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Full text of "Selected Papers Of Karl Abraham M D"

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SELECTED PAPERS 

OF 

KARL ABRAHAM, M.D. 



THE INTERNATIONAL PSYCHO- ANALYTICAL LIBRARY 

EDITED BY ERNEST JONES 
No. 13. 

SELECTED PAPERS 

* 

OF 

KARL ABRAHAM, M.D. 



.WITH AN INTRODUCTORY MEMOIR BY 

ERNEST JONES 



t TRANSLATED BY 

DOUGLAS BRYAN AND ALIX STRACHEY 



PUBLISHED BY LEONARD Si VIRGINIA WOOLF AT THE 

HOGARTH PRESS, 52 TAVISTOCK SQUARE, LONDON, W.C. 

AND THE INSTITUTE OF PSYCHO-ANALYSIS 

MCMXXVIt 



Printed in Great Britain l>y R. & R. CF.ARK, LIMIIRD, Edinfattgk. 



TRANSLATORS' NOTE 

THE Papers and Essays translated in this volume 
include the whole of Abraham's more important 
psycho - analytic work, except his Traum und 
Mythus, which has already appeared in English, and his 
study on Amenhotep, for which room could not, un- 
fortunately, be found. 

With an occasional exception, where the continuity of 
the subject-matter seemed to require it, the chapters are 
arranged in chronological order. 

The references in the foot-notes usually only give the 
title and date of first publication of the works referred to. 
In that case further information will be found at the end of 
the volume in the * List of Books and Papers referred to ', 
In addition, a complete and numbered bibliography of 
Abraham's publications has been appended, and these 
works are referred to by their number, together with the 
initials A. B. (Abraham Bibliography). 

D. B. 
A. S. 



INTRODUCTORY MEMOIR 1 

THERE can be no doubt that of all the blows the 
science of psycho-analysis has yet suffered the 
death of Karl Abraham is much the most cruel and 
severe. We have once before lost by death a President of 
a Branch Society, and we miss a number of other valued 
workers whose names will always live in our memory. 
Blows of another sort have several times affected the psycho- 
analytical movement, one of which even brought with it 
the loss, by another way than death, of a President of 
the International Psycho-Analytical Association. But, with 
all due respect to the memory of our other dead colleagues, 
none of them meant to psycho-analysis what Karl Abraham 
did ; for he was at once a master of its theory and practice, 
a pioneering contributor to our growing knowledge, a 
leader and organizer of the rarest order, as well as a loyal 
friend and colleague to all. Some of the reasons why the 
loss we have just sustained is so great will appear from the 
following record of his life and activities. 

The main events of Abraham s life, considered externally, 
are as follows. He was born in Bremen on May 3, 1877, 
so that he was forty-eight when he died. He came of 
an old Jewish family that had long been resident in the 
Hanseatic towns of North Germany; there was an older 
brother, but no sister. He attended the high school at home 
until 1896, when he entered on the medical curriculum. 

In his later school years Abraham developed an intense 
fondness for comparative linguistics and philology. Had 
he had the opportunity he would have preferred to devote 
himself entirely to such studies, and his interest in them 
persisted all his life. He certainly possessed an unusual 

1 Published in the International Journal of Psycho- Analysis, April 1926. 

9 



10 SELECTED PAPERS OF KARL ABRAHAM 

talent in this direction. Besides his mother tongue he 
could speak English, Spanish, Italian, and some Rhaeto- 
Romanic; he analysed patients in the first two of these, 
and his paper at the International Congress of Psychology 
in Oxford was delivered (unwritten) in English. He also 
had a respectable knowledge of Danish, Dutch and French, 
being doubtless accustomed to hearing something of the 
two former languages in his childhood. He was thoroughly 
at home in the classics and eagerly seized the opportunity 
of his children's school studies to revive his familiarity 
with them. No one who was present at the Hague 
Congress in 1920 will forget the astonishment with which 
we heard him deliver a speech in a Latin that had to be 
brought up to date for the occasion. 

He pursued his medical studies at Wiirzburg (a town 
for which he retained a great affection, hence perhaps the 
choice of it for the first German Psycho-Analytical Congress), 
Berlin, and Freiburg-im-Breisgau. He obtained his state 
doctorate in 1901 from the last-named university. 

During these studies his principal interest was in 
biology, a fact which had a profound influence on his later 
work and general scientific outlook. It was while he was 
at Freiburg that he first became acquainted with Switzer- 
land, the country which ever after he loved above all others. 
He liked the Swiss people and mode of life, but it was 
certainly the high mountains, which contrasted so much 
with his home scenery, that constituted the principal 
attraction. As soon as he had the chance he became an 
enthusiastic alpinist and made a number of first-class climbs. 
Like Segantini, who had died just before Abraham's first 
visit to Switzerland and in whose personality he was so 
deeply interested, he preferred the Upper Engadine to all 
other places on earth, and he returned there time and again. 
His last holiday, the convalescence from which we all hoped 
so much, was spent there in the summer of 1925, and he 
was able to carry out fairly arduous climbs even at that 
time. He had long cherished the desire to build a villa 
in that locality (near Sils Maria), and the last letter he ever 
wrote was a business one connected with this project. 



INTRODUCTORY MEMOIR I I 

While at Freiburg he conceived the wish to obtain a 
post at Burgholzli, partly so as to be in his beloved Switzer- 
land, partly because he had been impressed by Professor 
Bleuler's work in psychiatry and esteemed it higher than 
that of any other psychiatrist. He had, however, to 
wait a few years before this wish could be gratified, and 
so in April, 1901, he accepted the post of assistant at the 
Berlin Municipal Asylum at Dalldorf. For his chief here, 
Professor Liepmann, he always preserved the greatest 
respect, and two scientific contributions dating from this 
time were in Liepmann's special field, that of aphasia and 
apraxia. He worked for nearly four years at Dalldorf, 
thus laying a sound foundation in clinical psychiatry; but 
in December, 1904, he was made happy by obtaining an 
appointment at Burgholzli, with the title of Assistant at 
the University Psychiatric Clinic of Zurich. Here his 
attention was soon turned in a more definitely psycholo- 
gical direction, and through Bleuler and Jung he became 
acquainted with Freud's works. His first contribution to 
psycho-analysis dates from this period, a paper (9) l read 
before an annual meeting of the German Psychiatric 
Society at Frankfurt. By a sad coincidence his last appear- 
ance in public was in a suburb of the same town eighteen 
years later, when he presided over the Ninth International 
Psycho-Analytical Congress. 

About this time also occurred an event which was the 
main reason for the happiness and delight in life so char- 
acteristic of the man, and which was largely responsible 
for the energy and whole-hearted enjoyment with which 
he was able to devote himself to his work. Obtaining the 
appointment at Zurich coincided with his becoming engaged ; 
and, as his position there steadily improved, he was able 
to marry, in January, 1906. His choice of helpmeet was 
supremely fortunate, for he found a partner who shared his 
life to the full and possessed a capacity for happiness equal 
to his own, A daughter was born at Zurich at the end of 
1906, and a son a few years later in Berlin. 

Abraham's own hope was to be able to work permanently 

1 Such numbers, in brackets, refer to the appended bibliography. 



12 SELECTED PAPERS OF KARL ABRAHAM 

in Switzerland, but experience soon showed him that the 
chances of a regular psychiatric career there were very 
remote for a foreigner, so that he had to look elsewhere. 
His decision to leave was doubtless hastened by the un- 
comfortable atmosphere resulting from the tension between 
Bleuler and Jung. He therefore resigned his post in 
November, 1907. In the same month he met Professor 
Freud for the first time, on a visit he paid to him in Vienna; 
the last time the two met was in the August of 1924 on 
the Semmering. The conversations that then took place 
bore early fruit in an important paper (n), to which we 
shall have occasion to recur. The personal relations thus 
established ripened into a friendship which remained un- 
clouded till the end. Abraham was one of a small group 
who regularly visited Professor Freud during the holiday 
season; on one occasion he organized a tour in which they 
took part in a region, the Harz, which he knew well. 

In December, 1 907, Abraham settled in Berlin and began 
a private psychiatric practice. He was helped somewhat 
at first by Professor Oppenheim, a relative by marriage, 
and he worked for a time at Oppenheim's neurological 
clinic; but their divergent attitude towards Freud's theories 
soon brought about a distance between the two men. Of 
more lasting assistance was that rendered by Dr. Wilhelm 
Fliess, whom Abraham got to know a few years later and for 
whom he conceived a great regard; it was Fliess who was 
mainly responsible for his treatment during his last illness. 

Abraham was thus the first true psycho-analyst in 
Germany; for one can hardly call such the few men, 
Muthmann, Warda, etc., who had gone only a little way with 
Freud's theories. He immediately began, by means of 
private gatherings and lectures in his own house, to interest 
other physicians in the work. Of those whom he managed 
to interest at that time, however, only one, Dr. Koerber, 
has persevered to the present day. He also tried for a few 
years to present the subject at meetings of the various 
medical societies, where he displayed great courage and 
pertinacity in facing alone bitter and even fierce opposition. 
In spite of these qualities, however, and his characteristic 



INTRODUCTORY MEMOIR 13 

hopefulness, even Abraham had ultimately to recognize 
the futility of such an undertaking. But the clouds began 
to lift. In the autumn of 1 909 Dr. Eitingon, who had also 
worked at Burgholzli, joined him in Berlin, and from that 
time on Abraham had a colleague after his own heart. 

The International Psycho-Analytical Association was 
formally established in March, 1910, and the Berlin Psycho- 
Analytical Society was founded in the same month. It 
was the first branch of the International Association to be 
constituted, the Vienna and Zurich branches following in 
April and June respectively; both these cities had of 
course informal groups for years before Berlin. Of the 
nine original members (which included Dr. Warda, the 
first physician independently to give support to Freud's 
theories) only two still remain in the Society, Drs. Eitingon 
and Koerber. Something will be said later about what 
Abraham meant to the Berlin Society, but a few simple facts 
may be related at this point. He held the Presidency of 
the Society from its foundation until his death. He gave 
freely and of his best to the Society; its interests always 
stood first with him. He was unremitting in his attendance, 
in leadership and criticism. Nearly all his chief works 
were communicated first of all to the Society, In all he 
read no fewer than forty-six communications to it in the 
fifteen years of his Presidency, in several of which he was 
unavailable owing to either war or illness; twelve com- 
munications were delivered in a single year (1923). His 
capacities in the training and teaching of analysts found 
scope also outside the activities of the Society. He con- 
ducted a number of training analyses, and among his most 
distinguished pupils may be mentioned Helene Deutsch, 
Edward Glover, James Glover, Melanie Klein, Sandor Rad6, 
and Theodor Reik. Obvious disadvantages presented 
themselves, however, in local workers being analysed by the 
President of the Society, and it was a relief to Abraham 
when this difficulty was brilliantly solved by Dr. Hanns 
Sachs being invited to Berlin in 1920 and being given an 
official appointment in connection with this side of the 
work. On the other hand, Abraham freely devoted himself 



14 SELECTED PAPERS OF KARL ABRAHAM 

to delivering courses of lectures, and he rendered invaluable 
services in Berlin in this respect. The first course given 
under the auspices of the Society was a four weeks' one 
delivered in March, 1911; from then on he played a 
prominent part in every series arranged by the Society and 
later by the Lehrinstitut. Abraham was also active, though 
in a very minor way as compared with Eitingon, in founding 
and supporting the Berlin Polyclinic. From its inception 
in 1920 he was a prominent member of the Commission 
for the Education of Psycho- Analysts. In this field he 
was active in selecting suitable candidates, in training 
selected ones, particularly from abroad, and in general 
helpfulness in matters of organization. His time was of 
course too much in demand for him to engage in actual 
daily work at the Polyclinic itself. 

Similarly Abraham's relation to the International Associa- 
tion was throughout a close one. He was one of the five or 
six who have attended every Congress so far held. The 
first Congress, in April, 1908, though actually organized 
by Dr. Jung, was mainly Austro-Hungarian in personnel; 
Abraham was one of the three ' foreigners ' to speak at it 
(the other two being Jung and the present writer). He read 
a paper at every Congress except the last one, where he was 
deterred by ill-health together with the duties of presiding; 
this is a record equalled only by Professor Freud and Dr. 
Ferenczi. The eight papers in question are among the 
most valuable of his contributions to psycho-analysis, and 
we shall presently mention them all when considering his 
scientific work. At and after the Munich Congress, in 

1913, Abraham led the opposition against Jung, and after 
the latter resigned, the Advisory Council of the Association 
appointed Abraham to act as provisional President until 
the next Congress could be held. He made all the prepara- 
tions for one to take place in Dresden in the September of 

1914, and did in fact preside in this provisional capacity 
when it finally met in Budapest in the September of 1918. 
At the Seventh Congress, in 1922, he was made Secretary 
of the International Association, and at the Eighth, in 1924, 
he was finally elected, amid great applause, to the position 



INTRODUCTORY MEMOIR 17 

others. The collective reviews he wrote (15, 16, 51, 73) 
were models of what such things should be and are of 
permanent value in rapidly orienting the student of psycho- 
analysis; the same qualities are to be observed in the 
numerous reviews he wrote for the Zentralblatt&n&Zeitschrift, 
which are not listed in the bibliography. Abraham was a 
master of exposition and especially excelled in the difficult 
art of presenting case-histories. It is well known how hard 
it is to enter into a report of someone else's cases, which is 
apt to be so incomplete as to be useless or else so long and 
confused as to be boring. Abraham's smooth and easy 
style, combined with his feeling for the essential, enabled 
him to initiate the reader into the gist of a case in a page or 
two, and the clinical data with which he fortified his con- 
clusions were always as interesting as they were instructive. 
Few writers on psycho-analysis have equalled him in the 
gift of clear and attractive style, a gift all the more valuable 
in dealing with such a complicated subject-matter. 

Coming now to the nature and content of Abraham's 
writings, we should constantly bear in mind, in estimating 
their significance, the date at which they were written. It 
is a testimonial to the general accuracy of his work that so 
much of it has become incorporated into our daily knowledge 
as to make it not easy to appreciate the novelty it once had. 
His writings fall in a general way into four groups. There 
are first those pioneering works to which reference has just 
been made; among them may be mentioned those on the 
psychology of dementia praecox (n), the sexual aspects of 
alcoholism (12), the influence of incestuous fixations in the 
choice of a mate (13), and his book on dreams and myths 
(14). Secondly, there is a number of neat and finished 
studies, classics which we can always re-read with enjoy- 
ment and instruction; such are his essays on hysterical 
dream phantasies (17), Segantini (30), Amenhotep (34)> 
the transformations of scoptophilia (43), ejaculatio praecox 
(54), war neuroses (57), and the castration complex in 
women (67). Thirdly, we have his most original works, 
which constitute a valuable and permanent addition to our 
knowledge; prominent among these one would place his 



1 8 SELECTED PAPERS OF KARL ABRAHAM 

investigations into the pregenital stage of development 
(52) with his two books on the evolution of the libido (105) 
and character formation (106) respectively. The fourth 
and last group would comprise a large number of shorter 
papers always containing data that illustrated, confirmed 
or expanded our knowledge of psycho-analytical theory 
and practice. 

In reviewing Abraham's writings as a whole one is 
especially struck with the remarkable many-sidedness of 
them. They cover the whole field of psycho-analysis and 
there are few parts of that vast field which they do not 
illuminate. Even on the aspects of psycho-analysis on 
which he wrote least, e.g. homosexuality, dream interpreta- 
tion, and education, enough is implied in his other works 
to show that he was thoroughly conversant with the problems 
involved. The variety of his writings makes it expedient 
to divide them into different groups, and for the present 
purpose five main headings have been chosen. 

i. Childhood (including Infantile Sexuality). Abraham's 
first two papers on psycho-analysis dealt with infantile 
traumata (9, 10), and from the first he was concerned to 
point out the dynamic aspects of the individual's reaction 
to the trauma. He showed how the repeated experiencing 
of sexual assaults constitutes with some children a regular 
form of their sexual activity, an aspect of the subject quite 
ignored by criminologists, and indeed by psychologists. 
In the same connection, with special reference to the 
traumatic neuroses, he dealt with unconscious impulses 
directed against the self (injury or death), a theme which 
recurs many times in his works. These impulses, which 
we should now describe in terms of hostility against the 
ego or against some renounced object which has been 
incorporated into the ego, he attributed at that time to 
unconscious masochism. 

We pass now from his first writings to some of his last, 
which may well be called his most important ones. I refer 
to his work on the pregenital stage of libidinal development. 
Already in 1913 the title of a communication to the Berlin 
Society (41) tells us that he was preoccupied with the inter- 



INTRODUCTORY MEMOIR 19 

relation of the nutritional and sexual instincts, and in 1916 
he published one of the two most brilliant contributions 
he ever made to psycho-analysis (52). With the aid of an 
astonishing case material, containing examples of infantile 
oral habits persisting to an age when their erotic nature 
could be put beyond doubt by direct introspection, he con- 
firmed to the full Freud's conclusions about oral erotism. 
Adopting Freud's terms ' pregenital ' and ' cannibalistic ', 
he greatly enriched our knowledge of this phase in develop- 
ment, particularly as regards the phenomena in later life 
derived from it. Notable in the latter connection are the 
important relationships he established between oral erotism 
on the one hand and sleep and speech on the other. Many 
disturbances in eating were traced to a similar source. He 
distinguished between the cases where a disjunction has 
been effected between the two forms of mouth activity 
(nutritional and erotic), which are at first so closely united, 
and those where the union has persisted; and he pointed 
out that adult thumb-suckers, etc., belong to the former 
class, i.e. are in a more advanced stage of development 
than the person afflicted with neurotic disturbances of 
the eating function. The clinical parts of this paper, on 
manic-depressive insanity, will be mentioned in a later 
connection. 

The continuation of this work, which took the form of a 
book published only last year (105), contains such a wealth 
of thought and investigation that no summary could do it 
justice. It is Abraham's weightiest contribution to psycho- 
analysis. In it he subdivides the three main stages in 
libidinal development into six: oral (i, sucking; 2, biting); 
anal-sadistic (i, destructive and expulsive; 2, mastering and 
retaining); genital (i, partial love or phallic; 2, adult). 
None of these subdivisions was entirely original on his part, 
but the detailed and explicit way in which he analysed them 
and showed the precise relation of one to the other con- 
stitutes a masterly piece of work which must always rank 
highly in psycho-analytical literature. In conjunction with 
van Ophuijsen he clarified the problems of the infant's 
relation to its object on the alimentary level (incorporation, 



2O SELECTED PAPERS OF KARL ABRAHAM 

expulsion, etc.), and threw a flood of light on the obscure 
problems of pregenital sexual life altogether. 

Among other contributions to the study of childhood 
may be mentioned his papers on the part pkyed by grand- 
parents in infantile phantasy (40), the effects of overheard 
coitus (42; see also 43, Sect, ii.), the narcissistic attitude of 
infants towards excretory processes (63), and a series of 
pretty observations on infantile sexual theories (83, 94, 
no); Nos. 38, 85, and 93 also belong to this group. 

2. Sexuality. Abraham's interest in pregenital de- 
velopment was paralleled by that in the component instincts 
out of which adult sexuality is evolved. In an early paper 
on a case of foot and corset fetishism (18), he showed how 
the osphresiolagniac, scoptolagniac and sadistic impulses 
could undergo a complicated process of intertwining and 
displacement so as to produce a manifest perversion. 

His lengthiest single paper was concerned with the 
restrictions and transformations that the scoptophilic im- 
pulse may undergo (43). Using a rich case material on 
which to found his conclusions, he dealt with the various 
forms of anxiety in regard to the visual function, other 
disturbances of this function, and neurotic affections of the 
visual organ itself. He traced the neurotic dread of light 
to displacements from an ambivalent attitude towards the 
parental genitalia, particularly the paternal ones; one case of 
hysteria and two of dementia praecox were described in this 
connection and the therapeutic results recorded. Further 
themes in the same paper are ophthalmic pain and other 
neurotic eye symptoms, the symbolic significance of dark- 
ness (which will be described presently), phobias relating to 
ghosts and the sun, and a number of problems belonging 
to applied psycho-analysis which will be mentioned in their 
appropriate connection. 

A clever paper written in the middle of the war solved 
many problems relating to ejaculatio praecox (54). Again 
illustrating his points throughout from his ample clinical 
experience, he demonstrated how this symptom results from 
a failure in the evolution of urethral erotism. It is not, 
however, simply a fixation on this form of erotism, for it does 



INTRODUCTORY MEMOIR 21 

not occur in masturbation, but depends on some feature 
in the object relationship. The cowardice characteristic of 
the condition, and the dread of hurting women, indicate 
repressed sadism, Such patients have a narcissistic over- 
estimation of the penis as being the urinary organ ; they wish 
to exhibit urination in front of the woman, and because of 
her supposed contempt for the performance they react in a 
hostile manner by the impulse to pollute her. Disappointed 
love in respect of the mother, and consequently hostility 
towards her, furnish the key to the situation, as so often 
with the problems Abraham studied. 

Another extremely valuable paper is concerned with the 
obverse of this attitude, i.e. with the hostility of women 
towards men as displayed in what Abraham termed the 
female castration complex (67). This contribution, which 
is extremely rich and suggestive, constitutes the basis of our 
knowledge of an obscure topic and has already opened the 
way to important later investigations. After discussing 
the various ways in which the girl may react to the belief 
that she has been castrated, the replacement of the wish 
for a penis by that for a child (confirmed by Freud's latest 
contribution on the subject at the Homburg Congress), and 
so on, Abraham distinguished two neurotic types, which 
are, however, evidently not to be too sharply separated. 
They result respectively from repression of the wish to 
take over the man's part in a positive direction and of the 
wish to avenge themselves by castrating the man ; he called 
them the wish-fulfilling and the revenge types respectively. 
He contrasted these neuroses with the more positive ex- 
pressions in character formation, the former corresponding 
with female homosexuality and the latter with the archaic 
sadistic reaction. The motivating impulse in the second 
type is to bite off the man's penis, or at least to diminish his 
potency by disappointing him with frigidity and in other 
complicated hostile ways that will bring him into a posi- 
tion of contempt. This attitude logically culminates in a 
strong depreciation of the penis, and of men in general. 
Abraham showed the connection of the complex with 
various neurotic symptoms, such as vaginismus, enuresis, 



22 SELECTED PAPERS OF KARL ABRAHAM 

conjunctivitis neurotica, etc., and also pointed out the 
numerous ways in which it may influence women in their 
object choice. Last, but not least, he showed how such 
women can transmit their complex-conditioned reactions 
to their children. 

Abraham's contributions in the sphere of love relation- 
ships in the usual sense are less extensive. In one of his 
first papers (13) he showed how marriages among relatives 
are often the expression of an incestuous fixation, a fact of 
importance in connection with the transmission of neurotic 
tendencies. In this connection he also pointed out (at the 
same time as Ferenczi) the part played by such fixations in 
the aetiology of psychical impotence and frigidity. Another 
manifestation of this fixation he saw in the undue tendency 
to monogamy. Some years later he published a pendant to 
this study in which he discussed the obverse manifestation 
of neurotic exogamy (45). Incestuous fixation was the 
theme of several other papers (e.g. 20, 22, 23, 53, 97, 98, 
107, 1 12), and was of course extensively taken into account 
in all his analytic work. 

Other papers on purely sexual topics are two on sadism 
(21 and 33), one on the ear passage as an erotogenic zone 
(46), two on anal erotism (48 and 70) which will be men- 
tioned later, and a number of shorter ones (66, 86, 88, 89, 

103). 

3. Clinical Subjects. As was to be expected from a 
clinician of Abraham's rank, his contributions in this 
sphere are of special importance. The first one of note 
marked a turning-point in our knowledge of the psychology 
of dementia praecox (i i) and the differentiation between 
neuroses and psychoses in general. It is a matter for 
wonderment that a professional psychiatrist such as he was 
never returned to this subject later; presumably it was 
because his interest in this field was concentrated in the 
attempt to unravel another psychosis. Jealous colleagues 
in Zurich unjustly accused him of not sufficiently acknow- 
ledging his indebtedness to Jung in connection with this 
paper, but events showed clearly that Jung never accepted 
the main idea of the paper, which, as Abraham himself 



INTRODUCTORY MEMOIR 23 

avowed, emanated from a conversation with Freud (his 
first one). The main idea in question was the suggestion 
that disturbances of the ego functions could be purely 
secondary to disturbances in the sphere of the libido, in 
which event it might be possible to apply Freud's libido 
theory to the elucidation of dementia praecox. After dis- 
cussing the relation between sublimation and transference, 
Abraham pointed out that the capacity for both these pro- 
cesses is diminished in dementia praecox, and that the so- 
called dementia is simply the result of this state of affairs. 
In it the libido is withdrawn from objects the opposite of 
hysteria, where there is an exaggerated object cathexis 
and applied to the self. To this he traced the delusions of 
persecution and megalomania, the latter being an expression 
of auto-erotic sexual overestimation (of what later became 
termed narcissism). In contradistinction from hysteria, the 
psycho-sexual peculiarity of dementia praecox lies in an 
inhibited development at the auto-erotic level, with conse- 
quently a tendency to regress to this level. 

Abraham's most systematic, and probably his most im- 
portant, contribution to psychopathology consists in his three 
works on manic-depressive insanity. The brilliance of 
Freud's essay in the same field, and the striking manner in 
which he found the central key to the problems, have doubt- 
less obscured some of the credit which Abraham deserved, 
as genius always does when brought side by side with talent; 
and this was probably heightened by a purely accidental 
circumstance: Trauer und Melancholic^ that is to say, was 
written at a time when no reference could be made in it to 
some valuable contributions which Abraham had recently 
made (52), although, owing to war conditions, it was not 
actually published until a year later than the latter. No 
works of Abraham's reveal his scientific characteristics, as 
regards both his capacities and his limitations, better than 
these on manic-depressive insanity. It was also the study 
which evidently fascinated him more than any other, 
although it is probable, as indeed is hinted by the titles of 
two out of the three works, that he was more interested 
in the light the disease throws on certain early stages 



24 SELECTED PAPERS OF KARL ABRAHAM 

of libidinal development than in the clinical problems 
as such. 

In his first paper on the subject (Ansatze, etc.) 26), which 
was read at the Weimar Congress in 1911, Abraham started 
from the assumption that depression must bear a relation 
to grief similar to that of anxiety to fear, and he came to 
the conclusion that the despair about life is the result of a 
renunciation of the sexual goal. He narrated six cases, in 
all of which he found both clinical and psychological features 
very much akin to those of the obsessional neurosis. Thus, 
the patients showed many characteristics of the latter con- 
dition in the so-called free interval, and in both conditions 
there is a mutual paralysis of the love and hate instincts. 
In manic-depressive insanity the libido shows predominantly 
an attitude of hatred. It is as though the patient said: " I 
cannot love because of my hate; the result is that I am hated 
and so I am depressed and hate back " (return of the repressed 
sadism). The sense of guilt and sin corresponds with 
repressed hate. The delusion of poverty is an expression 
of the same fact (money = love). In mania the complexes 
overcome the inhibitions and the patient reverts to the care- 
free state of childhood. He related the beneficial effects of 
his therapeutic endeavours and regarded them as justifying 
the hope that it would fall to psycho-analysis to free psychiatry 
from the nightmare of therapeutic nihilism. 

His treatment of these clinical problems is more incidental 
in the second contribution (Untersuchungen iiber die friiheste 
pragenitale Entwicklungsstu/e der Libido >, 52), but none the 
less important. He here clearly recognized the oral fixation 
in melancholia and was able to explain a number of clinical 
features on that basis. Thus the refusal of food is due to 
regression to the old connection between eating and oral 
erotism, as is also the dread of starvation. He was further 
able to formulate the distinction between manic-depressive 
insanity and the closely allied obsessional neurosis in terms 
of pregenital libidinal organization. In the latter condition, 
with its anal-sadistic fixation, the attitude towards the object 
is one of mastering, whereas in the former condition it is one 
of annihilating through swallowing (late oral stage). The 



INTRODUCTORY MEMOIR 25 

most striking feature of melancholia, the intense self- 
reproaches and self-depreciation, Abraham regarded as self- 
punishment induced by horror at the repressed cannibalistic 
impulses. In this he was partly right, for a certain number 
of these do emanate in this way from a guilty conscience, 
but he failed to make the much more important observation, 
which Freud said was * not at all hard to perceive ', to the 
effect that these reproaches are chiefly directed against the 
image of the lost love-object which has been erected within 
the ego. In a later paper he described his difficulty in 
understanding the point when he first read it in Freud's 
essay, and gave some personal explanation for his inhibition ; 
it is not likely, however, that the explanation was a complete 
one. For a man of his rigid ethical standards it was 
evidently easier to grasp the fact that a person could inflict 
on himself severe suffering as a punishment for having had 
hostile wishes directed against a love-object than to believe 
that such a person was still torturing the image of that 
object. 

His third and most complete study of the problem (105) 
took full cognizance of Freud's epoch-making essay, and 
Abraham was able to confirm all Freud's conclusions in 
detail and even to amplify some of them. He identified 
the incorporating of the object to which Freud had called 
attention with the swallowing impulse dating from the oral 
Stage, and in this connection he developed some interesting 
considerations about the process of introjection in general. 
The facts that in the free interval the melancholiac can ad- 
vance to an obsessional (i.e. anal-sadistic) level, and further, 
that an essential difference between the two conditions is that 
the melancholiac gives up his object relationship whereas the 
obsessional neurotic retains his (Freud), brought him to the 
conclusion that the anal-sadistic phase must have two sub- 
stages (see above). He suggested that the line of demarca- 
tion between these two sub-stages may be of great practical 
importance in psychiatry as indicating the point where 
true object-relationship sets in, thus pointing to one of the 
main distinctions between neurosis and psychosis. The 
aetiology of manic-depressive insanity he sought in a con- 



26 SELECTED PAPERS OF KARL ABRAHAM 

stitutionally strong oral erotism, with a special fixation at 
this level induced by severe disappointments in relation to 
the mother ; he distinguished between disappointments of 
this kind that occur before, during, and after the Oedipus 
stage. The melancholiac's hatred is predominantly directed 
against the mother, but in a later passage Abraham pointed 
out that some of this originally referred to the father, there 
being in this disorder an unusual tendency to invert the 
Oedipus complex. This feature, and the ambivalence 
concerning both parents lead to complicated forms of 
introjection, and he could distinguish between reproaches 
emanating from either introjected love-object against the 
self and those directed by the self against the image of the 
object; the latter are, of course, the principal and more 
characteristic ones. 

Abraham drew an interesting parallel between melan- 
cholia and the processes of archaic grief as elucidated by 
R6heim. He further threw much light on the obscure 
matter of the curious course run by manic-depressive 
insanity. He regarded the incorporating of the object in 
the oral phase as being partly determined by an endeavour 
to preserve it from annihilation and considered that then, 
after the sadistic attack had worn itself out, the image of the 
love-object is once more expelled by the anal route. He 
drew a picture of what he called the * primal depression ' of 
infancy, the precursor of later melancholia, and suggested 
that patients affected with mania not preceded by melan- 
cholia were still engaged in shaking off this primal depression 
and the heightened sexual desire that follows the working 
through of grief, particularly as seen in primitive ceremonies. 

In an early work on hysterical dream states (17) Abraham 
brought this syndrome, described by Lowenfeld, into rela- 
tion with Freud's work on hysterical attacks and traced the 
genesis of them to masturbation phantasies which have 
undergone repression. Such patients linger in the stage of 
preliminary pleasure because end pleasure is associated with 
anxiety. He narrated six cases of the kind. In one of 
them he was able to trace the symptom of macropsia to a 
regression to childhood. His study of the condition fur- 



INTRODUCTORY MEMOIR 2J 

nished a link between allo- and hetero-suggestion, inasmuch 
as the attacks could be shown to occur either quite spon- 
taneously or in the presence of people by whom the patients 
felt themselves to be hypnotically influenced. Several of 
Abraham's short papers were on the subject of phantasy 
life, and his pretty analysis of the father-saving type of 
phantasy (76) is specially worthy of remembrance in this 
connection. 

Abraham published two papers on locomotor anxiety 
(39 and 44), a condition of which he had suffered slight 
symptoms himself in early life. He showed that the sexual 
origin of the anxiety could be demonstrated by re-converting 
it therapeutically, when the same patients took an unusual 
pleasure in locomotor acts (both active and passive). In 
the same paper (44) he threw light on the common symptom 
of ' dread of dread ' by connecting it with repression of 
4 fore-pleasure '. 

His war experience enabled him to confirm indepen- 
dently the view that had been put forward by the present 
writer concerning the narcissistic origin of the so-called * war- 
shock ' cases (57), as did also Ferenczi shortly afterwards. 
Criticism is often made of the supposedly subjective nature 
of psycho-analytic work, but this may be quoted as an 
experimental demonstration of the contrary. When faced 
with entirely novel problems observers in different countries, 
quite cut off from one another by war conditions, investigated 
them and came to substantially the same conclusions. 

In a discussion on Ferenczi's work on tic, Abraham 
threw out the interesting suggestion that the condition 
represents a conversion symptom on the anal-sadistic level 
to be contrasted with the symptoms of conversion-hysteria 
developed on the phallic level (72). 

Abraham's contributions on the subject of therapeutics 
were few, but important. The chief one was certainly his 
study of a special and difficult type of reaction characteristic 
of some patients (5 8). They are mostly obsessional neurotics 
who show a high degree of narcissistic defiance and who tend 
to avoid transference by identifying themselves with the 
analyst. They insist on conducting their analysis themselves, 



28 SELECTED PAPERS OF KARL ABRAHAM 

a tendency which Abraham connected with anal-sadistic 
reactions. Forbidden masturbation plays an important 
part in the aetiology of such cases. Abraham discussed 
helpfully the special therapeutic technique needed to deal with 
this difficult type. His paper on psycho-analytic treatment 
in advanced years (62) may be summed up in the dictum 
that the prognosis depends more on the age of the neurosis 
(i.e. the age of the patient at which the neurosis became 
severe) than on the actual age of the patient. Special 
measures are necessary, however, in these older cases, such 
as more active pressure and help on the part of the analyst. 
In this connection may also be mentioned the clear way in 
which he illustrated the value of Freud's advice not to 
encourage patients to write down their dreams before 
analysis (37). Finally, Abraham's work on the treatment 
of psychotic patients is the best we yet possess, and he must 
certainly be regarded as a pioneer in this difficult field. 
He showed a rare degree of scepticism and critical honesty 
in recording his results (26, 105), and he suggested useful 
criteria (e.g. transitory symptoms) for determining what pro- 
portion of a given change in mental state could be ascribed 
to the actual therapeutic endeavours of the physician. He 
demonstrated that manic-depressive insanity can, in favour- 
able cases, be radically affected by psycho-analysis, and he 
was very hopeful of further progress along these lines. 

Abraham took a special interest in the problems of 
alcoholism and drug habits. Almost the only papers he 
wrote in pre-analytical days, apart from those evidently 
inspired by his teacher's interests, were on the effects of 
drug-taking (3 and 4). His early paper on the relations 
between alcoholism and sexuality (12) showed the essential 
nature of the connection between the two and was the 
foundation of all our later knowledge on the subject. 
Indeed the only important later contribution that has been 
made on this matter has dealt with the inherent relation 
between alcoholism and homosexuality, a connection which, 
curiously enough, Abraham pointed out only in regard to 
women. He missed also the homosexual basis of alcoholic 
delusions of jealousy, ascribing these only to the displace- 



INTRODUCTORY MEMOIR 29 

ment of guilt on to the mate. He showed, however, that 
the motive of drinking was temporarily to heighten sexual 
potency by undoing repressions and sublimations and 
releasing especially the component impulses, and further 
that alcohol betrays its user later by diminishing his potency. 
He also revealed the unconscious identification of alcohol 
with semen, and of syringe with phallus. The connection 
between morphinism and repressed sexuality was insisted 
on in the same contribution, as also in later passages (17, 
S. 14 ; 52, S. 84), where the oral basis of both smoking 
and morphinism was pointed out. 

The numerous short communications on clinical sub- 
jects (24, 31, 32, 36, 49, 55, 68, 71, 90, 91, 104, in) 
mostly contain notable observations and suggestions. One 
may remark that Abraham's interest in the obsessional 
neurosis seems to have been greater than that in hysteria. 
A clinical paper on Coue's teachings (115), not available at 
the moment of writing, is being prepared from notes left 
by Abraham, and will be published at the same time as this 
obituary. 

4. General Topics. By far the most important work of a 
general nature that Abraham contributed to psycho-analysis 
was his investigation of characterology. Two of the three 
studies were published separately, and then all three united 
in a single volume (106). In his essay on the anal character 
Abraham expanded the extensive work that had been 
done on this subject and added a number of fresh obser- 
vations of considerable clinical and characterological value. 
We may especially note the two types he distinguished of 
excessive docility and defiance respectively, both of which 
may be present in the same person. He showed also how 
the two types react in the analytic situation: the latter one 
produces a resistance very similar to the characteristic one 
he had described in another connection (58, see above), 
whereas the former one, on the other hand, insists on the 
analyst doing the whole work himself; in both cases the 
result is a refusal to enter upon free associations. The 
details of regression from the genital to the anal level were 
also dealt with in an illuminating way. 



3O SELECTED PAPERS OF KARL ABRAHAM 

The second essay, on the contributions made by oral 
erotism to character-formation, was one of Abraham's most 
original contributions to psycho-analysis. The indirect 
effects of oral erotism in later life are in great part produced 
through the connection between it and anal erotism, and 
here Abraham showed how primordial is the triangular 
relationship between the functions of acquiring, possessing 
and expending, the economy of which varies greatly among 
different persons. Direct gratification of oral erotism is of 
course permitted to a considerable extent in the adult, so 
that sublimation is less extensive than it is with some other 
erotogenic zones. The most typical form of sublimation 
seems to be the character trait of optimism, one which 
Abraham himself possessed in a high degree; it contrasts 
with the seriousness and pessimism of certain anal types, 
particularly those associated with early disappointments of 
oral gratification. If this disappointment occurs during the 
second biting phase of the oral stage, then the later love 
will be characterized by great ambivalency due to the canni- 
balistic and hostile attitude towards the mother persisting. 
Abraham threw a great deal of light on the genesis and inter- 
relation of other traits concerned with oral-erotic displace- 
ments, notably greed, envy, thrift, avarice, and impatience. 

The third essay in this series dealt with the ' genital 
character ', and so was concerned with the problems of 
normality. Abraham disclaimed any attempt to set up 
absolute standards in this respect, and indeed insisted at 
length on the impossibility of doing so, but he nevertheless 
gave us a very valuable point of view by inquiring which of 
the pregcnital features are the last to be relinquished. He 
found that the most severe way of testing genital normality 
was to ascertain the extent to which the subject has overcome 
his narcissism and the attitude of ambivalency that runs 
through most of the earlier stages. In his discussion of the 
importance of aim-deflected feelings of genital origin for a 
satisfactory relationship with the outer world, Abraham 
dwelt on the supreme necessity of love in childhood and the 
injurious effects that may result from the child receiving 
too little of this essential pabulum. 



INTRODUCTORY MEMOIR 31 

In the same connection may perhaps be mentioned 
Abraham's attempts to solve the problems of grief (105), 
This also he considered to have an important connection 
with oral attitudes. Whereas Freud lays stress on the 
gradual and painful tearing of oneself away from the loved 
object under the demands of reality, Abraham paid more 
attention to the incorporation of the image of this object, and 
he regarded this as being carried out by the oral mechanism, 
(It is doubtful, however, whether this is a regular process 
in the ' grief-work '.) 

As a general contribution to psycho-analysis should also 
be mentioned the numerous social implications that belong 
to Abraham's work on the female castration complex (67, 
see above). These will be of very great importance socio- 
logically in the future, and when they are more fully worked 
out the part that Abraham played in indicating them will 
not be forgotten. 

Abraham's contributions to our knowledge of individual 
symbolisms were fairly extensive, and they have now for 
the most part been incorporated in the general body of 
science. Among them may be noted: house and garden 
as symbols of the mother, new house as that of the strange 
woman or baby (25 and 96); snake as a symbol of the 
father's penis, with the fear of death as a manifestation of 
dread of the father (32); spider as a symbol of the feared 
mother (80); his beautiful analysis of the forked road in 
connection with the Oedipus saga, as well as of the number 
three (76 and 82); and darkness (or anything mysterious 
and obscure) as a symbol of the mother's womb (including 
bowel) (43). 

Abraham confirmed Stekel's observation about the signi- 
ficance of personal names (28), though he added little new 
on the point. He also made several contributions to the 
psychopathology of every -day life, both throughout his 
clinical writings and in a few special notes (e.g. 78, 79, etc.). 

5. Applied Psycho- Analysis. Abraham's first work in 
this field was of historical importance (14), for it opened the 
way for much of the later research that has been carried out 
in the application of psycho-analysis to mythology, by Otto 



32 SELECTED PAPERS OF KARL ABRAHAM 

Rank, Theodor Reik, and others. It was of course mainly 
inspired by the Oedipus analysis in the Traumdeutung. 
Justifying the attempt to correlate dreams and myths on 
the ground that they are both products of human phantasy, 
he showed the far-reaching connections between the two. 
With both the essence of the phantasy is a wish-fulfilment 
and the wishes in both cases are unconscious and infantile. 
The egocentricity of the individual in the one corresponds 
with the egocentricity of the people in the other. The 
phenomena of censorship, repression and the formation of 
neologisms are common to both, as are the mechanisms of 
condensation, displacement, and secondary elaboration. He 
illustrated these conclusions by presenting some dream 
analyses side by side with a most interesting study of the 
Prometheus myth and the legend of the divine drinks; 
incidentally the sexual nature of the latter, soma, nectar 
and ambrosia, was clearly pointed out. Making good use 
of his philological knowledge, Abraham pointed out the 
resemblances between the etymological and the psycho- 
analytic points of view and showed how our knowledge of 
symbolism could be derived from investigation of the one 
field as well as from the other. His final conclusion was 
that ' myths are relics from the infantile mental life of the 
people, and dreams constitute the myths of the individual '. 
The universal validity of determinism in mental life was 
also insisted on. The book is written with extraordinary 
skill, and illustrates Abraham's lucidity and simplicity at 
their best. Although the contents are now fully assimilated 
in analytical circles, it is still a pleasure to fe-read it and 
enjoy the powers of exposition which Abraham possessed 
in so high a degree. 

Abraham's next work in this field also took book form, 
an interesting study of the Swiss painter Segantini (30). 
It was almost the first time that an attempt was made 
to analyse the personality of a painter and to correlate 
in detail the painter's unconscious trends with his choice 
of theme, composition, and mode of presentation. He 
demonstrated the enormous influence the painter's mother 
exercised on both his life and his work, and he was able to 



INTRODUCTORY MEMOIR 33 

trace in detail the ambivalent attitude of love and hate the 
painter bore to her ; once more we have a study of the * evil 
mother '. The closing pages of this book contain a remark- 
able foreshadowing of Freud's conception of the death 
instinct in its investigation of the unconscious motives lead- 
ing to self-destruction. Abraham's interest in this study 
was evidently with the psychology of the artist rather than 
in the psychology of art itself, but in a later paper (100), 
unfortunately never printed, he took up the question of the 
tendencies in modern art as seen from a psycho-analytic 
point of view. 

Abraham's analysis of Amenhotep IV. (Echnaton) (34) 
is not only of great interest in itself, but is noteworthy as 
being the first occasion when it was shown how a know- 
ledge of psycho-analysis could contribute to the elucidation 
of purely historical problems. To attempt the psycho- 
analysis of someone who died some twenty-three centuries 
ago may have seemed a desperate undertaking, but Abraham's 
painstaking study had nothing of the hypothetical about it,- 
and the conclusions he reached will be hard ever to impugn. 
Echnaton, ' the first great man in the spiritual realm to be 
recorded by history ', was a forerunner of the Christian 
teachers of the doctrine of love and an ethical revolutionary 
who reserved his hate for his father only, Abraham was 
able to show how all Echnaton's innovations, iconoclasms 
and reforms could be directly traced to the effects of his 
Oedipus complex. 

Abraham's wide education and general knowledge were 
turned to good account in many of his psycho-analytical 
studies. In his detailed investigation of scoptophilia (43, 
see above) he expounded his general conclusions with the 
help of a mass of mythological and folk-loristic material. 
His equating of beliefs and fears concerning the sun and 
ghosts respectively was a noteworthy achievement in this 
paper, and in it he also clearly indicated the ambivalence 
of the motives that led to man displacing the father on to 
the heavens (exaltation and relegation to a distance). In 
the same paper he made a practical contribution to our 
knowledge of sublimation in science, philosophy and 



34 SELECTED PAPERS OF KARL ABRAHAM 

religion by showing how chafing solicitude for the solving 
of questions that cannot be answered, such as those to do 
with the aim of life, the length of life, and the outcome of 
life after death, is largely the result of unconscious dis- 
placement from questions that may not or dare not be 
answered. 

The same wide range of knowledge comes to expression 
in a number of shorter papers in the field of applied psycho- 
analysis, such as those on the significance of the * day of 
atonement ' rites (64), the note on the Russian sect of 
yoni worshippers (25), the clever analysis of the details in 
the Oedipus legend (76 and 82), and many others (29, 56, 
59, 64, 69, 84). The last paper ever published by Abraham 
(95), a most interesting study of a rogue he had come across, 
was a thoughtful contribution to one of the chief problems 
in criminology. 

Summary. In attempting to summarize in a few words 
the essential characteristics of Abraham's written work, one 
would select the features of many-sidedness, one which 
speaks for itself in the review just made, and the high 
general average of excellence he maintained in his writings; 
hardly anything he wrote was of merely ephemeral value, 
and his work throughout was marked by the valuable 
qualities of sobriety, cautious scepticism and good judge- 
ment. 

This evenness in quality may perhaps be correlated 
with an important feature of Abraham's mode of thought, 
namely, his consistently biological outlook. This gave a 
stable background to all his work and furnished a criterion 
by which the inherent probability or validity of any general 
conclusion could be measured. One may be permitted 
the reflection that of all the many ways in which Abraham 
will be missed in psycho-analysis, the one that may well 
have the weightiest consequences for the future will be in 
connection with this very feature. Psycho-analysis has not 
even yet come to the most decisive turning-point in its 
development, although it has successfully survived im- 
portant preliminary ones. That will come, and very likely 
within the next twenty years, when the question of incor- 



INTRODUCTORY MEMOIR 35 

3rating psycho-analysis into the general body of science 
riously arises. There the most severe test for the young 
ience will present itself, for much will depend on the 
ternatives of whether it will be absorbed by a process 
: partial acceptance and continual attenuation, or whether 

will display sufficient vitality to preserve its essential 
aalities and impart them to the other branches of science 
ith which it will come into contact. Just in this task 
hich lies before us Abraham's characteristic qualities 
ould undoubtedly have been of peculiar value, for he 
assessed a breadth and sanity of outlook over science and 
fe as a whole combined in a rare degree with a single- 
tinded vision of the depths of psycho-analytic truths. 

On studying his original contributions one is struck 
y the preponderance of themes dealing with the pregenital 
ages of development, including auto-erotism and the 
3mponent instincts, and with the element of repressed 
ate, especially in regard to the mother. The latter theme 
>curs again and again in his works and far outweighs in 
rtent his contributions in the sphere of love, transference, 
id akin problems. It is similarly remarkable that such 

first-class clinician, a man with whom the clinical point 
f view was always the dominant one, contributed less to our 
nowledge of purely clinical problems, such as problems 
f the transference neuroses or even the psychoses (in 
pite of his work on manic-depressive insanity, which was 
le outstanding one in this field), than to genetic problems 
f libidinal development. It is likely that he will be 
smembered longer for his contributions in the genetic 
tan for those in the clinical field. 

If one had to select Abraham's most important single 
iece of work, though never forgetting the variety of his 
aluable contributions to all aspects of psycho-analysis, it 
/ould probably be that on oral erotism. Here he described 
i full its various manifestations, traced clearly its internal 
[evelopment and its evolution into succeeding libidinal 
Chases, worked out its relation to both love and hate, 
lemonstrated its clinical importance in respect of alcoholism, 
Irug-taking, and especially manic-depressive insanity, and 



36 SELECTED PAPERS OF KARL ABRAHAM 

last but not least gave us a revealing picture of the 
significant part it plays in the formation of character. 
Perhaps the most outstanding lesson in psychology we owe 
to Abraham is the vast importance of the suckling period 
and the fateful consequences that antagonism aroused to 
the mother during this period may have for later life. 



It remains to say something about Karl Abraham's 
personality, about his personal value to psycho-analysis. 
We have attempted to present an objective estimate of 
what Abraham's scientific writings have meant and mean 
for the development of our knowledge, but his value to 
psycho-analysis greatly transcended even this. The nature 
of it may be hinted at by a single consideration: just as 
he was the central fulcrum through which the advance 
of psycho-analysis operated in Berlin, and in Germany 
altogether, so his influence insensibly made Berlin in many 
important respects the centre of the whole international 
psycho-analytical movement. To understand the secret 
of this achievement is to know Abraham. For the domi- 
nating position he attained in psycho-analysis was not in 
the smallest degree the result of any personal ambition or 
striving; it proceeded altogether from the automatic con- 
sequence of his intrinsic worth, and therein lay the greatness 
of the man. 

Some men are born to be leaders. It is in their nature 
to command others. Abraham was not such a man. To 
the very end, as he remarked to me at the Homburg 
Congress, he found it strange that he should occupy a 
prominent position; it was, as he said, foreign to his 
nature, and it was not easy for him to apprehend and accept 
the evident fact. His influence over his fellows and the 
important part he played sprang not from any desire for 
eminence, but from more solid qualities, from a surpassing 
worth that could not but be recognized. What were those 
qualities ? 

This question can be answered only by resolving an 
antinomy. Prominent among Abraham's character traits 



INTRODUCTORY MEMOIR 37 

were a refreshing youthfulness and a sanguine optimism. 
Now these are not traits that usually inspire implicit 
reliance, nor do they generally go with such qualities as 
cautious scepticism and calm, sober judgement on which 
we laid stress when considering Abraham's scientific work. 
Nevertheless both descriptions are profoundly true. To 
comprehend this paradox is to hold the key to Abraham's 
personality. 

Even in the qualities that gave Abraham his great 
personal and social charm there were hints of stouter ones 
which formed the basis of his character. He was singularly 
youthful, and even boyish at moments when the circum- 
stances were appropriate; though he could be decidedly 
witty at times, a quiet fun, often very shrewd, was his more 
characteristic form of humour. This gave his personality, 
so winning to women and attractive to men, a freshness 
and vigour that always made him a stimulating companion 
or colleague. His demeanour was invariably cheerful, 
courteous and friendly. But these qualities were not to 
be presumed on. Behind them was a firmness impervious 
to the blandishments of man or woman. He could afford 
to be easy and pliant in his intercourse with others, just 
because he had himself so completely in hand; knowing 
that he could not be unduly influenced from either within 
or without, he was confident in any situation. This 
complete confidence was ultimately rooted in self-mastery. 

The same is true of one of his most characteristic traits, 
what his friends called his incurable optimism. He was 
always hopeful, however irksome or sinister the prospect, 
and his buoyancy, together with the confidence that went 
with it, often contributed materially to bringing about a 
more successful issue than at first seemed possible. As a 
rule this optimism was very nicely balanced with a keen 
sense of reality, so that its effect was purely invigorating, 
but once or twice in his life it played him false, marring 
what was otherwise a perfection of stability. 

Abraham's capacity for reserve was to be discerned in 
the quiet punctiliousness of his manner. Probably, how- 
ever, few even of his friends knew how deep this was. 



3 8 SELECTED PAPERS OF KARL ABRAHAM 

They only felt that somewhere there was a barrier beyond 
which one might not penetrate. For the purposes of life 
Abraham had compassed a peculiarly stable mental organiza- 
tion, but the very depths were not to be plumbed, perhaps 
even by himself. 

No one could know Abraham well without realizing 
that he was one of those men who are endowed with quite 
exceptional powers of sublimation, and that he had attained 
an unusually advanced measure of emotional and in- 
stinctual development. It is not chance that it was he who 
taught us what is perhaps the best criterion of full mental 
development: the overcoming of narcissism and of ambi- 
valence. For we shall not know many men who would 
emerge as he did when tried by this severe test. 

Abraham had been able to transmute his egocentric 
trends in a very remarkable degree, with the result that he 
could devote himself quite single-heartedly to the one goal 
of his life, namely, the advancement of psycho-analysis. 
With a solitary exception, the nature of which was such as 
to prove the rule, it was impossible to detect in him a trace 
of any personal ambition whatever; the exception was a 
rather odd desire to become a Docent at the University of 
Berlin, and this was itself obviously bound up with the 
prestige of psycho-analysis. His colleagues in Berlin will 
best know how completely he identified himself with the 
interests of the Society there from the moment he founded 
it, in March 1910, to the time of his last attendance, on 
May 9 of last year. His rare gifts as a teacher, investigator 
and lecturer were indispensable to the development of the 
Society, but of still greater value were his qualities as a 
leader, of which we have still to speak. 

His transmutation of purely personal interest, together 
with his native shrewdness of mind, gave Abraham an unusual 
capacity for viewing problems, personalities, and events 
in a detached and objective way. This to a great extent 
accounts for the marked sobriety of his judgement, but it 
had a further value. It gave him a social ease and friendli- 
ness of manner that made it possible for him to approach his 
fellows with unusual directness, so that no one would well 



INTRODUCTORY MEMOIR 39 

take amiss whatever he might have to say. Any criticisms 
he might wish to make were at once transferred from any 
personal basis to a purely objective one, and this attitude 
rarely failed in its effect of allaying emotion and conducing 
to a reasoned consideration of the matter. Courteously 
firm and, when his mind was made up, inflexible, he was 
never in the smallest way overbearing; his quiet decisive- 
ness was in itself authoritative. He was a delightful 
colleague to work with, as I had ample opportunity to 
observe when we were associated together in the Central 
Executive of the Association as well as in many other con- 
nections. He was always accessible to any ideas presented 
to him, and one could count on their not being refracted by 
any subjective elements; an answer to any proposal would 
be clear, concise, and concrete. All these qualities made 
him an admirable referee in matters of personal or scientific 
disputation. A great part, therefore, of both his sanity of 
judgement and his sagacity in human relationships pro- 
ceeded from his capacity for impersonal objectivity. 

Ambivalence was entirely foreign to Abraham's nature, 
both intellectually and emotionally. He seemed to be 
altogether devoid of hate. He sometimes disliked certain 
individuals, usually on the impersonal ground of regarding 
their activities as harmful to the cause of psycho-analysis; 
but even so I have never known of his hating anyone. He 
was even at times curiously oblivious to the strength of 
hostile emotions in other people; I have seen him cheer- 
fully reasoning with someone who was glowering with 
anger and resentment, apparently blandly ignoring the 
emotion and full of hope that a quiet exposition would 
change the situation. In controversy, even when heated, 
he would be unbending, but his temper never frayed. 
Abraham could please charmingly, help gladly and 
generously, love devotedly; he could withstand stubbornly 
and fight valiantly; but he could not hate. Consequently, 
though he occasionally excited criticism and opposition, 
he never provoked hatred: he had his opponents, and of 
course jealous rivals, but he had no enemies. 

Abraham's profound sense of confidence was thus 



4O SELECTED PAPERS OF KARL ABRAHAM 

founded in the stability of his own mind. With his evenly 
balanced mental organization and his securely firm self- 
control, one inclining slightly even towards austerity, he 
could freely give rein to his innate tendencies, knowing they 
would carry him only the ways he desired. When we say 
that Abraham was a normally developed member of society, 
we are using words which, though cold to the uninitiated, 
are rich with significance for all psycho-analysts. 

We can now see how inevitable it was that Abraham 
should be a leader in psycho-analysis, and why he was so 
successful in that position. His tireless energy and his 
demeanour of intrepid confidence, always fresh and un- 
perturbed, were bracing to others and inspired them with 
the assurance necessary for accomplishing difficult tasks. 
His shrewd perspicacity enabled him to criticize in a 
peculiarly cool way any inaccuracies or exuberances and to 
exercise a steadying influence on the divagations of fancy. 
His constantly benevolent and at the same time impersonal 
attitude made it possible to convey such criticisms 
without wounding or disheartening the person affected. 
His brightness and friendliness, aided by his general 
optimism, inclined him always to make prominent the best 
features of a colleague's work and, when commenting on 
it, insensibly to modify the weak features so as to present 
the work in the most favourable light. The result was 
that he always got the best out of his colleagues and pupils. 
And all the while it was plain to them that in Abraham they 
had a rallying point, a touchstone of objectivity, to which 
they rarely applied in vain. 

This last feature leads us to what were, in my opinion, 
the most salient of all Abraham's valuable qualities his 
fearlessness and his integrity. That he displayed a tenacious 
courage when ringed round with hostility in his lonely 
pioneering days is generally known, though it needs a similar 
experience fully to appreciate what that means. But few 
know that there were even more striking evidences of his 
courageous disregard for painful consequences; at more 
than one important juncture in his life I have known him 
risk the friendship of those very near to him by pursuing a 



INTRODUCTORY MEMOIR 4! 

course which seemed to him the only right one, even when 
he knew it was one that could readily lend itself to serious 
misinterpretation. 

For integrity with Abraham came before everything 
else. Honesty of purpose was so built into his nature that 
he invariably and unhesitatingly did what he felt to be the 
only right thing, and he never swerved from his course. 
This high degree of integrity produced on those around 
him such a sense of certainty and security that they came 
to rely on him as on a rock. Amid the turmoils of personal 
emotions and the clash of discordant tendencies Abraham 
stood always firm, a central steadiness in the shifting eddies 
around. And this was his greatest value to psycho- 
analysis, Karl Abraham was in truth un preux chevalier of 
Science, sans peur et sans reproche. 

ERNEST JONES. 



TABLE OF CONTENTS 



PACK 



TRANSLATORS' NOTE 7 

INTRODUCTORY MEMOIR BY ERNEST JONES . 9 

CHAP. 

I. THE EXPERIENCING OF SEXUAL TRAUMAS AS A FORM 

OF SEXUAL ACTIVITY (1907) . . -47 

II. THE PSYCHO-SEXUAL DIFFERENCES BETWEEN HYS- 
TERIA AND DEMENTIA PR^COX (1908) . . 64 

III. THE PSYCHOLOGICAL RELATIONS BETWEEN SEXU- 

ALITY AND ALCOHOLISM (1908) . . .80 

IV. HYSTERICAL DREAM-STATES (1910) . . . 90 

V. REMARKS ON THE PSYCHO-ANALYSIS OF A CASE OF 

FOOT AND CORSET FETISHISM (1910) . . 125 

VI. NOTES ON THE PSYCHO-ANALYTICAL INVESTIGATION 
AND TREATMENT OF MANIC-DEPRESSIVE INSANITY 
AND ALLIED CONDITIONS (191 1) . . . 137 

VII. A COMPLICATED CEREMONIAL FOUND IN NEUROTIC 

WOMEN (1912) ..... 157 

VIII. MENTAL AFTER-EFFECTS PRODUCED IN A NINE-YEAR- 
OLD CHILD BY THE OBSERVATION OF SEXUAL 
INTERCOURSE BETWEEN ITS PARENTS (1913) . 164 

IX. RESTRICTIONS AND TRANSFORMATIONS OF SCOPTO- 
PHILIA IN PSYCHO-NEUROTICS ; WITH REMARKS 
ON ANALOGOUS PHENOMENA IN FOLK- PSYCHO- 
LOGY (1913) ...... 169 

43 



44 SELECTED PAPERS OF KARL ABRAHAM 

CHAP. 

X. A CONSTITUTIONAL BASIS OF LOCOMOTOR ANXIETY 



....... 2 35 

XL THE EAR AND AUDITORY PASSAGE AS EROTOGENIC 

ZONES (1913) ...... 244 

XII. THE FIRST PREGENITAL STAGE OF THE LIBIDO 

(1916) ....... 248 

XIII. EJACULATIO PRJECOX (1917) .... 280 

XIV. THE SPENDING OF MONEY IN ANXIETY STATES 

09 1 ?) ....... 2 99 

XV. A PARTICULAR FORM OF NEUROTIC RESISTANCE 

AGAINST THE PSYCHO-ANALYTIC METHOD (igig) 303 

XVI. THE APPLICABILITY OF PSYCHO-ANALYTIC TREAT- 

MENT TO PATIENTS AT AN ADVANCED AGE (1919) 312 

XVII. THE NARCISSISTIC EVALUATION OF EXCRETORY 

PROCESSES IN DREAMS AND NEUROSIS (1920) . 318 

XVIII. CONTRIBUTION TO A DISCUSSION ON Tic (1921) . 323 
XIX. THE SPIDER AS A DREAM SYMBOL (1922) . . 326 

XX. AN INFANTILE THEORY OF THE ORIGIN OF THE 

FEMALE SEX (1923) ..... 333 

XXL AN INFANTILE SEXUAL THEORY NOT HITHERTO 

NOTED (1925) ...... 334 

XXII. MANIFESTATIONS OF THE FEMALE CASTRATION 

COMPLEX (1920) ..... 338 

CHAPTERS XXIIL, XXIV., XXV. 
Psycho-analytical Studies on Character-Formation 

XXIIL CONTRIBUTIONS TO THE THEORY OF THE ANAL 

CHARACTER (1921) ..... 370 

XXIV. THE INFLUENCE OF ORAL EROTISM ON CHARACTER- 

FORMATION (1924) ..... 393 



TABLE OF CONTENTS 45 

CHAP. |. AGH 

XXV. CHARACTER -FORMATION ON THE GENITAL LEVEL 

OF THE LIBIDO (1925) .... 407 

XXVI. A SHORT STUDY OF THE DEVELOPMENT OF THE 
LlBIDO, VIEWED IN THE LlGHT OF MENTAL 
DISORDERS (1924) . . . . .418 

PART I 

MANIC-DEPRESSIVE STATES AND THE PRE-GENITAL 
LEVELS OF THE LIBIDO . . . .418 

Introduction . . . . .418 

I. Melancholia and Obsessional Neurosis . 422 

II. Object- Loss and Introjection in Normal 

Mourning and in Abnormal States of Mind 433 

III. The Process of Introjection in Melancholia: 

Two Stages of the Oral Phase of the Libido 442 

IV. Notes on the Psychogenesis of Melancholia . 453 

V. The Infantile Prototype of Melancholic 

Depression ..... 464 

VI. Mania ...... 470 

VII. The Psycho-Analytic Therapy of Manic- 

Depressive States .... 476 

PART II 
ORIGINS AND GROWTH OF OBJECT-LOVE . 480 

BIBLIOGRAPHY OF PUBLICATIONS BY ABRAHAM . . 503 

LIST OF BOOKS AND PAPERS REFERRED TO . . . 511 

INDEX . . . . . . S 1 7 



CHAPTER I 

THE EXPERIENCING OF SEXUAL TRAUMAS 
AS A FORM OF SEXUAL ACTIVITY 



FREUD'S original theory of the aetiology of hysteria 
has undergone important alterations in the course 
of time. As he himself has pointed out, 2 however, 
two important points remain unchanged in it, namely, 
sexuality and infantilism, the significance of which he has 
investigated more and more deeply. 

Among other things, the problem of sexual traumas in 
youth has been affected by the alterations that the general 
theory of sexuality and of the neuroses has undergone. For 
some time Freud regarded those traumas as the ultimate 
source of hysterical phenomena, and assumed that they were 
discoverable in all cases of hysteria. But he has not been 
able to maintain this view in its original form. In the paper 
referred to he assigns a secondary role to sexual traumas 
in youth and assumes the presence of an abnormal psycho- 
sexual constitution as the primary cause of a neurosis. 
This view accords with the fact that not all children who 
experience a sexual trauma suffer later on from hysteria. 
According to Freud, children who are disposed to hysteria 
react in an abnormal manner to sexual impressions of all 
kinds in consequence of their abnormal disposition. I 
recently showed that infantile sexual traumas occurred in 
the psychoses 3 as well; and I put forward the view that the 
trauma could not be regarded as the cause of the disease, 

1 [No. 10, A. B.J 

2 " My Views on the Part played by Sexuality in the ^Etiology of the Neuroses ' 
(1905). 3 [Cf. No. 9, A. B.] 

47 



48 SELECTED PAPERS OF KARL ABRAHAM I 

but that it exercised an influence on the form taken by it. 
I agreed with Freud's assumption of an abnormal psycho- 
sexual constitution in the patient. 

Nevertheless this assumption only takes us one step 
forward, and stops before a second, more important diffi- 
culty. It certainly explains why a sexual trauma in child- 
hood is of such great significance in the history of many 
individuals. On the other hand, the problem remains 
why so many neurotic and psychotic persons can produce a 
sexual trauma in the anamnesis of their childhood. If we 
can solve this problem we shall gain some information at 
least as to the nature of the abnormal constitution which we 
have assumed to exist. 

In this paper I intend to go more closely into these 
questions. I shall more particularly try to establish the 
view that in a great number of cases the trauma was desired 
by the child unconsciously, and that we have to recognize 
it as a form of infantile sexual activity. 

Anyone who is interested in the psychology of children 
will have observed that whereas one child will resist temp- 
tation or seduction another will easily yield to it. There 
are children who will hardly oppose any resistance to the 
invitation of an unknown person to follow him; others 
who react in an opposite way in the same circumstances. 
Presents and sweets, or the mere expectation of them, 
influence children very differently. Further, there are 
children who quite definitely provoke adults in a sexual 
manner. With regard to this the reports of cases brought 
against persons charged with immoral conduct towards 
children are very instructive. In two cases in which a 
senile dement had assaulted a child I happen to know that 
the child had behaved in a provocative way; and in a number 
of other cases I had good grounds for suspecting a similar 
state of affairs. Even among brothers and sisters one finds 
striking differences in this respect. I know of many cases 
of this kind. In a family of several sisters, for instance, 
one allowed herself to be enticed by a strange person to go 
with him; and on another occasion, when playing with an 
older boy, she followed him into a distant room and allowed 



1907 THE EXPERIENCING OF SEXUAL TRAUMAS 49 

him to kiss her. Her two sisters showed the opposite 
tendency. This girl, of whom many similar episodes 
could be related, exhibited neurotic traits even in childhood 
and later became ill with pronounced hysteria. This 
example is not exceptional but typical. For the present 
we may say quite generally that certain children respond 
more readily than others to sexual or other kinds of seduction, 
and we may make use of this fact so as to classify sexual 
traumas, diverse as they are, into two groups. We can 
distinguish sexual traumas which take the child unawares 
from those which it has itself provoked or which are due to 
temptation or seduction, or which it could at any rate have 
foreseen and avoided. In the first group there are no 
grounds for assuming a compliance on the part of the 
child; in the second we cannot avoid assuming that there 
was a compliance of this sort. But the cases do not all 
belong to one or other of these two groups. If a sexual 
assault takes place unexpectedly, the person attacked may 
either defend itself actively and in earnest, or it may submit 
to the attack. In the latter case we again find a response, 
i.e. a yielding on the part of the person attacked. We 
might say that the person succumbs to a * vis haud tngrata ' 
to use an expression of Roman law. 

The subject of * vis haud ingrata ' has always attracted 
the attention of legislators, especially where it enters into 
the regulations for the punishment of sexual crimes. The 
Mosaic law, for instance, has taken it most carefully into 
account. In Deuteronomy xxii. 23-27 we read: 

* 23. If a damsel that is a virgin be betrothed unto a 
husband, and a man find her in the city, and lie with her; 

' 24. Then shall ye bring them both out unto the 
gate of that city and ye shall stone them with stones 
that they die; the damsel, because she cried not, being in 
the city; and the man, because he hath humbled his neigh- 
bour's wife: so thou shalt put away evil from among you. 

'25. But if a man find a betrothed damsel in the field, 
and the man force her and lie with her: then the man only 
that lay with her shall die: 

* 26. But unto the damsel thou shalt do nothing; there 

D 



5O SELECTED PAPERS OF KARL ABRAHAM I 

is in the damsel no sin worthy of death : for as when a man 
riseth against his neighbour, and slayeth him, even so is 
this matter : 

' 27. For he found her in the field, and the betrothed 
damsel cried, and there was none to save her.' 

I will also refer to the excellent little story out of Don 
Quixote, which Freud l has quoted : 

A woman brought a man before the judge and accused 
him of having robbed her of her honour by force. Sancho 
indemnified her with a purse full of money which he took 
from the accused ; but after she had gone he gave the man 
permission to follow her and take back the purse from her. 
Both came back struggling with each other; and the woman 
boasted that the villain had been unable to seize the purse 
from her. Thereupon Sancho said: * Had you fought to 
keep your virtue half as valiantly as you did to keep your 
purse, this man could not have robbed you of it '. 

It is true that these examples refer to adults; but we 
shall find later on that in this respect there is no difference 
between children and grown-up people. 

The Mosaic law makes the punishment of the girl 
dependent upon whether she had called for help or not, 
that is to say, upon whether she had done all she possibly 
could to prevent the occurrence. I have examined the 
cases which I have previously published 2 with reference to 
this point, and find that in all of them the trauma could 
have been prevented. The children could have called for 
help, run away, or offered resistance instead of yielding to 
the seduction. And I was able to establish the same thing 
in a number of other cases. 

What confirms us in our assumption of compliance on 
the part of the child is not only its conduct while the assault 
is in preparation and while it is actually going on, but after 
it has happened. In pointing out that hysterics are suffer- 
ing from * reminiscences ', Breuer and Freud have already 
called attention to the fact that as children they did not tell 
their relatives about the sexual trauma at the time, but kept 

1 Zur Psychotathologie des Alltagslebens, Zweite Auflage, S. 87. 
2 [No. 9, A.B.] 



IQ07 THE EXPERIENCING OF SEXUAL TRAUMAS 5! 

it secret; and that they did so not only while the impression 
of it was fresh in their minds, but that they repressed it into 
the unconscious so that they could not voluntarily recall it. 
I have found 1 similar conduct in children who later suffered 
from dementia praecox; though at the time I did not in- 
vestigate the problem further. 

It is a remarkable thing that a child who has experienced 
a sexual trauma should keep it secret from its parents in 
spite of the emotion associated with it. For a child who 
has been, say, chased and beaten by another one will come 
and complain to its mother. The objection will probably 
be raised that conventional prudishness prevents the child 
from speaking about it, since it has naturally been brought 
up to avoid talking about anything relating to sex. This 
objection, however, does not hold. To begin with, a child 
is not troubled by considerations of conventionality under 
the stress of violent emotion. And then not all children 
by any means behave in this way when they have had a sexual 
experience. 

I will give two examples to illustrate this difference. 
The first is this . A water-pipe had to be attended to in the 
cellar of a house. A workman came and asked for the key 
of the cellar. A woman who was living in the house told 
him to go down the stairs and said that she would send him 
the key. He went down and the woman's little daughter 
brought him the key. The man went into the cellar and 
came out again shortly afterwards. The child was waiting 
on the dimly lighted stairs in order to take back the key. 
Before she knew what was happening the man attempted 
an indecent act. The child ran terrified up the stairs and 
immediately told her mother what had happened. The 
man was followed and arrested. 

A case that I have previously published will serve as the 
second example. A girl of nine years old was enticed by 
a neighbour into a wood. She followed him quite willingly. 
He then attempted to rape her. It was only when he had 
almost or quite attained his purpose that the child succeeded 
in getting free. She hurried home, but said nothing about 

1 Loc. cit. 



5 2 SELECTED PAPERS OF KARL ABRAHAM I 

what had happened; nor did she ever speak about it after- 
wards to her family. 

The conduct of these two children after the trauma is 
quite opposite. Why is this ? Let us first compare the 
conduct of children on other occasions. A child, for 
example, who has hurt itself in a game which it has been 
forbidden to play will suppress the pain, and will not go 
to its mother for comfort as it would normally do. The 
reason is clear: the child had yielded to the attraction of 
doing something forbidden, and it now has the feeling that 
the accident is its own fault. 

This sense of guilt in children is extraordinarily sensitive. 
The following story from the childhood of a lady is an 
interesting illustration of the problem under discussion. 
She was out one day picking flowers with a friend, when a 
strange man came up and spoke to them, asking them to go 
with him, and saying that he would show them where more 
beautiful flowers were to be found. They went a little way 
with him. Presently she began to have scruples about 
going further with the stranger and suddenly turned round 
and ran off. Her friend did likewise. Now although 
nothing had taken place between the man and the children 
except that they had walked a certain distance together, the 
lady definitely remembered having felt a great dislike of 
speaking about the affair at home at the time. She kept 
it absolutely secret from her family, and never even spoke 
about it to her friend afterwards. The child's silence can 
only be explained by a sense of guilt. She evidently had a 
more or less definite feeling that the guilt was not only on 
the side of the seducer, but also on the side of the person 
who lets himself be seduced. 

The same explanation obviously fits the two examples 
given before. The one child was taken completely by 
surprise and found herself in a situation which she had not 
sought. It was her mother who had sent her into the cellar. 
No one could reproach her, and therefore she immediately 
found words in which to tell her mother what had happened. 
The other child, on the contrary, had allowed herself to be 
seduced. She had followed the neighbour into the wood 



1907 THE EXPERIENCING OF SEXUAL TRAUMAS 53 

and allowed him to go a long way in carrying out his 
purpose before she freed herself from him and ran off. It 
is not to be wondered at that this child kept the occurrence 
secret. 

It is the pleasure-gain present in every sexual activity 
which is the temptation. Freud 1 distinguishes between a 
fore-pleasure and satisfaction-pleasure in every sexual act. 
The fore-pleasure can be produced in a physical way 
through direct tactile stimulation of erotogenic zones of the 
body; or it can be called forth by other sensory stimuli, 
for instance through visual impressions; or, lastly, in a 
purely mental way by means of images as, for instance, 
through the tension and excitement of the situation. It is 
difficult to say which of the two kinds of pleasure plays 
the greater part in children. Undoubtedly there are 
marked individual differences in this respect. In some 
of the cases I have observed it seemed to me as though 
the unusualness and secrecy of the situation, that is, the 
adventure as such, were the chief attraction for the child. 
On the other hand, I must again refer to the cases in which 
children directly provoke adults to sexual acts. Here we 
obviously have to presume a desire for satisfaction-pleasure 
as well. 

When the child yields to the trauma it is because its 
libido is striving to obtain sexual fore-pleasure or satisfac- 
tion-pleasure. This fact of a pleasure-gain is the secret 
which the child guards so anxiously; it alone explains its 
sense of guilt and the psychological events which follow upon 
a sexual trauma. I will here refer to Freud's view con- 
cerning the early phases of sexuality. Freud has effectually 
destroyed the myth of a sexual latency period extending 
up to puberty. We learn from his investigations that the 
first traces of sexual activity appear very early and that for 
some time they are of an auto-erotic character. A stage 
follows in which the child turns to * object-love '; but its 
sexual object need not be of the opposite sex. In addition 
to heterosexual and homosexual impulses certain other 
impulses, of a sadistic and masochistic character, find 

1 Drei Abhandlungen zur Se xualtheorie (1905). 



54 SELECTED PAPERS OF KARL ABRAHAM I 

expression. Hence Freud speaks of a polymorpho- 
perverse stage. All these early impulses in the child 
originate in the unconscious and naturally do not come into 
consciousness in their true form; they tend towards a 
definite sexual aim without the child becoming clearly 
aware of this tendency. For a child disposed to hysteria 
or dementia prcecox a sexual experience constitutes a sexual 
aim of this kind. It undergoes the trauma in consequence 
of a tendency in its unconscious. If there is an underlying 
unconscious wish for it, the experiencing of a sexual trauma 
in childhood is a masochistic expression of the sexual 
impulse. It represents therefore one form of infantile 
sexual activity. 

In the sphere of sexuality as elsewhere, there is every 
degree of transition from the normal to the abnormal. 
Nevertheless, I consider that we may in general regard any 
craving for sexual excitation which leads to a submission 
to sexual traumas as an abnormal kind of sexual activity. 
It is a striking fact that we meet with it precisely in the 
early history of neurotic or mentally afflicted individuals, 
in whose later life numerous sexual abnormalities are found. 
At the time when I was attempting l to apply Freud's 
theory of the psycho-sexual basis of hysteria to dementia 
praecox, I had already roughly worked out the respects in 
which the sexuality of children who later succumbed to 
those illnesses was abnormal. I arrived at the conclusion 
that their sexual development was precocious and their 
libido itself quantitatively abnormal, and that their imagina- 
tion was prematurely occupied with sexual matters to an 
abnormal degree. This idea can now be expressed more 
definitely. We can say that children belonging to this 
category show an abnormal desire for obtaining sexual 
pleasure, and in consequence of this undergo sexual traumas. 

If we now observe what happens to the images associated 
with the trauma in the child's mind we shall find new 
evidence in support of our view. A feeling of guilt cannot 
be tolerated by its consciousness any more than by that of 
adults. It therefore attempts to deal with the displeasur- 

1 [No. 9, A. B.] 



IQ07 THE EXPERIENCING OF SEXUAL TRAUMAS 55 

able recollections in some way or other in order to eliminate 
their disturbing effect. They are split off from the rest 
of the contents of consciousness and thenceforward lead a 
separate existence as a * complex'. 

The case is different with those children who have 
suffered a sexual trauma without having been in any way 
responsive to it. These children can speak freely; they 
do not need to force out of their field of consciousness the 
recollection of that occurrence. 

The process of eliminating displeasurable ideas from 
consciousness is the same in hysteria and dementia prsecox 
(or in persons who suffer later from one or other of those 
diseases). Moreover, we can observe this process going 
on daily in healthy persons. But sooner or later it turns 
out that repression is only a make-shift measure. The 
complex can, no doubt, remain in the unconscious for a 
long time; but one day some event analogous to the primary 
sexual trauma takes place and the repressed material is 
roused to activity. Its conversion into symptoms of 
hysteria or dementia preecox then follows. In dementia 
prsecox, it is true, there exists another possibility, namely, 
that a new wave of the illness may come on from endogenous 
sources and that this material will be elaborated into 
symptoms. 

Freud has also drawn our attention to other mechanisms 
which fundamentally serve the same purpose as repression. 
One is the transposition of an affect on to indifferent ideas. 
If this takes place, obsessional symptoms develop. Like 
repression, this process of transposition on to indifferent 
ideas occurs in dementia praecox just as it does in the 
* neuroses \ An example of the first sort is the imaginary 
pregnancies which are so common in dementia praecox, 
and which in their psychological genesis are entirely similar 
to hysterical pregnancies. An example of the second sort 
is the fact that in many cases of dementia praccox in which 
the diagnosis is quite clear obsessive ideas constitute the 
most prominent characteristic of the illness. Hysteria and 
dementia praecox have therefore two methods in common 
of expressing a sense of sexual guilt. There is yet a third 



56 SELECTED PAPERS OF KARL ABRAHAM I 

method available in dementia prsecox. This is to produce 

a delusion of having sinned, and to displace it on to an 

indifferent set of ideas. I cannot in this place bring 

forward evidence from case-histories to show that delusions 

of sin are in a great measure based on self-reproaches with 

a sexual content. I referred in a preceding paper 1 to the fact 

that a number of patients sooner or later connect a delusion 

of sin with the fact that in their youth they had not been 

truthful and had said nothing to their relatives about some 

sexual experience they had had. They displace their 

sense of guilt, which is in reality associated with having 

submitted to a sexual trauma without resistance, on to the 

far more venial * sin ' of having been dishonest. It seems 

to me that this psychic mechanism of displacement on to 

a less affective idea is closely related to the process of 

transposition which underlies the formation of obsessional 

ideas. The result, however, is different. In the one case 

an obsessional idea is formed ; in the other, a delusion. 

I can in this place only mention in passing certain other 

mechanisms, also discovered by Freud, which are of a 

similar nature and serve similar purposes. There is, for 

instance, the very common process of * displacement ' 

which occurs in hysteria and dementia praccox and also in 

dreams. An example of this is the displacement of a 

genital sensation on to the mouth. 

Thus the later history of the complex and the subsequent 
forms it takes bear out the view put forward above as to 
the nature of sexual traumas in youth. Children who later 
suffer from hysteria or dementia praecox show a certain 
peculiarity which, however, is quite explicable from our 
point of view and goes to support our belief that their un- 
conscious responds to the sexual trauma. This peculiarity 
is the fact that they very often have experienced not merely 
a single trauma. One would expect that a burnt child 
would dread the fire, i.e. would avoid any repetition or even 
the bare possibility of a repetition of a sexual trauma, 
since besides pleasure the experience caused it pain or 
other displeasurable feelings either directly or indirectly. 

1 [Cf. No. 9f A. B.I 



1907 THE EXPERIENCING OF SEXUAL TRAUMAS 7 

Observation, however, shows the opposite. Individuals 
who have once suffered a sexual trauma, of which they 
were partly guilty through their compliant behaviour and 
which at the same time afforded them pleasure, show a 
tendency to expose themselves to further occurrences of the 
same nature. If they suffer a second trauma, they assimilate 
it in their unconscious to the first trauma which has already 
been repressed. The additional trauma acts in an auxiliary 
manner in disturbing the psychic balance, and the illness 
breaks out, either in the form of hysteria or dementia 
praecox according to the person's congenital disposition. 

The tendency to experience sexual traumas repeatedly 
is a peculiarity which we can often observe in adult 
hysterics. We might even speak of a traumatophilic 
diathesis, which, moreover, is not limited to sexual traumas. 
Hysterics are those interesting people to whom something 
is always happening. Female hysterics in particular are 
constantly meeting with adventures. They are molested 
in the public street, outrageous sexual assaults are made on 
them, etc. It is part of their nature that they must expose 
themselves to external traumatic influences. There is in 
them a need to appear to be constantly subjected to external 
violence. In this we recognize a general psychological 
characteristic of women in an exaggerated form. 1 The 
fact that in pronounced hysteria a tendency to experience 
traumas is also found in adults is valuable evidence in 
support of the assumption that people of this kind have a 
similar tendency in childhood. 

In his Psychopathologie des A I/tags le bens Freud has 
directed our attention to the fact that awkward behaviour, 
blunders, self-injuries, accidents, and similar occurrences in 
every-day life are often due to an unconscious purpose on 
the part of the subject. I have quoted above an anecdote 
related by Freud which shows that sexual 'accidents', too, 
can come from an unconscious wish. This theory of 

1 Incidentally we may allude to the dreams of healthy girls and women in 
which they are stabbed or murdered in some way by a man. Freud has shown 
that these dreams are to be recognized as symbolic representations of a sexual wish. 
In the dream the man is the assailant and the dreamer adopts the passive r61e; she 
is not even guilty of the symbolic sexual act. 



58 SELECTED PAPERS OF KARL ABRAHAM I 

Freud gives further very important support to my view 
that infantile sexual traumas of the kind I have specified 
are brought about by an unconscious wish on the part of 
the child. In order to justify my use of Freud's results I 
will give a few illustrations from my own experience in 
confirmation of the truth of his conclusions. 

A girl of nineteen was knocked down in the street by 
a soldier trotting past on a horse. It was broad daylight 
when this happened, and the thoroughfare was a wide and 
straight one. The girl was unconscious for a short time, 
but suffered no severe bodily injury. Shortly afterwards 
symptoms of a so-called traumatic neurosis appeared. 

The previous history of the girl was as follows : Since 
her childhood she had been through all sorts of experiences 
of a depressing nature. To begin with, she had been 
witness of quarrels between her parents. When they had 
separated she had been allocated to her mother. She did 
not like her mother, however, who was an uneducated 
woman without refinement. She was fond of her father, 
who carried on literary activities in spite of being a simple 
artizan. When she was twelve years old she ran away from 
her mother and went to her father. She was one of the 
best pupils in her school, and began to write poetry quite 
early on. She wanted to become a school-mistress, and 
her wish seems to have arisen from her admiration for a 
certain ^/nale teacher as well as from natural inclination. 
As her father had not the means to send her to a proper 
training college she had to leave school early and take 
work as a servant in one place after another. She was 
very unhappy because she could not gratify her desire 
to become educated or get into a higher social sphere. 
She remained a year and a half in one situation. Then 
she attempted to improve her position by learning short- 
hand and typewriting; but her financial resources failed 
before she had attained her end, and she had to go to work 
in a factory, where the association with uneducated women 
was not at all to her taste. She had been on bad terms 
with her mother ever since she had believed herself justified 
in the suspicion that her younger sister was the offspring 



1907 THE EXPERIENCING OF SEXUAL TRAUMAS 59 

of an illicit relationship on the part of her mother before 
the divorce. She stood quite alone, especially as even her 
father troubled himself very little about her. She had to 
do work that she hated and live in a social sphere that was 
distasteful to her. Her younger sister, whom she supported 
out of her earnings in order to enable her to learn an 
occupation, rewarded her sacrifice with ingratitude. All 
these circumstances, and probably an unfortunate love 
affair in addition, had such a depressing effect upon her 
that she lost all interest in life. During the time before 
the accident she wrote some poetry in which she gave 
expression to her weariness of life. Then the above- 
mentioned accident occurred. 

When, as in this case, a person has lost all pleasure in 
life, and the thought is obviously present in his mind that 
it would be better to die than go on living under such con- 
ditions; and when that person meets with an accident under 
circumstances which suggest that it might have been 
avoided, then I consider that we are justified in assuming 
that there is an unconscious intention of suicide. The girl 
did not deliberately throw herself in front of the horse. 
That would have been conscious suicide. But she did not 
perceive the possibility of getting out of the way clearly 
enough. Freud has already given this explanation in 
similar cases of suicide or attempted suicide which appeared 
on a superficial view to be accidents. It is worth noting 
that the girl's condition improved when she was given an 
occupation which lay in the direction of her complex, and 
when efforts were made to get her a better position. 

What strange and yet effective means the unconscious 
employs to attain its ends is shown in the following history 
of an accident met with by a lady suffering from dementia 
praecox. The patient suffered principally from a delusion 
of sin which was the result of long-continued masturbation. 
She declared that her masturbation was traceable to an 
accident which had happened to her a number of years 
before, when she had slipped and fallen so that her genital 
region had knocked against the corner of a table. Her 
description of the accident made it impossible to picture it 



6O SELECTED PAPERS OF KARL ABRAHAM I 

otherwise than as the result of an unconscious purpose. At 
that time the patient obviously felt a sexual excitation which 
she could not gratify in the normal way. She struggled 
against the longing to masturbate. But the gratification 
her conscious forbade her to obtain her unconscious pro- 
cured for her through her * accident '. 

Another patient had from childhood had an exceedingly 
strong affection for her brother. When she was grown up 
she measured every man by the standard of her brother. 
She did fall in love with a man later on, but the affair ended 
badly. Shortly after this, while she was still very much 
depressed, she twice got into serious danger through her 
carelessness on a climbing party. As she was a good 
climber, her falling twice in safe and easy places remained 
a mystery to her friends. It appeared later that at that 
time she was playing with ideas of suicide. After her 
unfortunate love affair she turned her whole affection back 
again to her brother, who some time afterwards became 
engaged. Soon after this she fell ill with dementia praecox. 
(Probably the illness had been developing gradually.) In 
the initial stage of depression she attempted to throw herself 
out of the window obviously the same thing as her falls 
in climbing. Her condition very slowly improved in the 
asylum, until at last she was able to go for walks in the park 
with an attendant. A ditch was being dug in the garden 
and she used to cross it by a plank bridge, although she 
could quite easily have jumped over it. At that time she 
was told the date on which her brother was to be married. 
She continually spoke of his wedding. On the day before it 
was to happen, as she was out walking as usual, she sprang 
over the ditch instead of crossing by the bridge, and did 
it so clumsily that she sprained her ankle. Later on, too, 
these self-injuries occurred so frequently that even the 
attendant began to suspect that there was something inten- 
tional in them. In these minor accidents her unconscious 
was obviously expressing the intention to commit suicide. 

Events of this kind appear in quite a new light as soon 
as we know something about the circumstances which pre- 
cede and accompany them. The more one subjects such 



THE EXPERIENCING OF SEXUAL TRAUMAS 6 1 

events to psychological analysis, the more room one is 
obliged to give to the significance of unconscious volition. 
Of course no strict line can be drawn between unconscious 
and conscious purpose in this connection. 

Adult neurotics and mental patients offer us highly 
interesting examples of frequent traumatic experiences (not 
only of a sexual kind). At this point we must make a 
slight digression into an allied field of interest. The fact 
that a traumatic hysteria is very often a * pension-hysteria ' 
is beyond dispute. It is the patient's desire to obtain com- 
pensation that prevents his symptoms from disappearing. 
If the patient has got better and a reduction or entire with- 
drawal of the pension is threatened as a consequence, then 
his symptoms which have disappeared or become less 
severe will once more reappear or grow more acute. Here 
we obtain an insight into the numerous ways in which the 
unconscious mind is able to realize wishes without their 
having to become conscious at all. It is not uncommon for 
persons who have just had an accident to meet with another, 
often a quite insignificant one, which comes just in the nick 
of time to support their claim to a pension. I have noticed 
this happen very frequently among a class of people especi- 
ally disposed to hysteria, namely, Polish workmen employed 
under the German Workmen's Compensation Act. It is 
well known that these people defend their claim to a pension 
with a peculiar tenacity, and that their traumatic-hysterical 
symptoms take an exceptionally firm hold on them. The 
number of Polish workmen who claim pensions on account 
of more than one accident is surprisingly large. 

The tendency to reinforce the first accident by means 
of a second one is even manifested in cases where the person 
is laid up with his hysterical symptoms and so has no oppor- 
tunity of having another one while at work. An Italian 
workman upon whom I had recently to give an opinion had 
been injured through an iron clamp falling on his head 
from some scaffolding. I got him to tell me his dreams. 
He repeatedly told me that in his dream someone had beaten 
him over the head with a stick, or that some other accident 
had happened to him. His unconscious clearly wished to 



62 SELECTED PAPERS OF KARL ABRAHAM I 

keep the traumatic symptom complex alive, and gave 
expression to this wish in his dreams. The fact that his 
dreams were accompanied by anxiety is no evidence against 
this view, if we accept Freud's theory of dreams. I con- 
sider that in this way the very frequent anxiety-dreams of 
persons injured accidentally fall into line with Freud's theory 
of wish-fulfilment. The unconscious is untiring in its 
efforts to give expression to a complex. It takes care that 
the affective value of the trauma suffered shall not be lost, 
and from time to time it brings the occurrence back to 
memory by means of an anxiety dream. 

