The Problem of Libido in Dementia Præcox
I have sought to show these infringements in a special work, “Wandlungen und Symbole der Libido,” and at the same time the necessity for creating a new conception of libido, which shall be in harmony with the energic conception. Freud himself was forced to a discussion of his original conception of libido when he tried to apply its energic point of view to a well-known case of dementia præcox—the so-called Schreber case. In this case, we had to deal, among other things, with that well-known problem in the psychology of dementia præcox, the loss of adaptation to reality, the peculiar phenomenon consisting in a special tendency of these patients to construct an inner world of phantasy of their own, surrendering for this purpose their adaptation to reality. As a part of the phenomenon, the lack of sociability or emotional rapport will be well known to you all, this representing a striking disturbance of the function of reality. Through considerable psychological study of these patients we discovered, that this lack of adaptation to reality is compensated by a progressive increase in the creation of phantasies. This goes so far that the dream-world is for the patient more real than external reality. The patient Schreber, described by Freud, found for this phenomenon an excellent figurative description in his delusion of the “end of the world.” His loss of reality is thus very concretely represented. The dynamic conception of this phenomenon is very clear. We say that the libido withdrew itself more and more from the external world, consequently entered the inner world, the world of phantasies, and had there to create, as a compensation for the lost external world, a so-called equivalent of reality. This compensation is built up piece by piece, and it is most interesting to observe the psychological materials of which this inner world is composed. This way of conceiving the transposition and displacement of the libido has been made by the every-day use of the term, its original pure sexual meaning being very rarely recalled. In general, the word “libido” is used practically in so harmless a sense that Claparède, in a conversation, once remarked that we could as well use the word “interest.”
The manner in which this expression is generally used has given rise to a way of using the term that made it possible to explain Schreber’s “end of the world” by withdrawal of the libido. On this occasion, Freud recalled his original sexual definition of the libido, and tried to arrive at an understanding with the change which in the meantime had taken place. In his article on Schreber, he discusses the question, whether what the psychoanalytic school calls libido, and conceives of as “interest from erotic sources” coincides with interest generally speaking. You see that, putting the problem in this way, Freud asks the question which Claparède practically answered. Freud discusses the question here, whether the loss of reality noticed in dementia præcox, to which I drew attention in my book,[[6]] “The Psychology of Dementia Præcox,” is due entirely to the withdrawal of erotic interest, or if this coincides with the so-called objective interest in general. We can hardly agree that the normal “fonction du réel” [Janet] is only maintained through erotic interest. The fact is that, in many cases, reality vanishes altogether, and not a trace of psychological adaptation can be found in these cases. Reality is repressed, and replaced by phantasies created through complexes. We are forced to say that not only the erotic interests, but interests in general—that is, the whole adaptation to reality—are lost. I formerly tried, in my “Psychology of Dementia Præcox,” to get out of this difficulty by using the expression “psychic energy,” because I could not base the theory of dementia præcox on the theory of transference of the libido in its sexual definition. My experience—at that time chiefly psychiatric—did not permit me to understand this theory. Only later did I learn to understand the correctness of the theory as regards the neuroses by increased experience in hysteria and the compulsion neurosis. As a matter of fact, an abnormal displacement of libido, quite definitely sexual, does play a great part in the neuroses. But although very characteristic repressions of sexual libido do take place in certain neuroses, that loss of reality, so typical for dementia præcox, never occurs. In dementia præcox, so extreme is the loss of the function of reality that this loss must also entail a loss of motive power, to which any sexual nature must be absolutely denied, for it will not seem to anyone that reality is a sexual function. If this were so, the withdrawal of erotic interests in the neuroses would lead to a loss of reality—a loss of reality indeed that could be compared with that in dementia præcox. But, as I said before, this is not the case. These facts have made it impossible for me to transfer Freud’s libido theory to dementia præcox. Hence, my view is, that the attempt made by Abraham, in his article “The Psycho-Sexual Differences Between Hysteria and Dementia Præcox,” is from the standpoint of Freud’s conception of libido theoretically untenable. Abraham’s belief, that the paranoidal system, or the symptomatology of dementia præcox, arises by the libido withdrawing from the external world, cannot be justified if we take “libido” according to Freud’s definition. For, as Freud has clearly shown, a mere introversion or regression of the libido leads always to a neurosis, and not to dementia præcox. It is impossible to transfer the libido theory, with its sexual definition, directly to dementia præcox, as this disease shows a loss of reality not to be explained by the deficiency in erotic interests.
It gives me particular satisfaction that our master also, when he placed his hand on the fragile material of paranoiac psychology, felt himself compelled to doubt the applicability of his conception of libido which had prevailed hitherto. My position of reserve towards the ubiquity of sexuality which I allowed myself to adopt in the preface to my “Psychology of Dementia Præcox”—although with a complete recognition of the psychological mechanism—was dictated by the conception of the libido theory of that time. Its sexual definition did not enable me to explain those disturbances of functions which affect the indefinite sphere of the instinct of hunger, just as much as they do those of sexuality. For a long time the libido theory seemed to me inapplicable to dementia præcox.