Recall the compulsive act of our first patient. The woman longs for her intensely beloved husband, with whom she cannot share her life because of his shortcoming and weaknesses. She feels she must remain true to him, she can give his place to no one else. Her compulsive symptom affords her that for which she pines, ennobles her husband, denies and corrects his weaknesses — above all, his impotence. This symptom is fundamentally a wish-fulfillment, exactly as is a dream; moreover, it is what a dream not always is, an erotic wish-fulfillment. In the case of our second patient you can see that one of the component purposes of her ceremonial was the prevention of the intercourse of her parents or the hindrance of the creation of a new child thereby. You have perhaps also guessed that essentially she strove to put herself in the place of her mother. Here again we find the removal of disturbances to sexual satisfaction and the fulfillment of personal sexual wishes. We shall soon turn to the complications of whose existence we have given you several indications.
I do not want to make reservations as to the universal applicability of these declarations later on, and therefore I wish to call to your attention the fact that everything that I say here about suppression, symptom-development and symptom-interpretation has been learned from three types of neuroses — anxiety-hysteria, conversion-hysteria, and compulsion-neuroses — and for the time being is relevant to these forms only. These three conditions, which we are in the habit of combining into one group under the name of “transference neuroses,” also limit the field open to psychoanalytic therapy. The other neuroses have not been nearly so well studied by psychoanalysis — in one group, in fact, the impossibility of therapeutic influence has been the reason for the neglect. But you must not forget that psychoanalysis is still a very young science, that it demands much time and care in preparation for it, that not long ago it was still in the cradle, so to speak. Yet at all points we are about to penetrate into the understanding of those other conditions which are not transference neuroses. I hope I shall still be able to speak to you of the developments that our assumptions and results have undergone by being correlated with this new material, and to show you that these further studies have not led to contradictions but rather to the production of still greater uniformity. Granted that everything, then, that has been said here, holds good for the three transference neuroses, allow me to add a new bit of information to the evaluation of its symptoms. A comparative investigation into the causes of the disease discloses a result that may be confined into the formula: in some way or other these patients fell ill through self-denial when reality withheld from them the satisfaction of their sexual wishes. You recognize how excellently well these two results are found to agree. The symptoms must be understood, then, as a substitute satisfaction for that which is missed in life.
To be sure, there are all kinds of objections possible to the declaration that neurotic symptoms are substitutes for sexual satisfaction. I shall still go into two of them today. If you yourself have analytically examined a fairly large number of neurotics you will perhaps gravely inform me that in one class of cases this is not at all applicable, the symptoms appear rather to have the opposite purpose, to exclude sexual satisfaction, or discontinue it. I shall not deny the correctness of your interpretation. The psychoanalytic content has a habit of being more complicated than we should like to have it. Had it been so simple, perhaps we should have had no need for psychoanalysis to bring it to light. As a matter of fact, some of the traits of the ceremonial of our second patient may be recognized as of this ascetic nature, inimical to sexual satisfaction; for example, the fact that she removes the clocks, which have the magic qualities of preventing nightly erections, or that she tries to prevent the falling and breaking of vessels, which symbolizes a protection of her virginity. In other cases of bed-ceremonials which I was able to analyze, this negative character was far more evident; the ceremonial might consist throughout of protective regulations against sexual recollections and temptations. On the other hand, we have often discovered in psychoanalysis that opposites do not mean contradictions. We might extend our assertion and say the symptoms purpose either a sexual satisfaction or a guard against it; that in hysteria the positive wish-fulfillment takes precedence, while in the compulsion neuroses the negative, ascetic characteristics have the ascendancy. We have not yet been able to speak of that aspect of the mechanism of the symptoms, their two-sidedness, or polarity, which enables them to serve this double purpose, both the sexual satisfaction and its opposite. The symptoms are, as we shall see, compromise results, arising from the integration of two opposed tendencies; they represent not only the suppressed force but also the suppressing factor, which was originally potent in bringing about the negation. The result may then favor either one side or the other, but seldom is one of the influences entirely lacking. In cases of hysteria, the meeting of the two purposes in the same symptom is most often achieved. In compulsion-neuroses, the two parts often become distinct; the symptom then has a double meaning, it consists of two actions, one following the other, one releasing the other. It will not be so easy to put aside a further misgiving. If you should look over a large number of symptom-interpretations, you would probably judge offhand that the conception of a sexual substitute-satisfaction has been stretched to its utmost limits in these cases. You will not hesitate to emphasize that these symptoms offer nothing in the way of actual satisfaction, that often enough they are limited to giving fresh life to sensations or phantasies from some sexual complex. Further, you will declare that the apparent sexual satisfaction so often shows a childish and unworthy character, perhaps approximates an act of onanism, or is reminiscent of filthy naughtiness, habits that are already forbidden and broken in childhood. Finally, you will express your surprise that one should designate as a sexual satisfaction appetites which can only be described as horrible or ghastly, even unnatural. As to these last points, we shall come to no agreement until we have submitted man’s sexual life to a thorough investigation, and thus ascertained what one is justified in calling sexual.
TWENTIETH LECTURE
GENERAL THEORY OF THE NEUROSES
THE SEXUAL LIFE OF MAN
One might think we could take for granted what we are to understand by the term “sexual.” Of course, the sexual is the indecent, which we must not talk about. I have been told that the pupils of a famous psychiatrist once took the trouble to convince their teacher that the symptoms of hysteria very frequently represent sexual matters. With this intention they took him to the bedside of a woman suffering from hysteria, whose attacks were unmistakable imitations of the act of delivery. He, however, threw aside their suggestion with the remark, “a delivery is nothing sexual.” Assuredly, a delivery need not under all circumstances be indecent.
I see that you take it amiss that I jest about such serious matters. But this is not altogether a jest. In all seriousness, it is not altogether easy to define the concept “sexual.” Perhaps the only accurate definition would be everything that is connected with the difference between the two sexes; but this you may find too general and too colorless. If you emphasize the sexual act as the central factor, you might say that everything is sexual which seeks to obtain sensual excitement from the body and especially from the sexual organs of the opposite sex, and which aims toward the union of the genitals and the performance of the sexual act. But then you are really very close to the comparison of sexual and indecent, and the act of delivery is not sexual. But if you think of the function of reproduction as the nucleus of sexuality you are in danger of excluding a number of things that do not aim at reproduction but are certainly sexual, such as onanism or even kissing. But we are prepared to realize that attempts at definition always lead to difficulties; let us give up the attempt to achieve the unusual in our particular case. We may suspect that in the development of the concept “sexual” something occurred which resulted in a false disguise. On the whole, we are quite well oriented as to what people call sexual.
The inclusion of the following factors in our concept “sexual” amply suffices for all practical purposes in ordinary life: the contrast between the sexes, the attainment of sexual excitement, the function