weakness of this defensive system in the phobias is of course that the fortress which is so well guarded from without remains exposed to danger from within; projection externally of danger from Libido can never be a very successful measure. In the other neuroses, therefore, other defensive systems are employed against the possibility of the development of anxiety; this is a very interesting part of the psychology of the neuroses. Unfortunately it would take us too far afield and also it would require a thorough grounding in special knowledge of the subject. I will merely add this. I have already spoken of the ‘counter-charges’ that are instituted by the Ego upon repression, which must be maintained so that the repression can persist. It is the task of this counter-charge to carry out the various forms of defence against the development of anxiety after repression.

To return to the phobias: I may now hope that you realize how inadequate it is to attempt merely to explain their content, and to take no interest in them apart from their derivation—this or that object or situation which has been made into a phobia. The content of the phobia has an importance comparable to that of the manifest dream—it is a façade. With all due modifications, it is to be admitted that among the contents of the various phobias many are found which, as Stanley Hall points out, are specially suited by phylogenetic inheritance to become objects of dread. It is even in agreement with this that many of these dreaded things have no connection with danger, except through a symbolic relation to it.

Thus we are convinced of the quite central position which the problem of anxiety fills in the psychology of the neuroses. We have received a strong impression of how the development of anxiety is bound up with the fate of the Libido and with the unconscious system. There is only one unconnected thread, only one gap in our structure, the fact, which after all can hardly be disputed, that ‘real anxiety’ must be regarded as an expression of the Ego’s instinct for self-preservation.

We have repeatedly, and again quite recently, referred to the distinction between the sexual and the Ego-instincts. First of all, repression showed how they can oppose each other, how the sexual instincts are then apparently brought to submission, and required to procure their satisfaction by circuitous regressive paths, where in their impregnability they obtain compensation for their defeat. Then it appeared that from the outset they each have a different relation to the task-mistress Necessity, so that their developments are different and they acquire different attitudes to the reality-principle. Finally we believe we can observe that the sexual instincts are connected by much closer ties with the affective state of anxiety than are the Ego-instincts—a conclusion which in one important point only still seems incomplete. In support of it we may bring forward the further remarkable fact that want of satisfaction of hunger or thirst, the two most elemental of the self-preservative instincts, never results in conversion of them into anxiety, whereas the conversion of unsatisfied Libido into anxiety is, as we have heard, a very well-known and frequently-observed phenomenon.

Our justification for distinguishing between sexual and Ego-instincts can surely not be contested; it is indeed assumed by the existence of the sexual instinct as a special activity in the individual. The only question is what significance is to be attached to this distinction, how radical and decisive we intend to consider it. The answer to this depends upon what we can ascertain about the extent to which the sexual instincts, both in their bodily and their mental manifestations, conduct themselves differently from the other instincts which we set against them; and how important the results arising from these differences are found to be. We have of course no motive for maintaining any difference in the fundamental nature of the two groups of instincts, and, by the way, it would be difficult to apprehend any. They both present themselves to us merely as descriptions of the sources of energy in the individual, and the discussion whether fundamentally they are one, or essentially different, and if one, when they became separated from each other, cannot be carried through on the basis of these concepts alone, but must be grounded on the biological facts underlying them. At present we know too little about this, and even if we knew more it would not be relevant to the task of psycho-analysis.

We should clearly also profit very little by emphasizing the primordial unity of all the instincts, as Jung has done, and describing all the energies which flow from them as ‘Libido.’ We should then be compelled to speak of sexual and asexual Libido, since the sexual function is not to be eliminated from the field of mental life by any such device. The name Libido, however, remains properly reserved for the instinctive forces of the sexual life, as we have hitherto employed it.

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:—

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.

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.

How can this resistance be got rid of? In the same way: by finding it out and telling the patient about it. The resistance too arises in a repression, either from the very one which we are endeavouring to dispel, or in one that occurred earlier. It is set up by the counter-charge which rose up to repress the repellent impulse. So that we now do just the same as we were trying to do before; we interpret, identify, and inform the patient; but this time we are doing it at the right spot. The counter-charge or the resistance is not part of the Unconscious, but of the Ego which co-operates with us, and this is so, even if it is not actually conscious. We know that a difficulty arises here in the ambiguity of the word ‘unconscious,’ on the one hand, as a phenomenon, on the other hand, as a system. That sounds very obscure and difficult; but after all it is only a repetition of what we have said before, is it not? We have come to this point already long ago.—Well then, we expect that this resistance will be abandoned, and the counter-charge withdrawn, when we have made the recognition of them possible by our work of interpretation. What are the instinctive propelling forces at our disposal to make this possible? First, the patient’s desire for recovery, which impelled him to submit himself to the work in co-operation with us, and secondly, the aid of his intelligence which we reinforce by our interpretation. There is no doubt that it is easier for the patient to recognize the resistance with his intelligence, and to identify the idea in his Unconscious which corresponds to it, if we have first given him an idea which rouses his expectations in regard to it. If I say to you: “Look up at the sky and you will see a balloon,” you will find it much more quickly than if I merely tell you to look up and see whether you can see anything; a student who looks through a microscope for the first time is told by the instructor what he is to see; otherwise he sees nothing, although it is there and quite visible.

