The two sources of ‘pain’ here indicated still do not nearly cover the
majority of our painful experiences, but as to the rest one may say with
a fair show of reason that their presence does not impugn the supremacy
of the pleasure-principle. Most of the ‘pain’ we experience is of a
perceptual order, perception either of the urge of unsatisfied instincts
or of something in the external world which may be painful in itself or
may arouse painful anticipations in the psychic apparatus and is
recognised by it as ‘danger’. The reaction to these claims of impulse
and these threats of danger, a reaction in which the real activity of
the psychic apparatus is manifested, may be guided correctly by the
pleasure-principle or by the reality-principle which modifies this. It
seems thus unnecessary to recognise a still more far-reaching limitation
of the pleasure-principle, and nevertheless it is precisely the
investigation of the psychic reaction to external danger that may supply
new material and new questions in regard to the problem here treated.
II
After severe shock of a mechanical nature, railway collision or other
accident in which danger to life is involved, a condition may arise
which has long been recognised and to which the name ‘traumatic
neurosis’ is attached. The terrible war that is just over has been
responsible for an immense number of such maladies and at least has put
an end to the inclination to explain them on the basis of organic injury
to the nervous system due to the operation of mechanical force.[2] The
clinical picture of traumatic neurosis approaches that of hysteria in
its wealth of similar motor symptoms, but usually surpasses it in its
strongly marked signs of subjective suffering—in this resembling rather
hypochondria or melancholia—and in the evidences of a far more
comprehensive general weakening and shattering of the mental functions.
Neither the war neuroses nor the traumatic neuroses of peace are as yet
fully understood. With the war neuroses some light was contributed, but
also on the other hand a certain confusion introduced, by the fact that
the same type of malady could occasionally occur without the
interposition of gross mechanical force. In the traumatic neuroses there
are two outstanding features which might serve as clues for further
reflection: first that the chief causal factor seemed to lie in the
element of surprise, in the fright; and secondly that an injury or wound
sustained at the same time generally tended to prevent the occurrence of
the neurosis. Fright, fear, apprehension are incorrectly used as
synonymous expressions: in their relation to danger they admit of quite
clear distinction. Apprehension (_Angst_) denotes a certain condition as
of expectation of danger and preparation for it, even though it be an
unknown one; fear (_Furcht_) requires a definite object of which one is
afraid; fright (_Schreck_) is the name of the condition to which one is
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