The Appearance of New Intentions.—All the outer and inner determinations which impede or hold at a distance the attainment of the normal sexual aim, such as impotence, costliness of the sexual object, and dangers of the sexual act, will conceivably strengthen the inclination to linger at the preparatory acts and to form them into new sexual aims which may take the place of the normal. On closer investigation it is always seen that the ostensibly most peculiar of these new intentions have already been indicated in the normal sexual act.

Touching and Looking.—At least a certain amount of touching is indispensable for a person in order to attain the normal sexual aim. It is also generally known that the touching of the skin of the sexual object causes much pleasure and produces a supply of new excitement. Hence, the lingering at the touching can hardly be considered a perversion if the sexual act is proceeded with.

The same holds true in the end with looking which is analogous to touching. The manner in which the libidinous excitement is frequently awakened is by the optical impression, and selection takes account of this circumstance—if this teleological mode of thinking be permitted—by making the sexual object a thing of beauty. The covering of the body, which keeps abreast with civilization, serves to arouse sexual inquisitiveness, which always strives to restore for itself the sexual object by uncovering the hidden parts. This can be turned into the artistic ("sublimation") if the interest is turned from the genitals to the form of the body.[20] The tendency to linger at this intermediary sexual aim of the sexually accentuated looking is found to a certain degree in most normals; indeed it gives them the possibility of directing a certain amount of their libido to a higher artistic aim. On the other hand, the fondness for looking becomes a perversion (a) when it limits itself entirely to the genitals; (b) when it becomes connected with the overcoming of loathing (voyeurs and onlookers at the functions of excretion); and (c) when instead of preparing for the normal sexual aim it suppresses it. The latter, if I may draw conclusions from a single analysis, is in a most pronounced way true of exhibitionists, who expose their genitals so as in turn to bring to view the genitals of others.

In the perversion which consists in striving to look and be looked at we are confronted with a very remarkable character which will occupy us even more intensively in the following aberration. The sexual aim is here present in twofold formation, in an active and a passive form.

The force which is opposed to the peeping mania and through which it is eventually abolished is shame (like the former loathing).

Sadism and Masochism.—The desire to cause pain to the sexual object and its opposite, the most frequent and most significant of all perversions, was designated in its two forms by v. Krafft-Ebing as sadism or the active form, and masochism or the passive form. Other authors prefer the narrower term algolagnia which emphasizes the pleasure in pain and cruelty, whereas the terms selected by v. Krafft-Ebing place the pleasure secured in all kinds of humility and submission in the foreground.

The roots of active algolagnia, sadism, can be readily demonstrable in the normal. The sexuality of most men shows a taint of aggression, it is a propensity to subdue, the biological significance of which lies in the necessity of overcoming the resistance of the sexual object by actions other than mere courting. Sadism would then correspond to an aggressive component of the sexual impulse which has become independent and exaggerated and has been brought to the foreground by displacement.

The conception of sadism fluctuates in the usage of language from a mere active or impetuous attitude towards the sexual object to the exclusive attachment of the gratification to the subjection and maltreatment of the object. Strictly speaking only the last extreme case has a claim to the name of perversion.

Similarly, the designation of masochism comprises all passive attitude to the sexual life and to the sexual object; in its most extreme form the gratification is connected with suffering of physical or mental pain at the hands of the sexual object. Masochism as a perversion seems to be still more remote from the normal sexual life by forming a contrast to it; it may be doubted whether it ever appears as a primary form or whether it does not more regularly originate through transformation from sadism. It can often be recognized that the masochism is nothing but a continuation of the sadism turning against one's own person in which the latter at first takes the place of the sexual object. Analysis of extreme cases of masochistic perversions show that there is a coöperation of a large series of factors which exaggerate and fix the original passive sexual attitude (castration complex, conscience).

The pain which is here overcome ranks with the loathing and shame which were the resistances opposed to the libido.

Sadism and masochism occupy a special place among the perversions, for the contrast of activity and passivity lying at their bases belong to the common traits of the sexual life.