And now for the fact! In quite a number of the various forms of nervous illness, in the hysterias, anxiety conditions, obsessional neuroses, our hypothesis proves sound. By seeking out the repression in this way, discovering the resistances, indicating the repressed, it is actually possible to accomplish the task, to overcome the resistances, to break down the repression, and to change something unconscious into something conscious. As we do this we get a vivid impression of how, as each individual resistance is being mastered, a violent battle goes on in the soul of the patient—a normal mental struggle between two tendencies on the same ground, between the motives striving to maintain the counter-charge and those which are ready to abolish it. The first of these are the old motives which originally erected the repression; among the second are found new ones more recently acquired, which it is hoped will decide the conflict in our favour. We have succeeded in revivifying the old battle of the repression again, in bringing the issue, so long ago decided, up for revision again. The new contribution we make to it lies, first of all, in demonstrating that the original solution led to illness and in promising that a different one would pave the way to health, and secondly, in pointing out that the circumstances have all changed immensely since the time of that original repudiation of these impulses. Then, the Ego was weak, infantile, and perhaps had reason to shrink with horror from the claims of the Libido as being dangerous to it. To-day it is strong and experienced and moreover has a helper at hand in the physician. So we may expect to lead the revived conflict through to a better outcome than repression; and, as has been said, in hysteria, anxiety-neurosis, and the obsessional neurosis success in the main justifies our claims.

There are other forms of illness, however, with which our therapeutic treatment never is successful, in spite of the similarity of the conditions. In them also there was originally a conflict between Ego and Libido, leading to repression—although this conflict may be characterized by topographical differences from the conflict of the transference neuroses; in them too it is possible to trace out the point in the patient’s life at which the repressions occurred; we apply the same method, are ready to make the same assurances, offer the same assistance by telling the patient what to look out for; and here also the interval in time between the present and the point at which the repressions were established is all in favour of a better outcome of the conflict. And yet we cannot succeed in overcoming one resistance or in removing one of the repressions. These patients, paranoiacs, melancholics, and those suffering from dementia præcox, remain on the whole unaffected, proof against psycho-analytic treatment. What can be the cause of this? It is not due to lack of intelligence; a certain degree of intellectual capacity must naturally be stipulated for analysis, but there is no deficiency in this respect in, for instance, the very quick-witted deductive paranoiac. Nor are any of the other propelling forces regularly absent: melancholics, for instance, in contrast to paranoiacs, experience a very high degree of realization that they are ill and that their sufferings are due to this; but they are not on that account any more accessible to influence. In this we are confronted with a fact that we do not understand, and are therefore called upon to doubt whether we have really understood all the conditions of the success possible with the other neuroses.

When we keep to consideration of hysterical and obsessional neurotics we are very soon confronted with a second fact, for which we were quite unprepared. After the treatment has proceeded for a while we notice that these patients behave in a quite peculiar manner towards ourselves. We thought indeed that we had taken into account all the motive forces affecting the treatment and had reasoned out the situation between ourselves and the patient fully, so that it balanced like a sum in arithmetic; and then after all something seems to slip in which was quite left out of our calculation. This new and unexpected feature is in itself many-sided and complex; I will first of all describe some of its more frequent and simpler forms to you.

We observe then that the patient, who ought to be thinking of nothing but the solution of his own distressing conflicts, begins to develop a particular interest in the person of the physician. Everything connected with this person seems to him more important than his own affairs and to distract him from his illness. Relations with the patient then become for a time very agreeable; he is particularly docile, endeavours to show his gratitude wherever he can, exhibits a fineness of character and other good qualities which we had perhaps not anticipated in him. The analyst thus forms a very good opinion of the patient and values his luck in being able to render assistance to such an admirable personality. If the physician has occasion to see the patient’s relatives he hears with satisfaction that this esteem is mutual. The patient at home is never tired of praising the analyst and attributing new virtues to him. “He has quite lost his head over you; he puts implicit trust in you; everything you say is like a revelation to him,” say the relatives. Here and there one among this chorus having sharper eyes will say: “It is positively boring the way he never speaks of anything but you: he quotes you all the time.”