The observation both of adults and children, and the 
analysis of dreams of healthy persons, as well as neurotics 
and mental cases, and of the symptoms of hysteria and 
dementia praecox, lead us to the conclusion that at the back 
of sexual traumas, particularly infantile ones, and of other 
traumas as well, there often lies an unconscious purpose 
on the part of the apparently passive party. We have 
traced back to supposed abnormalities in their infantile 
sexuality the fact that persons who later fall ill with hysteria 
or dementia praecox show in their youth an abnormal re- 
sponse to sexual traumas ; and we have come to regard such 
behaviour as a form of abnormal infantile sexual activity. 
Thus Freud's original view has undergone an important 
alteration. Infantile sexual traumas play no aetiological 
role in hysteria and dementia praecox. The experiencing 
of such traumas indicates rather that the child already has a 
disposition to neurosis or psychosis in later life. Instead of 
an Aetiological significance, the infantile sexual trauma now 
receives a formative one, and we can understand how it is 
able to lay down a definite course for the subsequent illness 
and to determine the individual character of many symptoms. 

Our investigations have once more brought before us 
the far-reaching similarity between the symptomatology of 
hysteria and dementia praecox. We have not yet arrived 
at the solution of the differences that undoubtedly exist 
between the two diseases. These are to be found for the 
most part in the psycho-sexual sphere, and will form the 
subject of a further inquiry. 



1907 THE EXPERIENCING OF SEXUAL TRAUMAS 63 

POSTSCRIPT (1920) 

This paper, which was written in 1 907, contains certain 
errors in its rendering of Freud's views. At the time of 
writing I had only recently begun to interest myself in the 
psycho-analytic method of thought. I consider it better 
to point out this fact in a general way than to make the 
necessary corrections in each place in the text, particularly 
since those errors do not invalidate the results of my 
investigations. 



CHAPTER II 

THE PSYCHO - SEXUAL DIFFERENCES BE- 
TWEEN HYSTERIA AND DEMENTIA 
PR^ECOX 1 (1908) 

THE psycho-analytic method has enabled us to recog- 
nize important analogies in the structure of hysteria 
and dementia praecox. 2 It will be sufficient in this 
paper to mention the most outstanding ones. The symp- 
toms of both diseases originate in repressed sexual complexes. 
In both cases normal as well as perverse impulses can deter- 
mine the formation of symptoms. The means of expression 
employed by both diseases are to a considerable extent the 
same. (I need only refer to sexual symbolism.) 

But that in spite of these common characteristics there 
exists a fundamental antithesis between the two diseases, 
all observers agree. Up to the present, however, they have 
not defined this antithesis satisfactorily. They have only 
described differences of degree, and these only bring out 
once more the similarity between the two forms of illness. 
Seeing that certain important characteristics common to 
hysteria and dementia praecox are of a psycho-sexual nature, 
the question arises as to where this analogy ends. And so, 
in seeking to discover the fundamental differences between 
the two illnesses, we are again brought back to the psycho- 
sexual sphere. 

Freud's Drei Abhandlungen zur Sexualtheorie (1905) 
offers us a basis for an investigation of this kind, and in 

1 [No. it, A. B.] 

* See particularly Jung, Vber die Psychologic der Dementia Pracox (1907). 

64 



1908 HYSTERIA AND DEMENTIA PR^ECOX 65 

particular his views on the sexuality of children, sexual 
perversions, and the sexual impulse of neurotics. The 
theoretical considerations that I am about to bring forward 
concerning the sexuality of chronic mental patients stand or 
fall by Freud's sexual theories. 1 

The earliest sexual impulses in the child are, according 
to Freud, connected with a single erotogenic zone the 
mouth. During the first years of its life other parts of the 
body assume the function of erotogenic zones in addition to 
the oral zone. The earliest expressions of its libido are 
auto-erotic. At this stage the child knows no sexual object 
as yet except itself. In the subsequent period of develop- 
ment it turns to object-love. But its object-love does not 
immediately have a fixed and definite direction towards 
persons of the opposite sex. There are a number of com- 
ponent-instincts in the child, and in the normal course of 
events one of these, the heterosexual one, acquires and retains 
the place of supremacy ; whereas the energy derived from 
the other component-instincts is withdrawn from sexual 
use and applied to important social aims. This latter 
process is termed sublimation. It may be said in general 
that feelings of disgust originate from the sublimation of 
homosexual components; shame from the sublimation of 
infantile scoptophilia and exhibitionism; and horror, pity 
and similar feelings from the sublimation of the sadistic and 
masochistic components. 

Learning to transfer its libido to persons of the opposite 
sex and converting its remaining component-instincts into 
social feelings are not all the child's psychosexual develop- 
ment. Both sexual transference and sublimation of sexual 
energy go far beyond these limits; and both processes 
normally work together in harmony. Artistic, 2 scientific, 
and to a certain extent many other occupational activities, 
depend upon sublimatory processes. Persons with un- 

1 In this paper many of the ideas which go some way beyond Freud's published 
views I owe in the first instance to written and oral communications from Freud 
himself. And I have also been able to formulate many points more clearly through 
discussion with Prof. Bleuler and Dr. Jung in the course of my work at the Zurich 
Psychiatric Clinic. 

2 Cf. Rank, Der Kiinstler, Ansatze zu einer Sexualpsychologie (1907). 

E 



66 SELECTED PAPERS OF KARL ABRAHAM II 

gratified libido frequently convert their free sexual energy 
into feverish activity in their work, or they direct their 
surplus libido to social activities and find in them their 
satisfaction. This is the best source from which flows 
the interest in sick nursing and the care of infants, 
in public charities, in societies for the protection of 
animals, etc. 

Man's social conduct depends upon his capacity for 
adaptation. This, however, is a sublimated sexual trans- 
ference. A positive or negative mental rapport develops 
between people after they have been together for a certain 
length of time, and it expresses itself in feelings of sympathy 
or antipathy. It is the basis of sentiments of friendship 
and mental harmony. The behaviour of a human being 
in social life is entirely in accord with the way in which he 
reacts to sexual stimuli. In both cases a given person shows 
himself easy or difficult of access, coarse or refined in his 
manner, fastidious or easy-going as to his choice. What 
we characterize in the behaviour of one person as stiff, 
awkward, or clumsy, and in another as graceful, adroit, 
etc., are signs of a lesser or greater capacity for adaptation, 
i.e. capacity for transference. 

In psycho-analysis we make use of the transference 
for therapeutic purposes as we do in all forms of mental 
treatment. 1 Suggestion, the effects of which are seen in 
their highest degree in hypnosis, is a very pronounced form 
of sexual transference. 

Man transfers his libido not only to animate but also 
to inanimate objects. He has a personal relation to almost 
all the objects of his environment, and this relation originates 
in his sexuality. In my monograph, Traum und Mythus* 
I have discussed this question in detail, and I will only 
mention here a few essential considerations on this point. 
Our German language gives a gender to inanimate objects, 
because it compares them with male and female by reason 
of definite characteristics. * The human being sexualizes 

1 Cf. Freud, ' Fragment of an Analysis of a Case of Hysteria ' (1905). Also 
Sadger, ' Die Bedeutung der psychoanalytischen Methode nach Freud ' (1907). 
[No. 14, A. B.] 



1908 HYSTERIA AND DEMENTIA PR^ECOX 67 

the universe ', says Kleinpaul. 1 The sexual symbolism of 
language which we meet again in dreams and mental dis- 
orders originates in the same source. To objects we have 
grown to like through use or because of their aesthetic 
value we obviously have a personal relationship which is 
quite analogous to sexual attraction. The direction taken 
by our taste in the choice of objects completely conforms 
to our sexual object-choice. There are many different 
degrees of this kind of object-love. Many persons have 
almost no needs in this respect, while others are completely 
under the dominion of their passion for certain objects. 
With a delicate perception of these psychological con- 
nections the German language terms a man who shrinks 
from no sacrifice in the attainment of a desired object a 
' Liebhaber ' [' lover '], thus likening him to a man who is 
in love with a woman. The most pronounced type of 
such a ' Liebhaber ' is the collector. The excessive value 
he places on the object he collects corresponds completely 
to the lover's over-estimation of his sexual object. A passion 
for collecting is frequently a direct surrogate for a sexual 
desire; and in that case a delicate symbolism is often con- 
cealed behind the choice of objects collected. A bachelor's 
keenness for collecting often diminishes after he has married; 
and it is well known that interest in collecting varies in 
different periods of life. 

The sexual impulse of the neurotic is distinguishable 
in the first place from that of the normal person by the 
excessive strength of his desire. Furthermore, the neurotic 
lacks internal harmony. His component-instincts are only 
incompletely subjected to his heterosexual one; and there 
exists on the other hand a tendency to repress this latter 
instinct. Ideas associated with normal sexual activities 
occasion repugnance and disgust in him. Throughout his 
life one component-instinct is opposing another, and ex- 
cessive desire for a thing wars with an extreme rejection of 
it. From this conflict the neurotic takes flight into illness. 
With the outbreak of his neurosis, repressed material comes 
into his consciousness and is converted into hysterical 

1 Kleinpaul, Stromgcbiet der Sprache, S. 468. 



68 SELECTED PAPERS OF KARL ABRAHAM II 

symptoms. The conversion serves as a discharge for re- 
pressed impulses which may be normal but are more 
especially of a perverse kind. The symptoms are them- 
selves abnormal sexual activities. Apart from periods of 
illness in the strict sense the neurotic libido manifests itself 
in an intensified transference. It cathects its objects in an 
abnormally high degree; and it shows more than the average 
tendency towards sublimation. 

In the light of this knowledge we may go on to com- 
pare the psychosexual conduct of persons suffering from 
dementia praecox with that of healthy persons and of 
neurotics. For this purpose we will select a few types 
from that large group of chronic mental cases which, 
in accordance with Kraepelin, we classify as dementia 
praecox. 

Let us suppose ourselves in a mental hospital. We 
see before us a patient suffering from a severe form of the 
illness and in an advanced stage of it. He is standing in 
a corner of a room or runnin^ about restlessly. He stares 
vacantly before him, hallucinates, whispers a couple of 
words, and gesticulates in a strange manner. He speaks to 
nobody and avoids everyone. He has no desire to occupy 
himself, neglects his appearance, eats noisily, is dirty, 
smears himself with excrement and masturbates openly 
without shame. It is as though his surroundings did not 
exist for him. 

We come to a less severe case who yet exhibits funda- 
mentally the same behaviour, though not in such an ex- 
treme degree. He, too, is unsocial and reserved and has 
persecutory and grandiose ideas. His conduct and manner 
of speech are peculiar, affected, and unnatural. He com- 
plains bitterly about his internment, but he utters these 
complaints, like all others, without adequate affect. He 
takes cognizance of events in the external world but has no 
real interest in them. He will do a little mechanical work, 
but it gives him no satisfaction. 

Here is another patient whose illness does not show 
any very marked symptoms and who need not necessarily 
be certified. He easily feels himself injured by others, 



1908 HYSTERIA AND DEMENTIA PR-ffiCOX 69 

does not get on with his relatives, makes no friends, and 
does not want any. He feels no need for human rela- 
tionships, and is devoid of tact and finer feelings. We 
cannot get into friendly relations with him. He may 
perhaps possess more than average intelligence, but every- 
thing he does is as a rule without value. His intellectual 
productions are generally peculiar and unnatural, violating 
the laws of good taste and being quite devoid of normal 
feeling. 

All these forms of the disease * have in common the 
same anomalies in regard to the patient's emotional life. 
(For the differences are only a matter of degree: a slight 
form can turn into a severe one, and a severe one can show 
considerable remissions.) Whereas the ideas of healthy 
persons are accompanied by adequate feeling, such an 
association of feeling is lacking in these patients. But 
since we have traced back all transference of feeling to 
sexuality we must come to the conclusion that dementia 
praecox destroys the person's capacity for sexual trans- 
ference, i.e. for object-love. 

The child's first unconscious sexual inclination is 
towards its parents, and particularly towards the one of the 
opposite sex. A lively transference also occurs between 
brothers and sisters in the same family. At the same 
time, however, feelings of rebellion and hate are present, 
especially between members of the same sex. These feel- 
ings succumb to the influence of education and other 
exogenous factors of repression. Under normal con- 
ditions there exists between parents and children an 
affectionate relationship and a feeling of unity. In 
hysterics we often find this affection morbidly increased 
towards one person, and changed into violent aversion 
towards another. Such family affection is usually lacking 
in dementia praecox patients; and we find in its place 
indifference or pronounced hostility passing into delusions 
of persecution. 

An educated patient, whose mother had never ceased 

1 In using the words * slight ' and ' severe ' nothing is implied about the 
morbid process of the disease, but only about its practical (social) effects. 



7O SELECTED PAPERS OF KARL ABRAHAM II 

her tender care for him during his long illness in spite 
of his coldness towards her, reacted to the news of her 
death with the remark, ' Is that the latest ? ' In the same 
way it is an every-day experience that in dementia praecox 
parents leave off having any feelings for their children. 

I had under my observation a young man in whom this 
mental trouble had developed very early. In early child- 
hood he had such a marked transference towards his mother 
that at three years old he once exclaimed : ' Mother, if you 
die I shall hit my head with a stone and then I shall be dead 
too '. He would not allow his mother to be with his father 
for a single moment. He used to insist on being taken 
walks by her alone, watched over her jealously, and was 
spiteful towards his brother. He had shown an abnormal 
tendency to contradiction from infancy. His mother said 
of him that even at that time he was * the spirit that always 
denies V He had not associated with other boys, but 
had clung to his mother alone. When he was thirteen 
years old he had become so uncontrollable at home that his 
parents had had to entrust him to other hands. From 
the moment that his mother had taken him to his new 
home and had gone away he had changed completely. The 
excessive love and tenderness for his mother changed into 
feelings of absolute coldness. He wrote stiff, formal 
letters in which he never mentioned her. He gradually 
developed a severe hallucinatory psychosis in which the 
process of decay of his affective life became more and more 
apparent. 

Psycho-analytic investigation has shown that in mental 
patients excessive affection often turns to violent hostility. 
This revulsion of the libido from an object upon which it 
was at one time transferred with particular intensity is an 
irrevocable one in dementia praecox. 

In the anamnesis of cases of dementia praecox we are 
very frequently told that the patient had always been quiet 
and inclined to brood, had never associated with anyone, 
had avoided company and amusements, and had never 

1 * Dcr Gcist dcr stets vcrneint.' [This is said of Mephistopheles in Goethe's 
Faust, Pt. I.] 



8 HYSTERIA AND DEMENTIA PR^ECOX 7! 

;n really gay like other people. These persons have in 
t never had a proper capacity for transferring their 
ido to the external world. It is they who form the 
social element in asylums. Their words are without 
active content. They speak of the most sacred things 
I the merest trivialities in the same tone of voice and with 
: same gestures. It is only if the conversation touches 
a complex that an affective reaction, sometimes a very 
lent one, may occur. 

Dementia praecox patients are in a certain sense very 
rgestible, and this may seem to contradict the idea of 
feak sexual transference. Their suggestibility, however, 
quite different to that of hysteria. It seems to me to 
isist simply in this, that they do not struggle against 
s or that influence, because at the moment they are too in- 
Ferent to oppose it (Kraepelin's ' automatic obedience '). 
ie disturbance in their capacity for attention is certainly 
great significance here in this connection. It seems to 
; therefore that this suggestibility is simply an absence 
resistance. But it very easily changes into resistance. 
ie negativism of dementia praecox is the most complete 
tithesis to transference. In contrast to hysteria, these 
tients are only in a very slight degree accessible to 
pnosis. In attempting to psycho-analyse them we notice 
5 absence of transference again. Hence psycho-analysis 
rdly comes into consideration as a therapeutic procedure 
this kind of illness. 

We can notice the failure of transference in these 
tients in many ways. We never see them really happy, 
ley have no sense of humour; their laughter is unreal 
convulsive, or grossly erotic, but never hearty. And it 
en means, not that they are in good spirits but that a 
tnplex has been touched. This is the case, for example, 
the stereotyped laughter of the patient who is hallucinat- 
*, for his hallucinations are always concerned with his 
mplex. The demeanour of such patients is clumsy and 
ff; it shows very clearly their lack of adaption to their 
vironment. Kraepelin speaks very significantly of a 
>ss of gracefulness * in them. They have lost the need 



72 SELECTED PAPERS OF KARL ABRAHAM II 

to make their environment comfortable and cheerful. 
Their attachment to their activities and occupation dis- 
appears in the same manner as their attachment to people. 
They readily become absorbed in themselves; and, what 
seems to me especially characteristic, they do not know 
what boredom is. It is true that most of these patients 
in institutions can be educated to do quite useful work 
by making a constant suggestion in this direction; but 
they take no pleasure in what they do, and as soon as the 
suggestion ceases they give it up. An apparent exception 
is seen in those patients who work from early morning till 
late at night without needing any rest or recreation. Such 
indefatigable industry invariably springs from a complex. 
One patient I know, for instance, is exceedingly active on 
the asylum farm because he regards the entire grounds 
as his own property. Another, a very old man, works 
untiringly in the scullery of his section and will not allow 
anyone else to help him. This is because he hears elves 
speaking out of the water in the sink, and they once 
prophesied to him that he should come to them if he 
washed 100,000 more pieces of crockery before his death. 
This octogenarian takes no interest in anything else but this 
work, which he performs to the accompaniment of secret 
ceremonies. 

These patients no longer take any real interest in 
objects, or in their property; and nothing that surrounds 
them has any attraction for them. It is true that they often 
express intense longing for some object, but if they get it 
it has no effect on them. It is also true that they take great 
care of certain things, but occasion will show that they 
have no real feeling for them. A certain patient collected 
a large quantity of common stones; he said they were 
precious stones, and set an enormous value upon them. 
The drawer in which he kept them finally broke in con- 
sequence of their weight. When the stones were taken 
away the patient protested against this interference with his 
rights; but he did not grieve after his lost treasures, but 
collected fresh stones. They did just as well as symbols 
of his supposed riches. The very frequent destructive 



IQ08 HYSTERIA AND DEMENTIA PR^COX 73 

mania of patients undoubtedly springs in part from their 
lack of pleasure in objects. 

In very many cases the mental disturbance affects not 
only those finer social sublimations which are gradually 
evolved in the course of the person's whole life, but also those 
which originated in his early childhood, such as shame, 
disgust, moral feelings, pity, etc. Careful investigation 
would probably show that these feelings are, at any rate to 
some extent, obliterated in every case of dementia praecox; 
and in all severe cases it is quite evident that this is so. The 
most pronounced manifestations of such a process are 
smearing with excreta, drinking urine, dirtiness, etc., all 
of which point to the loss of feelings of disgust; while 
obtrusive erotic conduct, such as exhibiting, implies a loss 
of feelings of shame. We are reminded of the behaviour 
of infants who have as yet no disgust of excreta, and no 
feelings of shame at nakedness. Other manifestations 
are the freedom with which many patients speak of the 
intimacies of their former life. They reject memories only 
when they have lost value or interest for them. Their 
attitude in regard to cruel acts committed by themselves 
shows most clearly of all that they have lost all sentiment of 
pity. I once saw a patient a few hours after he had shot 
an innocent neighbour dead and severely injured his wife. 
He was talking quite calmly about the motive of the deed 
and about the deed itself, and at the same time contentedly 
eating the meal that had been put before him. 

So far we can recognize two groups of phenomena in 
dementia praecox : one in which the libido of the patient is 
turned away from animate and inanimate objects, and the 
other in which he has lost those feelings which arise through 
sublimation. Thus we see that this illness involves a 
.cessation of object-love l and of sublimation. Only one 
similar sexual condition is known to us, namely, that of 
early childhood; we term it, with Freud, * auto-erotism '. In 
this period, too, interest in objects and sublimation is lacking. 
The psychosexual characteristic of dementia praecox is the 

1 A patient whom I was observing addressed himself as ' you ' in his numerous 
writings; for he himself was the only object in which he was interested. 



74 SELECTED PAPERS OF KARL ABRAHAM II 

return of the patient to auto-erotism, and the symptoms of 
his illness are a form of auto-erotic sexual activity. 

This of course does not mean that every sexual impulse 
in these patients is purely auto-erotic. But it does mean 
that every attraction to another person is, as it were, sicklied 
o'er with the pale cast of auto-erotism. When a female 
patient seems to have very intense feelings of love and ex- 
presses them with great violence, her singular lack of shame 
in showing them surprises us at the same time. The loss 
of feelings of shame, which are an effect of sublimation, is 
a step in the direction of auto-erotism. Moreover, we see 
such patients falling in love with some one quite suddenly 
and indiscriminately, and then as quickly exchanging that 
person for another. In every asylum there are always 
some women who are in love with whoever is their physician 
at the time ; and each of them soon has the delusion of being 
engaged or married to him, imagines herself with child by 
him, and sees a sign of love in every word he utters. If the 
physician leaves, his successor very quickly takes his place 
in the emotional life of those patients. They are therefore 
still able to direct their sexual desire on to a person, but are 
no longer capable of any steady attachment to him. Other 
patients cherish for years an imaginary love, which only 
exists in their minds; and they have probably never even 
seen their sexual object. In real life they keep away from 
any human contact. In short, there is always some evidence 
of their auto-erotic attitude. In those cases which on 
account of an extensive remission of symptoms give the 
impression of a cure, the deficient capacity for a continued 
interest in the external world is, as a rule, the morbid trait 
which is most clearly visible. 

The patient whose libido has turned away from objects 
has set himself against the world. He is alone, and faces 
a world which is hostile to him. It seems as though his 
ideas of persecution * were directed especially against that 
person upon whom he had at one time transferred his libido 

1 The turning away of the libido from the external world is the basis for the 
formation of delusions of persecution in general. I cannot in this place go into the 
further factors which come into consideration in this connection. 



igo8 HYSTERIA AND DEMENTIA PR-dECOX 75 

in a marked degree. In many cases, therefore, the perse- 
cutor would be his original sexual object. 

The auto-erotism of dementia praecox is the source not 
only of delusions of persecution but of megalomania. Under 
normal conditions, when two persons have transferred their 
libido on to one another each over-estimates the value of the 
other whom he loves (Freud calls this ' sexual over-estima- 
tion '). The mental patient transfers on to himself alone 
as his only sexual object the whole of the libido which the 
healthy person turns upon all living and inanimate objects 
in his environment, and accordingly his sexual over-estima- 
tion is directed towards himself alone and assumes enormous 
dimensions. For he is his whole world. The origin of 
megalomania in dementia praecox is thus a reflected or 
auto-erotic sexual over-estimation an over-estimation which 
is turned back on to the ego. 1 Delusions of persecution and 
megalomania are therefore closely connected with each other. 
Every delusion of persecution in dementia praecox is accom- 
panied by megalomania. 

The patient's auto-erotic isolation from the external 
world not only affects his reactive behaviour but also his 
receptive attitude. He shuts himself off from the sense- 
perceptions of reality that flow towards him. His uncon- 
scious produces sense-perceptions of a hallucinatory nature, 
and these correspond to repressed wishes. He thus carries 
his self-isolation so far that in a certain measure he boycotts 
the external world. He no longer gives it anything, or 
accepts anything from it. He grants himself a monopoly 
for the supply of sense-impressions. 

The patient who has no interest in the external world, 
who vegetates in complete absorption in himself, and whose 
apathetic expression gives an appearance of utter insensi- 
bility, seems to ordinary observation to be devoid of mental 
or emotional Activity. It is customary to use the term 
4 dementia ' for this condition. But the same expression 
is used for the condition that follows on other psychoses, on 

1 I regard auto-erotic sexual over-estimation as the source of megalomania 
in general in dementia praecox. The special idea in which it may take shape is 
determined by a definite repressed wish in this connection. 



76 SELECTED PAPERS OF KARL ABRAHAM II 

epileptic, paralytic, and senile dementia. The two con- 
ditions are in reality of quite a different nature, and it is only 
their effect the diminution of intellectual capacity which 
is the same in both, and even so only up to a certain point. 
In using the term ' dementia ', therefore, we should bear 
this fact in mind. Above all, we should be careful not 
to fall into the common error of calling delusions * feeble- 
minded ' because they are absurd ; if so, we should have to 
call the deeply significant absurdities that occur in dreams 
4 feeble-minded '. Both paralytic and senile dementia 
utterly destroy the patient's intellectual powers, and cause 
gross symptoms of mental deterioration in him; while 
epileptic dementia leads to an extraordinarily impoverished 
and monotonous ideational life, and an increased difficulty 
in comprehension. These diseases may become stationary 
for a time, but in general they are progressive. In 
dementia praecox, on the other hand, the dementia is 
based on a ' blocking ' of feeling. The patient retains his 
intellectual capacities at any rate, although the reverse has 
frequently been asserted it has never been proved. But 
in consequence of this auto-erotic ' blocking ', the patient 
does not receive any new impressions, and reacts to the 
external world either in an abnormal manner or not at 
all. But remissions may take place at any time, and even 
go so far that hardly any suspicion of a mental defect 
is left. 

The ' dementia ' of dementia praecox is an auto-erotic 
phenomenon in which the patient is without normal affective 
reactions to the external world. Epileptic or organic 
dements, on the other hand, react with very lively feelings 
in so far as they are capable of comprehending what is 
taking place. The epileptic never behaves with indiffer- 
ence; he shows a superabundance of affect, both in loving 
and hating. He transfers his libido on to people and 
objects in an extraordinary degree, and shows both affection 
and gratitude towards his relatives. He takes pleasure in 
his work and clings to his property with great tenacity, 
carefully preserving every scrap of paper and never ceasing 
to contemplate his treasures with great satisfaction. 



igo8 HYSTERIA AND DEMENTIA PR^COX 77 

Auto-erotism is also the feature which distinguishes 
dementia praecox from hysteria. In the one case the libido 
is withdrawn from objects, in the other it cathects objects 
in an excessive degree. On the one hand there is loss of 
the capacity for sublimation, and on the other increased 
capacity for it. 

Whereas we can often already recognize the psycho- 
sexual characteristics of hysteria in children, the severer 
pathological symptoms usually only develop much later. 
Nevertheless some of these cases do show outspoken signs 
of illness even in childhood. We conclude from this that 
the psychosexual constitution of hysteria is congenital. 
The same conclusion is true of dementia prsecox. We very 
frequently find in the anamnesis that the patients were 
always peculiar and dreamy, and never associated with anyone. 
Long before the actual outbreak of the illness they were 
unable to transfer their libido, and therefore carried out 
all their love adventures in the realm of phantasy. In all 
probability there is hardly a case which does not exhibit 
these characteristics. Such persons are also especially 
prone to onanism. They have therefore never completely 
overcome their infantile auto-erotism. Object-love has 
not fully developed in them, and when the disease becomes 
manifest they turn to auto-erotism once more. The psycho- 
sexual constitution of dementia praecox is based, therefore, 
on an inhibition in development. The few cases which 
show psychotic phenomena in a gross form in childhood 
corroborate this view in a striking manner; for they clearly 
show a pathological persistence in auto-erotism. One of 
my patients had shown a pronounced negativism at the early 
age of three. When he was being washed he would close 
his fist and not allow his fingers to be dried. He showed 
the same behaviour as a fifth-form boy at school. In his 
third year the same patient could not be induced to empty 
his bowels for months at a time, and his mother had to ask 
him every day to give up this habit. This example shows 
an abnormal fixation to an erotogenic zone a typical auto- 
erotic phenomenon. The young patient previously men- 
tioned, who suddenly withdrew his libido from his mother 



78 SELECTED PAPERS OF KARL ABRAHAM II 

when he was thirteen years old, had also behaved in a 
negativistic manner in earliest childhood. 

Inhibition of a person's psychosexual development is 
not only expressed in his failure to overcome his auto- 
erotism completely, but also in an abnormal persistence 
of his component-instincts. This characteristic, which 
deserves a separate and detailed investigation, can only be 
illustrated in this place by a single instance taken from the 
patient about whose negativistic and auto-erotic behaviour 
I have already spoken. When he was twenty-seven years 
old his physician had once had to feed him through a 
stomach-tube because he refused to eat anything. He 
conceived this measure as a pederastic act, and from that 
time regarded the physician as his homosexual persecutor. 
This example brings to light the homosexual component- 
instinct with displacement from the anal zone to another 
erotogenic zone (' displacement from below upwards ', 
Freud), and shows us at the same time the erotogenic origin 
of an idea of persecution. 

An abnormal persistence of the component-instincts is 
also characteristic of the neuroses, and shows that they 
too have undergone inhibitions in development. But in 
them the auto-erotic tendency is absent. In dementia 
praecox the disturbance is much more deeply rooted; a 
person who has never completely passed out of the primary 
stage of his psychosexual development is thrown back 
more and more into the auto-erotic stage as the disease 
progresses. 

A great part of the pathological manifestations of 
dementia praecox would, it seems to me, be explicable if 
we assumed that the patient has an abnormal psychosexual 
constitution in the direction of auto-erotism. Such an 
assumption would render the recently discussed toxin 
theory unnecessary. 

It is naturally impossible to deal in a short paper with 
all the numerous phenomena of the disease that can be 
traced back to such an inhibition in development; and 
even a much longer work could not do this, for analysis of 
the psychoses on the basis of Freudian theories is still in its 



IQ08 HYSTERIA AND DEMENTIA PR-dECOX 79 

infancy. And yet Freud's method will, I think, give us 
some knowledge which is not obtainable in any other way. 
What I have chiefly had in view in this paper has been 
to find a differential diagnosis between dementia prsecox, 
hysteria, and the obsessional neuroses. It furthermore 
seems to me that psycho-analytic research will be able to 
tackle the problem of the genesis of the various forms of 
delusions. Perhaps the method will also help to elucidate 
the intellectual disturbances seen in the clinical picture of 
dementia praecox disturbances which we are still far from 
understanding at present. 



CHAPTER III 

THE PSYCHOLOGICAL RELATIONS BETWEEN 
SEXUALITY AND ALCOHOLISM (1908)* 

IT is an undisputed fact that, generally speaking, men 
are more prone to taking alcohol than women. Even 
though in many countries women daily take alcohol 
as a matter of course just like men, and though in many 
places intoxicated women are often seen in the streets, still 
alcohol is never associated with the social life of women 
to anything like the extent that it is with that of men. 
There are wide circles in which to be a hard drinker is 
looked upon as a sign of manliness, even as a matter of 
honour. Society never demands in this way that women 
should take alcohol. It is the custom with us rather to 
condemn drinking as unwomanly; nor is drinking ever a 
matter of boasting among normal women as it is among 
men. 

It seems to me worth inquiring whether this difference 
in the attitude of men and women towards alcohol rests on 
sexual differences. But such an inquiry must start from 
the newer conceptions of the psycho-sexual constitution of 
men and women as laid down in Freud's works 2 in especial. 

It is a biological fact that the human body contains 
the genital organs of both sexes in a rudimentary form. 
In the course of its normal development one of the two 
sets of organs is suppressed or takes over other activities, 
whilst the other goes on developing until it is capable of 
performing its true functions. An analogous process takes 

1 [No.Jiz, A. B.J 8 Drei Abhandlungen zur Sexualthcorie, 1905. 

80 



1908 SEXUALITY AND ALCOHOLISM 8 1 

place in the psychosexual sphere. Here, too, the differ- 
entiation of the sexes proceeds from an original state of 
bi-sexuality. In childhood the expressions of the sexual 
instincts in boys and girls are still very much alike. 

We have learned, particularly through Freud's investiga- 
tions, that sexual activities are by no means lacking in 
childhood. Only the function of procreation does not as 
yet appear; that instinct only gradually finds its definitive 
form. According to Freud the infantile libido is without 
an object; it is * auto-erotic '. It obtains gratification by 
the stimulation of certain parts of the body which serve as 
erotogenic zones. Nevertheless in the pre-pubertal period 
not the whole of the child's sexual energy is employed in 
auto-erotic pleasure-gain. A large part of it is repressed 
out of consciousness. It is no longer applied to sexual 
ends, but takes over important social functions. This 
concept of * repression ', introduced by Freud, is indis- 
pensable for the understanding of many psychological 
processes, both normal and pathological. The deflection 
of repressed sexual ideas and feelings on to social spheres 
is termed by us, following Freud, 4 sublimation ' ; and this 
process serves to set up the barriers which restrain the 
sexual instincts of both sexes. 

On arrival at maturity the boy, like the girl, acquires 
the marked bodily and physical characteristics of his sex; 
and in the psychosexual sphere the important process of 
object-finding commences. The libido is now directed on 
to the other sex. But the male and female libido is 
differentiated not only in this respect but in another, and 
one which especially interests us here. The female sexuality 
shows a greater tendency to repression and to the formation 
of resistances. The infantile sexual repression in women 
receives a strong reinforcement at puberty. This gives 
rise to the greater passivity of the sexual instinct in woman. 
The male libido is of a more active nature. It overcomes 
by means of its aggressive components the psychical 
resistances with which it meets in its sexual object. In 
the German language two expressions characterize the 
psychosexual differences of the sexes. The man is said 

F 



82 SELECTED PAPERS OF KARL ABRAHAM III 

to ' make a conquest ' in love; the woman, to ' yield her- 
self ' up to it. 

Alcohol acts on the sexual instinct by removing the 
resistances and increasing sexual activity. These facts are 
generally known, but their real nature is not inquired into 
as a rule. 

The more we study the subject the more complicated 
does the sexual instinct appear. Besides ' normal ' hetero- 
sexual love, it includes a number of ' perverse ' impulses. 
In the child we see those impulses in a state of complete 
chaos; for the child is a * polymorpho-perverse * being 
(Freud). The ' component-instincts ' are only gradually 
subordinated to the single heterosexual one. They succumb 
to repression and sublimation, and from them originate 
shame and disgust, moral, aesthetic and social feelings, 
pity and horror, the child's filial devotion to its parents, 
and the parents' fond care of their child. Artistic and 
scientific activities, too, are based to a great extent on the 
sublimation of sexual energies. 1 On these products of 
sublimation depend our social life and our entire civiliza- 
tion. There is not one among them which is not weakened 
or removed through the effect of alcohol. 

In normal individuals the homosexual component of 
the sexual instinct undergoes sublimation. Between men, 
feelings of unity and friendship become divested of all 
conscious sexuality. The man of normal feelings is 
repelled by any physical contact implying tenderness with 
another of his own sex. And a number of similar feelings 
of repugnance or disgust originating in the same source 
could be mentioned. Alcohol suspends these feelings. 
When they are drinking, men will fall upon one another's 
necks and kiss one another; they feel that they are united 
by specially close bonds, and are easily moved to tears by 
this thought and very quick to use the intimate Du (' thou ') 
in speaking. When sober, the same men will term such 
conduct * effeminate '. Recent events have caused a lot 
of talk about 4 abnormal friendship * between men. The 

1 Cf. Freud, Drci Abhandlungen zur Sexualtheorie^ and Rank, Der Ktinstlcr, 
Ans&tzt zu riner Scxualpsychologie (1907). 



1908 SEXUALITY AND ALCOHOLISM 83 

presence of such feelings, which are stigmatized as morbid 
or immoral in that connection, can be observed by anyone 
during a drinking bout. In every public-house there is 
an element of homosexuality. The homosexual com- 
ponents which have been repressed and sublimated by the 
influence of education become unmistakably evident under 
the influence of alcohol. 

Freud was the first to give due importance to the pair 
of component-instincts which are manifested in scoptophilia 
and exhibitionism respectively. They are closely associated 
with sexual curiosity, and their sublimation produces the 
feelings of shame. In the first years of its life the child has 
no such feelings ; it has first to learn to feel ' embarrassment '. 
If sublimation does not take place then a perversion (voyeur- 
ism and exhibitionism) arises. Now the feeling of shame 
is not confined to the naked body only, but sets up im- 
portant barriers in regard to social relations, conversation, 
etc. It is precisely these barriers which fall before alcohol. 
Obscene wit, which according to Freud's * brilliant analysis 
represents an exposure in a psychological sense, is in- 
separably associated with the enjoyment of alcohol. Forel 2 
has described in a masterly manner how * flirting ' assumes 
coarse and repugnant forms under the influence of alcohol. 

There is another pair of component-instincts which also 
represent active and passive counterparts of each other. 
The one impels the individual to dominate his sexual object, 
the other to submit to its will. Feelings of pity, horror, 
etc., originate from the sublimation of these tendencies. 
If sublimation does not take place we get the perversions 
called sadism and masochism respectively. It is hardly 
necessary to mention that many brutal crimes are perpe- 
trated in states of alcoholic intoxication. Nevertheless, the 
repressed component-instincts need not necessarily be ex- 
pressed in such a crude way; we can recognize them in 
more disguised forms. Drinking customs and laws have 
existed since primitive times; the * drink king ' at a carousal 
is absolute master, I might point to the German students' 

1 Freud, Der Witx und seine Bexiehungen xum Unbewussten (1905). 
2 Forel, Die sexuelLe Frage. 



84 SELECTED PAPERS OF KARL ABRAHAM HI 

Komment of to-day with its rigorous obligation to drink, 
the proud satisfaction with which the older students compel 
the younger ones to do so, and the blind submission of the 
latter to the commands of their elders. I know that my 
view of these customs will meet with opposition. Let me 
therefore remark that these students' drinking laws have 
gradually developed their present more civilized forms out 
of incredibly gross customs in the past. 

We have still to mention one more important limitation 
of the sexual instinct. As it grows up the normal child 
first transfers its libido on to the persons of the opposite 
sex in its immediate environment, the boy on to his 
mother or sister, the girl on to her father or brother. A 
long period of cultural development was required before the 
nearest blood relations were excluded as eligible objects. 
The repudiation of incest led to the sublimation of the 
child's love for his parents, which became converted into 
filial respect. Every child has to repeat this process of 
development. At a certain period it transfers its awakening 
sexual wishes on to the parent of the opposite sex. These 
impulses become repressed, in the same way as our moral 
code condemns an unsublimated inclination on the part of 
a father for his daughter. But alcohol does not spare even 
these sublimations. Lot's daughters knew that wine would 
break down the incest barriers, and they attained their 
object by making their father drunk. 

It is generally said that alcohol removes mental inhibi- 
tions. We have now recognized the nature of these in- 
hibitions : they are the products of the sublimation of sexual 
energy. 

The re-emergence of repressed sexual impulses increases 
the individual's normal sexual activity so that he gets a 
feeling of increased sexual capacity. Alcohol acts as a 
stimulus to the 4 complex' of manliness. 1 We are familiar 
with the arrogance of the male from many examples in the 

1 In accordance with the nomenclature of the Psychiatric Clinic at Zurich, I 
use the shortened expression 4 complex ' to denote a complex of images and ideas, 
together with the feelings accompanying them, that is repressed into unconscious- 
ness in certain circumstances, but can, in others, force its way back into con- 
sciousness oqce more. 



IQ08 SEXUALITY AND ALCOHOLISM 85 

animal kingdom. And we meet with the same pheno- 
menon, mutatis mutandis^ in human beings. The man feels 
proud of being the begetter, the giver; the woman * re- 
ceives V Analysis of the myths of Creation shows in a 
surprising manner how deeply rooted this grandiose com- 
plex is in the male. In a work I have in preparation 2 I 
hope to bring forward detailed evidence to show that the 
myths of Creation among different peoples originally repre- 
sented a deification of the male power of procreation, 
thereby proclaiming it as the principle of all life. In myths 
the male power of reproduction and the divine power of 
creation are identified and the two are often used inter- 
changeably. We meet here a psychological process of 
extraordinary importance, whose effects we can recognize 
in all forms of imaginative activity, whether normal or 
morbid, whether of the individual or of the group ; and we 
term this process identification. 

A question which has occupied mankind from the be- 
ginning, but which we are still unable to answer satisfac- 
torily, is how ' sexual excitement ' arises. The assumption 
that in the male the stimulus proceeds from the semen was 
a very natural one; and, because intoxicating beverages 
are sexually exciting, the naive mind of the common people 
went on to identify such beverages with semen or with 
that unknown substance which (in the absence of artificial 
stimulants) causes sexual excitement. This popular idea 
finds expression in the German word Liebesrausch (* intoxi- 
cation of love '). 

The sphere of influence of this particular identifica- 
tion is very wide. Tales of the nectar of the gods and 
of its origin are found throughout the whole of Indo- 
Germanic mythology. This nectar, which is represented as 
an invigorating and inspiring drink, is identified with the 
intoxicating beverages of ordinary men. But the identifi- 
cation goes still further. In the above-mentioned work I 
have quoted the old Indian myths to show that the drink of 
the gods is considered equivalent to semen. This is because 

1 [German, empfangt also= " conceives '. Trans."] 
2 Traum und My thus (1909). 



86 SELECTED PAPERS OF KARL ABRAHAM III 

of the life-giving properties of semen. It is worth noting 
that stories about the begetting (Creation) of the first man, 
as found in the Prometheus Saga, etc., stand in the closest 
possible relation to stories about the drink of the gods. It 
is not possible to make a deeper psychological analysis of 
these myths here, I will only mention that the Greek tales 
of the birth of the god of wine, Dionysus, show the same 
identification. 

Love potions play a great part everywhere in myths. 
Undoubtedly the idea of their erotic effect is borrowed from 
the effect of alcoholic beverages. Here also intoxication 
and sexual excitement are identified. We meet the same 
idea in numerous customs. The banquets dedicated to the 
god of wine are always at the same time erotic in character. 
In many customs wine is used as a symbol of procreation or 
fertilization. Riklin 1 relates that" in a certain locality it is 
customary at the Spring Festival to pour wine into girls* 
laps. Here the symbolic representation of semen by wine 
is quite manifest. Drinking healths in wine is a universal 
custom. The alcoholic beverage represents the vital force 
on account of its stimulating effect. If one drinks the 
health of another person it is equivalent to saying : * May 
the invigorating effect of the wine benefit you ', 

This identification must be an exceedingly firmly estab- 
lished one. There is a close association between the defer- 
ence paid to prowess in drinking and prowess in the sexual 
field. He who does not drink is looked upon as a weakling. 
A man begins to take alcohol at puberty, at the time when 
he wishes to be looked upon as a man ; and if he does not 
drink with his companions he is regarded as immature. 
Boasting about drinking is never so pronounced as in the 
period of commencing manhood. If in later years he loses 
his potency, a man will eagerly seize upon pleasure-bringing 
alcohol; and it becomes a surrogate for his diminishing 
power of procreation. 

Men turn to alcohol because it gives them an increased 
feeling of manliness and flatters their complex of masculinity. 
The nature of her psychosexual constitution urges a woman 

1 Riklin, Wunschcrfullungund Symbolik im Marc hen (1908). 



SEXUALITY AND ALCOHOLISM - 87 

far less to take alcohol. Her sexual instinct is less active 
and her resistance against its impulses greater. We traced 
this difference in her attitude to the new onset of repression 
at puberty. A woman stimulates a man through her 
psychical resistances, just as a man pleases her by his ener- 
getic initiative. The girl at puberty has no motive to turn 
to alcohol, for it would remove the effects of repression 
the resistances and if she relinquished these she would 
no longer attract the man. We should expect to find on 
closer observation that women who show a strong inclination 
for alcohol always have a marked homosexual component 
in them. 

The results of alcohol i.e. -the facilitating of sexual 

transference and the removal of the effects of repression 

are not merely temporary, but, as is well known, chronic as 
well. Chronic drinkers exhibit a characteristic excess of 
feelings ; they are coarsely familiar, look upon every one as 
an old friend, indulge in unmanly sentimentality, and lose 
the feeling of shame. I need scarcely refer to the scenes 
that children of drinkers have to witness. In short, all 
the finer feelings which owe their origin to sublimation are 
destroyed in the habitual drunkard. 

And it is not the sublimations alone of the sexual 
impulse that are destroyed. An acute alcoholic intoxication 
will, as we know, reduce a man's actual sexual capacity. 
And we are acquainted with the poisonous effect of alcohol 
on the embryonic cells (blastophthoria). 1 We know that a 
great number of drinkers become impotent. Alcohol has 
proved a false friend. They imagined that it increased their 
virility, because it gave them a feeling of sexual power; and 
instead, it has robbed them of that power. But even so 
they fail to recognize the fraud. They will not give up 
alcohol, and they continue to identify it with their sexuality 
and to use it as a surrogate of the latter. I see in this an 
analogy to certain sexual perversions in which a sexual 
stimulus, which might normally have served as an intro- 
duction to the sexual act, is put in the place of that act. 
Freud terms this * fixation of a temporary sexual aim '. For 

1 Cf. Forel and Juliusburger, * tJber Blastophthorie ' (1908), p. 346. 



88* SELECTED PAPERS OF KARL ABRAHAM III 

instance, looking at the sexual object is under normal con- 
ditions a source of fore-pleasure merely, while the sexual act 
itself alone gives rise to satisfaction-pleasure. Certain per- 
verts, however, are content with looking alone. And the 
alcoholic behaves in a similar manner. Alcohol excites the 
sexual feelings ; this excitement the drinker seeks to capture 
and thereby loses his capacity for normal sexual activity. 

There are yet other analogies between alcoholism and 
sexual perversions. The investigations of Freud have 
shown us the intimate relations that exist between the per- 
versions and the neuroses, and that many neurotic symptoms 
are the expression of repressed perverse sexual phantasies, 1 
and are therefore a kind of sexual activity on the part of the 
patient. The patient always opposes an extraordinary 
resistance to the analysis of his symptoms; this is connected 
with his repression of his sexual complexes. In attempting 
to discover and resolve the patient's symptoms by psycho- 
analytic means the only reply which the physician obtains is 
a * no ', however much his inquiry may be justified. Instead 
of the real causes the patient brings forward cover-motives. 
In the same way the alcoholic will deny with his last breath 
facts which cannot possibly be disputed. He has a plentiful 
choice of cover-motives for his alcoholism and uses them to 
parry every attempt to get to the bottom of the matter. I 
think we must conclude that for the same reason that the 
neurotic protects his symptoms the drinker fights in defence 
of his alcoholism. It represents his sexual activity. 

There is yet another point that seems to me worth 
mentioning. Certain ideas of an undoubtedly sexual nature 
play a prominent part in the morbid changes that take place 
in the mentality of the alcoholic. I refer to the well-known 
jealousy of the drinker a jealousy which may increase until 
it becomes a delusion. The cause of this jealousy is, I 
believe, a feeling of diminishing potency on the subject's 
part (I base my conclusion on a wide range of experience 
which I cannot quote here in detail). The drinker makes 
use of alcohol as a means of obtaining pleasure without 
trouble. He gives up women and turns to alcohol. This 

1 Freud, ' Hysterical Phantasies and their Relation to Bisexuality ' (1908). 



1908 SEXUALITY AND ALCOHOLISM , 89 

state of affairs is exceedingly painful to his self-esteem ; and 
he represses it, just like the neurotic, and at the same time 
effects a displacement such as we are accustomed to find in 
the mechanism of the neuroses and psychoses. He dis- 
places his feelings of guilt on to his wife and accuses her of 
being unfaithful. 

We see, therefore, that alcoholism, sexuality and 
neurosis are connected in many ways. It seems to me 
necessary to employ the psycho-analytic procedure developed 
by Freud, which enables us to penetrate into the structure 
of the neuroses, for the analysis of alcoholism as well. 
From the oral communications of colleagues, I know that 
in cases of morphinism psycho-analysis has demonstrated 
the existence of unexpected relations between sexuality and 
the use of narcotics. I may also mention the inexplicable 
behaviour of many nervous persons in regard to narcotics. 
Hysterical patients often beg their physician not to prescribe 
morphia or opium for them whatever he does, because they 
cannot stand it; and they go on to tell of the unpleasant 
experiences they have had with it. It looks very much 
as though the drug evokes sexual excitement in certain 
hysterical persons an excitement which, in consequence 
of the hysteric's peculiar psychosexual constitution, is con- 
verted into physical symptoms and feelings of anxiety. 
Perhaps the intolerance of alcohol so frequently met with 
in nervous people has a similar cause. Finally, I might 
mention a remarkable fact which I have repeatedly observed 
in insane patients. When they are given a hypodermic 
injection of morphia, etc., they regard it as a sexual assault, 
and they interpret the injection syringe and the fluid in a 
symbolic way. 

As we see, the psychological investigation of alcoholism 
still offers many unsolved problems. External factors such 
as social influences, faulty education, hereditary taint, etc., 
are not by themselves sufficient to explain drunkenness. An 
individual factor must be present. Our first task is to 
investigate that factor; and it seems to me only possible to 
succeed in this if the connections between alcoholism and 
sexuality are constantly borne in mind. 



CHAPTER IV 
HYSTERICAL DREAM-STATES * (1910) 

IN a recently published paper, 2 Lowenfeld has dealt with 
certain peculiar disturbances in neurotics which have 
not previously been given sufficient consideration in the 
literature of the subject. As an introduction to my subject 
I will quote Lowenfeld's general description of these states. 
He says : * The external world does not make the usual 
impression on the patient. Familiar and every-day things 
seem changed, as though they were unknown, new and 
strange; or the whole surroundings give the impression of 
being the product of a phantasy, an illusion, a vision. In 
the latter case in particular it seems to the patients as though 
they were in a dream, or half asleep, or were hypnotized or 
somnambulic; and they generally speak of these conditions 
as their dream-states.' The author also says that these states 
differ greatly in degree, exhibit considerable variations in 
their duration, are often associated with the affect of anxiety 
and are, as a rule, accompanied by other nervous symptoms. 
Lowenfeld bases his description on a considerable num- 
ber of medical histories. I myself have come across these 
states in a number of patients whom I have treated by 
psycho-analysis. Since these dream-states have not been 
dealt with from a psycho-analytical point of view up to the 
present, I will give the main results of my observations in the 
following pages. They form a further addition to the know- 
ledge derived from psycho-analysis concerning the nature 
of episodic phenomena in the clinical picture of hysteria. 

1 [No. 17, A. B.] 

3 ' Ober traumartige und verwandte Zustande ' (1910). 
90 



HYSTERICAL DREAM-STATES 91 



CASE A 1 

The first example, a simple case, will show how far we 
can explain the nature of dream-states without making use 
of psycho-analysis. I was only able to give the patient in 
question one consultation. In it I examined him in the 
usual way and elicited the following relevant facts: The 
patient, still a young man, was prone to very vivid day- 
dreaming. According to his account his waking dreams 
were mainly stimulated by actual occurrences. For example, 
the account of the discovery of the North Pole gave rise to 
the phantasy that he was taking part in a great expedition. 
He imagined this with great minuteness of detail, especially 
as regards the part he himself played. Phantasies of this 
type had almost completely absorbed him for some con- 
siderable time past. He had only to catch a word said in 
the street for example, the word ' zeppelin ' for his 
imaginative faculties to be set in motion. As soon as 
his day-dreaming had attained a certain intensity he would 
begin to feel himself more and more removed from reality. 
A dream-like stupefaction would come over him. Next, 
there was a mental blankness lasting a short time ; and after 
that there followed rapidly a strong sensation of giddiness 
associated with anxiety and palpitation of the heart. He 
described the state up to the onset of the giddiness as a 
pleasurable one. He also had the following symptoms: 
nervous vomiting, nervous diarrhoea, headaches, irritability, 
timidity, etc. 

This case, and, as will be seen, all those that follow, 
plainly demonstrate the connection of dream-states with 
day-dreaming, I emphasize this fact, because Lowenfeld 
has paid no special attention to it. 

A state of pha ntastic exaltation forms the typical intro- 
duction of the dream-state, the content of which varies 
altogether in character according to the individual. This 

1 I have named the following cases A, B, C, etc., arranging them in alphabetical 
order. All details about their age, occupation, and personal relations which it is 
not necessary for us to know have been omitted. 



92 SELECTED PAPERS OF KARL ABRAHAM IV 

is followed by a condition of dream-like * removal from 
reality' (Entruckung 1 }. In this state, as Lowenfeld has 
well described, the person's familiar surroundings appear 
changed, unreal, and strange to him. He feels ' as if he 
were in a dream '. The word ' dream-state ', which is 
spontaneously used by many patients, describes the phan- 
tastical trend of thought belonging to the first stage and the 
alteration of consciousness belonging to the second one. I 
recognize, however, yet a third stage, that of mental blank- 
ness. This is described by patients thus: ' My thoughts 
stop ', ' an emptiness in my head ', and similar phrases. 
Finally a state of depression occurs, the most important 
characteristic of which is a feeling of anxiety with its usual 
accompanying phenomena of giddiness, palpitation of the 
heart, etc. Most patients also complain of phantasies of a 
depressive type. 

There is no sharp line of demarcation between the 
different stages. On the contrary, it is possible to observe 
transitions from one to the other. The practical utility and 
importance of differentiating between these states is only 
apparent when we come to discuss cases which have been 
thoroughly analysed; and I shall then be able to add con- 
siderably to the above brief and superficial description of 
those stages. 

The third stage undoubtedly forms the culminating 
point of the dream-state. It is its turning-point, as it were, 
not only because its appearance puts a sudden end to the 
production of the phantasy, but also because it is the line of 
demarcation between two affects of an opposite character. 
It is not unusual to find the dream-state, as in the present 
case, described as pleasurable up to its third stage and a 
high degree of displeasurable affect assigned to its later 
stages. 

By this kind of examination of the patient we are able 
to obtain much information about the ideas and feelings 
contained in the dream-states, the circumstances that give 
rise to them, and the fluctuations in consciousness that are 

1 The term Entriickung is borrowed from Breuer (cf. Breuer und Freud, 
SttuRen iiber Hysteric, Zweite Auflage, S. 191). 



19*0 HYSTERICAL DREAM-STATES 93 

involved in them. By investigating a further series of 
cases in a similar manner we should discover the individual 
variations in those respects, and we should also be able to 
confirm Lowenfeld's account of their differences in intensity 
and duration. So long, however, as we restrict ourselves 
to the consciousness of the patient, this is as far as we can 
go. The causes of the appearance of dream-states will 
remain unexplained. For as a rule the neurotic contents 
himself with ordinary day-dreams, and it remains obscure 
why this condition should occasionally undergo an aggra- 
vation of such a kind as to develop into an acute quasi- 
paroxysmal state accompanied by mild disturbances of 
consciousness. The state of ' removal from reality ' is 
altogether unintelligible to us, especially the feelings of 
strangeness and unreality, the temporary mental blankness, 
and finally the appearance of anxiety with its accompanying 
manifestations. All these phenomena are subject, besides, 
to individual variations; each case presents its own par- 
ticular problem. In particular, the phantasies of the initial 
stage and those of the final one are only intelligible to a 
limited extent in the absence of a thorough analysis. 

The knowledge of the phantasy-life of neurotics gained 
by psycho-analytic investigation gives us the key to the 
solution of the problem. Freud has shown us that our 
instinctual desires are revealed in our phantasies. When 
our desires are prevented from being fulfilled we endeavour 
to imagine them as fulfilled, or as about to be fulfilled. In 
the neurotic the whole instinctual life and all the component- 
instincts are originally of abnormal strength. At the same 
time there is a special tendency in him towards a repression 
of instincts. The neurosis develops from the conflict be- 
tween instinct and repression. The neurotic is a maker of 
phantasies because of the great variety and intensity of his 
instinctual life and the wealth of his repressed desires ; and 
therefore, as observation shows, he is very prone to day- 
dreaming. He has frequent and vivid dreams in his sleep 
as well. The dynamic power of his repressed wishes is, 
however, so strong that he finds those means of expression 
which he has in common with the normal individual in- 



94 SELECTED PAPERS OF KARL ABRAHAM IV 

adequate. His neurosis itself subserves those tendencies 
exclusively. The neurotic dream-state, as I shall presently 
show, is only one of a variety of phenomena by means of 
which the multitude of his repressed wishes finds expression. 
I shall now proceed to give such details from an exten- 
sive analysis of a case as are relevant to the problem of 
dream-states. This case gives us some insight into the 
confusion of instinctual tendencies that co-exist in the mind, 
either reinforcing or opposing one another. The analysis 
enables us to recognize the dominating significance of sexual 
phantasies. It will become quite clear that the conscious 
phantasies which, on the surface, appear to be non-sexual, 
have arisen from sexual wishes through the process of 
sublimation. The phantasies which are admitted to con- 
sciousness by the censorship serve as a medium for the 
representation of repressed wishes and derive their energy 
from the latter source. 

CASE B 

This patient suffered from an unusually severe hysteria 
accompanied by phobias and compulsions. His morbid 
anxiety about going out of the house alone had rendered 
him incapable of following his calling or of participating in 
any form of social life for the last five years. Besides his 
severe attacks of anxiety he was very liable to dream-states. 

He could remember that the first attack of this kind had 
occurred when he was ten years old, on an occasion when he 
had felt slighted. He had been overcome by a feeling of 
WeltschmerZ) which had been instantly succeeded by the 
counteracting idea, ' Later on, when I'm grown-up, I'll 
show you ', and he had fallen into a state of ecstatic exalta- 
tion and had experienced a dream-like alteration of con- 
sciousness. Since that time he used to be overcome by 
a dream-state whenever he had to recognize the superiority 
of others and his own inactivity. His present situation 
was naturally constantly exposing him to such states. For 
example, it was only necessary for someone to refer to the 
ability or success of any person of his own age for him to 



HYSTERICAL DREAM-STATES 95 

react in this way at once. As time went on the occasions 
giving rise to these states became more varied. The sight 
of women, the theatre, music, reading, etc., had this effect 
on him, since they induced phantasies of an ambitious or 
erotic nature. It is less easy to understand why such states 
were induced by vigorous bodily movement, such as walking 
in the street, or by hearing loud noises, such as that of a 
train passing over a bridge. They used to come on most 
frequently when he was in the street. 

Occasions of this kind would begin by producing a 
marked activity of his imagination, together with the resolve 
to work most energetically for the realization of his 
imaginary desires. He would, as he put it, summon up 
the whole of his will-power. First and foremost would 
be the thought that some day he would emerge from his 
seclusion and impress the whole world. He would imagine 
how he would cause a sensation on account of his great 
learning, or would be called before the curtain as the author 
of a drama and so be the centre of universal attention ; or 
how he would become a master-player at chess and go 
from table to table in a caf, playing simultaneous games, 
and would make his moves under the admiring gaze of 
the onlookers. At other times he would create the image 
of a great general, behind whom his own ambitions were 
concealed. His energetic resolutions would be outwardly 
manifested by his walking hurriedly about the room, or 
going at a tremendous pace along the streets. 

The patient himself described the process as an ever- 
increasing state of ' enthusiasm '. This condition would 
merge rapidly and almost imperceptibly into the second 
stage. His description of the latter was very characteristic : 
it was that there occurred a complete ' turning into oneself ', 
a shutting out of all external impressions, and that in making 
phantasies ' one loses the ground under one's feet '. That 
is to say, he was no longer able to control his train of thought 
and left the solid ground of reality. At this point he would 
seem to himself to be in a dream; his entire surroundings, 
even his own body, would appear strange to him, and 
he would even doubt the reality of their existence. The 



96 SELECTED PAPERS OF KARL ABRAHAM IV 

typical third stage that of * cessation of thoughts ' 
would follow. Morbid anxiety would develop immediately 
and usher in the fourth stage, in which he would be seized 
with giddiness and have the feeling that he was no longer 
going forward, that he could not lift his legs, that he was 
sliding, falling, sinking down. These sensations would 
be associated with the most intense anxiety. People and 
surrounding objects would appear to him remarkably 
big. He himself would feel small and want to be so in 
order not to be seen ; he would like to be * as nothing ', * to 
sink entirely into the earth '. He also described a feeling 
that he must crawl on all-fours in order to reach home. 

The patient described the first stage as pleasurable. 
Nevertheless even during his 4 enthusiasm ' there would 
come, as he expressed it, a current of an opposite character 
which was at first perceived as a sensation of coldness. We 
find here parassthesias and vaso-motor symptoms as accom- 
panying phenomena of the dream-state, to which we have 
as yet not given sufficient consideration. During the 
stage of mental blankness the feeling of coldness was in- 
tense. A sudden * heat wave ' would then sometimes set 
in with the anxiety, accompanied by a feeling of congestion 
in the head. When his anxiety used finally to give way to a 
feeling of weakness the sensation of coldness would always 
become very strong; and at the same time he would have 
the feeling that parts of his body had ' died off '. 

The patient used to welcome the commencement of 
the dream-state on account of its accompanying pleasure. 
Nevertheless, he often used to attempt to interrupt it before 
it had reached its culminating point, i.e. the stage of mental 
blankness. He said, * I try to tear myself away from my 
"enthusiasm"; I attempt to come out of it as from a 
cloud \ The expression * cloud ' should be noted; it 
indicates the feeling of a clouding of consciousness, that is, 
the dream-like quality of his state. If that state was 
prematurely interrupted he used to experience anxiety and 
a feeling of weakness. 

The last stage was very protracted in this patient. In 
order to free himself from his anxiety which he could not 



HYSTERICAL DREAM-STATES 97 

overcome he used to adopt a peculiar method: he lit a 
cigar. Incidentally, the desire to smoke used to come on 
as early as in the stage of * enthusiasm \ 

During the analysis of his dream-states the patient told 
me spontaneously that for a long time he had considered 
these states as a kind of translation of his sexual impulse 
into a mental form. My investigations fully confirmed 
this view. 

The patient was one of those neurotics who had been 
addicted to masturbation in early childhood and had later 
on maintained a continual struggle against that habit. He 
had frequently attempted, and as often failed, to renounce 
it; and this had given rise to the usual disappointments, 
self-reproaches, and hypochondriacal troubles. A number 
of his symptoms, which cannot be discussed here, had 
arisen in this connection. The conflict between wish and 
repression had found its solution in a compromise, as is 
so often the case in the neuroses. The patient had often 
given up onanism for long periods at a time, during which 
he had avoided physical self-excitation together with its 
final aim, ejaculation. Thus from a superficial point of 
view he had given up his sexual habits. But his unconscious 
required a substitutive gratification the nature and purpose 
of which should elude consciousness so that it could be 
carried out free from inhibiting influences. 

Freud l has conclusively shown that certain episodic 
phenomena of hysteria are a substitutive gratification for 
masturbation when this has been given up. (We shall 
later have to consider this point.) Now the dream-state 
is also a substitutive gratification of this kind. Before I 
bring forward evidence for this, I must mention that more 
recently the patient used also to have dream-states at a 
time when he did not resist the impulse to masturbate. 
However, this fact is only in appearance incompatible with 
the idea that the dream-state was a substitutive gratification, 
because at such times the patient was subject to counter- 
acting ideas which prevented him from yielding to his 
impulse quite freely. Besides, the strength of his impulse 

1 * General Remarks on Hysterical Attacks ' (1909). 

G 



9? SELECTED PAPERS OF KARL ABRAHAM IV 

was so great that it was difficult to obtain a complete gratifi- 
cation of it; so that even the frequent practice of masturba- 
tion did not render surrogates superfluous. Finally, these 
surrogates themselves became a source of pleasure, and we 
know how difficult it is, especially for the neurotic, to give 
up anything that is a source of pleasure. 

The patient had been accustomed in early youth to 
indulge in day-dreaming, and when the activity of a vivid 
phantasy was at its height, to make use of masturbation as 
an outlet for the accumulated excitement. When he tried 
to abandon the practice of masturbation his day-dreaming 
had to find a different end. It now formed an introduction 
to a dream-state, just as earlier it had been an introduction 
to masturbation. The second and third stages that of 
removal from reality and of mental blankness corresponded 
to the increasing sexual excitement and to its culminating 
point, the moment of ejaculation. The final stage of 
anxiety and weakness was transposed unaltered from the 
act of masturbation. Those symptoms are familiar to us 
as the regular consequence of masturbation in neurotics. 

The comparison we have made requires further confir- 
mation as regards the second and third stages. A stage 
similar to the removal from reality in the dream-state is also 
found in masturbation, in which the increasing sexual 
excitement leads to an exclusion of all external impressions. 
In the dream-state this effect is chiefly evident on the mental 
plane. The patient was aware of his attention being 
entirely ' turned inwards '. This auto-erotic seclusion from 
the outer world gave him a feeling of isolation. He 
' withdrew from the world '. His ideas transplanted him 
into another world which was founded on the model of his 
repressed wishes. So great was the power of his repressed 
wishes when once they emerged from the unconscious that 
he accepted their fulfilment in phantasy as reality and per- 
ceived reality as the empty fabric of a dream. His entire 
surroundings, and even his own body, seemed strange and 
unreal to him. 

The feeling of being isolated is peculiar to many 
neurotics who retire from the world in order to indulge in 



19*0 HYSTERICAL DREAM-STATES 99 

sexual practices in solitude. The patient remembered a 
favourite phantasy from his early youth which related to 
a secret underground room, hidden away somewhere in a 
forest, to which he wished to escape in order to be alone 
with his phantasies. Later on, anxiety appeared in the 
place of this wish. And anxiety of being alone in a closed 
room still dominated him as a grown-up man. 

The disappearance of thought the mental blankness 
that characterizes the third stage corresponds roughly 
to the marked 4 loss of consciousness ' * which takes place, 
especially in neurotics, at the climax of each sexual ex- 
citation; and there then occurs a marked sensation of 
giddiness or of something akin to giddiness but difficult 
to describe. The patient definitely stated that he had 
the same sensation during masturbation at the moment 
of ejaculation. This short suspension of consciousness 
corresponding to the moment of emission is also met with 
in hysterical attacks. 

It need no longer surprise us to find that the dream- 
state is pleasurable up to the stage of mental blankness; 
for this would tend to confirm its derivation from masturba- 
tion, which is also pleasurable up to the corresponding 
stage, and afterwards often produces the liveliest feelings 
of distress in neurotics. It is also very interesting to 
remember that the patient under discussion used frequently 
to interrupt his dream-state prematurely, i.e. before the 
onset of mental blankness. This is a kind of attempt to 
renounce the habit of having dream-states. Neurotics 
frequently do exactly the same when they wish to give up 
masturbation. 2 In their opinion it is the loss of semen 
which is the harmful thing in masturbation, and they con- 
tent themselves with breaking off the act before emission. 
They then indulge in the consoling idea that they have not 
really masturbated. One frequently meets with this sophism 
in neurotic persons. They endeavour to compensate for 
the renunciation of the end-pleasure by very greatly in- 
creasing the fore-pleasure. The anxiety they feel at the 

1 Freud, * General Remarks on Hysterical Attacks * (1909). 
2 See Rohleder, ' Uber Masturbatio interrupta ' (1908). 



IOO SELECTED PAPERS OF KARL ABRAHAM IV 

end, however, is something they cannot escape. The 
sexual excitement that has accumulated finds no discharge 
and is changed into anxiety. 

In regarding the patient's dream-states as a substitutive 
gratification for a form of sexual practice which has been 
relinquished, we are still far from fully understanding all 
the characteristics of those states. The phantasies of the 
first and fourth stages are of such an individual nature that 
they can only be understood after we have gained an 
intimate knowledge of the patient's instinctual life. 

In the present instance the patient's infantile tendencies 
had, in the regular way known to psycho-analysis, been 
fixated to such a degree upon the people in closest relation 
to him that at puberty he^had been unable to detach them 
in the normal way. His fixation was of a marked bisexual 
character. The heterosexual components of his libido had 
his mother as their object, in relation to whom he identified 
himself with his father who was dead. His homosexual 
components were attached to his father, and in relation to 
him he identified himself with his mother. Thus in his 
neurosis he sometimes played the father, sometimes the 
mother. His behaviour in general could be described as 
markedly passive. He had resigned himself to the mis- 
fortune of his neurosis. His love for his father, who had 
been a very energetic person, took the form of an uncon- 
ditional subjection to a superior person. He showed the 
typical jealousy of the neurotic, which he had preserved 
from childhood. As a boy he had regarded his father as 
his rival in regard to his mother, while his mother had 
stood in the way of his attachment to his father. As a 
result, there had arisen hostile wishes in him which as is so 
often the case in neurotic children had culminated in the 
phantasy of killing his father or mother. These sadistic 
impulses had been subjected to very strong repression. A 
great number of his dreams, in which he witnessed the 
death of his father or mother, bore witness to the persistence 
of those unconscious wishes. He also had frequent waking 
phantasies of the same kind, as well as sudden aggressive 
impulses. These repressed impulses, and certain instances 



HYSTERICAL DREAM-STATES IOI 

of aggressive conduct during childhood and puberty, were 
responsible for the idea he had that he was a criminal, as 
well as for a number of obsessive symptoms from which he 
suffered. 

The patient's aggressive tendencies had been exten- 
sively sublimated so that he could employ their impulsive 
force in planning high achievements outside the sphere of 
sexuality. However, this had not sufficed to stem the full 
force of his instincts. In order to be neutralized effectually 
those tendencies had had to be turned into their direct 
opposite. His aggressive feelings towards his mother 
had been replaced by complete passivity, by an absolute 
dependence upon her, which still persisted although he was 
long since a grown man. He now became wholly tied to 
her and to the house, just like a little child. This was the 
chief source of the anxiety which prevented him from going 
out alone. This dependence upon a particular person (or 
persons) is present in every case of street anxiety. The 
attempt to leave home alone represented to the patient a 
forbidden activity; it would have symbolized a loosening 
of the tie between himself and his mother, and also, as the 
analysis showed, a homosexual approach towards his father. 
As soon as he attempted to tear himself away from his 
heterosexual incestuous phantasies he fell a prey to his 
homosexual ones, which were likewise energetically rejected 
by his conscious. A very extensive suppression of his 
instinctual tendencies had therefore taken place, and this 
accounted for the peculiar intensity of his nervous anxiety. 

Like other neurotics, the patient endeavoured to correct 
the unsatisfying reality with the help of phantasies. He 
used this means in especial whenever some external 
occurrence made him realize how greatly he differed from 
his more healthy contemporaries owing to his childish 
dependence and passive conduct, and above all, his propensity 
for masturbation. Even in boyhood he had suffered from 
this feeling. It had been his ardent desire to become 
* like the others '. He used to torture himself with self- 
reproaches because he was singled out among the * others ' 
on account of his tendencies, and because those tendencies 



102 SELECTED PAPERS OF KARL ABRAHAM IV 

made him incapable of competing with them. He used to 
be especially tormented by the fear of appearing ridiculous 
or despicable in their eyes. This was the reason of his 
excessive sensitiveness to the idea of being slighted in 
favour of ' others '. He considered that such a slight 
would show that he was not respected, and all his suppressed 
activity would rise in revolt. Originally his aggressive 
tendencies would have moved him to react to a slight 
with an act of violence, but they had been rendered harmless 
early on by * reaction-formation ', and now only ventured 
forth in the shape of secret phantasies. When he thought 
himself slighted he reacted with sublimated desires to be 
active and with phantasies of grandeur whose fulfilment 
he placed in the future: * When I am grown up . . .' 

The older the patient became, the more pronounced 
became his feeling that he had remained a child. He 
failed to recognize that it was the strongest wish of his 
unconscious to preserve this childish state. His con- 
sciousness reacted with the opposite tendency. Every 
dream-state subserved a wish to be grown up. Being 
grown up signified many things to him it meant being 
independent, self-supporting, energetic (like his father), 
free from his besetting habit and, above all, capable of 
sexual activity. For he was dominated by a fear of being 
impotent, like every neurotic who is unable to relinquish 
his infantile sexual practices and the objects of his infantile 
sexual phantasies. The phantasies of grandeur which we 
have traced back to sublimated sadistic impulses were 
always connected in this patient with the idea of excelling 
before others and of drawing all eyes upon himself. This 
idea may be explained as a sublimation of repressed * ex- 
hibitionistic ' wishes. In neurotics who show morbidly 
pronounced ambition I have always been able to demonstrate 
that that feature of their character provides a kind of 
common outlet for their repressed sadistic and exhibition- 
istic wishes. In the present case it could be established 
that the patient had actually carried out actions of a sadistic- 
exhibitionistic character in his youth, and that he felt severe 
self-reproaches on that account. The constantly recurring 



HYSTERICAL DREAM-STATES IO3 

necessity of repressing those impulses was a continual 
source of anxiety to him. For example, he was not able 
to travel by tram because he would suddenly feel the 
impulse to expose himself before the people present or to 
make a sexual assault upon a woman. Similar impulses 
used to occur on other occasions, as, for instance, when he 
was in conversation with women. The process of sublima- 
tion led to a partial or total renunciation of the original aim 
of his instinct to exhibit, i.e. to expose himself in a sexual 
way. The forbidden exhibitionism was replaced by phan- 
tasies which contented themselves with a much more 
innocent aim; in them the patient drew attention to him- 
self, not on grounds of sexual desire or sexual curiosity, 
but merely in admiration. 

We have heard of various kinds of occasions which 
used to bring on the patient's dream-states. We can 
now say that they had this effect because they stimulated 
wishes of sexual aggression or exhibition in him which 
found expression in a sublimated form. It can now be 
easily understood why the sight of women was able to 
provoke a dream-state. Moreover, whenever he became 
too much aware of his passivity by contrast with other, 
energetic people, he used to correct reality with the help 
of his imagination and picture himself as a very active 
man and the object of everyone's interest. Vigorous move- 
ments of the body could also act as exciting causes by 
giving him a feeling of activity. The jolting and clatter 
of a train would stimulate in him the wish to be strong. 
And all his other phantasies belonged to the same category. 
As a player of chess in cafes, going from table to table and 
playing simultaneous games, he certainly had a good 
opportunity of exhibiting himself before the gaze of others. 
Moreover, chess itself, as his analysis showed, offered him 
ample opportunity for the employment of sublimated 
instincts. In chess there is a struggle between two parties, 
each of which attacks, takes pieces, overthrows the enemy's 
position, etc. a set of ideas which, according to the patient's 
own testimony, had a great fascination for him. He 
revelled in the technical expressions employed, and used 



IO4 SELECTED PAPERS OF KARL ABRAHAM IV 

to gratify his instinct of aggression by playing games by 
himself. 

Whereas the fulfilment in phantasy of his ambitious 
wishes, i.e. the gratification of his sublimated instincts, was 
associated with feelings of pleasure, the concluding stage 
of his dream-state exhibited the opposite affect of anxiety. 
And it can be demonstrated that in the concluding stage 
his phantasies had a quite different content from the 
earlier ones. The beginning of the dream-state lifted him 
out of his habitual passivity into activity. The concluding 
stage put him back into his former state. In place of his 
ambitious plans we find want of courage and a dispirited 
mind; and whereas a short while ago he was filled with 
feelings of power and strode along the streets he now felt 
weak and inhibited in his movements. He felt as if he 
could no longer go forward a striking symbolical repre- 
sentation of his actual situation! He was once more a 
small child who could not walk by himself. 1 The un- 
conscious tendency which preserved the infantile state in 
him had carried the day. It was because of this that the 
patient seemed to himself so diminutive, and people and 
things appeared to him to be so large. 2 He wanted to 
crawl home on all-fours to his mother like a child who has 
not learned to walk. A few moments before, he wished 
to draw all eyes upon him, but now he would have liked to 
disappear, to sink into the ground in order not to be noticed. 

The patient's intense feeling of weakness in the fourth 
stage had several determining factors. In the first place, 
it signified the dreaded sexual weakness. Whereas he 
had begun to feel strong and active at the commencement 
of his dream-state, he ended once more by relapsing into 
passivity. He lacked masculine vigour. His sensation of 
being too weak to stand up contained a symbolic allusion 
to impotence. A further determinant of his weakness was 
furnished by his death phantasies, which are never missing 
in cases where aggressive intentions against relatives have 

1 I shall not in this place discuss the further determinations of * slipping ' and 
4 falling \ 

a This is the most important cause of the symptom described as * macropsy '. 
I have also observed its presence in the anxiety-attacks of a female patient. 



HYSTERICAL DREAM-STATES 105 

had to be suppressed. These death phantasies of the 
concluding stage stood in marked contrast to the energy 
and animation of his phantasies in the first stage. 

In the last stage of his dream-state his impulses of 
aggression and exhibition were once again suppressed; 
and, as we have already said, he would seek to obtain relief 
from the state of depression in which he was left by smoking 
a cigar. It was, however, not so much the nicotine itself 
that gradually removed his depression. It was rather that 
smoking had the significance of a substitute gratification. 
It was a mark of that masculinity which he lacked, 1 and 
was a consolation to him in his state of weakness. 

The accompanying vaso-motor and paraesthetic symp- 
toms require separate consideration. The sensation of 
heat described by this patient, and, as will be shown, by 
others, too, is a normal accompaniment of sexual excitation. 
It had been transferred in his case from masturbation to 
the dream-state. It is worth noting that he blushed very 
easily. As soon as he came among people his extraordinarily 
excitable sexual phantasy became active, and expressed 
itself physically as a wave of heat. It should not surprise 
us to find that this increased flow of blood also accompanied 
his phantasies of activity, since, as we know, they repre- 
sented his unconscious sexual phantasies. Even in the 
early stage of his ' exalted ' phantasies he used to notice 
an ' under-current ' of coldness and anxiety besides the 
rising heat; and in the final stage the feeling of coldness 
dominated. In general, therefore, the feeling of heat used 
to appear when he wished to push forward to sexual activity, 
while the feeling of coldness used to come on when his 
instinctual emotions had changed into anxiety and the 
tendency to repression had obtained the upper hand once 
more. His blood was now no longer being impelled to the 
periphery with the same force. But the oncoming feeling 
of coldness was determined by still other causes. The 
patient used to feel as if parts of his body had died oflF, 
and as if he was going to collapse and vanish away in the 

1 Space does not permit me to go into the other determinants of smoking 
(such as utilization of the mouth zone, identification with the father, etc.). 



IO6 SELECTED PAPERS OF KARL ABRAHAM IV 

next minute. Thus the fourth stage was a symbolic death 
which was also expressed by the sensation of coldness. 
Further analysis showed that this dying also had a double 
significance: the impotence he feared gave it a second, 
more special meaning that the essential energy of life was 
lacking in him. 

Just as the first stage of his dream-state subserved his 
phantasies of vigour and masculinity, so the final stage 
exhibited a condensation of two sets of ideas which were 
opposed to those phantasies, namely, (i) to remain a child; 
(2) to die. The adult man, filled with vital energy, stands 
midway between childhood and death. 

The patient's dream-states give us an insight into the 
conflict between impulse and repression as it is fought 
out in every neurosis. Repressed impulses, originally of 
abnormal strength, succeed in struggling free from the 
unconscious, only once more to succumb swiftly to the 
forces of repression. Each of these dream-states represented 
a revolt against his neurosis, but one foredoomed to failure. 

The next case, however, will show that not all dream- 
states contain the same tendencies. 

CASE C 

In this patient (a woman) dream-states used to appear in 
the same way when she felt worried, depressed, or humiliated 
by a present situation which she could not avoid. Conver- 
sation of a painful nature, or a physical indisposition, par- 
ticularly menstruation, would induce these states. As she 
said, ' During menstruation I lose all sense of reality '. 
In her case, too, the dream-state brought on a feeling of 
isolation from the external world; and so we might expect 
to find that it served in the same way to remove her from 
the painfulness of reality. But the opposite was the case. 
Her phantasies used to induce a state of still greater suffering 
in her and one of absolute passivity; and from this she 
obtained masochistic pleasure. She gave interesting details 
from her childhood concerning actual masochistic practices. 
These masochistic impulses were still clearly recognizable 



HYSTERICAL DREAM-STATES IO7 

at the present day. For she was able to induce a dream- 
state at will. (I may say that I have met with this pheno- 
menon in other cases.) As she said herself, ' Something 
often impels me to bring on a dream-state '. To do this 
she used to recite from memory a passage out of Hebbel's 
Maria Magdalena (Act 3, Scene 2), where Clara makes the 
following declaration : 

4 I will serve you and I will work for you, and you shall 
give me nothing to eat. I will earn my own livelihood. I 
will sew and spin at night for other people. I will go 
hungry if I have nothing to do. I would rather bite into 
my own arm than go to my father, lest he should observe 
anything. If you should strike me because your dog is 
not at hand, or because you have put him away, I would 
sooner swallow my tongue than utter a single cry that 
might betray to the neighbours what is happening. I 
cannot promise that my flesh will not show the marks of 
your whip, for I cannot help that. But I will lie; I will 
say that I knocked my head against the cupboard, or that 
I fell down on the floor because it was slippery. And I 
will say all this before anyone has had time to ask what 
has caused my bruises. Marry me. I shall not live long. 
And if even so you should tire of me and not be willing 
to bear the expense of a divorce in order to free yourself 
of me, buy poison and put it somewhere as though it were 
meant for the rats and say nothing. I will take it, and 
when I am dying I will say to the neighbours that I 
thought it was powdered sugar! ' 

When the patient had sunk herself into these typically 
masochistic ideas she used to fall into a state of dream-like 
* removal from reality '. She felt the masochistic subjection 
of Clara, with whom she identified herself, and her own 
isolation from the world as pleasurable. She laid great 
stress on the pleasurable character of that seclusion, and 
used to experience similar situations in her dreams. In 
them the world was remote; her body seemed changed, and 
her own voice was unfamiliar to her. As she said, ' The 
person ' (meaning herself) ' who is speaking is quite strange 
to me ', To add to her torment, everything would assume 



IO8 SELECTED PAPERS OF KARL ABRAHAM IV 

absurd and distorted forms which recalled drawings by 
Kubin. * Everything is more cruel and gloomy than 
reality ', she used to say. Her masochistic phantasies used 
to culminate in thoughts of death, in the idea that she must 
jump out of the window, etc. After the crisis had passed 
extreme anxiety used to set in, accompanied by anxiety- 
ideas which varied with the situation of the moment. For 
example, if the patient happened to be in the street she 
would have the feeling that she must fall, that she could not 
get home alone, that she must go up to some man or other 
and accost him. ' To fall ' and ' to accost a man ' are 
equivocal expressions. They not only indicate a state of 
helplessness and need for assistance, but they point to those 
prostitution phantasies which are so often met with in 
hysterical women, but are kept so strictly secret by them. 1 
The patient used to have an impulse to give herself to the 
first man that came her way, and at times, when she was 
suffering from frequent attacks of the kind described, she 
used actually to do so. Her prostitution desires appeared 
as a special form of masochism, and represented to her, who 
had in general a high opinion of herself and was even some- 
what masterful, the deepest form of humiliation. 

In this patient we meet furthermore with the occurrence 
of very protracted dream-states, such as Lowenfeld has also 
described. In many neurotics the feeling of being in a 
dream and uncertain about the reality of their surroundings 
can last for some months or even longer. The present 
patient was for a long time under the impression that every- 
thing around her was only make-believe, and that her body 
was dead and she was only a spirit looking on at the real 
world without having anything to do with it. She said 
that this protracted state was particularly tormenting, but 
that, for that very reason, it procured her access to things 
which otherwise would have been hidden from her. These 
states enabled her to find refuge in a world of dreams 
from the world of reality in which her wishes found no 
gratification. 

1 These phantasies came to expression very clearly in many of the patient's 
dreams, and were also betrayed in her symptomatic actions. 



HYSTERICAL DREAM-STATES 1 09 



CASE D 

The patient, quite a young man, had suffered since 
childhood from severe hysteria which rendered him almost 
incapable of associating with other people. For example, 
he would scarcely speak to anyone at all, and would avoid 
eating in the presence of strangers, because on such occasions 
he always used to suffer from severe anxiety. His manner 
of living in itself, therefore, cut him off from the external 
world. And his dream-states reinforced this tendency. 

Such an eccentric mode of living in so young a man was 
due to a quite exceptionally strong fixation of his libido on 
his nearest relatives, to whose narrow circle he was almost 
entirely confined. Every time he overstepped those boun- 
daries he used to be overcome by anxiety. If he wished to 
leave the house or pay a call or speak to a superior, he would 
always be seized with anxiety. His unusually strong sexual 
phantasies centred about his family; and not only did he 
have heterosexual wishes fixated upon his mother and sister, 
but he was very much interested in his father from a homo- 
sexual and masochistic point of view. As soon as he 
approached a strange person he would begin to have sexual 
phantasies about him; but his attempt at a ' transference ' 
would be as rapidly suppressed. He had wanted for a 
moment to leave his narrow confines, but the fixation of his 
libido was too strong, and so every attempt he made in that 
direction resulted in anxiety. 

The patient's above-mentioned sexual phantasies always 
led up to masturbation, an act which he performed in a 
refined manner, never making a direct use of his hands, but 
applying long-continued and quite gentle stimulation such 
as gentle pressure of the thighs together and manipulations 
through his clothes. This physical stimulation and the 
accompanying phantasies used to bring on the dream-like 
' removal from reality '. Ejaculation never occurred, but 
he used to have a very pronounced period of mental blank- 
ness. In the present case we can see the dream-states still 
in their direct and original association with masturbation. 



IIO SELECTED PAPERS OF KARL ABRAHAM IV 

Yet they were also able to appear quite spontaneously. 
This was especially the case when the patient's father was 
present. For then those phantasies would be activated to 
which the patient was addicted when alone, and in this 
situation they would induce a dream-state, just as at other 
times they would lead to masturbation. 

For many years the patient had enjoyed these highly 
pleasurable states during school-hours. His teachers had 
noticed that he was inattentive at his lessons and usually 
absent-minded. He was preoccupied with phantasies which 
were quite remote from his studies; and if he was startled 
out of a reverie by a question from his teacher severe anxiety 
would occur. As the years passed this propensity persisted 
unchanged; and the dream-state still served him to this day 
as a means of completely secluding himself. He was wholly 
sunk in himself, and it was difficult for him to concentrate 
upon anything which lay outside the circle of his phantasies. 
If he found himself in some unwelcome situation he would 
often evoke a dream-state deliberately by a simple method 
which symbolized in the clearest manner an exclusion of 
external impressions: he would close his eyes. During 
psycho-analysis he always used to shut his eyes when he 
came to a subject which he did not want to talk about. 
Then it was quite impossible to get a single word out of him. 
He would sit there motionless and absent-minded. When 
I explained to him that his dream-states required a careful 
psycho-analytical investigation, he immediately reacted with 
a dream-state, which naturally made it impossible to institute 
such an investigation for the time being. He was also able 
to interrupt the dream-state at will ; this he did by giving a 
sudden jerk of his head. 

The patient used to employ his dream-state in one other 
way besides, and that was when he had to suffer a particular 
pain of psychological origin. He would then evoke a 
dream-state by means of certain sexually exciting manipula- 
tions, and his pain would become gradually transformed 
into a sensation of pleasure. 



HYSTERICAL DREAM-STATES III 



CASE E 

This patient, too, exhibited an excessively strong infantile 
sexual transference on to both parents, together with those 
death wishes which regularly accompany it and which are 
rigidly rejected by consciousness. These latter were especi- 
ally directed upon his mother, but had been transformed 
through reaction-formation into .an excessive attachment to 
her of a thoroughly childish character. Though he was 
long since grown up, it seemed strange to him that he 
was no longer the child he still felt himself to be. It is 
worth noting that it was the death of his mother which had 
brought on his first dream-state. This state had been a 
very protracted one, and for many months he had had the 
feeling of going about in a dream. But the intensity of 
this feeling showed great variations. He said quite spon- 
taneously, * I cannot think that anything is real if I am not 
at her ' (his mother's) * side '. In place of the repressed 
phantasies which had once been directed against his mother's 
life, therefore, the idea appeared in consciousness that his 
own life depended on hers and would end with it. His 
death phantasies had become turned back upon himself. 
To quote his own words : * Hand in hand with this goes the 
idea that all existence is futile '. When his mother had died 
the world had ceased to have any value for him. His libido 
had been temporarily withdrawn from the objects around 
him; and, as was the case with the other patients, every- 
thing seemed strange to him now, as though he had not 
seen it before. People to whom he was actually speaking 
did not seem to exist at all. All early events, i.e. those 
which had taken place in the lifetime of his mother, 
seemed remote. He said : * All the past has a dream-like 
character, as if it had happened an eternity ago.' The 
patient used often to have these states without par- 
ticularly noticing them. He was generally quite able to 
carry on his work, which necessitated great intellectual 
concentration. But more recently there had appeared 
dream -states which were of shorter duration and more 



112 SELECTED PAPERS OF KARL ABRAHAM IV 

acute. The history of their origin is very peculiar, and 
is as follows : 

The patient used to suffer periodically from violent 
headaches which caused him great agony. (We shall say 
something about their origin later.) About three years 
ago he decided to consult a nerve specialist, who specialized 
in hypnotic treatment. After a number of unsuccessful 
attempts had been made to produce hypnosis, he gave up 
the treatment. But he then began to try to put himself 
into a mental state which differed from his usual one, in the 
hope of getting rid of his headache in that way. He suc- 
ceeded a number of times in inducing a state of this kind, 
which was highly pleasurable and which he regarded as 
an ' auto-hypnosis '. But his headaches persisted. During 
his treatment with me, too, he repeatedly and earnestly 
expressed the wish to be hypnotized. To subordinate him- 
self to the will of another fitted in with his masochistic 
tendencies. As he himself said, his ideal was to be able 
to be completely passive, and it was torture to him to have 
to exert all his energy to go on with his life, 

His sexual life showed a great number of unmistakable 
masochistic traits. For a long time he used to masturbate 
to the accompaniment of masochistic phantasies, but after 
a severe struggle he succeeded in partly giving up the 
practice. The symptom of his sexual passivity which 
threw most light on his dream-states was his psychological 
impotence, which had begun at the same time as he had 
started bringing on his dream-states. Moreover, he spon- 
taneously told me that he had already had the wish to be 
sexually passive before. He wanted to be able to yield to 
sexual pleasure in a passive way like a woman. 

His dream-state brought about the realization of that 
ideal together with a high degree of pleasure. And it was 
quite in accordance with this desire to give up all activity 
that his method of inducing such a state should have been 
to concentrate all his will on thinking of nothing. His 
life in general necessitated great intellectual effort, but his 
desire was for the opposite. As we have seen in the other 
patients, a * mental blankness ' sets in at the height of the 



HYSTERICAL DREAM-STATES 113 

dream-state. In the present case the patient had a conscious 
intention of bringing on this stage, which, as we know, 
corresponds to the moment of greatest pleasure. 

