[*] The accompanying mental state characteristic of ticquers is absent in habits. We can stop doing the latter when our attention is directed to them; not so in tics Meige and Feindel have discussed these and other differences.
Perhaps I should also mention the fact that all of these symptoms or tendencies which one finds in ticquers occur in other individuals who do not present tics; and, furthermore, that all normal individuals possess these qualities or tendencies in varying degrees of intensity and in varying combinations, and that this applies to adults as well as to children, although, of course, they are seen most characteristically in children. I may further add that the difference between the mental infantilism which we find present in the tic psychoneurosis and that which we observe in other (normal and abnormal) conditions is one of degree rather than of kind. Therefore, the most we can say of the mental condition in ticquers is that there is an exaggeration of the mental infantilism or a fixation at or tendency toward regression to this type of thinking or of reaction. And this leads us to the further conclusion—and it is this point which I desire to bring out in this connection—namely, that since the difference between the mental infantilism in all of these conditions is relative, being one of degree and of proportionate relationship or at any rate of genesis, evolution and meaning, it naturally follows that what is in the conclusions of Clark, as mentioned above, asserted to be an absolute and basic principle or truth applicable to the tics, must consequently be true, but in different degree, of all the other conditions of a similar or allied nature. Surely the motive source is fundamentally the same in all of these conditions.
Furthermore, tics occur in animals, especially in horses; and the whole picture, physical and mental, of tics in horses resembles that which we find in human beings, particularly idiots and imbeciles, with tics. And the ultimate, fundamental meaning and motive source of tics in man is and must be the same as that of tics in horses.
To put Clark's idea in a nut-shell, it may be said that he believes that the primary purpose of tics is not that of a protective, defense mechanism against unpleasant situations in life but that of obtaining really pleasurable gratifications to the psyche, these autopleasurable acts being based on inherent defects and having a sexual significance in the sense in which sexuality is conceived by Freud. The protective, defense mechanism is, according to this view, but secondary to the primary and <p 340 > fundamental purpose of obtaining the autopleasurable gratifications to the psyche.
Although approving of the analytic and genetic tendency displayed by Freud, Clark and the Freudian school in general, it is regrettable to me that the analytic tendency and reconstructive efforts of the Freudians in the field of neurology and psychopathology have been seriously marred by their insistence on forcing all observed physical and psychical phenomena and reactions into line with their fixed sexual theories and their special psychology, which is basically wrong in many fundamental and important standpoints.
The writer will agree with the Freudians that there must be a cause for the appearance of these tics. This cause existed in the past. It has in the course of time been forgotten, but still exists somewhere in the subconsciousness or memory. This forgetting has been brought about by a process of dissociation from the original exciting cause. But the writer will not agree that this dissociation has been, of necessity, brought about by psychic repression on the part of the individual, that by psychoanalysis the condition can be traced back to the sexual activities or tendencies of infantile or early childhood origin, or that the condition may be cured when the original cause is made known to the patient through psychoanalysis, without the training of the will so necessary in this condition.
Thus the analytic tendency of the Freudian school is to be highly commended. But this analysis should not be limited to sexual analysis, but should include a consideration of all of man's instincts. Nor should the analysis be limited to present-life psychic factors alone, but should be viewed from a psychobiological standpoint. In this way only will all antecedent causative factors—physical and mental—be included in our analytic observation and speculation.
To fully discuss or to prove the error of Clark in his conclusions would necessarily lead me into a general discussion of Freudism, which I cannot do in this place, since the ramifications are too numerous and the problems involved would lead to lengthy and tiresome discussion, pro and con. I must, however, mention the exclusively sexual standpoint assumed by the Freudian school in their interpretations of physical and psychical activities, their classifying of all activities characterized by a certain rhythmicity and periodicity, and accompanied by a certain degree of satisfaction— in other words of all autopleasurable activities—as sexual (in the Freudian sense), and the neglect of comparative and behavioristic psychology with proper consideration for man's phylogeny and ontogeny or of his true genetic history, from the racial and world history and not alone from the individualistic psychological standpoint. As a matter of fact the conception of sexuality assumed by Freud and his followers has undergone many changes and is by no means definite and clean cut in its outlines. A criticism of the conception of sexuality cannot be entered upon here. I may merely state that what is an absolute and fixed law for the tics, what is the fundamental and basic explanation or theory of the genesis and meaning of the tics must apply also to all habit movements wherever and whenever they occur, and, in like manner, to all habit formations of whatever nature. And since our habits are but the prolongations of our instincts, the latter also would be included within the purview of the same generalization. In other words, if all tics have a sexual meaning, then all instincts, which means the vital energy of man, has the same meaning. This question I have discussed in another place[7] and cannot enter upon here.
[7] A Critical Review of the Conception of Sexuality Assumed by the Freudian School. Medical Record, March 27, 1915.
Without furthur elaboration or discussion I am content to give the Freudian conception to you as I have outlined it above and to let it stand for what it is worth.