We will hope that the physician is modest enough to ascribe the patient’s estimate of his value to the hopes of recovery which he has been able to offer to him, and to the widening in the patient’s intellectual horizon consequent upon the surprising revelations entailed by the treatment and their liberating influence. The analysis too makes splendid progress under these conditions, the patient understands the suggestions offered to him, concentrates upon the tasks appointed by the treatment, the material needed—his recollections and associations—is abundantly available; he astonishes the analyst by the sureness and accuracy of his interpretations, and the latter has only to observe with satisfaction how readily and willingly a sick man will accept all the new psychological ideas that are so hotly contested by the healthy in the world outside. A general improvement in the patient’s condition, objectively confirmed on all sides, also accompanies this harmonious relationship in the analysis.

But such fair weather cannot last for ever. There comes a day when it clouds over. There begin to be difficulties in the analysis; the patient says he cannot think of anything more to say. One has an unmistakable impression that he is no longer interested in the work, and that he is casually ignoring the injunction given him to say everything that comes into his mind and to yield to none of the critical objections that occur to him. His behaviour is not dictated by the situation of the treatment; it is as if he had not made an agreement to that effect with the physician; he is obviously preoccupied with something which at the same time he wishes to reserve to himself. This is a situation in which the treatment is in danger. Plainly a very powerful resistance has risen up. What can have happened?

If it is possible to clear up this state of things, the cause of the disturbance is found to consist in certain intense feelings of affection which the patient has transferred on to the physician, not accounted for by the latter’s behaviour nor by the relationship involved by the treatment. The form in which this affectionate feeling is expressed and the goal it seeks naturally depend upon the circumstances of the situation between the two persons. If one of them is a young girl and the other still a fairly young man, the impression received is that of normal love; it seems natural that a girl should fall in love with a man with whom she is much alone and can speak of very intimate things, and who is in the position of an adviser with authority—we shall probably overlook the fact that in a neurotic girl some disturbance of the capacity for love is rather to be expected. The farther removed the situation between the two persons is from this supposed example, the more unaccountable it is to find that nevertheless the same kind of feeling comes to light in other cases. It may be still comprehensible when a young woman who is unhappily married seems to be overwhelmed by a serious passion for her physician, if he is still unattached, and that she should be ready to seek a divorce and give herself to him, or, where circumstances would prevent this, to enter into a secret love-affair with him. That sort of thing, indeed, is known to occur outside psycho-analysis. But in this situation girls and women make the most astonishing confessions which reveal a quite peculiar attitude on their part to the therapeutic problem: they had always known that nothing but love would cure them, and from the beginning of the treatment they had expected that this relationship would at last yield them what life had so far denied them. It was only with this hope that they had taken such pains over the analysis and had conquered all their difficulties in disclosing their thoughts. We ourselves can add: ‘and had understood so easily all that is usually so hard to accept.’ But a confession of this kind astounds us; all our calculations are blown to the winds. Could it be that we have omitted the most important element in the whole problem?

And actually it is so; the more experience we gain the less possible does it become for us to contest this new factor, which alters the whole problem and puts our scientific calculations to shame. The first few times one might perhaps think that the analytic treatment had stumbled upon an obstruction in the shape of an accidental occurrence, extraneous to its purpose and unconnected with it in origin. But when it happens that this kind of attachment to the physician regularly evinces itself in every fresh case, under the most unfavourable conditions, and always appears in circumstances of a positively grotesque incongruity—in elderly women, in relation to grey-bearded men, even on occasions when our judgement assures us that no temptations exist—then we are compelled to give up the idea of a disturbing accident and to admit that we have to deal with a phenomenon in itself essentially bound up with the nature of the disease.