That cruelty and sexual impulse are most intimately connected is beyond doubt taught by the history of civilization, but in the explanation of this connection no one has gone beyond the accentuation of the aggressive factors of the libido. The aggression which is mixed with the sexual impulse is according to some authors a remnant of cannibalistic lust, a participation on the part of the domination apparatus (Bemächtigungsapparatus), which served also for the gratification of the great wants of the other, ontogenetically the older impulse.[21] It has also been claimed that every pain contains in itself the possibility of a pleasurable sensation. Let us be satisfied with the impression that the explanation of this perversion is by no means satisfactory and that it is possible that many psychic efforts unite themselves into one effect.

The most striking peculiarity of this perversion lies in the fact that its active and passive forms are regularly encountered together in the same person. He who experiences pleasure by causing pain to others in sexual relations is also able to experience the pain emanating from sexual relations as pleasure. A sadist is simultaneously a masochist, though either the active or the passive side of the perversion may be more strongly developed and thus represent his preponderate sexual activity.[22]

We thus see that certain perverted propensities regularly appear in contrasting pairs, a thing which, in view of the material to be produced later, must claim great theoretical value. It is furthermore clear that the existence of the contrast, sadism and masochism, can not readily be attributed to the mixture of aggression. On the other hand one may be tempted to connect such simultaneously existing contrasts with the united contrast of male and female in bisexuality, the significance of which is reduced in psychoanalysis to the contrast of activity and passivity.

Variation and Disease.—The physicians who at first studied the perversions in pronounced cases and under peculiar conditions were naturally inclined to attribute to them the character of a morbid or degenerative sign similar to the inversions. This view, however, is easier to refute in this than in the former case. Everyday experience has shown that most of these transgressions, at least the milder ones, are seldom wanting as components in the sexual life of normals who look upon them as upon other intimacies. Wherever the conditions are favorable such a perversion may for a long time be substituted by a normal person for the normal sexual aim or it may be placed near it. In no normal person does the normal sexual aim lack some designable perverse element, and this universality suffices in itself to prove the inexpediency of an opprobrious application of the name perversion. In the realm of the sexual life one is sure to meet with exceptional difficulties which are at present really unsolvable, if one wishes to draw a sharp line between the mere variations within physiological limits and morbid symptoms.

Nevertheless, the quality of the new sexual aim in some of these perversions is such as to require special notice. Some of the perversions are in content so distant from the normal that we cannot help calling them "morbid," especially those in which the sexual impulse, in overcoming the resistances (shame, loathing, fear, and pain) has brought about surprising results (licking of feces and violation of cadavers). Yet even in these cases one ought not to feel certain of regularly finding among the perpetrators persons of pronounced abnormalities or insane minds. We can not lose sight of the fact that persons who otherwise behave normally are recorded as sick in the realm of the sexual life where they are dominated by the most unbridled of all impulses. On the other hand, a manifest abnormality in any other relation in life generally shows an undercurrent of abnormal sexual behavior.

In the majority of cases we are able to find the morbid character of the perversion not in the content of the new sexual aim but in its relation to the normal. It is morbid if the perversion does not appear beside the normal (sexual aim and sexual object), where favorable circumstances promote it and unfavorable impede the normal, or if it has under all circumstances repressed and supplanted the normal; the exclusiveness and fixation of the perversion justifies us in considering it a morbid symptom.

The Psychic Participation in the Perversions.—Perhaps it is precisely in the most abominable perversions that we must recognize the most prolific psychic participation for the transformation of the sexual impulse. In these cases a piece of psychic work has been accomplished in which, in spite of its gruesome success, the value of an idealization of the impulse can not be disputed. The omnipotence of love nowhere perhaps shows itself stronger than in this one of her aberrations. The highest and the lowest everywhere in sexuality hang most intimately together. ("From heaven through the world to hell.")

