For your comprehension of the neuroses it is necessary to keep in mind this connection between fixation and regression. This will give you a secure hold upon the question of the cause of neuroses — of the etiology of neuroses — which we shall soon consider.
For the present we have still to discuss various aspects of regression. With the knowledge you have gained concerning the development of the function of libido, you must expect two kinds of regression: incestuous return to the first libidinous objects and return of the entire sexual organization to an earlier stage of development. Both occur in the transference neuroses and play an important part in its mechanism. Especially is the return to the first incestuous objects of libido a feature that the neurotic exhibits with positively tiresome regularity. We could say far more about regression of libido if we took into consideration another group of neuroses: neurotic narcism. But we cannot do this now. These conditions give us a clue to other stages of development of the function of libido, which have not been mentioned previously, and correspondingly show new kinds of regression. But I think the most important task before me at this point is to warn you not to confuse regression and suppression, and aid you to see clearly the connection between the two processes. Suppression, as you know, is the process by which an act capable of becoming conscious, in other words, an act that belongs to the fore-conscious system, is rendered unconscious and accordingly is thrust back into the unconscious system. Similarly we speak of suppression when the unconscious psychic act never has been admitted into the adjoining fore-conscious system but is arrested by the censor at the threshold. Kindly observe that the conception of suppression has nothing to do with sexuality. It describes a purely psychological process, which could better be characterized by terming it localized. By that we mean that it is concerned with the spatial relationships within the psyche, or if we drop this crude metaphor, with building up the psychological apparatus out of separate, psychic systems.
Through these comparisons we observe that up to this point we have not used the word regression in its general, but in a very special sense. If you accord it the general meaning of return from a higher to a lower stage of development you must include suppression as a form of regression, for suppression may also be described as the reversion to an earlier and lower stage in the development of a psychic act. Only in regard to suppression, this tendency to revert is not necessarily involved, for when a psychic act is held back in the early unconscious stage we also term it suppression in a dynamic sense. Suppression is a localized and dynamic conception, regression purely descriptive. What up this point we have called regression and considered in its relation to fixation, was only the return of libido to former stages of its development. The nature of this latter conception is entirely distinct and independent of suppression. We cannot call the libido regressions purely psychical processes and do not know what localization in the psychological apparatus we should assign to them. Even though the libido exerts a most powerful influence on psychic life, its organic significance is still the most conspicuous.
Discussions of this sort, gentlemen, are bound to be somewhat dry. To render them more vivid and impressive, let us return to clinical illustrations. You know that hysteria and compulsion-neurosis are the two chief factors in the group of transference neuroses. In hysteria, libidinous return to primary, incestuous sexual objects is quite regular, but regression to a former stage of sexual organization very rare. In the mechanism of hysteria suppression plays the chief part. If you will permit me to supplement our previous positive knowledge of this neurosis by a constructive suggestion, I could describe the state of affairs in this manner: the union of the partial instincts under the domination of the genitals is accomplished, but its results encounter the opposition of the fore-conscious system which, of course, is bound up with consciousness. Genital organization, therefore, may stand for the unconscious but not for the fore-conscious. Through this rejection on the part of the fore-conscious, a situation arises which in certain aspects is similar to the condition existing before the genitals had attained their primacy. Of the two libido regressions, the regression to a former stage of sexual organization is by far the more conspicuous. Since it is lacking in hysteria and our entire conception of the neuroses is still too much dominated by the study of hysteria which preceded it in point of time, the meaning of libido regression became clearer to us much later than that of repression. Let us be prepared to widen and change our attitude still more when we consider other narcistic neuroses besides compulsion-neurosis and hysteria in our discussion.
In contrast to this, regression of libido in compulsion-neurosis turns back most conspicuously to the earlier sadistico-anal organization, which accordingly becomes the most significant factor expressed by the symptoms. Under these conditions the love impulse must mask itself as a sadistic impulse. The compulsion idea must therefore be reinterpreted. Isolated from other superimposed factors, which though they are not accidental are also indispensable, it no longer reads: “I want to murder you”; rather it says “I want to enjoy you in love.” Add to this, that simultaneously regression of the object has also set in, so that this impulse is invariably directed toward the nearest and dearest persons, and you can imagine with what horror the patient thinks of these compulsion ideas and how alien they appear to his conscious perception. In the mechanism of these neuroses, suppression, too, assumes an important part, which it is not easy to explain in a superficial discussion of this sort. Regression of the libido without suppression would never result in neurosis but would finally end in perversion. This makes it obvious that suppression is the process most characteristic of neurosis, and typifies it most perfectly. Perhaps I shall at some future time have the opportunity of presenting to you our knowledge of the mechanism of perversions and then you will see that here also things do not work themselves out as simply as we should best like to construe them.
You will most readily reconcile yourself with these elucidations of fixation and regression, when you consider them as a preface to the investigation of the etiology of neuroses. Towards this I have only advanced a single fact: that people become neurotically ill when the possibility of satisfying their libido is removed, ill with “denial,” as I expressed myself, and that their symptoms are the substitutes for the denied gratification. Of course, that does not mean that every denial of libidinous satisfaction makes every person neurotic, but merely that in all cases known of neurosis, the factor of denial was traceable. The syllogism therefore cannot be reversed. You also understand, I trust, that this statement is not supposed to reveal the entire secret of the etiology of neurosis, but only emphasizes an important and indispensable condition.
Now, we do not know, in the further discussion of this statement, whether to emphasize the nature of denial or the individuality of the person affected by it. Denial is very rarely complete and absolute; to cause a pathological condition, the specific gratification desired by the particular person in question must be withheld, the certain satisfaction of which he alone is capable. On the whole there are many ways of enduring abstinence from libidinous gratification without succumbing to a neurosis by reason thereof. Above all we know of people who are able to endure abstinence without doing themselves injury; they are not happy under the circumstances, they are filled with yearning, but they do not become ill. Furthermore, we must take into consideration that the impulses of the sex instinct are extraordinarily plastic, if I may use that term in this connection. One thing may take the place of the other; one may assume the other’s intensity; if reality refuses the one gratification, the satisfaction of another may offer full compensation. The sexual impulses are like a network of communicating channels filled with fluids; they are this in spite of their subjugation to the primacy of the genitals, though I realize it is difficult to unite these two ideas in one conception. The component impulses of sexuality as well as the total sexual desire, which represents their aggregate, show a marked ability to change their object, to exchange it, for instance, for one more easily attainable. This displacement and the readiness to accept substitutes must exert powerful influences in opposition to the pathological effect of abstinence. Among these processes which resist the ill