I will quote his description of this state in his own 
words. He gave it of his own accord and with every sign 
of strong emotion; and it is quite intelligible to us after 
what has been said. He said: 'At first it is an effort, as 
in sexual intercourse. If I wanted to do it I should have 
to lie down and work at it. I have to concentrate with all 
my might upon thinking of nothing. I close my eyes. 
Nothing must be allowed to reach me from the outer world. 
Then comes a short stage of bliss in which all my sensations 
are reversed. It is the greatest physical change that I 
know, and I cannot find words strong enough to describe 
it. That short stage of pleasure is nevertheless like an 
infinity/ At the climax of the process of excitation for 
such we must term it his thoughts used to stop. 

The patient completed his description as follows : * One 
has the idea that in life everything is moving forward; I 
mean, for example, the circulation of the blood. But 
suddenly everything is changed: everything ebbs away, as 
though it were no longer going forward but backwards. 
It is as though some magic had begun to work. While at 
other times everything tends to leave the body, now every- 
thing is driven back into it. I no longer radiate things out 
but absorb them/ After a short pause he continued: 
* There is an absolute, harmonious peace about it, a com- 
forting passivity, in contrast to my real life. Waves flow 
over me. Something is done to me. If the state did not 
pass I would not move till the end of time/ 

These dream-states enabled the patient to obtain un- 
limited pleasure in imagination out of his sexual passivity. 
He wanted to be a woman, and in his dream-states he 
experienced the fulfilment of that wish. He was perfectly 
right when he spoke of the ' greatest conceivable change ', 
for a more radical alteration than a change of sex cannot 
be conceived. And to the patient it signified not only a 
change of sex, but a reversal of his whole mode of life. 

His wish to be a woman draws our attention to the 

H 



114 SELECTED PAPERS OF KARL ABRAHAM IV 

homosexual components in him.- We already know about 
his intense transference of infantile libido on to his father, 
so that we can assume that in wishing to be a woman he 
was identifying himself with his mother in order to occupy 
her place with his father. Such an assumption is confirmed 
by the aetiology of his headaches to which we have already 
referred, and which plainly served to identify him with his 
mother. For in his childhood she had suffered from 
headaches to which his own bore a striking resemblance. 
She always used to get them when her periods came on. 
At those times she used to be very irritable and have to 
take great care of herself. The patient's headaches used 
also to recur at intervals of four weeks and to last from 
three to four days on each occasion. During that time he 
would become extremely sensitive to every external stimulus, 
and be obliged to stop work and spend one or two days in 
bed. His headaches, therefore, served to identify him with 
his mother. That he had some inkling of this connection 
was shown by the fact that once in the early part of his 
treatment he jokingly said : * I have got my period just now '. 

His attacks of headache and his dream-states served 
to transform him into a woman. The monthly period and 
sexual passivity are two very important features in the 
sexual life of women. The patient was following a per- 
fectly correct instinct when he sought to expel, or as we 
should now more correctly say, to replace, his headache by 
a dream-state, since both served the same aim of sexual 
passivity. If his plan had succeeded he would have 
replaced a displeasurable symptom by an equivalent but 
pleasurable one. That he was disappointed in this expecta- 
tion is also quite explicable. For his headaches did not 
depend upon that one motive we have mentioned alone, 
but subserved other repressed wishes as well which would 
not have found adequate expression in his dream-states; 
so that the dream-states could only appear side by side 
with his headaches but not in place of them. 

The patient's attempt to ward off displeasure had 
miscarried, but he had obtained a new source of pleasure. 
Although his dream-states did not relieve him of his pain, 



HYSTERICAL DREAM-STATES 1 15 

they nevertheless offered him a compensatory pleasure 
which enabled him to put up with the pain he was obliged 
to endure. 

CASE F 

Intermediate States between Day-dreams and True 
Dream-states 

I will give an extract from an analysis of a case which 
did not exhibit marked dream-states in the sense we have 
described, but which showed a kind of introductory stage 
to these. It demonstrates in a particularly clear manner 
the origin of dream-states from day-dreams, and also the 
close relationship that exists between neurotic dream-states 
and dreams during sleep. 

The patient, F, was dominated to such an extent by 
certain recurring phantasies that he called them ' obsessive 
ideas '. Reading, in particular, used to furnish a stimulus 
for these phantasies. He used immediately to identify 
himself with the hero of the tale. He said : ' When I 
read a love romance I imagine myself to be the hero with 
whom all the women are infatuated '. Actually the patient's 
sexual activity was very limited. Besides these erotic day- 
dreams he used to be occupied with phantasies of greatness. 
In reading about a historical figure he would have the idea 
that he was that person, and he would live his life in imagi- 
nation. As he said: I like reading about Napoleon, for 
instance. For then I, too, seem to hear myself receive 
the acclamations which he received/ In fact, he had only 
to think of shouts of joy, fame, and acclamation to feel a 
shudder run over him. Music, chiefly military music, 
also had an exhilarating effect upon him and used to provoke 
this ' shudder '. In the day-dream which used to result 
from such occurrences the patient, who was a business 
man, used to imagine himself becoming an important 
or wealthy man, ' perhaps a manufacturer like Krupp '. 
He then used to imagine how he would completely dis- 
regard the feelings of his staff, and force his will upon them 
(cf. his idea of being Napoleon). It was difficult for him 



Il6 SELECTED PAPERS OF KARL ABRAHAM IV 

to free himself from these ideas. He said : ' When I have 
these obsessive ideas ' (day-dreams) ' I recite a poem in 
order to divert my thoughts generally the "Loreley", or 
"Hail to the Victor", or any poem from my school-days'. 
He had, however, to repeat such poems many times before 
they had the desired effect. 

The central figure of the patient's phantasies was either 
a doughty lover or a brutal despot or a military hero. It 
was not difficult to see that in his day-dreams he sought to 
gratify those wishes which proceeded from the confluence 
of his sexual instinct and his instinct of aggression, i.e. 
his sadistic feelings. He had the feeling in general that 
he did not give an impression of manliness, and that he 
was being treated like a child. This feeling resulted from 
the suppression of his sadism. In his dreamings he was the 
energetic, despotic man, but afterwards he changed back 
into the weak and dependent ' child '. The poems of his 
schooldays formed a suitable interruption of his phantasies, 
because they took him back into his childhood. One is 
immediately struck by the similarity in the content of this 
patient's phantasies with those of Case B, which have been 
fully described. This similarity extended to a particular 
symptom. We found in the patient B a striking tendency 
to blushing; and the patient F also suffered from blushing 
and marked erythrophobia. 

In the present case the dream-states did not have the 
same character as those previously described, for the stages 
of removal from reality, mental blankness, and subsequent 
anxiety were absent. Moreover, his states ran a different 
course. Nevertheless they went beyond the ordinary day- 
dream in their great intensity, and they had one character- 
istic in common with the dream-state proper. This was 
that the patient lost control over his own thoughts during 
his phantasies and could not interrupt them at will. 
Like the others, he had to discover a method by which he 
could break off his phantasies, and to make liberal use of it 
before it was effective. His extremely vivid visualization 
of his phantasies requires special notice; and we shall 
presently give closer consideration to this feature. 



HYSTERICAL DREAM-STATES 117 

This case also shows very well how waking phantasies 
are the precursors of dreams in sleep. The patient told 
some dreams which had often recurred since his childhood. 
In one of them he was being attacked in bed by a man with 
a beard. The man stabbed him with a dagger, while he 
himself lay still as though his hands were paralyzed. He 
would awake from this dream in great anxiety. He used 
still more frequently to dream that he was being pursued 
by a lion, and that finally, in great anxiety, he slipped 
through a cleft in the wall through which the lion could not 
follow him. 1 The man with the (symbolic) dagger was 
his father, whose (sexual) ' attacks ' on his mother he had 
observed as a little boy. The dream betrayed his re- 
pressed wish to occupy his mother's place with his father. 
His dream about the lion belonged to the same complex. 

When the patient, who was only under treatment for a 
short time, was asked to say what occurred to his mind, as 
is the rule in analytic procedure, he used usually to close 
his eyes and describe mental pictures which appeared 
before him. Concerning the dream of being stabbed with 
a dagger he said : 2 ' I see a man being stabbed by another 
man. The first one is lying on a couch, and the second 
one is kneeling on him and stabbing him in the breast. 
The one who is lying down is grasping his opponent's 
right hand tightly with his left. The kneeling man 
appears to be about thirty years of age. He looks very 
wild and has a dark beard. The other looks well-bred and 
aristocratic. He has on a silk doublet with a lace collar/ 

It is obvious that these mental pictures have the same 
content as the perennial dreams mentioned above. The 
lying man was the patient himself. (Incidentally, he was 
lying on the couch in my consulting-room at the time 
of having them.) It is particularly worth noticing that 
in his description he used the passive voice * a man is 
being stabbed by another man ' for he was the subject 

1 The patient B also had constantly recurring dreams of this kind. But I 
have not given the analysis of these dreams here, in order to avoid unnecessary 
complication. 

2 The interpretation given above of the dream was unknown to the patient at 
the time when he related his visions. 



Il8 SELECTED PAPERS OF KARL ABRAHAM IV 

himself. At the time wheu he had slept in his parents' 
bedroom as a child his father had been approximately thirty 
years old and had worn a beard. The fact that the patient 
endowed the recumbent figure with an aristocratic appear- 
ance is explained by the typical parentage phantasies l 
which occur with great intensity in neurotic children. The 
silk doublet with the lace collar was taken from a picture 
hanging over my sofa ( 4 The Laughing Cavalier ', by Franz 
Hals), He had regarded it attentively before shutting his 
eyes, because it had touched his infantile ' aristocratic ' 
complex. As he looked at it a second time he remarked 
that the dress reminded him of aristocratic ladies' clothes. 
The picture, therefore, had touched a further complex 
the homosexual one. A day or two afterwards the patient, 
again lying on the couch, had the following visions : 

4 A centaur now a little child appears ... he is a 
little centaur too.' (These were his father and himself. 
Note the sexual symbolism of the comparison with a wild 
centaur or a stallion,) 

' A race . . . the riders jumping over the hurdles.' 
(This represented his rivalry with his father. The patient 
had in general that character -trait which the patient B 
termed in himself a ' competitive feeling '). 

* A horse that has fallen down.' (The patient said that 
on the way to my house he had seen a horse that had fallen 
down. A deeper determinant of this picture is to be found 
in typical phantasies of his father's death.) 2 

4 The man in the helmet, the picture by Rembrandt.' 
(This picture did not hang in my room, but it was a favourite 
of the patient's. The patient's father was a big, powerful 
man. He had been in the Guards and had taken part in 
two wars. The patient wanted to be a soldier like his 
father, who was, moreover, the prototype of his Napoleon 
phantasy.) 

The patient had other visions of a similar character. 

1 Cf. my Traum und Mythus (1909), S. 40 [No. 14, A. B.] ; also Rank, Der 
My thus von der Geburt des Helden (1909). 

8 I have recently found the same phantasy of the fallen horse in another case. 
And a similar phantasy has been analysed by Freud in his 'Analysis of a Phobia in 
a Five-year-old Boy ' (1909). 



HYSTERICAL DREAM-STATES 119 

Both the patient's waking dreams and his night dreams 
derived their content from his childhood phantasies. They 
even had in common hallucinatory pictures. In his dream- 
states, too, there was a psychological process analogous to 
the * dream-work ' which formed the manifest content out 
of the repressed (latent) thought-material. I need only 
refer to the abundant use of symbolism, as well as to the 
very marked degree of condensation. We have met with 
numerous examples which show that some particular detail 
of the dream-state (and also the dream-state itself considered 
as a whole) served to express very different, even opposite, 
phantasies. 

Dreams and neurotic dream-states are not the only 
derivatives of day-dreaming. There are two more such 
derivative states, characterized by a deeper disturbance of 
consciousness. Out of the dream proceeds the somnambu- 
listic dream in which the neurotic converts his phantasies 
into more or less complicated actions of which later he has 
no remembrance.. Similarly, dream-states can give rise to 
' hypnoid states ' and ' twilight states '. In these latter 
we find elements which are familiar to us from the dream- 
states, such as * remoteness ', c fading away of surrounding 
reality ', and * affective cessation of thought V In these 
twilight states quite complicated actions can be carried out. 
The extent of the amnesia that follows on them is in 
proportion to the degree of disturbance of consciousness 
that has taken place during them. Such an amnesia is not 
characteristic of the dream-states we have been discussing. 

To these episodic phenomena of the clinical picture of 
hysteria there can be added other closely connected phen- 
omena whose relation to day-dreams has already been 
demonstrated in earlier investigations, I may mention in 
the first place hysterical attacks. Freud 2 has recently 
summed up his view of their nature in a very concise form. 
I will quote a few passages from his discussion of the 
subject to which I have already referred. 

1 I make use of Breuer's terminology. Cf. Breuer and Freud, Studien iiber 
Hysterie (1895). a See reference, p. 97 



I2O SELECTED PAPERS OF KARL ABRAHAM IV 

* Investigation of the childhood history of hysterical 
patients shows that the hysterical attack is a substitute for 
an auto-erotic gratification previously practised by them 
and since given up/ Our analysis of dream-states has led 
to analogous results, 

4 The anamnesis of the patient established the following 
stages: (a) Auto-erotic gratification without ideational 
content. (#) The same in connection with a phantasy, 
which culminates in the act of gratification, (c) Renun- 
ciation of the act with retention of the phantasy, (d) 
Repression of this phantasy, which then breaks through in 
the hysterical attack either unchanged or else modified and 
adapted to new experiences, and (e) which may even restore 
the act of gratification which belongs to the phantasy and 
has apparently been given up. This is a typical cycle of 
infantile sexual activity: repression, failure of the repression, 
and return of the repressed/ Thus the first three stages 
are common to dream-states and hysterical attacks. 

c The loss of consciousness, the mental vacancy of the 
hysterical attack, is derived from that transient but un- 
mistakable disappearance of consciousness which is ex- 
perienced at the height of every intense sexual gratification, 
including auto-erotic gratification. . . . The mechanism 
of this mental vacancy is a relatively simple one. At first 
all attention is fixed on the course of development of the 
gratificatory process; then with the actual appearance of 
the gratification itself the whole of this concentration of 
attention is suddenly arrested, so that a momentary blank- 
ness of consciousness takes place. These physiological 
gaps in consciousness, as we may call them, are then ex- 
tended in the service of repression until they can absorb 
everything which the repressing faculty repudiates/ 

Thus dream-states and hysterical attacks start from the 
same initial stages and subserve the same ends; but they 
differ in their methods of expression, and usually also in 
the part played by consciousness. Whereas the mental 
vacancy in dream-states is nearly always of short duration, 
especially in comparison with the protracted duration of 
the other stages, the ' gap in consciousness ' of the hysterical 



HYSTERICAL DREAM-STATES 121 

attack lasts according to the requirements of the case. The 
hysterical attack makes use of the * reflex mechanism of the 
action of coitus ' in order to express the repressed phantasies, 
and thus brings about a * motor discharge of the repressed 
libido '. In the dream-state the process expresses itself on 
the level of phantasy, if we except certain motor expressions 
(as, for example, alteration of bodily position or movement) 
which have no relation to the action of coitus. 

Next to the motor attacks of hysteria, anxiety-attacks 
stand in close genetic relation to dream-states. In this kind 
of episodic hysterical phenomenon, too, we have to recognize 
sexual excitatory processes that have undergone transforma- 
tion. 1 I may mention that the patients whose dream-states 
I have reported in detail all suffered from more or less 
frequent anxiety-attacks, but not, on the other hand, from 
hysterical motor attacks. There are evidently individual 
differences in the clinical picture here, but we have not yet 
obtained sufficient insight into them. 

I might mention that dream-states of a quite analogous 
type occur in insanity (dementia praecox). In the case of 
a young hebephrenic I have recently been able definitely 
to establish their origin from day-dreams. In this case the 
condition of ' remoteness ' was particularly marked. In 
his dream-states it seemed to the patient ' as if everything 
were only a theatre '. I may point out that twilight states 
also occur in dementia praecox and that they have important 
characteristics in common with hysterical states. Dream- 
like states which have a protracted course and are accom- 
panied by especially pronounced feelings of strangeness 
have been described by Wernicke, Juliusburger, and other 
writers. 2 

The cases that have been analyzed above were without 
exception severe psychoneuroses. But it does not follow 
from this that dream-states do not occur in slight cases. 
Undoubtedly a great number of people who are only slightly 

1 Cf. Stekel, Nervose Angstzustande und ihre Behandlung (1908). 

2 I have recently been able to observe a number of catatonic attacks in a female 
patient. They began by violent kissing movements of the mouth, and went on to 
represent a sexual act in a quite unmistakable fashion. We have here also, therefore, 
an analogy with a hysterical attack. 



122 SELECTED PAPERS OF KARL ABRAHAM IV 

ill suffer from such states as well as those who are more 
severely affected. All of them have a tendency to indulge in 
day-dreaming, and none have succeeded in overcoming their 
craving for the auto-erotic activities of childhood. Their 
simple waking dreams, or the more complicated mental 
structures derived from them, serve as a temporary means 
of fleeing from reality into the realms of childhood. If a 
person is disposed to dream-states a very slight stimulus 
touching upon his repressed complexes will be sufficient to 
evoke such a state. 

In the case of only slightly neurotic people dream-states 
often elude medical observation, or their particular signifi- 
cance is not recognized. Female patients, for example, 
frequently complain to the physician and not by any 
means only in psycho-analytic treatment that they feel 
themselves hypnotized by him. This is a transparent 
example of * transference '. The patient is unconsciously 
prepared to subordinate herself to the physician's will, i.e. 
is ready to adopt a passive attitude towards an unconsciously 
desired assault on the part of the physician. Her phantasy 
is working hard on the subject of the fulfilment of this wish, 
until the stage of * remoteness ' is brought on, followed by 
the further stages with which we are acquainted. In fact, 
the patient goes through a dream-state during her visit to 
the physician. With some hysterical women the presence 
of any man suffices to make them feel that they are being 
hypnotized. I once treated a patient who always had 
anxiety in trams. She would have the feeling that she 
was being * bored through ' by the glance of any man sitting 
opposite her. This feeling immediately induced a state 
which she called a kind of hypnosis and which ended in 
anxiety. 

Other neurotic girls state that in the middle of a con- 
versation with a man they will suddenly feel themselves 
' removed from reality ', and their own voice will appear 
strange to them as if someone else were speaking. Then 
will come the ' mental blankness ', and finally anxiety and 
a feeling of shame. Analysis shows that such persons are 
in the habit of indulging very liberally in day-dreaming. 



HYSTERICAL DREAM-STATES 123 

They are especially fond of having phantasies as they lie 
in bed in the morning. The thread of these day-dreamings 
is taken up again as soon as a suitable occasion arises, and 
there then follow the other typical stages of the dream- 
state. 

In the discussion previously referred to, Freud has given 
a condensed description of the exciting causes and the 
purpose of hysterical attacks. A hysterical attack is evoked 
associatively whenever the complex is stimulated through a 
connecting link with conscious life. It is evoked organically 
whenever the libido is increased from external or internal 
causes, and has no outlet. It is quite obvious that as a rule 
both situations arise together. The same stimuli are also 
operative in the production of dream-states. 

According to Freud hysterical attacks serve in the first 
place to assist the primary purpose of the illness (flight into 
illness), and are therefore a kind of consolation for the 
patient. In the second place they serve the secondary 
purpose of the illness, whenever the illness is of practical 
benefit. The same is true in every respect of dream-states. 
The patient E, who fell into a dream-state of long duration 
after the death of his mother, furnishes an excellent example 
of a ' flight into illness '. That dream-states also have a 
present and practical purpose has been evident in every 
case we have considered. In many patients the dream- 
state will appear as if at call in distressing situations. Not 
only this, but it must be particularly mentioned that many 
patients will call up a dream-state consciously and inten- 
tionally in order to avoid displeasure or to obtain pleasure. 
We are once more reminded of the genetic relation of 
dream-states to onanism. The neurotic often has recourse 
to onanism as a consolation to remove depression of 
spirits, for instance. 

Both dreams and neurotic dream-states have as their 
function the avoidance of displeasure, 1 But the dream- 
states also serve to provide a positive pleasure-gain. The 
patient B, whose dream-state used to remove him from his 
condition of passivity, used not only to escape displeasure 

1 See Freud, Der Witz> 1905, S. 154. 



124 SELECTED PAPERS OF KARL ABRAHAM IV 

by this means; in the first stages of the process he used also 
to derive positive pleasure from his phantasied activity. 

A change in the sexual aim such as occurred in the 
dream-states of the patient E is not the rule. There is 
another type, that represented by the patient C. In his 
case the phantasies developed along the lines of that passivity 
which was already his dominating attitude, and thus served 
to intensify his masochistic feelings to an extraordinary 
degree. 

Dream-states offer the neurotic patient, just as other 
neurotic phenomena do, a substitute for a sexual activity 
which is denied him. His unconscious makes use of 
this surrogate so long as he cannot obtain the gratification 
of certain desires. But if the libido experiences sufficient 
gratification, then the dream-states will diminish and even 
subside altogether. I saw this actually happen in the case 
of a slightly neurotic lady as soon as she obtained sufficient 
sexual gratification in her married life. And a young man 
who came to me for treatment on account of psychical 
impotence, found that the restless activity of his sexual 
phantasies subsided and attained a normal degree when 
he once more became potent and could obtain adequate 
gratification. 

The analysis of dream-states demonstrates once more 
the extraordinary fruitfulness of Freud's theories. Since 
the introduction of the psycho-analytical method of investi- 
gation we are no longer limited to a mere description of the 
symptoms of the neurosis without understanding their 
meaning or being able to explain their individual character 
in each case. We are able to comprehend the conditions 
that give rise to the neurosis and its motives, and to ascertain 
its hidden purpose and the instinctual forces at work in 
it. We are able to understand the individual peculiarities 
of each case, since we not only consider the present-day 
instinctual life of the neurotic, but investigate the repressed 
wishes of his childhood as well. For in the innermost 
recesses of his mind he is continually striving to repeat 
those infantile situations of gratification the memory of 
which he still retains in his unconscious. 



CHAPTER V 

REMARKS ON THE PSYCHO-ANALYSIS OF A 
CASE OF FOOT AND CORSET FETISHISM * 
(1910) 

IT is only latterly that special attention has been paid to 
the problems of fetishism by psycho-analysis. In the 
first edition of his Drei Abhandlungen zur Sexualtheorie 
Freud assigned to it a unique position among the other 
sexual aberrations and among the neuroses. Further obser- 
vation has shown, however, that in many cases fetishism 
and neurosis are both present in the same individual. In 
the second edition of his above-mentioned book Freud has 
made a short reference to this fact, and has traced the 
phenomena of fetishism back to a special variety of 
repression which he has called ' partial repression '. In 
consequence of this the once emphasized contrast between 
neurosis and fetishism has been done away with. 

The analysis of a case of shoe and corset fetishism which 
I am going to discuss has led me to certain conclusions 
regarding the psychogenesis of this form of fetishism; and 
other cases have confirmed that view. 

We must assume that as the basis of such an abnor- 
mality there is a specific sexual constitution which is 
characterized by the abnormal strength of certain component- 
instincts. Given this, the complex of fetishistic phenomena 
is formed by the co-operation of two factors, namely, the 
partial repression mentioned above, and a process of dis- 
placement 2 which we shall discuss in greater detail. 

1 [No. 18, A. B.] 
2 Concerning the idea of displacement see Freud, Traumdeutun^ S. 209. 

125 



126 SELECTED PAPERS OF KARL ABRAHAM V 

I will give as brief an account of the case as possible : 
At the time of his analysis the patient was twenty-two years 
old and a student at a technical college. At the commence- 
ment of the treatment he handed me an autobiography 
which dwelt in detail on his sexual life. The first thing 
to be noticed in it was that at the age of puberty he 
differed from other persons of his own age in that he did 
not share their sexual interest in women. He experienced 
no feelings of love in the usual sense towards male persons 
either. His conscious knowledge of the most important 
facts of sexuality was acquired very late. As soon as he 
did obtain such knowledge he had the idea that he would 
be impotent. He had a strong antipathy to manual self- 
gratification as carried out by young men of his own age. 

His sexual interests turned in another direction. At 
the age of fourteen he began to tie himself up, and he re- 
peated this performance whenever he was undisturbed at 
home. He derived pleasure from books whose theme was 
chaining or binding for instance, in stories about Red 
Indians in which the prisoners are tied to a stake and tor- 
tured. But he never attempted to bind another person, nor 
did he like to suffer such treatment at the hands of others. 

When he was about fifteen, while staying at a health 
resort, he saw a boy of eight or ten years of age who im- 
mediately attracted his attention on account of the elegant 
shoes he wore. He wrote in his autobiography : ' Each 
time I looked at his shoes I felt great pleasure and longed 
for this opportunity to recur '. On his return home he 
began to take an interest in elegant shoes, especially those 
worn by his school-fellows. This interest soon became 
transferred to women's shoes, and grew into a passion. 
* My eyes were attracted to women's shoes as though by 
magic force. . . , Ugly shoes repelled me and filled me 
with feelings of disgust.' Henceforth, the sight of dainty 
shoes on women induced in him an ' inward joy '. This 
feeling of pleasure used often to change into violent excite- 
ment, especially when he saw patent-leather boots with high 
heels like those worn by demi-mondaines. It was not only 
the appearance of the shoes that excited him, however, but 



A CASE OF FOOT AND CORSET FETISHISM 1 2J 

his vivid mental picture of the discomfort it must cause 
the person to walk in them. In order to have a direct 
experience of the feeling of having one's feet painfully com- 
pressed he would often wear his own shoes on the wrong 
foot, forcing his right foot into his left boot, and vice versa. 

His interest in corsets began soon after his interest in 
footwear. When he was sixteen he got hold of an old pair 
of his mother's stays, and used to lace himself tightly in 
them, and sometimes wear them under his ordinary clothes 
out of doors. The following description in his autobio- 
graphy is characteristic : ' If I see women and girls tightly 
laced and picture to myself the pressure of their corsets on 
their breasts and body I can get an erection. On those 
occasions I have often wished I was a woman, for then I 
could tight-lace myself, wear women's boots and high heels, 
and stand in front of corset-shops without attracting notice. 
This is impossible, but I often long to wear women's clothes, 
stays, and shoes/ Looking out for elegant shoes or tightly- 
laced waists became his most important sexual activity. 
This interest occupied the chief place in his vivid day- 
dreams. At night he had frequent erotic dreams about 
stays, tight-lacing, etc. And, as we have already said, he 
had a preference for reading stories of a sadistic nature. 
He had kept everything that related to these propensities 
strictly secret until he sought the advice of a specialist, who 
referred him to me for psycho-analysis. From the beginning 
I was sceptical of a therapeutic result. 

Accidental causes, to which in the older literature on 
the subject great significance in the aetiology of fetishistic 
tendencies is ascribed, could not be discovered in his case. 
The fact that the patient had as a boy frequently seen his 
mother put on her stays cannot have had the effect of a 
psychic trauma. His interest in his mother's corsets or 
later in boy's shoes was doubtless the expression of a per- 
version which was already in existence. An aetiological 
significance cannot be ascribed to these circumstances. 

What stands out most distinctly in this case and in every 
one of its kind is the extraordinary reduction in the person's 
sexual activity. In fact, we can hardly speak of a sexual 



128 SELECTED PAPERS OF KARL ABRAHAM V 

activity at all in the case of this patient, apart from his 
earlier attempts at lacing and tying himself up. He had 
never put into practice any sadistic or other desires towards 
other people; he gratified his wishes in this direction entirely 
in phantasy. In practice he had never moved outside the 
field of auto-erotism. 

If, on the one hand, we have found very little evidence 
of sexual activity in the patient, we have seen, on the other, 
that his sexual instinct to look was very pronounced. But 
even that instinct had been diverted from its real sphere of 
interest. It was not directed to other people's bodies as a 
whole, nor to their primary and secondary sexual charac- 
teristics, but to certain portions of their clothing. It was 
directed, therefore, not to the naked body but to its covering. 
And here again the patient had specialized on the footwear 
and on the constricting garments of the upper part of a 
woman's body. His sexual desire did not go beyond the 
viewing of these objects. It is therefore a question of 
fixation upon a preliminary sexual aim. 1 Nevertheless the 
sight of women's shoes only excited pleasure in him when 
they were elegant in form and design; clumsy, ugly foot- 
wear made him feel disgusted. We find, therefore, side by 
side with a sexual overestimation of the fetish, a pronounced 
tendency towards an emotional rejection of it, just as is the 
case with neurotics. The high aesthetic standard that the 
shoe-fetishist demands of his sexual object indicates a strong 
need to idealize it. 

Although the patient's sexual activity had been so much 
reduced, and although his instincts found gratification in the 
attainment of preliminary sexual aims, it by no means 
follows that there was a fundamental, primary weakness of 
the libido in him. Analysis of the neuroses has shown 
quite clearly that instincts which have originally been ex- 
cessively strong can be paralyzed through repression. And 
the analysis of the present case disclosed a similar state of 
affairs. Numerous facts, only a few of which can be 
brought forward in this place, showed that the patient's 
active sadistic component-instincts and his sexual pleasure 

1 Cf. Freud, Drei Abhandlungen zur Sexualtheorie . 



A CASE OF FOOT AND CORSET FETISHISM 129 

in looking had originally been abnormally strong. Both 
instincts, which were in the closest 'confluence' (Adler), 
had been overtaken by repression. 

It appeared, however, that other component instincts had 
been included in this process of repression. The particular 
need felt by the fetishist for aesthetic value in his sexual 
object indicates that his libido originally sought certain 
aims which seem particularly unaesthetic to the generality 
of normal adults and give rise to feelings of disgust in them. 
Before taking up this analysis I had had my attention drawn 
to a definite sphere of instinctual life. Professor Freud 
had told me in a private communication that according to 
his experience repression of the coprophilic pleasure in 
smell played a peculiar part in the psychogenesis of foot- 
fetishism. My own investigations have fully confirmed 
this view. In the present case of fetishism I found that 
the patient's pleasure in ' disgusting ' bodily odours had 
been unusually strong originally. Repression of his co- 
prophilic pleasure in smell, his scoptophilia and his sexual 
activity had led to the building up of compromise-forma- 
tions. And it is precisely these compromise-formations 
that constitute the characteristic peculiarities of foot- 
fetishism. 

There are cases of fetishism in which the sexual anomaly 
shows itself in an unrepressed, i.e. a fully conscious, pleasure 
in disgusting odours. In this so-called smell-fetishism 
pleasure is very frequently obtained from the odour of 
perspiring and unclean feet; and these attract the patient's 
scoptophilic instincts at the same time. In the present 
case it turned out that the patient had passed through a 
stage which corresponded to smell-fetishism, and that after 
this a peculiar modification had taken place by which his 
osphresiolagnia had been repressed and his pleasure in 
looking had been sublimated to pleasure in seeing foot-wear 
which had an aesthetic value. 

But how was it that his scoptophilic and osphresiolagnic 
instincts could turn so markedly to the feet, instead of 
being directed to the sexual organs and their secretions? 
Certain observations led me to suspect that both instincts 



I3O SELECTED PAPERS OF KARL ABRAHAM V 

had originally been concerned with the genital zone, but 
that other erotogenic zones had prematurely entered into 
competition with it. An ascendancy of this kind of other 
erotogenic zones (mouth, anus, etc.) is quite familiar to us 
from the theory of the sexual aberrations as well as from 
analyses of neuroses and dreams. 

And in fact the analysis of the patient showed that 
the genital zone had quite early been exposed to strong 
competition from the side of the anal zone. The purely 
sexual interest of his first period of childhood had given 
place to an interest in the processes of excretion; and at 
puberty he had been overtaken by another wave of repres- 
sion with a similar (feminine) aim. He had retained for an 
unusually long time those infantile ideas according to which 
the processes of excretion have the significance of a sexual 
function. The symbolism of his dreams was of a corre- 
sponding character. His scoptophilia and his osphresio- 
lagnia in so far as they were not displaced on to the feet 
were chiefly directed to the function and products of 
urination and defaecation. 

The patient's memories of early childhood were chiefly 
connected with impressions of smell, and only secondarily 
with impressions of sight. If his attention was directed 
back to that time certain obsessive ideas would frequently 
come into his mind. One of these was the smell of iodoform 
and pyroxylic acid, two substances used by his mother in 
his younger days. Another was a scene at a seaside resort, 
in which he saw his mother wading into the water. The 
real significance of this scene was only explained through 
his associations, and was this: he had once or twice 
soiled himself at that time and his mother had taken him 
into the sea to clean him. 

Many memories connected with smell occurred to him 
out of his later childhood, too. For instance, he remembered 
finding in his mother's room a packet of hair the odour of 
which was agreeable to him; and he remembered hugging 
his mother in order to smell her armpits. He had one 
more recollection dating from his early childhood in which 
his younger sister was at his mother's breast and he had 



IQIO A CASE OF FOOT AND CORSET FETISHISM 

touched the other breast with his mouth and had liked the 
smell of his mother's body. 

The patient's fondness for his mother lasted until he 
was about ten years old, and up to that time he had fre- 
quently got into her bed. But at ten his affection gave 
place to dislike. He became very intolerant of the bodily 
smell of women. At the same time as his pleasure in 
smell became repressed his sexual interest turned away 
from women and attached itself to the nearest male object 
his father. In this transference his interest in bodily 
evacuations came to the fore. His attention was un- 
doubtedly especially directed to these processes through 
certain peculiarities of his father, who would, for example, 
often make water before his children. His phantasies 
were occupied to a great extent with everything that con- 
cerned this function in himself and in his father. 1 

Intimately related to his transference on to his father 
was his wish to be a woman, a wish that persisted, as we 
know, after puberty. As far as he was conscious, however, 
this wish was not directed towards fulfilling the sexual 
function of a woman. What he desired was ' to wear 
laced shoes and corsets like a woman and be able to look 
at them in shop-windows without attracting notice '. Once 
or twice at the age of puberty, as has already been said, 
he had actually worn corsets under his clothes. His wish 
to be a woman was expressed unconsciously in various ways 
which have still to be mentioned. 

His infantile impulses of rebellion and jealousy were 
necessarily directed against his father and mother alternately. 
This attitude was associated in the customary way with 
death and castration phantasies, the latter being sometimes 
of an active and sometimes of a passive nature. His active 
castration phantasies also had as their object his mother, to 
whom his infantile imagination attributed a male sexual 
organ. His passive castration phantasies corresponded to 
his desire to be a woman. They originated in a period in 

1 In connection with this there developed a horse and giraffe symbolism 
absolutely identical with that described by Freud in his 'Analysis of a Phobia in a 
Five-year-old Boy* (1909). 



132 SELECTED PAPERS OF KARL ABRAHAM V 

which he held the view that the female sex had originally 
possessed a penis but had been deprived of it by castration. 
All these ideas played a large part in his dreams. He 
used to dream that he had to amputate the finger of a 
woman, or that he had to carry out an operation on a man 
(his father), and that afterwards his mother helped him to 
sew up the wound. In other dreams a child would have 
to be beheaded. A recurrent dream of his worth mention- 
ing was one in which a man was pursuing him with a 
knife in his hand. The exceptional development of his 
castration complex testifies to the original strength of his 
sado-masochistic impulses. 

In the patient's phantasies castration not only had the 
obvious significance of emasculation, but also had reference 
to a certain idea that had always interested him particularly, 
namely, that of being unable to urinate owing to castration. 
From this point there are connections which lead to another 
complex of ideas. 

All neurotics in whom the anal and urethral zones are 
especially erotogenic have a tendency to retain their excreta. 
This tendency was unusually strong in the patient in 
question. His childhood memories mostly concerned the 
pleasurable practices he used to indulge in in this direction. 
A nervous symptom of his a ' urinary stammer ' was 
also connected with those practices. 

The patient had all his life-long indulged in phantasies 
in which he was forced to refrain from relieving his needs. 
For instance, he would like to imagine that he was tied to 
a stake by Indians and compelled to hold back the contents 
of his bladder and bowels. A strong masochistic element 
was present in this phantasy as well. Another of his 
favourite ideas was that he was an Arctic explorer and was 
prevented by the terrible cold from opening his clothes 
even for a short time in order to relieve the calls of Nature. 
His experiments in tying himself up were also determined, 
among other things, by the same motives; and it is 
significant that those practices took place in the w.c. This 
tying-up, which plays a large part in the phantasies of sadists 
and masochists, acquired its significance in his case through 



A CASE OF FOOT AND CORSET FETISHISM 133 

its association with the functions of evacuation. Tight- 
lacing caused a pressure on the bowels and bladder which 
was pleasurable to him; and when he had put on corsets 
for the first time he had had an erection and had then 
passed water. One important determinant of this whole 
lacing-up motif was to be found in certain auto-erotic habits 
of his connected with squeezing-in the genitals. 

In this patient the anal zone greatly predominated. In 
his childhood it had subserved a peculiar auto-erotic 
practice in which he used to sit down so that the heel of 
his boot was pressed against the anal region. And in his 
memories we find a direct connection between foot and 
anus, in which the heel corresponded more or less to the 
male organ and the anus to the female organ. This 
connection was strengthened by his coprophilic pleasure in 
smell. His auto-erotism found abundant gratification in 
the odours of his own excretions and secretions. Such 
odours arising from the skin, the genital region, and the 
feet were pleasurable to him at an early age. In this way 
the foot was able to acquire genital significance in his 
unconscious phantasies. It may be mentioned with regard 
to his coprophilic pleasure in smell that many of his dreams 
had their setting in the w.c. or fulfilled anal-erotic desires 
by means of a transparent symbolism. A characteristic 
type of dream was one in which he put his nose between 
two big hemispheres. 

It has already been said that the patient's scoptophilic 
instinct was also chiefly directed on to excrement. He 
often used to dream of his father and brother in situations 
of this kind; and water occurred as a symbol in the majority 
of his dreams, of which the following is an interesting 
example. He was in a boat with his brother, going through 
a harbour. In order to get out of the harbour they had to 
pass through a peculiarly built passage, like a house on the 
water. Then they got into open water, but suddenly they 
were on dry land and the boat was passing down a street 
without touching the ground. Then they were floating 
along in the air, and a policeman was looking on at them. I 
will only say a few words about the interpretation of the 



134 SELECTED PAPERS OF KARL ABRAHAM V 

dream. The word * harbour ' (Haferi) contains a double 
meaning, since in certain dialects Hafen means chamber 
utensil. And the word 'boat* \?Schiff'~\ is very similar 
to a word vulgarly used for making water \^Schijfen ']. 
The passage out of the harbour reminded the dreamer of 
the tapering columns of the temple at Philae. Another 
association was * Colossus of Rhodes '. The Colossus 
represents a man standing with his legs apart over the 
entrance to the harbour of Rhodes. It reminded the patient 
of his father, whom he had seen urinating in a similar 
attitude. His subsequent voyage in the boat in company 
with his brother, and the part about the boat going through 
the air, were connected with a childhood memory which 
concerned a certain not infrequent contest among boys 
with respect to making water. The exhibitionistic factor 
in this dream was also of some importance; for the urinating 
was done in front of a policeman, and we know from 
experience that in dreams persons in authority signify the 
father. 

The extraordinarily rich dream-material which the 
patient supplied in the course of his analysis contained a 
great number of dreams with a similar theme. One can 
conclude from the amazing variety of these dreams that his 
phantasies were occupied in quite an unusual degree with a 
coprophilic pleasure in looking. It may be mentioned that 
he exhibited the typical character-traits of sublimated anal- 
erotism; pedantic economy and love of orderliness were 
especially prominent features. 

The degree to which the foot replaced the penis in the 
patient's mind was clearly seen in certain dreams of his, two 
of which I will briefly relate. In the one dream he was 
wearing slippers which were trodden down behind so that 
his heels were visible. This dream turned out to be an 
exhibitionistic dream. The heel was exposed to view as 
the sexual organs are in the ordinary exhibitionistic dream. 
The affect was the same as in typical exhibition dreams 
that are accompanied by anxiety. In the other dream he 
touched a woman with his foot and in this way dirtied her. 
This dream can be understood without further comment. 



A CASE OF FOOT AND CORSET FETISHISM 135 

It is now clear why the patient took particular interest 
in the high heels of women's shoes. The heel of the shoe 
corresponded to the heel of the foot a part of the body 
which, in virtue of the displacement referred to, had taken 
on the significance of a male genital. Thus the patient's 
predilection for women's feet and their covering, and more 
especially the heels, prolonged his infantile sexual interest 
in the supposed penis of the female. 

The facts brought forward here only represent a small 
part of those which his analysis furnished, but they seem 
to me sufficient to show that the foot can be a substitute for 
the genitals. The patient's scoptophilic and osphresiophilic 
instincts, which had been particularly directed to excreta 
from the first, had undergone far-reaching though certainly 
very dissimilar alterations. His osphresiophilic instinct 
had been repressed to a great extent, whereas his scopto- 
philic instinct had been very much accentuated but at the 
same time diverted from its original sphere of interest and 
idealized. To this latter process, which only- affected the 
second of the two instincts in question, we can apply 
Freud's term of 'partial repression ', 

Since having had this case I have more than once had 
an opportunity of analysing fetishistic traits in neurotics 
where such traits have formed secondary symptoms; and 
in every case I have come to the same conclusions concern- 
ing the importance of those instincts which formed the 
basis of the fetishistic symptoms in the present case. On 
account of this uniformity in my results I do not propose to 
bring forward new material from these later cases. 

A few words must be said about the therapeutic effect 
of psycho-analysis in the present case and in other cases of 
fetishism. I did not succeed in removing the fetishistic 
symptoms in this particular case ; but the analytic interpreta- 
tion succeeded in very greatly diminishing the power which 
the patient's sexual abnormality had hitherto exercised over 
him. ' His power of resistance against the attraction of 
women's shoes, etc., was considerably increased, and normal 
sexual instincts often emerged during his analysis. I do 
not think it impossible that if the treatment had been 



136 SELECTED PAPERS OF KARL ABRAHAM V 

persevered with, a gradual strengthening of the normal 
libido would have been achieved. 

The therapeutic outlook seems to me more favourable 
in less pronounced cases, as, for instance, when certain 
fetishistic symptoms accompany a neurosis. A case of this 
kind which I analysed recently seemed to show that psycho- 
analysis can remove both the neurotic and the fetishistic 
symptoms and can bring about a normal sexual attitude in 
the patient. 



CHAPTER VI 

NOTES ON THE PSYCHO-ANALYTICAL IN- 
VESTIGATION AND TREATMENT OF 
MANIC - DEPRESSIVE INSANITY AND 
ALLIED CONDITIONS^ (1911) 

WHEREAS states of morbid anxiety have been dealt 
with in detail in the literature of psycho-analysis, 
depressive states have hitherto received less atten- 
tion. Nevertheless the affect of depression is as widely 
spread among all forms of neuroses and psychoses as is 
that of anxiety. The two affects are often present together 
or successively in one individual ; so that a patient suffering 
from an anxiety-neurosis will be subject to states of mental 
depression, and a melancholic will complain of having 
anxiety. 

One of the earliest results of Freud's investigation of 
the neuroses was the discovery that neurotic anxiety origi- 
nated from sexual repression; and this origin served to 
differentiate it from ordinary fear. In the same way we 
can distinguish between the affect of sadness or grief and 
neurotic depression, the latter being unconsciously moti- 
vated and a consequence of repression. 

Anxiety and depression are related to each other in the 
same way as are fear and grief. We fear a coming evil; 
we grieve over one that has occurred. A neurotic will be 
attacked with anxiety when his instinct strives for a grati- 
fication which repression prevents him from attaining; 
depression sets in when he has to give up his sexual aim 

1 [No. 26, A. B.] 

137 



138 SELECTED PAPERS OF fcARL ABRAHAM VI 

without having obtained gratification. He feels himself 
unloved and incapable of loving, and therefore he despairs 
of his life and his future. This affect lasts until the cause 
of it ceases to operate, either through an actual change in 
his situation or through a psychological modification of the 
displeasurable ideas with which he is faced. Every neurotic 
state of depression, just like every anxiety-state, to which 
it is closely related, contains a tendency to deny life. 

These remarks contain very little that is new to those 
who regard the neuroses from the Freudian point of view, 
although surprisingly little has been written in the literature 
of psycho-analysis concerning the psychology of neurotic 
depression. But the affect of depression in the sphere of 
the psychoses awaits more precise investigation. This task 
is complicated by the fact that a good part of the diseases 
in question run a * cyclical ' course in which there is an 
alteration between melancholic and manic states. The few 
preliminary studies l which have hitherto been published 
have only dealt with one of these two phases at a time. 

During the last few years I have met with six undoubted 
cases of this kind in my practice. Two of these were light 
manic-depressive cases (so-called cyclothymia), one of whom 
I treated only for a short time. The third, a female patient, 
suffered from short but rapidly recurring states of depression 
accompanied by typical melancholic symptoms. Two more 
had succumbed to a depressive psychosis for the first time, 
but had previously shown a tendency to slight changes of 
mood in a manic or depressive direction. The last patient 
had been overtaken by a severe and obstinate psychosis at 
the age of forty-five. 

Most psychiatrists, following Kraepelin, do not con- 
sider states of depression as belonging to manic-depressive 
insanity if they come on after the patient's fortieth year. 
Nevertheless, as the analysis proceeded this last case dis- 
closed such a marked similarity in its psychic structure to 
those cases which did undoubtedly belong to the manic- 

1 Maeder, * Psychoanalyse bei einer melancholischen Depression ' (1910). Brill, 
*Ein Fall von periodischer Depression psychogenen Ursprungs ' (1911). Jones, 
* Psycho- Analytic Notes on a Case of Hypo mania * (1910). 



1911 NOTES ON MANIC-DEPRESSIVE INSANITY 139 

depressive insanities that I should certainly class it in 
that group. I do not, however, intend this as a statement 
of opinion concerning the line of demarcation between the 
two psychoses. And I do not wish to discuss states of 
depression occurring in dementia praecox. 

Even in my first analysis of a depressive psychosis I 
was immediately struck by its structural similarity with an 
obsessional neurosis. In obsessional neurotics l I refer 
to severe cases the libido cannot develop in a normal 
manner, because two different tendencies hatred and love 
are always interfering with each other. The tendency 
such a person has to adopt a hostile attitude towards 
the external world is so great that his capacity for love is 
reduced to a minimum. At the same time he is weakened 
and deprived of his energy through the repression of his 
hatred or, to be more correct, through repression of the 
originally over-strong sadistic component of his libido. 
There is a similar uncertainty in his choice of object as 
regards its sex. His inability to establish his libido in a 
definite position causes him to have a general feeling of 
uncertainty and leads to doubting mania. He is neither 
able to form a resolution nor to make a clear judgement; 
in every situation he suffers from feelings of inadequacy 
and stands helpless before the problems of life. 

I will now give as briefly as possible the history of a 
case of cyclothymia as it appeared after a successful analysis 
had been made. 

The patient remembered that his sexual instinct had 
shown itself very precociously before he was in his sixth 
year and had set in with great violence. His first sexual 
object at that time had been a governess whose presence 
had excited him. She still figured very vividly in his 
phantasies. His emotional excitement had led him to 
practise onanism, which he had done by lying on his 
stomach and making rubbing movements. He had been 
discovered doing this by his nurse (formerly his wet-nurse), 
who expressly forbade him to do it, and whipped him when- 

1 The following brief description adheres closely to Freud's characterization in 
his paper, ' Notes upon a Case of Obsessional Neurosis ' (1909). 



I4O SELECTED PAPERS OF KARL ABRAHAM VI 

ever he disobeyed her. She also impressed upon him the 
fact that he would suffer for it all his life. Later, when he 
was at school he had been attracted in an erotic way by a 
school-fellow for a period of several years. 

In his childhood and later he had never felt satisfied 
at home. He always had the impression that his parents 
favoured his elder brother, who was unusually clever, while 
he had only an average intelligence. He also believed 
that his younger brother, who was delicate, received greater 
attention from his mother than he did. The result of this 
was that he had a hostile attitude towards his parents, and 
one of jealousy and hatred towards his brothers. The 
intensity of this hate can be seen from a couple of impulsive 
acts which he carried out in his childhood. On two occasions 
when quarrelling over trifles he had become very violent 
towards his younger brother, and had knocked him 
down and seriously hurt him. Such violence is particularly 
remarkable when we learn that at school he was always the 
smallest and weakest among his contemporaries. He never 
made any real companions, but generally kept to himself. 
He was industrious, but had little to show for it. At 
puberty it became evident that his sexual instinct, which 
at first had shown itself so strongly, had become paralysed 
through repression. In contrast to his attitude in child- 
hood he did not feel attracted to the female sex. His 
sexual activity was the same that he had carried out in 
childhood; but he did not perform it in the waking state 
but only in his sleep or half-asleep. He had no friends. 
He was quite aware of his lack of real energy when he 
compared himself with others. He found no encourage- 
ment at home ; on the contrary, his father used to say con- 
temptuous things about him in his presence. Added to 
all these depressing factors he suffered a definite psychic 
trauma: a teacher had the brutality to call him a physical 
and mental cripple in front of the whole class. His first 
attack of depression appeared soon after this. 

Even later on he made no companions. He kept 
away from them intentionally, too, because he was afraid 
of being thought an inferior sort of person. Children 



igil NOTES ON MANIC-DEPRESSIVE INSANITY 14! 

were the only human beings he got on well with and liked, 
because with them he did not have his usual feeling of 
inadequacy. His life was a solitary one. He was posi- 
tively afraid of women. He was capable of normal sexual 
intercourse, but had no inclination for it and failed to 
obtain gratification from it. His onanistic practices in his 
sleep were his chief sexual activity even in later years. He 
showed little energy in practical life; it was always difficult 
for him to form a resolution or to come to a decision in 
difficult situations. 

Up to this point the patient's history coincided in all 
its details with what we find in obsessional neurotics. 
Nevertheless, we do not find obsessional symptoms in him 
but a circular parathymia that had recurred many times 
during the last twenty years. 

In his depressive phase the patient's frame of mind 
was ' depressed ' or * apathetic ' (I reproduce his own 
words) according to the severity of his condition. He was 
inhibited, had to force himself to do the simplest things, 
and spoke slowly and softly. He wished he was dead, 
and entertained thoughts of suicide. His thoughts had a 
depressive content. He would often say to himself, * I 
am an outcast ', * I am accursed ', * I am branded ', * I do 
not belong to the world '. He had an indefinite feeling 
that his state of depression was a punishment. He felt 
non-existent and would often imagine himself disappearing 
from the world without leaving a trace. During these 
states of mind he suffered from exhaustion, anxiety and 
feelings of pressure in the head. The depressive phase 
generally lasted some weeks, though it was of shorter 
duration at times. The intensity of the depression varied 
in different attacks; he would have perhaps two or three 
marked states of melancholy and probably six or more 
slighter ones in the course of a year. His depression 
gradually increased during the course of an attack until it 
reached a certain height, where it remained for a time, and 
then gradually diminished. This process was conscious to 
him and perceptible to other people. 

When the patient was about twenty-eight years old a 



142 SELECTED PAPERS OF KARL ABRAHAM VI 

condition of hypomania appeared, and this now alternated 
with his depressive attacks. At the commencement of this 
manic phase he would be roused out of his apathy and 
would become mentally active and gradually even over- 
active. He used to do a great deal, knew no fatigue, woke 
early in the morning, and concerned himself with plans 
connected with his career. He became enterprising and 
believed himself capable of performing great things, was 
talkative and inclined to laugh and joke and make puns. 
He noticed himself that his thoughts had something 
volatile in them; a slight degree of ' flight of ideas* could 
be observed. He spoke more quickly, more forcibly and 
louder than usual. His frame of mind was cheerful and 
a little elevated. At the height of his manic phase his 
euphoria tended to pass over into irritability and impulsive 
violence. If, for example, some one disturbed him in his 
work, or stepped in his way, or drove a motor-car quickly 
past him, he responded with a violent affect of anger and 
felt inclined to knock the offender down on the spot. 
While in this state he used often to become involved in 
real quarrels in which he behaved very unfeelingly. In 
the periods of* depression he slept well but during the manic 
phase he was very restless, especially during the second 
half of the night. Nearly every night a sexual excitement 
used to overtake him with sudden violence. 

Although his libido had appeared very early and with 
great force in his childhood, the patient had for the most 
part lost the capacity for loving or hating. He had become 
incapable of loving, in the same manner as the obsessional 
neurotic. Although he was not impotent, he did not 
obtain actual sexual enjoyment, and he used to get greater 
satisfaction from a pollution than coitus. His sexual 
activities were in the main restricted to his sleep. In this, 
like the neurotic, he showed an auto-erotic tendency to 
isolate himself from the external world. People of this 
kind can only enjoy pleasure in complete seclusion; every 
living being, every inanimate object, is a disturbing element. 
It is only when they have achieved the complete exclusion 
of every external impression as is the case when they are 



NOTES ON MANIC-DEPRESSIVE INSANITY 143 

asleep that they can enjoy a gratification of their sexual 
wishes, by dreaming them. Our patient expressed this in 
the following words : ' I feel happiest in bed ; then I feel 
as though I were in my own house V 

At puberty in especial the patient was made aware that 
he was behind his companions of the same age in many 
important respects. He had never felt their equal physi- 
cally. He had also been afraid of being inferior mentally, 
especially in comparison with his elder brother. And now 
the feeling of sexual inadequacy was added. It was 
precisely at this time that his teacher's criticism ' (a mental 
and physical cripple ') struck him like a blow. Its great 
effect was explained by the fact that it recalled to his 
memory the prophecy of his wet-nurse, when she had 
threatened him with lifelong unhappiness because of his 
masturbation. Just when he was entering upon manhood 
therefore, and ought to have had masculine feelings like his 
companions, his old feelings of inadequacy received a power- 
ful reinforcement. It was in this connection that he had 
had the first state of depression he could recollect. 

As we so often see in the obsessional neuroses, the 
outbreak of the real illness occurred when the patient had 
to make a final decision about his attitude towards the 
external world and the future application of his libido. In 
my other analyses a similar conflict had brought on the 
first state of depression. For example, one of my patients 
had become engaged to be married ; soon afterwards a 
feeling of incapacity to love overcame him, and he fell into 
a severe melancholic depression. 

In every one of these cases it could be discovered that 
the disease proceeded from an attitude of hate which 
was paralysing the patient's capacity to love. As in the 
obsessional neuroses, other conflicts in the instinctual life 
of the patients as well can be shown to be factors in the 
psychogenesis of the illness. I should like to mention 
especially the patient's uncertainty as to his sexual role in 

1 I might remark that the other male patients whose depressive psychoses I was 
able to analyse behaved in the same way. None of them were impotent, but they 
had all derived more pleasure from auto-erotic behaviour all along, and to have any 
relations with women was a difficult and troublesome business for them. 



144 SELECTED PAPERS OF KARL ABRAHAM VI 

this connection. In Maeder's case l a conflict of this kind 
between a male and female attitude was particularly pro- 
nounced; and in two of my patients I found a condition 
surprisingly similar to that described by him. 

In their further development, however, the two diseases 
diverge from each other. The obsessional neurosis creates 
substitutive aims in place of the original unattainable 
sexual aims; and the symptoms of mental compulsion are 
connected with the carrying out of such substitutive aims. 
The development of the depressive psychoses is different. 
In this case repression is followed by a process of * projec- 
tion* with which we are familiar from our knowledge of 
the psychogenesis of certain mental disturbances. 

In his c Psycho-Analytic Notes upon an Autobiographical 
Account of a Case of Paranoia (Dementia Paranoides)' Freud 
gives a definite formulation of the psychogenesis of paranoia. 
He sets out in short formulae the stages which lead up to 
the final construction of the paranoic delusion. I will 
here attempt to give a similar formulation of the genesis 
of the depressive psychoses, on the basis of my analyses of 
depressive mental disturbances. 

Freud considers that in a large portion at least of cases 
of paranoic delusions the nucleus of the conflict lies in 
homosexual wish-phantasies, i.e. in the patient's love of a 
person of the same sex. The formula for this is: 'I (a 
man) love him (a man)'. This attitude raises objections in 
the patient and is loudly contradicted, so that the statement 
runs: 4 I do not love him, I hate him'. Since internal 
perceptions are replaced by external ones in paranoia, this 
hatred is represented as a result of the hatred endured 
by the patient from without, and the third formula is : 
* I do not love him I hate him because he persecutes 
me'. 

In the psychoses with which we are here concerned a 
different conflict lies concealed. It is derived from an 
attitude of the libido in which hatred predominates. This 
attitude is first directed against the person's nearest relatives 
and becomes generalized later on. It can be expressed in 

1 [See footnote, p. 138.] 



igil NOTES ON MANIC-DEPRESSIVE INSANITY 145 

the following formula: * I cannot love people; I have to 
hate them '. 

The pronounced feelings of inadequacy from which 
such patients suffer arise from this discomforting internal 
perception. If the content of the perception is repressed 
and projected externally, the patient gets the idea that he is 
not loved by his environment but hated by it (again first 
of all by his parents, etc., and then by a wider circle of 
people). This idea is detached from its primary causal 
connection with his own attitude of hate, and is brought 
into - association with other psychical and physical 
deficiencies. 1 It seems as though a great quantity of such 
feelings of inferiority favoured the formation of depressive 
states. 

Thus we obtain the second formula : ' People do not 
love me, they hate me ... because of my inborn defects. 2 
Therefore I am unhappy and depressed/ 

The repressed sadistic impulses do not remain quiescent, 
however. They show a tendency to return into conscious- 
ness and appear again in various forms in dreams and 
symptomatic acts, but especially in an inclination to annoy 
other people, in violent desires for revenge or in criminal 
impulses. These symptomatic states are not usually 
apparent to direct observation, because for the most part 
they are not put into action ; but a deeper insight into the 
patient's mind as afforded in the catamnesis, for instance 
will bring a great deal of this kind of thing to light. 
And if they are overlooked in the depressive phase there is 
more opportunity for observing them in the manic one. 
I shall have more to say about this subject later on. 

It is more especially in regard to such desires to commit 
acts of violence or revenge that the patients have a tendency 
to ascribe their feelings to the torturing consciousness of 
their own physical or psychical defects, instead of to their 
imperfectly repressed sadism. Every patient who belongs 
to the manic-depressive group inclines to draw the same 

1 In many cases, and particularly in the slighter ones, the original connection 
is only partly lost; but even so the tendency to displacement is clearly recognizable. 

2 Cf. with this the etymology of the German word hdsslich (* ugly ') * that 
which arouses hate '. 

K 



146 SELECTED PAPERS OF KARL ABRAHAM VI 

conclusion as Richard III., who enumerates all his own 
failings with pitiless self-cruelty and then sums up : 

And therefore, since I cannot prove a lover . , . 
I am determined to prove a villain. 

Richard cannot love by reason of his defects which 
make him hateful to others; and he wants to be revenged 
for this. Each of our patients wishes to do the same, but 
cannot, because his instinctual activity is paralysed by 
repression. 

New and morbid states, such as feelings of guilt, 
result from the suppression of these frequent impulses 
of hatred and revenge. Experience so far seems to show 
that the more violent were the person's unconscious impulses 
of revenge the more marked is his tendency to form 
delusional ideas of guilt. Such delusions, as is well known, 
may attain enormous proportions, so that the patient 
declares that he alone has been guilty of all sins since the 
world began, or that all wickedness originates from him 
alone. In these persons an insatiable sadism directed 
towards all persons and all things has been repressed in the 
unconscious. The idea of such an enormous guilt is of 
course extremely painful to their consciousness; for where 
there is a great degree of repressed sadism there will be a 
corresponding severity in the depressive affect. Neverthe- 
less the idea of guilt contains the fulfilment of a wish 
of the repressed wish to be a criminal of the deepest dye, 
to have incurred more guilt than everyone else put together. 
This, too, reminds us of certain psychic processes in 
obsessional neurotics, as, for instance, their belief in the 
* omnipotence ' of their thoughts. They frequently suffer 
from anxiety lest they have been guilty of the death of a 
certain person by having thought about his death. The 
sadistic impulses are repressed in the obsessional neurotic 
also: because he cannot act in conformity with his original 
instincts he unconsciously gives himself up to phantasies 
of being able to kill by means of thoughts. This wish does 
not appear as such in consciousness but it takes the form 
of a tormenting anxiety. 



IQII NOTES ON MANIC-DEPRESSIVE INSANITY 147 

As a result of the repression of sadism, depression, 
anxiety, and self-reproach arise. But if such an important 
source of pleasure from which the active instincts flow is 
obstructed there is bound to be a reinforcement of the 
masochistic tendencies. The patient will adopt a passive 
attitude, and will obtain pleasure from his suffering and 
from continually thinking about himself. Thus even the 
deepest melancholic distress contains a hidden source of 
pleasure. 

Before the actual state of depression sets in many 
patidnts are more than usually energetic in their pursuits 
and manner of life. They often sublimate in a forced 
manner libido which they cannot direct to its true purpose. 
They do this so as to shut their eyes to the conflict within 
them, and to ward off the depressive frame of mind which is 
tending to break into consciousness. This attitude often 
succeeds for long periods, but never completely. The 
person who has to combat disturbing influences for a long 
time can never enjoy peace or security within himself. 
Any situation which requires a definite decision in the field 
of the libido will cause a sudden collapse of his psychic 
equilibrium which he has so laboriously kept up. When 
the state of depression breaks out his previous interests 
(sublimations) suddenly cease; and this leads to a narrow- 
ing of his mental outlook which may become so pronounced 
as to attain to monoideism. 

When the depressive psychosis has become manifest 
its cardinal feature seems to be a mental inhibition which 
renders a rapport between the patient and the external 
world more difficult. Incapable of making a lasting and 
positive application of his libido, the patient unconsciously 
seeks seclusion from the world, and his auto-erotic trend 
manifests itself in his inhibition. There are other means, 
it is true, by which neuroses and psychoses can give symp- 
tomatic expression to an auto-erotic tendency. That it 
should be inhibition rather than some other symptom that 
appears in this case is fully explained from the fact that 
the inhibition is able to serve other unconscious tendencies 
at the same time. I refer in particular to the tendency 



148 SELECTED PAPERS OF KARL ABRAHAM VI 

towards a ' negation of life '. The higher degrees of 
inhibition in especial i.e. depressive stupor represent a 
symbolic dying. The patient does not react even to the 
application of strong external stimuli, just as though he were 
no longer alive. It is to be expressly noted that in the 
foregoing remarks only two causes of the inhibition have 
been considered. In every case analysis revealed still 
further determinants, connected with the individual circum- 
stances of the patient. 

Certain features commonly present in states of depres- 
sion become comprehensible if we accept the well-founded 
conclusions of psycho-analytic experience. Take, for in- 
stance, the frequent ideas of impoverishment. The patient 
complains, let us say, that he and his family are exposed to 
starvation. If a pecuniary loss has actually preceded the 
onset of his illness, he will assert that he cannot possibly 
endure the blow and that he is completely ruined. These 
strange ideas, which often entirely dominate the patient's 
thoughts, are explicable from the identification of libido 
and money of sexual and pecuniary 'power' 1 with 
which we are so familiar. The patient's libido has dis- 
appeared from the world, as it were. Whereas other 
people can invest their libido in the objects of the external 
world he has no such capital to expend. His feeling of 
poverty springs from a repressed perception of his own 
incapacity to love. 

We very frequently meet with fears or pronounced 
delusions centering round the same idea in states of de- 
pression connected with the period of involution. As far 
as my not very extensive psycho-analytical experience of 
these conditions goes, I have reason to believe that it is 
people whose erotic life has been without gratification who 
are liable to such delusions. In the preceding decade of 
their life they had repressed this fact and had taken refuge 
in all kinds of compensations. But their repressions are 
not able to cope with the upheaval of the climacteric. 
They now pass in review, as it were, their wasted life, and 

1 [The German word used, Vermogen, means both ' wealth ' and * capacity ' 
in the sense of sexual potency. Trans.'] 



NOTES ON MANIC-DEPRESSIVE INSANITY 149 

at the same time feel that it is too late to alter it. Their 
consciousness strongly resists all ideas connected with this 
fact; but not being strong enough to banish them com- 
pletely, it has to allow them entrance in a disguised form. 
They are still painful in the form of a delusion of impoverish- 
ment, but not as intolerable as before. 

Viewed externally, the manic phase of the cyclical dis- 
turbances is the- complete opposite of the depressive one, 
A manic psychotic appears very cheerful on the surface; 
and unless a deeper investigation is carried out by psycho- 
andlytic methods it might appear that the two phases are 
the opposite of each other even as regards their content. 
Psycho-analysis shows, however, that both phases are 
dominated by the same complexes, and that it is only the 
patient's attitude towards those complexes which is different. 
In the depressive state he allows himself to be weighed down 
by his complex, and sees no other way out of his misery but 
death ; l in the manic state he treats the complex with 
indifference. 

The onset of the mania occurs when repression is no 
longer able to resist the assaults of the repressed instincts. 
The patient, especially in cases of severe maniacal excita- 
tion, is as if swept off his feet by them. It is especially 
important to notice that positive and negative libido (love 
and hate, erotic desires and agressive hostility) surge up 
into consciousness with equal force. 

This manic state, in which libidinal impulses of both 
kinds have access to consciousness, once more establishes a 
condition which the patient has experienced before in his 
early childhood, that is. Whereas in the depressive patient 
everything tends to the negation of life, to death, in the 
manic patient life begins anew. The manic patient returns 
to a stage in which his impulses had not succumbed to 
repression, in which he foresaw nothing of the approaching 
conflict. It is characteristic that such patients often say 
that they feel themselves ' as though new-born '. Mania 
contains the fulfilment of Faust's wish : 

1 Some patients cling to the idea that they can be cured by the fulfilment of 
some external condition usually one, however, which never can be fulfilled. 



I5O SELECTED PAPERS OF KARL ABRAHAM VI 

Bring back my passion's unquenched fires, 

The heavenly smart of bliss restore ; 
Hate's strength the steel of love's desires 

Bring back the youth I was once more. 

The maniac's frame of mind differs both from normal 
and from depressive states, partly in its care-free and un- 
restrained cheerfulness, partly in its increased irritability 
and feeling of self-importance. The one or the other altera- 
tion can predominate according to the individuality of the 
patient or the different stages of the disease, 

The affect of pleasure in mania is derived from the same 
source as is that of pleasure in wit. What I have to say 
about this is therefore in close agreement with Freud's 
theory of wit. 1 

Whereas the melancholiac exhibits a state of general 
inhibition, in the manic patient even normal inhibitions 
of the instincts are partly or wholly abolished. The 
saving of expenditure in inhibition thus effected be- 
comes a source of pleasure, and moreover a lasting one, 
while wit only causes a transitory suspension of the 
inhibitions. 

Economy of inhibition is, however, by no means the 
only source of manic pleasure. The removal of inhibitions 
renders accessible once more old sources of pleasure which 
had been suppressed; and this shows how deeply mania is 
rooted in the infantile. 

The technique of the manic production of thoughts 
may be regarded as a third source of pleasure. Abolition 
of logical control and playing with words two essential 
features of manic ideational processes indicate an exten- 
sive * return to infantile freedom '. 

Melancholic inhibition of thought finds its reverse in 
the manic flight of ideas. In the melancholic phase there 
is a narrowing of the circle of ideas, in the manic phase a 
rapid change of the content of consciousness. The essential 
difference between flight of ideas and normal thinking is 
that whereas in thinking or speaking the healthy person 
consistently keeps in view the aim of his mental processes 

1 Der Wit% and seine Bexiehung xum Unbewussten, 1905. 



NOTES ON MANIC-DEPRESSIVE INSANITY I I 

the manic patient very easily loses sight of that aim, 1 This 
differentiation serves to characterize the external aspect of 
the flight of ideas, but not its significance for the manic 
subject. It is especially to be noted that the flight of ideas 
offers the patient considerable possibilities for obtaining 
pleasure. As has already been said, psychic work is 
economized where the abolition of logical control is re- 
moved and where the sound instead of the sense has to be 
considered. But the flight of ideas has yet another function, 
and a double one: it makes it possible to glide by means 
of light allusions over those ideas that are painful to con- 
sciousness, for example, ideas of inadequacy; that is to say, 
it favours like wit transition to another circle of ideas. 
And it also permits of playful allusion to pleasurable things 
which are as a rule suppressed. 

The similarity between the mind of the maniac and that 
of the child is characterized in a number of ways of which 
only one need be mentioned in this place. In the slighter 
states of manic exaltation the patient has a kind of careless 
gaiety which bears an obviously childish character. The 
psychiatrist who has had much to do with such patients can 
clearly see that his rapport with them is the same as with 
a child of about five years of age. 

The severer forms of mania resemble a frenzy of 
freedom. The sadistic component-instinct is freed from 
its fetters. All reserve disappears, and a tendency to 
reckless and aggressive conduct takes its place. In this 
stage the maniac reacts to trifling occurrences with violent 
outbursts of anger and with excessive feelings of revenge. 
In the same way, when his exaltation had reached a certain 
height, the cyclothymic patient mentioned above used to 
feel an impulse to strike down anyone who did not at once 
make way for him in the street. The patients often have 
an excessive feeling of power, measuring it not by actual 
performance but by the violence of their instincts, which 
they are now able to perceive in an unusual degree. Fairly 
frequently there appear grandiose ideas which are very similar 
to children's boasts about their knowledge and power. 

1 Liepmann, Uber Ideenflucht (1904). 



152 SELECTED PAPERS OF KARL ABRAHAM VI 

Arising from the case of cyclothymia already described 
at length, there is one important question which I cannot 
attempt to answer definitely. It remains to be explained 
why, when the patient was about twenty-eight, states of 
manic exaltation should have appeared in addition to the 
depressive state which had already existed for a long time. 
It may be that it was a case where psychosexual puberty 
followed a long time after physical maturity. We often 
see the development of instinctual life delayed in a similar 
manner in neurotics. On this hypothesis the patient would 
not have experienced an increase of his instinctual life at 
puberty but have been overtaken, like a woman, by a wave 
of repression; and it would only have been towards the 
end of his third decade that a certain awakening of his 
instincts would have occurred in the form of the first manic 
state. And in fact it was at that age that his sexual interests 
turned more to the female sex and less towards auto-erotism 
than before. 

I must now say a few words about the therapeutic 
effects of psycho-analysis. 

The case I have most fully reported in these pages was 
so far analysed at the time when I read my paper at Weimar 1 
that its structure was apparent in general. But there still 
remained a great deal of work to be done on it; and thera- 
peutic results were only just beginning to be discernible. 
These have become more clearly visible during the last two 
and a half months. Naturally a definite opinion as regards 
a cure cannot yet be given, for after twenty years of illness, 
interrupted by free intervals of varying length, an improve- 
ment of two months' duration signifies very little. But 
I should like to record the result up to the present. In 
the period mentioned, no further state of depression has 
appeared, and the last one passed off very easily. In con- 
sequence of this the patient has been able to do continuous 
work. During the same period there did twice occur a 
changed frame of mind in a manic direction, which could 
not escape a careful observation ; but it was of a far milder 
character than his previous states of exaltation. And, 

1 [See No. 26, A. B.] 



NOTES ON MANIC-DEPRESSIVE INSANITY 153 

besides this, certain hitherto regularly observed phenomena 
were absent. Between these last two manic phases there has 
been no depressive one, as was usually the case, but a state 
which could be called normal, since no cyclothymic pheno- 
mena were present. For the rest we shall have to follow 
the further course of the case. There is only one more 
thing I should like to add: If the patient succeeds in 
permanently maintaining a state similar to that of the last 
two months, even this partial improvement will be of 
great value to him. In the other case of cyclothymia the 
period of observation has been too short to permit of an 
opinion regarding therapeutic results. But its pathological 
structure was found to be remarkably similar to that of the 
first case. 

The third case described at the beginning of this paper 
showed the effectiveness of analysis in a striking manner, 
in spite of the fact that external circumstances obliged the 
treatment to cease after about forty sittings. Even in the 
early part of the treatment I was able to cut short a melan- 
cholic depression which had just developed in the patient, 
a thing which had never happened before ; and as treatment 
proceeded its effect became more lasting and expressed 
itself in a distinct amelioration in the patient's frame of mind, 
and in a considerable increase of his capacity for work. In 
the months following the cessation of his analysis his state 
of mind did not sink back to its former level. It may be 
noted that in this case the preponderating attitude of hatred, 
the feeling of incapacity to love and the association of depres- 
sion with feelings of inadequacy were clearly to be seen. 

In the two above-mentioned cases of a melancholic 
depression occurring for the first time, a consistent analysis 
could not be carried out on account of external difficulties. 
Nevertheless, its effect was unmistakable. By the help of 
a psycho-analytical interpretation of certain facts and 
connections I succeeded in attaining a greater psychic 
rapport with the patients than I had ever previously achieved. 
It is usually extraordinarily difficult to establish a trans- 
ference in these patients who have turned away from all 
the world in their depression. Psycho-analysis, which has 



154 SELECTED PAPERS OF KARL ABRAHAM VI 

hitherto enabled us to overcome this obstacle, seems to me 
for this reason to be the only rational therapy to apply to 
the manic-depressive psychoses. 

The sixth case confirms this view with greater certainty, 
since I was able to carry the treatment through to the end, 
It had a remarkably good result. The patient came to me 
for treatment fifteen months after the onset of his trouble. 
Before this, treatment in various sanatoria had had only a 
palliative effect in relieving one or two symptoms. A few 
weeks after the commencement of psycho-analytic treat- 
ment the patient felt occasional relief. His severe depression 
began to subside after four weeks. He said that at moments 
he had a feeling of hope that he would once again be 
capable of work. He attained a certain degree of insight 
and said : * I am so egoistic now that I consider my fate 
the most tragic in the world '. In the third month of 
treatment his frame of mind was freer on the whole; his 
various forms of mental expression were not all so greatly 
inhibited, and there were whole days on which he used to 
feel well and occupy himself with plans for the future. 
At this time he once said with reference to his frame of 
mind: ' When it is all right I am happier and more care-free 
than I have ever been before '. In the fourth month he 
said that he had no more actual feelings of depression. 
During the fifth month, in which the sittings no longer took 
place daily, distinct variations in his condition were notice- 
able, but the tendency to improvement was unmistakable. 
In the sixth month he was able to discontinue the treatment; 
and the change for the better in him was noticeable to his 
acquaintances. Since then six months have passed without 
his having had a relapse. 

From a diagnostic point of view the case was quite 
clearly a depressive psychosis and not a neurosis of the 
climacteric period. I am unfortunately unable to publish 
details of the case; they are of such a peculiar kind that 
the incognito of the patient could not be preserved if I did. 
There are also other considerations which necessitate a 
quite special discretion a fact which is greatly to be 
regretted from a scientific point of view. 



NOTES ON MANIC-DEPRESSIVE INSANITY 155 

There is one objection that might be raised regarding 
the therapeutic results obtained in this case, and that is 
that I had begun treating it precisely at that period when 
the melancholia was passing off, and that it would have 
been cured without my doing anything; and from this it 
would follow that psycho-analysis did not possess that 
therapeutic value which I attribute to it. In answer to 
this I may say that I have all along been careful to avoid 
falling into an error of this kind. When I undertook the 
treatment I had before me a patient who was to all appear- 
ances unsusceptible to external influence and who had 
quite broken down under his illness ; and I was very 
sceptical as to the result of the treatment. I was the more 
astonished when, after overcoming considerable resistances, 
I succeeded in explaining certain ideas that completely 
dominated the patient, and observed the effect of this 
interpretative work. This initial improvement and every 
subsequent one followed directly upon the removal of 
definite products of repression. During the whole course 
of the analysis I could most distinctly observe that the 
patient's improvement went hand in hand with the progress 
of his analysis. 

In thus communicating the scientific and practical results 
of my psycho-analyses of psychoses showing exaltation and 
depression I am quite aware of their incompleteness, and I 
hasten to point out these defects myself. I am not in a 
position to give as much weight to my observations as I 
could have wished, since I cannot submit a detailed report 
of the cases analysed. I have already mentioned the 
reasons for this in one of the cases. In three other very 
instructive cases motives of discretion likewise prevented 
me from communicating any details. Nor will intelligent 
criticism reproach me for adopting this course. Those 
who take a serious interest in psycho-analysis will make 
good the deficiencies in my work by their own independent 
investigations. That further investigations are very greatly 
needed I am fully aware. Certain questions have not been 
considered at all or only barely touched upon in this paper. 
For instance, although we have been able to recognize up 



156 SELECTED PAPERS OF KARL ABRAHAM VI 

to what point the psychogenesis of obsessional neuroses 
and cyclical psychoses resemble each other, we have not 
the least idea why at this point one group of individuals 
should take one path and the other group another. 

One thing more may be said concerning the therapeutic 
aspect of the question. In those patients who have pro- 
longed free intervals between their manic or depressive 
attacks, psycho-analysis should be begun during that free 
period. The advantage is obvious, for analysis cannot be 
carried out on severely inhibited melancholic patients or 
on inattentive maniacal ones. 

Although our results at present are incomplete, it is 
only psycho-analysis that will reveal the hidden structure 
of this large group of mental diseases. And moreover, 
its first therapeutic results in this sphere justify us in the 
expectation that it may be reserved for psycho-analysis to 
lead psychiatry out of the impasse of therapeutic nihilism. 



CHAPTER VII 

A COMPLICATED CEREMONIAL FOUND 
IN NEUROTIC WOMEN i (1912) 

SEVERAL years ago Freud published a short paper 2 in 
which he discussed the relation between obsessional 
neurosis and religious practices. Ordinary observa- 
tion shows us that very many neurotics and not only 
obsessional ones carry on in private a cult which in its 
various forms reminds us of religious rites and ceremonies, 
and that they repeat some of these practices day by day 
with the same regularity and fixed procedure with which a 
religious community will repeat its prayers every morning 
and evening. 

Although there is a very wide scope for individual 
difference in a private cult of this kind, we often find 
persons making use of the same or of very similar neurotic 
ceremonials, notwithstanding that they come from entirely 
different social circles, and differ completely in their way 
of life, the circumstances in which they are placed, their 
intellectual abilities, and their opinions. This applies 
particularly to the simplest forms of ceremonial. For 
example, there is the very prevalent compulsion of having 
to step in a certain way on the flagstones of the pavement; 
and there is the equally frequent compulsion to count one's 
steps in walking or going upstairs and to end up with an 
even number. This compulsion has to do with ideas of 
fairness, and is also an over-compensation for certain 
forbidden impulses. But this is a subject we cannot enter 
into any further in this place. 

1 [No. 32, A. B.] 2 ' Obsessive Acts and Religious Practices f (1907). 

157 



158 SELECTED PAPERS OF KARL ABRAHAM VII 

The coincidence is far more striking, however, when 
we meet a really complicated ceremonial in one neurotic 
woman, and soon afterwards find an almost identical one 
in another female patient of quite a different character and 
unacquainted with the first patient. In this paper I shall 
discuss a coinciding ceremonial of this kind that has not as 
yet been described. I shall relate from the analysis of the 
first case as much as is necessary for an understanding of it, 
and shall only refer to those features of the second case 
which deviate in a characteristic way from the first. 

For certain reasons, which I shall give later, the patient, 
Frau Z., spontaneously told me the following facts in the 
course of her psycho-analysis. She said that whenever she 
went to bed she used to get herself ready with extreme care 
and in a most methodical fashion. She used to be especially 
careful about her hair being tidy; she used to undo it and 
then bind it up with a white ribbon. She gave as a reason 
for her ceremonial (this first description of which was an 
incomplete one) that she might happen to die suddenly 
in the night and that she would not like to be found in an 
untidy or unprepossessing condition. 

At the next sitting she supplemented the above de- 
scription, and said that she did her hair at night in the same 
way as she had worn it when quite a young girl. After 
overcoming perceptible resistances she went on to say that 
when she lay down she was careful that her bed should be 
in as perfect order as possible. She would often wake up 
in the night and straighten her nightdress and bedclothes 
if they had become disarranged. She would then be able 
to go to sleep again, but would always wake up after a little 
while and go through the same performance. Up to the 
present it had been impossible for her to forego any part of 
this procedure. 

The motives for her peculiar behaviour were for the 
most part unconscious, and they are not comprehensible on 
the face of them. So far we are only able to translate 
some part of this symbolic mode of expression into our own 
language. It is clear that Frau Z. expected her death 
every night, and that at the same time she put herself back 



IQI2 A COMPLICATED CEREMONIAL 159 

into the period of her childhood. The white ribbon she 
used to put in her hair points to bridal innocence and also 
to death. She was anxious that no signs of disorder should 
be found about her or her bed when she was dead that is, 
that no doubt could arise as to her bridal chastity. 

Further light was thrown on the meaning of the cere- 
monial from the circumstances in which the patient first 
mentioned it. After having told me of a very pronounced 
phobia of snakes that she had, she one day related a dream 
in which she had seen a little girl playing with a snake. 
From certain things about the girl she concluded on waking 
that the girl represented herself. Soon after, she said that 
latterly almost every night she had started up from sleep 
in great anxiety fearing that there was a big snake in her 
bed. During the analysis of this anxiety she always spoke 
of the ' big snake '. 

Her associations to the above dream led first of all to 
her elder brother who was dead and of whom she had been 
extraordinarily fond. She mentioned that as children they 
had daily seen each other naked while dressing, undressing, 
and in the bath; and that they had slept in the same room 
and had often got into each other's beds. Further associa- 
tions led to the subject of her later disgust of the male 
body. 

She related about her brother that he had been very 
imaginative as a boy and used to be quite absorbed in stories 
about Red Indians. He used to sleep on a shield he had 
made himself, and had adopted the name of a certain young 
Indian. After she told me this a * blank ' occurred, and she 
could not remember the name of the ' last of the Mohicans ' 
(it was * Uncas '). This disturbance of memory could only 
have had the purpose of preventing her thoughts from 
going any further in that direction. In this case, however, 
it was not difficult to establish the associations against 
whose recovery her resistance was directed. In Fennimore 
Cooper's story the father of Uncas is called ' Chingach- 
gook', which means ' Big Snake'. 

The interpretation of the dream in which the patient 
was a little girl and played with a snake now presents no 



l6o SELECTED PAPERS OF KARL ABRAHAM VII 

difficulties: she was playing with the genital organ of her 
brother, which was still small and infantile. A question in 
which boys and girls alike are much interested is whether 
the penis is very much bigger in the adult man (above all 
in the father) than in the boy. Children tend to have an 
exaggerated idea of its size. Stekel has alluded to this 
tendency in his monograph on nervous anxiety-states. In 
Freud's 'Analysis of a Phobia in a Five-year-old Boy ', the 
child's idea of the immense size of a man's penis plays a 
significant part. 

The 4 big ' snake, in contrast to the still infantile penis 
of her brother, can now be understood to refer to the penis 
of an adult man. In the patient's fear of finding a * big 
snake ' in her bed we recognize in the first place the typical 
anxiety of neurotic women regarding the male organ. But 
the constant recurrence of the term * big snake ' points 
quite definitely towards her father. The patient's analysis 
had already furnished material in this sense which could now 
be added to. It appeared that she had been intensely 
fixated upon her father from early childhood, and more 
especially since the early death of her mother. He was the 
chief object of her repressed sexual phantasies. In her eyes 
he was the only real man; no one else, she was convinced, 
could ever satisfy her. She had watched his behaviour to 
other people with great jealousy. Strong affects appeared 
when she related how after her mother's death she had slept 
for a short time near her father, and how he occasionally used 
to pass through her bedroom. Her father died when she 
reached the age of puberty. And it was in the same manner 
that she used to wear her hair at that period that she now 
dressed it with such painstaking care every evening. 

We can now understand her ceremonial to a great 
extent. In it she took herself back to a time when her 
father was still alive. It was he whom she was expecting 
every night. When she used to wake out of her sleep and 
imagine that the * big snake ' was in her bed, she was 
experiencing the fulfilment of her incestuous wishes directed 
to her father a fulfilment which, of course, could only 
take place to the accompaniment of violent anxiety. Her 



A COMPLICATED CEREMONIAL l6l 

repressed wish to have a child by her father, moreover, 
came to light as well, but in another connection. 

The patient was in fact married, but in her unconscious 
mind she rejected marriage with any other man but her 
father. She exhibited every imaginable sign of sexual 
aversion in evidence of this. Her phantasies removed her 
so far from reality that every evening she was able to attire 
herself as a young girl and a bride and thus give proof of 
her loyalty to the dead father whom she awaited. In her 
unconscious she was attached to him alone. 

It is true that consciously she expected, not her father, 
but death. But her analysis showed that the two ideas 
were identical. Assaults and acts of violence played a large 
part in her phantasies, and especially in her dreams. Her 
attitude in them was a masochistic one. She expected to 
be killed by a sexual attack on the part of a man, i.e. her 
father. She experienced in phantasy the fate of the Asra, 
' who die when they love '. Thus bridal garment and 
shroud, bridal bed and death-bed, were identified in her 
mind and were able to represent each other in the creations 
of her unconscious phantasy. 

It is to be noted that the repressing forces as well as the 
repressed incestuous wishes had participated in the forma- 
tion of her ceremonial. At the same time as she was con- 
tinually expecting a sexual attack in her unconscious she 
yet had always to keep her bed and night attire properly 
arranged so as to prove that her death had been preceded 
by no sexual act. 

Although the symbol of the snake did not come into 
the ceremonial itself, it occupied an important place in the 
ideatiorial material belonging to it and had a manifold 
determination. It was not merely a symbolic substitute 
for the male genital. A snake is able to kill by means of 
its poisonous bite, hence as a symbol it can give expression 
both to coitus and to death phantasies. In connection with 
this it is to be noted that a snake enfolds and crushes its 
victim. Death from a snake is thus death in an embrace. 
Moreover, the ideas of ' snake ' and ' worm ' are closely 
associated in unconscious thought. A worm is also a male 

L 



1 62 SELECTED PAPERS OF KARL ABRAHAM VII 

sexual symbol 1 and a death symbol as well. In the present 
case the patient's anxiety contained a childhood memory. 
When she was nine years old she and a boy had moved 
away a stone in a churchyard, and she had been terrified 
to see a quantity of worms under the stone. The thought 
of this scene still caused her the greatest anxiety. 

Her fear of the snake had yet another exceedingly 
important basis. The snake was for her the totem animal 
of her dead father. Her childhood fear of her father was 
transferred to this symbol. This was also connected with 
a definite memory of childhood. When she was about 
nine years old she had been very much afraid of her father's 
eye. We know from many instances that in folk-psychology 
the glance of a snake is considered especially dreadful. 
Thus her identification of father and snake is seen to be 
still further determined. 

The statements of the second patient showed that she 
too had observed a strict ceremonial each night for many 
years. After taking off her clothes, she would arrange 
them with the greatest possible neatness. Then she would 
lie down on her back, smooth the bedclothes and her night 
attire in an exceedingly careful manner, cross her arms 
over her breasts and force herself to lie as motionless as 
possible so that her position and clothes should remain 
undisturbed. As an explanation of this procedure she gave 
exactly the same reason as the first patient, viz. that she 
might die in the night, and nothing must be found in an 
untidy or slovenly condition about her. The reason for 
crossing her arms was that that was the way people's arms 
were placed when they were dead. She used also to arrange 
her hair in a particular way. This latter procedure she 
quite consciously explained by saying that she wanted to be 
certain what arrangement of her hair would best please a 
man if she were to be married later. This explanation 
was a satisfactory one in so far as it betrayed the erotic 
substratum of the ceremonial. But she put off her erotic 
expectation and placed it in an indefinite future, whereas 
she fixed her expectation of death in the next few hours. 

1 In neurotics worm phobias are usually found as well as snake phobias. 



igi2 A COMPLICATED CEREMONIAL 163 

The process of displacement was quite obvious in this case. 
Unfortunately, it was not possible to carry out a full psycho- 
analysis of this patient, so that I can say nothing definite 
concerning the connection of her ceremonial with her father 
complex. But the situation seemed to be very similar to 
the one in the first case. 

Complicated actions of a similar character to the ones 
described here will presumably be found in neurotics quite 
frequently once attention has been directed to them. I 
refer particularly to those persons who before going to 
sleep are compelled to arrange their clothes in an absolutely 
fixed way which must never be departed from. 

As a name for the form of ceremonial analysed above 
I would suggest * The Bride of Death Ceremonial '. 



CHAPTER VIII 

MENTAL AFTER-EFFECTS PRODUCED IN A 
NINE-YEAR-OLD CHILD BY THE OBSER- 
VATION OF SEXUAL INTERCOURSE BE- 
TWEEN ITS PARENTS^ (1913) 

THE editor of this Journal has asked for accounts of 
dreams occurring in childhood the interpretation 
of which would justify the conclusion that the 
dreamer had witnessed sexual intercourse at an early age. 
The following contribution only in part satisfies this request, 
in that in this case the observation of parental sexual inter- 
course did not take place in the earliest years of childhood, 
but in all probability took place immediately before the 
occurrence of the dream which I am about to relate and of 
the concomitant neurotic anxiety. Nevertheless, I consider 
it worth publishing, because the case shows with more than 
usual clearness how a child disposed to neurosis reacts to an 
event of this nature. 

Some time ago I was called in to see a little girl of nine 
and three-quarters who had recently begun to suffer from 
anxiety states. 

Ten days before the consultation the child had been put 
to bed as usual in the evening. After having slept for a 
good hour she called for her mother with screams of fear, 
Her mother, who was in the next room, went to her, and the 
little girl told her a dream with every sign of terror. She 
said : * A man wanted to murder you in bed, but I saved 
you'. While relating this she still could not distinguish 

1 [No. 42, A. B.] 
164 



1913 THE OBSERVATION OF SEXUAL INTERCOURSE 165 

between dream and reality. When her mother tried to 
soothe her she said with a horrified expression, ' Oh, you 
aren't my mother at all '. She then showed fear of objects 
in the room, mistaking them for animals. It was some 
time before she could be pacified; but she then slept till 
morning. On waking she declared that she had slept well 
and undisturbed during the night, and that she felt quite 
well. When her parents questioned her cautiously (and 
hence only superficially) it appeared that she did not remem- 
ber the episode. 

Thus in this case there had been a severe anxiety-dream 
followed by a twilight state. There was no family history 
of epilepsy, nor did the child show any symptoms that 
pointed directly to the existence of mental disorder in the 
narrower sense of the word. As a result of the further 
development of her condition and of my examination of her 
I was able to diagnose a hysterical twilight state. 

