The Activity of the Anal Zone.—Like the lip zone the anal zone is, through its position, adapted to conduct the sexuality to the other functions of the body. It should be assumed that the erogenous significance of this region of the body was originally very large. Through psychoanalysis one finds, not without surprise, the many transformations that are normally undertaken with the usual excitations emanating from here, and that this zone often retains for life a considerable fragment of genital [irritability].[14] The intestinal catarrhs so frequent during infancy produce intensive irritations in this zone, and we often hear it said that intestinal catarrh at this delicate age causes "nervousness." In later neurotic diseases they exert a definite influence on the symptomatic expression of the neurosis, placing at its disposal the whole sum of intestinal disturbances. Considering the erogenous significance of the anal zone which has been retained at least in transformation, one should not laugh at the hemorrhoidal influences to which the old medical literature attached so much weight in the explanation of neurotic states.
Children utilizing the erogenous sensitiveness of the anal zone can be recognized by their holding back of fecal masses until through accumulation there result violent muscular contractions; the passage of these masses through the anus is apt to produce a marked irritation of the mucus membrane. Besides the pain this must produce also a sensation of pleasure. One of the surest premonitions of later eccentricity or nervousness is when an infant obstinately refuses to empty his bowel when placed on the chamber by the nurse and reserves this function at its own pleasure. It does not concern him that he will soil his bed; all he cares for is not to lose the subsidiary pleasure while defecating. The educators have again the right inkling when they designate children who withhold these functions as bad. The content of the bowel which is an exciting object to the sexually sensitive surface of mucous membrane behaves like the precursor of another organ which does not become active until after the phase of childhood. In addition it has other important meanings to the nursling. It is evidently treated as an additional part of the body, it represents the first "donation," the disposal of which expresses the pliability while the retention of it can express the [spite] of the little being towards its environment. From the idea of "donation" he later gains the meaning of the "babe" which according to one of the infantile sexual theories is acquired through eating and is born through the bowel.
The retention of fecal masses, which is at first intentional in order to utilize them, as it were, for masturbatic excitation of the anal zone, is at least one of the roots of constipation so frequent in neuropaths. The whole significance of the anal zone is mirrored in the fact that there are but few neurotics who have not their special scatologic customs, ceremonies, etc., which they retain with cautious secrecy.
Real masturbatic irritation of the anal zone by means of the fingers, evoked through either centrally or peripherally supported itching, is not at all rare in older children.
The Activity of the Genital Zone.—Among the erogenous zones of the child's body there is one which certainly does not play the main rôle, and which cannot be the carrier of earliest sexual feeling—which, however, is destined for great things in later life. In both male and female it is connected with the voiding of urine (penis, clitoris), and in the former it is enclosed in a sack of mucous membrane, probably in order not to miss the irritations caused by the secretions which may arouse the sexual excitement at an early age. The sexual activities of this erogenous zone, which belongs to the real genitals, are the beginning of the later normal sexual life.
Owing to the anatomical position, the overflowing of secretions, the washing and rubbing of the body, and to certain accidental excitements (the wandering of intestinal worms in the girl), it happens that the pleasurable feeling which these parts of the body are capable of producing makes itself noticeable to the child even during the sucking age, and thus awakens desire for its repetition. When we review all the actual arrangements, and bear in mind that the measures for cleanliness have the same [effect] as the uncleanliness itself, we can then scarcely mistake nature's intention, which is to establish the future primacy of these erogenous zones for the sexual activity through the infantile onanism from which hardly an individual escapes. The action of removing the stimulus and setting free the gratification consists in a rubbing contiguity with the hand or in a certain previously-formed pressure reflex effected by the closure of the thighs. The latter procedure seems to be the more primitive and is by far the more common in girls. The preference for the hand in boys already indicates what an important part of the male sexual activity will be accomplished in the future by the impulse to mastery (Bemächtigungstrieb).[15] It can only help towards clearness if I state that the infantile masturbation should be divided into three phases. The first phase belongs to the nursing period, the second to the short flourishing period of sexual activity at about the fourth year, only the third corresponds to the one which is often considered exclusively as onanism of puberty.
The infantile onanism seems to disappear after a brief time, but it may continue uninterruptedly till puberty and thus represent the first marked deviation from the development desirable for civilized man. At some time during childhood after the nursing period, the sexual impulse of the genitals reawakens and continues active for some time until it is again suppressed, or it may continue without interruption. The possible relations are very diverse and can only be elucidated through a more precise analysis of individual cases. The details, however, of this second infantile sexual activity leave behind the profoundest (unconscious) impressions in the persons's memory; if the individual remains healthy they determine his character and if he becomes sick after puberty they determine the symptomatology of his [neurosis].[16] In the latter case it is found that this sexual period is forgotten and the conscious reminiscences pointing to them are displaced; I have already mentioned that I would like to connect the normal infantile amnesia with this infantile sexual activity. By psychoanalytic investigation it is possible to bring to consciousness the forgotten material, and thereby to remove a compulsion which emanates from the unconscious psychic material.
The Return of the Infantile Masturbation.—The sexual excitation of the nursing period returns during the designated years of childhood as a centrally determined tickling sensation demanding onanistic gratification, or as a pollution-like process which, analogous to the pollution of maturity, may attain gratification without the aid of any action. The latter case is more frequent in girls and in the second half of childhood; its determinants are not well understood, but it often, though not regularly, seems to have as a basis a period of early active onanism. The symptomatology of this sexual manifestation is poor; the genital apparatus is still undeveloped and all signs are therefore displayed by the urinary apparatus which is, so to say, the guardian of the genital apparatus. Most of the so-called bladder disturbances of this period are of a sexual nature; whenever the enuresis nocturna does not represent an epileptic attack it corresponds to a pollution.
The return of the sexual activity is determined by inner and outer causes which can be conjectured from the formation of the symptoms of neurotic diseases and definitely revealed by psychoanalytic investigations. The internal causes will be discussed later, the accidental outer causes attain at this time a great and permanent significance. As the first outer cause we have the influence of seduction which prematurely treats the child as a [sexual] object; under conditions favoring impressions this teaches the child the gratification of the genital zones, and thus usually forces it to repeat this gratification in onanism. Such influences can come from adults or other children. I cannot admit that I overestimated its frequency or its significance in my contributions to the etiology of hysteria,[17] though I did not know then that normal individuals may have the same experiences in their childhood, and hence placed a higher value on seductions than on the factors found in the sexual constitution and development.[18] It is quite obvious that no seduction is necessary to awaken the sexual life of the child, that such an awakening may come on spontaneously from inner sources.
Polymorphous-perverse Disposition.—It is instructive to know that under the influence of seduction the child may become polymorphous-perverse and may be misled into all sorts of transgressions. This goes to show that it carries along the adaptation for them in its disposition. The formation of such perversions meets but slight resistance because the psychic dams against sexual transgressions, such as shame, loathing and morality—which depend on the age of the child—are not yet erected or are only in the process of formation. In this respect the child perhaps does not behave differently from the average uncultured woman in whom the same polymorphous-perverse disposition exists. Such a woman may remain sexually normal under usual conditions, [but] under the guidance of a clever seducer she will find pleasure in every perversion and will retain the same as her sexual activity. The same polymorphous or infantile disposition fits the prostitute for her professional activity, and in the enormous number of prostitutes and of women to whom we must attribute an adaptation for prostitution, even if they do not follow this calling, it is absolutely impossible not to recognize in their uniform disposition for all perversions the universal and primitive human.