The new fact which we are thus unwillingly compelled to recognize we call Transference. By this we mean a transference of feelings on to the person of the physician, because we do not believe that the situation in the treatment can account for the origin of such feelings. We are much more disposed to suspect that the whole of this readiness to develop feeling originates in another source; that it was previously formed in the patient, and has seized the opportunity provided by the treatment to transfer itself on to the person of the physician. The transference can express itself as a passionate petitioning for love, or it can take less extreme forms; where a young girl and an elderly man are concerned, instead of the wish to be wife or mistress, a wish to be adopted as a favourite daughter may come to light, the libidinous desire can modify itself and propose itself as a wish for an everlasting, but ideally platonic friendship. Many women understand how to sublimate the transference and to mould it until it acquires a sort of justification for its existence; others have to express it in its crude, original, almost impossible form. But at bottom it is always the same, and its origin in the same source can never be mistaken.

Before we enquire where we are to range this new fact, we will amplify the description of it a little. How is it with our male patients? There at least we might hope to be spared the troublesome element of sex difference and sex attraction. Well, the answer is very much the same as with women. The same attachment to the physician, the same overestimation of his qualities, the same adoption of his interests, the same jealousy against all those connected with him. The sublimated kinds of transference are the forms more frequently met with between man and man, and the directly sexual declaration more rarely, in the same degree to which the manifest homosexuality of the patient is subordinated to the other ways by which this component-instinct can express itself. Also, it is in male patients that the analyst more frequently observes a manifestation of the transference which at the first glance seems to controvert the description of it just given—that is, the hostile or negative transference.

First of all, let us realize at once that the transference exists in the patient from the beginning of the treatment, and is for a time the strongest impetus in the work. Nothing is seen of it and one does not need to trouble about it as long as its effect is favourable to the work in which the two persons are co-operating. When it becomes transformed into a resistance, attention must be paid to it; and then it appears that two different and contrasting states of mind have supervened in it and have altered its attitude to the treatment: first, when the affectionate attraction has become so strong and betrays signs of its origin in sexual desire so clearly that it was bound to arouse an inner opposition against itself; and secondly, when it consists in antagonistic instead of affectionate feeling. The hostile feelings as a rule appear later than the affectionate and under cover of them; when both occur simultaneously they provide a very good exemplification of that ambivalence in feeling which governs most of our intimate relationships with other human beings. The hostile feelings therefore indicate an attachment of feeling quite similar to the affectionate, just as defiance indicates a similar dependence upon the other person to that belonging to obedience, though with a reversed prefix. There can be no doubt that the hostile feelings against the analyst deserve the name of ‘transference,’ for the situation in the treatment certainly gives no adequate occasion for them; the necessity for regarding the negative transference in this light is a confirmation of our previous similar view of the positive or affectionate variety.

Where the transference springs from, what difficulties it provides for us, how we can overcome them, and what advantage we can finally derive from it, are questions which can only be adequately dealt with in a technical exposition of the analytic method; I can merely touch upon them here. It is out of the question that we should yield to the demands made by the patient under the influence of his transference; it would be nonsensical to reject them unkindly, and still more so, indignantly. The transference is overcome by showing the patient that his feelings do not originate in the current situation, and do not really concern the person of the physician, but that he is reproducing something that had happened to him long ago. In this way we require him to transform his repetition into recollection. Then the transference which, whether affectionate or hostile, every time seemed the greatest menace to the cure becomes its best instrument, so that with its help we can unlock the closed doors in the soul. I should like, however, to say a few words to dispel the unpleasant effects of the shock that this unexpected phenomenon must have been to you. After all, we must not forget that this illness of the patient’s which we undertake to analyse is not a finally accomplished, and as it were consolidated thing; but that it is growing and continuing its development all the time like a living thing. The beginning of the treatment puts no stop to this development; but, as soon as the treatment has taken a hold upon the patient, it appears that the entire productivity of the illness henceforward becomes concentrated in one direction—namely, upon the relationship to the physician. The transference then becomes comparable to the cambium layer between the wood and the bark of a tree, from which proceeds the formation of new tissue and the growth of the trunk in diameter. As soon as the transference has taken on this significance the work upon the patient’s recollections recedes far into the background. It is then not incorrect to say that we no longer have to do with the previous illness, but with a newly-created and transformed neurosis which has replaced the earlier one. This new edition of the old disease has been followed from its inception, one sees it come to light and grow, and is particularly familiar with it since one is oneself its central object. All the patient’s symptoms have abandoned their original significance and have adapted themselves to a new meaning, which is contained in their relationship to the transference; or else only those symptoms remain which were capable of being adapted in this way. The conquest of this new artificially-acquired neurosis coincides with the removal of the illness which existed prior to the treatment, that is, with accomplishing the therapeutic task. The person who has become normal and free from the influence of repressed instinctive tendencies in his relationship to the physician remains so in his own life when the physician has again been removed from it.