During the next few days the patient showed various 
symptoms of illness. She was very nervous and inclined 
to start. In speaking with her mother she often used to 
talk in a way which resembled the paralalia of Ganser. 
She used to have pronounced anxiety in the evening. Once 
or twice she had visions of animals. On the occasion of 
my visit, for instance, she told me that she had been terri- 
fied by a snake which had crawled into her bed and tried 
to bite her leg; and she was afraid to go to the w.c, because 
there were black men there who threatened her with their 
fingers. She also exhibited a marked astasia abasia and 
fear of falling as an accompanying phenomenon. This 
disturbance reacted to the influence of suggestion to the 
extent that I was able to conduct her across the room 
only lightly holding her sleeve. In the end she was able 
to return to the bed alone without falling, although she 
staggered. No symptoms of an organic paralysis were 
present. 

In answer to my inquiries the patient told me that 
latterly she had often had anxiety-dreams. When I asked 
her to relate one of these dreams she immediately gave the 
one quoted above, although she had not been previously 



1 66 SELECTED PAPERS OF KARL ABRAHAM VIII 

reminded of it by her parents. Her amnesia in regard to 
the evening on which her illness had begun was therefore 
only a partial one. 

As I had only been called in for a consultation with the 
patient, I had to content myself with making a diagnosis of 
the state in which I found her, and with applying some 
therapeutic measures to calm her. 

With the help of the child's father I endeavoured to 
gain further knowledge regarding the aetiology of her 
illness. Her anxiety-dream had at once led me to suspect 
that she had witnessed sexual intercourse between her 
parents, and that she had re-modelled the impression in a 
typical childish manner, in accordance with a sadistic theory 
of coitus, and had then re-enacted the scene in her dream. 
(It is to be noted that she slept in her parents' bedroom.) 
I accordingly told her father my suspicions, and briefly 
gave my reasons for them. He at once took my point and 
said that he quite agreed with my view, adding that the 
little girl would also in recent times have heard occasional 
quarrels going on between her parents after they had gone 
to bed. Thus those quarrels would furnish a further 
determinant besides the sexual one for her idea that her 
mother was being murdered. 

The foregoing case clearly shows an attitude in the 
girl which is analogous to the Oedipus complex of the boy. 
The daughter dreams of an attempt upon her mother's 
life. The meaning of the phantasy is not altered by the 
fact that the dreamer * saves ' her mother. Even if this 
was not made clear from the well-known meaning of rescue- 
phantasies, it is only necessary to point out that the patient 
disowned her mother immediately after the dream ; she 
got rid of her in a way with which we are familiar in 
4 phantasies of descent '. 

In a waking hallucination, furthermore, she saw a 
snake, a male symbol obviously representing her father, 
approaching her. 1 Her statement that * the snake wanted 
to bite her leg ' was made with distinct hesitation and an 
altered expression of countenance. She seemed to be con- 

1 Cf. the preceding chapter. 



THE OBSERVATION OF SEXUAL INTERCOURSE 167 

cealing something. Probably she named her leg in place 
of her genitals, in the same way that the stork is said to bite 
a woman's leg. 

When, as is the case here, the parental complex appears 
in so acute and intense a form and, for the psycho-analyst, 
beneath so transparent a disguise, it justifies us in the 
conclusion that some affective experience connected with 
the parents has influenced the child. Both the external 
circumstances and her father's account tended to show that 
immediately before the appearance of her symptoms the 
child had observed parental intercourse. Of course it was 
not possible to question her directly in the first and only 
consultation. 

This episode, however, could not be a sufficient cause 
in itself for such a serious state of illness. Moreover, the 
connection between certain symptoms and that particular 
psychic trauma was, to say the least, uncertain. 1 Con- 
versation with the father brought further material to light. 
It appeared that the child was accustomed to associate with 
a neighbour's daughter who was said to practise mutual 
masturbation with other girls. It is probable, therefore, 
that, excited by sexual acts and conversations with this 
friend, she had reacted much more violently to the incident 
in her parents' room than she might otherwise have done. 
Her dread of figures making threatening gestures at once 
suggests a sense of guilt; and as far as our experience goes 
we can say that in all probability this could be traced to 
the practice of forbidden sexual acts. That she should 
have seen these figures in the w.c. is a fact of some interest, 
for this place is the most frequent scene of children's secret 
and forbidden acts. 

This fragmentary analysis is particularly disappointing 
in one respect. The patient's associations usually direct 
our attention to early infantile wishes and impressions from 
which the neurotic symptoms develop. In this case, 
however, it was not possible to investigate the deeper strata 
of the patient's unconscious. I am inclined to think that 

1 I have purposely omitted an interpretation of certain symptoms because 
sufficient evidence was not forthcoming. 



1 68 SELECTED PAPERS OF KARL ABRAHAM VIII 

such an investigation would have shown that the recent 
experience from which she was suffering had received its 
most important reinforcement from her unconscious, i.e. 
from repressed memories of a like nature belonging to the 
first period of childhood. But as I have said, satisfactory 
proof of this was not obtainable. 

I think we may come to the conclusion that in this case 
the child's observation of parental coitus had been the 
exciting cause of her psycho-neurotic attack, the first notice- 
able symptom of which was a severe anxiety-dream followed 
1 * i * i 

by a twilight state. 



CHAPTER IX 

RESTRICTIONS AND TRANSFORMATIONS OF 
SCOPTOPHILIA IN PSYCHO-NEUROTICS; 
WITH REMARKS ON ANALOGOUS PHEN- 
OMENA IN FOLK-PSYCHOLOGY 1 (1913) 

THE sexual component-instinct of scoptophilia,- or 
pleasure in looking, is like its counterpart, ex- 
hibitionism, or pleasure in displaying subject to 
numerous restrictions and transformations. Under normal 
conditions both instincts, which are allowed free expression 
in early childhood, are subjected to a considerable measure 
of repression and sublimation later on. In psycho-neurotics 
these instincts are inhibited and transformed to a very much 
greater degree than in normal people; while at the same 
time they carry on a continual struggle against the forces 
of repression. 

In a short paper 2 Freud has laid down certain lines of 
thought which open the way to a deeper insight into the 
neurotic inhibitions and transformations of the scopto- 
philic instinct. He makes use of his theory of the eroto- 
genic zones and component-instincts, and speaks as follows 
concerning the scoptophilic instinct and its erotogenic zone, 
the eyes: * The eyes perceive not only those modifications 
in the external world which are of import for the preserva- 
tion of life, but also the attributes of objects by means of 
which these may be exalted as objects of erotic selection, 

1 [No. 43, A. B.] 

2 * Psychogenic Visual Disturbance according to Psycho- Analytical Concep- 
tions ' (1910). 

169 



I7O SELECTED PAPERS OF KARL ABRAHAM IX 

their " charms ". We now perceive the truth of the saying 
that it is never easy to serve two masters at the same time. 
The more intimate the relation of an organ possessing such 
a duality of function with one of the great instincts, the 
more will it refuse itself to the other.' 

If this scoptophilic impulse has become too strong, or 
is directed on to forbidden objects, then a conflict in the 
subject's instinctual life results. In the same paper Freud 
says: ' If the sexual component-instinct which makes use 
of sight the sexual " lust of the eye " has drawn down 
upon itself, through its exorbitant demands, some re- 
taliatory measure from the side of the ego-instincts, so that 
the ideas which represent the content of its strivings are 
subjected to repression and withheld from consciousness, 
the general relation of the eye and the faculty of vision to 
thd ego and to consciousness is radically disturbed. The 
ego has lost control of the organ, which now becomes solely 
the instrument of the repressed sexual impulse. It would 
appear as though repression on the part of the ego had gone 
too far and poured away the baby with the bath-water, for 
the ego now flatly refuses to see anything at all, since the 
sexual interests in looking have so deeply involved the 
faculty of vision. The other representation of the situation, 
however, is probably closer to the facts, the aspect in which 
we see the active part in the process played by the repressed 
scoptophilia. It is the revenge, the indemnification of the 
repressed impulse, thus withheld from further psychical 
development, that it can succeed in so boldly asserting its 
mastery over the organ which serves it. The loss of 
conscious control over the organ is a detrimental substitute- 
formation for the miscarried repression, which was only 
possible at this cost.' 

Freud brings forward as the motive for such a far- 
reaching repression of scoptophilia the law of talion, i.e. 
self-punishment for the pleasure got from looking at a 
forbidden object. 

This is the first advance made by psycho-analysis into 
a large though little explored region. And it is the object 
of this paper to penetrate further into that region, where 



TRANSFORMATIONS OF SCOPTOPHILIA 

a great mass of material awaits careful investigation. 
Hysterical blindness, which Freud has chosen as the standard 
of neurotic disturbances of vision, is only one form though 
a particularly striking one of neurotic disturbance associ- 
ated with the instinct of looking. It is not very often 
met with in medical practice. During the last six years I 
have not come across a single unmistakable example of it, 
though I have observed that certain other disturbances 
some of which have not been written about at all occur 
comparatively often. 

From the clinical point of view these latter disturbances 
consist partly of a transformation of scoptophilia into a 
specific fear of exercising the instinct, partly of disturbances 
of vision and partly of neurotic symptoms which occur in 
the eye without being directly related to the sense of 
sight. In the following pages I shall not endeavour 
merely to add to our knowledge of the symptomatology 
of this affection on the basis of psycho-analytical investi- 
gation. I shall go beyond this purely medical interest and 
attempt to explain certain phenomena of folk psychology 
in the light of the results obtained in the field of individual 
psychology. 

For the sake of conciseness and clarity I shall limit my 
inquiry to the manifestations of scoptophilia and leave aside 
the consideration of exhibitionism. I am well aware that 
it would be more correct to treat the two instincts and their 
effects together, in the same way that Rank has done in 
his excellent work, 1 But since the neurotic symptoms 
which I am about to consider arise for the most part from 
repressed scoptophilic instincts, I feel justified in con- 
fining my investigation to this one side of the question. 

i. Neurotic Photophobia 

The analysis of a disturbance which I should like to 
call ' neurotic photophobia ' affords information of a par- 
ticularly instructive nature. This is by no means a rare 
affection, and it has received some attention in non-analytic 

1 ' Die Nacktheit in Sage und Dichtung ' (1913). 



SELECTED PAPERS OF KARL ABRAHAM IX 

literature. I have had the opportunity of observing several 
clear cases of this kind and of making a thorough analysis 
of most of them. These patients showed other symptoms 
which also originated in the repression of their scopto- 
philia, and I will include a psycho-analytical explanation of 
these as well in my discussion of their major symptom of 
photophobia. 

Persons who suffer from a photophobia of this kind 
find sunlight, daylight, and usually artificial light disagree- 
able. They even feel dazzled by a feeble light. Some 
of them complaimof a more or less violent pain in the eyes 
as soon as they are exposed to light, even if it is only for a 
short time. They will protect their eyes from light by all 
sorts of means. But they not only show a sensitiveness of 
the eyes to a light-stimulus but react to it with an aversion 
which has all the characteristics of neurotic anxiety. In 
pronounced cases they will protect their eyes from every 
ray of light in just as careful a manner as a neurotic person 
who suffers from fear of touching will preserve his hands 
from contact with an object. The ideational content of 
their anxiety is the danger that they may be blinded. 

Psycho-analytic literature has hitherto given no special 
consideration to the disturbances which I have thus briefly 
described, and yet it contains an important clue to our 
understanding of them. In his postscript to his * Psycho- 
Analytic Notes upon an Autobiographical Account of a Case 
of Paranoia * Freud has given a psycho-analytical interpreta- 
tion of a delusion of a psychotic patient, Dr. Schreber, 1 who 
declared that he could bear the light of the sun for several 
minutes without being dazzled. 2 It could be gathered from 
the patient's attitude to the sun an attitude which he de- 
scribed in all its remarkable details that it signified for 
him a ' sublimated father-symbol ', With reference to the 
ordeals imposed as tests of parentage among so many 
peoples, Freud concludes : * When Schreber boasts that 
he can look into the sun without being punished and 
without being dazzled, he has rediscovered the mythological 

1 Cf. his Denkwiirdigkeiten eines Nervenkranken, S. 139, Anm. 
* I have also met with the same delusion in other psychotic persons. 



19*3 TRANSFORMATIONS OF SCOPTOPHILIA 173 

method of expressing his filial relation to the sun, and has 
confirmed us once again in our view that the sun is a symbol 
of the father'. 

Schreber's delusion is the exact psychotic counterpart 
to a neurotic photophobia. The healthy individual re- 
acts, within certain limits, without any special sensitiveness 
to light falling on his eyes, and nevertheless instinctively 
protects himself efficiently from a glaring light ; the mentally 
affected person fancies he will not succumb to the blinding 
effect of the brightest sunlight; while the neurotic person 
is alarmed to an exaggerated degree at the risk of being 
blinded, so that he may truly be said to suffer from sun 
phobia, 

I should now like to give certain details from the psycho- 
analysis of a young man which may help to explain this 
aversion to light as well as certain phenomena closely 
related to it. 

The patient, whom I will call A, came to consult me 
about a disturbance of his sexual potency and a profound 
depression of spirits. At the commencement of the treat- 
ment he was in a state of great dejection. He had formerly 
been very much engaged in all that was going on around him, 
but he had now lost all interest in the people about him, 
in his vocation, his amusements, etc. His mental activity 
was becoming more and more restricted to neurotic brooding. 
On further investigation it transpired that the eye and 
the function of vision played a striking part in his mental 
life, that certain ideas in this connection caused him anxiety, 
that a sexual perversion from which he suffered likewise 
referred to the eye, and finally, that he was troubled with a 
pronounced photophobia. 

The severity of such a disturbance can be judged from 
the protective measures which the patients adopt against 
the object of their anxiety. In this case the patient pro- 
tected himself against broad daylight by tightly screwing up 
his eyes and by similar methods which he carried to far 
greater lengths than any normal person would do. He 
protected himself in a similar manner against artificial light 
in the evening. But the method he adopted to exclude 



174 SELECTED PAPERS OF KARL ABRAHAM IX 

any ray of light from reaching him at night after he had 
gone to bed was more striking still and decidedly patho- 
logical. He had hung up three thicknesses of curtain over 
his bedroom window so that no ray of light could penetrate 
in the morning; and to prevent any artificial light from 
coming in he had not only blocked up the keyhole of his 
bedroom door, but had carefully filled up the minutest 
cracks in the panels. 

At the beginning of his analysis other material came to 
the surface, and it was not until a month had passed that 
I was able to obtain any information about his numerous 
thoughts connected with the eye. This delay in itself 
tended to show that the thoughts relating to that subject 
were particularly painful to him. And the further course 
of his analysis proved this to be so, for it appeared that 
those thoughts were very closely associated with repressed 
incestuous wishes. 

In connection with this aversion to light the patient 
told me some more things. He said that he had a kind 
of obsessional anxiety that either he or one of his relatives 
might lose an eye. He was extremely sensitive to anything 
coming near his eyes. He was also very interested in 
affections of the eye in other people. He said: * People 
who have something wrong with their eyes compel my 
interest '. Girls who wore pince-nez were a source of 
great interest to him, and he was always on the look-out 
for girls who were blind in one eye. When he met women 
whose eyes were quite normal he ' persuaded himself that 
they were blind in one eye '. Once he had a dream about 
a girl with whom he was acquainted and who was blind 
in one eye, in which he thought that her eye had been 
knocked out by her father, so that the latter had been 
responsible for her partial blindness. 

It soon transpired that the patient's anxiety concerning 
the eyesight of other persons referred in the first instance 
to his father, towards whom, as had already become clear, 
he had a distinctly ambivalent attitude. He had first 
expressed this attitude by speaking of his ' ardent respect ' 
for his father; but no sooner had he said this than there 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 175 

occurred a sudden 4 breaking off ' of his thoughts and a 
short suspension of consciousness. Soon after, ideas of an 
opposite character occurred to him, such as phantasies of 
the death and burial of his father. He next complained 
about his failure in life, and said that his father literally 
weighed him down. He could not help recognizing the 
superior intellectual capacities of his father, who occupied a 
high position in his native town. He felt it was impossible 
for him ever to be his father's equal or superior. He had 
often wished to do or to know something better than his 
father, yet he had always had to acknowledge the latter's 
superiority. This made him feel that he was in his father's 
power. It had always been impossible for him to conceal 
anything from him, for he had seen everything. The 
patient's anxiety about his father's eyesight is now no longer 
entirely incomprehensible to us. It is in the first place a 
distorted expression of his wish to be removed from the 
observant eye of his father. 

At this point the patient produced one or two free 
associations between * father ' and * sun ' without being 
himself aware of the connection. He identified his father's 
watchful eye with the sun, an identification which was 
confirmed later on by numerous examples, one of which I 
will give here. It was the following recollection, which 
occurred to him accompanied with strong affect : When he 
had been at school he had regarded a certain poem as 
' disgusting '. In this poem, which was about a wicked 
man whose crime was unexpectedly brought home to him 
in the end, each verse ended with the words, ' The sun 
will bring the deed to light '. x 

But the sun had yet a second meaning as the repre- 
sentative of his father. For his attitude towards his father 
was not solely traceable to the latter's role of ' watcher ', 
to his ' omniscience ', one might almost say. This 
second determinant was his enthusiastic appreciation of his 
father's * greatness ' his intelligence, his knowledge, his 

1 The patient had also transferred to the sun his ambivalent attitude towards 
his father in a remarkable way. He disliked the light of the sun but he loved its 
warmth. 



176 SELECTED PAPERS OF KARL ABRAHAM IX 

4 ability V Burdened as he was with a sense of insufficiency, 
he compared his father's power and superiority with the 
splendour of the sun. He felt that his father's light 
would always outshine his own importance, just as the sun 
outshines the other stars. Yet in spite of his excessive 
praise of his father, his jealousy of him was unmistakable. 2 
When the patient's unconscious fused the idea of the 
paternal eye with that of paternal splendour, in order to 
give both a common symbolic expression in the sun, it 
did no more than primitive peoples have done from time 
immemorial. 

The function of watching over things has been fre- 
quently ascribed to the sun-god. In the Homeric poems, 
for example, Helios is constantly called * he who sees and 
hears all things '. 3 

In Psalm xix, which clearly contains the remains of an 
old hymn to the sun, we find the following verse: * His 
[i.e. the sun's, originally the sun-god's] going forth is from 
the end of the heaven, and his circuit unto the ends of it : 
and there is nothing hid from the heat thereof. 

The material of folk-psychology provides a great many 
parallels to such an identification of the eye of the father 
with the splendour or light of the sun. I will take a few 
examples from language. Although such examples are 
widely found in different languages, I will limit myself to 
those that occur in German. 

The most obvious example is the word Augenlicht 
['eyesight'. Augen^ eyes'; Licht^' light']. In reality 
the eyes perceive the light; language, however, makes it 
appear as though the light belonged to or originated in the 
eyes. The use of the word blind [' blind '] is interesting. 

1 I need only allude to the disturbance of potency mentioned at the beginning 
in order to render the patient's jealousy regarding his father's ' ability ' compre- 
hensible. I was able to substantiate the fact more clearly in other cases (cf. case B) 
than in this, that the sun represented not only the greatness, in other words, the 
potency, of the father, but that it was a symbol of the father's phallus. Aversion to 
the sight of the latter is also known to us as a phenomenon of folk psychology (cf. 
the Biblical tale of Noah's sons). 

* As will be shown later, the elevation of his father to the sun signified not only 
an increase but at the same time a reduction of his power. 

3 We may especially notice the passage in the Odyssey (viii. 266) where Helios 
observes the forbidden meeting of Ares and Aphrodite. 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 177 

It refers not only to a person who has lost the power of 
sight, who cannot see, but frequently also to a person or 
thing that is not seen. For instance, we speak of a blinde 
Passagier [' stowaway ']. It is also customary to denote 
as blind an object that has lost its lustre. This shows that 
our language identifies sehend [' seeing '] and glanzend 
[* shining ']. There is no doubt that these peculiarities 
of speech have originated in the ' antithetical meaning of 
primal words * (Abel). In a short paper x Freud has shown 
that antithetical ideas are paired off in the unconscious of 
the individual in the same way as they are in the primitive 
stages of language, traces of which still persist in its later 
stages. 

The patient's dread of his father's observing eye found 
an important extension in his avoidance of looking at his 
mother. He had in fact consciously imposed upon himself 
a prohibition of looking at her. From adolescence onwards 
he had refused as he expressed it to think that his mother 
was beautiful. At the time of the treatment he still shrank 
from seeing any portion of his mother's body uncovered 
except her face and hands. Even seeing her in a blouse 
with an open-work neck used to cause him great distress. 

It then came out that the sun whose sight the patient 
shrank from was a bisexual symbol for him. It not only 
represented his father (i.e. his watchful eye or his shining 
splendour) but also his mother, whom he must not look at 
for fear of calling down upon himself his father's anger. 
In this as other cases the prohibition of looking at his 
mother originated in the more particular prohibition of 
seeing her naked, and in especial of seeing her genitals. 
The idea of not being allowed to look at her was changed 
into the fear of not being able to look at the light of the sun. 

This bisexuality of the sun symbol appears in Schreber's 
case, too. In his Denkwurdigkeiten there is one place in 
which he shouts at the sun, reviling it in the words, ' The 
sun is a whore '. Here there can be no doubt of the female 
character of the sun symbol. 

Without going deeper into the prohibition of looking 

1 * The Antithetical Sense of Primal Words * (1910). 

M 



178 SELECTED PAPERS OF KARL ABRAHAM IX 

at the mother's body in this place, I will only say that accord- 
ing to my experience a particular avoidance of seeing even 
unimportant parts of the mother's body proceeds from a 
repressed pleasure in looking, which was originally directed 
in an excessive degree towards the mother, and especially 
towards her genitals. 

The patient's pleasure in looking at other women was 
inclined to be more than ordinarily great, but was not 
directed to those parts of their body which normally act as 
stimuli. He had a pronounced aversion to their genitals. 
His scoptophilia was directed in the first instance to two 
parts of the body far removed from the genitals, namely, to 
the eyes and the feet. Even these parts of the body were 
not themselves permitted to play the role assigned to them 
through the process of displacement, but had to yield it to 
accessory parts that did not belong to the body itself. Thus 
girls who wore glasses or who had a false leg would attract 
him most of all; and a lame gait which suggested a stiff 
leg or an artificial limb would have the same effect on him. 
Yet his horror of the female genitals was most clearly seen 
in the fact that he never in reality touched a girl who was 
lame or who had an artificial leg. 

The patient's aversion to the female body, or, to be more 
correct, to the female genitals, was found to have many 
determinants, chief among which was his fear of castration. 
Of special interest was an associative chain which disclosed 
a close relation between the following affective states of mind: 

1 . His astonishment as a little child on discovering the 
absence of a penis in his small sister. 

2. His anxious avoidance of touching his own penis. 

3. The deflection of his interest from the female genitals. 

4. His interest in women who had had an amputation. 
This last interest in particular showed the extraordinary 

strength of his castration images, for it represented the 
woman * who has had a member cut off '. We find here, 
as is so often the case in our psycho-analyses, that the 
unconscious has retained the infantile idea that the woman 
possesses a penis, too. When this is so, the fear of being 
castrated is often present in conjunction with an idea of an 



TRANSFORMATIONS OF SCOPTOPHILIA 179 

active nature that of castrating women. I have alluded 
to this phenomenon in a paper concerned with the analysis 
of foot fetishism. 1 In the present case, too, there was 
pronounced fetishism. Considerations of space make it 
impossible for me to go into this in detail; but I should 
like to say a few words about the connection of foot and 
eye-glass fetishism with the sadistic component-instinct. 

One of the patient's most pleasurable phantasies was the 
idea of taking away her glasses from a short-sighted girl, or, 
better still, a one-eyed girl, or of depriving a young woman 
of her artificial leg, thereby making her helpless. 2 His 
associations made it more and more evident that these ideas 
concerned displaced castration phantasies. Particularly 
important in this connection was the dream described above 
about a girl he knew by sight who could only see with one 
eye. His idea in the dream was that her missing eye had 
been knocked out by her father. From here his associations 
led to his own fear of losing an eye. This anxiety arose 
from two sources, namely, the idea of punishment for for- 
bidden looking, and the displacement of castration anxiety 
from the genitals to the eye. This displacement is quite 
analogous to the one mentioned above from the female 
genitals to the eye. Both ideas clearly bear the signifi- 
cance of a talion. I have the satisfaction of knowing that 
my conclusions in this respect agree with Freud's views, 
and also with those of other analysts. 

Ferenczi 3 has recognized in the self-blinding of Oedipus 
a symbolic substitute for self-emasculation, i.e. self-punish- 
ment proportionate to incest. Rank 4 and other authors 5 

1 Cf. Chapter V. 

2 It may be mentioned that these sadistic instincts were limited to phantasies; 
in actual life the patient was extremely kind-hearted. 

8 'Symbolic Representation of the Pleasure and Reality Principles in the 
Oedipus Myth ' (1912). 

4 Rank, Inxestmotw (1912), S. 271, A. 2. Cf. also: Storfer, < Jungfrau und 
Dime.' 

5 Eder, ' Augentraume '. Gebsattel (Ztitschrift fiir Pathopsychologie, 1912). 
The significance of the eye as a female genital symbol has been considered by Jung 
in the Indra-Mythus. I myself, following Kleinpaul, have likewise recognized in 
the eye, especially the pupil, a female genital significance (Traum und Mythus, 
1909). Bleuler (Dementia pracox oder Gruppe der Schixophrenieri) likewise mentions 
the eye as a female genital symbol in the delusions of the insane. Jones (' Einige 
Falle von Zwangsneurose ', 1913) shows the male genital significance of the eye. 



l8o SELECTED PAPERS OF KARL ABRAHAM IX 

supply abundant material from dream analyses to show that 
the eye can have sometimes a male and sometimes a female 
genital significance; and Eder has shown that in dreams 
things done to the eyes signify as with the teeth 
castration. 1 

The correctness of this assumption was confirmed by 
further dreams of the patient in which castration was 
expressed by means of other symbols of less doubtful 
significance. For instance, in one of his dreams a person 
appeared and cut off his pubic hair. 

The ' punishment ' of blinding proved to be a reprisal 
for the patient's unlawful desire to look at his mother and 
for his active castration or blinding phantasy directed against 
his father. Analysis showed that this latter assault played 
a direct part in the patient's phantasies. In this connection 
I shall mention only one obsessive idea which he used to 
have. When he was a schoolboy and was having lessons 
with a particular master he constantly had to imagine how 
he would shoot him through the middle of the forehead. 
It was easily discovered that this master was a substitute 
for his father. 

Shooting through the forehead would in itself certainly 
not be an obvious castration symbol; and indeed it would 
not be necessary to devote any special attention to it here 
did there not exist many unmistakable proofs that the fore- 
head is frequently used as a substitute for the eye. In the 
first instance I may refer to the myth of the blinding of 
the Cyclops by Odysseus. Beings who possess only one eye 
which is situated in the centre of the forehead are everywhere 
found in myths. It is interesting to note that at times some- 
thing similar to the myth of Polyphemus occurs in dreams. 
Eder has published a dream of this kind. 2 I have fairly 
often had the opportunity of corroborating this fact, and I 
can confirm from experience Eder's observation that the 
Cyclops corresponds to the father of the dreamer, and that 
the blinding of the giant represents a castration of the father. 

1 In the dreams of women something done to the eye can have the significance 
of coitus. A young girl, for example, dreamed that someone was opening her eye 
with a long instrument. 

8 Eder, < Augentraume '. 



1913 TRANSFORMATIONS OF SCOPTOPHILIA l8l 

It seems to me a particularly interesting fact that the 
middle of the forehead, which in phantasy primarily repre- 
sents the eye, can stand either for the male or the female 
genitals. With regard to its significance as the male organ, 
I should like to refer to an observation of Reitler's ; * and 
with regard to its female significance to an example taken 
from my own experience. 

Reitler discusses certain wooden figures made by the 
peasants in the Salzkammergut that are used for obscene 
jokes, and he gives reproductions of them. The joke is 
that when the head of the figure is pressed a big penis 
appears. On the forehead of the figure a third eye is 
roughly sketched. Reitler ascertained that among the people 
of that district this eye is directly recognized as a penis 
symbol. 

As a parallel to this curious fact of folk psychology I 
may mention the following observation I have made myself: 
One of my patients suffered from a compulsion to wrinkle 
her forehead in the middle, thus making a vertical crease. 
She used then to violently to rub this crease with the fore- 
finger of her right hand. Certain associations, which I am 
unfortunately unable to reproduce here, suddenly made it 
clear to her that the procedure was simply an act of mastur- 
bation displaced upwards, and that the vertical crease on 
her forehead corresponded to the vulva. This idea was 
confirmed by the fact that when rubbing the crease she used 
to experience a * feeling of pressure in the lower part of her 
body'. 2 

It seems to me that whenever the genital symbolism of 
the eye has been discussed its significance as a female organ 
has so far alone been considered. It is only quite recently 
that I have come across the male significance of the eye. It 
was in a dream analysis, and the dreamer, a woman, said 
that the glans penis seemed to her like an eye, 

I return to the subject of the patient A's fear about his 
eyesight. We have recognized in his fears of castration 

1 Reitler, ' Zur Augensymbolik *, 1913. 

2 I might here refer to a statement of Sadger's that the temples have a genital 
significance. Cf. ' t) her sexualsymbolische Verwertung des Kopfschmerzes * ( 1 9 1 2). 



1 82 SELECTED PAPERS OF KARL ABRAHAM IX 

an important determinant of his anxiety; and in this con- 
nection it is worth while mentioning a further detail which 
at first sight might seem quite unimportant. I have noticed, 
not only in the case before us but also in others, that the 
patients always speak of their anxiety regarding the eye of 
their father, and of their avoidance of touching their own 
eye. They never spoke of their eyes but, with a regularity 
which excluded all chance, only of an eye, as though only 
one eye existed. This is quite intelligible if we keep 
in view the mechanism of ' displacement upwards '. 
* The ' eye is a substitute for an organ which only exists in 
the singular. 1 

Anxiety about the eye of the father therefore corresponds 
to the repressed castration phantasy directed against him. 
Having established the identity of the eye and sun, however, 
there can be little doubt that the sun has the same phallic 
significance as the eye of the father. Avoidance of the 
sight of the sun has therefore the further significance of 
shunning the sight of the father's penis. This meaning is 
borne out, incidentally, in folk psychology. 

It is not possible to enter further into the subject of 
castration-anxiety in this place ; but I will add a few remarks 
in order to render more intelligible certain facts that ap- 
peared in the present case. We have learnt that the boy's 
desire to see his mother's genitals, and also his castration 
phantasy directed against his father, belong to those offences 
for which he is threatened with castration by someone or 
fears it in his own mind. Masturbation should also be 
included in them, since the phantasies that accompany it 
make it a deeply guilty act. We know from our psycho- 
analytic work that there are also certain other experiences 
of childhood which frequently give rise to a great deal of 
self-reproach. I refer in especial to the child's observation 
of sexual intercourse between its parents. With regard to 

1 I might remark that there are still further determinants to be considered. 
I need only refer to the above-discussed identification of the eye of the father with 
the sun, which is only a single thing. We may assume that there is a special form 
of condensation, a unification, at work which renders possible a number of parallels : 
one genital, one father, one sun, and also one eye. (One might add one God. The 
reader is referred to later parts of this paper.) 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 183 

all these * sins ' the boy is often very fearful lest he should 
be discovered by his father's watchful eye. 1 

It is precisely on account of such forbidden observa- 
tions that many neurotic persons suffer from the fear of 
going blind. But this kind of neurotic reaction does not 
concern us at the moment. What I want to bring forward 
here is the fact that in quite a number of instances the 
pleasure the child has derived at night from watching its 
parents and listening to them has led to an over-sensitiveness 
both to light and to sound. 2 In the present case there was 
a definite sensitiveness to sound as well as to light. Both 
symptoms are especially liable to occur at night, and the 
reason for this is now readily understood. We see why 
the patient in question was afraid of artificial illumination 
and of the slightest ray of light which might happen to 
penetrate through a crack in the door. The extreme 
precautions he adopted so as to exclude any light from 
without are of the nature of prohibitory measures. The 
careful blocking up of the tiniest crevice had also a further 
purpose. This was to prevent the patient from being 
observed by other people. It is quite obvious that here 
again the compelling motive was the avoidance of his 
father's watchful eye. Nevertheless, his procedures for 
darkening the room are not fully explained by his negative 
desire to exclude light and avoid every possibility of being 
observed. Being in complete darkness has a positive value 
for the patient as well. But I will exemplify this point in 
another case. 

For the present I will pass over certain of the trans- 
formations the patient's scoptophilia had undergone and 
only mention certain psychological peculiarities which he 
showed. These were, a compulsive curiosity, a propensity 
to brooding, and an exaggerated inclination for everything 
that was problematical. I shall return later to these 
characteristics. Finally, the following signs show us that 
the eye had an important erotogenic significance for this 

1 The child's pleasure in observing adults urinate also gives rise to neurotic 
self-reproaches. Cf. footnote on p. 188. 

8 I have been able to get some knowledge of the genesis of neurotic sensitiveness 
through a number of psycho-analyses, the results of which I shall publish later. 



184 SELECTED PAPERS OF KARL ABRAHAM IX 

patient, not only as an organ of sight : he derived pleasure 
from touching his eyes, he had a great tendency to rub 
them and to draw down the upper lids, and he had often 
cut off his eyebrows in the past. 1 

In regard to the therapeutic results of the analysis I 
may say that the patient was completely restored to health. 
His horror of light and his sensitiveness to noise entirely 
disappeared. His attitude towards his parents became like 
that of any healthy person of his age, as was seen when he 
returned to his home after the termination of his analysis. 
He developed normal sexual interests in place of his ab- 
normal ones, and his fetishistic interest in particular dis- 
appeared, except for certain slight and unimportant traces. 
As he was getting better he had dreams in which he felt 
pleasure in looking at the female body, especially the 
genitals ; and soon afterwards he was able to have a normally 
directed scoptophilia in his waking life. At the same time 
his unfruitful inquisitiveness and pathological brooding 
gave way to a keen desire for knowledge, which mani- 
fested itself in most varied directions. In other words, the 
sublimation of his scoptophilic instinct had completely 
succeeded. Social adaptation (capacity for work in his 
calling, etc.) went hand in hand with the establishment of a 
thoroughly normal sexual function. It is now a year and 
a half since his treatment was ended, and there has been no 
recurrence of the trouble so far. 

The psycho-analysis of neurotic photophobia in 
other patients has fully confirmed the above results and 
theories. I will briefly indicate the essential points in 
another of my cases. This was an undoubted case of 
dementia praecox (schizophrenia), which I had the oppor- 
tunity of treating by psycho-analysis only because the 
patient was sent to me as a neurotic case. It was only on 
going thoroughly into his symptoms that I discovered the 
nature of his illness. It has often been our experience 
that the secrets of the unconscious are much less disguised 

1 We may recall the dream previously mentioned in which someone cut off the 
patient's pubic hair. Cutting off the eyebrows obviously signified a symbolic 
castration, too. 



I9I3 TRANSFORMATIONS OF SCOPTOPHILIA 185 

in the psychoses than in the neuroses. And so it was in 
this case. The patient would produce associations, fre- 
quently without much resistance, in connection with the 
most extraordinary things, and associations of such a nature 
that the required connection was surprisingly quickly 
revealed. 

This patient, whom we will call B, drew attention to 
himself at the very first consultation by requesting that he 
might sit with his back to the light. In addition he kept 
his eyes closed most of the time and covered them with his 
hands as well. 1 He steadily continued to keep his eyes 
thus closed during the analytical sittings, although his 
face was turned away from the window; and this lasted 
until the amelioration of this symptom made such a proceed- 
ing unnecessary. 

The history of this patient was very similar to that 
of the first case. He too was the son of a remarkably 
intelligent and efficient man. In his own view his father's 
attainments were absolutely unrivalled. In speaking about 
him he made use of almost the same words as the first 
patient. He said that for a long time he had vainly hoped 
to surpass his father in some attainment or other. His 
ambivalent attitude towards his father, too, was similar to 
that of the other patient, except that it was less disguised 
on account of the nature of his illness, as has been pointed 
out. 

His father had always seemed to him a ' powerful and 
benevolent being '. This expression sounds a religious 
note, and had it not referred to a human being, one would 
have supposed that it was being used of God, or some 
other being held in religious awe. We have only to recall 
the all-seeing eye of God to notice that there is here a 
tendency to elevate the father into a higher being. Free 
associations brought to light with extraordinary rapidity 
one of the causes which had convinced the son that his 
father saw all things. His father's watchful eye had dis- 
covered that the boy masturbated; and he had obtained a 

1 I might add that this attitude is fairly frequent in neurotic persons and 
betrays the existence of neurotic dread of light. 



1 86 SELECTED PAPERS OF KARL ABRAHAM IX 

promise from him to give up this practice in future. At a 
later period the patient felt as though the eye of his father 
was watching him every time he relapsed into that habit. 
That this feeling of being observed had other and probably 
still more important sources will be shown later. Con- 
sciously, however, the patient attached the greatest im- 
portance to his father's discovery of his masturbatory 
activities. 

When the patient was about twenty years old his 
father died. Soon after this he had the idea that his 
father was standing in heaven next to the sun and looking 
down upon him in order to observe what he did. This was 
not a fixed delusion as yet. But a little later undoubted 
delusions did develop. The significance of placing his 
father in heaven is quite obvious. His position immediately 
next to the sun shows that he was being likened to the sun 
without as yet having been united with it into a single being. 

To this veneration and deification of his father which 
persisted after the latter's death there was opposed an 
extremely powerful affect of hostility, which was kept from 
consciousness for a long time. It was expressed during 
the treatment in a dream in which the patient slew his 
father in single combat and took possession symbolically 
of his mother. The killing of the father in single combat 
and the final taking possession of the mother are the two 
great events in the Oedipus myth and many related stories. 

The patient's castration anxiety found a similar ex- 
pression to that of patient A. I need therefore only bring 
out one or two details in connection with it. He too had 
anxiety regarding his father's eye, the meaning of which we 
already know. A childhood memory in connection with 
this anxiety is of some interest. When he was nine years 
old he had once seen his father naked and had inspected his 
genitals with great interest. His phantasies, which at this 
age turned towards male persons, often reverted to that 
scene. And yet the thoughts associated with it were by 
no means purely pleasurable ; on the contrary, he was 
continually worried by the question whether his genitals 
would attain the size of his father's. When he became 



TRANSFORMATIONS OF SCOPTOPHILIA 187 

grown up he fell a prey to the tormenting belief, so very 
common in neurotic persons, that his penis was too small. 

We once more meet, therefore, with a jealousy of the 
father's capacities. In the present case the son's awe of 
his father referred to his genital organ and his eye. 1 In 
this case, therefore, there was not such a far-reaching re- 
pression of the sexual character of the boy's dread of his 
father. All that was repressed was his pleasure in looking 
at his father's genitals. The patient used occasionally to 
have a kind of * lightning ' hallucinations, which for a 
moment showed him the object of his interest. 

Patient B also very closely resembled A in his relation 
to his mother. He had a most pronounced aversion to 
looking at her and also at his sister, even when they were 
fully dressed. When conversing with his mother he used 
to cover his eyes with his hands. He betrayed the in- 
cestuous direction of his wishes in the first hour of psycho- 
analytic treatment through a peculiar choice of expression. 
He was saying that after the death of his father he had 
remained at home with his mother and sister, and was 
emphasizing the fact that in a certain measure he had to 
consider himself as his father's successor; for, he went on 
to say, he was now ' the only male member ' in the family. 
The wish-phantasies that had determined the choice of this 
expression soon appeared. The patient suffered from 
anxiety lest he should unintentionally impregnate his 
mother and sister. In especial, when he had taken a bath 
after having had a pollution, he used to be very much 
afraid that remains of the semen might adhere to the sides 
of the bath and impregnate his mother or sister when they 
used the bath after him. From this fear we may infer the 
existence of a repressed wish of the same nature i.e. to 
possess all his female relations. 

The patient's libidinal wishes directed towards his 
mother were also transferred to other, mainly older women; 
but here, too, they were prevented from showing themselves 
in their real character, and were expressed in a dread of 

1 I refer here to the designation 'das Gemacht ' (' might ') for the male genitals; 
language has here transferred the strength of a man to his genitals. 



1 88 SELECTED PAPERS OF KARL ABRAHAM IX 

looking at women of this description. 1 This aversion was 
associated with a very troublesome neurotic symptom. At 
the sight of mature women, who often consciously reminded 
him of his mother, a blackness would come before his 
eyes. This symptom expresses an inhibition of scopto- 
philic tendencies, though it has, as far as I know, hitherto 
not been regarded in this sense. The * blackness ' arising 
before the eyes, so often described by neurotics, more 
especially as a phenomenon accompanying attacks of 
giddiness, should regularly be the outcome of a sup- 
pression of a libidinal tendency. The increased circulation 
of the blood associated with every sexual excitation often 
leads in neurotic persons to an increased flow of blood to 
the head, and especially to the eyes, and has as one of its 
effects an obscuration of the field of vision. 

In this way the patient was prevented in real life from 
seeing women who were attractive to him. That he should 
have found a substitute along hallucinatory paths for this 
imposed privation is in complete agreement with the 
psychology of dementia praecox. He would, for instance, 
see lying naked before him a middle-aged woman who, 
according to his own account, bore a great resemblance to 
his mother. He furthermore admitted in a way which 
carried conviction that his avoidance of the sight of female 
persons was in effect an avoidance of the female, or more 
correctly of the maternal, genitals. 

At the time when distinct signs of a return to health 
were already noticeable, the patient once visited his mother. 
He told me afterwards that he had once again had to cover 
his eyes with his hands in her presence, although his 
sensitiveness to light had already become distinctly less. 
As I was about to comment on this he put his hands to 
his eyes, and said spontaneously: ' I didn't want to look 
at the plate with the wire down the middle at all '. These 
words were spoken in a self-justificatory tone as though he 
was afraid I might put a wrong construction on his behaviour. 

1 I am indebted to Dr. de Bruine of Ley den for the interesting information 
that according to a Dutch popular belief anyone who looks at an old woman 
relieving the calls of nature will become blind. 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 189 

This remark was at first quite unintelligible to me; but 
the explanation immediately followed. The patient, who 
was reclining on a couch during the treatment, had directed 
his glance to the ceiling on which a round polished brass 
disc was fixed, through the centre of which there ran a 
wire connected with the electric lights. This visual 
impression, occurring at the moment when the conversation 
touched on his avoidance of the sight of his mother, had 
been sufficient to call forth the associations of vulva (disc) 
and penis (wire in the disc). 

His original hostility and jealousy towards his father 
had gradually changed to admiration and acknowledge- 
ment of his greatness and power. Nevertheless, his sup- 
pressed hostile feelings sometimes produced disturbances 
of the contrary feeling which had obtained control. In an 
ecstatic moment the patient had once wanted to write an 
ode to the sun, but he had only been able to produce a few 
words. They ran: 

Oh sun, endow us with thy might ! 

At this point so strong a disturbance (blocking) of his 
thoughts occurred that he could not get beyond the first 
words. It is characteristic that this * blocking ' should 
have happened at the moment when he wished to give 
expression to his veneration for the power of the sun, i.e. 
his father. It will be remembered that a similar ' blocking ' 
occurred in patient A when he began speaking of his ardent 
admiration for his father. 

On one occasion the patient's wish to be his father's 
equal found utterance in a form which clearly showed the 
symbolic equivalence of father and sun. He had the 
sensation that both his eyes became one. He saw this eye 
before him in a hallucination as though it was ' outside ', 
i.e. not part of his body. It then became a shining sun. 
In this way he raised himself to the level of his father. 
That it was precisely the eye and not any other part of the 
body to which this happened is explicable partly from what 
has already been said about the eye and sun, and partly as 
a symbolic substitution of the eye for the penis. This 



I9O SELECTED PAPERS OF KARL ABRAHAM IX 

hallucination furthermore enables us to recognize a tendency 
in the patient to liken his own power of procreation to the 
fructifying power of the sun. 

In psycho -analysing an obsessional neurotic I have 
met with a process that was similar in content, though 
different from a symptomatological point of view. After 
his father's death this patient had a great fear of his father's 
watching eye. He always localized that observing eye in 
the sky, as was also apparent from certain of his dreams. 
This acknowledgement and glorification of his father was 
nevertheless only one side of his ambivalent attitude towards 
him. At times he used to have an extremely defiant 
attitude towards his dead father. On such occasions he 
suffered from a compulsion to look at the sun in a bold and 
challenging fashion. At the same time there would arise 
the obsessional idea: * Perhaps I am God '. 

In my essay on Amenhotep IV. 1 I have analysed a 
remarkable episode in the history of Egypt in which its 
ruler attempted to identify himself with the sun. The 
ambivalent attitude of the king towards his dead father was 
the principal cause of the introduction of the Aton cult in 
which the power of the sun was worshipped. 

As in the case of patient A, B's dread of being blinded 
by the sun becomes fully explicable only when it is realized 
that the sun symbol had not only a paternal but a maternal 
significance. The polished brass disc on the ceiling above 
referred to from which hung the electric light on the 
ceiling represented a kind of sun in the sky. 2 

His tendency to transplant a female symbol, that is 
in his case a maternal one, into the sky was expressed in 
a phantasy which he told me of his own accord. During 
one sitting when the sky became considerably overcast, he 
said, ' It would give me great pleasure to push my head into 
a cloud'. This phantasy corresponds to certain mytho- 
logical ideas. 3 In the most ancient forms of the Prometheus 

1 [No. 34, A. B.] 

2 The identification of ceiling and sky bears a genuine infantile character. 
Quite recently I heard a boy of three and a half call the ceiling of the bathroom 
the ' bath sky '. 

8 Cf. my analysis of the Prometheus legend in Traum und Mythus (1909). 



TRANSFORMATIONS OF SCOPTOPHILIA 

myth, boring into a cloud so as to create heavenly fire is 
identified with the sexual act. 

As regards case B, I have only to add that the thera- 
peutic results were very satisfactory and that the patient's 
aversion to light entirely disappeared, 1 

I shall not give any more examples from analyses of this 
particular symptom of aversion to light, concerning which I 
have a good deal more material at my disposal ; for according 
to my experience neurotic dread of light is not a rare affection. 
A mild degree of such increased sensitiveness, as, for 
instance, towards glaring sunlight, is often found in the 
slighter neuroses. 

There is, however, one more point I should like to 
mention, in connection with a case of severe obsessional 
neurosis I once treated. The patient also suffered from a 
slight degree of photophobia; and once when his associa- 
tions brought him to certain prohibitions proceeding from 
the father-imago he suddenly covered his eyes with his 
hands. His behaviour was explained by his subsequent 
associations. He had always had a guilty conscience with 
respect to his father he had never been able to look at 
him properly. His antagonism against his father had, 
among other things, found expression in the phantasy of 
blinding his father. In this case covering the eyes had 
a further, special significance. It represented, besides the 
meaning we have already considered, a self-punishment, 
i.e. a blinding of himself. It was an application of the law 
of talion 2 for his designs against his father. 

ii. Other Forms of Neurotic Disturbances in Connection 
with the Scoptophilic Instinct 

As soon as a more detailed investigation of the neurotic 
inhibitions and transformations of scoptophilic tendencies 
is made, it is surprising to find what a variety of disturbances 

1 In explanation of the satisfactory result of psycho-analysis in this case of 
dementia praecox, I may remark that the patient soon proved himself capable of 
making a sufficient * transference '. His psychosis was but little advanced in the 
direction of the formation of delusions, whilst hallucinations played a predominating 
r61e. 2 Cf. Oedipus's blinding of himself. 



192 SELECTED PAPERS OF KARL ABRAHAM IX 

are based on these processes. Such disturbances sometimes 
appear in people who suffer from an aversion to light, 
sometimes as an isolated symptom. 

In my description of case B I only very briefly mentioned 
a disturbance of this kind which existed in addition to his 
aversion to light; and I should now like to add just a few 
more words about it. 

The patient complained of want of sharpness of vision 
and said that objects appeared blurred and indistinct. No 
defect of the eyes was discoverable. 1 The neurotic character 
of his affection was confirmed by the fact that it disappeared 
during his analysis at the same time as his aversion to light 
did. In order to avoid repetition I will describe in this 
place a similar disorder in another case about whose psycho- 
analysis I have something to say. 

This patient, C, a woman, was an artist. Although 
very keen on her work, she said that at times of strong 
neurotic excitability it was difficult for her to appreciate 
correctly the forms of objects and also to impress them on 
her memory. She began to speak of this trouble when 
certain motor attacks from which she suffered became the 
subject of interest in her psycho-analysis. The trouble 
proved to be mainly determined by a repressed and in- 
cestuously fixated pleasure in looking which was directed 
on to her father and his body. The analysis of certain 
special attacks which she had, and which I once or twice 
had an opportunity of witnessing, brought to light a specific 
determinant. While lying on the couch she would begin 
to show signs of marked psychical excitement and to 
stretch and raise herself in an arc de cercle of a not very 
pronounced kind. Her whole body, and especially the 
extremities, would then vibrate and twitch convulsively, 
and she would make groaning noises, until a general 
relaxation set in. Once during each attack she would 
suddenly sit upright, twist her head sideways for a moment, 
and then sink back again. 

1 I may remark that the affections described in this paper occurred in persons 
whose visual apparatus was perfectly normal. A single exception will be mentioned 
later. 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 193 

The analysis of these attacks was carried out in the teeth 
of a very strong resistance ; and it was not till the end of 
her treatment that, after having been several times begun 
and several times given up, it was finally successful. The 
attacks proved to be a mimic representation of an occur- 
rence in her early childhood, which had been associated 
with extremely violent affects and whose authenticity cer- 
tain facts made it impossible to doubt. It was this : One 
morning she had woken up earlier than usual and, since 
she shared her parents' bedroom, had witnessed sexual 
intercourse between them. As her associations bit by bit 
revealed, she had sat up in bed for a moment, and then, 
terrified, had lain down again. This, her own active share 
in what took place at that time, expressed itself in her 
later attacks in the sudden raising up of the upper part of 
her body. Her memory of the agitating event itself was re- 
pressed, but it showed itself in a disguised form on certain 
occasions which need not be gone into here. The really 
serious after-effects of the occurrence, however, were ex- 
pressed in violent self-reproaches and in certain inhibitions 
of her instinctual life, of which only the limitation of the 
scoptophilic instinct interests us here. This limitation first 
appeared as an avoidance of all sexual looking and know- 
ledge; for example, in an anxious avoidance of reading 
anything that might give her any enlightenment on love and 
sexual passion. Psycho-analysis showed that her aversion 
had extended to seeing in general, and that it more 
particularly referred to seeing the shapes of objects. 

This case shows very clearly the effect of witnessing 
parental sexual intercourse on a neurotically disposed child. 
Such impressions fixate the scoptophilic instinct on the 
parents in an unusual degree, so that later efforts to detach 
it from them are doomed to failure. At the same time they 
cause a restriction of the instinct, which extends far beyond 
the actual sphere of sexuality. The law of talion can be 
carried to very different lengths in different cases. It can 
go as far as neurotic blindness, or can content itself with 
certain restrictions of vision; or it can give rise to the 
formation of phobias. In this case the patient suffered from 

N 



Ip4 SELECTED PAPERS OF KARL ABRAHAM IX 

occasional compulsive thoughts of having to put out her 
own eyes. 

Although I did not treat them psycho-analytically, the 
next two cases are worth mentioning as showing the great 
diversity found in neurotic disturbances of vision, 

The first was that of a neurotic woman who used at 
times to suffer from a disturbance of vision which prevented 
her from reading a book without glasses. She, moreover, 
had a marked dislike of illustrations in books, and used to 
avoid them as far as possible. 

The second was that of a young man who had been 
affected since childhood by a dread of darkness and by an 
obstinate phobia of becoming blind. Later on he had a 
disturbance of vision which was at once diagnosed by an 
eye specialist as neurotic. The patient described his 
trouble as follows in a letter to me: ' For the last ten to 
fourteen days I have been seeing badly, i.e. there is a kind 
of flickering before my eyes, as though I were constantly 
dizzy, and I see as through a veil. It began one afternoon; 
I saw zigzag lines flickering in front of my eyes, just as 
though I had looked at the sun or at a dazzling light for 
a long time. This lasted about half an hour. The same 
thing happened three days later, and since then I have had 
it almost continually. The flickering effect is less now, 
but my vision is dimmed and I have a strong feeling of fear, 
of course. At first I was afraid that I might be going 
blind.' As I have said, I was not able to analyse this 
patient, but I was able to find out that he was at this time 
involved in a sexual conflict which was an exact replica of 
his infantile Oedipus situation. 

There is a rarer disturbance connected with the scopto- 
philic instinct which is entirely opposed in its external signs 
to the disturbances of perception described above, yet which 
has the same origin and serves the same purposes. This 
consists in an exaggerated concentration of attention on 
objects and processes in the external world, and associated 
with it, a surprisingly faithful memory for the minutest 
details. This constant visual tension, this noticing of 
things which seem unimportant to other persons and are 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 195 

rightly overlooked by them, gives an erroneous impression 
that the person takes a keen pleasure in looking. Such a 
person will be extraordinarily well-informed about a thou- 
sand trifling things that come within his field of vision. 
But that field is sadly circumscribed. It is limited to 
interests connected with his childhood, his family, or his 
home. There is, on the other hand, an aversion to getting 
to know what lies outside this sphere. Such a person will 
in especial avoid sexual looking and every kind of sexual 
activity. As is evident, a process of displacement has taken 
place. Whatever is likely to stimulate the person's scopto- 
philic instinct strongly is avoided as something illicit, and 
his interest is displaced on to indifferent and permissible 
things. 

In one of my cases such a process could be traced back 
to early childhood. Before coming for treatment the patient 
had vaguely heard something to the effect that infantile 
events had to be reproduced in psycho-analysis, and he told 
me during the first sitting that he had exceptionally detailed 
and accurate memories of his earliest childhood. He then 
told me one or two such recollections, and added many more 
later on. They had taken place when he was between four 
and seven years of age. The minuteness of his recollections 
at two points in his childhood when he was three and when 
he was six was the most astounding of all. In the second 
of these two periods he had been staying at a health resort 
with his parents. He remembered a great number of 
names from that short time, described minutely the appear- 
ance of his playfellows, remembered what this and that 
person had said, and recollected each piece of furniture in 
the house in which he lived. His memories were so vivid 
and gave such an impression of freshness that one could 
rightly speak of a regular hypermnesia. 

This phenomenon was puzzling to me at first. I was 
unable to believe in such a marked exception to the general 
rule of amnesia for early childhood years ; and there were 
no grounds for thinking that the patient's recollections were 
paramnesic. His statements had nothing of the phantastic 
about them, for they dealt with the most ordinary matters of 



196 SELECTED PAPERS OF KARL ABRAHAM IX 

everyday life. It was impossible to conceive from what 
motives this perfectly reasonable man should have chosen 
to embellish his childhood with such a mass of uninteresting 
details which contained no strongly affective impressions 
and no memories that might have flattered a desire for 
greatness either in the child or in the adult. 

His hypermnesia, however, was explained as soon as I 
was able to discover an apparently unimportant concealed 
amnesia in its neighbourhood. In connection with his 
stay at the health resort the patient remembered only one 
thing with which a strong affect was associated. This was 
that he had begun to have lively feelings of self-reproach. 
But he had completely forgotten what these self-reproaches 
had been about. It then transpired that he had already 
passed through a period of violent self-reproach in his 
fourth year. The cause of this was also unknown, 

In trying to remove an amnesia of this kind existing 
since childhood we usually meet with strong resistances in 
the patient; and it was so in this case, too. But gradu- 
ally, to a great extent by means of his dreams, the essential 
points were brought to light, and it became evident that in 
his case also observation of parental sexual intercourse in 
his early childhood had given rise to severe repression. 
This must have happened just before the first appearance 
of his self-reproaches. His sexual curiosity became re- 
pressed, and there appeared in its place an exaggerated 
attention to unimportant details of daily life. 

The investigation of the patient's early childhood 
brought to light material which showed that his interest 
had quite early on been directed in an unusual degree 
towards his mother's body. His fixation on his mother 
had persisted till after puberty and had been expressed in a 
severe neurosis an anxiety-hysteria. It is worth noting 
that he shrank from looking at his mother. The prohibition 
of looking at his mother's naked body had changed into an 
avoidance of the sight of her in general. He particularly 
liked looking into the faces of strange women, especially 
into their eyes. Doing this had an erotic attraction for 
him, and was his only sexual practice with the female sex. 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 197 

If we recall what has already has been said about the genital 
significance of the eye, it would appear that this greatly 
restricted sexual activity of his represented a scoptophilic 
gratification which had been deflected ('displaced upwards 1 ) 
from its original aim, the genitals. In this connection we. 
may remind ourselves that the expression of the eye easily 
betrays erotic excitement. Men with diminished sexual 
activity often seek this sign of affection in women ; they will 
sometimes restrict themselves to evoking this sign, and will 
renounce every other form of approach. These matters 
will be more fully discussed later on. It is sufficient here 
to point out this interesting displacement of the scoptophilic 
instinct. 

The same patient, however, also had a disinclination to 
look at male persons, even intimate friends. His pleasure 
in looking had therefore become repressed to a considerably 
greater extent in the homosexual direction than in the hetero- 
sexual direction. 

A similar suppression of scoptophilia is of considerable 
significance in the causation of a widely-spread motor 
symptom in connection with the eyes, namely, a compulsive 
kind of twitching of the eyelids. As far as my psycho- 
analytical experience goes, compulsive movements of this 
kind go back to a sudden closing of the eyes in horror. This 
is in the first place an expression of fear of castration ; for 
the twitching of the eyelids seems generally to be associated 
with dread of injury to the eyes, which, as we have already 
pointed out, is equivalent to anxiety regarding the genitals. 
The spasmodic closing of the lids corresponds furthermore 
to a shrinking from certain phantasies which have appeared 
with the clearness of a vision to the patient and given ex- 
pression to forbidden desires to look. It appears that these 
phantasies are concerned partly with erotic ideas, partly with 
ideas of a sadistic nature (phantasies of the death of relatives, 
for instance). These ideas impose themselves upon the 
patient one day in the form of pictures (obsessional hallucina- 
tions), are banished by him with a feeling of horror, and 
become repressed. The compulsive sudden closing of his 
eyelids, however, shows that these proscribed phantasies 



198 SELECTED PAPERS OF KARL ABRAHAM . IX 

still exist in the patient's unconscious, and that a constant 
expenditure of repressive energy is needed to keep them 
out of consciousness. 1 

One particular transformation undergone by the scopto- 
philic instinct is seen in that disturbance which I may call 
compulsive looking. I once treated an obsessional neurotic 
who, besides suffering from a compulsion to brood over the 
problem of the origin of every object, was obliged to see 
and examine the back of it. 2 In front of my house was a 
small garden, on the railings of which my plate was fixed. 
On his first visit to me, which took place in the evening, 
this patient was not content with reading what was on the 
plate but, after entering the garden, closely examined the 
reverse side by the light of a match. He then I am 
quoting his wife's account spent some time talking aloud 
to himself, pondering over the way in which plates of this 
kind were made. When his wife finally got him into my 
consulting-room his eyes were caught by a little bronze 
figure, and he took it from the table, turned it round, and 
examined the back of it with special attention. 

His analysis, which was very incomplete, showed that 
in his childhood he had manifested a very great interest in 
people's buttocks. His first compulsive symptoms had 
appeared after he had unexpectedly seen the buttocks of a 
woman. His interest in buttocks had then become dis- 
placed on to inanimate and indifferent objects, whose ' back- 
side ' he was obliged to inspect in a compulsive way. Why 
the scoptophilic instincts in this case and in many other 
neuroses should have been so strongly directed upon the 
buttocks instead of the genitals cannot be discussed at 
length in this place. 

One disturbance which occurs especially in neurotic 
women is the fear of causing sexual excitement in persons 
of the opposite sex by looking at them. This fear may 

1 I wish to state expressly that I am not proposing to give an exhaustive 
explanation of the symptom. The above points are taken from incidental obser- 
vations, not from a detailed analysis. 

1 Cf. an account of this in my paper * Eine Deckerinnerung, betreffend ein 
Kindheitserlebnis von scheinbar atiologischer Bedeutung f , 1913. [No. 38, 
A.B.] 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 199 

lead to a dread of meeting anyone at all, so that the subject 
is unable to go into society. 

The characteristic feature in this and in certain other 
cases I shall mention is that the person ascribes some kind 
of virtue to his eye or his glance as though he were in posses- 
sion of magic powers. And we find that such people 
restrict their thoughts in a quite surprising way to a circle 
of ideas in keeping with their overestimation of the eye and 
its power. Experience leads me to believe that these cases 
can be divided into two classes from a diagnostic point of 
view. In neurotics this fear of evoking sexual excitement 
in every person through the glance is associated with other 
phobias or obsessional thoughts. It seems to me to be 
exactly analogous to the idea of the 'omnipotence of thoughts ' . 
Such an 'omnipotence' is in this case ascribed to the glance. 
But there are other cases in which the patient fears that his 
glance will have an effect extending far beyond erotic excita- 
tion. Such cases belong to quite another class from a 
diagnostic point of view. They are psychoses of a paranoid 
character which often run their course for a long period 
under the outward form of a neurosis. 

A young girl had the fear that her glance would horrify 
other persons to such a degree that they would become 
motionless and die on the spot. The identity of her belief 
with the classical myth is most striking, and she herself 
likened her glance to the Gorgon's head. Her fear in- 
creased more and more in the course of years, and necessi- 
tated her withdrawal from all society. In one of her dreams 
she found herself among thousands of people in a huge 
room rather like the hall of a railway station. Suddenly a 
cry of terror resounded that the ' Rigor Mortis ' had 
broken out, whereupon the people fled in a panic before 
the dreamer, 

I found similar phantasies in another young girl. Her 
idea that she killed innumerable people through her glance 
was expressed not only in dreams, but also in delusions 
during the waking state. For example, on one occasion 
when she went to a ball she noticed to her dismay that 
the face of every person whom she looked at assumed the 



2OO SELECTED PAPERS OF KARL ABRAHAM IX 

greenish-white colour of a corpse. This gave her the im- 
pression that she was among dead people. 

Both these patients indulged in extravagant sadistic 
phantasies. One of them used to dream that she was 
breaking every bone in her mother's body; the other had 
phantasies of assaults by brigands on her family, members 
of which were murdered or tortured. Of such dreams and 
phantasies there was any number, and in them the eye was 
employed, as it were, as a sadistic weapon. 

As far as my experience goes, cases of this kind only occur 
among women. In both the last-mentioned cases, analytic 
treatment had to be carried out under great difficulties 
associated with the nature of the illness itself. It is only 
with the greatest reserve, therefore, that I can say that as 
far as I could observe in both these patients, who liked to 
assume the male sexual role in their phantasies, the eye 
seemed to have the significance of a penis with which people 
could be terrified and killed. This idea, which at first 
sounds strange and improbable, is confirmed by the fear not 
infrequently met with in neurotic women of being ' bored 
through ' or ' pierced ' by the glance of a man. Thus one 
of my patients used to avoid the glance of every man 
because she felt bored through by it in a literal sense. As 
soon as she encountered the glance of a man she felt a 
stabbing pain in the lower part of her body. 

Other neurotic persons experience stabbing or boring 
pains in the eye. In many of these it is a case of 4 dis- 
placement upwards ' of the genital sensation just mentioned. 
But there are also rare cases of severe neurotic pain in the eyes, 
which disclose a very complicated psychological structure. 
I will give a more detailed report from the analysis of such 
a case below. In it the pain in the eyes was associated with 
extreme aversion to light, and the patient, a woman, lived 
for a long time in complete darkness. This case is par- 
ticularly suited to explain the significance of darkness in the 
mental life of a person suffering from photophobia. I will 
begin by reviewing the results obtained in our analysis of 
this symptom. 



TRANSFORMATIONS OF SCOPTOPHILIA 2O1 



HI. On the Significance of Darkness in the Psychology of 

the Neuroses 

In our analysis of neurotic dread of light we have shown 
that the sun is in the first place a father symbol though it 
can also represent the mother. With regard to its second 
and decidedly minor significance we can say that the sun, 
as a unitary phenomenon, symbolizes the father - imago, 
and that the latter has, as it were, absorbed into itself 
the mother-imago. We find, for instance, distinct traces 
of such a process in the Biblical story of the Creation, If 
we carefully analyse this myth, which exhibits signs of 
an extraordinary degree of modification and distortion, we 
can see that the female and maternal element has been 
merged into a male and paternal one. Whereas a * parental 
pair ' is found in other cosmogonies with which we are 
familiar, in Genesis the single (male) God alone creates the 
world, all animals and finally mankind, or to be more 
correct, a man. It is from this man that woman originates, 
and the two produce sons but no daughters. This far- 
reaching elimination of the female element nevertheless 
proves to be a quite secondary phenomenon. We shall 
take up this point again later. 

Considering that it is principally the father-imago that 
finds expression in the sun symbol, it might be asked 
whether the imago of the mother is not perhaps also 
represented by some special symbol in the phantasy- 
formations of our patients. For the mother plays a 
significant part in their unconscious phantasies, so that 
the ideas relating to her have the same claim to adequate 
symbolic expression as the phantasies referring to the father. 
I found the answer to this problem in an indirect way as 
I was attempting to elucidate another unsolved question 
connected with neurotic dread of light. The patients' 
aversion to light was not entirely comprehensible so long 
as the question why they sought the darkness had not been 
fully answered. I was inclined at first to see in it merely 
an escape from light. But on making a more careful study 



2O2 SELECTED PAPERS OF KARL ABRAHAM IX 

of these cases I found that darkness had by no means only 
a negative significance. A communication by Dr. A. 
Stegmann of Dresden drew my attention to the positive 
pleasure-value of darkness. This enabled me for the first 
time to understand the very complicated measures that 
these patients sometimes adopt to ensure complete darkness, 
especially in the evening. I have intentionally omitted 
this important aspect of the patients' behaviour in the first 
two psycho-analyses I have considered here in order not 
to complicate the discussion. I will now supplement my 
account of these cases in this sense ; and in addition I will 
make reference to the psycho-analysis of a woman who was 
suffering from an extremely severe photophobia. 

The significance of darkness was shown to have several 
determinants in all three patients. Every time this subject 
was approached in the analysis certain mental currents came 
to the surface. It appeared that all these patients suffered 
from moods of depression and had an unmistakable tendency 
to flee from the world. In their unconscious the light of 
day was a symbol of life and darkness a symbol of death. 
This symbolic use of light and darkness is also found in 
usages of speech. Neurotic persons in general are more 
usually afraid of the day (especially on waking in the 
morning) and feel better in every respect in the evening, 
because the day is over and night is drawing near; but 
they do this without special reference to the question of 
light or darkness. Day is the time for life in general, 
for activity; night signifies the opposite. But to those 
neurotics with whom we are dealing here, it is the light of 
day that represents life and the darkness of night death. 
Neurotics in whom repressed pleasure in looking plays a 
dominant part talk a special * dialect ' in their symptoms, 
to use an apt expression of Freud's. This dialect is 
determined by the patient's prevailing component-instinct 
and his dominant erotogenic zone. 

The neurotic's aversion to light, and particularly his 
complicated arrangements for excluding any ray of light 
in the night, thus become more intelligible. He un- 
consciously longs for darkness, and when the day which he 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 2O3 

dislikes so much has ended he seeks to make the darkness 
as absolute as possible. As has already been described, 
one patient, a woman, actually lived in completely darkened 
rooms even in the daytime. 

Such a flight from the world is, needless to say, not 
merely a flight i.e. something purely negative but has 
a positive pleasure-value as well. The patient withdraws 
into the depth of the night in order to know nothing of the 
external world, that is, in order to be alone with himself 
and his phantasies. In those neurotics who tolerate the 
light of day, so long as it is not direct sunlight, we meet 
with a kind of compromise-formation. They keep a 
contact with the external world to some extent during the 
day, but at night they remove it completely. If, how- 
ever, a patient excludes every ray of light during the 
day it signifies that he has turned away entirely from real 
life. 

I should like to make a reference to a symptom which 
in its origin and effects is analogous to photophobia. 
This is a neurotic intolerance of noise. In this affection, 
too, one of the determinants is the patient's flight from the 
world. All life involves sound. Sounds are therefore for 
the neurotic signs of restless, pulsating life from which his 
repudiation of sexual life excludes him. He hates noise, 
but he particularly hates noisy people whose behaviour 
shows that they are free from inhibitions and feelings of 
uncertainty. It is interesting, too, to find that aversion to 
light and aversion to noise are often associated with each 
other. A particularly characteristic symptom of persons 
who suffer from both conditions is that they not only sleep 
in carefully darkened rooms at night, but draw the bed- 
clothes over their heads in order to be entirely isolated from 
both light and noise. 

The free associations of the patients regularly proceed 
from these ideas of flight into a darkened, occluded room 
to ideas which we know as ' womb phantasies ' and with 
which we are familiar in other neuroses. This leads us to 
the view that darkness is to be taken as a symbol of the 
mother. It is easy to corroborate this meaning of darkness 



2O4 SELECTED PAPERS OF KARL ABRAHAM IX 

from the data of folk psychology. The facts relating to 
this are too well known to require repetition in this place. 
I shall therefore go on to discuss the results gained from 
a very instructive neurotic case. 

At the time when she took up psycho-analytic treat- 
ment this patient a woman, whose case I have already 
alluded to once or twice in these pages was living day and 
night in absolute darkness. Not only did she suffer from 
an extreme dread of light, as has already been said, but 
any kind of light caused her severe pain in the eyes. There 
was nothing the matter with her eyes themselves except a 
certain degree of astigmatism. A number of well-known 
eye specialists had agreed that her symptom was not merely 
the pain which often accompanies astigmatism. The 
aetiological connection of her trouble with strong emotional 
excitement was emphasized by the patient herself. 

Each visit of the patient's to my house was rendered 
extremely difficult on account of her neurosis. She could 
not come in broad daylight, nor in the evening when the 
streets were lit up. Her only possible time was the hour 
of dusk. She used to prepare herself for her expedition 
by putting on a pair of pince-nez with very dark glasses, 
and over them dark motor goggles which more especially 
kept off the light from the sides. As a further protection 
she used to put on a thick veil and turn down the very 
broad brim of her hat. Thus protected she would come 
in a closed cab for treatment. She used to adopt similar 
complicated methods for excluding the light in her home. 

It soon turned out that in this case, too, light and life 
were identified, and that the enormously strong accentuation 
of the wish to live in darkness proved to be a longing for 
death. In one of her poems the patient, who had formerly 
had great ambitions in life, compared her existence to a 
churchyard. In her darkened room, where she for the 
most part lay in bed, she felt that she was buried alive. 
The element of self-punishment present in this proceeding 
is quite obvious to the psycho-analyst, who knows how 
frequently neurotic symptoms arise from repressed phan- 
tasies of being buried alive. 



TRANSFORMATIONS OF SCOPTOPHILIA 2O5 

But what was of decisive importance was, as we shall 
see, the phantasy of the return into the womb. The 
patient, who had great psychological insight, once said 
with reference to her extraordinarily strong fixation on her 
mother that, psychologically speaking, the 'umbilical cord* 
between her and her mother had never been severed 1 In 
one of her poems she gave a very graphic representation of 
this womb-phantasy. 

Special considerations make it impossible for me to 
mention more than a few of the various determinants of 
the patient's photophobia and pains in the eyes. In her 
phantasy -life there existed strong motives which caused 
her to forbid herself every pleasure in looking, and to 
punish herself with violent pain for every transgression 
against this self-imposed prohibition. Among her phan- 
tasies were some which were directed against a particular 
person in her immediate environment because that person, 
a woman, outshone her in every way. 

The strange procedures which the patient had to adopt 
before leaving the house were to a great extent explained 
by their effect. In consequence of her goggles and her 
veil she could not ' make eyes ' at any man, and she became 
a forbidding figure to every male person to her own 
husband, too, it may be added. 

I shall not enter any further into the causes of the 
patient's symptoms, whose sadistic determinants in especial 
I have passed over, but I may mention that in the course 
of a few months an amelioration of her horror of light took 
place to such an extent that with the help of relatively 
slight protective measures she was able to go out into 
society in the evening in brightly-lighted rooms. Once she 
spent four hours in a brightly-lit drawing-room. This 
very satisfactory result, which of course rested in part on 
the effects of transference, was followed by a period of 
intense resistance. Psycho-analysis had helped the patient 
to return to ordinary life and had almost severed her 
1 umbilical cord '. But she was not, as it were, permitted 
to see the light of the world. The resistance which now 
set in awakened her womb-phantasies anew. Her severe 



2O6 SELECTED PAPERS OF KARL ABRAHAM IX 

pains returned, and she retired into the prison she had 
scarcely left and refused all further treatment, which was 
in effect never resumed. 

The symbolic meaning of darkness is a thoroughly 
ambivalent one. Darkness signifies at once birth and 
death, just as earth and water do. In the symbolism of 
dreams and neuroses this double significance attaches to all 
cavities into which no light penetrates, and not only those 
of the human body but every other kind of cavity. 

Dark cavities which symbolically represent the womb 
are often to be interpreted not as the uterus but as the 
bowels. For those experienced in psycho-analysis it is 
sufficient to refer to the well-known infantile sexual theory 
that children are born out of the anus of the mother, and 
to the frequent over-accentuation of the child's (or the 
neurotic's) interest in the bowels and their functions. 
Psycho-analytic experience has drawn my attention more 
and more to the fact that the interest many neurotics show 
in being alone in a small dark room discloses still further 
determinants of an anal-erotic nature. In especial, as may 
be easily supposed, the room very often signifies the w.c. 
in their phantasies. What is more surprising, though 
explicable enough to the initiated, is the not infrequent 
idea neurotics have of being shut up in a cesspool (K/osett- 
grube}. 1 This place is sometimes the scene of their secret 
pleasurable desires and sometimes that of their haunting fears. 

In concluding this section I have referred to the in- 
fantile and the neurotic interest in closed dark places 
because this helps to explain other psychological phenomena 
which we must now consider. In many neurotics, particu- 
larly obsessional ones, the very pronounced interest in all 
that is ' dark ', i.e. mysterious, supernatural, mystic, etc., 
is not solely referable to repressed scoptophilia in general. 
It has a special determinant in that pleasurable interest in 
dark cavities which our knowledge of infantile sexuality 
has rendered intelligible to us, 

1 [Klosettgrube signifies a large receptacle in the cellar of a block of flats which 
collects the refuse from the lavatories situated on different floors. Trans.] 



TRANSFORMATIONS OF SCOPTOPHILIA 2O7 



iv. Notes on the Psychology of Doubting and Brooding^ 
with Parallels from Folk Psychology 

In his ' Notes upon a Case of Obsessional Neurosis ' 
(i 909) Freud has shown that certain symptoms in obsessional 
neuroses arise from a process of repression and displacement 
to which the scoptophilic instinct has been subjected. In 
doing this he has referred in especial to the relation between 
pleasure in looking, desire for knowledge, doubting and 
brooding. 

With the help of the analytical material at my disposal 
I intend to investigate more closely the processes discussed 
by Freud, and in certain respects to amplify his conclusions. 
And in addition I shall consider certain parallel phenomena 
of folk psychology. 

In neurotics who suffer from a mania for questioning 
and brooding we regularly find a diminution of sexual 
activity. That activity has in extreme cases succumbed 
completely to the brooding mania. 1 These people are as 
helpless as children in the face of the important questions 
of sexuality. Their interest has been diverted from the 
sexual field and displaced on to other interests in a way that 
may have momentous consequences for them. 

The child's first sexual curiosity is directed to the body, 
and especially to the genitals, of its parents, and then to the 
processes of fecundation and birth. The fact that boys, 
with whose behaviour we are here principally concerned, 
direct their interest to a much greater degree upon the 
mother than upon the father, is explicable not only on the 
ground of difference of sex, but chiefly because of the 
child's interest in the origin of children out of the mother's 
body. 

In its primitive curiosity the child desires to see these 
organs or processes; a desire to know about them implies 
that its scoptophilic instinct has already been subjected to 

1 This applies in the majority of cases to male patients. Among women the 
mania for brooding is much rarer. But wherever I have found in women symptoms 
of questioning mania or similar phenomena, there has regularly been an unusually 
marked turning away from sexual interests. 



2O8 SELECTED PAPERS OF KARL ABRAHAM IX 

restraint. In many neurotics this limitation goes a good 
deal further, and even knowing about sexual matters falls 
under an interdict. Numerous transformations of their 
scoptophilia ensue as a result of this, the most important 
of which have been dealt with by Freud in the paper 
already mentioned. Von Winterstein l has also furnished 
valuable contributions to this question. 

We will now discuss these transformative processes and 
their products. 

We assume with Freud that a considerable part of the 
scoptophilia of a healthy person succumbs to repression 
and sublimation in childhood. Some of the important 
psychological phenomena which owe their origin in a great 
part to this process are the desire for knowledge (in a 
general sense), the impulse towards investigation, interest 
in the observation of Nature, pleasure in travel, and the 
impulse towards artistic treatment of things perceived by the 
eye (for example, painting). 

In many neurotics we have to assume a constitutional 
intensification of the scoptophilic instinct. Nevertheless, 
the pleasure in looking can increase in importance as a 
result of an inhibition of sexual activity. In that case, 
instead of active sexual behaviour there appears a greater 
tendency to look on inactively at things from a distance. 
The results of this neurotic pleasure in looking may be 
very diverse. It may be in part preserved in its original 
form, in part altered through sublimation in the sense 
described above, and finally in part employed to form 
neurotic symptoms. The stronger the instinct is, the greater 
must be the work of sublimation in order to prevent the 
development of neurotic disturbances, and the more severe 
will such disturbances be if the formation of symptoms 
does take place. The sublimatory process may also take 
various directions. I shall first of all discuss those neurotics 
who show a keen interest in knowledge or investigation 
of a concrete nature. In this form of sublimation of 
scoptophilia the original instinct can sometimes be recog- 
nized without any special aids, but in other cases it requires 

1 * Psychoanalytische Anmerkungen zur Geschichte der Philosophic ' (1913). 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 2O9 

psycho-analytical methods to do this. The two following 
cases are particularly instructive. 1 

A very intelligent and cultivated neurotic man had a 
pronounced desire for universal scientific knowledge. In 
regard to his very active mental life he noticed that there 
was always one single problem which especially attracted 
him in each science which he took up. When I asked 
him to give an example he mentioned the following: 

What interested him most in chemistry was the status 
nascendi. On going more closely into this it appeared 
that the moment in which a substance was formed or in 
which two substances united to form a new one had a 
positive fascination for him. His interest in procreation 
(combination of two substances in the formation of a new 
one) and in birth (status nascendt) had been displaced on to 
scientific problems in a successful way. He unconsciously 
discovered in each science the problem that was best suited 
to afford a veiled representation of the interests of his child- 
hood. The field of palaeontology supplied another very 
instructive example of this sublimatory tendency. The geo- 
logical period termed pliocene the period in which man first 
appeared particularly engrossed his interest. The child's 
typical question concerning its own origin had been here sub- 
limated to a general interest in the origin of the human race. 

It would be easy to go on adding to the number of 
these examples. Those here quoted show that this form 
of sublimation has an important advantage for the neurotic, 
namely, that it brings him into close touch with phenomena 
of the external world. In other cases the repressed pleasure 
in looking is changed into an unproductive desire for 
knowledge which is not applied to real events. 2 This 
constitutes neurotic brooding, which might be termed a 
caricature of philosophic thinking. 

1 There is also an unproductive interest in concrete things which is not infre- 
quently found in neurotics and represents nothing else than curiosity of an infantile 
character. In case A this curiosity became successfully resolved, and in its place 
there appeared a thoroughly productive and active interest in the phenomena of the 
external world. 

2 It is worth mentioning that as a rule under such conditions the person's 
pleasure in the aspects of Nature is very small, as is his interest in the various forms 
gf visual art. 

9 



2IO SELECTED PAPERS OF KARL ABRAHAM IX 

We owe to von Winterstein 1 some very excellent re- 
marks on the unconscious motives of philosophic thinking. 
According to him the philosopher desires to see his own 
thoughts. His libido is no longer directed to the forbidden 
(incestuous) aim, no longer to that which one must not see, 
but to that which one cannot see. At the same time it 
has turned back upon the ego in a way which we can only 
comprehend as a regression to the position of infantile 
narcissism. I shall presently quote certain facts from 
one of my analyses which show clearly that a similar 
process takes place in the neurotic who is given to brood- 
ing. I shall eliminate as far as possible the question 
of narcissism in this connection so as not to overstep the 
bounds of my subject; and I shall restrict myself to the 
task of demonstrating the presence of traces of re- 
pressed incestuous scoptophilia in neurotic brooding and 
doubting. 

As an example of neurotic brooding I will take a very 
common problem which recurs with the persistence of 
an obsession in some patients. This is the problem of the 
origin of thoughts. An obsessional neurotic of advanced 
age whom I was treating brooded over this subject for many 
years. It transpired that this problem had originally been 
immediately preceded by another one, namely, the question, 
4 Where shall I go after death ? ' This question had arisen 
in his mind during a sea voyage shortly after he had 
developed certain hypochondriacal fears about his life. He 
had been seized with the fear: * If I were to die now during 
the voyage, will my body be buried at sea according to 
sailor custom ? ' He had wanted, that is, to be certain 
where he would go after death. Soon after this the second 
problem regarding the origin of thought had appeared, 
but it had not succeeded in entirely removing the earlier 
one. 

The patient had attempted to elude the first problem 
by taking a practical measure. When his mother had died 
he had built a mausoleum. He now knew where pro- 
vided his burial in the mausoleum was not prevented by 

1 Loc. c?/ t 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 211 

special circumstances he was going to lie after his death, 
at his mother's side. 1 

Without going into its manifold determinants I should 
like to say that the question, ' Where shall I go after 
death ? ' is a typical reversal of another question that is 
more interesting to the child : * Where was I before I was 
born ? ' Moreover, in the present case analysis showed 
that the patient's chief obsessional thought, that regarding 
the origin of thoughts, was only another metamorphosis of 
this primary, infantile question. 

The patient was not content with brooding and with 
abstract forms of thinking alone, but used to endeavour to 
get a visual image of how thoughts arose in the brain and 
how they * come out ' of it. He desired actually to see 
this process. A young philosopher whom I treated psycho- 
analytically volunteered the following astonishingly simple 
explanation, ' I compare the brain to the womb '. In the 
patient's desire to observe the origin of thoughts we can 
only see a displacement of the typical wish of the child to 
see with its own eyes the act of fecundation and birth. I 
might remark that the comparison of mental and sexual 
products is not uncommon. We speak, for instance, of 
the ' conception ' of a poetical work, etc. If we advance 
still deeper in the analysis, we come upon the identification 
of birth and the act of defecation, and thus to an equation 
of the products of the brain (thoughts) and those of the 
bowels. 

It is of interest to note that the patient who was so 
much occupied in brooding over the origin of thoughts 
and where his body was to be after his death was sur- 
prisingly ignorant of certain important facts connected 
with the process of birth. He had never surmounted his 
ignorance of the latter point and had displaced his desire 
for knowledge on to those problems over which he brooded. 

There is another very common speculation in which 

1 I have had the opportunity of making a number of similar observations in 
which a son desired to be buried beside his mother, or a daughter beside her father, 
so that the other parent would be deprived of his or her natural place. An inter" 
esting example of this way of possessing the mother is afforded by the ancient 
Egyptian king, Achnaton. Cf. my essay on Amenhotep [No. 34, A. B.J. 



212 SELECTED PAPERS OF KARL ABRAHAM IX 

the desire to see how human life begins undergoes another 
kind of inversion. This is not to ask after the origin but 
after the purpose of human life. This obsessive question, 
too, is insoluble in spite of the subject's attempts to answer 
it from a religious standpoint in a way satisfactory to his 
feeling. A young man, for instance, whom I was treating 
had been obsessed by this question for a long time during 
puberty. It turned out that he had a real terror of learning 
about the structure of the female body and about the sexual 
functions. In later years, too, anxiety and disgust had 
held him back when he had had the opportunity of looking 
at the female body. These affects referred particularly to 
looking at the genital region. When the patient came for 
treatment and found that sexual processes were talked 
about in psycho-analysis, he expressly begged me to give 
him for the present no * explanations ' about what he did 
not know. The analysis very clearly showed that his 
scoptophilic instinct, which was inhibited by such strong 
affects, was directed in his unconscious to his mother. 

The problems of the obsessional neurotic are always 
insoluble. The question which in fact he wants to ask is 
not allowed to be answered; the question which takes its 
place cannot be answered; and thus the secret is kept. 
There exists in the patient a permanent conflict between 
two parties, one of which would like to investigate and 
know the facts while the other strives to remain ignorant 
of them. 

We now see why brooding-mania and sexual ignorance 
are so regularly found together. But as a further reason 
for this connection it may be said that for many neurotics 
the secret itself has more pleasure-value than its disclosure. 
I have alluded to this already. Occasionally one meets 
patients who suffer seriously from their ignorance and yet 
cannot free themselves from it. I had a case of a young 
man of twenty-eight, for instance, who suffered from severe 
states of agitation. The content of his thoughts in these 
states was quite conscious. It was: * Everybody knows; 
I alone am kept from knowing'. * Knowing' signified to 
him not only knowledge of sexual matters but, in the first 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 213 

place, * seeing ' and sexual activity. It is quite evident 
that he who avoids sexual enlightenment is entirely with- 
drawn from sexual activity. On one occasion this patient 
left a piece of paper in my consulting-room ; it was covered 
with a medley of unintelligible and disconnected phrases. 
In the centre of the paper in large writing were the words, 
* I don't know '. It was in this phrase that he used to 
express the whole torment of his ignorance. In his states 
of agitation he used to run round the room shouting the 
same words. And he used to write them on sheets of 
paper and surround them with all sorts of curses. I was 
only able to see this patient for a few sittings, but they were 
sufficient to give me a certain insight into his unconscious 
mind. It became evident that his libido was fixated in an 
incestuous way to a degree which was astonishing even to 
a psycho-analyst. For purposes of comparison I will 
mention a fact of folk psychology, to which von Winterstein l 
has already referred. In Biblical Hebrew the word to 
' know ' is also used for the sexual act. A man is said to 
1 know ' his wife. The preliminary sexual act of looking 
at a woman by means of which a man gets to know her is 
used here in place of the final act itself. The words used 
in the Mosaic Law in reference to incest are particularly 
interesting: among all the many prohibitions it is not 
intercourse between blood-relatives which is forbidden, but 
it is said that the man must not ' uncover the shame ' of 
this or that woman. The prohibition of uncovering and 
viewing the object is an extension of the simple prohibition 
of incestuous intercourse. It corresponds in this respect 
to the strict prohibition against looking with which many 
neurotics protect themselves not merely from the sight of 
the actual prohibited thing but from exercising any kind 
of sexual activity. 

An investigation into the inhibitions of looking and 
knowing is incomplete without adequate consideration of 
the phenomenon of doubt. In doing this I shall once 
more have recourse to Freud's illuminating discussion of 
the subject. According to him the obsessional neurotic 

1 Loc . cit. 



214 SELECTED PAPERS OF KARL ABRAHAM IX 

' feels a need for uncertainty. He retreats from reality, 
from everything palpable or certain, and is unconsciously 
urged to maintain and cultivate his uncertainty and 
artificially to create new uncertainties. His doubt proceeds 
from an inner perception of his own conflict of thought. 
What he really doubts, therefore, is the trustworthiness of 
his own feelings, and he has a great tendency to displace 
this uncertainty on to objects and processes in the external 
world. In doing this he usually seizes upon those things 
which are actually subjected to doubt, as, for instance, 
memory, or the duration of life. 

We are here reminded of the phenomena of brooding 
mania, which are very similar to those of doubting mania. 
We saw that the man who broods withdraws his interest 
from the world of concrete things, of things perceptible to 
the senses, and applies it to insoluble problems. The 
brooder unconsciously seeks to preserve his ignorance just 
as the doubter endeavours to maintain his uncertainty. 
This explains why doubts and brooding usually exist 
together in the same individual. It is also obvious that 
every inhibition of scoptophilia and of the desire for know- 
ledge which we regard as inseparable from scoptophilia 
not merely promotes brooding on abstract subjects but also 
doubt. Doubting mania finds, as it were, increased points 
of attack if the individual is unable to direct his mind 
and thoughts towards real things. Again, his feelings of 
uncertainty urge the neurotic to a constant renewal of his 
brooding; he has to examine again and again the train of 
thought which he has already gone over a thousand 
times. 

The neurotic patient has various methods of eluding 
the tortures of his doubting and brooding mania. Although, 
as we have seen, he strives unconsciously to preserve the 
cause of his sufferings, he shows at the same time the 
opposite tendency to do away with his uncertainty and to 
banish his doubt and ignorance. But he cannot, of course, 
succeed in doing this of his own strength and by his own 
methods. He is obliged to rely on authority and to submit 
to the knowledge and opinions of others ; but in this way 



TRANSFORMATIONS OF SCOPTOPHILIA 215 

he puts the responsibility upon them. Many obsessional 
neurotics like to burden their physician with a responsibility 
of this kind. If they are unable to come to a decision on 
a particular matter, they will try to get the physician to 
pronounce some judgement and so remove their indecision. 
In this way they alter the situation in such a manner that 
it appears as if no doubt existed at all. 

In this place I must make a digression and consider 
certain phenomena of folk psychology which are apparently 
not directly associated with the scoptophilic instinct, but 
an understanding of which is indispensable for the further 
course of our investigation. In folk psychology devices 
for removing doubt are found which are quite similar in 
their mechanism to the neurotic behaviour described 
above, 

I will start with the peculiar and, as I believe, almost 
unremarked fact that in the Hebrew language of the 
Biblical writings there is no word for 'to doubt 1 . 1 And 
it must not be forgotten that those writings originate from 
very different periods. It is a fact worth noticing that 
such a word should be missing from the language of the 
people who first attained to a monotheistic religion; and 
still more so, when we consider that the languages and 
dialects of neighbouring peoples possessed a suitable 
expression, so that borrowing could easily have taken place. 
The fluctuation between the monotheistic cult and the 
worship of Baal, Astarte, and other deities of Asia Minor 
lasted for centuries, until finally the cult of a single male 
God obtained the victory. It has been pointed out above 
that in the Biblical myth of the Creation there is a tendency 
to ascribe everything to the work of the male God and of 
man, and to put the woman in a very secondary place. 
This is in complete accordance with the patriarchal system 
in which the sole power was vested in the male head of the 
family. 2 The women and children belonged to him just 
like all his other goods, animate and inanimate. 

