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Selected Papers on Psychoanalysis

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Covering a wide range of topics, the collection consists of twenty-six papers and essays published over a period of two decades. Readers of this book are thus enabled to trace the analyst's development, in which his scientific approach is evident throughout, from his earliest papers through to his last works.First published in 1927 in the International Psychoanalytical Library, Karl Abraham's Selected Papers on Psychoanalysis has since established itself as on of the seminal works essential to the training of workers in the psychoanalytic field. Includes Abraham's classic paper A Short Study of the Development of the Libido.

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I. THE EXPERIENCING OF SEXUAL TRAUMAS AS A FORM OF SEXUAL ACTIVITY (1907)

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FREUD’S original theory of the aetiology of hysteria has undergone important alterations in the course of time. As he himself has pointed out,2 however, two important points remain unchanged in it, namely, sexuality and infantilism, the significance of which he has investigated more and more deeply,

Among other things, the problem of sexual traumas in youth has been affected by the alterations that the general theory of sexuality and of the neuroses has undergone. For some time Freud regarded those traumas as the ultimate source of hysterical phenomena, and assumed that they were discoverable in all cases of hysteria. But he has not been able to maintain this view in its original form. In the paper referred to he assigns a secondary role to sexual traumas in youth and assumes the presence of an abnormal psycho-sexual constitution as the primary cause of a neurosis. This view accords with the fact that not all children who experience a sexual trauma suffer later on from hysteria. According to Freud, children who are disposed to hysteria react in an abnormal manner to sexual impressions of all kinds in consequence of their abnormal disposition. I recently showed that infantile sexual traumas occurred in the psychoses 3 as well; and I put forward the view that the trauma could not be regarded as the cause of the disease, but that it exercised an influence on the form taken by it. I agreed with Freud’s assumption of an abnormal psycho-sexual constitution in the patient.

 

II. THE PSYCHO-SEXUAL DIFFERENCES BETWEEN HYSTERIA AND DEMENTIA PRECOX (1908).

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THE psycho-analytic method has enabled us to recognize important analogies in the structure of hysteria and dementia praecox.2 It will be sufficient in this paper to mention the most outstanding ones. The symptoms of both diseases originate in repressed sexual complexes, In both cases normal as well as perverse impulses can determine the formation of symptoms. The means of expression employed by both diseases are to a considerable extent the same. (I need only refer to sexual symbolism.)

But that in spite of these common characteristics there exists a fundamental antithesis between the two diseases, all observers agree. Up to the present, however, they have not defined this antithesis satisfactorily. They have only described differences of degree, and these only bring out once more the similarity between the two forms of illness. Seeing that certain important characteristics common to hysteria and dementia praecox are of a psycho-sexual nature, the question arises as to where this analogy ends. And so, in seeking to discover the fundamental differences between the two illnesses, we are again brought back to the psycho-sexual sphere.

 

III. THE PSYCHOLOGICAL RELATIONS BETWEEN SEXUALITY AND ALCOHOLISM (1908)

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IT is an undisputed fact that, generally speaking, men are more prone to taking alcohol than women. Eventhough in many countries women daily take alcohol as a matter of course just like men, and though in many places intoxicated women are often seen in the streets, still alcohol is never associated with the social life of women to anything like the extent that it is with that of men. There are wide circles in which to be a hard drinker is looked upon as a sign of manliness, even as a matter of honour. Society never demands in this way that women should take alcohol. It is the custom with us rather to condemn drinking as unwomanly; nor is drinking ever a matter of boasting among normal women as it is among men.

It seems to me worth inquiring whether this difference in the attitude of men and women towards alcohol rests on sexual differences. But such an inquiry must start from the newer conceptions of the psycho-sexual constitution of men and women as laid down in Freud’s works 2 in especial. It is a biological fact that the human body contains the genital organs of both sexes in a rudimentary form. In the course of its normal development one of the two sets of organs is suppressed or takes over other activities, whilst the other goes on developing until it is capable of performing its true functions. An analogous process takes place in the psychosexual sphere. Here, too, the differentiation of the sexes proceeds from an original state of bi-sexuality. In childhood the expressions of the sexual instincts in boys and girls are still very much alike.

