Recently the Freudian school has endeavored to penetrate more deeply to the
nucleus of the problem and to solve it. Freud has delimited what he calls
obsessional or compulsion neurosis (Zwangsneurosis), which is classed under
psychasthenia by the French and under neurasthenia by others. The Freudians
regard this as a distinct neurosis, sometimes complicated by neurasthenic or
hysterical symptoms. The characteristic symptom is a feeling of compulsion.
The symptoms may be motor (obsessional acts, impulsions), sensory
(obsessional hallucinations or sensations), ideational (obsessions), and
affective (obsessive emotions, particularly doubt and fear). In this
condition we find that there is an excessive psychical significance attached
to certain thoughts. Obsessions are characterized by dissociations from the
main personality. They thus exist in the unconsciousness. The original
unconscious mental processes have brought about, by displacement, an excess
of psychical significance to these thoughts. Ernest Jones[5] states that
Freud found, by his work in psychoanalysis, that obsessions represented,
symbolically, the return of self-reproaches of ancient, infantile and early
childhood origin, which had been repressed and buried until the obsession
made its appearance. "They always refer to active sexual performances or
tendencies;" and, as Jones further explains, "there occurs early in life an
exaggerated divorce between the instincts of hate and love, and the conflict
and antagonism between the two dominate the most important reactions of the
person. A fundamental state of doubt, an incapacity for decision, results
from this paralyzing doubt. The patient oscillates between the two
conditions of not being able to act (when he wants to), and of being obliged
to act (when he doesn't want to). The symptom symbolizes the conflicting
forces. These are not, as in hysteria, fused into a compromise-formation,
but come to separate and alternating expression; one set of manifestations,
therefore, symbolizes the repressed forces, another the repressing."
[5] See his article on "The Treatment of the Psychoneuroses," White and
Jelliffe's Modern Treatment of Nervous and Mental Diseases, Vol I, pp.
408-409.
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