1 I shall deal with an exception later. 

a Von Winterstein deals in his above-quoted work (S. 192) with this question of 
the suppression of the female element. At the time of its appearance I had already 
arrived at the above results, which I found fully confirmed by von Winterstein. 



21 6 SELECTED PAPERS OF KARL ABRAHAM IX 

I must now refer to Freud's views, 1 which show in a 
convincing manner the origin of the male god from the 
attitude of the son towards the father. Originally the 
son's affection is directed towards his mother, while he has 
feelings of revolt and hostility towards his father. One of 
the earliest acts of repression which civilization demands 
is a renunciation of this hostile attitude. At first the son 
stood between father and mother; the repression of his 
Oedipus attitude then caused him to decide in favour of 
his father and unreservedly to acknowledge his power. 
Patriarchy in particular makes rigorous demands on the 
son in this respect. And just as in the patriarchal family 
the conflict in the son is decided unconditionally in favour 
of the father, so it is in the monotheistic religion of the 
Old Testament. 

The non-existence of a word for doubt in the Hebrew 
language might be regarded as an isolated phenomenon 
without especial interest if the same language did not show 
a second characteristic defect. A word signifying goddess 
is also missing, whereas other languages possess such a 
word. It might almost be said that in the same way as 
the conflict in the son, conditioned by his original doubtful 
position between father and mother, has been got rid of, 
so the question whether a god or a goddess should be 
venerated has been decided: and that now the language 
behaves not only as though this doubt no longer existed 
but as though all doubt whatever had ceased to exist in the 
human mind. 

A good deal of light is thrown upon this problem of the 
psychology of speech if we consider that in a great number 
of languages the word zweifeln [' to doubt '] is connected 
with the number zwei [* two ']. These languages, at any 
rate, do not deny the existence of doubt. Indeed, many 
even make use of a special grammatical construction in 
order to express doubt. We have only to think of the 
multiplicity of grammatical forms in Latin where the verb 
' to doubt ' requires special constructions which are other- 
wise hardly used. 

1 Totem und Tabu, Kap. iv., 1913. 



TRANSFORMATIONS OF SCOPTOPHILIA 217 

It is only in one of the late Biblical documents, Psalm 
cxix, that a word is found which can be correctly translated 
by * doubter'; strictly speaking, it means 'one who is 
divided ', According to the opinion of experts this Psalm 
belongs to a late period when Hellenistic influences had 
already begun to be felt, 1 A second word with the same 
significance, probably having originally the meaning of 
* divided ' or * split ', is found in still later Hebrew literature. 
It is very remarkable that a language more than two 
thousand years old should have expressed itself in the same 
way as the psychology of to-day, which speaks of a * psychical 
splitting '. A ' split ' suggests an internal conflict more 
clearly even than those designations for doubt which are 
connected with the word ' two '. 2 Once having borrowed 
two words from another language which admitted the 
existence of doubt, it became necessary to get rid of doubt 
in another way. A simple means was found. If, for 
example, it was doubtful whether a particular action was 
permitted or forbidden, the harsher view was regularly 
taken. The decision was made in accordance with the 
prohibition which was laid down in similar cases by the 
highest (divine) authority. At bottom this practice is 
equivalent to a denial of doubt, 

I shall now go on to give one or two especially remark- 
able observations which I have been able to make during 
the psycho-analysis of a complicated case of brooding and 
doubting mania. But I shall only discuss those factors 
,of the case which are connected with the repression of 
scoptophilia, and shall merely mention in passing other 
important sources of the symptom-formation, such as 
narcissism and sadism. 

The patient in question had had feelings of uncertainty 
quite early on in his life. As a boy he used to torment 
everybody with his mania for asking questions, and later 
on had worried himself with doubts on every possible 

1 Cf. Baethgen, Die Psalmen, 1897. 

8 This * inner perception of uncertainty * (Freud) finds a curious and striking 
expression in an ancient American language, the Nahuatl. This language expressed 
doubt by means of the word omeyolloa (' two hearts '). [Cf. the English expression 
* to be in two minds about a thing '. Trans, ,] 



21 8 SELECTED PAPERS OF KARL ABRAHAM IX 

subject. He doubted his intelligence, his c ability * in 
every respect, his memory and his judgement. He doubted 
his manliness, and when he was a child he used to doubt 
whether he ought to behave like a boy or a girl. His 
affections had oscillated between his father and mother. 
When he first became acquainted with two young girls he 
did not know which of them he was in love with. His 
whole life was a labyrinth of doubt which he sought in 
vain to overcome by the power of reason. He too had 
recourse to the subterfuge of delegating all decisions to 
an authority. In one instance he tried to kill his doubt 
in a very curious way. As a university student he came 
across a man whom he had heard speak in Berlin. This 
man's lectures and writings had previously aroused in him 
severe doubts and brooding. He had partly succeeded in 
getting away from this influence, but he was afraid that if 
he once again heard the man his influence would be renewed. 
He endeavoured to save himself from the dilemma by 
inciting his acquaintances to scoff at the speaker during a 
meeting. I might incidentally remark that this act was 
also an expression of a hatred which he felt for every person 
in authority, as he had originally felt it for his father. 

The facts which psycho-analysis elicited regarding the 
patient's childhood showed that his sexual curiosity and 
scoptophilia had originally been unusually strong and had 
only gradually given way to his questioning and brooding 
mania. Educational influences had been especially active 
in bringing about this change, and in particular the direct 
prohibition against asking questions which he had received 
from his mother at puberty when his desire for sexual 
knowledge had been re-awakened. This had accentuated 
the suppression of his desire for knowledge in the years 
that followed. When his neurosis appeared a whole 
number of symptoms showed that his incestuous pleasure in 
looking was striving to break through the repression. His 
dreams also betrayed the same tendency. At the beginning 
of treatment the patient, who had occupied himself with 
philosophical studies, stated that as a schoolboy he had 
envied Pythagoras. The cause of his envy was that 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 219 

according to his own assertion Pythagoras had witnessed 
his own birth three times. The patient's most intense 
interest was still associated with the child's question: 
' Where did I come from ? ' 

As we have said above, what the child really wants is 
to see where it comes from. The neurotic patient who is 
given to brooding has taken this childish interest along 
with him into a later period of life; his greatest wish is to 
see with his own eyes his own birth out of his mother's 
body. 

In the present patient the early forcing away of his 
scoptophilic instinct from its real objects and aims led not 
only to a typical brooding, but also to a morbid propensity 
towards secret and mystical things. The tendency we 
have already spoken of to cultivate and preserve the 
mysterious found expression in the eagerness with which 
he used to devour mystical, theosophical, and spiritual 
writings at a very youthful age. This tendency came into 
conflict with an opposing one of wanting to see with his 
eyes what could only be thought about. The desire to be 
able to see his thoughts was especially pronounced in him. 
He pictured mental processes in the most naive fashion, 
endowing them with physical and spatial properties. He 
thought of the brain as having compartments and pigeon- 
holes in which thoughts were deposited, and from which 
they occasionally emerged; and his brooding was chiefly 
occupied with these processes. He also of course had a 
desire to see supernatural things. He would brood 
endlessly over the problem of what ghosts and spirits 
looked like and what God looked like. Then inhibitions 
would arise and forbid him to think of such things. 

I need hardly refer to the countless similar phenomena 
that are to be found in folk psychology on the one hand, 
secret cults, mysteries, occultist movements, etc., and on 
the other, religious prohibitions against inquiring into the 
most secret things. 

Concerning the significance of ghosts, which played a 
very great part in the patient's thoughts, one of the factors 
that came out is familiar to us from other psycho-analyses. 



22O SELECTED PAPERS OF KARL ABRAHAM IX 

His brooding about ghosts was traceable to certain child- 
hood impressions he had received at night. Here, as in 
other cases, parents in their white night clothes are the 
prototypes or the child's conception of these mysterious 
forms. Into however distorted and phantastic a shape the 
thing observed had been fashioned by this patient's childish 
imagination, we can nevertheless recognize that he was on 
the right road to the formation of a correct conclusion. 
When later the prohibition against looking and knowing 
had obtained a hold over him, his repressed wish for a 
repetition of the pleasurable impressions of childhood was 
displaced on to ' ghosts '. He longed all the time to see 
ghosts. He went still further and transferred on to his 
brooding over ghosts all his desire for knowledge concerning 
the mystery of procreation. 

One of the problems which obsessed him for years was, 
1 How do ghosts come into a closed room ? ' I pass over 
the highly interesting determinants of the patient's various 
attempts to solve this question, and will only mention that 
behind that insoluble substitute-problem were concealed 
two problems the solution of which was forbidden, namely, 
the questions, ' How does the man penetrate the female 
body ? ' and, ' How does the child get into the womb ? ' 
What made the questions forbidden ones was their ultimate 
connection with his father and mother, and especially his 
originally pleasurable desire to see what was kept secret. 

His repressed pleasure in looking, however, not only 
sought a substitute -gratification in brooding, but took 
other means to this end. Those means are of great interest, 
and we must therefore consider them in greater detail, 
particularly as in doing so we shall gain valuable insight 
into the origin of certain phenomena of folk psychology. 

Like many people, the patient was able to visualize 
with pictorial clearness persons and processes, etc., about 
which he was thinking. In many neurotics simply shutting 
the eyes is sufficient to induce these visions, while others 
call up these * pictures ' intentionally and amuse themselves 
with them as though they were at a theatre. This capacity 
seems to exist in every one in childhood, but disappears in 



19*3 TRANSFORMATIONS OF SCOPTOPHILIA 221 

many as they grow older. It should therefore not necessarily 
be concluded that a man does not belong to the * visual ' 
type if he does not have such pictorial accompaniments 
of his thought. For it is more probable that there is 
an inhibition of his scoptophilic instinct resulting from 
a repression. 

Since his wish to see ' ghosts * could not be fulfilled, 
the patient attempted to procure a substitute by means of 
voluntarily evoked visions. And it is highly significant 
that what he endeavoured to visualize was his parents. 
But he did not succeed in the way he wished. The picture 
of his mother did not appear at all, and that of his father 
only in a distorted form. On the other hand, he easily 
succeeded in visualizing the appearance of other relatives. 
Both his attempts to obtain a substitute-gratification for his 
incestuous pleasure jn looking, and the failure of those 
attempts, are worth noting. 

After having observed a similar phenomenon in a 
number of other cases, I have come to the conclusion that 
greater importance should be attached to it. Many 
neurotics attempt to conjure up a vision of their parents, 
or at least to represent their appearance as distinctly as 
possible to themselves. One of my female patients, whose 
fixation on her father was most marked, could not succeed 
in visualizing him. In another case it was very difficult 
for the patient, a man, to portray clearly the features of his 
mother. He succeeded better with those of his father; 
but as soon as the picture of his father appeared the face 
became distorted and the eyes took on a fixed stare. In 
this case it turned out that the patient's scoptophilia directed 
towards his mother had undergone very intense repression, 
whereas his death-phantasy directed against his father had 
not been equally successfully repressed and found utterance 
in the rigid look of the eyes in his father's image. 

It is as though in these persons a prohibition was at 
work strictly circumscribing their scoptophilic instinct. A 
dream of a neurotic young girl furnished me with a good 
illustration of this. The dreamer found herself in a church 
among many other people who were looking at a picture 



222 SELECTED PAPERS OF KARL ABRAHAM IX 

of the Madonna. She alone could not see the picture. 
Analysis disclosed the presence of a strong homosexual 
tendency in her directed towards her mother. This in- 
clination had been changed in general into an intense 
repugnance, but it used occasionally to appear in its original 
form with great violence. Her mother was a particularly 
beautiful woman, and her daughter had to secure herself 
against those forbidden attractions by means of a regular 
prohibition against looking. 

In a recent publication l Freud has drawn our attention 
to certain phenomena common to the mental life of neurotics 
and savages. What interests us most in this place is the 
analogy between certain obsessional prohibitions in neurotics 
and the so-called taboos of certain peoples. These taboos 
have the characteristic peculiarity that the people who obey 
them can give no reason for doing so. In the same way 
neurotics who succumb to the obsessional prohibition in 
question are unable to furnish a reason for it. It is interest- 
ing to note the agreement between the neurotic looking- 
prohibition and the second commandment of the Decalogue, 
which strictly forbids the setting up of an image of the only 
(paternal) God. Freud has attempted to give a brief 
explanation of this prohibition on other lines. 1 The 
explanation given here is not in opposition to his but rather 
supplements it in accordance with the recognized over- 
determination of all psychological products. After I had 
practically completed the present paper I found in a recent 
publication by Storfer 2 an explanation of the second 
commandment based on the same view as my own. Storfer 
endeavours to trace back the prohibition of setting up an 
image of God to the dread of the paternal phallus, on the 
grounds that so many images of gods and cultural emblems 
bear a phallic character. This explanation seems to me 
to be in agreement with many of the ideas brought forward 
in this paper. Nevertheless it requires more thorough 
study and verification by the methods of comparative 
mythology. 

1 ' Animismus, Magie und Allmacht der Gedanken ' (1913). 
* Marias jungfrduliche Mutterschaft, 1914, S. 32, 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 223 

This parallel between phenomena of individual and 
folk psychology can be traced yet further. As has already 
been said, the patient in question was disturbed by constant 
doubt and uncertainty which referred among other things 
to his parents. In his relations to them doubt and prohibi- 
tions against looking at their image both played an important 
role. Now if we look more closely at the Decalogue we see 
that the commandment to recognize only one God and the 
commandment to make no image of him are in immediate 
juxtaposition. Psycho-analysis of a great number of 
mental products of every variety has led us to the conclusion 
that the immediate proximity of two mental elements points 
to an internal connection between them. And so it is 
worth noting that the prohibition against images immediately 
follows the commandment to recognize only one god, i.e. 
the commandment designed to eliminate all hesitation 
(doubt) between the father and the mother. 

The analysis of individual psychological products throws 
a new light on this subject. Let us return to the patient 
who felt that he ought not to make an image of his parents, 
and see what he did in order to find a substitute for the 
prohibited act. He endeavoured with the whole power of 
his imagination to represent to himself the appearance of 
ghosts which, as we know, stood for his parents in his 
brooding system. That his ultimate desire was to represent 
to himself sexual intercourse between his parents was made 
quite clear from the ideas he had formed as to what ghosts 
looked like. To quote his own expression, he conceived 
them as * big naked beings ', as ' voluptuous forms '.* 

As we have already said, the patient found abundant 
material for brooding in a certain class of literature, especially 
that of a theosophical character. In connection with what 
he had read there he identified his parents not merely 
with ghosts but also with ' giants '. He had found in one 
of these books the statement that the inhabitants of the 
submerged continent Atlantis had been giants, and that 

1 The evocation of such ideas or visionary appearances subserved other tenden- 
cies to which I can only briefly allude here. Among other things they were a 
gratification of the infantile grandiose idea of being able to procure everything by 
the power of imagination (omnipotence of thoughts). 



224 SELECTED PAPERS OF KARL ABRAHAM IX 

they had had a higher form of consciousness than ourselves 
i.e. an astral consciousness and that they had hence 
been initiated into secrets which were hidden from us. 
The book stated that ' their knowledge was so great that 
the earth resounded with it '. These giants immediately 
assumed the significance of parents to the patient. They 
4 knew ' more than he did, that is, they were in possession 
of the sexual secret. The child, however, had attempted 
not only to see that secret with its eyes but to hear it with 
its ears. He had obviously made the same equation which 
we met with as a linguistic phenomenon : he had identified 
* knowledge ' with sexual intercourse. 

It was furthermore characteristic that the patient had 
attempted to imagine God as a material being. We shall 
not be surprised to learn that he thought of God as a giant 
also. In phantasy the child ascribes extraordinary power 
to the father. It is very apt to compare him to a giant on 
account of his great superiority of size, as the dreams of 
adults often still show. When a child hears about God 
it can only represent him in the likeness of its father; it 
does neither more nor less than those religion-forming 
peoples who venerate a paternal god. And in pondering 
over the appearance of God, our patient was only once 
more repeating the attempt to break through the prohibition 
against looking at his father. 

How well the neurotic prohibition against representing 
the father or both parents pictorially and the Biblical 
prohibition against portraying God agree in their essence 
is evident from the fact that both prohibitions are trans- 
gressed in an identical manner. I have in mind here one 
of the typical brooding questions so frequently found in 
the writings of the Talmud. The prohibition against a 
concrete representation of God might not be infringed; 
and when for some reason or other men felt themselves 
obliged to give their idea of God a more living and material 
content, they had to have recourse to brooding. This 
need, together with the strict observance of the visual 
prohibition, explains the Talmudic question concerning the 
podily dimensions of God- The question could, however, 



I9 I 3 TRANSFORMATIONS OF SCOPTOPHILIA 225 

only be answered by keeping strictly to the statements 
found in the Scriptures. In them is contained the pro- 
nouncement made by God, * Heaven is my throne and 
the earth is my footstool ', from which it was inferred that 
his legs were so long that they reached from heaven to 
earth. This kind of brooding resembles that of our patient 
in an astonishing way, not merely because the repressed 
wish to visualize God, i.e. to look at him, recurs in it, but 
because the infantile idea of the giant form of the father or 
God is once more found. 

It is thus evident that there is an unmistakable analogy 
between the inhibitions of the scoptophilic instinct in 
neurotic individuals and in primitive peoples; and I shall 
now proceed to show that psycho-analysis affords us a yet 
deeper insight into the nature of this parallel. 

v. The Origin of Sun and Ghost Phobias from 
Infantile Totemism 

In the course of our present discussion we have met 
with two symbols to which we have had to ascribe a pre- 
ponderant father significance the sun and ghosts. We 
have seen that certain neurotics are distressed by sunlight 
or react with affects of rebellion or defiance at the sight 
of the sun in a manner that differs from the conduct of a 
healthy person; and we have learned that in each case 
these neurotic patients had an ambivalent emotional attitude 
towards the sun. They loved and reverenced the sun, but 
had at the same time a dread of it. In speaking of the 
latter condition I have definitely called it a sun phobia. 
Among neurotic brooders we found a particular interest 
in spiritistic phenomena. Ghosts or the idea of them also 
called forth ambivalent reactions the wish to see them 
and the dread of their appearance which we might call a 
ghost phobia. If we accept the sun and ghosts as symbols 
of the father, and if we are familiar with the ambivalent 
attitude of the neurotic towards his father, we shall not 
be astonished to find this division of feeling transferred to 
the symbols representing the father. Psycho-analysis, how- 



226 SELECTED PAPERS OF KARL ABRAHAM IX 

ever, cannot be content with this knowledge. As a theory 
of development which sets out to demonstrate the strict 
determination of all mental products it must inquire further 
into the origin of those phenomena. In order to obtain access 
to the origin of these symbols we must make use of that key 
which Freud has given us in his paper on Totem und Tabu. 

We find even at the present time in certain tribes 
whose civilization is very primitive an organization which 
regulates their religious and social life. It is called totemism, 
and is a form of ancestor cult. The central point of the 
cult is the totem, generally an animal, which is regarded 
as the original ancestor of the clan concerned. Freud has 
been able to show that these primitive peoples have an 
ambivalent attitude towards their totem. They will not 
hunt, kill, eat, or even touch the totem animal, i.e. in general 
they will preserve it; but under special circumstances they 
will kill and eat it with elaborate ceremonial. The totem 
is the object both of their love and their fear. Many 
customs of these people clearly indicate their double attitude 
towards the totem. 

Psycho-analytical investigation l has brought to light 
the remarkable fact that under the conditions of civilization 
of to-day the totemistic attitude still reappears in the 
mental life of the child, and leaves behind unmistakable 
traces in the unconscious of the individual. Certain 
products of children's phantasy bear an extraordinary re- 
semblance to the totemistic system of primitive peoples. 
A child who often openly displays an ambivalent attitude 
towards its father or mother, will frequently displace its 
feelings from them on to a certain animal or class of animals, 
or sometimes on to several such classes. It shows interest 
and love for this animal which is equivalent to a totem. 
But in its day dreams and night dreams the same object 
plays the part of an anxiety-animal. If the child develops 
a phobia, as so often happens, it is this animal which is 
usually the object of its anxiety. In not a few cases the 
animal retains its significance even later on, and appears in 
the phobias of adult neurotics just as it does in children. 

1 Cf. Freud's references to his sources in his work quoted above. 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 227 

I have made a considerable number of observations 
relative to this, though I cannot give them in detail in this 
place, I shall select one or two only on which to base the 
remarks which follow. In the first place, the ambivalence 
of their attitude towards their totem (the feared animal) is 
obvious to many of the patients themselves. One of my 
cases, a woman who suffered from a slowly progressive 
hebephrenia, gave me, with that freedom from inhibition 
which is characteristic of such patients, most precise and 
instructive information concerning this and other important 
points of individual totemism. In her case the fly played 
the main part as an anxiety-animal. On one occasion she 
volunteered the information that her feelings towards flies 
were ' full of love ', but that at the same time she had an 
impulse to kill them. 

It is also important to note that especially in dreams a 
particular animal may often represent not only the father 
(or mother) but the patient himself. In a dream of this 
kind which I came across, three generations the father of 
the dreamer, the dreamer himself, and his son were all 
represented by the same symbolic animal the dog. This 
corresponds to the very common hereditary totemism of 
primitive peoples. 

I next refer to another individual parallel to the primitive 
totemic cult. This is concerned with plant-totemism, 
which, though rarer than animal-totemism, is occasionally 
observed. A neurotic who was constantly fleeing from his 
incestuous desire for his mother, showed in his waking 
phantasies and in his dreams all the phenomena of tree- 
totemism. In the garden of a small chateau where he 
lived as a boy there was a very large old tree which he 
regarded with religious awe; he used to pray to it and 
receive oracles from its rustling sounds. 1 His defence 
against his incestuous wishes was associated with severe 
anxiety. He was pursued by continual unrest and could 
not settle down anywhere. In his waking dreams he 
seemed to be a tree standing in the parental garden, sur- 
rounded by other trees (his relatives) near the big oracle 

1 Cf. in this connection the oracle of Dodona. 



228 SELECTED PAPERS OF KARL ABRAHAM IX 

tree (his father), and to have taken firm root there. It 
seems to me that the repression of his incestuous desires 
demanded extraordinary measures so that his parents could 
not be symbolized by an animal. They had to be sym- 
bolized by a tree, which is sexually undifferentiated. This 
may throw some light on the totemism of certain primitive 
tribes, where the totem is not, as in most cases, an animal, 
but a plant. 

When we view infantile animal phobias and neurotic 
totemic symptoms we are struck by one fact which has 
hitherto found little or no consideration. In some of these 
cases the totem is a four-legged animal whose size and 
strength make it at once clear why it should be identified 
by the child with the mighty father. But in a considerable 
number of cases we find that the anxiety-animal is the 
smallest kind of animal known to the child, such as flies, 
wasps, butterflies, caterpillars, etc. The same thing occurs 
in a number of neurotics. The actual dangerousness of 
such animals is not a sufficient explanation of this form 
of infantile totemism, for only certain of them are at all 
injurious; others are quite harmless, and the child is able 
to kill them without risk. According to the evidence of 
my psycho-analyses of neurotics there seems to be a simpler 
and better explanation. These animals have the charac- 
teristic of making a sudden appearance. They approach 
all of a sudden, touch the human body unexpectedly, and 
disappear with equal rapidity. Of course individual 
determinants enter into every case. For instance, in one 
of my patients the wasp had replaced another animal, the 
tiger. The colour and marking of the wasp reminded 
the patient of the tiger, and its buzzing could represent the 
tiger's roar, which latter sound was associated with the 
child's dread of the deep, threatening voice of his father 
when he was angry. This patient spontaneously said that 
the sound of a wasp flying about with its threatening buzz 
was associated in his mind with feelings of rage. My 
psycho-analytic experience leads me to believe that small 
animals have a manifold significance. They represent the 
father who surprises the child by suddenly appearing near 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 229 

it or by alarming it with a threatening voice. It is also 
characteristic of these animals that they disappear quickly 
and can be killed more easily than big ones. Thus these 
small flying animals l indicate on the one hand the dangerous 
power of the father, but serve on the other as an expression 
for the child's ideas of getting rid of him. These are the 
same animals that we meet with in mythology as ' spirit 
animals '. Patient E, whom we have already often men- 
tioned, gave me quite freely considerable information about 
the infantilism which still persisted in him, and drew my 
attention among other things to his ambivalent attitude 
towards flies. He said that he used to amuse himself with 
killing flies and wasps in his childhood. 

In this place I must give further details from his 
psycho-analysis. (I may remark that certain phenomena 
which are also found in other patients were manifested in 
him in a quite undisguised form.) When he had killed a 
fly or a wasp he always became a prey to anxiety lest the 
dead fly should revenge itself upon him. This piece of 
information, spontaneously given by the patient, is of great 
importance. It concerns an individual psychological process 
which fully coincides with the fear of the dead found among 
primitive people. In his discussion of the taboo of the dead, 
Freud has analysed this unexplained element and has shown 
that the hostile impulses which one human being feels 
towards another while he is alive become repressed after 
his death through the appearance of opposite impulses of 
mourning and grief and are projected on to the dead 
person, who now becomes dangerous to those still alive 
and able, so to speak, to drag them after him. This patient, 
too, had Moving' feelings towards the animal he had killed; 
at the same time his murderous intentions were projected 
on to the killed animals, with the result that he was afraid 
of their revenge. 

During the treatment the same patient had a dream in 
which he was about to attack a tiger with a pole. Then 
(I pass over a great many details of the dream) the animal 

1 Small crawling animals (caterpillars, etc.) are like flying ones in that they 
suddenly appear on the child's body and thus excite fear. 



SELECTED PAPERS OF KARL ABRAHAM * IX 

was suddenly taken up into heaven, so that the patient did 
not succeed in killing it. 

Here we meet with the important element of trans- 
lation into heaven. It concerns an object to which the 
patient's attitude was ambivalent, and the process is one 
with which we are already familiar. I need only call 
to mind patient B, 1 who, in a phantasy bordering on a 
delusion, elevated his dead father to the sky and placed 
him next the sun. We must conclude, therefore, that 
symbolization of the father through the sun represents a 
heavenly translation of this kind, the motivation of which 
no longer presents any difficulty, since we can ascribe it to 
the ambivalent attitude of the son towards his father. 

I shall again refer to the spontaneous statements of 
patient E, which he made in the form of free associations. 
According to them, his father (tiger, wasp) was raised to 
heaven in order that he (the son) should be removed as 
far as possible from the dangerous animal. An idea im- 
mediately followed which confirmed the correctness of his 
view. The patient described the method by which, as a 
boy, he had kept as far away as possible from wasps and 
flies when he was killing them. Too timid to attack 
directly, he used to fasten a lighted candle on a long pole 
and bring it near an insect on the window pane, till the 
creature fell down dead or helpless. 2 The further away the 
animal, i.e. the totem or father, the less risk he ran from 
it; and at the same time the totem was exalted from an 
earthly plane to higher regions. This process must now 
be investigated in greater detail. 

The ambivalent significance of a translation of the totem 
to heaven is illustrated in a specially instructive manner by 
the following example from the nursery. Two children 
with very imaginative minds used often to watch the clouds, 
and to give them names. These names, which, for pro- 
fessional reasons, I must abstain from quoting, could easily 
be seen to contain a condensation of two elements an 

1 Cf. p. 1 86. 

* This explains the ' pole ' with which the patient was about to kill the tiger 
in the sky. 



IQI3 TRANSFORMATIONS OF SCOPTOPHILIA 23! 

obvious distortion of the words * papa ' and * mama ', and 
the word ' animal '. In this naive way their father and 
mother were first represented as animals and then taken up 
into the sky in the shape of unearthly forms (clouds). This 
example is the more interesting since both children were 
discovered to have an ambivalent attitude towards their 
parents; they showed, on the one hand, tenderness and 
respect towards them, but, on the other, tended to turn 
them, especially the father, into figures of fun. 

A short time ago I was able to analyse a dream of a 
neurotic woman in which admiration and respect for her 
father (as a sublimation of a strong erotic fixation) and also 
death-wishes against him were expressed in a very charac- 
teristic manner. He was represented by an enormous 
chandelier hanging in the sky, composed of innumerable 
stars and surrounded by a great number of phallic symbols. 

In all these products of individual phantasy, whether 
they are the thoughts of children at play, the dreams of 
adults, or the fears of neurotics, we perceive the same 
mental processes that go on in folk psychology and underlie 
the development of religion. I shall only refer in this 
place to those mythological products in which traces of the 
translation of the totem to heaven can be seen in an almost 
undisguised form, as, for instance, the lightning-bird of the 
Indians, the sun-cow of the Egyptians and the cloud-tree of 
the whole Indo-Germanic mythology. 

The effects of this elevation of the father or mother to 
the sky are numerous. I shall begin by discussing the 
representation of the father by means of the sun symbol. 
In view of what we know about the ambivalent character of 
the process, we may separate those effects into two groups. 

The first group is connected with the friendly, loving 
feelings which are turned towards the father, and the 
acknowledgement of his paternal power. The symbolic 
representation of the father by the sun obviously signifies 
a great enhancement of his power. All life around us is 
dependent on the sun. Through identification with the 
sun the father is literally raised into the principle of all life, 
and particular emphasis is laid on the recognition of his 



232 SELECTED PAPERS OF KARL ABRAHAM IX 

procreative powers. Doubt and unbelief can no longer 
assail his might. Since, however, one of the properties of 
the sun is that it outlives earthly beings, eternal life and 
indestructibility are ascribed to him through his identifica- 
tion with it. Placed in the sky as the sun he is able to 
observe all things, while his dazzling light hides him from 
his son's view. At the same time he is placed out of reach 
of the latter 's aggressive desires. He is raised above them, 
as in the saying about the moon which need not be troubled 
by the baying of the dog. 

But all this power is only a seeming one. For, as Freud 
has convincingly demonstrated in his essay on totemism, it 
is to the dead, or rather to the murdered, father that trans- 
lation to heaven and elevation to the level of a deity is 
accorded. The results of psycho-analysis justify us in 
coming to the conclusion that it is only when he thinks of 
him as a dead person, or wishes him to be so, that the son 
elevates his father to the level of a sun-god. These death 
phantasies give expression to impulses of hate, hostility, and 
jealousy on the part of the son. They rob the father of his 
power, so that he is in reality helpless and harmless. An 
omnipotent power is then subsequently granted him as a 
compensation. 

I should like to recall the fact that mankind not only 
transplants his deities and other powerful beings into the 
sky, but that, according to an idea which is still prevalent, 
human beings themselves ' go to heaven ' after death. The 
mental life of the individual gives rise to similar products. 
A dream will illustrate this : During a certain period of his 
treatment one of my patients had a number of dreams which 
gave expression to his unconscious incestuous impulses, 
After having dreamed many times that he had raped his 
step-mother, he had a dream whose content apparently 
differed from the previous dreams, but in reality formed a 
complement to them. In this dream he climbed up a ladder 
into heaven. There he found God sitting on his throne; 
but his face was that of his father. Analysis showed among 
other things that the patient had placed his father in heaven, 
i.e. had removed him from among the living. He had 



1913 TRANSFORMATIONS OF SCOPTOPHILIA 233 

exalted him into a god, but in doing so had only in appearance 
increased his power. He himself climbed up to the same 
height as his father in his dream. Climbing up ladders is 
a frequent coitus symbol, which is used here in the sense of 
an incest-wish. The patient takes possession symbolically 
of his step-mother, because his father is no longer living. 
The divine power of his father is ineffective and cannot 
hinder him from carrying out his intentions. 

With reference to this dream, in which the son contests 
the right of a father who is elevated into God, it is worth 
while remarking that any such elevation raises the son as 
well and makes him powerful like his father. It is sufficient 
to allude to certain royal dynasties and priestly castes who, 
in order to enhance their power, style themselves sons of 
the sun. 1 

Now that we have succeeded in understanding the sun 
phobia, the ghost phobia can be solved without special 
difficulty. The ghost is the ' dead ' father. If he is repre- 
sented by the sun, then it becomes unbearable to look at. 
If he is transformed into a ghost, then he is as a rule invisible; 
and his unexpected appearance excites violent anxiety. 
According to my observations, which nevertheless need 
supplementing in this direction, many neurotics seem at 
first to have a dread of sunlight or light, and only later 
acquire a dread of ghosts. With the advance of the repres- 
sion of their scoptophilia the symbol which represents the 
father or mother has always to become more and more 
incorporeal. One of my patients produced within a short 
period two dreams, in one of which his father appeared as 
light, while in the other he appeared as a ghost. In the 
first of these dreams the patient was in school (which he 
had left several years before). The headmaster, who in 
other dreams played a pronounced father-role, came into 
the class-room and spoke to him. At first the patient 
defiantly opposed his orders, but later he had to obey them, 
while there appeared over the master's head a blinding light, 

1 I might briefly mention that in many neurotics the father is not represented 
by the sun, but by lightning, i.e. by another phenomenon of light in the sky. 
Lightning here more especially represents the punishing (killing) power of the father. 



234 SELECTED PAPERS OF KARL ABRAHAM IX 

at the sight of which the patient fainted. Whereas in this 
dream the paternal power was represented by a blinding 
light, the same purpose was served by the ghost in the other 
dream. What was noticeable in this case was that it was 
the white form of the ghost which dazzled the dreamer. 
Ghosts are generally thought of as white, but faint and pale 
in appearance". The phobia of ghosts is most marked 
among neurotic doubters, who, as we have seen, show a 
tendency to substitute what is indefinite, indistinct, and 
non-material for what is clear and solid and perceptible to 
the senses. 

Those who have psycho-analytical experience themselves 
will easily recognize that these remarks in no way exhaust 
the extensive field with which they are concerned. No 
doubt much more could be added to the collection of the 
phenomena here analyzed, but I have aimed at the greatest 
possible conciseness in this study. I have omitted to con- 
sider many aspects of the question which might have con- 
tributed further to the explanation of the symptoms, and 
have only given others the merest mention. The fragmentary 
character of my remarks may, however, help to show how 
much further investigation of the symptoms is still needed. 
The line that such an inquiry will have to follow will be in 
the sense of our concepts of the ' component-instincts ' and 
the * erotogenic zones ' concepts which have become in- 
dispensable to our understanding of the subject; and in my 
present paper I have tried to demonstrate this in the case 
of one particular component-instinct and one particular 
erotogenic zone. 



CHAPTER X 

A CONSTITUTIONAL BASIS OF LOCOMOTOR 
ANXIETY' (1913) 

THOSE who have investigated the psychogenesis of 
locomotor anxiety with the help of Freudian methods 
have regularly met with certain factors operating in 
the formation of this trouble, so that they have been bound 
to regard them as typical for that illness. They were, of 
course, well aware that the neurotic who needs the constant 
company of particular persons shows the incestuous fixation 
of his libido in a particularly marked degree, and that every 
attempt he makes to separate himself from his love-object 
signifies in his unconscious an attempt to detach his libido 
from it. They have recognized, furthermore, that the 
anxiety such a person feels causes him suffering on the one 
hand, but, on the other, enables him to exert his power over 
the persons about him. Further typical determinants of 
his * topophobia ' are the subject's fear of life symbolically 
represented by streets and in particular, his fear of the 
temptations which beset him as soon as he leaves the pro- 
tection of his parental home. There is also his dread of 
death which might overtake him unawares when he is away 
from the people he loves. 

The knowledge of these determinants and many others 
could be added increases our understanding of street 
anxiety, but it does not completely solve the problem. It 
is still obscure why in a fairly large group of neurotics it 
should be precisely movement away from a place that is 

1 [No. 44, A. B.] 
235 



236 SELECTED PAPERS OF KARL ABRAHAM X 

rendered difficult through anxiety. The fixation of the 
patient's libido on particular persons in his immediate 
vicinity is not in itself a sufficient cause, otherwise we should 
expect that a much greater number of neurotics would 
suffer from street anxiety than is actually the case. And 
the other psychosexual factors mentioned above also operate 
in the formation of neurotic illnesses which do not exhibit 
locomotor anxiety. 

We are therefore bound to conclude that there must be 
a specific factor present in the sexual constitution of neurotics 
who suffer from locomotor anxiety a factor which does 
not affect all neurotics alike, and which, combined with 
other psychosexual factors of the kind described above, 
favours the appearance of street anxiety and similar 
affections. 

The psycho-analysis of a case of severe street anxiety 
has enabled me to form a definite opinion on the matter, 
which I shall proceed to discuss. 

My patient, who had suffered from this trouble for many 
years since puberty, that is to say was only able to 
venture out into the street in the company of his mother or 
of a few persons whom he knew very well. On one occasion 
he remarked to me quite unexpectedly that he found walking 
very pleasant in itself as long as anxiety was prevented by 
his having a suitable companion. He said that when he 
was walking in the street he felt as though he were dancing. 
It further transpired that the patient, who was sexually 
abstinent, derived great pleasure from dancing; and his 
pollution dreams were often dreams of dancing. In a poem 
he had once written he represented prostitution allegorically 
as a woman who danced with any man she came across. 

I do not propose to go into the erotic significance of 
dancing, or its capacity to represent erotic aims by mimicry. 
What interests us in this briefly sketched case is not the 
commonplace fact that the patient derived pleasure from 
dancing, but that walking and dancing offered him a sub- 
stitute for sexual gratification which was otherwise denied 
him by his neurotic inhibitions. 

It is not seldom the case in neurotics that the act of 



IQI3 LOCOMOTOR ANXIETY 237 

walking is accompanied by sexual excitation, especially a 
genital one. I have to thank Dr. Eitingon for a very in- 
teresting communication of a case which may very fairly 
be termed a * walking compulsion '. It was that of a 
neurotic who, in obedience to a powerful impulse, went for 
tremendous walks until they brought on an orgasm. 

The ' negative ' of this peculiar perversion, according 
to Freud's view in his Drei Abhandlungen zur Sexualtheorie^ 
seems to be the neurosis which we know as * street anxiety '. 
I have observed a number of cases which support this view. 
One woman whom I treated by psycho-analysis used to 
experience a violent excitement which passed into a para- 
lysing anxiety as soon as she left her parents' house. She, 
too, derived pronounced pleasure from bodily movement. 
Walking in especial had been particularly pleasurable to 
her originally. It is very characteristic that this patient 
used greatly to enjoy dancing alone in her room. On the 
other hand, if she danced with a man at a ball she would 
immediately have a feeling of excitement which would 
start with violent palpitation of the heart and then turn into 
anxiety associated with a kind of feeling of paralysis. This 
symptom made it in fact impossible for her to dance with a 
strange man. Not only could she not do this, but she was 
also unable to walk with anyone she chose to on account 
of her anxiety. She could go for walks with her nearest 
relatives, but not without suffering a certain degree of 
anxiety. She was only completely free from it when she 
was walking with her father. When she had no anxiety, 
however, walking gave her a pleasure which in her un- 
conscious was equivalent to sexual pleasure in the narrower 
sense. She used to enjoy going walks with her father, for 
walking with him represented a symbolic fulfillment of 
her incest-wish a substitute for real union. It was her 
fixation on her father that prevented her from walking with 
anyone else. Any deviation from this law enforced by her 
neurosis would have signified unfaithfulness to her father. 

I may call attention at this point to the fact that in very 
different languages the sexual act is denoted by an expression 
which signifies a mutual ' going together ' of the two 



238 SELECTED PAPERS OF KARL ABRAHAM X 

persons, as, for example, coire in Latin. I imagine that 
this meaning of going or walking together will be familiar 
to any psycho-analyst who has investigated a case of loco- 
motor anxiety. Nevertheless, it is not sufficient merely to 
point to the symbolic meaning of walking; emphasis must 
be laid on the pleasure-value of walking itself. My 
investigation of the present case, together with other observa- 
tions, have led me to the conclusion that neurotics who 
suffer from locomotor anxiety have to begin with a con- 
stitutionally over-strong pleasure in movement, and that 
neurotic inhibitions of bodily movement have arisen later 
from the failure of the repression of this tendency. 

Sadger l has laid especial emphasis on the significance 
of pleasure derived from movement. He speaks of ' muscle 
erotism ' as an independent source of sexual pleasure, and 
places it side by side with what he has termed ' skin erotism ' 
and ' mucous membrane erotism '. He gives some interest- 
ing data concerning positive pleasure derived from bodily 
movement. I can support his observations in many ways, 
but I will in this place only discuss the question in so far as 
it throws light on street anxiety. 

We find that pleasure in movement 2 is not completely 
repressed in the patients in question. The examples 
already briefly quoted show that they can enjoy this pleasure 
under certain conditions imposed on them by their illness. 
Since I have had my attention called to the significance of 
this constitutional factor I have reviewed my earlier analysed 
cases of street anxiety and the material they contain is 
quite considerable and I have been astonished to find how 
strongly this element comes to the fore. I found that I had 
discovered data of this kind without recognizing that they 
were of a typical character. As a result of my second 
inspection I was able to detect this factor as a constantly 
recurring theme. It found expression partly as pleasure 
in movement with a directly sexual colouring recognized as 
such by the patients themselves, partly as pleasurable motor- 

1 * Haut-, Schleimhaut- und Muskelerotik ' (1912). 

2 I prefer this expression to the term * muscle erotism ' because it avoids any 
localization of the pleasure. 



LOCOMOTOR ANXIETY $39 

impulses of an apparently non-sexual character. These 
phenomena should throw further light on those neurotic 
symptoms which I have attempted to attribute to a pleasure 
in movement which is kept out of consciousness. 

I have repeatedy been able to observe that the patients 
in question show a peculiar interest in the rhythm of their 
movements. This fact seems to me to be of great import- 
ance. They will carry out their movements, so far as 
outward circumstances permit, in some definite rhythm 
which they specially like. If they think they are unob- 
served they will walk across the room in this rhythm, and 
perhaps whistle some tune to their step. One patient 
stated quite spontaneously that this rhythm reminded him 
of sexual rhythms. It seems as though it was partly the 
rhythm of masturbatory acts, partly that of ejaculation, that 
was concerned. This particular patient noted down his 
rhythm in the following manner: 



While a female patient noted down her favourite one thus: 



She had even composed a prose poem which was entirely 
about the feet and their movements during dancing. 

Many patients who suffer from locomotor anxiety have a 
pronounced pleasure in taking firm or rapid steps. 1 They 
also often find pleasure in running downhill quickly, and 
sometimes feel a pressure in the bladder, accompanied by 
sexual feelings. On the other hand, one of my female 
patients, who suffered from street anxiety as an adult, had, 
as a child, been afraid of going downhill ; and her anxiety 
was certainly not explicable merely as a fear of suddenly 
falling to the bottom. I have repeatedly observed in 
neurotics a fear of walking too quickly. This is connected 
with the repression of pleasurable emotions which might 
* run away ' 2 with them. (It is significant that language 

1 When they are walking very quickly some neurotics feel great anxiety and 
have a pollution. 

1 [Durchgehen, lit. to ' go through '= to ' run away ' of a horse. It is also used 
in the sexual sense of 'running away' or eloping with someone. Trans.] 



24O SELECTED PAPERS OF KARL ABRAHAM X 

compares this to the uncurbed energy of a bolting 
horse.) 

Among such patients pleasure in bodily movement is 
not of course limited to the lower extremities, although, as 
we have said, walking is especially pleasurable to them. 
For instance, I observed in a young man suffering from 
street anxiety that he was continually clenching his fists, 
contracting the muscles of his arm, and in particular pressing 
his jaws tightly together, for which latter purpose he strongly 
contracted the masticatory muscles. 1 Another patient, a 
woman, was obliged to clench her fists convulsively, to take 
forced breaths, or to make heaving movements with the 
upper part of her body. Neurotics of this description often 
seem to have a feeling of stiffness or rigidity all over their 
body. 

Besides these physical signs I have regularly found in 
these patients a psychical condition which I am inclined to 
trace to the same sources. It is worth noting that many 
patients spontaneously select the same term for both groups 
of phenomena. They speak of a ' tension ' in the body as 
well as of a state of mental * tension '. 

A person who suffers from severe locomotor anxiety 
finds himself in an almost permanent state of mental tension. 
He wakes in the morning with the anxious expectation of 
having to go out somewhere in the course of the day. As 
the time for setting out approaches, the tension increases. 
It continues while he is out. When he arrives home again 
he begins to worry about what will happen the next day. 

Many patients describe this state by a phrase which is 
familiar to every neurologist. They speak of a * fear of 
fear '. It has always struck me that patients make use of 
this expression with a certain emphasis, as though they 
are saying something especially profound and as though 
they are giving the physician a most important clue to their 
condition. And they are in fact quite right. Superficially 
the expression ' fear of fear ' seems foolish enough. The 
psycho-analyst, however, cannot fail to recognize that this 

1 In his case there was also an unusual erotogenic significance attached to the 
mucous membrane of the mouth. 



LOCOMOTOR ANXIETY 24! 

tension preceding the real anxiety is analogous in every 
respect to the fore-pleasure which precedes the satisfaction- 
pleasure in sexual life. 

Many of these neurotics say that they cannot at all 
imagine what their life would be without a state of permanent 
expectation of anxiety. A more precise knowledge of the 
sexuality of these patients shows furthermore that they 
exhibit an excessive tendency to protract their fore-pleasure 
and not to leave it. Among patients suffering from street 
anxiety one finds in particular a remarkably large number 
who have wholly renounced normal sexual gratification- 
pleasure in consequence of their neurotic inhibitions. They 
are pronouncedly auto-erotic, and thus they are inclined to 
postpone reaching the end-pleasure indefinitely. As a form 
of protracted enjoyment of fore-pleasure I may mention 
the so-called * dream-states ' which I have dealt with in 
detail in a previous paper. 1 Among the patients in whom I 
studied these states a considerable percentage suffered from 
street anxiety. The dream-states themselves show in the 
clearest manner how erotic tendencies pass over into 
anxiety and other neurotic symptoms. 

The psycho-analysis of ' topophobia * shows that we are 
dealing with patients who dread attaining their libidinal aim. 
Their anxiety prevents them from becoming free from them- 
selves and from the objects upon which their love was fixed 
in childhood, and from finding the way to objects belonging 
to the external world. Every path which leads them away 
from the charmed circle of those people upon whom they 
are fixated is closed to them. They may only enjoy their 
pleasure in movement in the company of those very people. 
If they act in opposition to the prohibition dictated by the 
neurosis and go for a walk without their prescribed com- 
panion, their pleasure in movement is changed into fear of 
movement. It is impossible for them to enlist their pleasure 
in movement in the service of object-love in the same way 
that in healthy people the originally autonomous component- 
instincts enter the service of a central tendency. 

Now that we have succeeded in tracing back the neurotic's 

1 See Chapter IV, 

Q 



SELECTED PAPERS OF KARL ABRAHAM X 

fear of independent movement to a factor in his sexual 
constitution which has not yet been sufficiently taken into 
account hitherto, the question as to the origin of such a 
* prohibition ' answers itself. The fact that the presence 
or his father or mother releases the patient from anxiety 
enables us to recognize sufficiently clearly that the source 
of his inhibition in movement is an incestuous fixation. I 
need hardly mention that all my psycho-analyses of topo- 
phobias agreed in bearing out this view. 

The preceding remarks require to be completed in one 
direction. In order to simplify matters I have only spoken 
so far about pleasure derived from active movement and 
about the change of such pleasure into anxiety. As a rule, 
however, the same patients are afraid of movement in a 
passive sense, too, as soon as it removes them from the 
neighbourhood of certain persons. My experience points 
to the fact that originally travelling also gave a high degree 
of pleasure to these patients. Anyone who has studied 
their dreams will have noticed how frequently they are con- 
cerned with travelling, and in more recent times especially 
with travelling in the air. Many neurotics experience a pro- 
nounced bodily pleasure in travelling. 1 As a particularly 
characteristic example I may mention one patient of mine 
who used to make long railway journeys and to keep awake 
all through even the longest of them in order not to lose 
his pleasure in travelling; and who used to travel chiefly 
for the sake of that pleasure. It may be mentioned that in 
many persons a long railway journey always brings on a 
pollution during the following night. 

The view that such a repression of pleasure in passive 
movement has occurred in the group of neurotics under 
discussion was recently confirmed to me by a spontaneous 
remark made by a female patient. She had at first only 
been able to make the journey from her house to mine with 
the greatest effort. Psycho-analysis had at first only effected 
a diminution of her anxiety; until one day she arrived in 

1 Reference may also be made to children's pleasure in travelling. I knew a 
boy who as soon as he received his pocket-money of one shilling regularly spent it 
in going for tram rides the whole afternoon. 



LOCOMOTOR ANXIETY 243 

very high spirits and told me that she had been quite 
astonished to find that the journey had given her pleasure 
that day. Her anxiety in connection with the journey had 
given way to a pronounced pleasure in it. A few years ago 
I succeeded in obtaining very satisfactory and complete 
therapeutic results in a case of severe street anxiety. The 
patient, who had previously only been able to leave her 
house with the strongest feelings of anxiety, not only got 
pleasure from travelling after her cure but even put her 
name down to take part in a balloon trip. She was no 
longer debarred by neurotic prohibitions from deriving 
pleasure from movement. 

The fact that fear of movement can change into a corre- 
sponding pleasure seems to confirm the views advanced 
above regarding the basis of locomotor anxiety. The 
derivation of fear of movement from an originally over- 
strong pleasure in it falls into line with other psycho-analytic 
results that have been confirmed by experience. As an 
example I need only mention the fear of touching which we 
have been able to trace to originally pleasurable impulses 
to touch things. 

Psycho-analysts have been occupied for a long time 
with the difficult question of what the psychological con- 
ditions are which determine the form of the neurotic disease 
to which the individual will succumb. It is as though he 
had a choice between different illnesses and led by un- 
known impulses selected one or other of them. 

From the most recent investigations (I refer principally 
to Freud's paper on the origin of the obsessional neurosis, 1 
and Jones's 2 contributions on the same subject) we have 
got a step nearer the problem of the ' choice of neurosis '. 
I hope that the views put forward in this paper on the psycho- 
genesis of ' locomotor anxiety ' may be regarded as a slight 
contribution to the solution of this problem. 

1 'The Predisposition to Obsessional Neurosis' (1913). 
2 * Hate and Anal Erotism in the Obsessional Neurosis * (1913). 



CHAPTER XI 

THE EAR AND AUDITORY PASSAGE AS 
EROTOGENIC ZONES * (1913) 

SEVERAL years ago my attention was drawn by the 
following observation to the significance of the ear 
and external auditory meatus as erotogenic zones. 
A neurotic patient suffered from peculiar attacks * 
which occurred ten to twenty times a day and even more 
often. I had ample opportunity of observing these * attacks ' 
during a long psycho-analytic treatment. In the middle of 
a conversation the patient would suddenly jump up, turn 
pale, put his hands up to his ears, and run to the door; then 
he would stick the forefinger of his right hand into his right 
ear and move the finger violently about in it with every sign 
of the most intense excitement. At the same time his face 
would work as though he were in a towering rage, and he 
would wriggle about and stamp his feet. The motor Ener- 
vation would finally be discharged in panting breaths, and 
he would then sink down exhausted. After a few moments 
he would be able to continue his previous train of thought, 
though I sometimes had to recall to his memory the words 
he had been speaking immediately before his attack. Con- 
sciousness was always clouded during the attacks ; and after 
them the patient had a feeling of returning to reality out of 
a different state. He knew that quite definite thoughts 
appeared at the height of his state of excitement, but he was 
never able to recollect what they were precisely. The 
analysis, which cannot be given in full here, showed that at 
the beginning of each attack the patient felt violent itching 
in the auditory meatus, of which he rid himself with every 
sign of great excitement. These attacks were a surrogate 
for certain kinds of sexual activity which were denied him, 

1 [No. 46, A. B.] 



IQI3 THE EAR AS AN EROTOGENIC ZONE 245 

It is particularly interesting to note that the attacks, and 
most of his other symptoms as well, disappeared on one 
occasion for some months. This was at a time when he 
had become acquainted with a girl. They did not proceed 
to sexual intercourse, but found pleasure in tickling each 
other with feelings of great excitement until they became 
exhausted. 

In this case there was obviously an unusually strong 
erotogenic state of the skin in general, while the ear and 
auditory meatus exhibited this characteristic in an extreme 
degree. It is well known that some neurotics derive an 
extraordinary pleasure from being tickled. If other ways 
of sexual gratification are closed to them the neurotic symp- 
tom of pruritus frequently appears, in which the person is 
led to perform chafing or scratching movements which some- 
times lead to orgasm. For instance, I was able to observe 
a female patient with pruritus of the left arm who, by 
scratching the part with increasing violence until it reached 
a kind of frenzy, could produce a complete orgasm. This 
method had the advantage over masturbation, which she had 
practised earlier, in that no self-reproach was attached to 
it. To scratch oneself on account of a nervous skin irrita- 
tion or a concomitant eczema would appear as a necessity 
and not as a moral lapse. 

It has long been known that in early childhood the 
ear is used to obtain auto-erotic pleasure. I need only 
refer to the frequent habit of children who suck their 
thumbs, etc., of catching hold of an ear and rhythmically 
pulling the lobe while sucking for pleasure. Furthermore, 
it must be remembered that during their childhood, and 
even later, many people poke their fingers into the auditory 
meatus, insert things into it, and like to occupy themselves 
with the auditory secretions. In one case a boy caught a 
fly and put it into his ear. In consequence of his manipula- 
tions the * foreign body ' passed so deeply into his ear that 
medical intervention was necessary. Children often put 
small objects such as peas, etc., into their ears. 1 

1 Mental patients frequently exhibit a tendency to put all kinds of things 
into their ears. 



246 SELECTED PAPERS OF KARL ABRAHAM XI 

It is only recently, however, that I have become con- 
vinced that a much more general significance attaches to the 
ear as an erotogenic zone. I have to thank my colleague 
Dr. H. Hempel, an ear specialist in Berlin, for the following 
reliable observations which I quote here because observations 
such as these deserve the attention of psycho-analysts and 
because their importance has not been sufficiently appreci- 
ated up to the present. 

Small children often suffer from a moist eczema of the 
ear and external auditory meatus, accompanied by intense 
itching. After the physician has treated the ear such 
children adopt a different behaviour towards his subsequent 
visits from that usually shown when medical attention is 
called for. The child who has been crying before on account 
of the discomfort of the eczematous condition will become 
extraordinarily quiet at the physician's approach and will 
not struggle in the least. As long as the physician is doing 
anything to the itching part the child will remain quiet and 

Ol 9 Ji 

will even murmur contentedly; it only starts crying again 
when his manipulations cease. I may mention that these 
observations were made without any special knowledge of 
the Freudian conception of infantile sexuality, and that 
nevertheless the observer had come to the conclusion that 
the conduct depicted was very similar to the conduct of the 
child during masturbatory stimulation. It may be added 
that adults also exhibit unmistakable signs of agreeable 
sensations during the treatment of aural eczema. Dr. 
Hempel mentioned to me that he once saw a man who had 
scratched both ears till they were raw, but who would not 
consent to be treated for this affection. 

Many products of phantasy show what an important 
part the ear can play in the sexuality of the child. One 
patient told me of a tendency she had had from childhood 
to invent phantastic stories. When she was about nine 
years old (and probably earlier as well) she often used to 
imagine that she was being punished for some misdeed. 
She was particularly fond of picturing a scene in which she 
was going for a walk with her younger sister, and the 
Kaiser came driving along in a carriage and had them 



1913 THE EAR AS AN EROTOGENIC ZONE 247 

arrested for some unspecified crime. Punishment followed 
which consisted in this, that both children had to have 
their ears cleaned ! The child experienced at once pleasure 
and fear during this procedure. Her phantasies on this 
theme not only contained a partly longed-for, partly feared 
stimulation of an erotogenic zone but also a gratification 
of masochistic tendencies. 

In the same way we can observe children or adults who 
imagine scenes in which they are being tickled in the most 
sensitive parts of their body. Various signs point to a 
fusion of sado-masochistic impulses with pleasure in tickling 
or being tickled. I will only give as an instance here the 
signs of a violent affect of rage which were evident in the 
4 attacks ' of the neurotic described above, and in the patient 
who scratched her arm so violently. 

I have only to refer to a few facts which up to now 
have been little considered. In the first place there is 
the reddening of the ears to which many neurotic people 
incline. I intend later to consider in greater detail the 
connection between that symptom and processes of sexual 
excitation. It would appear, furthermore, that in some 
people the part of the neck adjacent to the ears, especially 
the angle between the neck and the jaw, has a particular 
erotogenic significance. The erotogenic significance of the 
ear should also be considered in relation to neurotic ringing 
in the ears and other sounds of subjective origin. And 
finally, reference may be made to the fact, well known to 
psycho-analysts, that the ear has at all times been frequently 
employed as a genital symbol. 

I am probably right in assuming that every psycho- 
analyst could produce observations similar to those given 
here. Sadger l has mentioned a number of interesting 
observations which admirably supplement mine, and in a 
paper by Jekels 2 there is an allusion to mutual stimulation 
of the auditory meatus in inverts. 

1 Sadger, ' Haut-, Schleimhaut- und Muskelerotik ' (1912). 
2 Jekels, ' Einige Bemerkungen zur Trieblehre ' (1913). 



CHAPTER XII 

THE FIRST PREGENITAL STAGE OF THE 
LIBIDO 1 (1916) 

I 

IN his Drei Abhandlungen zur Sexualtheorie^ which first 
appeared in 1 905, Freud gave a comprehensive account 
of his views concerning the sexuality of the child. In 
the third edition of the book, published in 1915, he has 
amplified those views, so that it is still to-day the standard 
work on the subject. 

The advances which have been made in psycho-analytical 
knowledge have required us to assume the existence of 
certain stages in the early development of the infantile 
libido. Freud calls those stages the ' pregenital organiza- 
tions ' of the libido, since they do not as yet show a pre- 
dominating importance of the genital organs. 

The following remarks relate to the earliest of those 
stages of development. They are supported by extensive 
observations which were exclusively made before the 
theoretical views concerning the libidinal stages were put 
forward.) A preconceived theory of the pregenital organiza- 
tions cannot therefore have influenced the choice of that 
material. It seems to me necessary to point out this, since 
each further extension of the sexual theory will probably 
meet with objections similar to those raised at the first 
appearance of the Drei Abhandlungen. Nevertheless, before 
presenting my material and the conclusions which I have 

1 [No. 52, A. B.] 

248 



IQI6 THE FIRST PREGENITAL STAGE 249 

drawn from them, I shall have to review the fundamental 
facts upon which the theory of the pregenital stages of the 
libido is based. 

|Tn his remarks on the earliest phenomena of infantile 
sexuality Freud was able to refer to an authority who long 
before him had arrived at new and daring, but at the same 
time convincing, conclusions in this sphere. This important 
piece of pioneer work had been carried out by Lindner in 
1879 in his studies on sucking habits in children. He had 
not failed to notice the libidinal character of the process; 
he remarked on the fact that sucking, even when it did not 
serve the purpose of satisfying hunger, was carried out by 
children with an intensity which completely absorbed their 
attention. He had also observed an excitement in the child 
during the act of sucking which increased to a kind of 
orgasm, and he considered that the falling asleep of the 
child after this occurrence was an effect of the gratification 
it had obtained. Furthermore, he drew special attention to 
the instinct of grasping which is associated with sucking, 
and recognized the gradual transition of sucking to mastur- 
bation that is, to an activity of an undoubtedly sexual 
character. ^ 

CFreud accepted Lindner's views, and he established 
definite characteristics for infantile sexuality, as they are 
most clearly seen in that primitive form of instinctual 
activity, sucking. These characteristics are, that in the 
first place the instinct is not directed on to another object, 
but is manifested auto-erotically. In the second place, this 
most primitive form of sexual expression is not an inde- 
pendent phenomenon, but is dependent upon a function 
important for the preservation of life, namely, sucking for 
nourishment; so that it is the reproduction of a pleasurable 
stimulus which the child has experienced during feeding. 
In the third place, the attainment of the pleasure is attached 
to an * erotogenic zone ' the mucous membrane of the lips. 
Gratification of the need for nourishment and gratification 
of the erotogenic zone cannot be separated from each other 
in their earliest state. The mucous membrane of the lips 
must, moreover, possess erotogenic quality, which fluctuates 



250 SELECTED PAPERS OF KARL ABRAHAM XII 

in intensity in different children, for they exhibit the 
tendency to suck for pleasure in very different degrees?) 

(According to Freud a similar double function attaches 
to the anal aperture of the alimentary canal as well. He 
believes that in early childhood this aperture does not have 
excretory functions alone but also subserves infantile 
sexuality as an erotogenic zone. The child seeks to re- 
experience the local sensations necessarily associated with 
the emptying of the bowel, and, by holding back its contents, 
is able to intensify those sensations. As with the lip-zone, 
the erotogenic capacity of the anal zone must be presumed 
to vary with each individual. The deliberate intensifica- 
tion of this accessory pleasure obtained in defaecation by 
stimulating an erotogenic zone is, like sucking, similar in 
nature to genital masturbation, which is also practised in 
early infancy,) 

Besides the auto-erotic phenomena of early childhood 
Freud describes certain component-instincts which are 
directed from the outset upon other persons as sexual objects 
(pleasure in looking and exhibiting, active and passive com- 
ponents of cruelty). At first these component-instincts are 
not organized firmly together, but proceed independently 
in the obtaining of pleasure. It is only later that the 
erotogenic zones and component-instincts become united 
under the primacy of the genital zone. When the sexual 
instinct enters into the service of procreation its development 
reaches its normal completion. 

As we have said,Freud has called ' pregenital * those 
stages of the development of the libido which precede the 
setting in of the primacy of the genital zone. They relate 
to antecedent stages of the later ' normal ' sexuality, through 
which the libido of the child generally passes without anyone 
being aware of the alterations that are occurring. The 
same processes, which under normal conditions are not 
especially noticeable, become * highly active and able to be 
detected by superficial observation ' (Freud) in pathological 
cases. 

Up till now the psycho-analysis of neurotic cases has 
enabled us to infer the existence of two such pregenital 



IQI6 THE FIRST PREGENITAL STAGE 251 

organizations. The earliest is the oral stage, which may also 
be called the cannibalistic stage. As has already been said, 
in this stage sexual activity is not yet separated from the 
taking of nourishment. Freud says: ' The object of the 
one activity is also that of the other. The sexual aim con- 
sists in the incorporation of the object ' (p. 60) ; and he 
adds a remark which is important for the understanding of 
sucking for pleasure : ' Pleasure-sucking can be considered 
as being the remains of this hypothetical stage of organiza- 
tion which our pathological material has led us to assume. 
It can be looked upon as a sexual activity which has become 
detached from nutritive activity, and which has exchanged 
its external object for one belonging to its own body.' 

From his psycho-analysis of the obsessional neurosis 
Freud was able to infer the existence of yet another pregenital 
organization. He says: 'A second pregenital phase is the 
sadistic-anal organization. In this the duality of sexual 
life which is an integral part of it has already come into 
existence. But it cannot at this period be called male and 
female ; it must be termed active and passive. The activity 
arises from the bodily musculature in virtue of the instinct 
of possession ; the passivity is pre-eminently connected with 
the erotogenic mucous membrane of the intestinal canal. 
Both impulses are directed to objects, which are not, 
however, the same^f At the same time other component- 
instincts are functioning in an auto-erotic way. In this 
phase, therefore, sexual polarity and the external object are 
already discoverable. But there is as yet no organization 
of the component-instincts or subordination to the function 
of procreation/ 

I have now roughly indicated the present position of the 
theory of sexuality as far as it applies to our subject. While 
the observations which have led to the description of the 
sadistic-anal organization have found special consideration 
in psycho-analytic literature I refer particularly to Jones' 
important communications the earliest, ' oral ' stage of 
development of the libido awaits further investigation. As 
Freud has stated, it is our pathological material which 
compels us to assume its existence. This fact indicates that 



2$2 SELECTED PAPERS OF KARL ABRAHAM XII 

we are concerned with developmental processes which are 
hardly accessible to direct observation in children. At 
this early period the child can give no information about 
the processes of its instinctual life. Besides, in normal 
conditions development in the first year of life takes place 
so quietly that generally no obvious manifestations of the 
changes that are occurring can be observed; and later, 
when repression has fully set in, the individual is naturally 
less able than ever to give information about the earliest 
events of his life. 

I The facts of normal erotism make it plain that the 
mouth has by no means given up its significance as an 
erotogenic zone. And the study of the sexual perversions 
shows still more clearly that the mouth can take over the 
whole significance of a sexual organ, i.e. can fulfil a genital 
role. Furthermore, psycho-analysis of the neuroses shows 
that very frequently the mouth has lost its significance as 
an erotogenic zone only as far as consciousness is concerned, 
and that this significance persists in the unconscious and is 
manifested in consciousness through substitutive formations, 
which we know as neurotic symptoms. We owe to psycho- 
analysis the knowledge that these phenomena are equivalent 
to infantilisms. They represent partly a persistence of 
infantile instincts in the unconscious, partly a return to 
libidinal stages which had already been left behind. That 
such repressed infantilisms could be rendered unrecogniz- 
able through numerous alterations and indeed turned into 
their exact opposites, has been shown by Freud in 1915, 
precisely in connection with phenomena related to the 
mouth zone. According to him, neurotics in whom the 
erotogeneity of the oral zone had originally been very 
marked, and in whom this had perhaps been expressed by a 
continuance of the sucking habit for many years, are often 
affected by nervous vomiting in later life. ) 

But even though all these phenomena justify us in 
inferring the existence of an early * oral ' stage of the libido, 
we still have no clear picture, no direct view, of this archaic 
condition which is extraordinarily far removed from the 
instinctual life of the normal adult. I should therefore like 



1916 THE FIRST PREGENITAL STAGE 253 

to bring forward some psychopathological material which 
has hitherto been almost unknown or at least quite dis- 
regarded, and which goes to show that the instinctual life 
of the infant persists in some adults in a positive and un- 
mistakable fashion, and that the libido of such persons 
presents a picture which appears to correspond in all its 
details to the oral or cannibalistic stage set up by Freud. 
I shall begin by giving the most extreme symptoms of a 
case of this kind as far as they are of interest in this con- 
nection. They will throw light on a whole series of psycho- 
pathological phenomena to which no special investigation 
has hitherto been devoted. Finally, I shall consider a 
question which has arisen out of the recent studies made 
on the psychogenesis of the obsessional neurosis. The 
investigations of Freud l and Jones 2 have shown that com- 
pulsive symptoms result from a defence against sadistic- 
anal impulses. It may be expected that a similar defence 
against a threatened relapse into the oral organization will 
also lead to the formation of quite typical symptoms; and 
the correctness of this expectation seems to be corroborated 
by certain findings of psycho-analysis. I should like to 
attempt, on the basis of our material connected with the 
earliest pregenital organization, to make two contributions 
to psycho-analytic theory namely, to consider the question 
of the origin of psychic states of depression, and to discuss 
the problem of the ' choice of neurosis '. 

II 

(The material I shall first bring forward comes from the 
psycho-analysis of a case of dementia praecox (Bleuler's 

* schizophrenia '). The patient did not present the well- 
known picture of a psychosis with delusions, hallucinations, 
etc., but that variety of the illness which has been termed 

* simple ' dementia praecox. Patients of this group, which 
Bleuler has also recently classified as * schizophrenia sim- 
plex ', do not show the above-mentioned gross symptoms 

1 ' The Predisposition to Obsessional Neurosis * (1913). 
* * Hate and Anal Erotism in the Obsessional Neurosis ' (1913). 



254 SELECTED PAPERS OF KARL ABRAHAM XII 

K 

of mental disturbance. They rather exhibit definite associa- 
tive disturbances and, particularly, alterations of feeling and 
impulse, such as one finds in severe cases side by side with 
delusions. The associative activity of these patients pro- 
ceeds so far along organized paths that a psycho-analysis 
can be carried out with them just as well as with a psycho- 
neurotic. Indeed the work is even facilitated in such 
patients on account of the abolition of many inhibitions^ 
In the neurotic a great deal of material is prevented from 
becoming conscious, and therefore from being spoken about, 
on account of the intense repression; whereas in these 
patients the material lies quite near consciousness, and in 
certain circumstances is expressed without resistance. 
'*t My patient came from a family in which cases of severe 
catatonic dementia praecox had already occurred. He was 
by no means deficient in intelligence, and had had a secondary 
education. After leaving the routine of school life he had 
made but little progress in his academic studies, and .certain 
peculiarities which he had shown as a scholar had developed 
more strongly in him. When he came to me for treatment 
his conduct in many ways resembled that of an intelligent 
child. Neither his special subject nor any events in the 
external world were able to excite any serious interest in 
him. He amused himself at most with trifles and purely 
superficial things; but he turned his attention chiefly on 
to his own ego in a markedly narcissistic manner. The 
slightest fancy, a pun on a word, etc., could occupy him 
intensely and for long periods of time. His own physical 
condition absorbed his interest more than anything else. 
His genital and anal sensations were of the highest import- 
ance to him. Moreover, he was addicted to anal as well as 
to genital masturbation. During the period of puberty he 
derived pleasure from playing with faeces, and later on he 
occupied himself with his bodily excretions. For instance, 
he took pleasure in eating his own semen. But his mouth 
played a very special role as an erotogenic zone. As often 
happens in this kind of case, he was conscious of the sexual 
character of certain of his symptoms, though to an out- 
sider they would not at once have appeared in this light. 



1916 THE FIRST PREGENITAL STAGE 255 

The patient directed my attention to the erotogenic signifi- 
cance of the mouth when one day he spoke of * mouth 
pollutions ' as something quite ordinary and well recognized. 
On being questioned, he described an occurrence which 
frequently took place. He would wake up in the night 
from an exciting dream to find that saliva was dribbling out 
of his mouth. In his free associations he proceeded to 
bring forward a great deal of material regarding the eroto- 
genic significance of the mouth. I will give the most 
instructive facts in this connection. 

According to the patient's own statements he had not 
been able to wean himself from the love of milk as a boy. 
At school he had never been able to get sufficient milk to 
drink. This tendency still existed, but had changed in 
certain respects. Up to the age of fifteen he had not simply 
drunk milk out of a cup or glass, but had had a particular 
method of sucking it in. He used to curve his tongue 
upwards and press it behind the upper teeth on the palate 
and then suck in the milk. The milk had to be neither 
hot nor cold, but at body temperature. He obtained a 
particularly pleasant sensation in doing this. He added 
spontaneously: ' It is like sucking at the breast '. ' I suck 
at my own tongue as though it were the nipple.' At 
fifteen he had given up this kind of sucking and had at the 
same time begun to take cold beverages. Nevertheless, his 
desire for milk had by no means been overcome, and indeed 
its sexual determination had come out very distinctly in the 
following years through frequent occurrences which the 
patient reported as though they were something quite 
ordinary. He used often to wake up at night with violent 
sexual desires; he then used to drink some milk which he 
had placed ready in his bedroom. He used often to get 
up at night and go to the kitchen for milk. If at any time 
he could not find any he used to put an end to his sexual 
excitement by masturbating; but otherwise he used to 
satisfy himself by taking milk. He himself felt that his 
longing to suck milk was his deepest and most primitive 
instinct. Genital masturbation, strongly though it dominated 
him, seemed to him to be a secondary thing. 



SELECTED PAPERS OF KARL ABRAHAM XII 

These facts speak for themselves. There cannot be 
the slightest doubt of the sexual significance of the patient's 
sucking of milk or of the role played by his mouth as an 
erotogenic zone. His behaviour at night, as described 
by himself, can easily be seen to be a continuation of the 
behaviour which neurotically disposed children show in the 
first and second years of life. These children find great 
difficulty in acquiring the habit of an unbroken night's 
sleep. They wake up in the night once or more often and 
make known through their crying, or, if they are old enough, 
through other signs, that they desire the breast or the bottle. 
If they are given milk to suck they are gratified and become 
quiet; if not, they are able to obtain a substitutive gratifica- 
tion by putting their thumb or finger in their mouths and 
thereby stimulating the oral zone, or by giving another 
erotogenic zone, say the genital one, an adequate mastur- 
batory stimulus. 

Our patient's behaviour fully coincided with that of the 
infant. From the fact that as an adult he still felt most 
intensely that form of gratification which bore the character 
of incorporation, it is clear that his libido had experienced 
a strong fixation in the earliest pregenital stage, /',<?> the oral 
or cannibalistic one. Sucking served him as a method of 
taking nourishment and of obtaining sexual pleasure, 
although its first function certainly sank into the back- 
ground in comparison with the second* I may remind the 
reader of the so-called * mouth pollutions ' already men- 
tioned by the patient. We generally consider the flow of 
saliva as a sign of appetite. But in this patient, whose 
mouth zone was so markedly in the service of his sexuality, 
such a flow was an accompanying symptom of a sexual 
excitement occurring during sleep. His libido therefore 
showed a tendency to discharge itself through the pre- 
dominant erotogenic zone of the first years of childhood. 

What psycho-analysis was able to discover in regard to 
the patient's further libidinal development is of extreme 
interest. From the subject of sucking, his associations led 
on to the historically later developed form of taking nourish- 
ment, i.e. to eating. In this connection he brought forward 



THE FIRST PREGENITAL STAGE 257 

a memory to which other important associations became 
added. He said that when he was a little boy he had had 
the idea that loving somebody was exactly the same as the 
idea of eating something good. Since childhood he had 
had ' cannibalistic ideas '.* These ideas were at first traced 
back along associative paths to his fourth year. At this 
age I was able to check the correctness of his statements 
as to the date he had had a nurse to whom he had been 
very much attached. It was she who was the centre of his 
cannibalistic phantasies. At a later period the patient still 
often used to want to bite into her, and * to swallow her, 
skin, hair, clothes, and all '. 

But psycho-analysis was able to penetrate even deeper. 
A further association of the patient's showed that the taste 
of meat reminded him of milk; both were ' greasy and 
sweet '. He said that just as he many times experienced 
a sudden longing for milk, so he did for meat. It seemed 
to him as though he wanted a substitute for human flesh. 
His associations led from this point to the phantasy of biting 
into the female breast; and here it was that his ideas of 
meat and milk had a direct connection. I may add that 
the period during which he had been nursed at the breast 
had been unusually full of important occurrences. Various 
circumstances had rendered it necessary for his wet-nurse 
to be changed several times and for the period of breast 
feeding to be considerably prolonged. These events were 
bound to have an effect on a child in whose sexual constitu- 
tion the mouth zone was so strongly accentuated. They 
must have facilitated the fixation of his libido on an earlier 
stage or its regression to such a stage. 

In conclusion, it may be mentioned that the patient also 
experienced a marked degree of pleasure in eating, of which 
his tendency to over-eat gave ample proof. But this 
accentuation of pleasure in eating did not to his mind bear 

1 Perhaps it is not superfluous to remark that the expression as well as the idea 
here quoted came from the patient himself. The expression ' cannibalistic ideas * is 
not borrowed from the Drei Abhandlungen xur Sexualtheorie. The psycho- 
analysis from which I am quoting took place in 1912, whereas the third edition of 
Freud's book, which contains that expression for the first time, did not appear 
till 1915. 

R 



258 SELECTED PAPERS OF KARL ABRAHAM XII 

the same sexual significance as the sucking did; it appeared 
to him to have a secondary character. Nevertheless, it 
showed his tendency to excite his erotogenic zones in every 
way. Even when his libido found new sources of pleasure 
the earlier ones showed no diminution of their importance ; 
and this peculiarity persisted in the further development of 
his instinctual life. It explains the fact that when he was 
grown up his libido never achieved uniformity of direction. 
He could not attain a normal emotional attitude towards 
other persons and could not advance to object-choice; and 
at the same time his different erotogenic zones maintained 
their original independent significance. Of these, however, 
it was the mouth zone whose excitation he found by far the 
most pleasurable, and about whose importance for him he 
spoke with most affect. 

The characteristics of this case may be summed up as 
follows : 

1. The oral zone was more important than the other 
erotogenic zones. Pleasure in sucking was particularly 
strong. Sucking milk produced a state of gratification. 

2. The sexual function and the nutritive one were 
associated in the act of sucking. 

3. The patient had the desire to incorporate the object 
which attracted his wish-phantasies. (He himself called 
this a cannibalistic impulse.) 

These are, however, the same characteristics which 
Freud has been led to attribute to the earliest stage of 
libidinal development in infancy. The agreement is com- 
plete, and causes no astonishment to anyone who has recog- 
nized from his own psycho-analytical work to how great a 
degree Freud's theories are the result of direct observation, 
and how far they are removed from idle speculation. 

An adult whose libido is found to be in a condition such 
as that just described deviates to an extraordinary degree 
from the normal. The extreme nature of the symptoms 
in such a case renders intelligible to us related phenomena 
which we meet in other persons in a less marked degree or 
in a more disguised form/^ 



1916 THE FIRST PREGENITAL STAGE 259 



III 

There are considerable differences even in healthy chil- 
dren with regard to the time at which they are weaned. 
These differences are partly based on external conditions, 
but they can in part only be explained by variations in the 
individual. Thus the transition from the taking of nourish- 
ment by sucking to drinking in the narrower sense takes 
place sometimes earlier, sometimes later. 

With regard to the external factors, ethnological, social 
and family conditions have to be taken into consideration. 
In quite a number of partially civilized peoples the children 
are not weaned until the fourth or even the sixth year. And 
even among the people of one country, or even of one dis- 
trict, weaning takes place at very different periods. Among 
our own lower classes it is fairly frequent for older children 
to be given the mother's breast from time to time when 
she has a younger child to suckle. Neurotic mothers will 
frequently delay the weaning of their child for a long time, 
because the act of giving suck gives them the strongest 
physical feelings of pleasure; this is particularly so in 
women with genital frigidity in whom the breast has obtained 
an over-great significance as an erotogenic zone. 

However, we are more interested in those cases in which 
the child itself causes difficulties in its weaning. We can 
recognize these resistances in a child even during the 
period of sucking, when it has to pass from the mother's 
or wet-nurse's breast to the bottle; and we observe very 
remarkable differences in the behaviour of children in this 
connection. Many become used to the change in the 
course of a few days; and some children, who in feeding 
at the breast do not use sufficient energy in sucking, very 
soon prefer the bottle, because the food flows out from it 
without trouble to them. There are, however, children who 
resist with great obstinacy the transition from the breast to 
the bottle. This resistance becomes quite manifest when 
the child is expected finally to give up taking nourishment 
by sucking, (it frequently happens that neurotically dis- 



26O SELECTED PAPERS OF KARL ABRAHAM XII 

posed children react to the attempt at weaning by taking so 
little food that the mother is compelled to give in to them 
for the time being. In pronounced cases difficulties of this 
kind can continue up to school age. I might mention, for 
example, a girl of nine years who could not be induced to 
take her breakfast with her family before going to school. 
In order not to allow the little girl to go to school fasting, her 
mother used to bring a bottle of warm milk to her in bed 
every morning. The other meals the obstinate little girl 
took with the family as usual. In a case reported by Gott, 
a thirteen-years-old boy had to be weaned from the bottle. 
This reminds us of the particularly marked case which I 
have given above in detail. 

Such behaviour on the part of the child can be explained 
in no other way than as an obstinate adherence to the 
pleasure which sucking affords him through the agency of 
the lips as an erotogenic zone. New-we have learned from 
observation that persons who cling to infantile pleasure- 
sucking are invariably seriously hampered in the develop- 
ment of their sexuality. Their instincts of nutrition and 
of sexuality remain to a certain extent intermingled. Their 
libido does not find the way to a living, human object in a 
normal manner, but seeks its gratification in the first 
instance in sucking up a material into the mouth/*} 

The part that sexuality plays in pleasure-suclung which 
persists into later years appears very clearly in those persons 
who, as adults, have the impulse to suck at the female breast. 
This kind of sexual practice stimulates them more strongly 
than normal cohabitation. One of my patients explained 
to me that in such an erotic situation he was in a curious 
state of divided feelings. On the one hand he was afraid 
that milk might come out of the breast, and on the other 
he was angry and disappointed when none did. In this 
case the sexual interest in sucking greatly preponderated; 
nothing remained of its other significance except an in- 
quisitive, uneasy expectancy as to whether the breast would 
yield milk. 

("It is well known that after being weaned children 
preserve a tendency to suck sweet things. We frequently 



THE FIRST PREGENITAL STAGE 26 1 

find in neurotic men with strongly suppressed libido an 
intense, impulsive desire for sweet things. They take a 
particular pleasure in sucking at sweets very slowly. In 
two very pronounced cases I could establish with certainty 
that it was the sucking-pleasure originating in infantile 
auto-erotism 'which had pushed aside the active impulses 
of the libido and which procured for the subject the most 
pleasurable feeling of all. One of these patients used to 
suck sweets in bed in the evening, and then go off to sleep 
with a feeling of having been gratified. The similarity of 
this behaviour with that of the child in the sucking period 
is very obvious. Normal male erotic behaviour was com- 
pletely suppressed in this case. The other patient showed 
infantile traits to an unusual degree. His libido was quite 
without male activity, and instead made thorough use of 
every auto-erotic source of pleasure. When he set out to 
his work in the morning he used to go through a character- 
istic performance. He used to behave as though he were 
a little boy, and on going used to say to his wife: ' Sonny 
is going to school now '. On the way he used to buy sweets 
just as children do, and take great pleasure in slowly sucking 
them. The patient spoke of this childish amusement with 
great animation, while sexuality in the sense of normal male 
behaviour possessed an unusually small interest for him. In 
the course of his psycho-analysis it became evident from 
many signs that the libidinal interest belonging to the 
normal sex function was entirely attached to auto-erotic 
processes. We can here clearly see/the failure of the 
separation of the function of taking nourishment from that 
of sex, from the fact that sucking sweet substances received 
such a strong libidinal emphasis, \ 

In this briefly outlined case we have an example of a 
failure to leave the infantile pleasure in sucking. The next 
example will illustrate a subsequent regression to this source 
of pleasure. 

A neurotic young girl, who had for many years practised 
masturbation, was one day ' enlightened ' by a book as to 
the wickedness and danger of her habit. She was seized 
with anxiety and succumbed to a depression of spirits which 



262 SELECTED PAPERS OF KARL ABRAHAM XII 

persisted for a long time. She abstained completely from 
masturbation. During this period of sexual abstinence 
and depression of spirits she was often taken with a violent 
longing for sweets. She bought and consumed sweets in 
the greatest secrecy and with feelings of pleasure and 
gratification the intensity of which surprised her. She 
had all along had the most extreme disgust of normal union 
with a man; and now she had completely abandoned her 
genital sexuality through this strict self-prohibition against 
masturbation. It was therefore comprehensible that her 
libido should enter upon a regressive path and take posses- 
sion of the oral zone in the manner described. It may be 
added that in her psycho-analysis many facts were produced 
which indicated the existence of repressed wishes referring 
to sucking the male genital. 

Having seen that the sucking of substances into the 
mouth is to be looked upon as a sexual act in certain people, 
we shall find that new light is thrown upon certain other 
phenomena that appear very frequently in neurotics. 

IV 

Many neurotics suffer from abnormal feelings of hunger. 
Women in particular are affected with this symptom. 
Specialists in nervous diseases are very well acquainted with 
those female patients who are suddenly seized with hunger 
in the street or other places, and must therefore take care 
always to have something to eat with them. Such persons 
habitually wake up with a gnawing hunger, and they pre- 
pare for this before going to bed by putting some food 
beside them. Certain characteristics of this neurotic hunger 
are to be noted, namely, that it has no relation to whether 
the stomach is full or empty, that it comes on at irregular 
intervals, and that it sets in like an attack with accompani- 
ments of a harassing nature which do not belong to the 
normal need for nourishment, the most important of which 
are feelings of anxiety. 

The patients complain of their ' attacks of ravenous 
hunger \ They recognize the difference between normal 



THE FIRST PREGENITAL STAGE 263 

hunger and this * ravenous hunger ', but nevertheless are 
inclined to confuse the two conditions with one another. 
They show the most violent resistances when psycho- 
analysis discloses the connection of their neurotic ravenous 
hunger with repressed libido. However, certain signs 
betray the fact that we are on the right path. For example, 
the great frequency of these hunger attacks in frigid women 
is very striking. And one of my male patients, who showed 
the symptom of neurotic hunger in a pronounced degree, 
laid emphasis on the sensation that his hunger was pulling 
at his testicles. 

Strong libidinal impulses, against the undisguised 
appearance of which consciousness protects itself, can be 
unusually well masked by a feeling of hunger. For hunger 
is a sensation that can be admitted to oneself and to others, 
even if it is excessive. No one, not even the patient himself, 
suspects from what source the neurotic symptom obtains 
its power. In some cases this impulse can be so strong 
that the patient is forced to adapt and subordinate his whole 
way of life to his morbid craving for food. The power that 
such a neurotic hunger obtains over the patient enables us 
to estimate the enormous strength of the repressed impulses 
which gain expression by this means. As examples I will 
bring forward some facts of a really amazing nature taken 
from one of my psycho-analyses. 

A female patient of mine used to suffer from severe 
attacks of ravenous hunger as soon as she had gone a few 
steps from home. She never left her house without taking 
some food with her, and when she had eaten this she used 
to have to go into a confectioner's or some such place in order 
to appease her hunger. But it was in the night that this 
need for food used to overcome her most strongly. In 
the course of years her condition had got to such a pitch 
that she used to take two or three big meals during the 
night. Although her dinner was not enough and she used 
to eat another big meal before going to bed, she used to 
wake up in the night with a gnawing hunger to which she 
always had to yield. The result of this constant eating was 
naturally a marked increase in her weight. She used to eat 



264 SELECTED PAPERS OF KARL ABRAHAM XII 

chiefly vegetables at night, ostensibly because they were less 
fattening. At the time of her psycho-analytic treatment 
she was living in a boarding-house. She had accumulated 
large supplies of preserved vegetables, and each evening 
she used to prepare the meals she was going to take at night. 
She used to go to sleep at about ten o'clock and wake up 
at one, three, and five A.M., and eat a large meal each time. 
Between six and seven in the morning she would hurry 
down to the kitchen and beg for her breakfast. Her 
behaviour was very reminiscent of the ' spoilt ' baby who 
repeatedly wakes up in the night and will only be quietened 
when its mother gives it something to drink. This patient 
was, it may be remarked, an only child. On the other 
hand, the behaviour of patients of this kind, who crave for 
food at short intervals and undergo tortures if their desires 
are not gratified, is extraordinarily similar to that of mor- 
phinists and a good many dipsomaniacs. Regarding those 
conditions, psycho-analysis has succeeded in showing that 
the intoxicating poison affords the patient a substitutive 
gratification for that activity of his libido which is denied 
him. The symptom of excessive and compulsive eating 
may be regarded in the same light. 

The case just described differs from those discussed 
earlier in that the patient did not desire to suck milk or to 
indulge in other sucking activities, but had a morbid crav- 
ing for taking solid food very frequently. The patient's 
whole behaviour becomes intelligible to us only when we 
recognize the pleasure-value conscious or unconscious 
which eating had for her. Although she never enjoyed a 
night of peaceful, uninterrupted sleep, she offered the greatest 
resistance to an analysis of her attacks of hunger and to 
giving up her meals during the night. It was, moreover, 
not merely the eating itself that was charged with so much 
affect; for she enjoyed a certain fore-pleasure in the pur- 
chase of her provisions, the preparation of her meals, etc. 1 

1 In order to supplement the above very incomplete abstract of a psycho- 
analysis, I may refer to the patient's preference for vegetarian meals at night. 
The rational explanation she herself gave was insufficient and not really correct as 
to facts. If we see in her whole behaviour a form of auto-erotic gratification, then 
her avoidance of flesh at night is quite intelligible. 



THE FIRST PREGENITAL STAGE 265 



Neurotics whose sexuality is stunted to such an extent 
that they remain in a greater or lesser degree attached to 
nutritional sucking or to eating, show as adults no special 
tendency to thumb-sucking, at least as far as my ex- 
perience goes. And again, those adult neurotics who have 
remained pronounced thumb-suckers show as a rule no 
particular libidinal accentuation of the function of taking 
food. On the contrary, such persons often have a dislike 
of food, especially milk and meat, and suffer from nausea 
and vomiting. 

It may sound a strange assertion, but we can nevertheless 
say that compared with that group of neurotics which we 
have just discussed, adult thumb-suckers represent a more 
advanced stage of libidinal development. Their libido 
has achieved a certain independence of the nutritive instinct, 
in so far as the obtaining of pleasure is no longer associated 
with sucking for nutriment. Their oral zone has certainly 
retained its predominant role, and they, too, are still far 
removed from having made a successful transference of 
their libido on to objects. In real life they show many 
signs of the strongest repudiation of sexuality, whereas in 
their phantasies the use of the mouth for sexual purposes 
(such as fellatio and cunnilinctus) plays a prominent role 
for the most part, if not always, it is true, with the negative 
affect of nausea and horror. 

{The tenacity with which these neurotics cling to the 
auto-erotic stimulation of the mucous membrane of the lips 
and to the erotic use of the mouth at any rate in their 
abundant store of phantasies is easily comprehensible if 
we look back at the behaviour of the small child. We need 
only call to mind the intensity with which the child even 
from its earliest days indulges in * pleasure-sucking '. The 
zest with which it pushes both hands into its mouth, the 
impetuous way in which it catches at its fingers with its 
lips, its complete abandonment to the rhythmical motion 
of sucking and the final gratificatory effect of the whole 



266 SELECTED PAPERS OF KARL ABRAHAM XII 

process all this shows what power is exercised by those 
early instinctual impulses. This power is clearly perceptible 
from the fact that many people remain subservient to it even 
in adult lifeA 

The behaviour of such persons resembles that of the 
infant in another respect also. According to my experience, 
neurotics who have not overcome the sucking habit tend to 
indulge in a very high degree of auto-erotic stimulation of 
other zones, especially the genitals. We also find that the 
small child, besides having pleasure in sucking, tends to 
take hold of some part of its own body and to carry out on 
it rhythmical plucking movements. We may call to mind 
the child's habit of pulling at the lobe of its ear with one 
hand while sucking the thumb of the other. And very 
often that hand will seek the genital region in order to 
stimulate it by means of similar movements. 

