Translation｜SIGMUND FREUD Somatic tendencies in obsessive-compulsive neurosis A little contribution to the problem of choice in neurosis (1913)
Author: SIGMUND FREUD Translated by Deng Lin and Ling Ze
Translator’s Introduction: Is sexual life and reproductive life completely consistent in humans? This article once again emphasizes the inconsistency between the two, and the key reason is the existence of sexual tissue life during the pre genital period in children. The disorder in the development of psychological function (including sexual function and self function) during this period is an important factor affecting the selection results of neurosis. This article categorizes this factor as physical inclination. Then, starting from a case of adult female obsessive-compulsive disorder, this article discusses the physical tendencies of obsessive-compulsive disorder and draws a supplementary idea to the previous development path of libido: between “narcissism” and “object love” dominated by reproductive impulses, there is still a period when the object of love has transformed into an external object but the dominant impulse is sadism and anal desire. Finally, based on the discussion of the tendency of OCD constitution, this article proposes that while “libido development” exists, there is also a “self-development” path, and the interweaving of the two paths affects the overall development of individuals. What are the impulses related to “self-development”? This article mentions “controlling impulses”, “seeking knowledge impulses”, and “seeking harmonious self impulses”.
The question of why a person may suffer from neurosis and how to do so naturally belongs to the problem that psychoanalysis needs to solve. However, before answering this question, we may first need to address another more specific question – that is, why this or that person is destined to suffer from this rather than that type of neurosis. This is the issue of “neurosis selection”. What do we currently know about this issue? Strictly speaking, only one general disposition can be determined on this issue. I remember we once divided the pathogenic factors related to neurosis into two categories: one is brought into life by a person, and the other is brought to them by life – congenital and accidental – generally speaking, we can determine the pathogenic factors only by their combination. Therefore, the viewpoint of overall physical inclination mentioned above advocates that the decision to choose neurosis is entirely based on the former – that is, they are essentially constitutional and unrelated to the pathogenic experience. Where will we go to find the source of these physical tendencies? We already know that human psychological functions – first sexual function, then other equally important ego functions – must go through a long and complex developmental process in order to reach a state unique to normal adults. We can assume that these developments are not always smooth, so the overall functionality always undergoes continuous and developmental modifications. If a certain part of it is held at a certain stage before it is released, a “fixation point” will be formed in this place, and then when the subject becomes ill due to some external interference, the function will regress to this point. Therefore, it can be said that our physical inclination is the inhibition of development. This viewpoint can be confirmed by comparing it with the common pathological facts of other diseases. But what factors can bring about such developmental disorder? Faced with this problem, psychoanalysis concluded its work: it left the issue to biological research. (Note 1)
Note 1
Since William Fritz’s works have already revealed the biological meaning of specific time periods, we can imagine that individual developmental disorders can be traced back to the temporal changes of continuous developmental fluctuations.