 

IV. HYSTERICAL DREAM-STATES (1910)

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IN a recently published paper,2 Lowenfeld has dealt with certain peculiar disturbances in neurotics which have not previously been given sufficient consideration in the literature of the subject. As an introduction to my subject I will quote Lowenfeld’s general description of these states. He says: ‘The external world does not make the usual impression on the patient. Familiar and every-day things seem changed, as though they were unknown, new and strange; or the whole surroundings give the impression of being the product of a phantasy, an illusion, a vision. In the latter case in particular it seems to the patients as though they were in a dream, or half asleep, or were hypnotized or somnambulic; and they generally speak of these conditions as their dream-states.’ The author also says that these states differ greatly in degree, exhibit considerable variations in their duration, are often associated with the affect of anxiety and are, as a rule, accompanied by other nervous symptoms, Lowenfeld bases his description on a considerable number of medical histories. I myself have come across these states in a number of patients whom I have treated by psycho-analysis. Since these dream-states have not been dealt with from a psycho-analytical point of view up to the present, I will give the main results of my observations in the following pages. They form a further addition to the knowledge derived from psycho-analysis concerning the nature of episodic phenomena in the clinical picture of hysteria.

 

V. REMARKS ON THE PSYCHO-ANALYSIS OF A CASE OF FOOT AND CORSET FETISHISM (1910)

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IT is only latterly that special attention has been paid to the problems of fetishism by psycho-analysis. In the first edition of his Drei Abhandlungen zur Sexualtheorie Freud assigned to it a unique position among the other sexual aberrations and among the neuroses. Further observation has shown, however, that in many cases fetishism and neurosis are both present in the same individual. In the second edition of his above-mentioned book Freud has made a short reference to this fact, and has traced the phenomena of fetishism back to a special variety of repression which he has called ‘partial repression’, In consequence of this the once emphasized contrast between neurosis and fetishism has been done away with.

The analysis of a case of shoe and corset fetishism which I am going to discuss has led me to certain conclusions regarding the psychogenesis of this form of fetishism; and other cases have confirmed that view.

We must assume that as the basis of such an abnormality there is a specific sexual constitution which is characterized by the abnormal strength of certain component-instincts. Given this, the complex of fetishistic phenomena is formed by the co-operation of two factors, namely, the partial repression mentioned above, and a process of displacement 2 which we shall discuss in greater detail.

 

VI. NOTES ON THE PSYCHO-ANALYTICAL INVESTIGATION AND TREATMENT OF MANIC-DEPRESSIVE INSANITY AND ALLIED CONDITIONS (191 I)

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WHEREAS states of morbid anxiety have been dealt with in detail in the literature of psycho-analysis, depressive states have hitherto received less attention. Nevertheless the affect of depression is as widely spread among all forms of neuroses and psychoses as is that of anxiety. The two affects are often present together or successively in one individual; so that a patient suffering from an anxiety-neurosis will be subject to states of mental depression, and a melancholic will complain of having anxiety.

One of the earliest results of Freud’s investigation of the neuroses was the discovery that neurotic anxiety originated from sexual repression; and this origin served to differentiate it from ordinary fear. In the same way we can distinguish between the affect of sadness or grief and neurotic depression, the latter being unconsciously motivated and a consequence of repression.

Anxiety and depression are related to each other in the same way as are fear and grief. We fear a coming evil; we grieve over one that has occurred. A neurotic will be attacked with anxiety when his instinct strives for a gratification which repression prevents him from attaining; depression sets in when he has to give up his sexual aim without having obtained gratification. He feels himself unloved and incapable of loving, and therefore he despairs of his life and his future. This affect lasts until the cause of it ceases to operate, either through an actual change in his situation or through a psychological modification of the displeasurable ideas with which he is faced. Every neurotic state of depression, just like every anxiety-state, to which it is closely related, contains a tendency to deny life.

 

VII. A COMPLICATED CEREMONIAL FOUND IN NEUROTIC WOMEN (1912)

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SEVERAL years ago Freud published a short paper 2 in which he discussed the relation between obsessional neurosis and religious practices. Ordinary observation shows us that very many neurotics—and not only obsessional ones—carry on in private a cult which in its various forms reminds us of religious rites and ceremonies, and that they repeat some of these practices day by day with the same regularity and fixed procedure with which a religious community will repeat its prayers every morning -and evening.

Although there is a very wide scope for individual difference in a private cult of this kind, we often find persons making use of the same or of very similar neurotic ceremonials, notwithstanding that they come from entirely different social circles, and differ completely in their way of life, the circumstances in which they are placed, their intellectual abilities, and their opinions. This applies particularly to the simplest forms of ceremonial. For example, there is the very prevalent compulsion of having to step in a certain way on the flagstones of the pavement; and there is the equally frequent compulsion to count one’s steps in walking or going upstairs and to end up with an even number. This compulsion has to do with ideas of fairness, and is also an over-compensation for certain forbidden impulses. But this is a subject we cannot enter into any further in this place.

