ABSTRACT
As we have learned, the hysterical symptom is an outcome of an instinctual conflict and is due to the return from repression of the infantile sexual excitation. To be sure, defensive forces also took part in the formation of the symptoms. However, generally speaking, the gratificational component of the symptom seems in hysteria to outweigh the element of defense. We shall hear later that in compulsion neuroses the status of the symptoms appears to be different. There the defensive meaning of the symptom is most striking, but even in compulsion neuroses, there are in addition to these symptoms others which represent a distorted breaking through of the instinct, or these symptoms contain a concealed gratification, so that the return of the repressed appears to be an essential feature of the compulsion neurosis too. Let us now think of the two other types of symptoms which we have already studied. In the development of a phobia, for instance, we could observe two different stages: after a harmless function, like walking on the street, is sexualized, at first, anxiety appears whenever the individual is in a situation which reminds him of the repellent function. Then, in order to avoid this anxiety, the phobic façade is developed; properly speaking, the patient simply avoids the situation (or does not make use of the function) which would produce the anxiety. This second, actually phobic symptom formation is easily understood. Its explanation does not lie in the instinctual conflict; the ego, which controls the individual’s motor apparatus, and which had been the victim of the unpleasant anxiety, simply refuses to carry out the motor action in question and consequently avoids the anxiety. This process may be regarded as taking place solely within the ego, and we designate it an inhibition. In phobias, the inhibitions appear only after the anxiety hysteria as such has set in and been elaborated. It is, of course, also conceivable that in other cases the ego might succeed in avoiding an unpleasant conflict by inhibiting the offensive sexualized function, once, through internal perception, the ego becomes aware of the repellent nature of this function. We must ask, then, as we did in the case of repression, how the ego puts into play this mechanism of preventing motor expression.