A few years have passed, and at that time we used these assumptions to take risks in dealing with the issue of neurosis selection. Our goal is to find normal developmental conditions by studying the disorder of developmental conditions, and this working method has allowed us to accept a very unique and unexpected line of attack. Generally speaking, we list the order of major psychiatric disorders – hysteria, obsessive-compulsive neurosis, Paranoia, and Dementia Praecox – corresponding to the age sequence at which these developmental disorders first appear (although not very precise). Hysteric disease manifestations can even be observed in children at the earliest stages; Compulsive neurosis often first manifests symptoms in the second stage of child development (between 6 and 8 years old); And the other two types of psychiatric disorders – both of which I categorize as “delusional dementia” – only appear after adolescence and during adulthood. It is precisely these final developmental disorders that enable us to first investigate the constitutional tendencies that influence the outcome of neurosis selection. The unique characteristics of these two – arrogance, which increases the difficulty of transfer due to their distance from the object world – force us to conclude that their fixation caused by physical tendencies needs to be sought in the developmental stage of libido before determining object choice – that is, the developmental stage of self sexuality and narcissism. It can be seen that these diseases that appeared so late actually have to be traced back to very early inhibition and fixation. Therefore, this will lead us to infer that hysteria and obsessive-compulsive neurosis, two types of metastatic neurosis that develop symptoms at a younger age, have a physical tendency to form in the late stages of libido development. But when should we look for the inhibition of development? And, what we should first look for is, what differences in developmental stages determine the physical tendency of a compulsive neurosis, rather than hysteria? We haven’t found this for a long time; Moreover, my earlier attempts to reveal these two physical tendencies – for example, the belief that hysteria can be determined by passivity experienced in infancy, and obsessive-compulsive disorder by initiative – were quickly dismissed as incorrect. Now, based on clinical observation of a case, I want to address this issue again. For a long time, I have been studying a female patient whose neurosis has undergone an unusual change. At first, after experiencing a traumatic experience, she developed anxiety type hysteria and maintained this characteristic for several years. However, one day it suddenly became the most severe form of obsessive-compulsive neurosis. A case like this is bound to have profound implications in more than one aspect. On the one hand, it is likely to be treated as a bilingual document to demonstrate how to express the same content in two different neurotic languages. On the other hand, it may completely overturn our theory that physical tendencies stem from developmental inhibition, unless we are prepared to accept the assumption that a person may be born with more than one developmental deficiency in libido. I don’t think we have the right to ignore the latter possibility, but I really hope to find an explanation for this case. During the analysis process, I found that the situation was completely different from what I had imagined. Her obsessive-compulsive neurosis is not a further reaction to the same trauma that initially caused anxiety type hysteria; But rather a reaction to the second experience, which completely erased the first one. (Here comes an exception that goes against our hypothesis – but it is a true and unquestionable exception – which confirms that the choice of neurosis is not related to experience.)Unfortunately, due to family reasons, I am unable to delve into the history of the case as I wish, and I must stop at the following description. Before she fell ill, this patient could be said to be a happy and satisfied wife. Based on her stubbornness in childhood desires, she wanted to have a child. When she learned that due to her husband, the only person she loved, she couldn’t have a child, she fell ill. As she quickly realized herself, anxiety hysteria, as a response to this setback, is equivalent to giving up on the fantasy of temptation, in which she expresses her deep-rooted desire for a child. Now, she is doing everything in her power to prevent her husband from knowing that her illness is due to the setbacks caused by his husband. However, I have every reason to believe that everyone has a tool in their unconsciousness that can interpret what another person wants to express unconsciously. Without any confirmation or explanation from her, her husband understood what his wife’s anxiety meant; He felt hurt, but did not show it, and then it was his turn to make a neurotic response – his first sexual encounter with her failed. Immediately after, he went on a trip. His wife believed that he would be permanently impotent, so she developed the first compulsive symptom before the expected day of his return.
Her obsessive-compulsive neurosis manifests in the compulsion to meticulously wash and clean, and in order to avoid situations where she believes others have reason to believe that she will cause serious harm, she implements overly proactive protective measures – that is, various reactions formed by confronting her own anal and sadistic impulses. Her sexual needs were forced to seek expression in these forms after losing all their value in her reproductive life, and the reason was attributed to the sexual incompetence that meant all the only men to her.
This is the starting point of a new small fragment of the theory I have constructed. Of course, on the surface, this appears to be based solely on the observation of this single case; In fact, it integrates many early impressions together, even if their understanding can only rely on recent experiences. I think an additional supplement is needed to illustrate the development of my Libi multifunctional diagram. At the beginning, I only distinguished between the initial period of self sexuality – during which all component impulses of the subject seek fulfillment of their desires on their own bodies, and the subsequent period of combination of all component impulses towards object selection under the command of the reproductive organs serving reproduction. Later, as is well known, the analysis of delusional dementia forced us to insert a narcissistic stage between these two periods, during which the subject had already chosen an object that only overlapped with their own self. Now, we have found that another stage needs to be inserted before the final illustration is completed. At this stage, the impulses of the components have already been combined due to object selection, and compared to the subject itself, this object comes from the outside. However, at this time, the dominant position of the genital area has not yet been established. On the contrary, the component impulses that dominate this pregenital organization are anal desire and sadistic component impulses.