 

VIII. MENTAL AFTER-EFFECTS PRODUCED IN A NINE-YEAR- OLD CHILD BY THE OBSERVATION OF SEXUAL INTERCOURSE BETWEEN ITS PARENTS (1913)

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THE editor of this Journal has asked for accounts of dreams occurring in childhood the interpretationof which would justify the conclusion that the dreamer had witnessed sexual intercourse at an early age. The following contribution only in part satisfies this request, in that in this case the observation of parental sexual intercourse did not take place in the earliest years of childhood, but in all probability took place immediately before the occurrence of the dream which I am about to relate and of the concomitant neurotic anxiety. Nevertheless, I consider it worth publishing, because the case shows with more than usual clearness how a child disposed to neurosis reacts to an event of this nature.

Some time ago I was called in to see a little girl of nine and three-quarters who had recently begun to suffer from anxiety states.

Ten days before the consultation the child had been put to bed as usual in the evening. After having slept for a good hour she called for her mother with screams of fear, Her mother, who was in the next room, went to her, and the little girl told her a dream with every sign of terror. She said: ‘A man wanted to murder you in bed, but I saved you\ While relating this she still could not distinguish between dream and reality. When her mother tried to soothe her she said with a horrified expression, ‘Oh, you aren’t my mother at all’, She then showed fear of objects in the room, mistaking them for animals. It was some time before she cotild be pacified; but she then slept till morning. On waking she declared that she had slept well and undisturbed during the night, and that she felt quite welL When her parents questioned her cautiously (and hence only superficially) it appeared that she did not remember the episode.

 

IX. RESTRICTIONS AND TRANSFORMATIONS OF SCOPOPHILIA IN PSYCHO-NEUROTICS J WITH REMARKS ON ANALOGOUS PHENOMENA IN FOLK-PSYCHLOGY (1913) .169

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THE sexual component-instinct of scopophilia, or pleasure in looking, is—like its counterpart, exhibitionism, or pleasure in displaying—subject to numerous restrictions and transformations. Under normal conditions both instincts, which are allowed free expression in early childhood, are subjected to a considerable measure of repression and sublimation later on. In psycho-neurotics these instincts are inhibited and transformed to a very much greater degree than in normal people; while at the same time they carry on a continual struggle against the forces of repression.

In a short paper 2 Freud has laid down certain lines of thought which open the way to a deeper insight into the neurotic inhibitions and transformations of the scopo-philic instinct. He makes use of his theory of the erotogenic zones and component-instincts, and speaks as follows concerning the scopophilic instinct and its erotogenic zone, the eyes: ‘The eyes perceive not only those modifications in the external world which are of import for the preservation of life, but also the attributes of objects by means of which these may be exalted as objects of erotic selection, their “ charms “. We now perceive the truth of the saying that it is never easy to serve two masters at the same time. The more intimate the relation of an organ possessing such a duality of function with one of the great instincts, the more will it refuse itself to the other.’

 

X. A CONSTITUTIONAL BASIS OF LOCOMOTOR ANXIETY (1913)

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THOSE who have investigated the psychogenesis of locomotor anxiety with the help of Freudian methods have regularly met with certain factors operating in the formation of this trouble, so that they have been bound to regard them as typical for that illness- They were, of course, well aware that the neurotic who needs the constant company of particular persons shows the incestuous fixation of his libido in a particularly marked degree, and that every attempt he makes to separate himself from his love-object signifies in his unconscious an attempt to detach his libido from it. They have recognized, furthermore, that the anxiety such a person feels causes him suffering on the one hand, but, on the other, enables him to exert his power over the persons about him. Further typical determinants of his ‘ topophobia ‘ are the subject’s fear of life—symbolically represented by streets—and in particular, his fear of the temptations which beset him as soon as he leaves the protection of his parental home. There is also his dread of death which might overtake him unawares when he is away from the people he loves.