( The thumb-sucking of adults which appears so strange 
to us is more explicable when we remember that in normal 
adults the mouth has not quite lost its role of an erotogenic 
zone. We look upon kissing as a thoroughly normal ex- 
pression of the libido, although it is true that the erotogenic 
zone in this case serves the purpose of object-love. The 
kiss does not claim the significance of a final sexual aim, 
but only represents a preparatory act. And yet here, too, 
the boundaries are ill-defined ; certain forms of kissing can 
constitute the essential aim of the person's sexual desire. 
The lip zone in particular takes over real genital functions 
with a frequency that must not be underestimated^ 

I shall give some further details from two of m^ psycho- 
analyses. They show the course taken by the childish 
propensity for the sucking habit in a particularly instructive 
manner, and supplement one another in many ways. 

The first patient, a middle-aged man, was suffering 
from a chronic neurosis, the most troublesome symptom 
of which was an intractable insomnia. In tracing the 
psychosexual causes of this trouble, we discovered certain 
things concerning the vicissitudes of his libido (or, what 
comes to the same, the development of his neurosis), some 
of which I give below. 



19*6 THE FIRST PREGENITAL STAGE 267 

In his earliest childhood the patient had been addicted 
in an unusual degree to sucking his thumb. When he 
grew older and nevertheless kept up the habit, the usual 
nursery methods were applied. His fingers were smeared 
with a bitter-tasting fluid; and the boy did in fact leave 
off sucking them. Nevertheless the success of this device 
was only apparent. The little boy made use of a corner 
of his pillow or bedclothes instead and used to fall asleep 
sucking or chewing at them. His parents interposed to 
stop this new practice, with the result that he submitted 
to all outward appearance, only to seek a fresh pleasure- 
substitute. Presently traces of his teeth were discovered 
in his wooden bedstead. He had adopted the habit of 
gnawing it as he lay in bed. 

During the years before puberty the patient's need of 
giving his mouth pleasurable stimulus before going to 
sleep became more and more imperative, and some such 
stimulus became the indispensable condition of his falling 
asleep. For many years masturbation played an important 
part in his auto-erotic methods of getting to sleep. After 
puberty, especially when he was about twenty years old, 
he had severe struggles about giving up the habit, struggles 
in which old prohibitions out of his childhood became 
operative once more. He used often to succeed for long 
periods in giving up masturbation, but he had to purchase 
this success at the expense of an intractable insomnia 
which used to last for the same length of time. He 
resorted to medical advice and took sleeping-draughts. 
But he soon got so dependent on these that he had to carry 
out another struggle to give them up in their turn. And 
this struggle, alternating with the struggle against masturba- 
tion, had recurred several times in the course of years. 
When the patient had begun treatment with me and was 
feeling slightly better, he abstained from the use of sleeping- 
draughts on two successive nights. On the day after the 
second night he came to me in an obvious state of annoyance, 
and when he had lain down in the usual manner for treat- 
ment and had told me about the previous night, I observed 
that he placed his right thumb in his mouth, and instead 



468 SELECTED PAPERS OF KARL ABRAHAM XII 

of going on speaking, sucked his thumb. His resistance 
could scarcely have been expressed more clearly. This 
resistance, originally directed against his parents and 
teachers, and now against the physician through the trans- 
ference, was as much as to say: ' If gnawing at the sheets, 
masturbation, and all other means of sleep are forbidden 
me by you, then I shall turn again to my oldest gratification. 
So now you see that you can do nothing with me.' The 
fact that he should have sucked his thumb under the very 
eyes of his physician was an obvious sign of defiance. 

Just as this observation allows us to see very clearly the 
relations of thumb-sucking to sexuality, so the following 
abstract from another psycho-analysis shows what com- 
plicated phenomena are derived from infantile sucking for 
pleasure. 

A large group of neurotics have an abnormally strongly 
accentuated pleasure in sucking from the beginning, and 
tend in adult life to make perverse use of the mouth, yet 
they nevertheless produce the strongest resistances against 
acts of this kind. They also present nervous symptoms 
which occur in the region of the mouth zone. The patient 
of whom I am about to speak belongs to this group. 

The patient, a seventeen-year-old boy who came to me 
on the advice of his medical attendant, was extremely 
taciturn and reserved during the first consultation. As I 
was with difficulty succeeding in getting single short 
answers out of him, I noticed that he was continually 
doing something with his mouth and the surrounding 
parts. Sometimes he would bite his upper or his lower 
lip, or lick them with his tongue; sometimes he could be 
seen to suck in his cheeks; then he would clench his jaws 
so tightly together that the muscles of mastication stood 
out visibly; or he would open his mouth wide and close 
it again; then again he would obviously be sucking at his 
teeth or gums. 

When the treatment had succeeded in removing his 
inhibition in speaking, for a time at least, he told me of a 
great many more practices associated with the oral cavity, 
all of which were of a pleasurable nature. An ungovernable 



THE FIRST PREGENITAL STAGE 269 

impulse to suck was the especial feature of those habits. 
He needed to make continual sucking movements, no 
matter whether he was alone or with other people, whether 
he was occupied or idle. When he was about thirteen 
years old he had had to wear a regulating plate on account 
of the irregularity of his teeth. The pressure of the plate 
on his gums had been painful to him. But he had made 
no complaint and had preferred to react to the stimulus 
with a continual sucking at the part of the gums concerned. 
He further admitted that he could obtain pleasurable 
feelings in yet other ways. He used to use his tongue in 
order to make stroking and tickling movements against 
his palate; and these movements gave him voluptuous 
sensations. He was quite aware of the sexual nature of all 
these acts. We may well speak of an oral masturbation in 
a case of this kind. 

Certain symptoms of the patient stood in the closest 
relation to the erotogeneity of his oral cavity. In the first 
place his compulsive habit, already mentioned, of opening 
his mouth wide certainly had such an origin. For as soon 
as he was with a male person he had a compulsive phantasy 
of taking the other man's penis into his mouth. And while 
he was half giving way to this phantasy with feelings of 
terror, and half attempting to ward it off, he would make 
that gasping movement of his mouth whose meaning could 
not be a matter of doubt for a moment. 

Now we regularly observe that an organ from which 
too much is demanded as an erotogenic zone is no longer 
able to carry out successfully its other functions. 1 In the 
present case the mouth could not carry out those functions 
which were of a non-sexual nature. As soon as the patient 
was in the company of other persons it was almost impossible 
for him to speak or eat. For instance, he was unable to 
carry on a conversation with his colleagues in the common 
workroom. And if in the course of the morning they took 
out some lunch which they had brought with them and 

1 Freud has dealt with this process more especially in the case of the eye in 
his paper on * Psychogenic Visual Disturbance according to Psycho- Analytical 
Conceptions ' (1910). 



27O SELECTED PAPERS OF KARL ABRAHAM XII 

began to eat it, it was impossible for him to do the same. 
He used to bring back his sandwich uneaten in the middle 
of the day, and throw it away in the street, so as not to be 
questioned about it at home. The effect of the psycho- 
analytic treatment in this connection is worth noting. His 
compulsive homosexual attitude, associated with constant 
anxiety, had scarcely given way to normal sexual interests 
when he became capable of eating and speaking with his 
colleagues. 

We can see in both these cases what a dominating 
influence the pleasure in sucking obtains when it persists 
into adult life, and how it can affect a person's whole 
conduct. Apart from the few extreme cases of this nature, 
there are a great many people who have to pay a certain 
permanent tribute to their oral zone without actually 
forming any severe neurotic symptoms. The conflict 
between their auto-erotism and other interests in life is 
settled by means of compromise-formations. For instance, 
such people may be efficient and capable in their work 
they may have been able to sublimate successfully a part 
of their libido but their auto-erotism dictates the condi- 
tions on the fulfilment of which their capacity to work 
depends. I once treated a neurotic who could only con- 
centrate on mental work if he had previously masturbated. 
In a similar manner many people can only concentrate 
their thoughts if they at the same time put a finger in their 
mouth or bite their finger nails or gnaw a pen-holder. 
Others have to bite or lick their lips while they are doing 
hard work. Their auto-erotism only permits them to work 
consecutively so long as it receives a certain measure of 
gratification at the same time. And the necessity many 
men are under of smoking while they work may be to 
some extent accounted for in the same way. But there are 
more complicated factors at work here. 

It is not possible to make a sharp distinction between 
normal inclination and habit on the one hand, and patho- 
logical compulsion on the other in this matter. For 
practical purposes, however, we can in general set up one 
criterion, viz. the manner in which the individual tolerates 



IQl6 THE FIRST PREGENITAL STAGE 271 

temporary abstinence from the accustomed stimulus. The 
reaction of a person to the frustration of a source of pleasure 
on which he is morbidly fixated will bear a pathological 
stamp. He will form neurotic symptoms, 

VI 

There is no doubt that in the normal person the grati- 
fication of his sexual needs exercises a marked influence 
on his disposition. Yet the healthy person is capable of 
tolerating a temporary lack of his accustomed gratification 
within certain limits. He is, moreover, able to procure 
certain substitutive gratifications along the line of sublima- 
tion. The same thing can be said of a great number of 
neurotics. But others are extremely intolerant of every 
diminution of their accustomed pleasure, and the more 
so the less their instinctual life is removed from the infantile 
level. They are very like ' spoilt ' children. Their libido 
incessantly craves for its accustomed gratification. In 
consequence they become completely dependent on it and 
react with great displeasure if they have to dispense with 
their usual pleasure. And this displeasure passes over into 
a marked depression of spirits. 

This origin of neurotic depression of spirits does not 
seem to me to have been sufficiently highly estimated. 
The neurotic person's auto-erotic gratification has two 
uses : it prevents a depression of spirits when it is threatened 
and removes it when it is there. Its use in the first sense 
is illustrated by the fact that many neurotics immediately 
turn to their usual method of gratification early in the 
morning in order to prevent a depression of spirits. This 
refers to those people who have difficulty in the morning 
in shaking off sleep. Every new day, every return to 
waking life, fills them with lively displeasure. This dis- 
pleasure would last and spoil the whole day for them if 
they did not have recourse to their usual form of gratifica- 
tion as to a prophylactic against their neurotic depres- 
sion. And the various kinds of excitation of the oral 
zone, which have already been discussed in detail, are of 



272 SELECTED PAPERS OF KARL ABRAHAM XII 

particular significance in this respect. Neurotic behaviour 
of this kind cannot be better exemplified than in the case 
mentioned above of the nine-year-old child who could not 
be got to leave her bed in the morning until she had been 
given her beloved bottle of milk. 

I should like to discuss in greater detail those neurotics 
who employ a pleasurable oral stimulus to dispel their 
depression. I shall purposely leave aside the question of 
alcohol as a corrective for depression, because its effect as 
a narcotic complicates the matter. 

The case of a young cyclothymic female patient whom 
I had under observation is particularly instructive. She 
was scarcely able to get mental contact with other people 
at all, and had tended to withdraw from them and yield 
entirely to her auto-erotic inclinations. When she became 
depressed she used to employ various means to relieve her 
condition, of which the chief one interests us here. This 
was to buy some food. Even while she was eating it she 
would feel her spirits rise. Another method which acted 
beneficially on her frame of mind was characteristic of her 
ai^to-erotic tendencies. She used to ride in a tram for hours 
together and obtain from this a very marked pleasure in 
movement. 1 If she felt depressed she used to spend the 
greater part of the day in taking tram rides and eating food 
which she carried about with her. 

How deeply rooted in the infantile all things of this kind 
are was demonstrated to me very clearly in the psycho- 
analysis of a young man whom I treated for a neurotic 
depression. He was unable for many years after puberty 
to transfer his libido on to other women on account of being 
very strongly fixated on his mother. For a long time he 
had found a substitutive gratification in his profession, 
until certain circumstances brought on an internal conflict 
of which he was not conscious. His fixation on his mother 
and his contrary tendency to detach himself from her came 
into violent conflict. His work ceased to gratify him. The 
first result was a depression of spirits, at the beginning 
of which something surprising happened. One day, filled 

1 See Chapter X. 



THE FIRST PREGENITAL STAGE 273 

with an intense dissatisfaction with life, feeling without 
energy and wanting nothing to eat, he went to bed. His 
mother brought him a cup of milk. As he put the cup to 
his mouth and his lips came in contact with the fluid, he 
had, as he expressed it, * a mingled sensation of warmth, 
softness, and sweetness '. This sensation surprised him, 
and yet seemed to be something known to him in the distant 
past; and at the same time it had an inexplicably soothing 
effect on him. Psycho-analysis soon solved the puzzle. 
The patient had been nursed by his mother during the 
whole first year of his life, and had sucked with great 
intensity (a fact which was told me by his own parents). 
During the following years he had often grasped at his 
mother's breast, and had used fond expressions for it in his 
childish language. When now his attempt to get rid of 
his fixation had failed, as I have described, and he began to 
suffer from a severe depression, he unconsciously turned 
again to his earliest source of pleasure. The milk brought 
him by his mother awakened the earliest traces of pleasur- 
able memories, and he was able to alleviate his depression 
for the time being. 

A phenomenon well known to the specialist in nervous 
diseases now becomes intelligible. Depressed or excited 
neurotics are often favourably influenced, though only for 
a time, by merely swallowing medicines, even when they 
have no sedative action. To explain this fact we are 
accustomed to fall back upon the suggestive effect of the 
medical prescription; but experience goes to show that 
neurotics can feel soothed for the moment by taking any- 
thing into the mouth, without a medical prescription. An 
important factor is here easily overlooked. In the life of 
every person there was a time when he was freed from all 
excitement by taking a fluid. The ' suggestive ' effect of 
a bottle of medicine does not lie only in the physician's 
treatment by any means, but at least as much in its function 
of supplying something to the patient's mouth which arouses 
echoes in him of his earliest pleasurable memories. 

The tendency of nervous people to want first one diet 
and then another prescribed for them, and to prefer as far 



274 SELECTED PAPERS OF KARL ABRAHAM XII 

as possible a fluid rlgime^ is also partly explicable in this way. 
We may call to mind more especially that class of patients 
who like to be fed by a nurse in bed. 

We must, however, not forget the very frequent re- 
fusal of food by such patients. This symptom appears in 
neurotic diseases in numerous and often disguised forms. 
I will only mention loss of appetite, nausea in regard to 
eating, sickness and vomiting. Concerning the origin of 
these symptoms there is nothing of importance to be added 
to what has already been said. 

We often find in people who are mentally depressed a 
conscious and openly expressed tendency to reject food. 
This tendency is observable in its most pronounced form 
in those depressions which are met with in the psychoses. 
Hence we may expect that the psycho-analysis of these 
diseases will give us information about the deeper causes 
of such a refusal of food. 



VII 

Among the most important and striking manifestations 
of depressive mental disturbances are found two symptoms 
which have an immediate relation to the taking of food. 
These are the refusal to take food and the fear of dying of 
starvation. 

When, some years ago, I made a first attempt l to explain 
the structure of depressive mental disturbances on psycho- 
analytical lines, I did not give those two symptoms the 
consideration which they now appear to me to merit. I 
believe that I am now in a position to give further informa- 
tion concerning the psycho-genesis of depressive states, but 
I am well aware how far I am from being able to furnish a 
comprehensive and conclusive solution of the problem. 

Anyone who observes a melancholic depressed person 
at all attentively will at once receive the impression that the 
patient has no desire to live; and he will be inclined to see 
in his refusal of food the expression of a suicidal tendency. 
There is nothing to object against the correctness of this 

1 [No. 26, A. B.] 



19*6 THE FIRST PREGENITAL STAGE 275 

explanation in itself. Nevertheless, the psycho-analyst can- 
not be satisfied with it, because it is incomplete and one- 
sided. The question arises why, if the patient has decided 
to die, he should choose the lengthy and uncertain way of 
starvation. Moreover, psycho-analytical experience puts 
one on one's guard against accepting too readily an idea 
which seeks to trace back a psycho-pathological phenomenon 
to conscious and logical causes. 

In the same way the origin of the second of the two 
symptoms mentioned above the fear of dying of hunger 
cannot be accounted for by a few simple causes. This fear 
of starvation is found most frequently in states of depres- 
sion belonging to the period of involution. A primitive 
psychological view of this condition would perhaps be as 
follows : When a man feels that he is ageing he inclines to 
worry about the future; and, since the tendency to nervous 
and psychic disturbances is especially great in the period 
of involution, this worry is expressed in a morbid anxiety 
or in a depressive delusion, according to the disposition of 
the individual. 

Such an explanation does not deal with the essence 
of the condition. It only views the idea as it is formulated 
its manifest content. It discloses neither the impelling 
forces of the psychosis, nor the deeper meaning of the 
symptoms. In psycho-analysis the latent content of the 
morbid ideas is looked for. Already in my earlier paper 1 
I was able to point out that depressed, low-spirited patients 
mourn for their lost capacity to love. Now the period of 
involution, in which states of depression break out most 
frequently, brings with it a decrease of genital erotism. 
Among women the feeling of being no longer the object of 
male desire is of especial significance. But psycho-analysis 
of depressive mental disturbances occurring in earlier life 
shows that the same situation obtains. The sick person 
rejects from consciousness the perception of this internal 
alteration. At the same time his libido undergoes a re- 
gressive change of a particularly far-reaching nature. 

A deeper insight into the structure of depressive psy- 
1 [No. 26, A. B.] 



276 SELECTED PAPERS OF KARL ABRAHAM XII 

choses has led me to conclude that in these patients the 
libido has regressed to the most primitive stage of its 
development known to us, to that stage which we have 
learned to know as the oral or cannibalistic stage. 

Even under normal conditions traces of a regressive 
change of the libido can be seen in the age of involution ; 
and in neurotic persons the signs of this process stand out 
with unmistakable clearness. But as a rule the regression 
is not such an extensive one, and it pursues a quiet and even 
course. The certain signs of this process are so well known 
to the psycho-analyst that a slight reference to them will be 
sufficient. 

In the climacteric many persons give more attention to 
the question of nutrition than they used to do. Parallel 
with the retrogression of the sexual functions (in the strict 
sense of the word) there appears an increased interest in the 
matter of food. The regressive tendency of this process is 
clearly shown from the fact that such persons frequently 
revert to a childish partiality for sweets. It is also worth 
noting that at the same time increased attention is given to 
the functions of the bowels. The more the genital zone 
retires into the background as a source of pleasure, the more 
many individuals turn back to oral and anal erotism. It 
can be frequently noticed that people of this age have 
an increasing tendency to make oral and anal matters the 
subject of their conversation. 

As we have said, the same kind of thing is found in 
neurotics to a marked extent. In them ideas concerned 
with the taking of food assume a hypochondriacal l character. 

In melancholic states of depression the libido seems to 
regress to the earliest stage of development known to us. 
That is to say, in his unconscious the melancholic depressed 
person directs upon his sexual object the wish to incorporate 
it. In the depth of his unconscious there is a tendency to 
devour and demolish his object. 

In my earlier paper I pointed out certain striking agree- 

1 I refer the reader to Freud's discussion of the psychogenesis of hypochondria. 
According to him this affection is based on a regression to narcissism; in other 
words, to one of the early stages of the libido. (Cf. Freud, ' On Narcissism: an 
Introduction ' (1914). 



IQl6 THE FIRST PREGENITAL STAGE 277 

ments in the structure of melancholia and obsessional 
neurosis, and in this connection I called special attention to 
the ambivalence of feelings and the original predominance 
of sadism in the affective life of both classes of patients. I 
see now the necessity of emphasizing what seems to me to 
be an essential difference between those two disorders. I 
still think that in each case the libido is predominantly 
hostile towards the object of its desires and endeavours to 
destroy it; but it seems to me that in contrast to the sadistic 
desires of the obsessional neurotic, the unconscious wish of 
the melancholic is to destroy his love-object by eating it up. 

Some of the self-accusations of melancholies draw the 
attention of the psycho-analyst to impulses of this kind, 
although the patients themselves are entirely unconscious 
of the connection. These self-reproaches have much that 
is typical in them. Many patients assert that they are the 
greatest criminals of all times and insist that they alone 
have brought all misfortune, all sin, into the world. Anyone 
who is acquainted with the methods of expression used by 
neurotics and psychotics will understand without difficulty 
the deeper meaning of such hyperbolic self-accusations. 
The patient is warding off from consciousness quite dif- 
ferent ideas which would otherwise be particularly terrible 
and intolerable to him; and I think I am able to say that 
these ideas relate to his cannibalistic impulses. In certain 
cases this is quite obvious. For instance, Kraepelin in his 
text-book of psychiatry quotes among other examples the 
following: * According to himself the patient had plunged 
the whole world into misfortune, had eaten his children and 
drunk up the springs of grace '. Most often, however, those 
self-accusations undergo a peculiar distortion. 

We see the cannibalistic wish-phantasies very clearly 
expressed in one particular form of depressive delusion. 
This delusion was extraordinarily widespread among people 
in the past and has not wholly disappeared even at present. 
It is that of being transformed into a wild, man-eating 
animal a were-wolf. The older psychiatry was so familiar 
with this delusional self-accusation that it gave to this 
particular form of * possession ' the name of lycanthropy. 



278 SELECTED PAPERS OF KARL ABRAHAM XII 

More frequently, however, a peculiar distortion of the 
patient's self-accusations takes place. Whereas he con- 
sciously denies the quality of the desired act, he accuses 
himself of a quantity of crimes which he cannot possibly 
have committed in reality. 

If we assume that the deepest repressed wishes of the 
melancholic are of a cannibalistic nature, that his * sins ' 
in their essence refer to a forbidden, even detested, act of 
eating, then we understand the great frequency with which 
he refuses to take food. He behaves as though complete 
abstention from food could alone keep him from carrying 
out his repressed impulses. At the same time he threatens 
himself with that punishment which is alone fitting for his 
unconscious cannibalistic impulses death by starvation. 

The patient's anxiety lest he should die from hunger is 
now quite easy to understand too. His desire to ' incor- 
porate ', to devour the desired object, meets with powerful 
internal resistances. Just like other desires the cannibalistic 
desire becomes changed into neurotic anxiety when its 
realization meets with too great a resistance. It is threatened 
with the fate of never being realized. The edict has gone 
forth that the mouth zone shall never experience that 
satisfaction which it longs for; and the result is a fear of 
dying of starvation. 

I cannot leave the subject of the melancholic disturb- 
ances without pointing out that in the above discussion I 
have attempted only to explain the wish-content of certain 
depressive delusional ideas and the unconscious strivings 
that underlie certain characteristics in the conduct of the 
melancholic, and not the causes of melancholic depression 
in general. To attempt to solve this far-reaching problem 
does not come within the scope of the present investigation. 

VIII 

The unconscious cannibalistic impulses which appear 
to me to underlie definite symptoms of depressive mental 
disturbances also exist in normal adult people. They 
occasionally come to light in their dreams. 



THE FIRST PREGENITAL STAGE 279 

An acquaintance once reported to me the following 
dream : He saw before him a dish of food which his wife 
had prepared for him. The food looked like vegetables, 
but upon it lay the legs of a child, as though they had 
been cooked in the vegetables. They reminded him in 
his dream of the limbs of his little son. He awoke in great 
horror and, starting up out of sleep, realized quite clearly 
that he had been about to devour parts of his own child 
in his dream. 

The horror which this man experienced at the mere 
thought of such an act is the same with which we are all 
filled when we think of the customs of cannibals. Even 
at the present time it occurs among certain peoples that a 
chief will kill his rebellious son, or cause him to be killed, 
and then eat him up. 

In many legends of civilized people we meet with the 
god who devours his own children. This is not the place to 
enter into mythological and ethnological details. I can only 
refer the reader to the wealth of material which Rank has 
collected in his work on the Inzestmotiv, particularly the 
chapter which is devoted to the 4 motif of dismemberment'. 

The numerous facts which I have brought together 
compel us to accept Freud's theory of an early cannibalistic 
stage in the development of the libido. This phase of the 
individual instinctual life corresponds exactly to the canni- 
balistic stage of civilization which has persisted up to the 
present day among certain peoples and which has also been 
traversed by the so-called * cultural ' races on the long road 
of their development. And just as certain psychic products 
of the healthy and sick individual are reminiscent of that 
early stage of his childhood, so in its legends and fairy-tales 
does the race as a whole preserve the traces of its remotest 
past. 



CHAPTER XIII 
EJACULATIO PR^COX^ (1917) 

No disturbance of male potency is so frequently 
observed by the nerve-specialist as that of ejaculatio 
pr<ecox. This affection is well known not only to 
the medical profession but to the laity. In it there is a 
premature emission of semen immediately after or even 
before the intromission of the penis during sexual inter- 
course, and the erection comes to an end. This description 
is of course a very rough one. But although it has been the 
subject of special investigation its real nature has not been 
explained, still less its origin. 

Up to the present this disorder has not been given 
a separate and thorough examination in the literature of 
psycho-analysis. It has only been treated in conjunction 
with other disturbances of potency. Steiner has made a 
condensed survey of psycho-analytical knowledge regarding 
impotence, while Ferenczi has gone more deeply into the 
origin of disturbances of potency, and has discussed its 
unconscious causes; but he has made no special inquiry 
into ejaculatio praecox. 

Nevertheless, psycho-analytic literature already contains 
certain data which can form the basis of a more exact 
investigation of the subject. Besides Freud's works, I 
have in mind Sadger's 2 important contributions; and in 
the course of this paper I shall frequently refer to both 
those sources of information. 

I have had the opportunity of treating quite a number 

1 [No. 54, A. B.] 2 < Uber Urethralerotik ' (1910). 

280 



1917 EJACULATIO PRAECOX 28 1 

of cases of ejaculatio praecox in neurotic persons. It is not 
my intention to report in detail any one analysis of such a 
case, but to give a brief account of the general conclusions 
I have gained from them in so far as they have a bearing 
on the subject. 

i. The Urethra as a leading Erotogenic Zone 

As has been said, the usual description of ejaculatio 
praecox is incomplete in various ways. If we follow atten- 
tively the accounts and free associations of patients and 
if they are good self-observers we shall discover a fact 
which has not hitherto received sufficient consideration. 
This is that in their case emission does not take place as a 
rhythmical expulsion but as a simple outflow of the semen. 
If the emission is not accompanied by active bodily move- 
ments or a maximum erection or even rhythmical contrac- 
tions of the perineum, and if it actually takes place ante 
portas, then the presence of the semen as a substance is all 
that is left to remind us of a normal emission of the sex 
products. On the other hand, the similarity of ejaculatio 
praecox to another physiological process, namely, micturition, 
becomes very striking. This latter process takes place with 
the body at rest and the penis flaccid, and to the accompani- 
ment of constant (not rhythmical) muscular contractions. 
Ejaculatio praecox can thus be looked upon as a combination 
of two processes: it is an ejaculation with regard to the 
substance of the emission, and a micturition with regard to 
the manner of it. 

It is astonishing with what regularity the associations 
of the patients lead to this view sooner or later. And on 
the way to it a number of facts are discovered which indicate 
that in this group of neurotic persons there is a particular 
pleasure-value attached to micturition, and a strongly 
accentuated erotogeneity of the urethra. 1 

Nevertheless, the associations of the patients also point 
to an important difference between ejaculatio praecox and 
micturition which must not be overlooked. After infancy, 

1 Cf. Sadger's work quoted above. 



282 SELECTED PAPERS OF KARL ABRAHAM XIII 

although urination takes place under the compulsion of a 
stimulus which sooner or later cannot be resisted, the child 
has yet some free choice as to the moment it shall pass 
water. And up to a certain point the same is true of normal 
ejaculation. Premature ejaculation is, on the other hand, 
independent of the patient's will in general. Consciously he 
wishes to perform the sexual act normally, and he is each 
time surprised at the premature occurrence of the emission, 
as if it was something that was happening in too great haste. 
Many patients say that at the moment of premature emission 
they experience a feeling of shame with which anxiety and 
palpitation of the heart are associated. 

Ejaculatio praecox therefore takes place against the 
person's conscious will. The process reminded us at first 
of normal micturition, but now we shall have to modify this 
view to some extent. We shall compare it with the manner 
in which urine is passed in infancy. The passive outflow 
of semen in ejaculatio praecox corresponds to the involuntary 
passing of urine by the infant a type of behaviour which, 
as is well known, may be prolonged in certain neurotics 
into adult age to a greater or less extent. 

The free associations of the patients furnish material 
which points unmistakably to this solution. If we follow 
those associations without prejudice we come upon anam- 
nesic data which are astonishingly similar in each case. 
We learn apart from those reminiscences relating to the 
strongly accentuated pleasure connected with the voluntary 
passing of urine in childhood that it had been a difficult 
task to train these patients in habits of cleanliness, that even 
in adult age they often passed urine involuntarily in smaller 
or larger quantities, that they were bed-wetters up to a late 
period of childhood, and that they easily react to excitement 
of any kind with an irresistible desire to urinate. The 
same persons who have gained control only late on or 
imperfectly over the functions of the bladder also tend to 
have a premature and precipitate emission of semen. 
According to their own account, the physical sensation of 
premature emission is identical with that of urinary incon- 
tinence. We shall consider later on certain very important 



EJACULAT10 PR^ECOX 283 

memories of childhood connected with exhibitionistic 
pleasure in passing urine in the sight of another person 
and with the assistance rendered by that person in such a 
situation. 

It is now evident that these neurotic persons have re- 
mained behind at a definite stage in the development of 
their libido, and derive infantile pleasure from the outflow 
of their bodily products. Nevertheless, ejaculatio prae- 
cox has at the same time a pleasure and a displeasure 
value for them. Unable to attain the highest pleasure 
through a full masculine activity, they have turned to what 
is to them the most intense pleasure to the passive one 
of allowing bodily products to flow out. On the other 
hand, the ejaculatio praecox is itself a source of severe dis- 
pleasure for them. They suffer from tormenting feelings 
of insufficiency, experience nervous anxiety when premature 
ejaculation occurs, and are not infrequently sensible of 
something resembling self-reproach. This state of ambi- 
valence is particularly to be noted in the same way as the 
pleasurable character of ejaculatio praecox, which is as a 
rule overlooked. In some patients the pleasurable side is 
emphasized > while in others the displeasure predominates. 

It is clear from what has already been said that the 
libido of persons suffering from ejaculatio praecox has not 
attained full masculine activity. And this introduces us to 
a new peculiarity in the sexual life of these neurotics. But 
first we will turn again for a moment to the question of 
the pleasure in excretion exhibited by these patients. 

If urethral pleasure is excessively marked we shall find 
that the * too much ' in this place corresponds to a * too 
little ' in another. Investigation of a number of such cases 
has shown in spite of many individual variations, which 
will be mentioned later that in all the patients the genital 
zone in the strict sense of the word has not become the 
leading zone. We must here call to mind Freud's classical 
theory, as it appeared in the first edition of his Drei Abhand- 
lungen zur Sexualtheorie. According to it, the primacy of 
the genital zone is established in the male child with the 
advent of puberty, and the remaining erotogenic zones 



284 SELECTED PAPERS OF KARL ABRAHAM XIII 

become subordinated to it. They supply the fore-pleasure, 
while the excitation of the genital zone (in particular the 
glans penis) leads to the final, satisfaction - pleasure. In 
the female sex the chief erotogenic state should pass to the 
vagina at puberty, but this transition often does not take 
place, because the girl retains from her childhood the pre- 
dominant excitability of the clitoris the organ which repre- 
sents the female analogue to the penis. As Freud says, 
female sexuality gives up a male characteristic when it 
transfers the leading erotogenic role from the clitoris to 
the vaginal orifice. But if the pre-eminence of the clitoris 
persists, a lack of excitability in the woman during the sex 
act frigidity is the result. 

In very many cases of ejaculatio praecox it is in fact 
found that the surface of the glans penis is deficient in ex- 
citability. Very frequently these patients cannot tolerate 
the use of condoms, since the covering sheath removes what 
little remains of the irritability of the nerve-endings of the 
mucous membrane. 

In some cases, however, this statement seems to be 
completely contradicted. I refer to those neurotic in- 
dividuals in whom the slightest genital contact with the 
female body and especially the slightest manual contact 
on the part of the woman is sufficient to cause a pre- 
cipitate flow of semen. But such an over-excitability of the 
genital zone is no indication of its primacy; on the contrary, 
it is an expression of its weakness. The specific male 
genital functions -erection, intromission, friction of the 
female parts are completely absent. Even before erection 
has begun to take place a flow of semen occurs, which we 
have already recognized as equivalent to micturition. We 
shall later obtain a better understanding of this process. 

Whereas in female frigidity the glans clitoridis has, so 
to speak, taken over all the irritability, the reverse has 
happened in the ejaculatio praecox of the male. In this 
the glans penis has lost its normal excitability, so that the 
person's sexuality has lost its specific male character. 

Ejaculatio praecox and female frigidity have still further 
corresponding characteristics. Besides a deficiency of 



1917 EJACULATIO PR^ECOX 285 

genital sensitiveness there frequently exists in the male 
patients a particular erotogenic state of the perineum and 
posterior part of the scrotum. These parts correspond 
developmen tally to the introitus vaginae and its surrounding 
parts. The relation between ejaculatio praecox and female 
frigidity might now be stated as follows : The leading zone 
in each sex has surrendered its natural importance to those 
parts of the body which are the equivalent of the leading 
.zone in the opposite sex. It is the perineal portion of the 
male urethra in which the pleasurable sensations of ejaculatio 
praecox are localized. The muscles in the perineum which 
act in the expulsion of semen deserve particular notice. 
They normally carry out their function by making rhythmical 
contractions. In ejaculatio praecox, on the other hand, a 
relaxation of those muscles occurs, exactly as in micturition. 
Now it is worth noting that in some patients the muscles 
of the perineum occasionally contract spontaneously. But 
this process is equivalent to a neurotic symptom acting 
independently of consciousness. I refer to those perineal 
spasms which patients so often describe. 

So far our conception of ejaculatio praecox, based on 
psycho-analytical investigations, seems to be contradicted 
by one fact. In by far the greater majority of cases prema- 
ture ejaculation only occurs when the person attempts to 
carry out the sex act, and not in masturbatory excitation. 
It may be asked why in the latter case the compromise which 
we have spoken of between ejaculation and micturition 
does not take place. We can meet this objection provision- 
ally by conjecturing that it is precisely the presence of the 
woman which occasions the neurotic disturbance. And 
this brings us to the problem of the attitude of the patients 
i in question to the female sex. 

ii. The Masculine-Active Impulses and their Modifications 

Persons who suffer from premature ejaculation can be 
divided into two groups, which, however, are not sharply 
separated from each other. In the first place, the condition 
is met with in those men whose entire individuality seems 



286 SELECTED PAPERS OF KARL ABRAHAM XIII 

inert, without energy and passive, in short, * unmanly ', 
In the second place, it is met with in erethistic, over-lively 
men who seem to be in a constant state of haste. This 
apparent contradiction is easily explicable to the psycho- 
analyst. Every activity which can only attain its object in 
a hurried and precipitate way is threatened with resistances. 
The neurotic who does everything in haste is fleeing from 
the unconscious resistances within him ; he has to carry out 
his projects in feverish haste before his resistances break 
through and compel him to renounce all. The inert 
neurotic has given up the struggle against these forces; the 
erethistic man is still fighting against them. 

We may say that premature ejaculation occurs in those 
men who are burdened with strong partly unconscious, 
partly conscious resistances against activities of a specific- 
ally masculine character. 

The neurotic type who is without energy usually ex- 
presses a conscious antipathy towards exercising any 
activity in sexual matters; he even has an open desire to 
assume the female role. One of my patients liked to play 
the part of the succubus, and gave as a reason for this that 
if he paid a girl he did not want to have to exert himself as 
well that she ought to 4 work ' for her money. Naturally, 
neurotic persons with this degree of displeasure in move- 
ment are not favourable subjects for medical treatment, 
particularly if they consciously defend their abnormality. 
Their chief desire is to attain sexual gratification without 
taking any active part in it. 

The erethistic neurotic type who lives in perpetual haste 
generally looks upon coitus as a troublesome task to be got 
through as quickly as possible. His nervous haste does 
not leave him even when he is with his female partner. 
Under the influence of unconscious factors the sexual act 
reaches its end precipitately before it has actually begun. 

The antipathy felt by the first group of neurotics to any 
active motor performance extends to other things. I shall 
take as an example their attitude towards sport. Many of 
them have a pronounced antipathy to all physical exertion, 
whereas others go in for sport with excessive enthusiasm 



EJACULATIO PR-dECOX 287 

and in an over-zealous and precipitate manner; but as 
soon as they fail in any way they give the whole 
thing up. 

The inertness and passivity exhibited by these neurotics 
is, however, a reactive manifestation. It can be found that 
such an attitude ^has taken the place of a too forcible sadistic 
impulse. The tendency to be quarrelsome, to have fits of 
anger, and to commit violent acts, is extraordinarily marked 
in such people, in so far as it is not paralyzed by another 
character-trait which distinguishes them namely, cowardice. 
Excessive irascibility and a paralysis of the normal male 
pleasure in attack are found here in close proximity. The 
frequent juxtaposition of excessive ambition and severe 
resistance against work is also met with in this group of 
neurotic persons. 

In this description we have touched upon a number 
of important manifestations which are usually found in 
neurotic persons side by side with their ejaculatio praecox, 
but we have not penetrated beneath the surface of this 
condition. If we allow ourselves to be guided by the free 
associations of the patients, we learn that originally their 
libido was not lacking in a sadistic component. Psycho- 
analysis teaches us that in most of the cases, besides the 
unmanly and passive or precipitate and over-active attitude, 
there exists in the unconscious an aggressive and cruel 
attitude towards the female. In their dreams and other 
products of phantasy these patients often produce the idea 
of killing the woman by copulating with her. In these 
phantasies the penis is the sadistic weapon. 

The reactive transformation of these impulses leads to a 
result which we can observe often enough in such patients. 
The male genital is robbed of its dangers. It may no longer 
get into that condition in which it might be employed in 
a sadistic way against the woman. Premature flaccidity 
and ejaculation removes that danger. In addition to this, 
many of the patients have a pronounced anxiety before 
carrying out the sexual act about causing the woman pain. 
There remains to them a remnant of potency only if they 
are certain of the complete consent of the woman; and their 



288 SELECTED PAPERS OF KARL ABRAHAM XIII 

aggressive impulses are so suppressed that all sexual initia- 
tive, in the strict sense of the term, is absent. Many of 
them are quite unable to establish any relations with women 
on their own initiative; others are capable of beginning 
such a relationship, but lose their activity at the moment 
when it ought to pass over into physical action. 

One of my patients was, in general, impotent at the 
commencement of his marriage. He was conscious of a 
hostile and aggressive attitude towards his wife. The 
slightest quarrel with her used to result in complete im- 
potence on his part. On the other hand, he noticed that 
immediately after having had a reconciliation with her he 
used to have a relatively good potency. Thus whenever 
the external reason for hostility and a desire for revenge 
had temporarily disappeared he used to attain a transitory 
sexual activity. 

The associations of the patients indicate in addition, 
moreover, that in their unconscious ejaculatio praecox 
signifies the extreme opposite of killing. It is very 
frequently associated with the unconscious, or even 
conscious, idea of the subject's own death as a kind of 
effortless expiring. Many patients make use of the ex- 
pression that they feel themselves vanishing or melting 
away. It is typical that a feeling of faintness is sometimes 
connected with premature ejaculation. 

The element of loss of male activity is further shown in 
the affect of anxiety that so frequently accompanies ejaculatio 
praecox. Such an anxiety is found more especially in those 
patients whose lives are spent in a state of perpetual haste. 
Now, haste and anxiety again remind us of the behaviour 
of frigid women who according to our experience are 
constantly in a state of hurry. The peculiar fear such 
women have of never ' getting a thing done ', which is 
shown in all their daily tasks, is also found in these male 
neurotics. They execute their sexual functions in haste, 
as though they expected to be disturbed every moment. 
This fear of being disturbed is closely associated in their 
unconscious with their attitude towards their father. They 
dread his all-seeing eye and his chastising hand. We find 



EJACULATIO PR^ECOX 289 

ourselves on familiar ground here, namely, that of castration 
anxiety. This fear, whose importance Freud has recognized 
in the mental life of the small boy and in the unconscious of 
the growing man, also exerts its influence on the psycho- 
(genesis of ejaculatio praecox. 

The same patients exhibit marked dread of the female 
genital. It seems to them to be something uncanny. 
Psycho-analysis repeatedly confirms the fact that it was the 
lack of the penis in women which originally called out 
their castration anxiety. And physical proximity with a 
woman always re-awakens this horror in them. 

Closely related to this anxiety is another one that of 
losing the penis through the sexual act itself. It is not rare 
for patients to tell the physician of a fear which they have 
had since puberty that they may not be able to withdraw 
their penis from the body of the woman, and have to leave 
it behind. This fear is founded on one of the infantile 
sexual theories which are re-vivified at puberty. According 
to it there is only one union between the woman and the 
man, and in it she robs him of his genital organ by tearing it 
off or pinching it in. The fear of such an event furnishes 
a further explanation of the fact that libidinal desire and 
erection are frequently present in the patients to begin with, 
but that immediately after intromission or just before bodily 
contact erection disappears. These unconscious ideas force 
the patient to seek safety at the last moment. In conscious- 
ness he reacts to this unmanly retreat with lively and 
tormenting feelings of insufficiency. 

In some cases the patients' associations made it clear 
that the ejaculatio praecox was a kind of castration in the 
presence of the woman. We shall later on discover the 
explanation of phantasies of this kind. 

The lack of sexual activity in our patients is expressed 
in yet another form. As we know, neurotic resistances 
against the carrying out of an action are often expressed by 
clumsiness in its execution. Persons who suffer from 
Jpremature ejaculation regularly exhibit a marked clumsiness 
in the performance of the sexual act. Their incapacity to 
introduce the penis without the help of the female partner 



290 SELECTED PAPERS OF KARL ABRAHAM XIII 

is a typical instance of this. It is chiefly on this ground 
that they fear to have intercourse with a sexually in- 
experienced woman who cannot come to their aid in this 
way, and from whom they cannot ask any such assistance. 
I shall give a further explanation of this behaviour later on. 

in. Narcissism as a Source of Sexual Resistances 

So far our investigations have definitely shown that in 
the patients in question there has been an inhibition in the 
development of the libido. The patient has not reached 
the normal attitude of a man towards a woman, and his 
sexuality shows a number of infantile traits. To put this 
more accurately: the patients have normal feelings in so 
far as their libido is consciously directed, if not exclusively 
yet in its essentials, towards having normal sexual inter- 
course with women. It is true that in some even getting 
on to terms of intimacy with women is difficult; but they 
share this difficulty with other neurotic persons. They 
only react in an abnormal and specific manner when they 
have to prove their sexual activity in the strict sense of the 
word. At that moment a disturbance makes itself evident 
which is opposed to their conscious wish and which proceeds 
from unconscious libidinal counter-impulses. We have 
already learned that these impulses are infantile in their 
nature. Their tendency is to prevent the sexual act (in 
its strict sense) from taking place. Instead of it there 
occurs a passive emission of semen, similar to the involuntary 
flow of urine in the child. The active motor behaviour of 
the male is replaced by complete passivity. 

What is the nature and origin of the unconscious 

resistances which prevent the individual from adopting a 

f normal attitude towards the opposite sex ? My psycho- 

i analyses invariably pointed to the factor of narcissism, not 

I in the sense of a complete regression of the libido to that 

infantile stage, as Freud has shown to be the case in paranoia, 

but as a disturbing influence emanating from repressed 

narcissistic tendencies that have not succeeded in obtaining 

complete control. But they nevertheless manifest their 



IQI7 EJACULATIO PR^ECOX 29! 

power in that they compel the individual to make certain 
compromises, one of which is that disturbance of potency 
with which we are here concerned. 

A cursory observation of some of the persons suffering 
from ejaculatio praecox will make this idea clear. These 
people display an unusual amount of vanity as regards 
their clothing and appearance The slightest criticism 
will make them fly into a rage. They want to be admired 
by their entourage, and are filled with a pathological desire 
to excel. Psycho-analysis brings to light the narcissism of 
these patients, and never fails to reveal the fact that their 
object-love is very imperfect. Their true love-object is 
themselves. In accordance with Freud's view, 1 we find 
in all our patients a particularly high and abnormally 
emotional estimation of the penis. An excessive fear of 
loss or damage to that organ is one of the results of such 
an over-valuation of it. The psycho-analysis of every case 
of ejaculatio prsecox reveals an abundance of other mani- 
festations of narcissism as well. In order to estimate 
these at their true value it is necessary to glance briefly 
at related manifestations in childhood. 

The child experiences the first gratifications of its 
libido from its bodily functions, such as the taking of 
nourishment and the excretory processes. It directs its 
first feelings of love to those persons who feed it and take 
care of it. And since in doing this they have to touch 
its body, those persons evoke in it pleasurable sensations 
through the stimulation of erotogenic zones. The child 
accepts these pleasurable sensations as gifts. This stage of 
the development of the libido, in which the child itself is 
the central point of its still limited world, and in which it 
accepts demonstrations of love from other persons without 
giving anything in return, we term narcissism. 

The child's relations to its love-object develop a step 
further when it begins to give to other persons some- 
thing of its own. The products of its own body which 
according to the child's idea are a part of its own body 
are the first coinage which it makes use of. These products 

1 Freud, 'On Narcissism : an Introduction' (1914). 



SELECTED PAPERS OF KARL ABRAHAM XIII 

are subjected to a narcissistic over-estimation. I will quote 
the common instance of a child who when it is handed 
round the family circle will always elect, for some unknown 
reason, to wet a particular person with its urine. This act 
is one of the most primitive marks of love, and is far more 
primary than kissing or embracing, which the child learns 
only through imitation. In this connection we are reminded 
of the forms of greeting of many primitive peoples. When 
one man gives another a part of his own bodily products, 
for example, saliva, it signifies: * I am giving you a part 
of myself, something that is very precious to me; therefore 
I mean well by you '. 

The history of our patients enabled us to establish the 
fact that they had taken particular pleasure in micturition 
in childhood, and had set a higher value on the penis than 
is usually found in childish narcissism. As regards 
micturition, it seems as though a constitutional peculiarity 
underlay the pleasure taken in that function. If we 
realize what a high value is normally assigned to the penis 
in the stage of childish narcissism a value which is based 
both on pleasure in touching and pleasure in excretion 
then we begin to see what are the possible consequences of 
a constitutionally reinforced urethral pleasure. At a time 
when he should long since have turned to normal object-love, 
the individual will still retain a strong tendency to linger 
behind in his narcissism. Furthermore, an over-estimation 
of the penis as an organ of micturition will be firmly im- 
planted in his mind; so that when later on the organ has 
to fulfil its true sexual function it refuses to do so. The 
result is that compromise which we have already recognized 
in ejaculatio praecox. 

We are now at last able to comprehend the unconscious 
sexual aim of that symptom. The normal sexual aim is a 
physical union with the woman. In this the man has to 
accomplish a motor act which should produce gratification 
in him and at the same time in the woman. The tendency 
of ejaculatio praecox is quite different. 

As we have said, the patient's libido has remained to a 
great extent in the stage of narcissism. Just in the same 



EJACULATIO PR-ffiCOX 293 

way as the small child wets his mother with his urine 
which he cannot as yet contain, the patient wets his partner 
in his premature ejaculation, thus making evident that she 
is a substitutue for his mother. Moreover, the mother or 
nurse is compelled to touch the little boy's genitals when 
she assists him in making water or in washing and drying 
his body. The pleasure got by the child from being 
touched in this way is evident from the patient's associations, 
coming as they do from his unconscious. One of his 
unconscious sexual aims is to have his genitals touched 
by the woman, 1 and then to ejaculate as though he was 
passing urine. The significance of the woman as mother 
is obvious in this connection too. And, in especial, one 
peculiarity of our patients which we have already mentioned 
now becomes intelligible. This is their tendency to 
require manual help from the woman in effecting intro- 
mission. Pleasurable touching of the penis was one of the 
early and very significant proofs of love on the part of the 
mother. As we know, the person suffering from premature 
ejaculation is not able to give love, but only to receive it. 
And in order to do this his unconscious endeavours once 
more to restore the ways of life of early childhood. 

One of these ways has not yet been considered, but the 
ideas expressed by the patients bring it into prominence. 
Giving away the products of its own body is not the child's 
only expression of love in the stage of narcissism. Another 
method of conferring love and asking for it is found in 
exhibitionism. In the second half of their third year and 
the first half of their fourth year more especially, small 
boys are very prone to exhibit themselves before their 
mother, particularly when micturating, for which function 
they no longer need their mother's help as they did before. 
A boy of about four years of age whose urethral erotism 
was well within the normal limits often used to ask his 
mother if he should show her his penis. He, moreover, 
used a self-invented term for this part of his body. When 
he had passed water he often used to ask if it was ' a lot '. 
His narcissism appears very clearly here his desire to be 

1 Cf. once more Sadger's work mentioned above. 



294 SELECTED PAPERS OF KARL ABRAHAM XIII 

admired for his performance. On one occasion when he 
was with his parents at the seaside he used to take pleasure 
in passing water whenever a wave approached him. On 
being asked why he did this, he replied, * so that there shall 
be a whole lot of water '. The child's narcissism evidently 
found particular gratification in the idea that the whole sea 
was his own product. 

This narcissistic vanity in regard to the quantity of 
the emitted substance finds many forms of expression in 
neurotic persons and is a factor in ejaculatio praecox. As 
we have already said, some patients are proud of the 
ejaculation which does not take place inside the body of the 
female but as it were before her eyes. It is clear therefore 
that there is an exhibitionistic tendency in ejaculatio praecox. 
Premature ejaculation carries on the theory of infantile 
narcissism, according to which the child's own attraction 
and particularly his penis and his urinary activities 
exercise an irresistible charm over the woman (the mother). 

We have already mentioned one form of self-deception 
which can be explained as a result of narcissism. Some 
patients delude themselves with the belief that ejaculatio 
praecox is a sign of an unusually passionate temperament. 
With this piece of self-deception there is occasionally 
associated another one, which is that ejaculatio praecox 
is a sign of a more refined and exalted nature in contrast 
to the coarse aggressiveness of other men. The symptom 
which has arisen from repressed narcissism is thus given a 
secondary justification of a narcissistic kind whose purpose 
is easy to see. The patient would like to show himself 
more delicate than his father, whom he considers as a violent 
and brutal man, and so to supplant him in his mother's 
affections. The idea of his father's brutality originates in 
certain childhood experiences. As a child the patient had 
witnessed sexual intercourse between the parents, and had 
pictured it as an act of violence on the man's part. This 
' sadistic ' theory of coitus becomes active at the time of 
his own sexual maturity, and normal sexual intercourse 
appears to him to be an act of brutality. Ejaculatio praecox 
appeals, as it were, to the feminine delicacy of his mother. 



19*7 EJACULATIO PR-ffiCOX 295 

It says in effect: ' Look, I am treating you more gently 
than my father does '. 

It must, however, be borne in mind that this exhibiting 
before the woman (the mother) bears an ambivalent char- 
acter. It is not only a proof of the person's love and of 
his desire to be admired and touched, but at the same time 
a rejection of the woman. My psycho-analytical experience 
has regularly shown that this exhibitionism contains a 
strongly affective hostile attitude which is more especially 
expressed in a feeling of contempt for the woman. The 
hostility is derived from infantile sources, especially from 
childish jealousy. The contempt finds its natural explana- 
tion in the person's over-estimation of the penis. He looks 
upon the woman as inferior and contemptible because she 
lacks this part of the body. Quite a number of those who 
suffer from ejaculatio praecox have a disdain for women in 
general; they cannot cease scoffing at their ' imperfections '. 
In many cases this attitude is expressed in a violently 
affective antagonism to the present-day feminist movement. 

We have thus arrived at the rather curious conclusion 
that ejaculatio praecox is also an expression of hostility 
and contempt which the patient evidences towards women 
in general as well as to a particular one. Several of my 
psycho-analyses have given me information about this 
tendency which I had not at once recognized. From this 
point of view ejaculatio praecox and especially when it 
occurs ante Aortas is a soiling of the woman with a sub- 
stance representing urine. We must here have regard to 
the ambivalent character which attaches to the giving of 
one's own excreta to another person. Up till now we have 
recognized it as a means of expression of childish love. A 
parallel from folk psychology will make this ambivalence 
clearer. Spitting at another person, which among certain 
peoples represents a friendly form of greeting, becomes, as 
repression advances (i.e. with the development of civiliza- 
tion) an expression of the strongest contempt. Every 
child passes through a stage which corresponds to the point 
of view of these most primitive people the point of view 
belonging to the stage of narcissism. On one occasion a 



296 SELECTED PAPERS OF KARL ABRAHAM XIII 

little girl of four years called her saliva * beautiful, clean 
tongue-water ', thus showing a narcissistic appreciation of it 
which was quite contrary to the canons of polite behaviour. 
What is later looked upon as nasty and unclean appears in 
this stage of development in an entirely opposite light. We 
may also note that neither the small child nor the primitive 
man feel any disgust of urine. We need only call to mind 
the fact that among certain negro tribes the cooking utensils 
are cleaned with urine. Among such people a narcissistic 
estimation of the bodily products is still very prevalent. 

There is another motive which is very closely asso- 
ciated with the unconscious purpose of soiling the woman. 
My psycho-analyses have again and again demonstrated 
the fact that wetting the woman in this way represents an 
act of defiance. The mother has the task of educating 
the child in habits of cleanliness and in the control of its 
sphincters. If the mother becomes an object of hostility 
and contempt, the child opposes her endeavours with a 
marked defiance an attitude which we very often meet 
with in the character of adult neurotics. Thus we must 
also see in ejaculatio praecox a defiant relapse into that 
uncontrolled emptying of the bladder which is a charac- 
teristic of infancy. 

We began by saying that the soiling of the love-object 
with urine or other bodily products is an infantile narcis- 
sistic expression of fondness ; but deeper analysis now shows 
that we have here an example of most marked ambivalence, 
and once again teaches us that premature ejaculation has the 
character of a compromise. For when the neurotic person 
with an ambivalent attitude towards women gives the woman 
something of his bodily possessions by means of ejaculatio 
praecox, he is only giving something in appearance. In 
reality his hostile attitude causes him to guard these posses- 
sions jealously. His partner receives nothing, for he keeps 
his physical energy, and gives her no sensation of pleasure. 
It is true that he pours out his semen, but he does not 
give it to her; and, incidentally, he gives her no child. 
On the contrary, he excites expectation in her and then 
disappoints her. 



1917 EJACULATIO PRAECOX 297 

As we have already said, every patient of this kind has 
a passive attitude towards women. He is permanently 
dependent on his mother, and struggles against this depend- 
ence which is lodged in his unconscious. This defensive 
struggle appears on the surface as a struggle against women. 
But in it he does not have the advantage of possessing a 
powerful male activity. He has to content himself with 
disappointing them, and in this way he takes revenge on 
every woman for the disappointments of love to which as 
a child his mother subjected him, and which he finds 
repeated again in later years. 

A hint may be given here regarding other symptoms 
that are often found in conjunction with ejaculatio praecox, 
and that arise from the same sources and manifest themselves 
in the entire social attitude of the patients. In agreement 
with the narcissism and ambivalence of their feelings, they 
oscillate between a precipitate transference and a too timid 
reserve. Many of these patients react to a difference of 
opinion, to criticism by others, etc., either with a sudden 
outburst of anger or with a cold withdrawal into themselves. 
A certain combination of character-traits is so typical of this 
kind of neurotic that whenever it is met with the presence 
of ejaculatio praecox can be inferred with some degree of 
certainty. At a meeting of the Berlin Psycho-Analytical 
Society on one occasion, certain abnormal affective states in 
a neurotic patient were being discussed. During the dis- 
cussion I expressed the opinion, based on the description 
of the patient's social attitude, that he suffered from ejacu- 
latio praecox; and this surmise proved to be quite correct. 

In conclusion, I might mention a rarer neurotic dis- 
turbance which is not so well known in medical circles, yet 
which, although the reverse of ejaculatio praecox, is inti- 
mately related to it. I refer to the symptom of impotentia 
ejaculandi. In many neurotic persons no ejaculation occurs 
during the sexual act. In this case also there is a sexual 
disinclination arising from narcissism. In these patients 
the ' keeping to themselves ' is the predominant motive. 
The effect is the same as in ejaculatio praecox: narcissism 
gains the upper hand and the woman is disappointed. It 



298 SELECTED PAPERS OF KARL ABRAHAM XIII 

need hardly be mentioned here that there is every kind of 
gradation from normal ejaculation to premature emission 
on the one hand and to its entire absence on the other. 
Retarded ejaculation is a not infrequent symptom of many 
neuroses. 

It is the task of psycho-analytical treatment to free the 
patient from his narcissistic attitude, and to point out to 
him the path to a normal transference of feelings. If we 
can succeed in removing his narcissistic rejection of the 
female, the path is made free for him to carry out the normal 
sexual functions. Psycho-analysis acts in a similar manner 
in removing the female counterpart to ejaculatio praecox 
frigidity. 

""Naturally, different cases present various degrees of 
severity of the illness. The milder disturbances of this 
nature can appear at times in men disposed to them and 
disappear without any treatment, though there is a constant 
risk of relapse. A cure, or at least a distinct amelioration 
of the symptoms, can be obtained by psycho-analysis even 
in severe and obstinate cases. 1 From the point of view 
of prognosis those cases are least favourable in which the 
ejaculatio praecox set in immediately on the attainment of 
sexual maturity, and has reappeared again and again for a 
number of years. These are the cases which exhibit an 
exceptionally marked urethral erotism as opposed to a 
genital erotism, and in which the pleasure-value of ejaculatio 
praecox outweighs its displeasure-value. The treatment of 
this condition may be technically one of the most difficult 
tasks for the psycho-analyst, since he has to contend with 
the very considerable amount of narcissism present in such 
patients. Nevertheless, a persevering and consistent use 
of the psycho-analytic method will enable him to surmount 
difficulties even as considerable as these. 

1 In two cases of impotentia ejaculandi also I have succeeded in obtaining a 
permanent cure through psycho-analysis. 



CHAPTER XIV 

THE SPENDING OF MONEY IN ANXIETY 
STATES^ (1917) 

f ^ HE attitude of the neurotic to the possession of money 
I has been the subject of much study in psycho- 
M analytic literature. Both Freud and other analysts 
who have followed him in directing their interest to ' anal * 
character-traits have dealt with neurotic avarice and the 
anxious retention of money from the point of view of un- 
conscious motives; but the opposite behaviour of many 
neurotics, the excessive spending of money, has not received 
the same attention, although the psycho-analyst frequently 
comes across it. This tendency appears suddenly in 
many neurotics, like a kind of attack, and stands in con- 
spicuous contrast to their usual parsimony. 

From the few cases that I have been able to observe 
during my psycho-analytic work, it seems to me that this 
condition is found in a definite group of neurotics in 
persons who are in a state of permanent infantile dependence 
on the parental home and who are attacked with depression 
or anxiety as soon as they are away from it. The patients 
themselves say that the spending of money relieves their 
depression or anxiety; and they produce rational explana- 
tions for this, such as that spending money increases their 
self-confidence, or that it distracts them from their condition. 
Psycho-analysis takes the unconscious into consideration 
and adds a deeper explanation to this purely superficial one. 
Every psycho-analysis of a case of this kind shows once 

1 [No. 55, A. B.] 
299 



3OO SELECTED PAPERS OF KARL ABRAHAM XIV 

again that the patient, in consequence of the fixation of his 
libido, is prevented from removing himself physically from 
his parents or the persons representing them. Leaving the 
home signifies to his unconscious a detachment of the libido 
from its object. Two contrary mental currents can always 
be found to exist in these patients a conservative one, in 
the direction of a permanent fixation, and another one, in the 
direction of turning towards objects of the external world. 

Every attempt to transfer the libido on to new subjects 
is accompanied by severe anxiety, for the very reason 
that the unconscious desire is so especially violent and 
impetuous. It is only necessary to call to mind the fact 
that female patients who suffer from street anxiety are heavily 
burdened with unconscious, at times even conscious, phan- 
tasies of prostitution. Their unconscious wants to yield 
without restraint to every person they meet; but their 
conscious anxiety restricts the transference of their libido 
within the narrowest bounds, so that they become incapable 
of making free use of it, and this not only in the strict sense 
of actual sex-relationships. 

A far-reaching limitation of genital sexuality leads to a 
substitutive and increased emphasis of other erotogenic 
zones. Anal erotism takes the place of genital erotism to 
a greater or less degree. In many cases it can be very 
clearly shown that the morbid fixation of the patient on his 
father or mother is carried on through the agency of the 
anal zone. A small abstract from an analysis will illustrate 
this. 

The patient, a woman, who suffered from severe street 
anxiety, was completely attached to her father. Her repeated 
attempts to loosen the fixation always miscarried. This 
fixation had been very much reinforced by the patient's 
father during her childhood by the fact that he had 
been excessively careful about the activity of her bowels, 
and had very frequently administered enemas, etc. This 
mistaken procedure had contributed in a fatal manner to 
maintaining her childish dependence. To use a nursery 
expression, she could * do ' nothing without her father, 
could only ' leave the room ' under his superintendence. 



1917 SPENDING OF MONEY IN ANXIETY STATES 30! 

As her analysis showed, her attempts to free herself also 
demonstrated her anal fixation. To her unconscious, 
emptying her bowels without paternal superintendence 
signified independence. If she went out of the house and 
was overtaken by anxiety she used as a defence against it to 
spend money on all sides in a quite needless way. She was 
giving out money instead of libido. The explanation of this 
compensatory significance of money is derived from the 
unconscious equation of money and faeces. It is worth 
noting that the patient herself suspected that she frequently 
intensified her anxiety in order to provide herself with a 
reason for spending money. 

In this patient, and also in two other cases, I noticed the 
tendency to buy many objects at random, articles that were 
for the most part valueless and only desired at the moment. 
In this way they could deceive themselves about the free 
motility of their libido, which in reality was fixed and 
inhibited to the last degree. Buying objects which have 
only a momentary value, and passing quickly from one 
object to another, are symbolic gratifications of a repressed 
desire that of transferring the libido in rapid succession 
to an unlimited number of objects. The allusion to prosti- 
tution is unmistakable in this connection; for there, too, 
money is the means of obtaining transitory and easily 
changed relationships. 

The patients' idea that they spend money in order to 
increase their self-reliance now receives corroboration in a 
certain sense; for the spending of money deceives them as 
to the want of freedom of their libido and thus relieves 
them for a short time of the painful feeling of sexual in- 
sufficiency. In other words, they are under an abnormally 
strict prohibition, proceeding from the parental imago, 
against expending their libido freely. A compromise 
between instinct and repression is made by which the 
patient, in a spirit of defiance, does expend not his sexual 
libido but an anal currency. 

We are here reminded of the attitude of certain neurotics 
whose libido is also bound in an excessive degree. They are, 
in part or wholly, incapable of sexual love in the mental and 



3O2 SELECTED PAPERS OF KARL ABRAHAM XIV 



I sense. They give other people not love but pity and 
become benefactors, and often give money away too freely. 
They are for ever doomed to this form of substitutive 
gratification; and, in the vague feeling that they are not 
giving the right gift in a qualitative sense, they exaggerate 
it in a quantitative one. Nevertheless, their spending of 
money is altruistic in its effect, while in the previously 
described cases such an effect is entirely absent. What is 
common to both groups is that the spending of money forms 
a substitute for the sexual transference which their neurosis 
forbids and at the same time serves as a bulwark against 
neurotic disturbances. 



CHAPTER XV 

A PARTICULAR FORM OF NEUROTIC RESIST- 
ANCE AGAINST THE PSYCHO-ANALYTIC 
METHOD i (1919) 

WHEN we begin to give a patient psycho-analytic 
treatment we make him acquainted with its funda- 
mental rule to which he has to adhere uncondition- 
ally. The behaviour of each patient in regard to that rule 
varies. In some cases he will easily grasp it and carry it out 
without particular difficulty; in others he will frequently 
have to be reminded of the fact that he has to make free 
associations ; and in all cases we meet at times with a failure 
to associate in this way. Either he will produce the result 
of his reflected thoughts or say that nothing occurs to him. 
In such a situation the hour of treatment can sometimes 
pass without his producing any material whatever in the 
way of free association. This behaviour indicates a 
4 resistance ', and our first task is to make its nature clear 
to the patient. We regularly learn that the resistance is 
directed against allowing certain things in the mind from 
becoming conscious. If at the commencement of the treat- 
ment we have explained to the patient that his free associa- 
tions give us an insight into his unconscious, then his refusal 
to give free associations of this kind is an almost obvious 
form for his resistance to take. 

Whereas in most of our cases we meet with a resistance 
of this kind which appears and disappears by turns, there is 
a smaller group of neurotics who keep it up without inter- 

1 [No. 58, A. B.] 

303 



3O4 SELECTED PAPERS OF KARL ABRAHAM XV 

ruption during the whole of their treatment. This chronic 
resistance to the fundamental rule of psycho-analysis may 
obstruct its progress very much and even preclude a success- 
ful result. The question has hitherto received little con- 
sideration in our literature, like so many other questions of 
technique. I have met with this difficulty in a number of 
cases, and other psycho-analysts tell me that they have had 
the same experience. There is therefore a practical as well 
as a theoretical interest in investigating more strictly this 
kind of neurotic reaction to psycho-analysis. 

The patients of whom we are speaking hardly ever say 
of their own accord that ' nothing occurs ' to them. They 
rather tend to speak in a continuous and unbroken manner, 
and some of them refuse to be interrupted by a single 
remark on the part of the physician. But they do not give 
themselves up to free associations. They speak as though 
according to programme, and do not bring forward their 
material freely. Contrary to the fundamental rule of 
analysis they arrange what they say according to certain 
lines of thought and subject it to extensive criticism and 
modification on the part of the ego. The physician's 
admonition to keep strictly to the method has in itself no 
influence on their conduct. 

It is by no means easy to see through this form of 
behaviour. To the physician who is not experienced in 
recognizing this form of resistance the patients seem to 
show an extraordinarily eager, never-wearying readiness to 
be psycho-analysed. Their resistance is hidden behind a 
show of willingness. I must admit that I myself needed 
long experience before I was able to avoid the danger of 
being deceived. But once I had correctly recognized this 
systematic resistance its source also became clear to me, 
For although neurotics of this type, of whom I have treated 
a certain number, exhibited great variety as regards illness 
and symptoms, in their attitude towards psycho-analysis 
and the physician they all produced a certain number of 
characteristics with astonishing regularity. And I should 
like to make those characteristics the subject of discussion 
in the following pages. 



19*9 A FORM OF NEUROTIC RESISTANCE 305 

Under the apparent tractability of these patients lies 
concealed an unusual degree of defiance, which has its 
prototype in the child's conduct towards its father. Whereas 
other neurotics will occasionally refuse to produce free 
ideas, these patients do so continually. Their communi- 
cations are superabundant in quantity, and, as we have said, 
it is this fact that blinds the inexperienced physician to 
their imperfection as regards quality. They only say 
things which are c ego-syntonic '. These patients are 
particularly sensitive to anything which injures their self- 
love. They are inclined to feel * humiliated ' by every 
fact that is established in their psycho-analysis, and they 
are continually on their guard against suffering such 
humiliations. They furnish any number of dreams, but 
they adhere to the manifest content and understand how to 
glean from the dream-analysis only what they already know. 
And they not only persistently avoid every painful impres- 
sion but at the same time endeavour to get the greatest 
possible amount of positive pleasure out of their analysis. 
This tendency to bring the analysis under the control of the 
pleasure principle is particularly evident in these patients 
and is, in common with a number of peculiarities, a clear 
expression of their narcissism. And it was in fact those 
among my patients who had the most pronounced narcissism 
who resisted the fundamental psycho-analytic rule in the 
way described. 

The tendency to regard a curative measure merely as an 
opportunity for obtaining pleasure and to neglect its real 
purpose must be regarded as a thoroughly childish charac- 
teristic. An example will illustrate this. A boy of eight 
was ordered to wear spectacles. He was delighted with this, 
not because he was to be relieved of an unpleasant visual 
disturbance by their use, but because he was to be allowed 
to wear spectacles. It soon turned out that he paid no 
attention to whether the trouble was removed by means of 
the spectacles or not; the fact of possessing them and being 
able to show them at school pleased him so much that he 
forgot all about their therapeutic value. The attitude of 
the class of patients we are discussing to psycho-analysis is 

v 



3O6 SELECTED PAPERS OF KARL ABRAHAM XV 

exactly the same. One expects from it interesting contri- 
butions to the autobiography which he is writing in the 
form of a novel; another hopes that psycho-analysis will 
advance him to a higher intellectual and ethical level, so 
that he will be superior to his brothers and sisters towards 
whom he has hitherto had uncomfortable feelings of 
inferiority. The aim of curing their nervous disabilities 
retreats into the background in proportion as such narcis- 
sistic interests predominate. 

The narcissistic attitude such patients adopt towards the 
method of treatment also characterizes their relations to 
the analyst himself. Their transference on to him is an 
imperfect one. They grudge him the role of father. If 
signs of transference do appear, the wishes directed on to 
the physician will be of a particularly exacting nature; thus 
they will be very easily disappointed precisely in those 
wishes, and they will then quickly react with a complete 
withdrawal of their libido. They are constantly on the 
look-out for signs of personal interest on the part of the 
physician, and want to feel that he is treating them with 
affection. Since the physician cannot satisfy the claims of 
their narcissistic need for love, a true positive transference 
does not take place. 

In place of making a transference the patients tend to 
identify themselves with the physician. Instead of coming 
into closer relation to him they put themselves in his place. 
They adopt his interests and like to occupy themselves 
with psycho-analysis as a science, instead of allowing it to 
act upon them as a method of treatment. They tend to 
exchange parts, just as a child does when it plays at being 
father. They instruct the physician by giving him their 
opinion of their own neurosis, which they consider a particu- 
larly interesting one, and they imagine that science will be 
especially enriched by their analysis. In this way they 
abandon the position of patient and lose sight of the purpose 
of their analysis. In particular, they desire to surpass their 
physician, and to depreciate his psycho-analytical talents 
and achievements. They claim to be able to * do it better '. 
It is exceedingly difficult to get them away from precon- 



A FORM OF ^NEUROTIC RESISTANCE 307 

ceived ideas which subserve their narcissism. They are 
given to contradicting everything, and they know how to 
turn the psycho-analysis into a discussion with the physician 
as to who is ' in the right '. 

The following are a few examples: A neurotic patient 
I had not only refused to associate freely but to adopt the 
requisite position of rest during the treatment. He would 
often jump up, go to the opposite corner of the room and 
expound, in a superior and didactic manner, his self- 
formed opinions about his neurosis. Another of my 
patients displayed a similar didactic attitude. He actually 
said straight out that he understood psycho-analysis better 
than I did because it was he and not I who had the neurosis. 
After long-continued treatment he once said, ' I am now 
beginning to see that you know something about obsessional 
neurosis '. One day a very characteristic fear of his came 
out. It was that his free associations might bring to light 
things that were strange to him but familiar to the physician ; 
and the physician would then be the ' cleverer ' and 
superior person of the two. The same patient, who was 
much interested in philosophical matters, expected nothing 
less from his psycho-analysis than that science should gain 
from it the ' ultimate truth '. 

The presence of an element of envy is unmistakable in 
all this. Neurotics of the type under consideration grudge 
the physician any remark that refers to the external progress 
of their psycho-analysis or to its data. In their opinion 
he ought not to have supplied any contribution to the 
treatment; they want to do everything all by themselves. 
This brings us to a particularly striking characteristic 
which all these patients show, which is that they make up 
at home for their failure to associate freely during the hour 
of treatment. This procedure, which they very often call 
' auto-analysis ', contains an obvious depreciation of the 
physician's powers. The patients actually see in him a 
hindrance to progress during the hours of treatment, and 
are exceedingly proud of what they imagine they have 
achieved without his assistance. They mix the free 
associations obtained in this way with the results of con- 



3O8 SELECTED PAPERS OF KARL ABRAHAM XV 

sidered thought, classify them according to some definite 
idea, and produce them in this state to the physician next 
day. In consequence of severe resistances, one of my 
patients thought that he was making very little progress 
during a succession of hours, and finally that he was making 
none at all. The next day he came to me and said he had 
had to ' work * for many hours alone at home. Naturally 
I was meant to infer from this the weakness of my own 
abilities. One element in such an * auto-analysis ' is a 
narcissistic enjoyment of oneself; another is a revolt 
against the father. The unrestrained occupation with his 
own ego and the feeling of superiority already described 
offers the person's narcissism a rich store of pleasure. The 
necessity of being alone during the process brings it extra- 
ordinarily near to onanism and its equivalent, neurotic 
day-dreaming, both of which were earlier present to a 
marked degree in all the patients under consideration. 
* Auto-analysis ' is for them a form of day-dreaming, a 
substitute for masturbation, free from reproach, since it is 
justified and even prescribed on therapeutic grounds. 

I may say that the cases to which I refer belong chiefly 
to the obsessional neuroses. One case was an anxiety- 
hysteria mixed with obsessional symptoms, and in another 
there was a paranoid disturbance. In view of the more 
recent results of psycho-analysis we shall not be surprised 
to find pronounced sadistic-anal traits in all the cases. 
Their hostile and negative attitude towards the physician 
has already been mentioned ; and anal-erotic motives 
explain the rest of their behaviour. I will give a few 
examples of this. In these as in other neurotics with 
strong anal erotism, talking in the analysis, by means of 
which psychic material is discharged, is compared to 
emptying the bowels. (I may say that some identify free 
associations with flatus.) They are persons who have only 
with difficulty been taught in childhood to control their 
sphincters and to have a regular action of the bowels. 
They used to refuse to empty their bowels at a specific 
time, so that they could do this when it suited their con- 
venience ; and they now behave towards psycho-analysis 



1919 A FORM OF NEUROTIC RESISTANCE 309 

and the physician in the same way from unconscious 
motives. Tausk l has recently pointed out the fact that 
small children like to deceive adults with regard to emptying 
their bowels. They appear to try very hard to satisfy the 
demands of their mother or nurse, but they have no motion. 
Tausk adds that this is perhaps the earliest occasion on 
which the child becomes aware that it can take grown-up 
people in. The neurotics under discussion continue this 
tradition of infantile behaviour. They pride themselves, 
as it were, upon being able to decide whether, when, or 
how much they will give out from their unconscious psychic 
material. Their tendency to bring perfectly arranged 
material to the analytic hour shows not only an anal-erotic 
pleasure in systematizing and cataloguing everything but 
exhibits yet another interesting feature. Freud 2 has 
recently drawn attention to the unconscious identification 
of excrement and gifts. Narcissistic neurotics with a 
strong anal disposition such as we are dealing with here 
have a tendency to give presents instead of love. 3 Their 
transference on to the physician is incomplete. They are 
not able to expend themselves unconstrainedly in free 
associations. As a substitute they offer their physician 
gifts ; and these gifts consist of their contributions to 
psycho-analysis which they have prepared at home and 
which are subject to the same narcissistic over-estimation as 
the products of the body. The narcissistic advantage for 
them is that they keep the power of 'deciding what they 
are going to give. 

One of my obsessional patients who suffered from 
brooding and doubting mania contrived to make psycho- 
analysis itself, its methods and its results, the subject of his 
brooding and doubts. He was almost entirely dependent 
on his family, and he used to plague himself among other 
things with doubts as to whether his mother or Freud was 
4 in the right '. His mother, he said, had often advised 
him, in order to improve his constipation, not to dream in 

1 Internationale Zeitschrift fUr arxttiche Psychoanalyse, v. Jahrgang, 1919, S. 15, 
footnote i. 

2 * From the History of an Infantile Neurosis ' (1918). 
8 See Chapter XIV. 



3IO SELECTED PAPERS OF KARL ABRAHAM XV 

the closet but only to think of the process of defalcation 
itself 5 whereas Freud, on the contrary, gave exactly the 
opposite rule, namely, to associate freely and then ' every- 
thing comes out of itself '. It was a long time before the 
patient carried out his psycho-analysis no longer according 
to his mother's method, but according to that of Freud. 

The well-known parsimony of anal-erotics seems to be 
in contradiction with the fact that these patients readily 
make material sacrifices for the treatment, which, for the 
reasons above mentioned, is a protracted one. This 
behaviour, however, is explicable from what has already 
been said. The patients are making a sacrifice to their 
narcissism. They are all too apt to lose sight of the fact 
that the object of the treatment is to cure their neurosis. It 
is another consideration which enables them not to pay 
attention to expense. To paraphrase an old anecdote, it 
might be said that nothing is too dear for their narcissism. 

The character-trait of parsimony is, besides, found 
elsewhere in them. They save up their unconscious 
material. They are prone to build on the belief that one 
day Everything will come out all at once'. They practise 
constipation in their psycho-analysis, just as they do in 
the sphere of bowel activity. Evacuation is to take place 
on some occasion after a long delay and to give them 
particular pleasure. This finale is again and again post- 
poned, however. 

The analysis of patients of this description presents 
considerable difficulties. These difficulties reside in part 
in the pretended compliance with which the patients 
cloak their resistance. For analysis is an attack on the 
patient's narcissism, that is, on that instinctual force upon 
which our therapeutic endeavours are most easily wrecked. 
Everyone who is acquainted with the situation will there- 
fore understand that none of my cases gave quick results. 
I must add that in no case did I obtain a complete cure, 
though I did succeed in effecting an improvement of some 
practical value, which in a few cases was of a far-reaching 
character. My experiences perhaps give a too unfavourable 
picture of the therapeutic prospects. When I treated my 



A FORM OF NEUROTIC RESISTANCE 3! I 

first cases I lacked a deeper insight into the peculiar nature 
of the resistances. It must be remembered that it was not 
until 1914 that we got our first knowledge of narcissism, 
thanks to Freud's classical study. I certainly have the 
impression that it is easier to overcome such narcissistic 
resistances now that I make known to these patients the 
nature of their resistances at the very beginning of the 
treatment. I lay the greatest stress on making an ex- 
haustive analysis of the narcissism of such patients in all 
the forms it takes, and especially in its relation to the father 
complex. If it is possible to overcome their narcissistic 
reserve, and, what amounts to the same thing, to bring 
about a positive transference, they will one day unexpectedly 
produce free associations, even in the presence of the 
physician. At first these associations come singly, but 
with the advance of the process described they become 
more abundant. Therefore, though I have to begin with 
called special attention to the difficulties of the treatment, 
I should like in conclusion to issue a warning against 
making an entirely unfavourable prognosis for all such 
cases. 



CHAPTER XVI 

THE APPLICABILITY OF PSYCHO-ANALYTIC 
TREATMENT TO PATIENTS AT AN AD- 
VANCED AGE 1 (1919) 

THE question of what the conditions are under which 
psycho - analytic treatment promises therapeutic 
success has hardly been discussed at all up to the 
present, except for some general remarks by Freud in a 
paper which appeared many years ago. 2 

Since then psycho-analytic experience has been much 
increased and its technique greatly developed. It there- 
fore seems an opportune moment to consider more care- 
fully this question, which is of great practical importance. 
The following remarks are intended as a first attempt to 
throw light on the subject. 

In his paper Freud has expressed the opinion that psycho- 
analysis loses its effectiveness if the patient is too advanced 
in years. There is no doubt about the general correctness 
of this view. It was only to be expected that at the com- 
mencement of physical and psychical involution a person 
should be less inclined to part with a neurosis which he 
has had most of his life. Daily psycho-analytical experi- 
ence, however, shows that we must not expect mental 
processes to be too uniform. It warns us against approach- 
ing the investigation or treatment of nervous conditions 
with a -priori theories. For instance, has it not been shown 
that certain mental diseases which psychiatric medicine has 
pronounced to be quite intractable are accessible to psycho- 

1 [No. 62, A. B.] 
* * Sexuality in the ^Etiology of the Neuroses ' (1898). 

312 



TREATMENT AT AN ADVANCED AGE 313 

analytic methods? It would seem therefore incorrect to 
deny a priori the possibility of exercising a curative in- 
fluence upon the neuroses in the period of involution. It 
is rather the task of psycho-analysis as a scientific procedure 
to inquire into precisely this question as to whether, and 
under what conditions, the method of treatment can attain 
results in patients in the later years of life. 

Freud's opinion quoted above is often taken to mean 
that treatment in the fourth decade of life holds out doubtful 
prospects of relief, and that in the fifth decade, and particu- 
larly in the climacteric, the chances of achieving favourable 
results are decidedly adverse. Beyond fifty it is often 
denied that our therapy has any effect at all. 

In my psycho-analytical practice I have treated a 
number of chronic neuroses in persons of over forty and 
even fifty years of age. At first it was only after some 
hesitation that I undertook cases of this kind. But I was 
more than once urged to make the attempt by patients 
themselves who had been treated unsuccessfully elsewhere. 
And I was, moreover, confident that if I could not cure the 
patients I could at least give them a deeper and better 
understanding of their trouble than a physician untrained 
in psycho-analysis could. To my surprise a considerable 
number of them reacted very favourably to the treatment. 
I might add that I count some of those cures as among my 
most successful results. I will give a few examples. 

The first case of this kind held out the least favourable 
prospects of all. It was a melancholic depression, and the 
patient, a man, was in the period of involution and had 
proved refractory to treatment in institutions both for 
nervous and insane patients. Psycho-analysis had an 
exceedingly difficult task before it in this inhibited patient, 
who was in his fiftieth year. Nevertheless, within five 
months it succeeded in freeing him from his self-accusations 
and his negation of life, and in making him able to carry 
on his work. When treatment was begun, his trouble, 
which had been preceded by a nervous condition that had 
lasted many years, had existed in its pronounced form 
for fifteen months. Although the illness that was cured in 



SELECTED PAPERS OF KARL ABRAHAM XVI 

this case was not of very long standing, there was no doubt 
that it promised to become a chronic one. And it was, 
besides, a very severe illness. After this I was scarcely able 
to regard as hopeless the treatment of a neurosis in the age 
of involution. 

Later I undertook the psycho-analysis of a patient of 
nearly fifty years of age who was suffering from an obses- 
sional neurosis ; and by a not uncommon coincidence I soon 
afterwards received a second patient of the same class, aged 
fifty-three. In both these cases I succeeded in obtaining 
very good results. 

The first patient had exhibited all the marks of what is 
called the obsessional character from his youth upwards; 
but until he was thirty-five years old he had only shown 
obsessional symptoms in a slight degree, and had not greatly 
suffered from them. After his marriage he had become 
completely dependent on his wife, and she used to decide 
everything for him. One day he discovered that she 
permitted herself an intimacy with a relative. This event 
awakened his jealousy, and led to the outbreak of his 
neurosis in its severe form. Now that his wife in whom he 
had placed absolute trust had proved herself unworthy of 
it, there was nothing left for him to depend upon. He 
developed the severest doubting mania imaginable. Among 
other things, he was constantly in doubt whether he had 
just committed a crime or not. If he saw a man turn out of 
the street and disappear into a house he was tortured with 
the thought that he might have murdered him and done 
away with the body. After the postman had brought a 
parcel and gone away again he used to search the whole 
house in the greatest state of anxiety in order to convince 
himself that he had not murdered him and hidden away 
parts of his body. All this was accompanied by torturing 
doubt as to whether he had written his name on a piece of 
paper that had been thrown away, so that it might be 
misused in some way. I only mention these few instances 
out of a great number in order to give some idea of 
the severity of the case. This man, who at the beginning 
of the treatment was filled with apprehensions, utterly 



19*9 TREATMENT AT AN ADVANCED AGE 315 

helpless and dependent, made a very considerable recovery. 
Six years have now passed since the conclusion of the 
treatment without his having had any important relapse. 
He has had occasional fluctuations in his state of health, 
but none of any importance. 

The other obsessional patient whom I treated at the 
same time suffered from very severe attacks of anxiety and 
states of depression. He too had always exhibited the 
signs of an obsessional character, among which exaggerated 
kind-heartedness and over - conscientiousness were espe- 
cially prominent. Certain conflicts connected with his 
fixations on his family brought about the onset of his 
neurosis when he was between thirty and thirty-five years 
old. Psycho-analysis succeeded in removing his severe 
neurotic symptoms, including his attacks of anxiety and 
morbid doubt, and made him once more fit to take up the 
work he had been obliged to give up, and to enjoy his life. 

I should also like to refer to the recovery of a female 
patient of forty-one with pronounced street and travelling 
anxiety. She had been subject to numerous neurotic 
symptoms from childhood, and had suffered for the last 
six years from the two serious disabilities mentioned above. 
She was completely cured. Eight years have now passed 
since the treatment and she remains without inhibitions as 
regards her freedom of movement. 

Other cases might be adduced, and also some in which 
partial results were obtained in very severe and deeply- 
rooted anxiety-hysterias, states of depression, etc. 

Having mentioned these gratifying results I must go on 
to report the failures. I need only briefly touch on those 
extremely unfavourable cases which very soon necessitate 
a discontinuance of the treatment. These are patients who 
instinctively retreat from every unwished-for discovery in 
their analysis, and even to the necessity of speaking about 
their instinctual life. More important for our present 
discussion are those cases in which we have to be satisfied 
with a partial improvement in spite of continued treatment. 

If we survey a certain quantity of successful and un- 
successful treatments in patients of this group, the problem 



31 6 SELECTED PAPERS OF KARL ABRAHAM XVI 

of their varying results is explained in a simple manner. The 
prognosis in cases even at an advanced age is favourable if 
the neurosis has set in in its full severity only after a long 
period has elapsed since puberty, and if the patient has 
enjoyed for at least several years a sexual attitude approach- 
ing the normal and a period of social usefulness. The 
unfavourable cases are those who have already had a pro- 
nounced obsessional neurosis, etc., in childhood, and who 
have never attained a state approaching the normal in the 
respects just mentioned. These, however, are also the kind 
of cases in which psycho-analytic therapy can fail even if the 
patient is young. In other words, the age at which the 
neurosis breaks out is of greater importance for the success 
of psycho-analysis than the age at which treatment is begun. 
We may say that the age of the neurosis is more important 
than the age of the patient. 

In this connection a comparison suggests itself with the 
prognosis in mental disorders. Among the psychoses known 
as dementia praecox (schizophrenia, paraphrenia) the prog- 
nosis is most unfavourable in those cases which have broken 
out at puberty or even in childhood, while those that set 
in at a more mature age tend more to remissions and to 
remissions which are of greater permanence. The course 
taken by the psychoneuroses follows the same laws. 

The question how far psycho-analysis can succeed in 
tracing out the infantile sexuality of neurotics of an advanced 
age is of great importance. From my experience i should 
say that it is by no means impossible to work back to the 
very earliest period of childhood. In a case of obsessional 
neurosis that I have recently treated, though the treatment 
is not yet terminated, I succeeded in this with a thorough- 
ness which one could only have hoped for if the patient had 
been quite a young person, 

In some of the cases psycho-analytic treatment in the 
age of involution is not conducted in quite the same manner 
as in younger patients. While in general we leave the 
conduct of the analysis to the patient, in that he chooses in 
each hour of treatment the starting-point of his free asso- 
ciations, certain older neurotics need to receive a stimulus 



1919 TREATMENT AT AN ADVANCED AGE 317 

from the physician on each occasion. I have repeatedly 
observed this in a pronounced form in obsessional neurotics 
of older years. Such patients were persons with a weak 
initiative in general, who had been dependent and lacking 
in self-confidence since their youth in definite respects. 
They now wished to be guided by their physician, who 
signified to their unconscious the superior father. I have 
many times met with the same thing in these patients at 
the beginning of their hour. They could not find the 
way to the psychic material by themselves; but as soon as 
a little stimulus was given to them, perhaps in the form 
of an allusion to what had already been spoken about, 
they immediately produced associations. This conduct is 
thoroughly infantile in character. I have met it in the 
treatment of children as well; for instance, in an intelligent 
boy of eleven who had adopted a strong positive attitude 
towards me as a father-substitute. It is significant that in 
youthful patients this behaviour ceases when opposition 
towards the father or father-substitute appears in the 
foreground. 

With these remarks I hope to have afforded some guide 
in the choice of cases suitable for psycho-analytic treatment 
where the patient's age is somewhat advanced. In con- 
clusion, I should like to call attention to the fact that more 
precise investigations would be useful as to why certain 
youthful cases prove refractory to psycho-analysis. A more 
precise standpoint as regards indication would spare us many 
failures and lead to a full development of the effectiveness 
of psycho-analytic therapy. 



CHAPTER XVII 

THE NARCISSISTIC EVALUATION OF EX- 
CRETORY PROCESSES IN DREAMS AND 
NEUROSIS 1 (1920) 

WHILE undergoing psycho-analytic treatment, a 
female patient had the following dream : 
4 I was sitting in a basket-chair near the wall of 
a house which was at the edge of a big lake. The chair was 
standing right on the water. There were boats on the lake 
and many people swimming in it. I_saw two men in a boat, 
a young one and an older one. As the boat was approach- 
ing me there came a gust of wind which made a huge wave 
rise just behind the boat and engulf it and its occupants. 
The people who were swimming in the lake were drowned 
as well. Only one person, a woman, kept herself above 
water. She swam up to me and clutched at my chair, I 
thought that I could stretch out my leg for her to hold on 
to; but I had just as little sympathy for her as for the other 
unfortunate people, and I did nothing to help her.' 

The analysis of the dream, as far as it is of interest here, 
elicited the following facts: 

The two men in the boat were the patient's father and 
brother, upon both of whom her libido was over-strongly 
fixated. The woman who was swimming was her mother. 
I shall pass over the psychic constellation which caused the 
dreamer unconsciously to wish for the death of her whole 
family, and I shall only consider the method by which it 
was destroyed in her dream, 

1 [No. 63, A. B.] 



1920 EVALUATION OF EXCRETORY PROCESSES 319 

In the dreams and neurotic symptoms of this patient, 
whose genital erotism was unusually strongly repressed, we 
find a very strong expression of anal and urethral erotism. 
The dream just quoted is an example of this. * Stool V 
* wind ', and ' water ' are its principal features. The 
dreamer's family is exterminated by wind and water. She 
herself appears, on account of the censorship, to be an un- 
interested looker-on. The lack of feeling with which she 
views the catastrophe arouses the suspicion that she herself 
is the cause of the disaster. And this suspicion becomes a 
certainty when we see how the dream ends. By refusing 
to help her mother she becomes the cause of her death. 