Two Results.—In the study of perversions we have gained an insight into the fact that the sexual impulse has to struggle against certain psychic forces, resistances, among which shame and loathing are most prominent. We may presume that these forces are employed to confine the impulse within the accepted normal limits, and if they have become developed in the individual before the sexual impulse has attained its full strength, it is really they which have directed it in the course of development.[23]

We have furthermore remarked that some of the examined perversions can be comprehended only by assuming the union of many motives. If they are amenable to analysis—disintegration—they must be of a composite nature. This may give us a hint that the sexual impulse itself may not be something simple, that it may on the contrary be composed of many components which detach themselves to form perversions. Our clinical observation thus calls our attention to fusions which have lost their expression in the uniform normal behavior.

Psychoanalysis.—A proper contribution to the knowledge of the sexual impulse in persons who are at least related to the normal can be gained only from one source, and is accessible only by one definite path. There is only one way to obtain a thorough and unerring solution of problems in the sexual life of so-called psychoneurotics (hysteria, obsessions, the wrongly-named neurasthenia, and surely also dementia præcox, and paranoia), and that is by subjecting them to the psychoanalytic investigations propounded by J. Breuer and myself in 1893, which we called the "cathartic" treatment.

I must repeat what I have said in my published work, that these psychoneuroses, as far as my experience goes, are based on sexual motive powers. I do not mean that the energy of the sexual impulse merely contributes to the forces supporting the morbid manifestations (symptoms), but I wish distinctly to maintain that this supplies the only constant and the most important source of energy in the neurosis, so that the sexual life of such persons manifests itself either exclusively, preponderately, or partially in these symptoms. As I have already stated in different places, the symptoms are the sexual activities of the patient. The proof for this assertion I have obtained from the psychoanalysis of hysterics and other neurotics during a period of twenty years, the results of which I hope to give later in a detailed account.

Psychoanalysis removes the symptoms of hysteria on the supposition that they are the substitutes—the transcriptions as it were—for a series of emotionally accentuated psychic processes, wishes, and desires, to which a passage for their discharge through the conscious psychic activities has been cut off by a special process (repression). These thought formations which are restrained in the state of the unconscious strive for expression, that is, for discharge, in conformity to their affective value, and find such in hysteria through a process of conversion into somatic phenomena—the hysterical symptoms. If, lege artis, and with the aid of a special technique, retrogressive transformations of the symptoms into the affectful and conscious thoughts can be effected, it then becomes possible to get the most accurate information about the nature and origin of these previously unconscious psychic formations.

Results of Psychoanalysis.—In this manner it has been discovered that the symptoms represent the equivalent for the strivings which received their strength from the source of the sexual impulse. This fully concurs with what we know of the character of hysterics, which we have taken as models for all psycho-neurotics, before they have become diseased, and with what we know concerning the causes of the disease. The hysterical character evinces a part of sexual repression which reaches beyond the normal limits, an exaggeration of the resistances against the sexual impulse which we know as shame and loathing. It is an instinctive flight from intellectual occupation with the sexual problem, the consequence of which in pronounced cases is a complete sexual ignorance, which is preserved till the age of sexual maturity is attained.[24]

This feature, so characteristic of hysteria, is not seldom concealed in crude observation by the existence of the second constitutional factor of hysteria, namely, the enormous development of the sexual craving. But the psychological analysis will always reveal it and solves the very contradictory enigma of hysteria by proving the existence of the contrasting pair, an immense sexual desire and a very exaggerated sexual rejection.

The provocation of the disease in hysterically predisposed persons is brought about if in consequence of their progressive maturity or external conditions of life they are earnestly confronted with the real sexual demand. Between the pressure of the craving and the opposition of the sexual rejection an outlet for the disease results, which does not remove the conflict but seeks to elude it by transforming the libidinous strivings into symptoms. It is an exception only in appearance if a hysterical person, say a man, becomes subject to some banal emotional disturbance, to a conflict in the center of which there is no sexual interest. Psychoanalysis will regularly show that it is the sexual components of the conflict which make the disease possible by withdrawing the psychic processes from normal adjustment.

