Now that we have decided what is to be understood as infantile sexuality, we can follow up the discussion of the theory of the neuroses, which we began in the first lecture and then dropped. We followed the theory of the neuroses up to the point where we ran against Freud’s statement, that the tendency which brings a traumatic event to a pathological activity, is a sexual one. From our foregoing considerations we understand what is meant by a sexual tendency. It is a standing still, a retardation in that process whereby the libido frees itself from the manifestations of the pre-sexual stage.
First of all, we must regard this disturbance as a fixation. The libido, in its transition from the function of nutrition to the sexual function, lingers unduly at certain stages. A disharmony is created, since provisional and, as it were, worn-out activities, persist at a period when they should have been overcome. This formula is applicable to all those infantile characteristics so prevalent among neurotic people that no attentive observer can have overlooked them. In dementia præcox it is so obtrusive that a symptom complex, hebephrenia, derives its name therefrom.
The matter is not ended, however, by saying that the libido lingers in the preliminary stages, for while the libido thus lingers, time does not stand still, and the development of the individual is always proceeding apace. The physical maturation increases the contrast and the disharmony between the persistent infantile manifestations, and the demands of the later age, with its changed conditions of life. In this way the foundation is laid for the dissociation of the personality, and thereby to that conflict which is the real basis of the neuroses. The more the libido is in arrears in practice, the more intense will be the conflict. The traumatic or pathogenic moment is the one which serves best to make this conflict manifest. As Freud showed in his earlier works, one can easily imagine a neurosis arising in this way.
This conception fitted in rather well with the views of Janet, who ascribed neurosis to a certain defect. From this point of view the neurosis could be regarded as a product of retardation in the development of affectivity; and I can easily imagine that this conception must seem selfevident to every one who is inclined to derive the neuroses more or less directly from heredity or congenital degeneration.
The Infantile Sexual Etiology Criticized
Unfortunately the reality is much more complicated. Let me facilitate an insight into these complications by an example of a case of hysteria. It will, I hope, enable me to demonstrate the characteristic complication, so important for the theory of neurosis. You will probably remember the case of the young lady with hysteria, whom I mentioned at the beginning of my lectures. We noticed the remarkable fact that this patient was unaffected by situations which one might have expected to make a profound impression and yet showed an unexpected extreme pathological reaction to a quite everyday event. We took this occasion to express our doubt as to the etiological significance of the shock, and to investigate the so-called predisposition which rendered the trauma effective. The result of that investigation led us to what has just been mentioned, that it is by no means improbable that the origin of the neurosis is due to a retardation of the affective development.
You will now ask me what is to be understood by the retardation of the affectivity of this hysteric. The patient lives in a world of phantasy, which can only be regarded as infantile. It is unnecessary to give a description of these phantasies, for you, as neurologists or psychiatrists, have the opportunity daily to listen to the childish prejudices, illusions and emotional pretensions to which neurotic people give way. The disinclination to face stern reality is the distinguishing trait of these phantasies—some lack of earnestness, some trifling, which sometimes hides real difficulties in a light-hearted manner, at others exaggerates trifles into great troubles. We recognize at once that inadequate psychic attitude towards reality which characterizes the child, its wavering opinions and its deficient orientation in matters of the external world. With such an infantile mental disposition all kinds of desires, phantasies and illusions can grow luxuriantly, and this we have to regard as the critical causation. Through such phantasies people slip into an unreal attitude, preeminently ill-adapted to the world, which is bound some day to lead to a catastrophe. When we trace back the infantile phantasy of the patient to her earliest childhood we find, it is true, many distinct, outstanding scenes which might well serve to provide fresh food for this or that variation in phantasy, but it would be vain to search for the so-called traumatic motive, whence something abnormal might have sprung, such an abnormal activity, let us say, as day-dreaming itself. There are certainly to be found traumatic scenes, although not in earliest childhood; the few scenes of earliest childhood which were remembered seem not to be traumatic, being rather accidental events, which passed by without leaving any effect on her phantasy worth mentioning. The earliest phantasies arose out of all sorts of vague and only partly understood impressions received from her parents. Many peculiar feelings centered around her father, vacillating between anxiety, horror, aversion, disgust, love and enthusiasm. The case was like so many other cases of hysteria, where no traumatic etiology can be found, but which grows from the roots of a peculiar and premature activity of phantasy which maintains permanently the character of infantilism.
You will object that in this case the scene with the shying horses represents the trauma. It is clearly the model of that night-scene which happened nineteen years later, where the patient was incapable of avoiding the trotting horses. That she wanted to plunge into the river has an analogy in the model scene, where the horses and carriage fell into the river.
Since the latter traumatic moment she suffered from hysterical fits. As I tried to show you, we do not find any trace of this apparent etiology developed in the course of her phantasy life. It seems as if the danger of losing her life, that first time, when the horses shied, passed without leaving any emotional trace. None of the events that occurred in the following years showed any trace of that fright. In parenthesis let me add, that perhaps it never happened at all. It may have even been a mere phantasy, for I have only the assertions of the patient. All of a sudden, some eighteen years later, this event becomes of importance and is, so to say, reproduced and carried out in all its details. This assumption is extremely unlikely, and becomes still more inconceivable if we also bear in mind that the story of the shying horses may not even be true. Be that as it may, it is and remains almost unthinkable that an affect should remain buried for years and then suddenly explode. In other cases there is exactly the same state of affairs. I know, for instance, of a case in which the shock of an earthquake, long recovered from, suddenly came back as a lively fear of earthquakes, although this reminiscence could not be explained by the external circumstances.