In the psycho-analyses of neurotics we are accustomed 
to find that anal and urethral sensations are closely related 
to infantile impulses of love. And the analysis of the 
present patient produced a quantity of material in evidence 
of this. It entirely corresponds to our experience of the 
ambivalence present in the instinctual life of the neurotic 
when we find the functions and products of the bowel and 
bladder used as vehicles of hostile impulses. But it is 
rare to find those impulses so glaringly exhibited as in the 
example given above, where the functions of the bladder 
and the bowel are placed exclusively in the service of sadism, 
and urine and flatus appear as the instruments of a sadistic 
attack. 

The enormous power which the dreamer ascribes to her 
excretions deserves special consideration. On the basis of 
this dream we are able to set beside the primitive idea of 
the omnipotence of thoughts, with which we are quite 
familiar, the idea of the omnipotence of the functions of 
bladder and bowel. Both ideas quite obviously express 
the same narcissistic over-estimation of the self. But the 
omnipotence of the functions of the bladder and bowel 
seems to be the more primitive of the two to be the 
preliminary stage of the ' omnipotence of thoughts '. 
A second example may help to confirm this view: 

A neurotic patient, a man, who had constantly imagined 

1 [German ' Stuhl '= (i) ' chair ' ; (2) ' stool ', ' faeces '. Cf. ' basket-chair ', 
German * Korbstuhl '.] 



32O SELECTED PAPERS OF KARL ABRAHAM XVII 

he was a ' prince ', and had played at being * Kaiser * during 
his early years and who had in later childhood revelled in 
phantasies of dominating the world, experienced a peculiar 
change when he was eleven years old. Up till then he had 
been entirely fixated on his mother, who had systematically 
prejudiced him against his father. She had greatly in- 
creased his anal erotism by almost elevating to a cult her 
preoccupation about his motions. She was constantly con- 
cerned about their quality and quantity, and used to give 
him an enema almost daily. The boy had on his side 
developed neurotic pains in his stomach in order to compel 
his mother to continue the enemas. When he was eleven 
years old he went a long journey with his parents. One 
night, when they were staying in an hotel, he overheard his 
parents having sexual intercourse. This event made all 
the more impression on him since for many years at home 
his parents had had separate bedrooms. He now re- 
membered that this event had seemed unbearable to him, 
and that he had quite consciously determined to prevent 
its recurrence. For the remainder of the journey he 
managed to arrange things so as to share a room with his 
father. Since his observation of parental intercourse he 
had identified himself with his mother and transferred his 
phantasies of anal coitus on to his father. Up to this time 
he had attributed a penis to his mother, which was repre- 
sented by the enema tube. But now he took up a female- 
passive attitude towards his father. 1 Soon afterwards he 
was confined to his bed. During this time he went a couple 
of days without having an evacuation, and as a consequence 
of this he had a feeling of pressure in the abdomen. That 
night he dreamed that he had to expel the universe out of 
his anus. 

The idea of the omnipotence of defalcation is very 
clearly expressed in this dream. It recalls the myths of 
the Creation, in which a human being is produced from earth 
or clay, i.e. from a substance similar to excrement. The 

1 In his phantasies the patient retained the idea of a woman with a penis even 
in later years. He used to conceal his genital organs between his thighs in order 
to feel like a woman. 



IQ20 EVALUATION OF EXCRETORY PROCESSES 321 

Biblical myth of the Creation has two different accounts 
concerning this. In the * Elohistic ' version God created 
the universe and also human beings by means of his com- 
mand, * Let there be ', i.e. by the omnipotence of his 
thought, will, or deed. In the * Jahvistic * version a human 
being is created out of a clod of earth into which God 
breathes ; so that here we find expressed the more primitive 
idea of the omnipotence of the products of the boweL But 
we cannot go on to consider other mythological parallels in 
this place. 

Returning to the sadistic significance of defaecation, I 
may mention that the patient who killed her family in her 
dream by means of her excretions was severely troubled 
with nervous diarrhoea. Besides the usual causes, psycho- 
analysis discovered a sadistic element at the bottom of this 
symptom. Her diarrhoea proved to be an equivalent of 
suppressed outbursts of rage. Other analysed cases have 
confirmed this connection. For instance, I know a neurotic 
woman who reacts with diarrhoea to any event which excites 
anger or rage. 

It seems a curious thing that an outburst of rage should 
be represented by precisely this neurotic symptom. To 
find its explanation we must consider the behaviour of the 
child in the earliest period of its life. In the affect of rage 
the infant exhibits the same facial congestion, the same 
gestures, the same movements of the body as when it is 
expelling its stool. And it makes the same moaning sounds 
on both occasions. This identity between the means of 
expression employed in the two conditions indicates a 
close association between what are apparently dissimilar 
impulses. We can thus understand how an explosive 
evacuation of the bowels can offer to the unconscious of the 
neurotic a substitute for a discharge of angry affect that has 
not taken place. 

The most fundamental relationship between sadism 
and anal erotism doubtless lies in the fact that the passive 
sexual feeling associated with the anal zone becomes coupled 
with the active-sadistic impulses a combination of oppo- 
sites which represents the earlier stage of the polarity of 



322 SELECTED PAPERS OF KARL ABRAHAM XVII 

male and female. The very marked ambivalent attitude 
present in the instinctual life of obsessional neurotics is 
based on this close connection between the active and 
passive impulses. The connection of sadistic and anal 
impulses mentioned above does not contradict this view; 
on the contrary, it shows that libidinal impulses of an active 
nature are also associated with activity of the bowels, 1 and 
shows us the over-determination of that relationship. 

The narcissistic over-estimation of the excreta has long 
been recognized in psycho-analytic literature. As early as 
1 900, in his Traumdeutung, Freud has given examples of it. 
Dreams in which a flow of urine exercises powerful effects 
occur in women with a strongly marked * masculine com- 
plex '. In an earlier paper 2 I have mentioned the case of 
a boy of three years old whose narcissistic megalomania 
was entirely unrepressed so that its connection with the 
excretions was easily recognizable. As he stood and 
urinated into the sea he tried to give the impression that 
the sea was his own product. 

The two dreams I have mentioned are closely con- 
nected with this infantile phantasy. Whereas in the excre- 
tion dreams with which we are already familiar the products 
of the body are simply over-estimated in a quantitative 
sense, in the examples before us it is the functions of 
excretion that are over-estimated, and in the sense of 
possessing great and even unlimited power to create or 
destroy every object. 

1 The double active and passive erotogenic significance of the anal zone has 
been discussed in detail by Federn in his ' Beitragen zur Analyse des Sadismus und 
Masochismus ' (1913). 

* See Chapter XIII. 



CHAPTER XVIII 

CONTRIBUTION TO A DISCUSSION ON 
TIC 1 (1921) 

A NUMBER of different phenomena were originally in- 
7\ eluded under the name ' Tic ', as, for instance, tic 
JL j^ douloureux (trigeminal neuralgia), facial spasms, 
and many compulsive symptoms, as well as the symptoms 
still designated as tics to-day. Nowadays it is only the 
separation of tics from compulsive actions which raises 
difficulties from the point of view of differential diagnosis. 
Neither Meige, Feindel, nor Ferenczi solve this difficulty. 
The characteristics of a tic as given by the first two authors 
apply equally well to compulsive actions. The incapability 
of mastering a stimulus, which Ferenczi describes, is very 
well observed, but this likewise occurs in the obsessional 
neurotic. Again, narcissistic phenomena on which Ferenczi 
lays particular stress can be seen in all hysterical and 
obsessional patients. Regression to narcissism, however, 
certainly never goes so far in the person suffering from a 
tic as in the psychotic patient. Ferenczi is quite right 
in calling attention to the similarities between tics and 
catatonia, but he overlooks the much more fundamental 
differences between the two conditions. There can be no 
question of a tic ending in dementia. On the other hand, 
the assumption of an increased organ libido and the con- 
ception of a ' pathoneurotic tic ' seem to be very useful. 

1 [No. 72, A. B.] 

[NOTE. This is the report of a contribution by Abraham to a discussion at a 
meeting of the Berlin Psycho -Analytical Society on June 9, 1921, on the subject of 
Ferenczi's paper * Psycho-Analytical Observations on Tic ', which had appeared 
earlier in the year.] 

323 



324 SELECTED PAPERS OF KARL ABRAHAM XVIII 

As far as I can see, a complete separation of tic and com- 
pulsive actioft is not possible, just as hysterical anxiety and 
conversion phenomena cannot be completely separated from 
each other. But the relationship between the two is very 
similar. The person suffering from a tic gives an aetiology 
for it; that is to say, he connects his suffering with events in 
his life, in the way that the hysteric does. But he does not 
attribute any significance to it in his mental life as the 
obsessional patient does, who fears disastrous results if 
he omits a compulsive action. The suppression of a tic 
is displeasurable; its resumption serves undoubtedly to 
relieve tension. I cannot agree with the view that the 
suppression of a tic causes anxiety. 

An important objection follows from another considera- 
tion. Ferenczi says that a tic does not seem to contain 
any relation to an object. In my analyses, however, I 
have found a double relation to the object, namely, a 
sadistic and an anal one, and herein lies the similarity of a 
tic to an obsessional neurosis. This similarity seems to 
me to be a closer one than that to catatonia. 

The tic first mentioned in psycho-analytic literature 
(Studien uber Hysteric^ 1895) was a clicking tic, by means of 
which the patient wished unconsciously to awaken her sick 
father who had just fallen asleep. A purpose directed 
against his life is undoubtedly expressed in this case. One 
of my patients suffering from tic general made snapping 
movements with his fingers, while at the same time he threw 
his arm forward with an aggressive gesture. The tic which 
takes the form of making grimaces has an obvious hostile 
significance. Many more examples of this kind can be 
adduced. 

Other tics, particularly coprolalia, show their anal origin 
quite clearly, as Ferenczi has pointed out. Some for 
example, the whistling tic are derived directly from anal 
processes (flatus). Here the patient carries out his hostile 
and degrading purposes by anal means. Others again are 
imitations of sphincter contractions. Certain tics seem to be 
veritable mimic representations of Gotz von Berlichingen's 
famous challenge. 



ON TIC 



On the basis of my material, which I cannot quote here 
in detail, the tic seems to me to be a conversion symptom at 
the anal-sadistic stage. The following scheme will make 
this view clear : 



Object-love 


Genital 
Organization 


Control of organ 
innervation 

V _____ 


Capacity to deal 
with psychi- 
cal stimuli 

^> 


(NORMAL STATE) 


Object-love 


Genital 
Organization 


Conversion 
Hysteria 


Anxiety 
Hysteria 


Object-love 


Sadistic-anal 
Organization 


Tic 


Obsessional 
Neurosis 


Narcissism to 
Autoerotism 


... 


Catatonia 


Paranoic states 



According to this table tic is placed beside the obsessional 
neuroses, as conversion hysteria is beside anxiety hysteria. 

It represents a regression one stage lower than the 
hysterical conversion symptom, and is nearer to catatonia 
than to hysteria. It stands, if one may say so, in the con- 
version and not in the anxiety series. 

The differences between Ferenczi's views and mine as 
I have mentioned them in no way detract from the merit 
due to this author, who for the first time has ventured to 
make a comprehensive and psycho-analytic investigation of 
tics. And certain of Ferenczi's ideas, although they seem 
to me erroneous, have guided me in the opinions I have 
expressed above. 



CHAPTER XIX 
THE SPIDER AS A DREAM SYMBOL * (1922) 

A c ar as I know there has been nothing of any practical 
value written in psycho-analytic literature about the 
significance of the spider as a symbol, although every 
analyst must have come across this symbol in the dreams of 
patients. Freud has once said that a spider represents one 
aspect of the mother, namely, the angry mother of whom 
the child is afraid. But it is not clear why it should be 
precisely the spider that stands for this side of the mother. 
One might say that it is because spiders catch and kill 
small animals, and small animals often represent children 
in dreams. But there are numbers of other creatures who 
prey on smaller, defenceless ones; why, then, should the 
spider be singled out to symbolize the wicked mother? 
The spider is one of those dream symbols whose meaning 
we know at least in one aspect without knowing the 
reason why it has that meaning. 

In practice, however, we find that this meaning of spiders 
is not always true or, at least, is not always their only mean- 
ing as we should expect from our knowledge of the 
ambiguity of symbols. But we shall search our literature 
in vain for further information on this point. Stekel 2 
mentions the spider as a phallic symbol, it is true, but he 
interprets the dreams he quotes in such a superficial manner 
that he throws no further light on the subject. In only one 
of the dreams quoted are the long legs of a species of spider 
(Phalangium) interpreted as phallic symbols. But this 

1 [No. 80, A. B.] 

2 Die Sprache des Traumes, S. 135. 

326 



1922 THE SPIDER AS A DREAM SYMBOL 327 

spider does not spin a web, so that it remains uncertain 
what significance is to be attached to those spiders which 
do not have long legs and which spin webs. 

In these circumstances we ought to make a careful note 
of each example independently. Several dreams of one 
of my patients at different periods of the treatment enable 
me to contribute something to the explanation of dreams 
about spiders. 

The patient's first dream occurred a few days after the 
beginning of his treatment, one result of which had so far 
been the discovery of his attitude towards his mother. This 
had made a very great impression on him. It appeared 
that his fixation on he'r expressed itself in an excessive 
dependence on her will and on her views. There is no 
doubt that she was the dominant partner in his parents' 
married life. She had also taken upon herself to some 
extent the maintenance of the family, and in many respects 
played the part of the father in the patient's life. The 
ambivalence of his feelings towards her was expressed in a 
violent opposition to her which existed side by side with his 
dependence on her, but which up to the time of treatment 
had exhausted itself in fruitless outbursts of passion. It 
came out later that the normal Oedipus attitude of the 
patient had undergone a reversal. His mother figured in 
his unconscious as a male being endowed with masculine 
attributes, and in this layer of his unconscious phantasies 
his attitude towards her was a female-passive one. 

The patient told the first dream as follows : * I was in a 
bedroom with two beds in it. Two servants were tidying up 
the room, I and the maid who was on my left suddenly 
discovered a horrid spider on the ceiling. She lifted up a 
long broom and crushed the spider, although I told her it 
could be removed in a less drastic manner.' 

The patient remembered that a spider had fallen into 
the bath on the day before the dream. His wife had wanted 
to let it drown, but he had rescued it and put it out of the 
window. The dream ended in the opposite way the spider 
was killed. It is true that according to the manifest content 
of the dream it was not he himself but the servant on his 



328 SELECTED PAPERS OF KARL ABRAHAM XIX 

left who killed the spider. This girl represented the 
dreamer's wife who had on the previous day wanted to let 
the spider drown, and who in real life signified to the patient 
the opposite of his mother. Through his marriage he had 
become disloyal, as it were, to his mother. We can also 
recognize in the two girls the two tendencies in him, namely, 
one hostile to his mother (the girl on his left) and the other 
friendly to her (the girl on his right). In his dream the 
first tendency obtains the upper hand. The significance of 
the spider as a mother symbol now at once becomes clear 
to us. The particular method of killing the spider in the 
dream crushing it is to be explained by the sadistic 
theory of coitus. (Incidentally, certain of the patient's 
day-dreams used to culminate in a number of people being 
crushed to death.) The associations showed that the long 
broom was a phallic symbol; so that the patient's latent 
wish to kill his mother by copulating with her becomes 
unmistakable. 

The second dream occurred about two months later 
and was this: ' I was standing beside a cupboard in the 
office with my mother or my wife. As I was taking a pile 
of deeds out of the cupboard, a big, hairy, long spider fell 
out at my feet. I felt very glad that it did not touch me. 
A little later we saw the spider sitting on the floor, looking 
almost bigger and more horrible than before. It flew up 
and came whirring at me in a big semicircle. We fled 
through the door into the next room. Just as I was pulling 
the door to, the spider reached me on a level with my face. 
Whether it got into the next room, or was shut out in the 
office, or was crushed in the door I do not know.' 

For some weeks prior to this dream the patient's resist- 
ances towards the female sex, or to be more correct, towards 
the female sex-organs, had come to light, together with his 
tendency to make himself into a woman by way of castration 
phantasies, and on the other hand to turn his mother into 
a man. He brought me a drawing of the spider as it 
appeared in the dream, and was himself astonished to 
recognize in his drawing the oval shape of the external 
female sex-organs, the hair surrounding it, and in the 



THE SPIDER AS A DREAM SYMBOL 329 

middle, where the body of the spider was, something that 
was unquestionably very like a penis. 

The spider's falling down in the dream represents the 
fall of his mother's penis, which becomes detached on his 
going to the cupboard (mother symbol). His relief at not 
having come in contact with the spider, i.e. the maternal 
genitals, comes from his horror of incest. In real life the 
sight of the female sex-organs, and still more any manual 
contact with them, used to horrify him. The subsequent 
increase in size of the spider, which also rises up and flies 
in a semicircle through the air, is an obvious symbol of 
erection: the maternal phallus attacks the dreamer. The 
doubt at the conclusion of the dream as to whether it 
was crushed in the door, is significant. We here find a 
phantasy of crushing the penis such as we meet with in 
the phantasies of neurotic women with a marked castration 
complex. This feature also reminds us of the first dream 
in which the spider was also crushed. 

We thus arrive at the conclusion that the spider has a 
second symbolic meaning. It represents the penis em- 
bedded in the female genitals, which is attributed to the 
mother. In support of this I may quote the dream of 
another patient, in which the dreamer attempted to enter 
a certain dark room filled with a number of small animals. 
From certain allusions in the manifest content of the dream, 
but particularly from the patient's associations, there was 
no doubt that the room represented the mother's body. As 
he entered it a butterfly fluttered towards him. For the sake 
of brevity I need only mention that, just as in other dreams, 
the wings of the butterfly had the significance of female 
genitals; this symbolic use of the wings is based, among 
other things, on the observation of their opening and closing. 
The body of the butterfly, which is concealed between the 
wings, was unmistakably a male genital symbol. The idea 
of a hidden female penis also came out in this patient's 
neurotic phantasies. 

The * wicked ' mother who, according to Freud's view, 
is represented by the spider, is clearly a mother formed in 
the shape of a man, of whose male organ and masculine 



33O SELECTED PAPERS OF KARL ABRAHAM XIX 

pleasure in attack the boy is afraid just as young girls are 
timid in regard to men. The patient's feeling towards 
spiders can be best described by the word * uncanny '. 

A third dream which occurred about two months after 
the second one throws further light on the matter. The 
patient said: ' I was standing by the side of a bed. A 
spider was hanging in the air over the bed by one or two 
threads. It had a tuft of yellow hair on the upper part of 
each thigh. I was afraid that as it swung to and fro on its 
thread it might touch me or climb on to me. My wife, 
who was standing on my left, warned me of this. I hit my 
right hand against the principal thread on which the spider 
hung, and this prevented it from coming too near me. I 
repeated this several times, so that in a way I was playing 
with the spider or teasing it. I said to my wife proudly: 
" Now I know how to get the better of the spider! " It 
then disappeared from the dream. I had finally removed it, 
and I let my hand fall on the bed. To my horror I dis- 
covered that my hand was actually resting on a spider's web 
lying there. The web was the size of my hand, oval and 
somewhat convex. It was a spider's nest and perhaps full 
of little spiders. I pulled away my hand and ran into the 
passage; whether my hand had come in contact with little 
spiders, or whether any had settled on it I do not know. 
I could not examine the nest in my haste, but I called on 
my wife to do so.' 

The hanging spider and the threads again represent 
the male genital organ of the mother; the swinging move- 
ment and the getting nearer to the dreamer signify erection 
and sexual attack, Hike certain symbols in the second dream. 
The tufts of hair also have a phallic significance; their 
duplication characteristically represents the absence of the 
thing they represent in reality. During the dream the 
dreamer becomes actively hostile to the spider; his fear of 
his mother's imagined penis disappears. We need not go 
into the other details of this part of the dream. 

The dreamer next comes in contact with the spider's 
web, from whose size and shape we have no difficulty in 
recognizing the female genitals. He now has anxiety with 



THE SPIDER AS A DREAM SYMBOL 33! 

regard to the real female genitals (that is to say, to the lack 
of a penis) in place of his previous anxiety regarding that 
fancied attribute. We again meet with the horror of touch- 
ing that part of a woman's body. The little spiders which 
the dreamer imagines are inside it are typical symbols of 
children. (The patient is the eldest of the family.) 

In conclusion, we can say that these three dreams give 
an explanation of spider symbolism in three directions. 
The spider represents in the first place the wicked mother 
who is formed like a man, and in the second place the male 
genital attributed to her. In this the spider's web repre- 
sents the pubic hair and the single thread the male genital. 

The fact that each dream contains a special use of spider 
symbolism indicates that there are probably still further 
meanings of this symbol. Perhaps this communication of 
mine will stimulate others to publish similar and supple- 
mentary analyses. 

The significance of the spider in folk psychology has 
not been sufficiently considered from the psycho-analytical 
point of view. The fact that it serves both as a good and a 
bad omen may be regarded as an expression of a generally 
widespread ambivalent attitude towards this insect. There 
is no doubt that it produces a feeling of ' uncanniness ' 1 in 
many people. We feel justified in assuming that those 
feelings of uncanniness originate in the same unconscious 
source as that of the neurotics described above. 

POSTSCRIPT 

My view that the symbolic significance of the spider 
has not been exhausted in my communication has found 
speedy confirmation. After I had spoken on this subject 
at a meeting of the Vienna Psycho-Analytical Society, Dr. 
Nunberg mentioned some points from his analysis of a 
phobia of spiders. The spider in this case also represented 
the dangerous mother, but in a special sense. The patient's 
unconscious phantasies were concerned with the danger of 
being killed by his mother during incestuous intercourse. 

1 See Freud, ' The Uncanny ' (1919). 



332 SELECTED PAPERS OF KARL ABRAHAM XIX 

Nunberg laid stress on the fact that the spider kills its victim 
by sucking its blood, and that this sucking served as a 
castration symbol in the case observed, i.e. it gave expression 
to the typical phantasy of losing the penis during the 
sexual act. 

I might remark that I was on the track of similar con- 
nections from the beginning; but they were not supported 
by the associations of my patient, and I preferred to limit 
myself to the indisputable material obtained in that way. 
My patient's treatment had to be broken off for external 
reasons. If it can be taken up again later I shall probably 
be able to confirm Nunberg's very interesting findings, 
which form a necessary and illuminating supplement to my 
analysis. 

During the same discussion Prof. Freud drew my 
attention to a remarkable biological fact which was unknown 
to me. Whether my patient consciously or unconsciously 
knew of it I do not know and have no means at present 
of finding out. It is this : the female spider is far superior 
in size and power to the male, and during copulation the 
latter runs a very great risk of being killed and devoured by 
her. There exists, therefore, a striking agreement between 
the ideational content of the phobia analyzed by Nunberg 
and a fact of natural science. I must refrain from attempting 
to explain this coincidence; but further investigations may 
perhaps throw some light upon it. 



CHAPTER XX 

AN INFANTILE THEORY OF THE ORIGIN 
OF THE FEMALE SEX* (1923) 

FROM the psycho-analyses of many patients we become 
acquainted with the infantile idea, which is retained 
in the unconscious, that the daughter has been made 
a girl by castration on the part of the father. Recently a 
female patient told me a dream in which the determination 
of her sex was assigned in this way to her father. The 
process, however, was different from that which I have met 
before in dreams, and was, besides, located in the period 
before the patient's birth. The dream was as follows: 

* I was lying on the ground under water. I was dead, 
that is to say, I was lying motionless; but I could still observe 
everything. I saw a big ship sailing on the water. A man 
with a long pole was standing on it. He was moving the 
ship forward with the pole, as they do on our rivers. He 
now plunged the pole into the water in my direction and 
made a hole in me with it in the region of my mouth. The 
next thrust struck me in the breast, and the third one bored 
a hole in my abdomen.' 

The dreamer is inside her mother's body witnessing 
sexual intercourse between her parents a situation which 
occurs in many patients' dreams. The particular point in 
this dream is, however, that the dreamer is made a woman 
by the process she is witnessing. The dream, therefore, 
gives expression to the idea that the vagina of the female 
child is bored out by the father's penis before her birth. 

I need not go into the remaining determinants of the 
dream, as I merely wish to draw attention to an infantile 
sexual theory in it which I have not come across before. 

1 [No. 83. A. B.j 
333 



CHAPTER XXI 

AN INFANTILE SEXUAL THEORY NOT 
HITHERTO NOTED i (1925) 

A PATIENT in whose childhood there had been an un- 
/\usually severe struggle between repression and 
A \. sexual curiosity recounted to me during psycho- 
analysis two childish theories of procreation. The first 
was that the man embraces the woman and kisses her, and 
when this happens some of his spittle passes into her mouth 
and produces a child in her. Besides this theory, with 
which the psycho-analyst is familiar, the patient had con- 
structed a second, according to which the man's breast, 
when he embraces the woman, excretes milk which passes 
into her breast. 

I had never heard of this infantile theory before. It 
certainly does not belong to the primary theories of sexuality 
which are formed by all children with a great degree of 
uniformity. Moreover, it was proved that the theory was 
constructed when the patient had already passed the age 
at which the primary theories are formed. Now since the 
views of children in later years vary greatly according to the 
different external influences to which they are subjected, 
there would be little reason to spend time over this secondary 
sexual theory about which the patient told me. But the 
analysis of it helped me to understand better one of the 
common primary theories of reproduction, and this seems 
to justify me in making the present communication. 

The capacity of loving the opposite sex was impaired 
in this patient owing to a vivid phantasy-life of a homo- 

1 [No. 1 10, A. B.] 
334 



1925 AN INFANTILE SEXUAL THEORY 335 

sexual character. In part it was a question of passive 
homosexual phantasies having reference to older men, 
these latter being father-substitutes. In relation to his father 
the patient identified himself with his mother in a manner 
which we know from other observations to be quite common. 
A second group of phantasies was active in character and 
concerned boys or, later, young men some years younger 
than the patient. He remembered that in early childhood 
he had a strong impulse to put his penis into the mouths of 
smaller boys, though he never did any such thing. Analysis 
showed beyond doubt that in these imaginings also he 
identified himself with his mother. The boys or young men 
stood for the patient's younger brothers, whom he, as the 
eldest, had seen at their mother's breast. This had roused 
in him the most violent envy; his brothers were in possession 
of something which he himself had once enjoyed but had 
had to give up long ago. His identification with his 
mother was his reaction to the preference shown to his 
younger brothers. 

At a later period nothing stimulated his libido so much 
as the sight of a nursing mother. In his native country it is 
quite customary for women of the lower classes to suckle 
their children in the street. The remarkable sexual excite- 
ment which accompanied every such impression in our 
patient leads us to conclude that for him the suckling of a 
child, i.e. the introduction of the nipple into the mouth of 
another person, was the essence of sexual gratification. To 
his unconscious this situation was a substitute for coitus, 
the active role being given to the nursing mother. He 
identified himself with her in the homosexual phantasies 
mentioned which had to do with the introduction of his own 
organ into the mouth of a boy. 

I may mention here that in the patient's mother-tongue 
the vulgar expression for semen is * milk '. This term 
(which is widespread elsewhere) had been heard by him as a 
little boy from older persons. 

The identification of the male nipple with the penis 
throws a light upon another of the sexual theories most 
commonly met with. I refer to the idea that the female has 



33^ SELECTED PAPERS OF KARL ABRAHAM XXI 

concealed within her a very large penis into which the 
smaller male organ of the man must penetrate. I think this 
infantile theory has hitherto not received an adequate 
psychological explanation. It has been so natural to explain 
it from two sources: first, from the familiar idea that the 
female body possesses a male organ an idea which is 
universal at a certain period of childhood and which Freud l 
has recently related to the ' phallic ' phase of libidinal 
development; and secondly, one was bound to add that, 
logically, only a smaller object could penetrate into a greater, 
so that the child had to assume the existence of a larger 
female organ. But we must not forget that in general 
rational explanations of this sort have very little psycho- 
logical value. 

A disparity between the male and female organ, in 
which the latter is the larger, does actually exist as regards 
the breast. Moreover, in my patient's case there was the 
additional fact that in his mother-tongue the male nipple is 
designated by a word which is a diminutive of the term used 
for the female breast. His idea of the little male nipple 
discharging some substance into the large female breast thus 
helps us to understand better the typical theory of a small 
male organ penetrating into the larger female one. 

Neurotic men who are found on analysis to have retained 
the idea of the large female penis regularly suffer from the 
fear that they themselves have an abnormally small organ. 
This was the case with my patient, in whom the idea was 
an obsession, until it disappeared under analysis. The 
displacement of coitus-phantasies from the genital region to 
the breast meant for the patient a considerable saving of 
displeasure. For the smallness of the nipple in relation to 
the female breast was a characteristic of all men, so that this 
disparity did not give him any feeling of personal deficiency. 

I think it is possible that the facts which I have only 
briefly touched on here may be of some importance in regard 
to infantile sexual investigations. To all appearance the 
male sex is superior as regards the genital organ and the 
female as regards the breast. This contrast must force 

1 Freud, ' The Infantile Genital Organization of the Libido ' (1923), 



AN INFANTILE SEXUAL THEORY 337 

itself upon the child, and we cannot wonder if he carries his 
discoveries in respect of the one region over to the other. 
The sexual theories of children would thus contain a 
deposit of this psychological process, and the idea of the 
great size and strength of the woman's penis would there- 
fore be largely determined by that organ being equated 
with the breast. 



CHAPTER XXII 

MANIFESTATIONS OF THE FEMALE 
CASTRATION COMPLEX 1 (1920) 

THE psychological phenomena which we ascribe to 
the so-called castration complex of the female sex 
are so numerous and multiform that even a detailed 
description cannot do full justice to them. These questions 
are made still more complicated by their relations to bio- 
logical and physiological processes. The following investi- 
gation, therefore, does not pretend to present the problem 
of the female castration complex in all its aspects, but is 
limited to the purely psychological consideration of material 
gathered from a wide field of clinical observation. 

I 

Many women suffer temporarily or permanently, in 
childhood or in adult age, from the fact that they have 
been born as females. Psycho-analysis further shows that 
a great number of women have repressed the wish to be 
male ; we come across this wish in all products of the un- 
conscious, especially in dreams and neurotic symptoms. 
The extraordinary frequency of these observations suggests 
that the wish is one common to and occurring in all women. 
If we incline to this view we place ourselves under the 
obligation of examining thoroughly and without prejudice 
the facts to which we attribute such a general significance. 

Many women are often quite conscious of the fact that 
certain phenomena of their mental life arise from an intense 

1 [No. 67, A. B.] 

338 



IQ20 THE FEMALE CASTRATION COMPLEX 339 

dislike of being a woman; but, on the other hand, many 
of them are quite in the dark as regards the motives of 
such an aversion. Certain arguments are again and again 
brought forward to explain this attitude. For instance, it 
is said that girls even in childhood are at a disadvantage 
in comparison to boys because boys are allowed greater 
freedom; or that in later life men are permitted to choose 
their profession and can extend their sphere of activity in 
many directions, and in especial are subjected to far fewer 
restrictions in their sexual life. Psycho-analysis, however, 
shows that conscious arguments of this sort are of limited 
value, and are the result of rationalization a process 
which veils the underlying motives. Direct observation of 
young girls shows unequivocally that at a certain stage of 
their development they feel at a disadvantage as regards 
the male sex on account of the inferiority of their external 
genitals. The results obtained from the psycho-analysis of 
adults fully agree with this observation. We find that a 
large proportion of women have not overcome this disadvan- 
tage, or, expressed psycho-analytically, that they have not 
successfully repressed and sublimated it. Ideas belonging 
to it often impinge with all the force of their strong libidinal 
cathexis against the barriers which oppose their entry into 
consciousness. This struggle of repressed material with 
the censorship can be demonstrated in a great variety of 
neurotic symptoms, dreams, etc. 

This fact that the non-possession of a male organ 
produces such a serious and lasting effect in the woman's 
mental life would justify us in denoting all the mental 
derivatives relating to it by the collective name * genital 
complex '. We prefer, however, to make use of an ex- 
pression taken from the psychology of male neurotics, and 
to speak of the * castration complex ' in the female sex as 
well. And we have good reason for this. 

The child's high estimation of its own body is closely 
connected with its narcissism. The girl has primarily no 
feeling of inferiority in regard to her own body, and does 
not recognize that it exhibits a defect in comparison with 
the boy's. Incapable of recognizing a primary defect in 



34O , SELECTED PAPERS OF KARL ABRAHAM XXII 

her body, she later forms the following idea: * I had a 
penis once as boys have, but it has been taken away from 
me ', a theory which we repeatedly come across. She 
therefore endeavours to represent the painfully perceived 
defect as a secondary loss and one resulting from castration. 

This idea is closely associated with another which we 
shall later treat in detail. The female genital is looked upon 
as a wound, and as such it represents an effect of castration. 

We also come across phantasies and neurotic symptoms, 
and occasionally impulses and actions, which indicate a 
hostile tendency towards the male sex. In many women 
the idea that they have been damaged gives rise to the wish 
to revenge themselves on the privileged man. The aim 
of such an impulse is to castrate the man. 

We find therefore in the female sex not only the tendency 
to represent a painfully perceived and primary defect as a 
secondary loss, a ' having been robbed ', but also active 
and passive phantasies of mutilation alongside each other, 
just as in the male castration complex. These facts justify 
us in using the same designation in both sexes. 

II 

As was mentioned above, the girl's discovery of the 
male genitals acts as an injury to her narcissism. In the 
narcissistic period of its development the child carefully 
watches over its possessions and regards those of others 
with jealousy. It wants to keep what it has and to get 
what it sees. If anyone has an advantage over it two 
reactions occur which are closely associated with each 
other: a hostile feeling against the other person associated 
with the impulse to deprive him of what he possesses. The 
union of these two reactions constitutes envy, which repre- 
sents a typical expression of the sadistic-anal develop- 
mental phase of the libido. 1 

The child's avaricious-hostile reaction to any additional 
possession it has noticed in another person may often be 

1 For a more detailed discussion of the character-trait of envy, cf. Chapter 
XXIII. , 'Contributions to the Theory of the Anal Character *. 



IQ20 THE FEMALE CASTRATION COMPLEX 34! 

lessened in a simple manner. It may be told that it will 
eventually receive what it longs for. Such pacifying 
promises may be made to a little girl with respect to many 
things about her body. She can be assured that she will 
grow as big as her mother, that she will have long hair 
like her sister, etc., and she will be satisfied with those 
assurances; but the future possession of a male organ 
cannot be promised her. However, the little girl herself 
applies the method that has often been successful to this 
case, too; for some time she seems to cling to this expecta- 
tion as to something self-evident, as though the idea of a 
lifelong defect were quite incomprehensible to her. 

The following observation of a little girl of two is 
particularly instructive in this respect. One day, as her 
parents were taking coffee at table, she went to a box of 
cigars that stood on a low cabinet near by, opened it, and 
took out a cigar and brought it to her father. Then she 
went back and brought one for her mother. Then she 
took a third cigar and held it in front of the lower part of 
her body. Her mother put the three cigars back in the 
box. The child waited a little while and then played the 
same game over again. 

The fact of the repetition of this game excluded its 
being due to chance. Its meaning is clear: the child 
endowed her mother with a male organ like her father's. 
She represented the possession of the organ not as a privilege 
of men but of adults in general, and then she could expect 
to get one herself in the future. A cigar was not only a 
suitable symbol for her wish on account of its form. She 
had of course long noticed that only her father smoked 
cigars and not her mother. Her impulse to put man and 
woman on an equality is palpably expressed in presenting 
a cigar to her mother as well. 

We are well acquainted with the attempts of little girls 
to adopt the male position in urination. Their narcissism 
cannot endure their not being able to do what another can, 
and therefore they endeavour to arouse the impression that 
at least their physical form does not prevent them from 
doing the same as boys do. 



34-2 SELECTED PAPERS OF KARL ABRAHAM XXII 

When a child sees its brother or sister receive something 
to eat or play with which it does not possess itself, it turns 
its eyes to those persons who are the givers, and these in 
the first instance are its parents. It does not like to be 
less well off than its rivals. |The small girl who compares 
her body with her brother's, often in phantasy expects that 
her father will give her that part of the body she so painfully 
misses; for the child still has a narcissistic confidence that 
she could not possibly be permanently defective, and she 
readily ascribes to her father that creative omnipotence 
which can bestow on her everything she desires/ 

But all these dreams crumble after a time. The pleasure 
principle ceases to dominate psychical processes uncondition- 
ally, adaptation to reality commences, and with it the child's 
criticism of its own wishes. fThe girl has now in the course 
of her psychosexual development to carry out an adaptation 
which is not demanded of boys in a similar manner; she 
has to reconcile herself to the fact of her physical ' defect ', 
and to her female sexual role. The undisturbed enjoyment 
of early genital sensations will be a considerable aid in 
facilitating the renunciation of masculinity, for by this 
means the female genitals will regain a narcissistic value. } 

In reality, however, the process is considerably more 
complicated. Freud has drawn our attention to the close 
association of certain ideas in the child. In its eyes a 
proof of love is almost the same thing as a gift. The first 
proof of love which creates a lasting impression on the 
child and is repeated many times is being suckled by the 
mother. This act brings food to the child and therefore 
increases its material property, and at the same time acts 
as a pleasurable stimulus to its erotogenic zones. It is 
interesting to note that in certain districts of Germany 
(according to my colleague Herr Koerber) the suckling of 
a child is called Schenken (to give, to pour). Within 
certain limits the child repays its mother's * gift ' by a 
* gift ' in return it regulates its bodily evacuations accord- 
ing to her wishes. The motions at an early age are the 
child's material gift par excellence in return for all the proofs 
of love it receives. 



THE FEMALE CASTRATION COMPLEX 343 

Psycho-analysis, however, has shown that the child in 
this early psychosexual period of development considers its 
faeces as a part of its own body. The process of identifica- 
tion further establishes a close relation between the ideas 
4 faeces ' and * penis '. The boy's anxiety regarding the 
loss of his penis is based on this assimilation of the two 
ideas. He is afraid that his penis may be detached from 
his body in the same way as his faeces are. In girls, 
however, the phantasy occurs of obtaining a penis by way 
of defaecation to make one themselves, therefore or of 
receiving it as a gift, in which case the father as beatus 
possidens is usually the giver. The psychical process is thus 
dominated by the parallel, motion = gift = penis. 

The little girl's narcissism undergoes a severe test of 
endurance in the subsequent period. Her hope that a 
penis will grow is just as little fulfilled as her phantasies of 
making one for herself or of receiving it as a gift. Thus 
disappointed, the child is likely to direct an intense and 
lasting hostility towards those from whom she has in vain 
expected the gift. Nevertheless, the phantasy of the child 
normally finds a way out of this situation. Freud has 
shown that besides the idea of motion and penis in the 
sense of a gift there is still a third idea which is identified 
with both of them, namely, that of a child. Infantile 
theories of procreation and birth adequately explain this 
connection. 

The little girl now cherishes the hope of getting a child 
from her father as a substitute for the penis not granted 
her, and this again in the sense of a gift. Her wish for a 
child can be fulfilled, although not till in the future and 
with the help of a later love-object. It is therefore an 
approximation to reality. By making her father her love- 
object, she now enters into that stage of libido develop- 
ment which is characterized by the domination of the female 
Oedipus complex. At the same time her maternal impulses 
develop through her identification with her mother. The 
hoped-for possession of a child is therefore destined to 
compensate the woman for her physical defect, 

We regard it as normal for the libido in a woman to be 



344 SELECTED PAPERS OF KARL ABRAHAM XXII 

narcissistically bound to a greater extent than in a man, 
but it is not to be inferred from this that it does not 
experience far-reaching alterations right up to maturity. 

The girl's original so-called ' penis envy ' is replaced 
in the first instance by envy of her mother's possession of 
children, in virtue of her identification with her mother. 
These hostile impulses need sublimation just as the libidinal 
tendencies directed towards her father do. A latency 
period now sets in, as with boys; and similarly when the 
age of puberty is reached the wishes which were directed 
to the first love-object are re-awakened. The girl's wish 
for the gift (child) has now to be detached from the idea 
of her father, and her libido, thus freed, has to find a new 
object. If this process of development takes a favourable 
course, the female libido has from now on an expectant 
attitude towards the man. Its expression is regulated by 
certain inhibitions (feelings of shame). The normal adult 
woman becomes reconciled to her own sexual role and to 
that of the man, and in particular to the facts of male and 
female genitality; she desires passive gratification and longs 
for a child. Her castration complex thus gives rise to no 
disturbing effects. 

Daily observation, however, shows us how frequently 
this normal end of development is not attained. This 
fact should not astonish us, for a woman's life gives cause 
enough to render the overcoming of the castration complex 
difficult. We refer to those factors which keep recalling to 
her memory the * castration ' of the woman. The primary 
idea of the ^ wound ' is re-animated by the impression 
created by the first and each succeeding menstruation, and 
then once again by defloration ; for both processes are con- 
nected with loss of blood and thus resemble an injury. A 
girl need not have experienced either of these events; as 
she begins to grow up, the very idea of being subjected to 
them in the future has the same effect on her. And we 
can readily understand from the standpoint of the typical 
infantile sexual theories that delivery (or child-birth) is also 
conceived of in a similar manner in the phantasies of young 
girls; we need only call to mind, for example, the * Caesarian 



IQ20 THE FEMALE CASTRATION COMPLEX 345 

section theory ' which conceives of delivery as a bloody 
operation. 

In these circumstances we must be prepared to find in 
every female person some traces of the castration complex. 
The individual differences are only a matter of degree. In 
normal women we perhaps occasionally come across dreams 
with male tendencies in them. From these very slight 
expressions of the castration complex there are transition 
stages leading up to those severe and complicated pheno- 
mena of a pronounced pathological kind, with which this 
investigation is principally concerned. In this respect 
also, therefore, we find a similar state of affairs to that 
obtaining in the male sex. 

Ill 

In his essay on 'The Taboo of Virginity* Freud contrasts 
the normal outcome of the castration complex, which is in 
accord with the prevailing demand of civilization, with the 
1 archaic ' type. Among many primitive peoples custom 
forbids a man to deflorate his wife. Defloration has to be 
carried out by a priest as a sacramental act, or must occur 
in some other way outside wedlock. Freud shows in his 
convincing analysis that this peculiar precept has arisen from 
the psychological risk of an ambivalent reaction on the part 
of the woman towards the man who has deflorated her, so 
that living with the woman whom he has deflorated might 
be dangerous for him. 

Psycho-analytical experience shows that an inhibition 
of the psychosexual development is manifested in phenomena 
which are closely related to the conduct of primitive peoples. 
It is by no means rare for us to come across women in our 
civilization of to-day who react to defloration in a way which 
is at aJl events closely related to that archaic form, I know 
several cases in which women after being deflorated had an 
outburst of affect and hit or throttled their husband. One 
of my patients went to sleep beside her husband after the 
first intercourse, then woke up, attacked him violently and 
only gradually came to her senses. There is no mistaking 
the significance of such conduct: the woman revenges 



346 SELECTED PAPERS OF KARL ABRAHAM XXII 

herself for the injury done to her physical integrity. Psycho- 
analysis, however, enables us to recognize a historical element 
in the motivation of such an impulse of revenge. The 
most recent cause of the woman's desire for retaliation is 
undoubtedly her defloration; for this experience serves as 
a convincing proof of male activity, and puts an end to all 
attempts to obliterate the functional difference between male 
and female sexuality. Nevertheless every profound analysis 
reveals the close connection of these phantasies of revenge 
with all the earlier events phantasied or real which have 
been equivalent to castration. The retaliation is found to 
refer ultimately to the injustice suffered at the hands of the 
father. The unconscious of the adult daughter takes a late 
revenge for the father's omission to bestow upon her a penis, 
either to begin with or subsequently; she takes it, however, 
not on her father in person, but on the man who in conse- 
quence of her transference of libido has assumed the father's 
part. The only adequate revenge for her wrong for her 
castration is the castration of the man. This can, it is 
true, be replaced symbolically by other aggressive measures ; 
among these strangling is a typical substitutive action. 

The contrast between such cases and the * normal ' 
end-stage is evident. The normal attitude of love towards 
the other sex is both in man and woman indissolubly bound 
up with the conscious or unconscious desire for genital 
gratification in conjunction with the love-object; whereas 
in the cases just described we find in the person a sadistic- 
hostile attitude with the aim of possession arising from anal 
motives, in place of an attitude of love with a genital aim. 
The patient's impulse to take away by force is evident from 
numerous accompanying psychical conditions; and closely 
connected with her phantasy of robbery is the idea of trans- 
ferring the robbed penis to herself. We shall return to this 
point later. 

As has already been mentioned, the woman's desires to 
be masculine only occasionally succeed in breaking through 
in this * archaic ' sense. On the other hand, a considerable 
number of women are unable to carry out a full psychical 
adaptation to the female sexual role. A third possibility 



IQ20 THE FEMALE CASTRATION COMPLEX 347 

is open to them in virtue of the bisexual disposition common 
to humanity namely, to become homosexual. Such women 
tend to adopt the male role in erotic relations with other 
women. They love to exhibit their masculinity in their dress, 
in their way of doing their hair, and in their general behaviour. 
In some cases their homosexuality does not break through to 
consciousness ; the repressed wish to be male is here found 
in a sublimated form in the shape of masculine pursuits of 
an intellectual and professional character and other allied 
interests. Such women do not, however, consciously deny 
their femininity, but usually proclaim that these interests 
are just as much feminine as masculine ones. They con- 
sider that the sex of a person has nothing to do with his or her 
capacities, especially in the mental field. This type of woman 
is well represented in the woman's movement of to-day. 

It is not because I value their practical significance 
lightly that I have described these groups so briefly. But 
both types of women are well known and have been dis- 
cussed in psycho-analytical literature, so that I need not 
enlarge on the subject and can rapidly pass on to the con- 
sideration of the neurotic transformations of the castration 
complex. Of these there are a great number, and I will 
endeavour to describe accurately some of them for the 
first time and to render them intelligible from a psycho- 
analytical point of view, 

IV 

The neurotic transformations originating in the female 
castration complex may be divided into two groups. The 
phenomena of the one group rest on a strong, emotionally- 
toned, but not conscious desire to adopt the male role, i.e. on 
the phantasy of possessing a male organ ; those of the other 
express an unconscious refusal of the female role, and a 
repressed desire for revenge on the privileged man. There 
is no sharp line of demarcation between these two groups. 
The phenomena of one group do not exclude those of the 
other in the same individual; they supplement each other. 
The preponderance of this or that attitude can nevertheless 



348 SELECTED PAPERS OF KARL ABRAHAM XXII 

often be clearly recognized, so that we may speak of the 
preponderating reaction of a wish-fulfilment type or of a 
revenge type. 

We have already learned that besides the normal out- 
come of the female castration complex there are two abnormal 
forms of conscious reaction, namely, the homosexual type 
and the archaic (revenge) type. We have only to recall the 
general relation between perversion and neurosis with which 
we are familiar from Freud's investigations in order to be 
able to understand the two neurotic types above described 
in respect of their psychogenesis. They are the * negative ' 
of the homosexual and sadistic types described above; 
for they contain the same motives and tendencies, but in 
repressed form. 

The psychical phenomena which arise from the un- 
conscious wishes for physical masculinity or for revenge on 
the man are difficult to classify on account of their multi- 
plicity. It has also to be borne in mind that neurotic 
symptoms are not the sole expressions of unconscious origin 
which have to concern us here; we need only refer to the 
different forms in which the same repressed tendencies 
appear in dreams. As I have said at the beginning, there- 
fore, this investigation cannot pretend to give an exhaustive 
account of the phenomena arising from the repressed castra- 
tion complex, but rather lays stress on certain frequent and 
instructive forms of it, and especially some which have not 
hitherto been considered. 

The wish-fulfilment which goes farthest in the sense of 
the female castration complex comprises those symptoms 
or dreams of neurotics which convert the fact of femininity 
into its opposite. In such a case the unconscious phantasies 
of the woman make the assertion: * I am the fortunate 
possessor of a penis and exercise the male function '. Van 
Ophuijsen gives an example of this kind in his article on the 
* masculine complex ' of women. 1 It concerns a conscious 
phantasy from the youth of one of his patients, and gives 
us therefore at first only an insight into the patient's still 
unrepressed active-homosexual wishes; but at the same 

1 'Beitrage zum Mannlichkeitskomplex der Frau ' (1917). 



IQ20 THE FEMALE CASTRATION COMPLEX 349 

time therefore it clearly demonstrates the foundation of 
those neurotic symptoms which give expression to the same 
tendencies after they have become repressed. The patient 
used to place herself in the evening between the lamp and 
the wall and then hold her finger against the lower part of 
her body in such a manner that her shadow appeared to have 
a penis. She thus did something very similar to what the 
two-year-old child did with the cigar. 

In conjunction with this instructive example I may men- 
tion the dream of a neurotic woman. She was an only child. 
Her parents had ardently desired a son and had in conse- 
quence cultivated the narcissism, and particularly the mascu- 
linity wishes, of their daughter. According to an expression 
of theirs she was to become ' quite a celebrated man '. In 
her youthful day-dreams she saw herself as a ' female 
Napoleon ', in which she began a glorious career as a female 
officer, advanced to the highest positions, and saw all the 
countries of Europe lying at her feet. After having thus 
shown herself superior to all the men in the world, a man 
was to appear at last who surpassed not only all men but 
also herself; and she was to subject herself to him. In 
her marital relations in real life she had the most extreme 
resistance against assuming the feminine role; I shall 
mention symptoms relating to this later. I quote here one 
of my patient's dreams. 

' My husband seizes a woman, lifts up her clothes, finds 
a peculiar pocket and pulls out from it a hypodermic morphia 
syringe. She gives him an injection with this syringe and 
he is carried away in a weak and wretched state.' 

The woman in this dream is the patient herself, who takes 
over the active role from the man. She is able to do this 
by means of a concealed penis (syringe) with which she 
practises coitus on him. The weakened condition of the 
man signifies that he is killed by her assault. 

Pulling out the syringe from the pocket suggests the 
male method of urinating, which seemed enviable to the 
patient in her childhood. It has, however, a further signifi- 
cance. At a meeting of the Berlin Psycho- Analytical Society 
Boehm has drawn attention to a common infantile sexual 



35 SELECTED PAPERS OF KARL ABRAHAM XXII 

theory according to which the penis originally ascribed 
to both sexes is concealed in a cleft from which it can 
temporarily emerge. 

Another patient, whose neurosis brought to expression 
the permanent discord between masculinity and femin- 
inity in most manifold forms, stated that during sexual 
excitation she often had the feeling that something on her 
body was swelling to an enormous size. The purpose of 
this sensation was obviously to give her the illusion that she 
possessed a penis. 

In other patients the symptoms do not represent the 
wish to be masculine as fulfilled, but show an expectation 
of such an event in the near or distant future. While the 
unconscious in the cases just described expresses the 'idea, 
4 I am a male ', it here conceives the wish in the formula, 
4 I shall receive the " gift " one day; I absolutely insist 
upon that 1 ' 

The following conscious phantasy from the youth of a 
neurotic girl is perfectly typical of the unconscious content 
of many neurotic symptoms. When the girl's elder sister 
menstruated for the first time she noticed that her mother 
and sister conversed together secretly. The thought flashed 
across her, * Now my sister is certainly getting a penis ', and 
that therefore she herself would get one in due course. This 
reversal of the real state of affairs is highly characteristic: 
the acquisition of that longed-for part of the body is precisely 
what is put in place of the renewed ' castration ' which the 
first menstruation signifies. 

A neurotic patient in whom psycho-analysis revealed 
an extraordinary degree of narcissism one day showed the 
greatest resistance to treatment, and manifested many signs 
of defiance towards me which really referred to her deceased 
father. She left my consulting room in a state of violent 
negative transference. When she stepped into the street 
she caught herself saying impulsively : ' I will not be well 
until I have got a penis '. She thus expected this gift from 
me, as a substitute for her father, and made the effect of the 
treatment dependent upon receiving it. Certain dreams of 
the patient had the same content as this idea which suddenly 



IQ20 THE FEMALE CASTRATION COMPLEX 351 

appeared from her unconscious. In these dreams, being 
presented with something occurred in the double sense of 
getting a child or a penis. 

Compromises between impulse and repression occur in 
the sphere of the castration complex as elsewhere in the 
realm of psychopathology. In many cases the unconscious 
is content with a substitute-gratification in place of a 
complete fulfilment of the wish for a penis in the present 
or the future. 

A condition in neurotic women which owes one of its 
most important determinants to the castration complex is 
enuresis nocturna. The analogy between the determination 
of this symptom in female and male neurotics is striking. 
I may refer to a dream of a male patient of fourteen who 
suffered from this complaint. He dreamt that he was 
in a closet and urinating with manifest feelings of pleasure, 
when he suddenly noticed that his sister was looking at 
him through the window. As a little boy he had actually 
exhibited with pride before his sister his masculine way of 
urinating. This dream, which ended in enuresis, shows 
the boy's pride in his penis; and enuresis in the female 
frequently rests on the wish to urinate in the male way. 
The dream represented this process in a disguised form 
and ended with a pleasurable emptying of the bladder. 

Women who are prone to enuresis nocturna are regularly 
burdened with strong resistances against the female sexual 
functions. The infantile desire to urinate in the male 
position is associated with the well-known assimilation of 
the ideas of urine and sperma, and of micturition and ejacula- 
tion. The unconscious tendency to wet the man with urine 
during sexual intercourse has its origin in this. 

Other substitute formations show a still greater displace- 
ment of the libido in that they are removed some distance 
from the genital region. When the libido for some reason 
or other has to turn away from the genital zone it is attracted 
to certain other erotogenic zones, the particular ones chosen 
being a result of individual determinations. In some neurotic 
women the nose acquires the significance of a surrogate of 
the male genital. The not infrequent neurotic attacks of 



SELECTED PAPERS OF KARL ABRAHAM XXII 

redness and swelling of the nose in women represents in 
their unconscious phantasy an erection in the sense of their 
desire to be masculine. 

In other cases the eyes take over a similar role. Some 
neurotic women get an abnormally marked congestion of 
the eyes with every sexual excitation. In a certain measure 
this congestion is a normal and common accompaniment of 
sexual excitation. However, in those women of whom we 
are speaking it is not simply a case of a quantitative increase 
of the condition, lasting for a short period; but they exhibit 
a redness of the sclerotics accompanied by a burning sensa- 
tion, while swelling persists for several days after each sexual 
excitation, so that in such cases we are justified in speaking 
of a conjunctivitis neurotica. 

I have seen several women patients, troubled by many 
neurotic consequences of the castration complex, who 
thought of this condition of the eyes, which was often 
associated with a feeling of having a fixed stare, as an 
expression of their masculinity. In the unconscious the 
' fixed stare ' is often equivalent to an erection. I have 
already alluded to this symptom in an earlier article dealing 
with neurotic disturbances of the eyes. 1 In some cases the 
person has the idea that her fixed stare will terrify people. 
If we pursue the unconscious train of thought of these 
patients who identify their fixed stare with erection, we can 
understand the meaning of their anxiety. Just as male 
exhibitionists seek among other things to terrify women 
by the sight of the phallus, so these women unconsciously 
endeavour to attain the same effect by means of their fixed 
stare. 

Some years ago a very neurotic young girl consulted 
me. The very first thing she did on entering my con- 
sulting-room was to ask me straight out whether she had 
beautiful eyes. I was startled for a moment by this very 
unusual way of introducing oneself to a physician. She 
noticed my hesitation, and then gave vent to a violent out- 
burst of affect on my suggesting that she should first of all 
answer my questions. The general behaviour of the patient, 

1 Cf. Chapter IX. 



1920 THE FEMALE CASTRATION COMPLEX 353 

whom I only saw a few times, made a methodical psycho- 
analysis impossible. I did not succeed even in coming to 
a clear diagnosis of the case, for certain characteristics of the 
clinical picture suggested a paranoid condition. Neverthe- 
less, I was able to obtain a few facts concerning the origin 
of her most striking symptom, and these, in spite of their 
incompleteness, offered a certain insight into the structure 
of her condition. 

The patient told me that she had experienced a great 
fright as a child. In the small town where she was living 
at that time a boa constrictor had broken out from a menagerie 
and could not be found; and as she was passing through 
a park with her governess she believed that she suddenly 
saw the snake in front of her. She became quite rigid 
with terror, and ever since was afraid that she might have 
a fixed stare. 

It could not be decided whether this experience was a 
real one or whether it was wholly or partially a phantasy. 
The association, snake = rigidity, is familiar and compre- 
hensible to us. We also recognize the snake as a male 
genital symbol. Fixity of the eye is then explicable from 
the identification, fixed eye = snake = phallus. The patient, 
however, protected herself against this wish for masculinity, 
and put in its place the compulsion to get every man to 
assure her that her eyes were beautiful, i.e. had feminine 
charms. If anyone hesitated to answer her question in the 
affirmative it is probable that she became exposed to the 
danger of being overwhelmed by her male-sadistic impulse 
which she repressed with difficulty, and fell into a state of 
anxiety at the rising force of her masculine feelings. 

I should like to point out here that these various obser- 
vations by no means do justice to the great multiplicity of 
the symptoms belonging to this group. Besides these 
examples which illustrate the vicarious assumption by various 
parts of the body of the male genital role, there are others 
which show that objects which do not belong to the body 
can also be made use of for the same purpose, provided 
their form and use permits in any way of a symbolic inter- 
pretation as a genital organ. We may call to mind the 



354 SELECTED PAPERS OF KARL ABRAHAM XXII 

tendency of neurotic women to use a syringe and to give 
themselves or relatives enemas. 

There are numerous points of contact here with the 
normal expressions of the female castration complex, 
especially with typical female symptomatic acts. Thrusting 
the end of an umbrella into the ground may be mentioned 
as an example. The great enjoyment many women obtain 
from using a hose for watering the garden is also charac- 
teristic, for here the unconscious experiences the ideal 
fulfilment of a childhood wish. 

Other women are less able or less inclined to find a 
substitutive gratification of their masculinity wishes in 
neurotic surrogates. Their symptoms give expression to 
a completely different attitude. They represent the male 
organ as something of secondary importance and unneces- 
sary. To this attitude belong all the symptoms and phan- 
tasies of immaculate conception. It is as though these women 
want to declare by means of their neurosis : * I can do it by 
myself '. One of my patients experienced an immaculate 
conception of this kind while in a dream-like, hazy state of 
consciousness. She had had a dream once before in which 
she held a box with a crucifix in her hands ; the identification 
with the Virgin Mary is here quite clear. I invariably found 
that neurotic women who showed these phenomena exhibited 
especially pronounced anal character-traits. The idea of 
being * able to do it alone ', expresses a high degree of 
obstinacy, and this is also prominent in these patients. They 
want, for example, to find out everything in their psycho- 
analysis by themselves without the help of the physician. 
They are as a rule women who through their obstinacy, 
envy, and self-overestimation destroy all their relationships 
with their environment, and indeed their whole life. 



The symptoms we have so far described bear the 
character of a positive wish-fulfilment in the sense of the 
infantile desire to be physically equal to the man. But the 
last-mentioned forms of reaction already begin to approxi- 



IQ20 THE FEMALE CASTRATION COMPLEX 355 

mate to the revenge type. For in the refusal to acknowledge 
the significance of the male organ there is implied, although 
in a very mitigated form, an emasculation of the man. 
We therefore approach by easy stages to the phenomena of 
the second group. 

We regularly meet two tendencies in repressed form 
in the patients of this second group : a desire to take revenge 
on the man, and a desire to seize by force the longed-for 
organ, i.e. to rob him of it. 

One of my patients dreamed that she and other women 
were carrying round a gigantic penis which they had 
stolen from an animal. This reminds us of the neurotic 
impulse to steal. So-called kleptomania is often traceable 
to the fact that a child feels injured or neglected in respect 
of proofs of love which we have equated with gifts or 
in some way disturbed in the gratification of its libido. It 
procures a substitute pleasure for the lost pleasure, and at 
the same time takes revenge on those who have caused it 
the supposed injustice. Psycho-analysis shows that in the 
unconscious of our patients there exist the same impulses 
to take forcible possession of the ' gift ' which has not been 
received. 

Faginismus is from a practical point of view the most 
important of the neurotic symptoms which subserve 
repressed phantasies of castrating the man. The purpose 
of vaginismus is not only to prevent intromission of the 
penis, but also, in the case of its intromission, not to let it 
escape again, i.e. to retain it and thereby to castrate the man. 
The phantasy therefore is to rob the man of his penis and 
to appropriate it. 

The patient who had produced the previously-mentioned 
dream of the morphia syringe showed a rare and complicated 
form of rejection of the male at the beginning of her 
marriage. She suffered from an hysterical adduction of her 
thighs whenever her husband approached her. After this 
had been overcome in the course of a few weeks there 
developed as a fresh symptom of refusal a high degree 
of vaginismus which only completely disappeared under 
psycho-analytic treatment. 



SELECTED PAPERS OF KARL ABRAHAM XXII 

This patient, whose libido was very strongly fixated on 
her father, once had a short dream before her marriage, 
which she related to me in very remarkable words. She 
said that in the dream her father had been run over and had 
* lost some leg or other and his money '. l The castration 
idea is here not only expressed by means of the leg but also 
by the money. Being run over is one of the most frequent 
castration symbols. One of my patients whose * totem * 
was a dog dreamed that a dog was run over and lost a leg. 
The same symbol is found in phobias that some particular 
male person may be run over and lose an arm or a leg. 
One of my patients was the victim of this anxiety with 
reference to various male members of her family. 

For many years, and especially during the late war, I 
have come across women who take particular erotic interest 
in men who have lost an arm or a leg by amputation or 
accident. These are women with particularly strong feelings 
of inferiority; their libido prefers a mutilated man rather 
than one who is physically intact. For the mutilated man 
has also lost a limb, like themselves. It is obvious that such 
women feel an affinity to the mutilated man ; they consider 
him a companion in distress and do not need to reject him 
with hate like the sound man. The interest some women 
have in Jewish men is explicable on the same grounds; 
they regard circumcision as at any rate a partial castration, 
and so they can transfer their libido on to them. I know 
cases in which a mixed marriage of this kind was contracted 
by women chiefly as a result of an unconscious motive of 
this nature. They also show an interest in men who are 
crippled in other ways and have thereby lost their masculine 
4 superiority '. 

It was the psycho-analysis of a girl seventeen years old 
that gave me the strongest impression of the power of the 
castration complex. In this case there was an abundance 
of neurotic conversions, phobias, and obsessive impulses, 
all of which were connected with her disappointment at 
being a female and with revenge phantasies against the 

1 [' PcrmSgen ' (' money ') also means ' capacity ' and ' sexual potency '. 
mf.] 



THE FEMALE CASTRATION COMPLEX 357 

male sex. The patient had been operated on for appendicitis 
some years previously. 1 The surgeon had given her the 
removed appendix preserved in a bottle of spirit, and this 
she now treasured as something sacred. Her ideas of being 
castrated centred round this specimen, and it also appeared 
in her dreams with the significance of the once possessed 
but now lost penis, 2 As the surgeon happened to be a 
relative it was easy for her to connect the * castration ' 
performed by him with her father. 

Among the patient's symptoms which rested on the 
repression of active castration wishes was a phobia which 
can be called dread of marriage. This anxiety was expressed 
in the strongest opposition to the idea of a future marriage, 
because the patient was afraid ' that she would have to do 
something terrible to her husband '. The most difficult 
part of the analysis was to uncover an extremely strong 
rejection of genital erotism, and an intense accentua- 
tion of mouth erotism in the form of phantasies which 
appeared compulsively. Her idea of oral intercourse was 
firmly united with that of biting off the penis. This 
phantasy, which is frequently expressed in anxiety and 
phenomena of the most varied kinds, was in the present case 
accompanied by a number of other ideas of a terrifying 
nature. Psycho-analysis succeeded in stopping this 
abundant production of a morbid imagination. 

These kinds of anxiety prevent the subject from having 
intimate union with the other sex, and thereby from carrying 
out her unconsciously intended * crime '. The patient is 
then the only person who has to suffer from those impulses, 
in the form of permanent sexual abstinence and neurotic 
anxiety. The case is altered as soon as the active castration 
phantasy has become somewhat distorted and thereby un- 
recognizable to consciousness. Such a modification of the 
manifest content of the phantasies makes it possible for the 
tendencies in question actually to have stronger external 
effects. It can, for instance, cause the idea of robbing the 

1 The removal of the vermiform appendix often stimulates the castration 
complex in men as well. 

2 Another patient imagined she had a brother and had to remove his appendix. 



SELECTED PAPERS OF KARL ABRAHAM XXII 

man of his genital to be abolished and the hostile purpose 
to be displaced from the organ to its function, so that 
the aim is to destroy his potency. The wife's neurotic 
sexual aversion will now often have a repelling effect on 
the man's libido so that a disturbance of his potency does 
actually occur. 

A further modification of the aggressive impulse is 
seen in an attitude of the woman to the man that is 
fairly frequent and that can be exceedingly painful to him; 
it is the impulse to disappoint him. To disappoint a 
person is to excite expectations in him and not fulfil them. 
In her relations with the man the woman can do this by 
responding to his advances up to a certain point and then 
refusing to give herself to him. Such behaviour is most 
frequently and significantly expressed in frigidity on the 
part of the woman. Disappointing other persons is a 
piece of unconscious tactics which we frequently find in 
the psychology of the neuroses and which is especially 
pronounced in obsessional neurotics. These neurotics are 
unconsciously impelled towards violence and revenge, but 
on account of the contrary play of ambivalent forces these 
impulses are incapable of effectually breaking through. 
Since their hostility cannot express itself in actions, these 
patients excite expectations of a pleasant nature in their 
environment and then do not fulfil them. In the sphere of 
the female castration complex the tendency to dicappoint 
can be formulated in respect of its origin as follows : 

First stage: I rob you of what you have because I lack it. 

Second stage: I rob you of nothing. I even promise you 
what I have to give. 

Third stage: I will not give you what I have promised. 

In very many cases frigidity is associated with a con- 
scious readiness on the part of the woman to assume the 
female role and to acknowledge that of the man. Her 
unconscious striving has in part as its object the disappoint- 
ment of the man, who is inclined to infer from her conscious 
willingness the possibility of mutual enjoyment. Besides 
this, she has the desire to demonstrate to herself and her 
partner that his sexual ability is of no importance. 



IQ20 THE FEMALE CASTRATION COMPLEX 359 

If we penetrate to the deeper psychic layers we recognize 
how strongly the desire of the frigid woman to be male 
dominates her unconscious. In a previous article I have 
attempted to show in accordance with Freud's well-known 
observations on frigidity l that this condition in the female 
sex is the exact analogue of a disturbance of potency in the 
man, namely, ' ejaculatio praecox \ 2 In both conditions 
the libido is attached to that erotogenic zone which has 
normally a similar significance in the opposite sex. In 
cases of frigidity the pleasurable sensation is as a rule 
situated in the clitoris and the vaginal zone has none. The 
clitoris, however, corresponds developmentally with the 
penis. 

Frigidity is such an exceedingly widespread disturbance 
that it hardly needs to be described or exemplified. On 
the other hand, it is less well known that the condition 
has varying degrees of intensity. The highest degree, that 
of actual anaesthesia, is rare. In these cases the vaginal 
mucous membrane has lost all sensitiveness to touch, so 
that the male organ is not perceived in sexual intercourse. 
Its existence is therefore actually denied. The common 
condition is a relative disturbance of sensitivity, in which 
contact is perceived but is not pleasurable. In other cases 
a sensation of pleasure is felt but does not go on to orgasm, 
or, what is the same thing, the contractions of the female 
organ corresponding with the climax of pleasure are 
absent. It is these contractions that signify the complete 
and positive reaction of the woman to the male activity, 
the absolute affirmation of the normal relation between the 
sexes. 

Some women do obtain gratification along normal paths 
but endeavour to make the act as brief and prosaic as 
possible. They refuse all enjoyment of any preliminary 
pleasure; and in especial they behave after gratification as 
if nothing had happened that could make any impression 
on them, and turn quickly to some other subject of conver- 
sation, a book or occupation. These women thus give 
themselves up to the full physical function of the woman 

1 Drei Abhandlungen zur Sexualtheorie, 4. Aufl., S. Sjf. * Cf. Chap. XIII. 



360 SELECTED PAPERS OF KARL ABRAHAM XXII 

for a few fleeting moments only to disown it immediately 
afterwards. 

It is an old and well-known medical fact that many 
women only obtain normal sexual sensation after they have 
had a child. They become, so to speak, only female in 
the full sense by the way of maternal feelings. The deeper 
connection of this is only to be comprehended in the light 
of the castration complex. As we know, a child was at an 
early period the ' gift ' which was to compensate the little 
girl for the missed penis. She receives it now in reality, 
and thus the ' wound ' is at last healed. It is to be noted 
that in some women there exists a wish to get a child from 
a man against his will; we cannot fail to see in this the 
unconscious tendency to take" the penis from the male and 
appropriate it in the form of a child. The other extreme 
in this group is represented by those women who wish to 
remain childless at all costs. They decline any kind of 
* substitute ', and would be constantly reminded of their 
femininity in the most disturbing manner if they became 
mothers. 

A relative frigidity exists not only in the sense of the 
degree of capacity for sensation, but also in the sense that 
some women are frigid with certain men and capable of 
sensation with others. 

It will probably be expected that a marked activity on 
the part of the man is the most favourable condition to call 
forth sexual sensations in women who are frigid in this 
second sense. This, however, is not always the case; on 
the contrary, there are many women in whom a debasement 
of the man is just as essential a condition of love as is the 
debasement of the woman to many neurotic men. 1 A 
single example may be given in illustration of this by no 
means rare attitude. I analyzed a woman whose love-life 
was markedly polyandrous, and who was invariably anaes- 
thetic if she had to acknowledge that the man was superior 
to her in any way. If, however, she had a quarrel with the 
man and succeeded in forcing him to give in to her, her 
frigidity disappeared completely. Such cases show very 

1 See Freud, 'Beitrage zur Psychologic des Liebeslebens ', sections I. and II. 



1920 THE FEMALE CASTRATION COMPLEX 361 

clearly how necessary is the acknowledgement of the male 
genital function as a condition of a normal love-life on the 
part of the woman. We also meet here with one source of 
the conscious and unconscious impulses of prostitution in 
women. 

Frigidity is practically a sine qua non of prostitution. 
The experiencing of full sexual sensation binds the woman 
to the man, and only where this is lacking does she go 
from man to man, just like the continually ungratified 
Don Juan type of man who has constantly to change his 
love-object. Just as the Don Juan avenges himself on 
all women for the disappointment which he once received 
from the first woman who entered into his life, so the 
prostitute avenges herself on every man for the gift she 
had expected from her father and did not receive. Her 
frigidity signifies a humiliation of all men and therefore a 
mass castration to her unconscious; and her whole life is 
given up to this purpose. 1 

While the frigid woman unconsciously strives to 
diminish the importance of that part of the body which is 
denied her, there is another form of refusal of the man 
which achieves the same aim with opposite means. In 
this form of refusal the man is nothing else than a sex 
organ and therefore consists only of coarse sensuality. 
Every other mental or physical quality is denied him. 
The effect is that the neurotic woman imagines that the 
man is an inferior being on account of his possession of a 
penis. Her self-esteem is actually enhanced, and indeed 
she can rejoice at being free from such a mark of inferiority. 
One of my patients who showed a very marked aversion 
to men had the obsessing hallucination of a very big penis 
whenever she saw a man. This vision continually brought 
to her mind the fact that there was nothing else in men 
than their genital organ, from which she turned away in 
disgust, but which at the same time represented something 
that greatly interested her unconscious. She had certain 
phantasies connected with this vision which were of a 

1 The remarks of Dr. Theodor Reik in a discussion at the Berlin Psycho- 
Analytical Society have suggested this idea to me. 



362 SELECTED PAPERS OF KARL ABRAHAM XXII 

complementary nature. In these she represented herself 
as though every opening in her body, even her body as a 
whole, was nothing else than a receptive female organ. 
The vision therefore contained a mixture of over-estimation 
and depreciation of the male organ. 

VI 

We have already shown that the woman's tendency to 
depreciate the importance of the male genital undergoes a 
progressive sexual repression, and often appears outwardly 
as a general desire to humiliate men. This tendency is 
often shown in an instinctive avoidance of men who have 
pronounced masculine characteristics. The woman directs 
her love-choice towards the passive and effeminate man, 
by living with whom she can daily renew the proof that her 
own activity is superior to his. Just like manifest homo- 
sexual women, she likes to represent the mental and physical 
differences between man and woman as insignificant. When 
she was six years old one of my patients had begged her 
mother to send her to a boys' school in boy's clothes be- 
cause ' then no one would know that she was a girl '. 

Besides the inclination to depreciate men there is also 
found a marked sensitiveness of the castration complex 
towards any situation which can awaken a feeling of in- 
feriority, even in the remotest way. Women with this 
attitude refuse to accept any kind of help from a man, and 
show the greatest disinclination to follow any man's lead. 
A young woman betrayed her claims to masculinity, 
repressed with difficulty, by declining to walk along a 
street covered in deep snow in her husband's footsteps. 
A further very significant characteristic of this patient may 
be mentioned here. As a child she had had a strong 
desire for independence, and in adolescence she used to be 
very envious of the calling of two women in particular 
the cashier in her father's office, and the woman who swept 
the street in her native town. The cause of this attitude 
is obvious to the psycho-analyst. The cashier sweeps 
mohey together and the crossing-sweeper sweeps dirt, and 



IQ20 THE FEMALE CASTRATION COMPLEX 363 

both things have the same significance in the unconscious. 
There is here a marked turning away from genital sexuality 
in favour of the formation of anal character traits, a process 
which I shall mention in another connection. 

How strong a person's disinclination to be reminded 
of her femininity in any way can be is already well shown 
in the behaviour of children. It not infrequently happens 
that little girls give up knowledge they have already 
obtained of procreation and birth in favour of the stork 
fable. They dislike the role bestowed upon them by 
Nature, and the stork tale has the advantage that in it 
children originate without the man's part being a more 
privileged one than theirs in respect of activity. 

The most extreme degree of sensitiveness in regard to 
the castration complex is found in the rarer case of psychical 
depression. Here the woman's feeling of unhappiness on 
account of her femininity is wholly unrepressed; she does 
not even succeed in working it off in a modified form, 
One of my patients complained about the utter uselessness 
of her life because she had been born a girl. She con- 
sidered the superiority of men in all respects as obvious, 
and just for this reason felt it so painfully. She refused to 
compete with men in any sphere, and also rejected every 
feminine act. In particular she declined to play the female 
role in sexual life, and equally so the male one. In con- 
sequence of this attitude all conscious eroticism was entirely 
foreign to her; she even said that she was unable to imagine 
any erotic pleasure at all. Her resistance against female 
sexual functions assumed grotesque forms. She trans- 
ferred her rejection of them to everything that reminded 
her, if only remotely, of bearing fruit, propagation, birth, 
etc. She hated flowers and green trees, and found fruit 
disgusting. A mistake which she made many times was 
easily explicable from this attitude; she would read furchtbar 
( 4 frightful ') instead offruchtbar (' fruitful '). In the whole 
of Nature only the winter in the mountains could give 
her pleasure; there was nothing to remind her there of 
living things and propagation, but only rock, ice, and snow. 
She had the idea that in marriage the woman was of quite 



364 SELECTED PAPERS OF KARL ABRAHAM XXII 

secondary importance, and an expression of hers clearly 
showed how much this idea was centred in her castration 
complex. She said that the ring which was to her a 
hated female symbol was not fit to be a symbol of marriage, 
and she suggested a nail as a substitute. Her over-emphasis 
of masculinity was quite clearly based on her penis envy 
as a little girl an envy which appeared in a strikingly 
undisguised form when she was grown up. 

In many women the failure to reconcile themselves to 
their lack of the male organ is expressed in neurotic horror 
at the sight of wounds. Every wound re-awakens in their 
unconscious the idea of the * wound ' received in childhood. 
Sometimes they have a definite feeling of anxiety at the 
sight of wounds; sometimes this sight or the mere idea of 
it causes a ' painful feeling in the lower part of the body '. 
At the commencement of her psycho-analysis the patient 
whom I mentioned above as having a complicated form of 
vaginismus spoke of her horror of wounds before there had 
been any mention of the castration complex. She said 
that she could look at large and irregular wounds without 
being particularly affected, but that she could not bear to 
see a cut in her skin or on another person, however small it 
was, if it gaped slightly and if the red colour of the flesh 
was visible in the depth of the cut. It gave her an intense 
pain in the genital region coupled with marked anxiety, 
4 as though something had been cut away there '. {Similar 
sensations accompanied by anxiety are found in men with a 
marked fear of castration.) In many women it does not 
need the sight of a wound to cause feelings of the kind 
described; they have an aversion, associated with marked 
affect, to the idea of surgical operations and even to knives. 
Some time ago a lady who was a stranger to me and who 
would not give her name rang me up on the telephone and 
asked me if I could prevent an operation that had been 
arranged for the next day. On my request for more 
information she told me she was to be operated on for a 
severe uterine haemorrhage due to myomata. When I told 
her it was not part of my work to prevent a necessary and 
perhaps life-saving operation she did not reply, but ex- 



I92O THE FEMALE CASTRATION COMPLEX 365 

plained with affective volubility that she had always been 
* hostile to all operations ', adding, * whoever is once 
operated on is for ever afterwards a cripple for life '. The 
wild exaggeration of this statement becomes comprehensible 
if we remember that from the point of view of the unconscious 
an operation of this sort has made the little girl a ' cripple ' 
in early childhood. 

VII 

A tendency with which we are well acquainted and 
which we have already mentioned leads in the sphere of the 
female castration complex to modifications of the woman's 
aversion to that which is tabooed, and even to a conditional 
admission of it and in especial to compromise formations 
between impulse and repression. 

In some of our patients we come across phantasies which 
are concerned with the possibility of an acceptance of the 
man and which formulate the conditions under which 
the patient would be prepared to reconcile herself to 
her femininity. I will mention a certain proviso which I 
have met with many times ; it is : 'I could be content with 
my femininity if I were absolutely the most beautiful of all 
women '. All men would lie at the feet of the most beautiful 
woman, and the woman's narcissim would consider this 
power not a bad compensation for the defect she is so 
painfully aware of. It is in fact easier for a beautiful woman 
to assuage her castration complex than for an ugly one. 
Nevertheless, this idea of being the most beautiful of all 
women does not have the aforesaid softening effect in all 
cases. I know of a woman who said: * I should like to be 
the most beautiful of all women so that all men would adore 
me. Then I would show them the cold shoulder.' In this 
case the craving for revenge is clear enough ; this remark was 
made by a woman of an extremely tyrannical nature which 
was based on-^a wholly unsublimated castration complex. 

Most women, however, are not so extreme. They are 
inclined to compromise and to satisfy themselves with 
relatively harmless expressions of their repressed hostility. 
In this connection we are able to understand a characteristic 



366 SELECTED PAPERS OF KARL ABRAHAM XXII 

trait in the conduct of many women. We must keep in 
view the fact that sexual activity is essentially associated 
with the male organ, that the woman is only in the position 
to excite the man's libido or respond to it, and that other- 
wise she is compelled to adopt a waiting attitude. In a 
great number of women we find resistance against being 
a woman displaced to this necessity of waiting. In their 
married life these women take a logical revenge upon the 
man in that they keep him waiting on every occasion in 
daily life. 

There is another proviso of a similar nature to the 
above mentioned 'If I were the most beautiful woman*. 
In some women we find a readiness to admit the activity of 
the male and their own passivity, provided that they are 
desired by the most manly (greatest, most important) man. 
We have no difficulty in recognizing here the infantile desire 
for the father. I have already related from one of my 
psycho-analyses an example of a phantastic form of this 
idea. I was able to follow the development of a similar 
phantasy through different stages in the psycho-analysis of 
other patients. The original desire ran: * I should like to 
be a man *. When this was given up, the patient wished 
to be * the only woman ' (' the only woman belonging to 
my father ' being originally meant). When this wish had 
to give way to reality, too, the idea appeared : ' As a woman 
I should like to be unmatchable '. 

Certain compromise formations are of far greater 
practical importance, and though well known to psycho- 
analysts nevertheless merit special consideration in this 
connection. They concern the acknowledgement of the 
man, or, to be more correct, his activity and the organ 
serving it, under certain limiting conditions. The woman 
will tolerate and even desire sexual relations with the man 
so long as her own genital organ is avoided, or is, so to 
speak, considered as non-existent. She displaces her libido 
on to other erotogenic zones (mouth, anus) and softens her 
feelings of displeasure originating in the castration complex 
by thus turning away her sexual interest from her genital 
organ. The body openings which are now at the disposal 



IQ20 THE FEMALE CASTRATION COMPLEX 367 

of the libido are not specifically female organs. Further 
determinants are found in the analysis of each of this kind 
of cases, one only of which need be mentioned, namely, 
the possibility of active castration through biting by means 
of the mouth. Oral and anal perversions in women are 
thus to a considerable extent explicable as effects of the 
castration complex. 

Among our patients we certainly have to deal more 
frequently with the negative counterpart of the perversions, 
i.e. with conversion symptoms which occur in relation to the 
specific erotogenic zones, than with the perversions them- 
selves. Examples of this kind have already been given 
above. I referred among other cases to that of a young 
girl who had a phobia of having to do some horrible thing 
to her husband in the event of her marriage. The * horrible 
thing ' turned out to be the idea of castrating him through 
biting. The case showed most clearly how displacement of 
the libido from the genital to the mouth zone can gratify 
very different tendencies simultaneously. In such phan- 
tasies the mouth serves equally to represent the desired 
reception of the male organ and its destruction. Facts like 
these warn us not to be too ready to over-estimate a single 
determinant. Although in the preceding presentation we 
have estimated the castration complex as an important 
impelling force in the development of neurotic phenomena, 
we are not justified in over-valuing it in the way Adler does 
when he represents the ' masculine protest ' as the essential 
causa movens of the neuroses. Experience that is well- 
founded and verified anew every day shows us that precisely 
those neurotics of both sexes who loudly proclaim and lay 
emphasis on their masculine tendencies frequently conceal 
and only superficially intense female-passive desires. 
Our psycho-analytic experience should constantly remind 
us of the over-determination of all psychical structures. 
It has to reject as one-sided and fragmentary every psycho- 
logical method of working which does not take into full 
account the influence of various factors on one another. 
In my present study I have collected material belonging 
to the castration complex from a great number of psycho- 



368 SELECTED PAPERS OF KARL ABRAHAM XXII 

analyses. And I should like to say expressly that it is solely 
for reasons of clearness that I have only occasionally alluded 
to the ideas connected with female-passive instincts which 
none of my patients failed to express. 

VIII 

Women whose ideas and feelings are influenced and 
governed by the castration complex to any great extent 
no matter whether consciously or unconsciously transplant 
the effect of this complex on to their children. They 
influence the psychosexual development of their daughters 
either by speaking disparagingly of female sexuality to them, 
or by unconsciously showing their aversion to men. The 
latter method is the more permanently effective one, 
because it tends to undermine the heterosexuality of the 
growing girl. On the other hand, the method of deprecia- 
tion can produce really traumatic effects, as when a mother 
says to her daughter who is about to marry, ' What is 
going to happen now is disgusting '. 

It is in particular those neurotic women whose libido has 
been displaced from the genital to the anal zone who 
give expression to their disgust of the male body in this or a 
similar manner. These women also produce serious effects 
on their sons without foreseeing the result of their attitude. 
A mother with this kind of aversion to the male sex injures 
the narcissism of the boy. A boy in his early years is proud 
of his genital organs; he likes to exhibit them to his mother, 
and expects her to admire them. He soon sees that his 
mother ostentatiously looks the other way, even if she does 
not give expression to her disinclination in words. These 
women are especially given to prohibiting masturbation on 
the grounds that it is disgusting for the boy to touch his 
genital organ. Whereas they are most careful to avoid 
touching and even mentioning the penis, they tend to caress 
the child's buttocks and are never tired of speaking of its 
' bottom ', often getting the child to repeat this word. They 
also take an excessive interest in the child's defaecatory 
acts. The boy is thus forced into a new orientation of his 



THE FEMALE CASTRATION COMPLEX 369 

libido. Either it is transferred from the genital to the anal 
zone, or the boy is impelled towards a member of his own sex 
his father in the first instance to whom he feels himself 
bound by a bond which is quite comprehensible to us. At the 
same time he becomes a woman-hater, and later will be con- 
stantly ready to criticize very severely the weaknesses of the 
female sex. This chronic influence of the mother's castra- 
tion complex seems to me to be of greater importance as a 
cause of castration-fear in boys than occasionally uttered 
threats of castration. I can produce abundant evidence for 
this view from my psycho-analyses of male neurotics. The 
mother's anal-erotism is the earliest and most dangerous 
enemy of the psychosexual development of children, since 
she has more influence on them in the earliest years of life 
than the father. 

To everyone of us who is a practising psycho-analyst 
the question occurs at times whether the trifling number 
of individuals to whom we can give assistance justifies the 
great expenditure of time, labour and patience it involves. 
The answer to this question is contained in what has been 
said above. If we succeed in freeing such a person from the 
defects of his psychosexual ity, i.e. from the difficulties of 
his castration complex, we obviate the neuroses of children 
to a great extent, and thus help the coming generation. 
Our psycho-analytic activity is a quiet and little appreciated 
work and the object of much attack, but its effect on and 
beyond the individual seems to us to make it an aim worth 
a great deal of labour. 



2 A 



CHAPTER XXIII 

CONTRIBUTIONS TO THE THEORY OF THE 
ANAL CHARACTER 1 (1921) 

THE wide field which is open to the science of psycho- 
analysis at the present time offers an abundance of 
instances of the rapid increase of psychological know- 
ledge along the lines of purely inductive investigation. 
Perhaps the most remarkable and instructive of these is the 
development of the theory of the anal character. In 1908, 
about fifteen years after the appearance of his first contribu- 
tions to the psychology of the neuroses, Freud published a 
short paper entitled * Character and Anal Erotism'. It 
occupied only three pages of a journal, and was a model of 
condensed statement and of cautious and clear summing up. 
The gradually increasing number of his co-workers, among 
whom may be mentioned Sadger, Ferenczi, and Jones, has 
helped to extend the range of ascertained knowledge. The 
theory concerning the products of the transformation of anal 
erotism gained unsuspected significance when in 1913, 
following on Jones' important investigation on 'Hate and 
Anal Erotism in the Obsessional Neurosis', Freud formulated 
an early * pregenital ' organization of the libido. He con- 
sidered that the symptoms of the obsessional neurosis were 
the result of a regression of libido to this stage of develop- 
ment, which is characterized by a preponderance of the anal 
and sadistic component instincts. This threw a new light 
both on the symptomatology of the obsessional neurosis and 
on the characterological peculiarities of the person suffering 

1 [No. 70, A. B.] 

370 



THE ANAL CHARACTER 371 

from it on the so-called * obsessional character \ I might 
add, anticipating a future publication, that very similar 
anomalies of character are found in those people who tend 
to melancholic or manic states of mind. And the strictest 
possible study of the sadistic-anal character-traits is necessary 
before we can proceed to investigate those last mentioned 
diseases which are still so enigmatical to us. The present 
study is mainly concerned with the anal contributions to the 
formation of character. Jones' l last great work on this 
subject presents an abundance of valuable material, but it 
does not exhaust it. For the work of a single person cannot 
do justice to the multiplicity and complexity of the pheno- 
mena; each analyst who possesses data of his own should 
publish them, and so help to contribute to the body of 
psycho-analytical knowledge. In the same way the purpose 
of the following remarks is to extend the theory of the anal 
character-traits in certain directions. Another problem of 
great theoretical importance will be very frequently alluded 
to in this study. Up to the present we understand only 
very incompletely the particular psychological connections 
that exist between the two impulses of sadism and anal 
erotism which we always mention in close association 
with each other, almost as a matter of habit. And I 
shall attempt the solution of this question in a later 
paper. 

In his first description of the anal character Freud has 
said that certain neurotics present three particularly pro- 
nounced character-traits, namely, a love of orderliness which 
often develops into pedantry, a parsimony which easily turns 
to miserliness, and an obstinacy which may become an 
angry defiance. He established the fact that the primary 
pleasure in emptying the bowels and in its products was 
particularly emphasized in these persons; and also that 
after successful repression their coprophilia either becomes 
sublimated into pleasure in painting, modelling, and similar 
activities, or proceeds along the path of reaction-formation 
to a special love of cleanliness. Finally he pointed out 
the unconscious equivalence of faeces and money or other 

1 'Anal-erotic Character Traits' (1918). 



372 SELECTED PAPERS OF KARL ABRAHAM XXIII 

valuables. Among other observations Sadger l has re- 
marked that persons with a pronounced anal character 
are usually convinced that they can do everything better 
than other people. He also speaks of a contradiction 
in their character, namely, great perseverance side by side 
with the tendency to put off doing everything till the last 
moment. 

I will pass over isolated remarks in psycho-analytic 
literature by other authors and turn to Jones' very thorough 
and comprehensive study on this subject. I might remark 
in advance that I do not differ from this author on any 
points, but that nevertheless I feel that his statements need 
amplification and completion in certain respects. 

Jones quite rightly distinguishes two different acts in 
the process we usually designate as the education of the child 
in cleanly habits. The child has not only to be taught not 
to soil its body and surroundings with excreta, but it has 
also to be educated to perform its excretory functions at 
regular times. In other words, it has to give up both its 
coprophilia and its pleasure in the process of excretion. 
This double process of limitation of infantile impulses 
together with its consequences in the psychical sphere re- 
quires further investigation. 

The child's primitive method of evacuation brings the 
entire surface of its buttocks and lower extremities in con- 
tact with urine and faeces. This contact seems unpleasant, 
even repulsive, to adults, whose repressions have removed 
them from the infantile reaction to these processes. They 
cannot appreciate the sources of pleasure on which the 
libido of the infant can draw, in whom the stream of warm 
urine on the skin and contact with the warm mass of faeces 
produce pleasurable feelings. The child only begins to 
give signs of discomfort when the excreted products grow 
cold against its body. It is the same pleasure which the 
child seeks when it handles its faeces at a somewhat later 
period. Ferenczi 2 has traced the further development of 
this infantile tendency. It must not be forgotten, moreover, 

1 * Analerotik und Analcharakter * (1910). 
8 *On the Ontogenesis of an Interest in Money* (1916). 