Neurosis and Perversion.—A great part of the opposition to my assertion is explained by the fact that the sexuality from which I deduce the psychoneurotic symptoms is thought of as coincident with the normal sexual impulse. But psychoanalysis teaches us better than this. It shows that the symptoms do not by any means result at the expense only of the so called normal sexual impulse (at least not exclusively or preponderately), but they represent the converted expression of impulses which in a broader sense might be designated as perverse if they could manifest themselves directly in phantasies and acts without deviating from consciousness. The symptoms are therefore partially formed at the cost of abnormal sexuality. The neurosis is, so to say, the negative of the perversion.[25]

The sexual impulse of the psychoneurotic shows all the aberrations which we have studied as variations of the normal and as manifestations of morbid sexual life.

(a) In all the neurotics without exception we find feelings of inversion in the unconscious psychic life, fixation of libido on persons of the same sex. It is impossible, without a deep and searching discussion, adequately to appreciate the significance of this factor for the formation of the picture of the disease; I can only assert that the unconscious propensity to inversion is never wanting and is particularly of immense service in explaining male hysteria.[26]

(b) All the inclinations to anatomical transgression can be demonstrated in psychoneurotics in the unconscious and as symptom-creators. Of special frequency and intensity are those which impart to the mouth and the mucous membrane of the anus the rôle of genitals.

(c) The partial desires which usually appear in contrasting pairs play a very prominent rôle among the symptom-creators in the psychoneuroses. We have learned to know them as carriers of new sexual aims, such as peeping mania, exhibitionism, and the actively and passively formed impulses of cruelty. The contribution of the last is indispensable for the understanding of the morbid nature of the symptoms; it almost regularly controls some portion of the social behavior of the patient. The transformation of love into hatred, of tenderness into hostility, which is characteristic of a large number of neurotic cases and apparently of all cases of paranoia, takes place by means of the union of cruelty with the libido.

The interest in these deductions will be more heightened by certain peculiarities of the diagnosis of facts.

α. There is nothing in the unconscious streams of thought of the neuroses which would correspond to an inclination towards fetichism; a circumstance which throws light on the psychological peculiarity of this well understood perversion.

β. Wherever any such impulse is found in the unconscious which can be paired with a contrasting one, it can regularly be demonstrated that the latter, too, is effective. Every active perversion is here accompanied by its passive counterpart. He who in the unconscious is an exhibitionist is at the same time a voyeur, he who suffers from sadistic feelings as a result of repression will also show another reinforcement of the symptoms from the source of masochistic tendencies. The perfect concurrence with the behavior of the corresponding positive perversions is certainly very noteworthy. In the picture of the disease, however, the preponderant rôle is played by either one or the other of the opposing tendencies.

γ. In a pronounced case of psychoneurosis we seldom find the development of one single perverted impulse; usually there are many and regularly there are traces of all perversions. The individual impulse, however, on account of its intensity, is independent of the development of the others, but the study of the positive perversions gives us the accurate counterpart to it.

Keeping in mind what we have learned from the examination of the positive and negative perversions, it becomes quite obvious that they can be referred to a number of "partial impulses," which are not, however, primary but are subject to further analysis. By an "impulse" we can understand in the first place nothing but the psychic representative of a continually flowing internal somatic source of excitement, in contradistinction to the "stimulus" which is produced by isolated excitements coming from without. The impulse is thus one of the concepts marking the limits between the psychic and the physical. The simplest and most obvious assumption concerning the nature of the impulses would be that in themselves they possess no quality but are only taken into account as a measure of the demand for effort in the psychic life. What distinguishes the impulses from one another and furnishes them with specific attributes is their relation to their somatic sources and to their aims. The source of the impulse is an exciting process in an organ, and the immediate aim of the impulse lies in the elimination of this organic stimulus.

Another preliminary assumption in the theory of the impulse which we cannot relinquish, states that the bodily organs furnish two kinds of excitements which are determined by differences of a chemical nature. One of these forms of excitement we designate as the specifically sexual and the concerned organ as the erogenous zone, while the sexual element emanating from it is the partial impulse.[27]

In the perversions which claim sexual significance for the oral cavity and the anal opening the part played by the erogenous zone is quite obvious. It behaves in every way like a part of the sexual apparatus. In hysteria these parts of the body, as well as the tracts of mucous membrane proceeding from them, become the seat of new sensations and innervating changes in a manner similar to the real genitals when under the excitement of normal sexual processes.

