This history raises a number of questions. For instance, what do we know about the mother? It should be said of her that she was very nervous, and had tried many kinds of sanatoria and systems of cure. She also had symptoms of fear and nervous asthma. The relations between her and her husband had been very strained as far back as the patient could remember. The mother did not understand the father; the daughter always felt that she understood him better. She was moreover her father's declared favourite, being inwardly correspondingly cool towards her mother.
These facts are indications for a survey of the meaning of the illness. Behind the present symptoms phantasies are operative, connected in the first place with the young Italian, but further clearly referring to the father, whose unhappy marriage furnished the little daughter with an early opportunity of acquiring a position that really should have been filled by her mother. Behind this conquest there lies, of course, a phantasy of being the woman who was really suited to her father. The first attack of neurosis broke out at the moment when this phantasy received a violent shock, presumably similar to that the mother had once experienced (a fact that was, however, unknown to the child). The symptoms are easily comprehensible as the expression of disappointed and rejected love. The choking is based upon a sensation of tightening in the throat that is a well-known accompanying phenomenon of violent effects which we cannot quite "swallow." The metaphors of language often refer to similar physiological occurrences. When the father died, it seemed that her consciousness sorrowed deeply but her unconscious laughed, after the manner of Till Eulenspiegel, who was sad when he went downhill but was jolly when climbing laboriously, happy in anticipation of what was coming. When the father was at home the girl was low-spirited and ill, but whenever he was away she felt much better. Herein she resembles numerous husbands and wives who as yet are mutually hiding from each other the secret that they are not under all circumstances indispensable to one another.
That the unconscious had some right to laugh was shown by the subsequent period of good health. She succeeded in letting all that had passed retire behind the trap-door. The experience with the Italian, however, threatened to bring the netherworld up again. But she quickly pulled the handle and shut the door. She remained quite well until the dragon of neurosis came creeping in, just when she imagined herself to be already safely out of her troubles, in the so-to-say perfected state of wife and mother. Sexual psychology finds the cause of the neurosis in the fact that the patient is not at bottom free from the father. This forces her to resuscitate her former experience at the moment when she discovered in the Italian the very same disturbing something that had formerly made such a deep impression upon her when perceived in her father. These recollections were naturally revived by the analogous experience with another man, and formed the starting-point of the neurosis. It might therefore be said that the content and cause of the neurosis lay in the conflict between the phantastic infantile-erotic relation to the father on the one hand, and her love for the husband on the other.
But if we now consider the course of the same illness from the standpoint of the other instinct, that is, of the will to power, a different complexion is put upon the matter. Her parents' unhappy marriage afforded an excellent opportunity for the exhibition of childish instinct for power. The instinct for power desires that, under all circumstances, the ego should be "on top," whether by straight or crooked means. At all costs the integrity of the personality must be preserved.
Every attempt, even what appears to be an attempt of the surroundings, to bring about the slightest subjection of the individual, is retorted to by the "masculine protest," as Adler expresses it. The mother's disappointment and her taking refuge in a neurosis brought about an opportunity for the development of power and the attainment of a dominating position. Love and excellence of conduct are, as everybody knows, extremely well-adapted weapons for the purposes of the instinct for power. Virtue is not seldom made the means of forcing recognition from others. Already as a child she knew how to obtain a privileged position with her father by means of specially pleasing and amiable behaviour, even occasionally to supplant her mother. This was not out of love for her father, although love was a good means of obtaining the coveted superiority. The hysterical laughter at the death of her father is a striking proof of this fact. One is inclined to consider such an explanation as a deplorable depreciation of love, if not actually a malicious insinuation. But let us pause a moment, reflect, and look at the world as it really is. Have we never seen those innumerable people who love, and believe in their love, only until its purpose is achieved, and who then turn away as if they had never loved? And, after all, does not Nature herself do the same? In fact, is a "purposeless" love possible? If so, it belongs to the highest human virtues, which confessedly are extremely rare. Perhaps there is a general disposition to reflect as little as possible about the nature and purpose of love; discoveries might be made which would show the value of one's own love to be less considerable than we had supposed. However, it were dangerous to life to subtract anything from the value of fundamental instincts, perhaps specially so to-day, when we seem to have only a minimum of values left.
