Epilepsy, with the exception of the Jacksonian type, is a particular form of hysteria. In the hysterical attack, too, the unconscious forces break through and the individual carries out various instinctive promptings while his consciousness is side-tracked. The epileptic attack represents more the criminal, the hysterical corresponds more to the sexual urge. Naturally the epileptic attack may also substitute some sexual crime (crime passionelle), and that, frequently, is the theme of the attack. It is thus obvious that homosexuals who shun crimes of passion may fall easily a victim to attacks during which the crimes are carried out vicariously. In our study of sadism we shall analyze in detail such a case.[[4]] Here I wish to point out merely the interesting fact that during the epileptic attack heterosexuals commit homosexual acts and reversely.
56. Mr. W. H., 39 years of age, a strongly built young man, comes to me to be treated for epilepsy and every time he is accompanied by an attendant. Since his 16th year he suffers attacks and several times he was seized while on the street. For that reason he does not go out alone and is always accompanied by his attendant, a simple fellow to whom he seems much attached. He is totally incapacitated from following any occupation for it turns out that his attacks are more frequent when he endeavors to work. On account of his attacks he has prevailed upon his well-to-do father to keep him in the country where he has nothing to do but to go on walks. He is soft and pliant so long as things go his way. But if contradicted he flies into great rage. He does not burst out with anger but tries to control himself and soon afterwards he has an attack during which he sees red. He reproaches himself a great deal on account of his failure to achieve something in life and because he is the cause of so much trouble to his parents. His ethical standard is a very high one and that is a point of great significance in the differential diagnosis of genuine epilepsy. He bemoans his misspent life and wants to be cured. If only there were some way to free him of the trouble! Regarding his sexual life: he relates that he is decidedly homosexual and that boys and handsome young men particularly attract him. The attendant is clearly a protection against his homosexual excitations. When he meets boys who attract him he clings to his attendant pretending to fear an oncoming attack. While living in the country at the present his attacks come on only at night and in bed. He does not recall the aura, except that he sees red, and he remembers no dream starting or accompanying the attack. He masturbates occasionally; always with the fancy that he is playing with small boys. I suggest to his parents that he ought to be psychoanalyzed. In view of the hopeless character of other current therapy this may be his only chance of recovery. The father agrees. But as the patient lives some distance from Vienna I advise the father to remove him to the city for the duration of the treatment. This he also agrees to do. Next day the mother calls and asks me to use my influence to prevent the boy from staying in Vienna. That would bring him back home and she is tremendously afraid of him. Her husband does not know it, she has kept it from him. During the attacks the son turns on her and attempts to attack her. Once she succeeded to repel him only by the exercise of her strength. During the attack he rolls his eyes fearfully and threatens she must die because she is responsible for everything. I arrange that the patient should see me only twice a week after that. But on the third appointment he failed to appear, because I had stipulated as one of the first conditions of my treatment that he must go to work. The very next day he reacted with several attacks. The father found that the treatment proved “too exciting” for the boy, and I agreed readily to give up the analysis when the father took entirely the son’s side and disagreed with the suggestion that the boy must take up some occupation.
This case shows the outbreak of homosexuality during the attacks and an affective relationship to the mother such as is shown by many homosexuals, as we shall explain more fully later.
The reverse also happens,—heterosexuals committing homosexual deeds during the attacks. The repressed components of sexuality always break through during the attack.
Tarnowsky, too, speaks of “epileptic pederasty.”[[5]] The “epileptic pederasts” are usually of active character. As an example he mentions the case of a criminal who came under his personal observation. A young man, wealthy, apparently fully heterosexual, goes to the house of his beloved after a sumptuous dinner during which he had imbibed a great amount of wine. The lady of the house not being at home he went to a room where a 14-year-old boy was asleep, assaulted him and also the chamber maid who ran to the spot attracted by the boy’s outcries. After that he fell into a sleep which lasted 12 hours. When he awoke he recalled nothing of the episode. It was found that he was subject to epileptic attacks particularly after wine. Hirschfeld observes in this connection:
“Usually the epileptic neurosis—which, as a matter of fact, I have noticed but rarely among homosexuals—influences homosexuality in the sense of removing the inhibitions and increasing the impulsive energy of the instinctive cravings. I have had under examination a particularly serious case of this character, a man-servant, subject to epilepsy who during a fit of rage and anger strangled to death and then hacked to pieces a boy. In this, as in similar cases, there was a previous history of a fusion of homosexuality and epilepsy. At any rate it is conceivable that during the beclouding of consciousness induced by the epileptic seizure all psychic factors undergo such a complete transformation that even tendencies ordinarily wholly foreign to consciousness and not even tolerated in the foreconscious, insofar as the latter may be revealed, find ready outlet. Burchard, too, has observed an epileptic of normal sexuality who during the seizures committed homosexual assaults on other patients.” (Hirschfeld, loc. cit., p. 214.)
What I have said about the influence of alcoholics holds true also of epileptic attacks. The latter also neutralize the inhibitions and the bisexual and criminal aspects of human nature come clearly to surface. It is noteworthy that Tarnowsky’s patient also indulged in alcohol before the onset of the attack.
The following case shows that the attacks may also be simulated:
57. Mr. Z. T., a bisexual, subject to anxiety attacks, relates that he suffered a great deal once because his mother devoted herself very lovingly to a brother during the latter’s illness. He was 22 years of age at the time and extremely jealous. Once he found himself alone in the room with his mother. Without knowing what he was doing he threw himself on her with the intent of assaulting her. The mother shouted and the sisters and servants came rushing in. He simulated an epileptic fit, threw himself on the floor and remained for an hour apparently in a faint. Physicians were called in and they declared the condition epilepsy. For two days he acted as if he heard nothing of what was said and knew nothing of what was going on. His deed caused him endless shame. He was not reproached on account of it and he spent two months in a comfortable sanatorium.
How closely related are make-believe and illness with every neurotic! This young man suffered also from fear and disgust of women but that, as well as his whole anxiety neurosis, disappeared completely under psychoanalytic treatment. The case stands as one of my most successful therapeutic accomplishments.