The significance of the erogenous zones in the psychoneuroses, as additional apparatus and substitutes for the genitals, appears to be most prominent in hysteria though that does not signify that it is of lesser validity in the other morbid forms. It is not so recognizable in compulsion neurosis and paranoia because here the symptom formation takes place in regions of the psychic apparatus which lie at a great distance from the central locations for bodily control. The more remarkable thing in the compulsion neurosis is the significance of the impulses which create new sexual aims and appear independently of the erogenous zones. Nevertheless, the eye corresponds to an erogenous zone in the looking and exhibition mania, while the skin takes on the same part in the pain and cruelty components of the sexual impulse. The skin, which in special parts of the body becomes differentiated as sensory organs and modified by the mucous membrane, is the erogenous zone, κατ ex ogen.[28]

The sexuality of psychoneurotics has perhaps been placed in a false light by the above discussions. It appears that the sexual behavior of the psychoneurotic approaches in predisposition to the pervert and deviates by just so much from the normal. Nevertheless, it is very possible that the constitutional disposition of these patients besides containing an immense amount of sexual repression and a predominant force of sexual impulse also possesses an unusual tendency to perversions in the broadest sense. However, an examination of milder cases shows that the last assumption is not an absolute requisite, or at least that in pronouncing judgment on the morbid effects one ought to discount the effect of one of the factors. In most psychoneurotics the disease first appears after puberty following the demands of the normal sexual life. Against these the repression above all directs itself. Or the disease comes on later, owing to the fact that the libido is unable to attain normal sexual gratification. In both cases the libido behaves like a stream the principal bed of which is dammed; it fills the collateral roads which until now perhaps have been empty. Thus the manifestly great (though to be sure negative) tendency to perversion in psychoneurotics may be collaterally conditioned; at any rate, it is certainly collaterally increased. The fact of the matter is that the sexual repression has to be added as an inner factor to such external ones as restriction of freedom, inaccessibility to the normal sexual object, dangers of the normal sexual act, etc., which cause the origin of perversions in individuals who might have otherwise remained normal.

In individual cases of neurosis the behavior may be different; now the congenital force of the tendency to perversion may be more decisive and at other times more influence may be exerted by the collateral increase of the same through the deviation of the libido from the normal sexual aim and object. It would be unjust to construe a contrast where a cooperation exists. The greatest results will always be brought about by a neurosis if constitution and experience cooperate in the same direction. A pronounced constitution may perhaps be able to dispense with the assistance of daily impressions, while a profound disturbance in life may perhaps bring on a neurosis even in an average constitution. These views similarly hold true in the etiological significance of the congenital and the accidental experiences in other spheres.

If, however, preference is given to the assumption that an especially formed tendency to perversions is characteristic of the psychoneurotic constitution, there is a prospect of being able to distinguish a multiformity of such constitutions in accordance with the congenital preponderance of this or that erogenous zone, or of this or that partial impulse. Whether there is a special relationship between the predisposition to perversions and the selection of the morbid picture has not, like many other things in this realm, been investigated.

By demonstrating the perverted feelings as symptomatic formations in psychoneurotics, we have enormously increased the number of persons who can be added to the perverts. This is not only because neurotics represent a very large proportion of humanity, but we must consider also that the neuroses in all their gradations run in an uninterrupted series to the normal state. Moebius was quite justified in saying that we are all somewhat hysterical. Hence, the very wide dissemination of perversions urged us to assume that the predisposition to perversions is no rare peculiarity but must form a part of the normally accepted constitution.

We have heard that it is a question whether perversions should be referred to congenital determinations or whether they originate from accidental experiences, just as Binet showed in fetichisms. Now we are forced to the conclusion that there is indeed something congenital at the basis of perversions, but it is something which is congenital in all persons, which as a predisposition may fluctuate in intensity and is brought into prominence by influences of life. We deal here with congenital roots in the constitution of the sexual impulse which in one series of cases develop into real carriers of sexual activity (perverts); while in other cases they undergo an insufficient suppression (repression), so that as morbid symptoms they are enabled to attract to themselves in a round-about way a considerable part of the sexual energy; while again in favorable cases between the two extremes they originate the normal sexual life through effective restrictions and other elaborations.