So the patient had an attack of hysterical laughter at the death of her father; she had finally arrived at the top. It was hysterical laughter, therefore a psychogenic symptom, that is, something proceeding from unconscious motives and not from those of the conscious ego. That is a difference that should not be underrated, for it enables us to recognise whence and how human virtues arise. Their contraries led to hell, that is, in modern terms, to the unconscious, where the counterparts of our conscious virtue have long been gathering. That is why our very virtue makes us desire to know nothing of the unconscious; indeed, it is even the summit of virtuous wisdom to maintain that there is no unconscious at all. But unfortunately we are all in a like predicament with Brother Medardus in E. T. A. Hoffman's "The Elixir of the Devil": somewhere or other there exists a sinister, terrible brother, our own incarnate counterpart bound to us by flesh and blood, who comprehends everything, maliciously hoarding whatever we most desire should disappear beneath the table.
The first outbreak of neurosis occurred in our patient at the moment when she became aware of the fact that there was something in her father which she did not control. And then it dawned upon her of what use her mother's neurosis was. When one meets with an obstacle that cannot be overcome by sensible and charming means, there yet exists an arrangement hitherto unknown to her which her mother had been beforehand in discovering, and that is neurosis. That is the reason why she now imitates her mother. But, the astonished reader asks, what is supposed to be the use of neurosis? What does it effect? Whoever has had a pronounced case of neurosis in his immediate environment, knows all that can be "effected" by a neurosis. In fact, there is altogether no better means of tyrannising over a whole household than by a striking neurosis. Heart attacks, choking fits, convulsions of all kinds achieve enormous effects, that can hardly be surpassed. Picture the fountains of pity let loose, the sublime anxiety of the dear kind parents, the hurried running to and fro of the servants, the incessant sounding of the call to the telephone, the hasty arrival of the physicians, the delicacy of the diagnosis, the detailed examinations, the lengthy courses of treatment, the considerable expense; and there, in the midst of all the uproar, lies the innocent sufferer, to whom the household is even overflowingly grateful, when he has recovered from the "spasms."
The girl discovered this incomparable "arrangement" (to use Adler's term), applying it on occasion when the father was there with success. It became unnecessary when the father died, for now she was finally uppermost. The Italian was soon dismissed, because he laid too much stress upon her femininity by an inopportune reminder of his manliness. When the way opened to the possibility of a suitable marriage, she loved, adapting herself without any complaint to the deplorable rôle of the queen bee. As long as she held the position of admired superiority, everything went splendidly. But when her husband evinced a small outside interest, she was obliged again to have recourse to the extremely efficacious "arrangement," that is, to the indirect application of power, because she had once again come upon that thing—this time in her husband—that had already previously withdrawn her father from her influence.
That is how the matter appears from the standpoint of the psychology of power. I fear that the reader will feel as did the Kadi, before whom the counsel of one party spoke first. When he had ended, the Kadi said: "Thou hast spoken well. I perceive that thou art right." Then spoke the counsel for the other party, and when he had ended, the Kadi scratched himself behind his ear and said: "Thou hast spoken well. I perceive that thou also art right." There is no doubt that the instinct for power plays a most extraordinary part. It is true that the complexes of neurotic symptoms are also exquisite "arrangements," that inexorably realise their aims with incredible obstinacy and unequalled cunning. The neurosis is final; that is, it is directed towards an aim. Adler merits considerable distinction for having demonstrated this.
Which of the two points of view is right? That is a question that might well cause much brain-racking. For the two explanations cannot be simply combined, being absolutely contradictory. In one case, it is love and its course that is the principal and decisive fact; and in the other case, it is the power of the ego. In the first case the ego is merely a kind of appendage to the passion for love; and in the second love is upon occasion merely a means to the end, that of gaining the upper hand. Whoever has the power of the ego most at heart rebels against the former conception, whilst he who cares most about love, will never be able to be reconciled to the latter.