I am well aware that any such assumption sounds strange at the beginning. Only by revealing their relationship with our previous knowledge can they become familiar to us; But in the end, it is often regarded as a secondary and already foreseen innovation. Let’s turn to the discussion of “pregenital sexual organization” with such foresight.
(a) In the symptomatology of obsessive-compulsive disorder, the extraordinary roles played by impulses of hate and anal sex have left a deep impression on many observers, and have recently been emphasized in a very clear manner by Ernest Jones (1913). If we say that in neurosis, the component impulses mentioned here were originally pioneers of reproductive impulses during development, and later took over the expression of reproductive impulses again, then this speculation directly comes from our hypothesis.
There is a part of our case that I haven’t mentioned yet, which perfectly fits this point. This patient’s sexual activity began during her early childhood with accompanying beating phantasys. After her fantasies were suppressed, she entered an unusually long incubation period, during which the girl went through a highly praised period of moral growth without any awakening of female sexuality. The marriage she entered when she was young opened up a period of normal sexual activity for her. As a happy wife, her period lasted for several years until her first major setback led her to suffer from hysteria. Later, when her reproductive life lost all its value as mentioned earlier, her sexual life returned to the sadism stage of infancy.
It is not difficult to determine which characteristic to use in order to distinguish this case of obsessive-compulsive neurosis from those that occur more frequently, typically starting at a younger age, and then entering a more or less significant long-term process of deterioration. In these cases, sexual organizations containing tendencies towards obsessive-compulsive neurosis have never been completely overcome once established; In our case, it was initially replaced by a higher stage of development and subsequently reactivated by regression.
(b) If we want to establish a connection between our theoretical assumptions and biological approaches, we must remember that the gender opposition introduced by reproductive function has not yet emerged in the pre genital stage of object selection. During this period, we discovered the opposition between two trends – active goals and passive goals, which will firmly adhere to gender opposition in the future. Proactivity is provided by the universal impulse of control, and when we discover that it serves sexual function, we call it sadism; Even in fully developed sexual life, this tendency plays an important auxiliary role. The passive tendency is supported by anal sexual desire, and its erogenic zone corresponds to the ancient undifferentiated cloaca. When men reach the next stage of sexual function – the stage of genital dominance – the tension brought by anal sexual desire in the pre genital tissue stage leaves a significant homosexual tendency behind them. The method established in the later period on top of the previous period, along with the accompanying transformation of the libido betting method, provides the most interesting questions for psychoanalytic research.
We can argue that if we deny the existence of any pre genital sexual organization, insist that sexual activity is always consistent with reproductive and reproductive functions, and that the initial sexual activity is accompanied by reproductive functions, then all the difficulties and complexities involved here can be avoided. If so, considering the undeniable findings of psychoanalytic research, we can claim that neurosis is driven by sexual repression, expressing sexual impulses through other non sexual impulses, and then sextualizing the former through compensation. However, this approach will take us away from the field of psychoanalysis. It will bring us back to before the emergence of psychoanalysis, which means abandoning the understanding of the relationship between health, inversion, and neurosis that psychoanalysis has brought us. Whether to acknowledge the existence of sexual impulses and sexual belts, as well as the possibility of expanding the concept of “sexual function” relative to the narrow definition of “reproductive function,” determines the success or failure of psychoanalysis. In fact, observing the normal development of children is already enough to resist this temptation.
(c) In the field of character development, we will inevitably encounter the same impulsive forces that have been discovered in the field of neurosis work. However, the theoretical difference between the two is very obvious, and the reason for this result is only one fact, which is that the suppression failure and the return of repressed substances unique to the neurosis mechanism do not exist in the formation of character. In personality formation, either there is no suppression or the goal is successfully achieved, that is, using reaction formation and sublimation to replace the suppressed object. Therefore, the process of personality formation is more obscure and difficult to analyze than the process of neurosis formation.