But we must also remember that the assumed constitution which shows the roots of all perversions will be demonstrable only in the child, though all impulses can be manifested in it only in moderate intensity. If we are led to suppose that neurotics conserve the infantile state of their sexuality or return to it, our interest must then turn to the sexual life of the child, and we will then follow the play of influences which control the processes of development of the infantile sexuality up to its termination in a perversion, a neurosis or a normal sexual life.

Note 1: The facts contained in the first "Contribution" have been gathered from the familiar publications of Krafft-Ebing, Moll, Moebius, Havelock Ellis, Schrenk-Notzing, Löwenfeld, Eulenberg, J. Bloch, and M. Hirschfeld, and from the later works published in the "Jahrbuch für sexuelle Zwischenstufen." As these publications also mention the other literature bearing on this subject I may forbear giving detailed references.

The conclusions reached through the investigation of sexual inverts are all based on the reports of J. Sadger and on my own experience.

Note 2: For general use the word "libido" is best translated by "craving." (Prof. James J. Putnam, Journal of Abnormal Psychology, Vol. IV, 6.)

Note 3: For the difficulties entailed in the attempt to ascertain the proportional number of inverts compare the work of M. Hirschfeld in the Jahrbuch für sexuelle Zwischenstufen, 1904. Cf. also Brill, The Conception of Homosexuality, Journal of the A.M.A., August 2, 1913.

Note 4: Such a striving against the compulsion to inversion favors cures by suggestion of psychoanalysis.

Note 5: Many have justly emphasized the fact that the autobiographic statements of inverts, as to the time of the appearance of their tendency to inversion, are untrustworthy as they may have repressed from memory any evidences of heterosexual feelings.

Psychoanalysis has confirmed this suspicion in all cases of inversion accessible, and has decidedly changed their anamnesis by filling up the infantile amnesias.

Note 6: With what reserve the diagnosis of degeneration should be made and what slight practical significance can be attributed to it can be gathered from the discussions of Moebius (Ueber Entartung; Grenzfragen des Nerven- und Seelenlebens, No. III, 1900). He says: "If we review the wide sphere of degeneration upon which we have here turned some light we can conclude without further ado that it is really of little value to diagnose degeneration."

Note 7: We must agree with the spokesman of "Uranism" that some of the most prominent men known have been inverts and perhaps absolute inverts.

Note 8: In the conception of inversion the pathological features have been Separated from the anthropological. For this credit is due to I. Bloch (Beiträge zur Ätiologie der Psychopathia Sexualis, 2 Teile, 1902-3), who has also brought into prominence the existence of inversion in the old civilized nations.

Note 9: Compare the last detailed discussion of somatic hermaphroditism (Taruffi, Hermaphroditismus und Zeugungsunfähigkeit, German edit. by R. Teuscher, 1903), and the works of Neugebauer in many volumes of the Jahrbuch für sexuelle Zwischenstufen.

Note 10: J. Halban, "Die Entstehung der Geschlechtscharaktere," Arch. für Gynäkologie, Bd. 70, 1903. See also there the literature on the subject.

