Selected papers on hysteria and other psychoneurosesFreud, Sigmund
Science
Selected papers on hysteria and other psychoneuroses
Freud, Sigmund
Hysteria; Neuroses; Psychoanalysis
The main objection against my formulation of a sexual etiology of the
anxiety neurosis will probably be to the purport that such abnormal
relations of the sexual life can be found so very often that wherever
one will look for them they will be found near at hand. Their
occurrence, therefore, in the cases cited of anxiety neurosis does not
prove that the etiology of the neurosis was revealed in them. Moreover,
the number of persons practicing coitus interruptus, etc., is
incomparably greater than the number of those who are burdened with
anxiety neurosis, and the overwhelming number of the first are quite
well in spite of this injury.
To this I can answer that we certainly ought not to expect a rarely
occurring etiological moment in the conceded enormous frequency of the
neurosis, and especially anxiety neurosis; furthermore, that it really
fulfills a postulate of pathology if on examining an etiology the
etiological moments can be more frequently demonstrated than their
effects, for, for the latter still other determinants (predisposition,
summation of the specific etiology, reinforcement through other banal
injuries) could be demanded; and furthermore, that the detailed analysis
of suitable cases of anxiety neurosis show quite unequivocally the
significance of the sexual moment. I shall, however, here confine myself
to the etiological moment of coitus interruptus, and I will render
prominent obvious individual experiences.
1. As long as the anxiety neurosis in young women is not yet constituted
but appears in fragments which again spontaneously disappear, it can be
shown that every such turn of the neurosis depends on a coitus with lack
of gratification. Two days after this influence, and in persons of
little resistance the day after, there regularly appears the attack of
anxiety or vertigo to which all the other symptoms of the neurosis
attach themselves, only to separate again on rarer marriage relations.
An unexpected journey of the husband, a sojourn in the mountains causing
a separation of the married couple, does good; the benefit from a course
of gynecological treatment is due to the fact that during its
continuation the marriage relations are stopped. It is noteworthy that
the success of a local treatment is only transitory, the neurosis
reappears while in the mountains if the husband joins his wife for his
own vacation, etc. If, in a not as yet constituted neurosis, a physician
aware of this etiology causes a substitution of the coitus interruptus
by normal relations there results a therapeutic proof of the assertion
here formulated. The anxiety is removed and does not return unless there
be a new or similar cause.
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