However, it is in the field of personality development that we have encountered a very similar aspect to the case we are referring to – which confirms the existence of pre sexual sadistic anal sexual organization. There is a well-known fact that when a woman loses her reproductive function, her personality often undergoes a special change, which can also be used to explain women’s complaints. They become argumentative, unreasonable, domineering, petty, and petty, exhibiting typical characteristics of abuse and anal desire that were not present during their previous feminine temperament. Comedians and satirists from various eras have done their utmost to suppress the annoying images of charming girls, dear wives, and gentle mothers that later became. We can see that this personality change is synchronized with the regression of sexual activity to the pre genital stage of abuse and anal desire, where we have also found a physical tendency towards obsessive-compulsive neurosis. Therefore, this stage seems to be not only a precursor to the reproductive phase, but often enough to become its successor, the end after the reproductive organs complete their functions.
The contrast between this change in personality and obsessive-compulsive neurosis is impressive. In both cases, regression is very obvious. However, after successfully completing suppression (or suppression), the former experiences a complete regression; However, what appears in neurosis is the formation of conflicts, efforts to prevent regression, reactions to regression, and symptoms of compromise between two opposing sides, as well as the division of psychological activity into parts that can be allowed to enter consciousness and other parts of the unconscious.
(d) There are two aspects of our hypothesis about pre genital tissue that are not sufficiently comprehensive. Firstly, it does not take into account the influence of other components of impulsivity – there is a lot worth examining and discussing about this, and it is satisfied with the emphasis on the dominance of abuse and anal sexual desire. Especially, we often have the impression that the impulse for knowledge can actually replace the mechanism of abuse in obsessive-compulsive neurosis. In fact, its essence is a branch of sublimation, which involves controlling the impulse of the master to be elevated to a certain intellectual activity, and the rejection of the intellect manifested by questioning is widely present in obsessive-compulsive neurosis.
The second oversight in our hypothesis is more important. As is well known, only by considering both the developmental stage of libido and the self-development stage of fixation, can the discussion of the developmental tendency of neurotic constitution be complete. But our hypothesis only considers the development of libido and does not encompass all the knowledge we should seek. At present, we know very little about the developmental stages of ego impulses; All I know about is the promising attempt made by Ferenc (1913) to solve these problems. I am not sure if it would be too hasty for me to propose a discussion on the tendency of obsessive-compulsive disorder constitution based on the facts we currently have, considering the fact that self-development occurs before the development of libido in terms of developmental time. Under the influence of self impulses, this precocious puberty makes object selection inevitable, and at this time, sexual impulses have not yet revealed their final form, thus leaving behind fixation in the next stage of pre sexual tissue. If we consider obsessive-compulsive neurosis, in order to protect their object love from being undermined by hidden hostility, and have to develop a possibility of super morality, then we will be more likely to accept the self-development of this certain degree of precocity as a typical human nature, and find explanatory space for the origin of morality from the fact that hate develops earlier than love. This may be the meaning of Steckel’s (1911a, 536) assertion, which I didn’t understand at the time. His meaning was probably that the primary emotional relationship between humans is hate, not love.
(e) The discussion that followed was that hysteria retained a close relationship with the final stage of libido development, marked by the dominance of the reproductive organs and the introduction of reproductive function. In hysterical neurosis, this developmental achievement is suppressed, but does not involve regression back to the pre genital stage. In the process of determining physical tendencies, hysteria is more pronounced than obsessive-compulsive disorder due to the negligence caused by our neglect of self-development factors.
On the other hand, it is not difficult to observe that another type of regression returning to earlier levels can also occur in hysteria. As we know, the sex of girls is dominated and controlled by a male organ (clitoris), and they often engage in sexual behavior similar to boys. This male sexuality must be eliminated in the final wave of puberty, and at the same time, the vagina – an organ originating from the cloaca – must be cultivated as the dominant sex belt. For hysterical neurosis, the suppressed male sex is now easily reactivated and confronts ego synchronous impulses seeking harmony in defensive battles. However, for me, it seems too early to start discussing the issue of hysterical tendencies.