Note 11: According to a report in Vol. 6 of the Jahrbuch f. sexuelle Zwischenstufen, E. Gley is supposed to have been the first to mention bisexuality as an explanation of inversion. He published a paper (Les Abérrations de l'instinct Sexuel) in the Revue Philosophique as early as January, 1884. It is moreover noteworthy that the majority of authors who trace the inversion to bisexuality assume this factor not only for the inverts but also for those who have developed normally, and justly interpret the inversion as a result of a disturbance in development. Among these authors are Chevalier (Inversion Sexuelle, 1893), and v. Krafft-Ebing ("Zur Erklärung der konträren Sexualempfindung," Jahrbücher f. Psychiatrie u. Nervenheilkunde, XIII), who states that there are a number of observations "from which at least the virtual and continued existence of this second center (of the underlying sex) results." A Dr. Arduin (Die Frauenfrage und die sexuellen Zwischenstufen, 2d vol. of the Jahrbuch f. sexuelle Zwischenstufen, 1900) states that "in every man there exist male and female elements." See also the same Jahrbuch, Bd. I, 1899 ("Die objektive Diagnose der Homosexualitat," by M. Hirschfeld, pp. 8-9). In the determination of sex, as far as heterosexual persons are concerned, some are disproportionately more strongly developed than others. G. Herman is firm in his belief "that in every woman there are male, and in every man there are female germs and qualities" (Genesis, das Gesetz der Zeugung, 9 Bd., Libido und Manie, 1903). As recently as 1906 W. Fliess (Der Ablauf des Lebens) has claimed ownership of the idea of bisexuality (in the sense of double sex). Psychoanalytic investigation very strongly opposes the attempt to separate homosexuals from other persons as a group of a special nature. By also studying sexual excitations other than the manifestly open ones it discovers that all men are capable of homosexual object selection and actually accomplish this in the unconscious. Indeed the attachments of libidinous feelings to persons of the same sex play no small rôle as factors in normal psychic life, and as causative factors of disease they play a greater rôle than those belonging to the opposite sex. According to psychoanalysis, it rather seems that it is the independence of the object, selection of the sex of the object, the same free disposal over male and female objects, as observed in childhood, in primitive states and in prehistoric times, which forms the origin from which the normal as well as the inversion types developed, following restrictions in this or that direction. In the psychoanalytic sense the exclusive sexual interest of the man for the woman is also a problem requiring an explanation, and is not something that is self-evident and explainable on the basis of chemical attraction. The determination as to the definite sexual behavior does not occur until after puberty and is the result of a series of as yet not observable factors, some of which are of a constitutional, while some are of an accidental nature. Certainly some of these factors can turn out to be so enormous that by their character they influence the result. In general, however, the multiplicity of the determining factors is reflected by the manifoldness of the outcomes in the manifest sexual behavior of the person. In the inversion types it can be ascertained that they are altogether controlled by an archaic constitution and by primitive psychic mechanisms. The importance of the narcissistic object selection and the clinging to the erotic significance of the anal zone seem to be their most essential characteristics. But one gains nothing by separating the most extreme inversion types from the others on the basis of such constitutional peculiarities. What is found in the latter as seemingly an adequate determinant can also be demonstrated only in lesser force in the constitution of transitional types and in manifestly normal persons. The differences in the results may be of a qualitative nature, but analysis shows that the differences in the determinants are only quantitative. As a remarkable factor among the accidental influences of the object selection, we found the sexual rejection or the early sexual intimidation, and our attention was also called to the fact that the existence of both parents plays an important rôle in the child's life. The disappearance of a strong father in childhood not infrequently favors the inversion. Finally, one might demand that the inversion of the sexual object should notionally be strictly separated from the mixing of the sex characteristics in the subject. A certain amount of independence is unmistakable also in this relation.

Note 12: Although psychoanalysis has not yet given us a full explanation for the origin of inversion, it has revealed the psychic mechanism of its genesis and has essentially enriched the problems in question. In all the cases examined we have ascertained that the later inverts go through in their childhood a phase of very intense but short-lived fixation on the woman (usually on the mother) and after overcoming it they identify themselves with the woman and take themselves as the sexual object; that is, proceeding on a narcissistic basis, they look for young men resembling themselves in persons whom they wish to love as their mother has loved them. We have, moreover, frequently found that alleged inverts are by no means indifferent to the charms of women, but the excitation evoked by the woman is always transferred to a male object. They thus repeat through life the mechanism which gave origin to their inversion. Their obsessive striving for the man proves to be determined by their restless flight from the woman.

Note 13: The most pronounced difference between the sexual life (Liebesleben) of antiquity and ours lies in the fact that the ancients placed the emphasis on the impulse itself, while we put it on its object. The ancients extolled the impulse and were ready to ennoble through it even an inferior object, while we disparage the activity of the impulse as such and only countenance it on account of the merits of the object.