 

XI THE EAR AND AUDITORY PASSAGE AS EROTOGENIC ZONES (1913)

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SEVERAL years ago my attention was drawn by the following observation to the significance of the ear and external auditory meatus as erotogenic zones, A neurotic patient suffered from peculiar ‘ attacks ‘which occurred ten to twenty times a day and even more often. I had ample opportunity of observing these ‘attacks’ during a long psycho-analytic treatment. In the middle of a conversation the patient would suddenly jump up, turn pale, put his hands up to his ears, and run to the door; then he would stick the forefinger of his right hand into his right ear and move the finger violently about in it with every sign of the most intense excitement. At the same time his face would work as though he were in a towering rage, and he would wriggle about and stamp his feet. The motor innervation would finally be discharged in panting breaths, and he would then sink down exhausted. After a few moments he would be able to continue his previous train of thought, though I sometimes had to recall to his memory the words he had been speaking immediately before his attack. Consciousness was always clouded during the attacks; and after them the patient had a feeling of returning to reality out of a different state. He knew that quite definite thoughts appeared at the height of his state of excitement, but he was never able to recollect what they were precisely. The analysis, which cannot be given in full here, showed that at the beginning of each attack the patient felt violent itching in the auditory meatus, of which he rid himself with every sign of great excitement. These attacks were a surrogate for certain kinds of sexual activity which were denied him. It is particularly interesting to note that the attacks, and most of his other symptoms as well, disappeared on one occasion for some months. This was at a time when he had become acquainted with a girl. They did not proceed to sexual intercourse, but found pleasure in tickling each other with feelings of great excitement until they became exhausted.

 

XII. THE FIRST PREGENITAL STAGE OF THE LIBIDO (1916)

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I

IN his Drei Abhandlungen zur Sexuahheorie, which first appeared in 1905, Freud gave a comprehensive account of his views concerning the sexuality of the child. In the third edition of the book, published in 1915, he has amplified those views, so that it is still to-day the standard work on the subject,

The advances which have been made in psycho-analytical knowledge have required us to assume the existence of certain stages in the early development of the infantile libido. Freud calls those stages the ‘pregenital organizations of the libido, since they do not as yet show a predominating importance of the genital organs.

The following remarks relate to the earliest of those stages of development. They are supported by extensive observations which were exclusively made before the theoretical views concerning the libidinal stages were put forward, A preconceived theory of the pregenital organizations cannot therefore have influenced the choice of that material. It seems to me necessary to point out this, since each further extension of the sexual theory will probably meet with objections similar to those raised at the first appearance of the Drei Abhandlungen. Nevertheless, before presenting my material and the conclusions which I have drawn from them, I shall have to review the fundamental facts upon which the theory of the pregenital stages of the libido is based,

 

XIII. EJACULATIO PRECOX (1917)

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No disturbance of male potency is so frequently observed by the nerve-specialist as that of ejaculatio precox. This affection is well known not only to the medical profession but to the laity. In it there is a premature emission of semen immediately after or even before the intromission of the penis during sexual intercourse, and the erection comes to an end. This description is of course a very rough one. But although it has been the subject of special investigation its real nature has not been explained, still less its origin.

Up to the present this disorder has not been given a separate and thorough examination in the literature of psycho-analysis. It has only been treated in conjunction with other disturbances of potency. Steiner has made a condensed survey of psycho-analytical knowledge regarding impotence, while Ferenczi has gone more deeply into the origin of disturbances of potency, and has discussed its unconscious causes; but he has made no special inquiry into ejaculatio praecox.

 

XIV. THE SPENDING OF MONEY IN ANXIETY STATES (1917)

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THE attitude of the neurotic to the possession of money has been the subject of much study in psycho-analytic literature. Both Freud and other analysts who have followed him in directing their interest to ‘ anal’ character-traits have dealt with neurotic avarice and the anxious retention of money from the point of view of unconscious motives; but the opposite behaviour of many neurotics, the excessive spending of money, has not received the same attention, although the psycho-analyst frequently comes across it. This tendency appears suddenly in many neurotics, like a kind of attack, and stands in conspicuous contrast to their usual parsimony.

From the few cases that I have been able to observe during my psycho-analytic work, it seems to me that this condition is found in a definite group of neurotics—in persons who are in a state of permanent infantile dependence on the parental home and who are attacked with depression or anxiety as soon as they are away from it. The patients themselves say that the spending of money relieves their depression or anxiety; and they produce rational explanations for this, such as that spending money increases their self-confidence, or that it distracts them from their condition. Psycho-analysis takes the unconscious into consideration and adds a deeper explanation to this purely superficial one.