Note 14: I must mention here that the blind obedience evinced by the hypnotized subject to the hypnotist causes me to think that the nature of hypnosis is to be found in the unconscious fixation of the libido on the person of the hypnotizer (by means of the masochistic component of the sexual impulse).

Ferenczi connects this character of suggestibility with the "parent complex" (Jahrbuch für Psychoanalytische und psychopathologische Forschungen, I, 1909).

Note 15: Moreover, it is to be noted that sexual overvaluation does not become pronounced in all mechanisms of object selection, and that we shall later learn to know another and more direct explanation for the sexual rôle of the other parts of the body.

Note 16: Further investigations lead to the conclusion that I. Bloch has overestimated the factor of excitement-hunger (Reizhunger). The various roads upon which the libido moves behave to each other from the very beginning like communicating pipes; the factor of collateral streaming must also be considered.

Note 17: This weakness corresponds to the constitutional predisposition. The early sexual intimidation which pushes the person away from the normal sexual aim and urges him to seek a substitute, has been demonstrated by psychoanalysis, as an accidental determinant.

Note 18: The shoe or slipper is accordingly a symbol for the female genitals.

Note 19: Psychoanalysis has filled up the gap in the understanding of fetichisms by showing that the selection of the fetich depends on a coprophilic smell-desire which has been lost by repression. Feet and hair are strong smelling objects which are raised to fetiches after the renouncing of the now unpleasant sensation of smell. Accordingly, only the filthy and ill-smelling foot is the sexual object in the perversion which corresponds to the foot fetichism. Another contribution to the explanation of the fetichistic preference of the foot is found in the Infantile Sexual Theories (see later). The foot replaces the penis which is so much missed in the woman. In some cases of foot fetichism it could be shown that the desire for looking originally directed to the genitals, which wished to reach its object from below, was stopped on the way by prohibition and repression, and therefore adhered to the foot or shoe as a fetich. In conformity with infantile expectation, the female genital was hereby imagined as a male genital.

Note 20: I have no doubt that the conception of the "beautiful" is rooted in the soil of sexual excitement and originally signified the sexual excitant. The more remarkable, therefore, is the fact that the genitals, the sight of which provokes the greatest sexual excitement, can really never be considered "beautiful."

Note 21: Cf. here the later communication on the pregenital phases of the sexual development, in which this view is confirmed. See below, "Ambivalence."

Note 22: Instead of substantiating this statement by many examples I will merely cite Havelock Ellis (The Sexual Impulse, 1903): "All known cases of sadism and masochism, even those cited by v. Krafft-Ebing, always show (as has already been shown by Colin, Scott, and Féré) traces of both groups of manifestations in the same individual."

Note 23: On the other hand the restricting forces of the sexual evolution—disgust, shame, morality—must also be looked upon as historic precipitates of the outer inhibitions which the sexual impulse experienced in the psychogenesis of humanity. One can observe that they appear in their time during the development of the individual almost spontaneously at the call of education and influence.

Note 24: Studien über Hysterie, 1895, J. Breuer tells of the patient on whom he first practiced the cathartic method: "The sexual factor was surprisingly undeveloped."

Note 25: The well-known fancies of perverts which under favorable conditions are changed into contrivances, the delusional fears of paranoiacs which are in a hostile manner projected on others, and the unconscious fancies of hysterics which are discovered in their symptoms by psychoanalysis, agree as to content in the minutest details.

Note 26: A psychoneurosis very often associates itself with a manifest inversion in which the heterosexual feeling becomes subjected to complete repression.—It is but just to state that the necessity of a general recognition of the tendency to inversion in psychoneurotics was first imparted to me personally by Wilh. Fliess, of Berlin, after I had myself discovered it in some cases.

Note 27: It is not easy to justify here this assumption which was taken from a definite class of neurotic diseases. On the other hand, it would be impossible to assert anything definite concerning the impulses if one did not take the trouble of mentioning these presuppositions.

Note 28: One should here think of Moll's assertion, who divides the sexual impulse into the impulses of contrectation and detumescence. Contrectation signifies a desire to touch the skin.