 

XV. A PARTICULAR FORM OF NEUROTIC RESISTANCE AGAINST THE PsYCHO-ANALYTIC METHOD (1919)

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WHEN we begin to give a patient psycho-analytic treatment we make him acquainted with its fundamental rule to which he has to adhere unconditionally. The behaviour of each patient in regard to that rule varies. In some cases he will easily grasp it and carry it out without particular difficulty; in others he will frequently have to be reminded of the fact that he has to make free associations; and in all cases we meet at times with a failure to associate in this way. Either he will produce the result of his reflected thoughts or say that nothing occurs to him. In such a situation the hour of treatment can sometimes pass without his producing any material whatever in the way of free association. This behaviour indicates a ‘resistance ‘, and our first task is to make its nature clear to the patient. We regularly learn that the resistance is directed against allowing certain things in the mind from becoming conscious. If at the commencement of the treatment we have explained to the patient that his free associations give us an insight into his unconscious, then his refusal to give free associations of this kind is an almost obvious form for his resistance to take.

 

XVI. THE APPLICABILITY OF PSYCHO-ANALYTIC TREATMENT Ta PATIENTS AT AN ADVANCED AGE (1919)

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THE question of what the conditions are under which psycho - analytic treatment promises therapeutic success has hardly been discussed at all up to the present, except for some general remarks by Freud in a paper which appeared many years ago.2

Since then psycho-analytic experience has been much increased and its technique greatly developed. It therefore seems an opportune moment to consider more carefully this question, which is of great practical importance. The following remarks are intended as a first attempt to throw light on the subject.

In his paper Freud has expressed the opinion that psychoanalysis loses its effectiveness if the patient is too advanced in years. There is no doubt about the general correctness of this view. It was only to be expected that at the commencement of physical and psychical involution a person should be less inclined to part with a neurosis which he has had most of his life. Daily psycho-analytical experience, however, shows that we must not expect mental processes to be too uniform. It warns us against approaching the investigation or treatment of nervous conditions with a priori theories. For instance, has it not been shown that certain mental diseases which psychiatric medicine has pronounced to be quite intractable are accessible to psycho-analytic methods? It would seem therefore incorrect to deny a priori the possibility of exercising a curative influence upon the neuroses in the period of involution. It is rather the task of psycho-analysis as a scientific procedure to inquire into precisely this question as to whether, and under what conditions, the method of treatment can attain results in patients in the later years of life.

 

XVII. THE NARCISSISTIC EVALUATION OF EXCRETORY PROCESSES IN DREAMS AND NEUROSIS (1920)

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WHILE undergoing psycho-analytic treatment, a female patient had the following dream: ‘ I was sitting in a basket-chair near the wall of a house which was at the edge of a big lake. The chair was standing right on the water. There were boats on the lake and many people swimming in it. I saw two men in a boat, a young one and an older one. As the boat was approaching me there came a gust of wind which made a huge wave rise just behind the boat and engulf it and its occupants. The people who were swimming in the lake were drowned as well. Only one person, a woman, kept herself above water. She swam up to me and clutched at my chair. I thought that I could stretch out my leg for her to hold on to; but I had just as little sympathy for her as for the other unfortunate people, and I did nothing to help her.’

The analysis of the dream, as far as it is of interest here, elicited the following facts:

The two men in the boat were the patient’s father and brother, upon both of whom her libido was over-strongly fixated. The woman who was swimming was her mother. I shall pass over the psychic constellation which caused the dreamer unconsciously to wish for the death of her whole family, and I shall only consider the method by which it was destroyed in her dream.

 

XVIII. CONTRIBUTION TO A DISCUSSION ON TIC (1921)

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A NUMBER of different phenomena were originally included under the name ‘Tic’, as, for instance, ticdouloureux (trigeminal neuralgia), facial spasms, and many compulsive symptoms, as well as the symptoms still designated as tics to-day. Nowadays it is only the separation of tics from compulsive actions which raises difficulties from the point of view of differential diagnosis, Neither Meige, Feindel, nor Ferenczi solve this difficulty. The characteristics of a tic as given by the first two authors apply equally well to compulsive actions. The incapability of mastering a stimulus, which Ferenczi describes, is very well observed, but this likewise occurs in the obsessional neurotic. Again, narcissistic phenomena on which Ferenczi lays, particular stress can be seen in all hysterical and obsessional patients. Regression to narcissism, however, certainly never goes so far in the person suffering from a tic as in the psychotic patient. Ferenczi is quite right in calling attention to the similarities between tics and catatonia, but he overlooks the much more fundamental differences between the two conditions. There can be no question of a tic ending in dementia. On the other hand, the assumption of an increased organ libido and the conception of a ‘pathoneurotic tic ‘seem to be very useful.

 

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