THE ANAL CHARACTER 373 

that pleasure in the sight and smell of faeces is associated 
with these feelings. 

The special pleasure in the act of excretion, which 
we must differentiate from pleasure in the -products of the 
excretory process, comprises besides physical sensations a 
psychical gratification which is based on the achievement 
of that act. Now in that the child's training demands 
strict regularity in its excretions as well as cleanliness it 
exposes the child's narcissism to a first severe test. The 
majority of children adapt themselves sooner or later to 
these demands. In favourable cases the child succeeds in 
making a virtue out of necessity, as it were; in other 
words, in identifying itself with the requirements of its 
educators and being proud of its attainment. The 
primary injury to its narcissism is thus compensated, and 
its original feeling of self-satisfaction is replaced by grati- 
fication in its achievement, in ' being good ', in its parents' 
praise. 

All children are not equally successful in this respect. 
Particular attention should be drawn here to the fact that 
there are certain over-compensations behind which is hidden 
that obstinate holding fast to the primitive right of self- 
determination which occasionally breaks out violently later. 
I have in mind those children (and of course adults also) 
who are remarkable for their ' goodness ', polite manners, 
and obedience, but who base their underlying rebellious 
impulses on the grounds that they have been forced into 
submission since infancy. These cases have their own 
developmental history. In one of my patients I could trace 
back the course of events to her earliest infancy, in regard 
to which, it is true, previous statements of her mother were 
of assistance. 

The patient was the middle one of three sisters. She 
showed unusually clearly and completely the traits character- 
istic of a ' middle ' child, which Hug-Hellmuth l has recently 
described in such an illuminating way. But her refractori- 
ness, which was associated in the clearest manner with her 
assertion of the infantile right of self-determination in the 

1 <Vom "mittlerem" Kinde' (1921). 



374 SELECTED PAPERS OF KARL ABRAHAM XXIII 

sense mentioned above, went back, in the last instance, to a 
particular circumstance of her childhood. 

When she was born her elder sister had been still 
under a year old. Her mother had not quite succeeded in 
educating the elder child to habits of cleanliness when the 
newcomer had imposed on her a double amount of washing, 
both of clothes and body. When the patient was a few 
months old her mother had become pregnant for the third 
time, and had determined to hasten the education of her 
second child in cleanly habits, so that she should not still 
be too much taken up with her when the third child was 
born. She had demanded obedience on its part regarding 
the carrying out of its needs earlier than is usual, and had 
reinforced the effect of her words by smacking it. These 
measures had produced a very welcome result for the 
harassed mother. The child had become a model of 
cleanliness abnormally early, and had grown surprisingly 
submissive. When she was grown up, the patient was 
in a constant conflict between a conscious attitude of sub- 
missiveness, resignation and willingness to sacrifice herself 
on the one hand, and an unconscious desire for vengeance 
on the other. 

This brief account illustrates in an instructive manner 
the effect of early injuries to infantile narcissism, especially 
if these injuries are of a persistent and systematic nature, 
and force a habit prematurely upon the child before it is 
psychically ready for it. This psychical preparedness only 
appears when the child begins to transfer on to objects 
(its mother, etc.) the feelings which are originally bound 
narcissistically. Once the child has acquired this capacity 
it will become cleanly 4 for the sake of ' this person. If 
cleanliness is demanded too soon, it will acquire the habit 
through fear. Its inner resistance will remain and its 
libido will continue in a tenacious narcissistic fixation, and 
a permanent disturbance of the capacity to love will result. 

The full significance of such an experience for the 
psychosexual development of the child only becomes 
apparent if we examine in detail the course of narcissistic 
pleasure. Jones lays stress on the connection between the 



THE ANAL CHARACTER 

child's high self-esteem and its excretory acts. In a short 
paper * I have brought forward some examples to show that 
the child's idea of the omnipotence of its wishes and thoughts 
can proceed from a stage in which it ascribed an omnipotence 
of this kind to its excretions. Further experience has since 
convinced me that this is a regular and typical process. 
The patient about whose childhood I have spoken had 
doubtless been disturbed in the enjoyment of a narcissistic 
pleasure of this sort. The severe and painful feelings of in- 
sufficiency with which she was later afflicted very probably 
went back in the last instance to this premature destruction 
of her infantile ' megalomania '. 

This view of the excretions as a sign of enormous 
power is foreign to the consciousness of normal adults. 
That it persists in the unconscious, however, is shown 1 in 
many everyday expressions, mostly of a jocular nature; for 
example, the seat of the closet is often denoted as the 
' throne '. It is not to be wondered at that children who 
grow up in a strong anal-erotic environment incorporate 
these kinds of comparisons which they so frequently hear, in 
the fixed body of their recollections and make use of them 
in their later neurotic phantasies. One of my patients had 
a compulsion to read a meaning of this kind into the German 
national anthem. By transposing himself in his phantasies 
of greatness into the Kaiser's place he pictured to himself 
' the high delight ' of ' bathing in the glory of the throne ', 
i.e. of touching his own excreta. 

Once again language gives us characteristic instances 
of this over-estimation of defaecation. In Spanish, the 
common expression for it, ' regir el vientre ' (' to rule the 
belly '), which is used quite seriously, clearly indicates the 
pride taken by the person in the functioning of his bowels. 

If we recognize in the child's pride in evacuation a 
primitive feeling of power we can understand the peculiar 
feeling of helplessness we so often find in neurotically con- 
stipated patients. Their libido has been displaced from the 
genital to the anal zone, and they deplore the inhibition of 
the bowel function just as though it were a genital impotence. 

1 Cf. Chapter XVII. 



37^ SELECTED PAPERS OF KARL ABRAHAM XXIII 

In thinking of the person who is hypochondriacal about his 
motions one is tempted to speak of an intestinal impotence. 

Closely connected with this pride is the idea of many 
neurotics, which was first described by Sadger, that they 
must do everything themselves because no one else can do 
it as well. According to my experience this conviction is 
often exaggerated until the patient believes that he is a 
unique person. He will become pretentious and arrogant 
and will tend to under-estimate everyone else. One patient 
expressed this as follows: ' Everything that is not me is 
dirt*. These neurotics only take pleasure in possessing a 
thing that no one else has, and will despise any activity which 
they have to share with other people. 

The sensitiveness of the person with an anal character 
to external encroachments of every kind on the actual or 
supposed field of his power is well known. It is quite 
evident that psycho-analysis must evoke the most violent 
resistance in such persons, who regard it as an unheard-of 
interference with their way of life. ' Psycho-analysis pokes 
about in my affairs ', one patient said, thereby indicating 
unconsciously his passive-homosexual and anal attitude 
towards his analyst. 

Jones emphasizes the fact that many neurotics of this 
class hold fast obstinately to their own system of doing 
things. They refuse altogether to accommodate themselves 
to any arrangement imposed from without, but expect com- 
pliance from other people as soon as they have worked out a 
definite arrangement of their own. As an example, I might 
mention the introduction of strict regulations for use in the 
office, or possibly the writing of a book which contains 
binding rules or recommendations for the organization of all 
offices of a certain kind. 

The following is a glaring example of this kind. A 
mother drew up a written programme in which she arranged 
her daughter's day in the most minute manner. The orders 
for the early morning were set out as follows : ( i ) Get up. (2) 
Use the chamber. (3) Wash, etc. In the morning she would 
knock from time to time at her daughter's door, and ask, 
* How far have you got now? ' The girl would then have to 



THE ANAL CHARACTER 377 

reply, * 9 ' or * 1 5 ', as the case might be. In this way the 
mother kept a strict watch over the execution of her plan. 

It might be mentioned here that all such systems not 
only testify to an obsession for order in its inventor, but 
also to his love of power which is of sadistic origin. I 
intend later to deal with the combination of anal and sadistic 
impulses in detail. 

Allusion may be made here to the pleasure these 
neurotics take in indexing and registering everything, in 
making up tabular summaries, and in dealing with statistics 
of every kind. 

They furthermore show the same self-will in regard to 
any demand or request made to them by some other person. 
We are reminded of the conduct of those children who 
become constipated when defaecation is demanded of them, 
but afterwards yield to the need at a time that is agreeable 
to themselves. Such children rebel equally against the 
' shall ' (being told to empty their bowels) as against the 
* must ' (a child's expression for the need to defaecate); 
their desire to postpone evacuation is a protection against 
both imperatives. 

The surrender of excrement is the earliest form in 
which the child ' gives ' or ' presents ' a thing; and the 
neurotic often shows the self-will we have described in 
the matter of giving. Accordingly in many cases he will 
refuse a demand or request made to him, but will of his 
own free choice make a person a handsome present. The 
important thing to him is to preserve his right of decision. 
We frequently find in our psycho-analyses that a husband 
opposes any expenditure proposed by his wife, while he 
afterwards hands her of his ' own free will ' more than 
what she first asked for. These men delight in keeping 
their wives permanently dependent on them financially. 
Assigning money in portions which they themselves 
determine is a source of pleasure to them. We come 
across similar behaviour in some neurotics regarding 
defaecation, which they only allow to take place in refracta 
dosi. One special tendency these men and women have 
is to distribute food in portions according as they think 



37^ SELECTED PAPERS OF KARL ABRAHAM XXIII 

best, and this habit occasionally assumes grotesque forms. 
For instance, there was a case of a stingy old man who fed 
his goat by giving it each blade of grass separately. Such 
people like to arouse desire and expectation in others and 
then to give them gratification in small and insufficient 
amounts. 

In those instances where they have to yield to the 
demand of another person some of these neurotics endeavour 
to maintain a semblance of making a personal decision. 
An example of this is the tendency to pay even the smallest 
amounts by cheque; in this way the person avoids using 
current notes and coin, but creates his ' own money ' in each 
case. The displeasure of paying out is thereby diminished 
by just as much as it would be increased if payment were 
made in coin. I should like to make it quite clear, how- 
ever, that other motives are also operative here. 

Neurotics who wish to introduce their own system into 
everything are inclined to be exaggerated in their criticism 
of others, and this easily degenerates into mere carping. 
In social life they constitute the main body of malcontents. 
The original anal characteristic of self-will can, however, 
develop in two different directions, as Jones has convincingly 
shown. In some cases we meet with inaccessibility and 
stubbornness, that is, with characteristics that are unsocial 
and unproductive. In others we find perseverance and 
thoroughness, i.e. characteristics of social value as long as 
they are not pushed to extremes. We must here once 
more draw attention to the existence of other instinctual 
sources besides anal erotism which go to reinforce these 
tendencies. 

The opposite type has received very little consideration 
in psycho-analytical literature. There are certain neurotics 
who avoid taking any kind of initiative. In ordinary life 
they want a kind father or attentive mother to be constantly 
at hand to remove every difficulty out of their way. In 
psycho-analysis they resent having to give free associations. 
They would like to lie quite still and let the physician do all 
the analytical work, or to be questioned by him. The 
similarity of the facts disclosed by the analysis of these 



THE ANAL CHARACTER 379 

cases enables me to state that these patients used in child- 
hood to resist the act of defaecation demanded of them, 
and that then they used to be spared this trouble by being 
given frequent enemas or purges by their mother or father. 
To them free association is a psychical evacuation, and 
just as with bodily evacuation they dislike being asked to 
perform it. They are continually expecting that the work 
should be made easier or done for them altogether. I 
may recall a reverse form of this resistance, which I have 
likewise traced back to anal erotic sources in an earlier 
paper. 1 It concerns those patients who wish to do every- 
thing themselves according to their own method in their 
psycho-analysis, and for this reason refuse to carry out the 
prescribed free association. 

In this paper I do not intend so much to discuss 
the neurotic symptom-formations arising from repressed 
anal erotism, as its characterological manifestations. I shall 
therefore only touch upon the various forms of neurotic 
inhibition which obviously have to. do with a displacement 
of libido to the anal zone. The fact that avoidance of 
effort is a frequent feature of the anal character needs 
further discussion; and we must briefly consider what 
the state of affairs is in the person with a so-called 
4 obsessional character '. 

If the libido of the male person does not advance in 
full measure to the stage of genital organization, or if it 
regresses from the genital to the anal developmental phase, 
there invariably results a diminution of male activity in 
every sense of the word. His physiological productiveness 
is bound up with the genital zone. If his libido regresses 
to the sadistic-anal phase he loses his productive power, 
and not only in the purely generative sense. His genital 
libido should give the first impulse to the procreative act, 
and therewith to the creation of a new being. If the 
initiative necessary for this reproductive act is lacking, we 
invariably find a lack of productivity and initiative in other 
respects in his behaviour. But the effects go even beyond 
this. 

1 Cf. Chapter XV. 



38O SELECTED PAPERS OF KARL ABRAHAM XXIII 

Together with the man's genital Tactivity there goes 
a positive feeling-attitude towards his love-object, and this 
attitude extends to his behaviour towards other objects 
and is expressed in his capacity for social adaptation, his 
devotion to certain interests and ideas, etc. In all these 
respects the character-formation of the sadistic-anal stage 
is inferior to that of the genital phase. The sadistic 
element, which in a normal man's emotional life is of great 
importance once it has undergone appropriate transforma- 
tion through sublimation, appears with particular strength 
in the obsessional character, but becomes more or less 
crippled in consequence of the ambivalence in the instinctual 
life of such persons. It also contains destructive tendencies 
hostile to the object, and on account of this cannot become 
sublimated to a real capacity for devotion to a love-object. 
For the reaction-formation of too great yieldingness and 
gentleness which is frequently observed in such people 
must not be confused with a real transference-love. Those 
cases in which object-love and genital libido-organization 
have been attained to a fair extent are more favourable. 
If the character-trait of over-kindness mentioned above is 
combined with a partial object-love of this kind, a socially 
useful ' variety ' is produced, which in essential respects is, 
nevertheless, inferior to full object-love. 

In individuals with more or less impaired genitality we 
regularly find an unconscious tendency to regard the anal 
function as the productive activity, and to make it appear 
as if the genital activity were unessential and the anal one 
far more important. The social behaviour of these persons 
is accordingly strongly bound up with money. They like 
to make presents of money or its equivalent, and tend to 
become patrons of the arts or benefactors of some kind. 
But their libido remains more or less detached from 
objects, and so the work they do remains unproductive in 
the essential sense. They are by no means lacking in per- 
severance a frequent mark of the anal character but 
their perseverance is largely used in unproductive ways. 
They expend it, for instance, in the pedantic observance of 
fixed forms, so that in unfavourable cases their preoccupation 



*9 21 THE ANAL CHARACTER 381 

with the external form outweighs their interest in the reality 
of the thing. In considering the various ways in which 
the anal character impairs male activity we must not forget 
the tendency, often a very obstinate one, of postponing 
every action. We are well acquainted with the origin of 
this tendency. There is often associated with it a tendency 
to interrupt every activity that has been begun; so that 
in many cases as soon as a person begins doing anything 
it can already be predicted that an interruption will occur 
very soon. 

More rarely I have found the reverse conduct. For 
instance, one of my patients was prevented from writing 
his doctor's thesis through a long-standing resistance. 
After several motives for his resistance had come to light 
we found the following one: he declared that he shrank 
from beginning his work because when he had once begun 
he could not leave off again. We are reminded of the 
behaviour of certain neurotics in regard to their excretions. 
They retain the contents of the bowel or bladder as long 
as they possibly can. When finally they yield to the need 
that has become too strong for them there is no further 
holding back, and they evacuate the entire contents. A 
fact to be particularly noted here is that there is a double 
pleasure, that of holding back the execreta, and that of 
evacuating it. The essential difference between the two 
forms of pleasure lies in the protracted nature of the 
process in the one case, and in its rapid course in the other. 
As regards the patient just mentioned the long-deferred 
beginning of the work signified a turning from pleasure in 
retention to pleasure in evacuation. 1 

A detail from the history of the same patient will show 

1 The tendency to retain the faeces represents a special form of adherence to 
fore-pleasure, and seems to me to merit special consideration. I will only mention 
one point concerning it in this place. Recently frequent attempts have been made 
Dosite ' psychological types ' and to bring all individuals into one 



to set up two opposite \ 

or other category. We* may recall inVhis connection Jung's * extraverted ' and 
4 introverted ' types. The patient whom I mentioned above was undoubtedly 
turned in upon himself in the highest degree, but he gave up this attitude of hostility 
to objects more and more in the course of his analysis. This and many similar 
experiences go to prove that * introversion ' in Jung's sense is an infantile clinging 
to the pleasure in retention. We are therefore dealing with an attitude that can bi 
acquired or given up, and not with a manifestation of a rigid psychological type. 



382 SELECTED PAPERS OF KARL ABRAHAM XXIII 

the degree to which a preponderance of anal over genital 
erotism makes the neurotic inactive and unproductive. 
During his analysis as well he remained wholly inactive for a 
long period, and by means of this resistance prevented any 
alteration taking place in his condition and circumstances. 
As is often the case in obsessional patients, his sole method 
of dealing with his external and internal difficulties was 
to swear violently. These expressions of affect were ac- 
companied by very significant behaviour. Instead of 
thinking about the success of his work, he used to ponder 
over the question of what would happen to his curses 
whether they reached God or the devil, and what was the 
fate of sound-waves in general. His intellectual activity 
was thus replaced by neurotic brooding. It appeared 
from his associations that the brooding question about the 
place where noise finally got to referred also to smell, 
and was in the last instance of anal erotic origin (flatus). 

Generally speaking, it may be said that the more male 
activity and productivity is hindered in neurotics, the more 
pronounced their interest in possession becomes, and this in 
a way which departs widely from the normal. In marked 
cases of anal character-formation almost all relationships 
in life are brought into the category of having (holding fast) 
and giving, i.e. of proprietorship. It is as though the 
motto of many of these people were : ' Whoever gives me 
something is my friend; whoever desires something from 
me is my enemy '. One patient said that he could not 
have any friendly feelings towards me during his treatment, 
and added in explanation: ' So long as I have to pay 
anybody anything I cannot be friendly towards him*. We 
find the exact reverse of this behaviour in other neurotics ; 
their friendly feeling towards a person increases in pro- 
portion to the help he needs and asks for. 

In the first and larger group envy stands out clearly 
as the main character-trait. The envious person, however, 
shows not only a desire for the possessions of others, but 
connects with that desire spiteful impulses against the 
privileged proprietor. But we will only make a passing 
reference to the sadistic and anal roots of envy, since both 



1921 THE ANAL CHARACTER 383 

are of minor and auxiliary significance in the production 
of that character-trait, which originates in the earlier, oral 
phase of libido-development. One example will suffice to 
illustrate the connection of envy with anal ideas of pos- 
session, and that is the frequent envy of his analyst on 
the part of the patient. He envies him the position of 
a * superior ', and continually compares himself with him. 
A patient once said that the distribution of the rdles in 
psycho-analysis was too unjust, for it was he who had 
to make all the sacrifices; he had to visit the physician, 
produce his associations, and to pay the money into the 
bargain. The same patient also had the habit of calculating 
the income of everyone he knew. 

We have now come very close to one of the classical 
traits of the person with an anal character, namely, his 
special attitude to money, which is usually one of parsimony 
or avarice. Often as this characteristic has been confirmed 
in psycho-analytical literature, there are yet a number of 
features connected with it which have not received much 
notice, and which I shall therefore proceed to deal 
with. 

There are cases in which the connection between 
intentional retention of faeces and systematic parsimony is 
perfectly clear. I may mention the example of a rich 
banker who again and again impressed on his children 
that they should retain the contents of the bowels as long 
as possible, in order to get the benefit of every bit of the 
expensive food they ate. 

Some neurotics limit their parsimony or their avarice 
to certain kinds of expenditure, while in other respects they 
spend money with surprising liberality. There is a class 
of patient who avoids spending any money on ' passing ' 
things. A concert, a journey, a visit to an exhibition, 
involves expense and nothing permanent is got in return. 
I knew a person who avoided going to the opera for this 
reason ; nevertheless he bought piano scores of the operas 
which he had not heard, because in this way he obtained 
something * lasting '. Some of these neurotics avoid 
spending money on food, because it is not retained as a 



384 SELECTED PAPERS OF KARL ABRAHAM XXIII 

permanent possession. It is significant that there is 
another type of patient who readily incurs expense for 
food in which he has an over-great interest. These 
are the neurotics who are always anxiously watching their 
bodies, testing their weight, etc. Their interest is concerned 
with the question of what remains of the material introduced 
into their body as a lasting possession. It is evident that 
they identify the content of the body with money. 

In other cases we find that the neurotic carries his 
parsimony into every part of his life ; and on certain points 
he goes to extremes without effecting any appreciable 
economy. I might mention an eccentric miser who used 
to go about in his house with the front of his trousers 
unbuttoned, in order that the button-holes should not wear 
out too quickly. It is easy to guess that in this instance 
other impulses were also operative. Nevertheless it is 
characteristic that these could be concealed behind the anal 
erotic tendency to save money, and that this motive should 
be so much emphasized. In some patients we find a 
parsimony in the special instance of using toilet paper. In 
this a dislike of soiling a clean thing co-operates as a 
determining factor. 

The displacement of avarice from money or the value 
of money to time may be observed quite frequently. Time, 
it may be remembered, is likened to money in a familiar 
saying. Many neurotics are continually worrying over 
waste of time. It is only the time which they spend alone 
or at their work that seems to them well employed. Any 
disturbance in their work irritates them exceedingly. They 
hate inactivity, pleasures, etc. These are the people who 
tend to exhibit the i Sunday neuroses ' described by 
Ferenczi, 1 i.e. who cannot endure an interruption of their 
work. Just as every neurotically exaggerated purpose 
often fails to achieve its object, so is this the case here. 
The patients often save time on a small scale and waste it 
on a great one. 

Such patients frequently undertake two occupations at 
once in order to save time. They like, for example, to 

1 'Sunday Neurosis' (1919). 



THE ANAL CHARACTER 385 

learn, read, or accomplish other tasks during defaecation. 1 
I have repeatedly come across people who in order to save 
time used to put on or take off their coat and waistcoat 
together, or on going to bed would leave their pants in their 
trousers in order to put on both garments in one movement 
in the morning. Examples of this kind could easily be 
multiplied. 

The forms in which pleasure in possession can express 
itself are very numerous. The stamp-collector who deeply 
feels the gap in his set of stamps is not so far removed from 
the miser who, according to popular notion, counts and 
gloats over his gold pieces. But Jones' work concerning 
the impulse to collect is so informative that I can add nothing 
of importance to it. 

On the other hand, it seems to me necessary to make 
a brief allusion to a phenomenon which is closely related 
to the subject's pleasure in looking at his own possessions. 
I refer to the pleasure in looking at one's own mental 
creations, letters, manuscripts, etc., or completed works of 
all kinds. The prototype of this tendency is looking at one's 
own faeces, which is an ever-new source of pleasure to many 
people, and is in some neurotics a form of psychical 
compulsion. 

This fact of a libidinal over-emphasis of possession 
explains the difficulty our patients have in separating 
themselves from objects of all kinds, when these have 
neither practical use nor monetary value. Such people 
often collect all sorts of broken objects in the attics under 
the pretext that they might need them later. Then 
on some occasion or other they will get rid of the whole 
lot of rubbish at once. Their pleasure in having a mass 
of material stored up entirely corresponds to pleasure in the 
retention of faeces. We find in this case that the removal 
(evacuation) of the material is delayed as long as possible. 
The same persons collect bits of paper, old envelopes, worn- 
out pens and similar things, and cannot get rid of these 

1 For these neurotics the w.c. is the true place of ' production ', to which its 
solitude is an assistance. One patient who showed violent resistance against giving 
free associations during the analytic hours produced them at home in the w.c., 
and brought them ready made to the analysis. 

2 B 



386 SELECTED PAPERS OF KARL ABRAHAM XXIII 

possessions for long periods of time, and then at rare intervals 
they make a general clearance, which is likewise associated with 
pleasure. Among business men and clerks I have some- 
times come across a particular tendency to preserve carefully 
quite soiled and torn blotting-paper. In the unconscious of 
these neurotics the spots of ink are equivalent to the stain of 
faeces. I might mention that I knew a senile and weak- 
minded woman with a strong regression of libido to the 
anal stage who used to put the toilet paper she had used 
in her pocket and carry it about with her. 

The following peculiar habit of a woman who also 
exhibited unusually pronounced anal traits in other respects 
shows clearly that throwing away objects is equivalent in 
the unconscious to evacuating faeces. This woman was 
unable to throw away objects that had become useless. 
Nevertheless, she sometimes felt impelled to throw some 
object of this kind away, and so she had invented a method 
of tricking herself, as it were. She would go from her house 
into a neighbouring wood with the object to be removed- 
perhaps some old clothes fixed to her back by one corner 
tucked under her apron-string. On her way through the 
wood she would ' lose ' it and return home another way so 
that she should not catch sight of the ' lost ' object. In 
order to give up possession of an object, therefore, she had 
to let it fall from the back part of her body. 

People who do not like to get rid of worn-out objects 
do not as a rule readily take to new ones. They buy new 
clothes, but do not wear them; they * keep ' them for the 
future, and only take a real pleasure in them so long as they 
hang unused in the cupboard. 

The disinclination to throw away worn-out or worthless 
objects frequently leads to a compulsive tendency to make 
use of even the most trifling thing. A rich man used to 
cut his empty match-boxes into small strips and give them 
to his servants to light the fires with. A similar tendency 
appears in women in the period of involution. 

In many cases the person's interest in making use of 
remnants undergoes an incomplete kind of sublimation; 
as, for instance, when a neurotic has as his favourite day- 



IQ2I THE ANAL CHARACTER 387 

dream the utilization of the refuse of a whole town, though 
no practical result of his reflections may appear. We shall 
deal later with day-dreams of this nature. 

We find a tendency to extravagance less frequent than 
parsimony in our patients. In an observation communicated 
to the Berlin Psycho-Analytical Society, Simmel made the 
parallel between extravagance and neurotic diarrhoea just 
as evident as that between avarice and constipation, which 
has long been clear to us. I can confirm the correctness 
of his view from my own experience, and indeed I drew 
attention some years ago to the fact that spending money 
can represent an equivalent for a longed-for but neurotically 
inhibited release of libido. 1 I might mention here the 
inclination some women have to throw away money. It 
expresses hostility towards the husband, whose * means ' 2 
are taken from him in this way; it concerns, therefore if 
we leave out other determinants an expression of the female 
castration complex in the sense of a revenge on the man. 
We see here again sadistic motives co-operating with those 
of anal-erotic origin. 

We can quite understand, from their contradictory 
attitude towards defalcation, the meanness many neurotics 
show in saving small sums of money while they will spend 
largely and generously from time to time. These persons 
postpone emptying the bowels as long as possible often 
giving lack of time as a reason and when they do go to the 
w.c. only evacuate a small quantity of faeces. But every now 
and then they have an evacuation on a grand scale. 

We occasionally come across persons with pronounced 
anal character whose libido has turned quite exclusively 
to the possession of money. A patient told me that as a 
boy he did not play at battles with lead soldiers like other 
children, but with pieces of money. He got people to 
give him copper coins, and these represented ordinary 
soldiers. Nickel ones were non-commissioned officers of 
various rank, and silver ones were officers. A silver five- 

1 Cf. Chapter XIV. 

2 [The German word * Permogen '= ' means ', ' wealth ' j also = 'sexual capacity '. 
Trans.] 



388 SELECTED PAPERS OF KARL ABRAHAM XXIII 

mark piece was the field-marshal. This officer was secured 
from all attack in a special building 4 behind the front '. 
One side took ' prisoners ' from the other in the battle and 
added them to its own army. In this manner one side 
increased its possession of money until the other had nothing 
left. It is quite obvious that the * struggle ' in the patient's 
unconscious was against his ' rich ' father. It is worth 
noting, however, that money entirely replaced human beings. 
And indeed when this patient came to me for treatment he 
took no personal interest in other people whatever; only 
the possession of money and money values attracted him. 

The conduct of our patients with regard to order and 
cleanliness is just as contradictory as it is in spending money. 
This fact is so familiar to every psycho-analyst that a general 
reference to it should not be necessary; but certain parti- 
culars in this connection deserve special consideration. 

Pleasure in indexing and classifying, in compiling lists 
and statistical summaries, in drawing up programmes and 
regulating work by time-sheets, is well known to be an 
expression of the anal character. This tendency is so marked 
in many people that the fore-pleasure they get in working 
out a plan is stronger than their gratification in its execution, 
so that they often leave it undone. I have known a number 
of patients with a long-standing inhibition in their work who* 
would draw up a plan of work say every Sunday for the 
coming week, and would then fail utterly to put it into 
practice. It is to be noted that they included not only 
undecided people but obstinate ones who in their self- 
opinionated way rejected the proved methods of others and 
wanted to act according to their own. 

Many neurotics remain during life in a particular 
attitude of ambivalency towards order and cleanliness. There 
are people who are very well groomed as far as their exterior 
goes. But whereas their visible costume and linen is irre- 
proachable, their underclothing and the covered parts of 
their body are exceedingly dirty. 1 These same people tend 

1 There is a saying in Berlin regarding such people: Oben hui> unten pfui! 
[' On top all spry, below, oh fie ! ']. In Bavaria they say more coarsely, Oben beglissen 
[ = < shining'], unten beschissen [='beshat']. The contradictions in some people 
in this respect is a matter, therefore, of common knowledge. 



THE ANAL CHARACTER 389 

to preserve scrupulous order in their houses. On the writing 
table, for instance, every object will have its special place, and 
the books are placed with great care and regularity in the 
book-case where they are visible. In the drawers, however, 
complete disorder reigns, a disorder which is only corrected 
by a thorough clearance on rare occasions, and then only 
in a temporary way. 

I might mention here that in the unconscious of these 
neurotics a disordered room, disarranged drawers, etc., 
represent the bowel filled with faeces. I have repeatedly 
had occasion to analyse dreams which allude to the bowel 
in this way. One of my patients brought me a dream in 
which he climbed up a ladder after his mother in order to 
get into a lumber-room in the attics. It was an incest- 
dream with an anal coitus-phantasy in which the anus was 
represented symbolically as a narrow ladder and the bowel 
as a lumber-room. 

Character-traits connected with orderliness, as, for 
example, thoroughness and accuracy, are often closely 
associated with the opposite characteristic. These traits are 
particularly dealt with in Jones' investigations, and I need 
not go into them, but I may mention the craving for 
symmetry and fairness' which is often represented in the 
anal character. 

Just as some neurotics count their steps in order to 
reach their destination with an even number of paces, so 
they tolerate no asymmetry in other matters. They arrange 
all their objects symmetrically. They divide everything 
with minute exactness. A husband will draw up calcula- 
tions to show his wife that there is no equality between their 
respective expenditure on clothes, etc.; he will constantly 
be working out what the one has spent and what the other 
is therefore entitled to spend to make things even. During 
the food shortage in the Great War two unmarried brothers 
kept house together. When the rationed meat for both 
was put on the table they divided it by weighing each portion 
on a pair of letter scales. Both were anxious lest the other 
should go short or feel himself unfairly treated. The 
perpetual desire to be 'quits' with other people, i.e. to be 



39O SELECTED PAPERS OF KARL ABRAHAM XXIll 

under no obligation, however trifling, is also significant. 
That other people with pronounced anal character have a 
tendency to forget their debts (particularly when they are 
for small sums) may be taken as a symptom of unsublimated 
anal erotism. 

Finally, a discovery of Jones must be discussed which 
he only mentions by the way, but which obviously is the 
condensed result of wide experience. 

A most interesting result of anal erotism, he writes, ' is 
the tendency to be occupied with the reverse side of various 
things and situations. This may manifest itself in many 
different ways; in marked curiosity about the opposite or 
back side of objects and places e.g. in the desire to live on 
the other side of a hill because it has its back turned to a 
given place; in the proneness to make numerous mistakes 
as to right and left, east and west; to reverse words and 
letters in writing; ?.nd so on.' 

I could support Jones' view with numerous examples 
from my own experience. They are of far-reaching im- 
portance for understanding certain neurotic symptoms and 
character-traits. There is no doubt that the displacement 
of libido from the genital to the anal zone is the prototype 
of all these ' reversals '. In this connection the conduct of 
many people who are considered eccentric may be mentioned. 
Their nature is built up for the most part on anal character- 
traits. They tend to act in great and small things in a 
manner opposite to that of other people. They wear 
clothes that are as dissimilar as possible from the prevailing 
fashion. They work when others play. If they do work 
at which others sit, they stand. When others ride, they go 
on foot; or run while others walk. If people wear warm 
clothing, they do the opposite. The food they enjoy is 
opposed to the general taste. The connection between this 
and the familiar character-trait of obstinacy is unmistakable. 

During my student days I knew a young man who 
was noticeable for his peculiar habits. He lived unsoci- 
ally, resisted the fashion of the time in an ostentatious 
manner, and would not conform to the customs of the rest 
of the students. As I was having a mid-day meal with him 



THE ANAL CHARACTER 39! 

one day in a restaurant I noticed that he took the menu in 
the reverse order, i.e. he commenced with the sweet and 
ended with the soup. Some years later I was asked by his 
relatives to see him professionally. I found that he had 
already developed definite paranoic delusions. If we bear 
in mind the great significance of anal erotism in the psycho- 
genesis of paranoia, a significance which Keren czi has 
pointed out, we can understand this man's eccentric behaviour 
as an anal character-formation, and therefore as a precursor 
of paranoia. 

Certain cases of neuroses in women, in which an un- 
usually strong castration complex is expressed, reveal to us 
best the deeper meaning of such a tendency to reversal. 
We find in them that it springs from two main motives 
a displacement of libido from ' in front * to ' behind ', 
and the wish for a change of sex. I hope to have some- 
thing to say concerning this condition of mind in another 
connection. 

I should like to conclude these remarks on anal character- 
traits with an observation the truth of which I should like 
others to test. This is that the anal character sometimes 
seems to stamp itself on the physiognomy of its possessor. 
It seems particularly to show itself in a morose expression. 
Persons who are deprived of normal genital gratification 
tend to surliness l as a rule. A constant tension of the line 
of the nostril together with a slight lifting of the upper lip 
seem to me significant facial characteristics of such people. 
In some cases this gives the impression that they are 
constantly sniffing at something. Probably this feature 
is traceable to their coprophilic pleasure in smell. In the 
case of a man who had this kind of facial expression I once 
remarked that he looked as though he were constantly 
smelling himself. Someone who knew him quite well said 
that he really did have the habit of smelling his hands and 
every object he picked up. I might add that he exhibited 
the typical anal character-traits in a pronounced form. 

I do not claim to have dealt exhaustively with the subject 

1 Some, it is true, have at their command plentiful narcissistic sources of pleasure, 
and live in a state of smiling self-satisfaction. 



SELECTED PAPERS OF KARL ABRAHAM XXIII 

of anal character-traits in this paper. On the contrary, I 
am conscious how little justice I have done to the richness 
and variety of the material. In reality I have had in view 
another object, namely, to increase our knowledge of the 
pregenital phases of the development of the libido by making 
some additions to the investigation of the anal character. As 
I have said at the beginning, this paper is intended to be 
followed by a study of the manic-depressive states, for the 
understanding of which a knowledge of the pregenital stages 
of development is essential. 



CHAPTER XXIV 

THE INFLUENCE OF ORAL EROTISM ON 
CHARACTER-FORMATION 1 (1924) 

A:ORDING to the usual view the formation of 
character is to be traced back partly to inherited 
disposition, and partly to the effects of environment, 
among which particular significance is ascribed to up- 
bringing. Psycho-analytical investigation has for the first 
time drawn attention to sources of character-formation 
which have not hitherto been sufficiently considered. On 
the basis of psycho-analytical experience we have come to 
take the view that those elements of infantile sexuality which 
are excluded from participation in the sexual life of the 
adult individual undergo in part a transformation into 
certain character-traits. As is well known, Freud was the 
first to show that certain elements of infantile anal erotism 
undergo a transformation of this kind. Some part of this 
anal erotism enters into the final organization of mature 
sexual life, some becomes sublimated, and some goes to 
form character. These contributions to character from anal 
sources are to be regarded as normal. They render it possible 
for the individual to adapt himself to the demands of his 
environment as regards cleanliness, love of order, and so on. 
Apart from this, however, we have learnt to recognize an 
' anal character ' in the clinical sense, which is distinguished 
by an extreme accentuation of certain character-traits; but 
it is to be noted that the excessive addiction to cleanliness, 
parsimony, and similar tendencies found in such characters 

1 [No. 99, A. B.] 
393 



394 SELECTED PAPERS OF KARL ABRAHAM XXIV 

never succeeds completely. We invariably find the opposite 
extreme more or less strongly developed in them. 

Now experience teaches us that not all deviations from 
the final character-formation of the genital stage originate 
in the anal sources just mentioned. We find that oral 
erotism is a source of character-formation as well. Here, too, 
we can see that the supplies from this source can fall within 
the normal or can greatly exceed it. If our observations are 
correct, then we can speak of oral, anal, and genital sources 
of character-formation; in doing so, however, we quite 
consciously neglect one aspect of the problem, since we are 
only taking into consideration those contributions to the 
formation of character which are derived from the erotogenic 
zones, and not those coming from the component-instincts. 
This neglect is, however, more apparent than real; for 
example, the close connection of the component of cruelty 
in infantile instinctual life with oral erotism will become 
evident in the character-formation of the individual as 
elsewhere, so that it is hardly necessary to draw special 
attention to it. 

What I shall be able to say about character-traits of 
oral origin will perhaps be disappointing in some respects, 
because I cannot offer a picture comparable in completeness 
to that of the anal character. I shall therefore begin by 
pointing out certain differences between the two which 
should not be lost sight of, and which will moderate our 
expectations as regards the oral character to more suitable 
proportions. 

In the first place, it should be remembered that of the 
pleasurable tendencies that are connected with intestinal 
processes only a small part can come to form part of 
normal erotism in an unrepressed form ; whereas an incom- 
parably greater part of the libidinal cathexis of the mouth 
which characterizes infancy can still be employed in later 
life. Thus the oral elements of infantile sexuality do not 
need to be changed into character-formation or sublimated 
to the same extent as the anal ones. 

In the second place, we must bear in mind that a retro- 
grade transformation of character, such as is connected with 



IQ24 ORAL EROTISM AND CHARACTER 395 

the outbreak of certain nervous disturbances, in the main 
comes to a stop at the anal stage. If it proceeds further 
and a pathological intensification of oral traits, such as will 
be described later, ensues, then these latter will show an 
admixture of traits belonging to the anal stage; and we 
should in that case expect to find a combination of the 
two kinds of character-traits rather than a pure culture 
of oral ones. 

If we proceed to study these mixed products of two 
different sources of character-formation more deeply we 
make a new discovery, namely, that the origin of the anal 
character is very closely connected with the history of oral 
erotism, and cannot be completely understood without 
reference to it. 

Clinical experience has led Freud to the view that in many 
people the particular libidinal emphasis that attaches to the 
intestinal processes is a constitutional factor. There can be 
no doubt that this is so. We need only call to mind how in 
certain families positive phenomena of anal erotism as well 
as anal character-traits are everywhere observable in the 
most different members. Nevertheless, correct as this view 
is, the facts admit of further explanation in the light of the 
following psycho-analytic observations. 

In infancy the individual has an intense pleasure in the 
act of sucking, and we have familiarized ourselves with the 
view that this pleasure is not to be ascribed entirely to the 
process of taking food, but that it is conditioned in a high 
degree by the significance of the mouth as an erotogenic zone. 

This primitive form of obtaining pleasure is never 
completely abandoned by the individual but persists under 
all kinds of disguises during the whole of his life, and even 
experiences a reinforcement at certain times and in particular 
circumstances. Nevertheless, as it grows up both physically 
and mentally, the child does effect a far-reaching renunciation 
-of its original pleasure in sucking. Now observation shows 
that every such renunciation of pleasure only takes place 
, on the basis of an exchange. It is this process of renunciation 
and the course it takes under different conditions which 
merits our attention. 



39^ SELECTED PAPERS OF KARL ABRAHAM XXIV 

First of all there is the process of the irruption of teeth, 
which, as is well known, causes a considerable part of the 
pleasure in sucking to be replaced by pleasure in biting. 
We need only call to mind how during this stage of develop- 
ment the child puts every object it can into its mouth and 
tries with all its strength to bite it to pieces. 

In the same period of development the child begins to 
have ambivalent relations to external objects. It is to be 
noted that the friendly as well as the hostile aspect of its 
attitude is connected with pleasure. At about the same 
period a further displacement of pleasurable sensation to 
other bodily functions and areas occurs. 

What is of particular significance is that the pleasure in 
sucking undertakes a kind of migration. At about the time 
that the child is being weaned it is also being trained in 
habits of cleanliness. An important prerequisite for the 
success of this latter process lies in the gradually developing 
function of the anal and urethral sphincters. The action of 
these muscles is the same as that of the lips in sucking, and 
is obviously modelled on it. The original unchecked voiding 
of bodily excretions was accompanied by stimulation of the 
apertures of the body which was undoubtedly pleasurable. 
If the child adapts itself to the demands of training and 
learns to retain its excretions this new activity also gets to be 
accompanied by pleasure. The pleasurable sensations in 
the organ connected with this process form the foundation 
upon which the mental pleasure in retention of every kind 
of possession is gradually built up. More recent investi- 
gations have shown that the possession of an object originally 
signified to the infantile mind the having incorporated it 
into its own body. Whereas to begin with, pleasure was 
only associated with taking in something coming from 
without or with expelling bodily contents, now there is 
added the pleasure in retaining bodily contents, which leads 
to pleasure in all forms of property. The relation in which 
these three sources of physical and mental gratification 
stand to one another is of the greatest practical significance 
for the later social conduct of the individual. If the pleasure 
in getting or taking is brought into the most favourable 



1924 ORAL EROTISM AND CHARACTER 397 

relation possible with the pleasure in possession, as well 
as with that in giving up, then an exceedingly important 
step has been made in laying the foundations of the indi- 
vidual's social relations. For when such a relationship 
between the three tendencies is present, the most important 
preliminary condition for overcoming the ambivalence of 
the individual's emotional life has been established. 

In what has so far been said we have only called attention 
to single features of a multiform developmfental process. 
For the purpose of our investigation it is sufficient to make 
clear that the first and therefore perhaps the most important 
step the individual makes towards attaining a normal 
attitude in his final social and sexual relationships consists 
in dealing successfully with his oral erotism. But there are 
numerous ways in which this important process of develop- 
ment may suffer disturbance. In order to understand this 
we must bear in mind that the pleasure of the sucking period 
is to a great extent a pleasure in taking, in being given 
something. It then becomes apparent that any quantitative 
divergence from the usual degree of pleasure gained can 
give rise to disturbances. 

Given certain conditions of nourishment the sucking 
period can be an extremely displeasurable one for the child. 
In some cases its earliest pleasurable craving is imperfectly 
gratified, and it is deprived of the enjoyment of the sucking 
stage. 1 In other cases the same period is abnormally rich in 
pleasure. It is well known how some mothers indulge the 
craving for pleasure in their infants by granting them every 
wish. The result is that it is extraordinarily difficult to 
wean the child, and it sometimes takes two or three years 
to do it. In a few cases the child persists in taking food 
by sucking from a bottle until it is almost grown up. 

Whether in this early period of life the child has had to 
go without pleasure or has been indulged with an excess of 
it, the effect is the same. It takes leave of the sucking stage 
under difficulties. Since its need for pleasure has either 
not been sufficiently gratified or has become too insistent, 

1 l Freud made it clear long ago that stomach and bowel troubles in infancy can 
have a harmful effect on the mental development of the child. 



39^ SELECTED PAPERS OF KARL ABRAHAM XXIV 

it fastens with particular intensity on the possibilities of 
pleasure to be got from the next stage. In doing this it finds 
itself in constant danger of a new disappointment, to which it 
will react more readily than the normal child with a regression 
to the earlier stage. In other words: In the child who has 
been disappointed or over-indulged in the sucking period the 
pleasure in biting, which is also the most primitive form of 
sadism, will be especially emphasized. Thus the formation 
of character in such a child begins under the influence of 
an abnormally pronounced ambivalence of feeling. In 
practice such a disturbance of the development of character 
expresses itself in pronounced characteristics of hostility 
and dislike. It accounts for the presence of the abnor- 
mally over-developed envy which is so common. Eisler has 
already referred this character-trait to an oral source. 1 I 
fully agree with his view, but would like to emphasize its 
relation to the later oral stage. In many cases an elder 
child, who is already at the stage of taking food by biting 
and chewing, has an opportunity of observing a younger 
child being suckled. In such cases the characteristic of 
envy receives a special reinforcement. Sometimes it is 
incompletely overcome by being turned into its opposite; 
but the original feeling is easily seen to persist in various 
disguises. 

But if the child escapes the Scylla of this danger, it is 
threatened by the Charybdis of another. It attempts to 
resume the abandoned act of sucking in an altered form 
and in another locality. We have already spoken of the 
sucking activity of the sphincters at the excretory apertures 
of the body, and have recognized that an inordinate desire 
to possess, especially in the form of abnormal parsimony 
and avarice, stands in close relation to this process. Thus 
we see that those traits, which belong to the clinical pheno- 
mena of the anal character, are built up on the ruins of an 
oral erotism whose development has miscarried. In the 
present paper I shall only describe this one path of defective 
development. The preceding remarks will suffice to show 
how dependent is our understanding of the anal character 

1 Pleasure in Sleep and Disturbed Capacity for Sleep' (1921). 



ORAL EROTISM AND CHARACTER 399 

on an adequate knowledge of the preceding stages of 
development. 

We will pass on to consider the direct contributions 
rendered by oral erotism to the formation of character, and 
will begin with an example taken from ordinary psycho- 
analytical observation. 

Neurotic parsimony, which may be developed to the 
point of avarice, is often met with in people who are inhibited 
from properly earning a livelihood; and the anal sources of 
character-formation provide no explanation of it. It is in 
fact connected with an inhibition of the craving for objects, 
and this indicates that the libido has undergone some special 
vicissitude. The pleasure in acquiring desired objects seems 
in this case to have been repressed in favour of pleasure in 
holding fast to existing possessions. People in whom we 
find this inhibition are always haunted by a fear lest they 
should lose the smallest part of their possessions. This 
anxiety prevents them from trying to earn money, and renders 
them in many ways helpless in practical life. We shall 
understand this type of character-formation if we go on to 
examine related symptoms. 

In certain other cases the person's entire character is 
under oral influence, but this can only be shown after a 
thorough analysis has been made. According to my 
experience we are here concerned with persons in whom 
the sucking was undisturbed and highly pleasurable. They 
have brought with them from this happy period a deeply- 
rooted conviction that everything will always be well with 
them. They face life with an imperturbable optimism which 
often does in fact help them to achieve their aims. But we 
also meet with less favourable types of development. Some 
people are dominated by the belief that there will always 
be some kind person a representative of the mother, of 
course to care for them and to give them everything 
they need. This optimistic belief condemns them to 
inactivity. We again recognize in them individuals who 
have been over-indulged in the sucking period. Their 
whole attitude towards life shows that they expect the 
mother's breast to flow for them eternally, as it were. They 



4OO SELECTED PAPERS OF KARL ABRAHAM XXIV 

make no kind of effort, and in some cases they even disdain 
to undertake a bread-winning occupation. 

This optimism, whether it is allied to an energetic 
conduct in life or, as in the last-mentioned aberration, to a 
care-free indifference to the world, stands in noteworthy 
contrast to a feature of the anal character that has not 
been sufficiently appreciated up to the present. I refer to 
a melancholy seriousness which passes over into marked 
pessimism. I must point out, however, that this character- 
istic is to a great extent not directly of anal origin, but goes 
back to a disappointment of oral desires in the earliest years. 
In persons of this type the optimistic belief in the benevo- 
lence of fate is completely absent. On the contrary, they 
consistently show an apprehensive attitude towards life, and 
have a tendency to make the worst of everything and to 
find undue difficulties in the simplest undertakings. 

A character thus rooted in oral erotism influences the 
entire behaviour of the individual, as well as his choice of 
profession, his predilections, and his hobbies. We may cite 
as an instance the type of neurotic official who is only able 
to exist when all the circumstances of his life have been 
prescribed for him once and for all. To him the necessary 
condition of life is that his means of sustenance should be 
guaranteed to him up to the day of his death. He renounces 
all ideals of personal success in favour of receiving an assured 
and regular income. 

So far we have dealt with people whose entire character 
is explained on the supposition that their libido has been 
fully gratified in the oral stage of their development. In 
psycho-analytic work, however, we observe other individuals 
who are burdened throughout their whole life with the 
after-effects of an ungratified sucking period. In them 
there is no trace of such a development having taken place. 

In their social behaviour these people always seem to be 
asking for something, either in the form of a modest request 
or of an aggressive demand. The manner in which they 
put forward their wishes has something in the nature of 
persistent sucking about it; they are as little to be put off 
by hard facts as by reasonable arguments, but continue to 



1924 ORAL EROTISM AND CHARACTER 40! 

plead and to insist. One might almost say that they 'cling 
like leeches ' to other people. They particularly dislike 
being alone, even for a short time. Impatience is a marked 
characteristic with them. In some cases, those in which 
psycho-analytic investigation reveals a regression from the 
oral-sadistic to the sucking stage, their behaviour has an 
element of cruelty in it as well, which makes them some- 
thing like vampires to other people. 

We meet certain traits of character in the same people 
which can be traced back to a peculiar displacement within 
the oral sphere. Their longing to experience gratification 
by way of sucking has changed to a need to give by way of 
the mouth, so that we find in them, besides a permanent 
longing to obtain everything, a constant need to communi- 
cate themselves orally to other people. This results in an 
obstinate urge to talk, connected in most cases with a feeling 
of overflowing. Persons of this kind have the impression 
that their fund of thought is inexhaustible, and they ascribe 
a special power or some unusual value to what they say. 
Their principal relation to other people is effected by the 
way of oral discharge. The obstinate insistence described 
above naturally occurs chiefly by means of speech. But 
that function serves at the same time for the act of giving. 
I could, moreover, regularly establish the fact that these 
people could not control their other activities any more 
than they could their speech. Thus one frequently finds 
in them a neurotically exaggerated need to urinate, which 
often appears at the same time as an outburst of talking or 
directly after it. 

In those features of character-formation which belong 
to the oral-sadistic stage, too, speaking takes the place of 
repressed impulses from another quarter. In certain 
neurotics the hostile purpose of their speech is especially 
striking. In this instance it serves the unconscious aim 
of killing the adversary. Psycho-analysis has shown that in 
such cases, in place of biting and devouring the object, a milder 
form of aggression has appeared, though the mouth is still 
utilized as the organ of it. In certain neurotics speaking 
is used to express the entire range of instinctual trends, 

2 c 



4O2 SELECTED PAPERS OF KARL ABRAHAM XXIV 

whether friendly or hostile, social or asocial, and irrespective 
of the instinctual sphere to which they originally belonged. 
In them the impulse to talk signifies desiring as well as 
attacking, killing, or annihilating, and at the same time 
every kind of bodily evacuation, including the act of fertiliza- 
tion. In their phantasies speaking is subject to the narcis- 
sistic valuation which their unconscious applies to all physical 
and psychical productions. Their entire behaviour shows 
a particularly striking contrast to reticent people with anal 
character-formation. 

Observations of this kind most emphatically draw our 
attention to the varieties and differences that exist within 
the realm of oral character-formation, and show that the 
field which we are investigating is anything but limited or 
poor in variations. The most important differences, how- 
ever, are those which depend on whether a feature of 
character has developed on the basis of the earlier or the 
later oral stage; whether, in other words, it is the expression 
of an unconscious tendency to suck or to bite. In the latter 
case we shall find in connection with such a character-trait 
the most marked symptoms of ambivalence positive and 
negative instinctual cravings, hostile and friendly tendencies; 
while we may assume on the basis of our experience that the 
character-traits derived from the stage of sucking are not 
as yet subjected to ambivalence. According to my obser- 
vations, this fundamental difference extends to the smallest 
details of a person's behaviour. At a meeting of the British 
Psychological Society (Medical Section) Dr. Edward Glover 
recently read a paper in which he gave these differences 
particular consideration. 1 

The very significant contrasts found in the character- 
formation of different individuals can be traced psycho- 
analytically from the fact that decisive influences on the 
process of formation of character have been exercised in 
the one case by oral impulses, and in the other case by 
anal ones. Equally important is the connecting of sadistic 
instinctual elements with the manifestation of libido flowing 
from the various erotogenic zones. A few examples may 

1 * The Significance of the Mouth in Psycho-Analysis ' (1924). 



1924 ORAL EROTISM AND CHARACTER 403 

roughly illustrate this point. In our psycho-analyses we 
are able to trace phenomena of very intense craving and 
effort back to the primary oral stage. It need hardly be said 
that we do not exclude other sources of impulse as factors 
in those phenomena. But the desires derived from that 
earliest stage are still free from the tendency to destroy 
the object a tendency which is characteristic of the im- 
pulses of the next stage. 

The covetous impulses which are derived from the 
second oral stage are in strong contrast to the unassuming 
character of the anally constituted person. But we must 
not forget that the weakness of the acquisitive tendency in 
the latter is balanced by his obstinate holding fast to things 
which he has already got. 

Characteristic, too, are the differences in the inclination 
to share one's own possessions with others. Generosity 
is frequently found as an oral character -trait. In this 
the orally gratified person is identifying himself with the 
bounteous mother. Things are very different in the next, 
oral-sadistic stage, where envy, hostility, and jealousy make 
such behaviour impossible. Thus in many cases generous 
or envious behaviour is derived from one of the two oral 
stages of development ; and in the same way the inclination 
to avarice corresponds to the succeeding anal-sadistic stage 
of character-formation. 

There are noteworthy differences in the person's social 
conduct, too, according to the stage of his libido from which 
his character is derived. People who have been gratified 
in the earliest stage are bright and sociable ; those who are 
fixated at the oral-sadistic stage are hostile and maVgious; 
while moroseness, inaccessibility, and reticence go together 
with the anal character. 

Furthermore, persons with an oral character are access- 
ible to new ideas, in a favourable as well as an unfavourable 
sense, while the anal character involves a conservative 
behaviour opposed to all innovations an attitude which 
certainly prevents the hasty abandonment of what has been 
proved good. 

There is a similar contrast between the impatient im- 



SELECTED PAPERS OF KARL ABRAHAM XXIV 

portunity, haste, and restlessness of people with oral character- 
formation, and the perseverance and persistence of the anal 
character, which, on the other hand, tends to procrastina- 
tion and hesitation. 

The character-trait of ambition, which we meet with so 
frequently in our psycho-analyses, has been derived long 
ago by Freud l from urethral erotism. This explanation, 
however, does not seem to have penetrated to the deepest 
sources of that characteristic. According to my experience, 
and also that of Dr. Edward Glover, this is rather a character- 
trait of oral origin which is later reinforced from other 
sources, among which the urethral one should be particularly 
mentioned. 

Besides this, it has to be noted that certain contributions 
to character-formation originating in the earliest oral stage 
coincide in important respects with others derived from 
the final genital stage. This is probably explicable from 
the fact that at these two stages the libido is least open to 
disturbance from an ambivalence of feeling. 

In many people we find, beside the oral character-traits 
described, other psychological manifestations which we 
must derive from the same instinctual sources. These are 
impulses which have escaped any social modification. As 
examples a morbidly intense appetite for food and an 
inclination to various oral perversions are especially to be 
mentioned. Further, we meet many kinds of neurotic 
symptoms which are determined orally; and finally there 
are phenomena which have come into being through sublima- 
tion. These latter products deserve a separate investiga- 
tion, tahich, however, would exceed the limits of this paper; 
henceil shall only briefly give a single example. 

The displacement of the infantile pleasure in sucking 
to the intellectual sphere is of great practical significance. 
Curiosity and the pleasure in observing receive important 
reinforcements from this source, and this not only in child- 
hood, but during the subject's whole life. In persons with 
a special inclination for observing Nature, and for many 
branches of scientific investigation, psycho-analysis shows a 

1 ' Character and Anal Erotism ' (1908). 



1924 ORAL EROTISM AND CHARACTER 405 

close connection between those impulses and repressed oral 
desires. 

A glance into the workshop of scientific investigation 
enables us to recognize how impulses pertaining to the 
different erotogenic zones must support and supplement 
one another if the most favourable results possible are to 
be achieved. The optimum is reached when an energetic 
imbibing of observations is combined with enough tenacity 
and ability to * digest ' the collected facts, and a sufficiently 
strong impulse to give them back to the world, provided this 
is not done with undue haste. Psycho-analytical experience 
enables us to recognize various kinds of divergences from 
this optimum. Thus there are people with great mental 
capacity for absorbing, who, however, are inhibited in 
production. Others again produce too rapidly. It is no 
exaggeration to say of such people that they have scarcely 
taken a thing in before it comes out of their mouths again. 
When they are analysed it often proves that these same 
persons tend to vomit food as soon as they have eaten it. 
They are people who show an extreme neurotic impatience ; 
a satisfactory combination of forward- moving oral impulses 
with retarding anal ones is lacking in the structure of their 
character. 

In conclusion, it seems to me particularly important to 
allude once more to the significance of such combinations. 
In the normal formation of character we shall always find 
derivatives from all the original instinctual sources happily 
combined with one another. 

It is important, moreover, to consider the numerous 
possibilities of such combinations because it prevents us 
from over-estimating some one particular aspect, important 
though it may be. If we consider the problems of character- 
formation from the one large unifying point of view which 
psycho-analysis affords us, from that of infantile sexuality, 
then it is obvious how everything weaves itself into a 
whole in the characterological sphere. The realm of 
infantile sexuality extends over two quite different fields. 
It covers the entire unconscious instinctual life of the 
mature human being. It is likewise the scene of the very 



406 SELECTED PAPERS OF KARL ABRAHAM XXIV 

important mental impressions of the earliest years of the 
child, among which we have to reckon prenatal influences. 
Sometimes we may feel dismayed in face of the mass of 
phenomena which meets us in the wide field of human 
mentality, from the play of children and other typical pro- 
ducts of the early activity of phantasy, through the first 
development of the child's interests and talents, up to the 
most highly valued achievements of mature human beings 
and the most extreme individual differentiations. But then 
we must remember that Freud has given us in the practice 
and theory of psycho-analysis an instrument with which to 
investigate this wide subject and to open up the road to 
infantile sexuality, that inexhaustible source of life. 



CHAPTER XXV 

CHARACTER-FORMATION ON THE GENITAL 
LEVEL OF LIBIDO-DEVELOPMENT i 

0925) 

IN the two phases of development discussed in the pre- 
ceding chapters 2 we were able to recognize archaic types 
of character-formation. They represent in the life of 
the individual recapitulations of primitive states which the 
human race has passed through at certain stages of its 
development^} Here, as in general in biology, we find the 
rule holding good that the individual repeats in an abbre- 
viated form the history of his ancestors. Accof dmgly7 in 
normal circumstances the indivIduaTwill traverse those early 
stages of character-formation in a relatively short space of 
time. In this chapter I shall give in very rough outline an 
idea of the way in which the character of men and women 
in its definitive form is built up on those early foundations. 
According to the traditional view, character is defined 
as the direction habitually taken by a person's voluntary 
impulses. It is not part of the intention of this paper to 
spend much time in finding an exact definition of character. 
We shall, however, find it advisable not to be too much 
influenced by the * habit ' of attributing great importance 
to the direction usually taken by these impulses of the will. 
For our previous discussions have already made it clear 
that character is a changeable thing. We shall therefore 
do better not to make their duration and permanence an 

1 [No. 106, A. B.]. 

2 [These two chapters, together with the present one, were issued in book-form 
under the title of Psychological Studies upon Character- Formation.] 

407 



4O8 SELECTED PAPERS OF KARL ABRAHAM XXV 

essential criterion of character-traits. It will be sufficient 
for our purposes to say that we consider the character of a 
person to be the sum of his instinctive reactions towards his 
social environment. 

We have already seen that in early life the child reacts 
to the external world purely on the basis of its instincts. 
It is only by degrees that it overcomes to some extent its 
egoistic impulses and its narcissism and takes the step 
towards object-love. And, as we know, attainment of this 
stage of development coincides with another important 
event, namely, attainment of the highest level of libidinal 
organization the genital level, as it is called. Believing 
as we do that the character-traits of men and women have 
their origin in definite instinctual sources, we should 
naturally expect that the development of a person's char- 
acter would only be complete when his libido has reached 
its highest stage of organization and has achieved the 
capacity for object-love. And in fact Freud's view that a 
person's sexual attitude is reflected in the whole trend of 
his mental attitude in general finds complete confirmation 
from all the facts observed in this field as well. 

In the first of these three essays it has been shown in 
detail that the individual is able to fill his place and exercise 
his powers fully and satisfactorily in his social environment 
only if his libido has attained the genital stage. But we 
have not as yet given special attention to that process 
which consists in the transition from the second stage of 
character-formation to the third and final one. 

The first function of this third stage in the formation 
of character is of course to get rid of the remaining traces 
of the more primitive stages of development, in so far as 
they are unfavourable to the social behaviour of the indi- 
vidual. For he will not, for instance, be able to achieve 
a tolerant and fair-minded attitude to other people and to 
interests outside his own, until he has got the better of his 
destructive and hostile impulses springing from sadistic 
sources, or of his avarice and mistrust derived from anal 
ones. We shall therefore examine with great interest the 
process by means of which such a transformation takes place. 



GENITAL CHARACTER-FORMATION 409 

An overwhelming abundance of material connected with 
the processes which we have grouped under the general 
heading of the Oedipus complex presents itself to us, and 
draws our attention to this class of mental events. If we 
confine ourselves to the case of the male child, we find that 
tj^gjiiost powerful sources of affect in qarly years Consist jn 
hisTrotic desire for jus mother and his wish to put his father 
gut of the way. And closely allied to them are his ideas 
about c^tajration. If he can successfully master the emotions 
centred round this subject it will have a decisive effect on 
the form taken by his character. I shall content myself 
with a very brief survey of this question, since I can refer 
the reader to the paper by Alexander, already published, 1 
on the relations between character and the castration- 
complex. Generally speaking, we may say that when the 
child has been able to subdue his Oedipus complex with 
all its constituents he has made the most important step 
towards overcoming his original narcissism and his hostile 
tendencies ; and at the same time he has broken the power 
of the pleasure-principle to dominate the conduct of his life. 

At this point I will dwell in greater detail on a particular 
aspect of this process of change, since its significance for 
the formation of character has as yet received hardly any 
attention. This is the extensive alteration which takes 
place in the boy's attitude towards the body of persons of 
the opposite sex, i.e. in the first instance towards that of 
his mother. Originally her body was to him an object 
of mingled curiosity and fear; in other words, it aroused 
ambivalent feelings in him. But gradually he achieves a 
libidinal cathexis of his love -object as a whole, that is, 
with the inclusion of those parts of it which had formerly 
aroused those contrary feelings in him. If this has been 
achieved there arise in him expressions of his libidinal 
relation to his object that are inhibited in their aim 
feelings of fondness, devotion, and so on and these co-exist 
with his directly erotic desires for it. And indeed, during 
the boy's latency period, these * aim-inhibited ' sentiments 
predominate over his sensual feelings. If the child's 

1 ' The Castration Complex in the Formation of Character * (1922). 



4IO SELECTED PAPERS OF KARL ABRAHAM XXV 

development continues to be normal, these new sentiments 
that have been established towards his mother next become 
carried over to his father. They gradually extend their 
field and the child adopts a friendly and well-wishing 
attitude, first to persons of his near environment, and then 
to the community at large. This process seems to me to 
be a very important basis for the final and definitive forma- 
tion of a person's character. It occurs at the time at which 
he passes out of that phase of his libidinal development 
which Freud has called the phallic stage. It implies that 
he has attained a point in his object-relations where he no 
longer has an ambivalent attitude towards the genital organ 
of his heterosexual object, but recognizes it as a part of 
that object whom he loves as an entire person. 

Whereas on the earlier levels of character-development 
the interests of the individual and those of the community 
ran counter to one another, on the genital level the interests 
of both coincide to a great extent, 

We are thus led to the conclusion that the definitive 
character developed in each individual is dependent upon 
the history of his Oedipus complex, and particularly on 
the capacity he has developed for transferring his friendly 
feelings on to other people or on to his whole environment. 
If he has failed in this, if he has not succeeded in sufficiently 
developing his social feelings, a marked disturbance of his 
character will be the direct consequence. Among our 
patients, with every aspect of whose mental life we become 
acquainted in psycho-analytic treatment, there are a great 
number who are suffering in a greater or less degree from 
disturbances of this kind. The history of their early 
childhood never fails to show that certain circumstances 
occurred to prevent the development of their social feelings. 
We always find that the sexual impulses of such people are 
unaccompanied by any desire for affectionate relations. 
And, similarly, in their daily life they have difficulties in 
getting a proper contact of feeling with other people. How 
greatly such a favourable development of character from a 
social point of view depends upon the degree to which 
these ' affectionate * instinctual components develop is most 



1925 GENITAL CHARACTER-FORMATION 4! I 

clearly seen in a class of persons whose childhood has been 
in especial stamped by the circumstances of their birth. I 
refer to illegitimate children. From the very beginning these 
children have suffered from a want of sympathy and affection 
from the people about them. If a child has no examples 
of love before it, it will have difficulty in entertaining any 
such feelings itself, and it will besides be incapable of 
discarding those primitive impulses which are originally 
directed against the external world. And thus it will 
readily succumb to an unsocial attitude. We see the same 
thing happen with the neurotic patient who, though born 
and educated in ordinary circumstances, feels that he is not 
loved, that he is the c Cinderella * of the family. 

Since we are on the topic of the definitive stage of 
character-formation it may be as well to obviate a possible 
misunderstanding. It is not the intention of this discussion 
to say what exactly a ' normal ' character is. Psycho- 
analysis has never set up norms of this sort, but contents 
itself with ascertaining psychological facts. It simply 
ascertains how far an individual or a group of persons has 
managed to travel along the line of development from the 
earliest stage to the latest in the structure of their character. 
It is precisely analytic experience which teaches us that 
even the most complete characterological development in 
a social sense merely represents a relative success in over- 
coming the more primitive types of mental structure, and that 
individual circumstances of an internal and external nature 
determine how completely the final aim will be achieved or 
how far that achievement will be a lasting one. 

In 1913 Freud drew attention to the case of a female 
patient in whom at the time of the menopause there appeared, 
side by side with neurotic symptoms, certain phenomena 
of involution of character. 1 This was the first time that 
such an observation had been made. We look upon 
neurotic symptoms as products of a regression in the psycho- 
sexual sphere. By uniting both processes under the general 
heading of regression, Freud was able to explain why a 
change in character takes place at the same time as neurotic 

1 ' The Predisposition to Obsessional Neurosis ' (1913). 



412 SELECTED PAPERS OF KARL ABRAHAM XXV 

symptoms are formed. This observation of Freud's has 
often been confirmed since. But it is not only at one par- 
ticular period of his life that a person's character is dependent 
upon the general position of his libido; that dependence 
exists at every age. The proverb which says ' Youth knows 
not virtue ' (' Jugend kennt keine Tugend ') is expressing the 
truth that in early life character is still without definite 
form or stability. Nevertheless, we should not over- 
estimate the fixity of character even in later years, but ought 
rather to bear in mind certain psychological facts which I 
shall briefly touch upon now. 

It was Freud who first pointed out that important 
changes can take place at any time in the mental make-up 
of the individual through the process of introjection. 
Women in particular tend to assimilate their character to 
that of the man with whom they are living. And when 
they change their love-object it can happen that they change 
their character accordingly. It is moreover worth noticing 
that husbands and wives who have lived long together tend 
to resemble one another in character. 

Psycho-analysts are familiar with the fact that when a 
neurosis sets in it can bring with it a regressive change 
of character; and conversely, that an improvement in the 
neurosis can be accompanied by a change of character in 
a progressive direction. Some time ago l I was able to 
point out that in the intervals between the periodical return 
of symptoms persons suffering from cyclical disorders 
exhibit a character similar to that of obsessional neurotics, 
so that according to our view they progress from the oral 
to the anal-sadistic level. 

But there are other reasons why we cannot set up a 
norm for character. As we know, individuals show extra- 
ordinarily wide variations in character, according to their 
social class, nationality, and race. We need only consider 
how widely nations or groups of people differ from one 
another in their sense of order, love of truth, industry, 
and other mental qualities. But, besides this, each group 
of people will vary in its behaviour at different times. A 

1 Cf. Chapter XXVI. 



GENITAL CHARACTER-FORMATION 413 

single nation, for instance, will change its conceptions of 
cleanliness, economy, justice, etc., more than once in the 
course of its history. Observation has shown, further- 
more, that alterations in the external circumstances of a 
people, a social class and so on, can entail radical 
changes in its dominating characteristics. The effect of 
the Great War in this respect is still fresh in our 
memory. Thus we see that, as soon as suitable alterations 
take place in their internal or external relations, a group 
of people shows the same mutability of character as an 
individual. 

In the two preceding papers I showed how the final 
stage of character-formation was built up on earlier phases 
of its development and absorbed into itself essential elements 
of these former phases. And we were led to attribute 
special importance in the formation of character to the 
various vicissitudes which befall the Oedipus complex. So 
that to set up a fixed norm for human character would be 
to deny not only the already acknowledged fact that char- 
acter is variable but also all that we know about the way in 
which such variations arise. 

We should be inclined to consider as normal in the social 
sense a person who is not prevented by any too great eccen- 
tricity in his character from adapting himself to the interests 
of the community. But a description like this is very 
elastic and allows room for a great number of variations. 
From the social point of view all that is required is that the 
character-traits of the individual should not be pushed to 
an excess; that he should be able, for instance, to find some 
sort of mean between the extremes of cruelty and over- 
kindness or between those of avarice and extravagance. 
We ought above all to avoid the mistake of setting up a 
norm in regard to the ratio in which the various mental 
qualities should be combined in any person. It need hardly 
be said that by this we are not intending to proclaim the 
ideal of the c golden mean ' in all the relations of man to 
his surroundings. 

It follows from what has been said that there is no 
absolute line of demarcation between the different kinds of 



414 SELECTED PAPERS OF KARL ABRAHAM XXV 

character-formation. Nevertheless in practice we do find 
that they fall fairly naturally into distinct classes. 

The best subjects for psycho-analytic investigation are 
those patients who exchange certain character-traits for 
others from time to time under the direct observation of 
the analyst. One young man who came to me for analysis 
gradually changed his attitude to such an extent under the 
influence of treatment that he quite got rid of certain 
markedly unsocial features of his character. Before that he 
had been unfriendly, ill-disposed, overbearing and grasping 
in his relation to others, and in fact had exhibited a great 
number of oral and anal characteristics. This attitude 
changed more and more as time went on. But at certain 
irregular intervals violent resistances appeared and were 
accompanied every time by a temporary relapse into that 
archaic phase of character-development which he had by 
now partly given up. On those occasions he would become 
disagreeable and hostile in his behaviour, and overbearing 
and contemptuous in his speech. From having conducted 
himself in a friendly and polite manner he became suspicious 
and irritable. While his resistance lasted all his friendly 
feelings towards his fellow-men including his analyst 
ceased, and he took up a completely opposite attitude 
towards the external world. At the same time as he reacted 
in this way with aversion and hatred towards human beings, 
he centred his desires in an unmeasured degree on inanimate 
objects. His whole interest was absorbed in buying things. 
In this way he set up as much as possible a relationship of 
possession between himself and his environment. During 
this time he was filled with fear that something belonging 
to him might get lost or stolen. His whole attitude to the 
external world was thus dominated by ideas of possession, 
acquisition, and possible loss. Directly his resistance began 
to diminish, his oral character-trait of covetousness and his 
anal one of avarice in regard to objects retreated into the 
background, and he began once more to entertain personal 
relationships towards other people and normal feelings about 
them which continued to develop and establish themselves. 

Cases of this kind are particularly instructive, not only 



GENITAL CHARACTER-FORMATION 415 

because they show the connection between certain features of 
character and a particular level of libidinal organization, but 
also because they are evidence of the mutability of character; 
they show that the character of a person can on occasion 
rise to a higher level of development or sink to a lower one. 
The final stage of character-formation shows traces 
everywhere of its association with the preceding stages. It 
borrows from them whatever conduces to a favourable 
relation between the individual and his objects. From 
the early oral stage it takes over enterprise and energy; 
from the anal stage, endurance, perseverance, and various 
other characteristics; from sadistic sources, the necessary 
power to carry on the struggle for existence. If the develop- 
ment of his character has been successful the individual is 
able to avoid falling into pathological exaggerations of those 
characteristics, whether in a positive or a negative direction. 
He is able to keep his impulses under control without being 
driven to a complete disavowal of his instincts, as is the 
obsessional neurotic. The sense of justice may serve as 
an illustration; in a case of favourable development this 
character-trait is not heightened to an excessive punctili- 
ousness and is not liable to break out in a violent way on 
some trivial occasion. We have only to think of the many 
actions done by obsessional neurotics in the way of * fair- 
ness ': suppose the right hand has made a movement or 
touched an object, the left hand must do the same. We 
have already said that ordinary friendly feelings remain 
entirely distinct from exaggerated forms of neurotic over- 
kindness. And similarly it is possible to steer a middle 
course between the two pathological extremes of either 
delaying everything or always being in too great a hurry; 
or of either being over-obstinate or too easily influenced. 
As regards material goods, the compromise arrived at is that 
the individual respects the interests of others up to a certain 
point, but at the same time secures his own existence. He 
preserves to some extent the aggressive impulses necessary 
for the maintenance of his life. And a considerable portion 
of his sadistic instincts is employed no longer for destructive 
but for constructive purposes. 



41 6 SELECTED PAPERS OF KARL ABRAHAM XXV 

In the course of this general alteration of character, as 
presented here in rough outline, we also observe that the 
individual achieves a steady conquest of his narcissism. In 
its earlier stages his character was still in a large measure 
governed by his narcissistic impulses. And we cannot deny 
that in its definitive stage it still contains a certain proportion 
of such impulses. Observation has taught us that no 
developmental stage, each of which has an organic basis of 
its own, is ever entirely surmounted or completely obliterated. 
On the contrary, each new product of development pos- 
sesses characteristics derived from its earlier history. Never- 
theless, even though the primitive signs of self-love are to 
some extent preserved in it, we may say that the definitive 
stage of character-formation is relatively unnarcissistic. 

Another change of great importance in the formation of 
character is that in which the individual overcomes his 
attitude of ambivalence (I speak again in a relative sense). 
Instances have already been given to show in what way a 
person's character avoids extremes on either side after it has 
attained its final stage of development. I should also like to 
draw attention here to the fact that as long as a severe con- 
flict of ambivalent feelings continues to exist in a person's 
character, there is always a danger both for him and for his 
environment that he may suddenly swing from one extreme 
to its opposite. 

Thus if a person is to develop his character more or less 
up to that point which we have taken to be its highest level, 
he must possess a sufficient quantity of affectionate and 
friendly feeling. A development of this sort goes hand in 
hand with a relatively successful conquest of his narcissistic 
attitude and his ambivalence, 

We have seen that the customary view of character- 
formation did not give us any real clue to the sources of that 
process as a whole. Psycho-analysis, on the other hand, 
based on empirical observation, has demonstrated the close 
connection that character-formation has with the psycho- 
sexual development of the child, in especial with the 
different libidinal stages and with the successive relations 
of the libido to its object. And, furthermore, it has 



IQ25 GENITAL CHARACTER-FORMATION 417 

taught us that even after childhood the character of the 
individual is subject to processes of evolution and involution. 
In psycho-analysis we view abnormal character in close 
and constant relation to all the other manifestations of the 
person's psycho-sexual life. This and the fact that character 
is not a fixed thing, even in adults, make it possible for us 
to exert a corrective influence upon pathological character- 
formations. Psycho-analysis is by no means simply con- 
fronted with the task of curing neurotic symptoms in the 
narrow sense of the word. It often has to deal with patho- 
logical deformities of character at the same time, or even in 
the first instance. So far our experience goes to show that 
the analysis of character is one of the most difficult pieces 
of work which the analyst can undertake, but that it has 
undoubtedly proved in some cases to be the most repaying. 
At present, however, we are not in a position to make any 
general judgement about the therapeutic results of character- 
analysis; that we must leave to future experience. 



2 D 



CHAPTER XXVI 

A SHORT STUDY OF THE DEVELOPMENT 
OF THE LIBIDO, VIEWED IN THE LIGHT 
OF MENTAL DISORDERS (1924) * 

PART I 

MANIC-DEPRESSIVE STATES AND THE PRE-GENITAL 
LEVELS OF THE LIBIDO 

INTRODUCTION 

MORE than ten years have passed since I first attempted 
to trace the aetiology of manic-depressive disorders 
on psycho-analytical lines. 2 I was quite aware at 
the time of the shortcomings of that attempt and was at pains 
to make this clear in the title of my paper. But we should 
do well to remember how very little had been written as yet 
on any psycho-analytical subject. And in especial there were 
very few earlier works in existence on the circular insanities. 
Private psychotherapeutic practice offers little opportunity 
for the analysis of cases of this kind, so that it was not 
possible for any single analyst to collect and compare 
sufficient data on this subject. 

Nevertheless, in spite of the shortcomings of that first 
attempt, its results have proved to be correct in certain not 
unimportant particulars. Freud's paper, * Mourning and 
Melancholia ', confirmed my view that melancholia stood 
in the same relation to normal mourning for a loss as did 

1 [No. 105, A. B.] 2 See Chapter VI. 

418 



IQ24 DEVELOPMENT OF THE LIBIDO 419 

morbid anxiety to ordinary fear. And we may now regard 
as definitely established the psychological affinity between 
melancholia and obsessional neuroses. Furthermore, these 
two illnesses show similarities in regard to the process of 
the disengagement of the libido from the external world. 
On the other hand, it had not hitherto been possible to 
discover anything concerning the point of divergence of 
melancholic and obsessional states; nor indeed had any 
light been shed as yet on the problem of the specific cause 
of the circular insanities. 

After Freud had established the theory of the pre-genital 
levels in the organization of the libido I made an attempt 
to discover this specific cause, Freud had been led by the 
analysis of obsessional neuroses to postulate a pre-genital 
phase in the development of the libido which he called 
the sadistic-anal phase. A little later l he gave a detailed 
description of a still earlier phase, the oral or cannibalistic 
one. Basing my views on a large and varied collection of 
empiric material I was able 2 to show that certain psycho- 
neuroses contain clear traces of that earliest phase in the 
organization of the libido; and I ventured the suggestion 
that what we saw in melancholia was the result of a regression 
of the patient's libido to that same primitive oral level. But 
my clinical material was not very complete in this respect, 
and I was not able to bring forward any convincing proofs 
of my view. 

At about the same time Freud approached the problem 
of melancholia from another angle, and he made the first 
real step towards the discovery of the mechanism of that 
illness. He showed that the patient, after having lost his 
love-object, regains it once more by a process of intro- 
jection (so that, for instance, the self-reproaches of a 
melancholiac are really directed towards his lost object). 

Subsequent experience has confirmed in my mind the 

importance of both processes the regression of the libido 

; to the oral stage and the mechanism of introjection. And 

more than that, it has shown that there is an intimate 

1 In the third edition of his Drei Abhandlungen zur Sexualtheorie. 
9 See Chapter XII. 



42P SELECTED PAPERS OF KARL ABRAHAM XXVI 

connection between the two. The analyses on which the 
present publication is based leave no doubt as to this last 
point. As I hope to be able to make quite clear, the intro- 
jection of the love-object is an incorporation of it, in keeping 
with the regression of the libido to the cannibalistic level. 

Two more discoveries in this field of research must be 
mentioned, again in connection with Freud's name. In 
the first place he pointed out that in melancholia the event 
of underlying importance is the loss of the object which 
precedes the outbreak of the illness, and that this does 
not happen in obsessional cases. The obsessional neurotic 
has, it is true, a markedly ambivalent attitude towards his 
object and is afraid of losing it; but he does ultimately 
keep it. The discovery of this difference between the two 
pathological states is of great consequence, as I hope will 
become plain in the course of my study. In the second 
place, Freud has recently given a more definite direction to 
our investigation of states of manic exaltation. 1 It will 
become clear to the reader presently what an advance his 
theories represent over my first uncertain attempts in 1911. 

In 1920 I was invited to read a paper on the manic- 
depressive psychoses at the Sixth Psycho-Analytical Con- 
gress. I was obliged to refuse, since I had no fresh data in 
my possession. Since that time I have had an opportunity 
of making an almost complete analysis of two marked cases 
of circular insanity, and of gaining a brief glimpse into the 
structure of some other cases belonging to this class. The 
results of those analyses confirm in a surprising way Freud's 
view of the structure of melancholic and manic disorders. 
Besides this, they bring forward a number of new points 
which supplement his theory in one or two important 
respects. 

Motives of discretion impose a great deal of reserve 
in the publication of my psycho-analytical material. They 
prevent me, in especial, from giving a consecutive case- 
history of the two cases which I analysed thoroughly, and I 
can only bring forward short extracts from each. In order 
to preclude the possibility of a mistaken diagnosis I may say 

1 Cf. Group Psychology and the Analysis of the Ego (1921). 



1924 DEVELOPMENT OF THE LIBIDO 421 

at once that both my patients had repeatedly been put in 
asylums or sanatoriums where they were under the observa- 
tion of able psychiatrists, and that they had been examined 
by eminent mental specialists. The clinical picture was 
absolutely typical and the circular course of the illness quite 
characteristic in both cases, so that in point of fact there 
was never any doubt about the diagnosis. 

In one respect my data is insufficient; and I point this 
fact out at once, although I do not myself attribute very 
great importance to it. All the manic-depressive patients 
I have treated, including the two recent cases I analysed 
completely, were male. I have only had the opportunity of 
making cursory psycho-analytical observations of female 
patients of this class, except for a quite recent case in whose 
analysis I am still engaged. 

But I do not think it likely that an analysis of female 
patients would lead to any fundamentally different con- 
clusions, especially when we consider that the patients of 
both sexes exhibit an extremely marked bisexuality in their 
symptoms, so that they doubtless have many points of 
similarity. 

At the time when I read a part of this publication before 
the Seventh Psycho-Analytical Congress, 1 the interest felt 
in the subject was clearly shown by the fact that many of 
the other papers read there dealt with the same questions 
and arrived at conclusions strikingly similar to mine, 
although they approached the matter from quite a different 
standpoint. In especial I may mention the important 
contribution made by Roheim 2 in which he added a great 
deal to our knowledge of the psychology of cannibalism. 

In the first part of this book I shall briefly examine 
certain problems concerning manic-depressive states in 
particular the problem of the patient's relation to his love- 
object during his states of depression and mania and during 
his 'free interval'. In the second part I shall treat those 
problems in a broader way and shall consider the subject of 
the development of the libido as a whole. 



1 Held in Berlin in 1922^. 
2 ' Nach dem Tode des Urvaters ' (19*3)- 



422 SELECTED PAPERS OF KARL ABRAHAM XXVI 



MELANCHOLIA AND OBSESSIONAL NEUROSIS: 

Two STAGES OF THE SADISTIC-ANAL PHASE OF 
THE LIBIDO 

In setting out to examine the mental disorder called 
melancholia we shall still do well to compare it with the 
obsessional neuroses, since this affection, closely related to 
melancholia in its psychology, has to some extent been 
robbed of its mystery by psycho-analysis. 

As early as 191 1, in mentioning the similarities between 
the two illnesses, both as regards their clinical picture and 
their structure, I pointed out that obsessional symptoms 
were very frequently present in cases of melancholia and 
that obsessional neurotics were subject to states of depres- 
sion. I went on to say that in both kinds of illness a 
high degree of ambivalence was to be found in the patient's 
instinctual life; and that this was most clearly seen in 
the want of adjustment between his emotions of love and 
of hate, and between his homosexual and heterosexual 
tendencies. 

More recent researches have led me to the view that 
obsessional neurosis and melancholia resemble one another 
not only in their acute symptoms, but also have important 
points in common during their periods of quiescence. 
And therefore in my present study on melancholia I propose 
to take as my starting-point not the complete clinical picture, 
but the so-called * free interval ' which is interposed between 
two periods of illness. 

From the point of view of the clinical observer manic- 
depressive states run an intermittent course, whereas 
obsessional states are on the whole chronic in character. 
Nevertheless, the latter do show a clear tendency to have 
considerable remissions. Indeed, in some obsessional cases 
the illness comes on in acute attacks which are very similar 
to the periodic outbreaks of the illness in melancholia. 
Careful observation spread over a long period of time shows 



DEVELOPMENT OF THE LIBIDO 423 

us that here, as in so many other cases, the one condition 
shades off into the other, whereas at first we only saw an 
absolute cleavage between the two. 

This view receives fresh confirmation as we advance 
deeper in our psychological inquiry. For we find that the 
patient who is liable to periodic fits of depression and exalta- 
tion is not really perfectly well during his * free interval '. 
If we merely question such patients rather closely we 
learn that during long intervals of this kind they pass 
through depressive or hypo-manic states of mind from time 
to time. But what is specially interesting to the analyst is 
the fact that in all cycloid illnesses the patient is found to 
s have an abnormal character-formation during his ' free 
interval ' ; and that this character-formation coincides in a 
quite unmistakable way with that of the obsessional neurotic. 
As far as my experience goes, at any rate, it does not seem 
possible to make a hard and fast distinction between the 
melancholic character and the so-called * obsessional 
character '. In their * free interval ' patients suffering 
from circular insanity exhibit the same characteristics as 
psycho-analysis has made us acquainted with in the ob- 
sessional neuroses the same peculiarities in regard to 
cleanliness and order; the same tendency to take up an 
obstinate and defiant attitude alternating with exaggerated 
docility and an excess of ' goodness ' ; the same abnor- 
malities of behaviour in relation to money and possessions. 
These character-traits furnish important evidence that these 
two pathological conditions have a close psychological rela- 
tionship with one and the same pre-genital phase of the 
libido. If we assume the existence of such an extensive 
agreement in the characterological constitution of persons 
who incline to melancholia and of those who incline to an 
obsessional neurosis, it is quite incomprehensible to us why 
an illness which takes its inception from the same character- 
formation should be now of the one type, now of the other. 
It is true that we have come to the conclusion that in 
melancholia the patient gives up his psycho-sexual relations 
to his object, whereas the obsessional neurotic does in the 
end manage to escape that fate. But we are then faced 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

with the prpblem why the object-relation is so much more 
labile in the one class of patients than in the other. 

According to the psycho-analytic view, the fixation 
points that have been formed in the course of the develop- 
ment of the libido will determine to what level of organiza- 
tion the libido of the individual will advance, and to what 
level it will retreat in the event of a neurotic illness. And 
the same is true of the relation of the individual to the outer 
world: inhibitions in development and regressive pro- 
cesses are always found to be determined by earlier fixations 
in the sphere of the libido. Now in spite of their common 
relation to the anal-sadistic organization of the libido, melan- 
cholia and obsessional neurosis exhibit certain fundamental 
differences not only in respect of the phase to which the 
libido regresses at the onset of the illness, but also in respect 
of the attitude of the individual to his object, since the 
melancholiac gives it up, while the obsessional patient retains 
it. If, therefore, it appears that such widely divergent 
pathological processes can take their inception from the 
sadistic-anal stage, it follows that this stage contains hetero- 
geneous elements which we have not been able to separate out 
hitherto. In other words, our knowledge of this stage of 
libidinal development must be insufficient. And moreover, 
other considerations give us good reason for believing that 
this is in fact the case. 

Up till now we have been acquainted with three stages 
in the development of the libido, in each of which we 
were able to observe that one particular erotogenic zone was 
of preponderant importance. These erotogenic zones are, 
in order of time, the oral, the anal, and the genital. We 
found that the libidinal excitations belonging to anal 
erotism had close and manifold connections in that stage 
with sadistic impulses. I have already once pointed out 
in an earlier paper, 1 that since Freud's discovery our 
clinical observation has confirmed over and over again the 
close relationship that exists between these two instinctual 
spheres; and yet we have never inquired into the origin of 
that especial relationship. We have learnt from the psycho- 

1 See Chapter XXIII. 



DEVELOPMENT OF THE LIBIDO 425 

analysis of neurotic patients that excretory processes are 
employed for sadistic purposes, and have found this fact 
confirmed by observation of the psychology of children. 
We have also seen that a single character-trait defiance, 
for instance proceeds from sadistic as well as from anal 
sources. But these observations and others like them have 
not enabled us to understand the reason of that combination 
of sadistic and anal activities. 

We can get a step nearer to the solution of the problem 
if we take into consideration another piece of well-ascer- 
tained psycho-analytic knowledge which I have discussed 
in my above-mentioned paper. 1 This is, that a complete 
capacity for love is only achieved when the libido has reached 
its genital stage. Thus we have on the one hand anal 
erotic processes combined with sadistic behaviour, in especial 
with unkind and hostile emotions which are destructive 
to their object; and on the other, a genital erotism 
combined with tendencies which are friendly to their 
object. 

But this comparison only serves, as I have said, to bring 
us a step nearer to our problem, which remains unanswered 
so long as we do not know why, at a certain level of 
development, the sadistic impulses exhibit a special affinity 
precisely for anal erotism and not, for instance, for oral or 
genital erotism. Here again the empirical data of psycho- 
analysis may be of use to us. For they show us 

1. That anal erotism contains two opposite pleasurable 
tendencies. 

2. That similarly two opposite tendencies exist in the 
field of sadistic impulses. 

The evacuation of the bowels calls forth a pleasurable 
excitation of the anal zone. To this primitive form of 
pleasurable experience there is presently added another, 
based on a reverse process the retention of the faeces. 

Psycho-analytic experience has shown beyond a doubt 
that in the middle stage of his libidinal development the 
individual regards the person who is the object of his desire 
as something over which he exercises ownership, and that 

1 Chapter XXIII. 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

he consequently treats that person in the same way as he 
does his earliest piece of private property, i.e. the contents 
of his body, his faeces. 1 Whereas on the genital level 
' love ' means the transference of his positive feeling on 
to the object and involves a psycho-sexual adaptation to 
that object, on the level below it means that he treats 
his object as though it belonged to him. And since t;he 
ambivalence of feelings still exists in full force on this 
inferior level, he expresses his positive attitude towards 
his object in the form of retaining his property, and his 
negative attitude in the form of rejecting it. Thus when 
the obsessional neurotic is threatened with the loss of his 
object, and when the melancholiac actually does lose his, it 
signifies to the unconscious mind of each an expulsion of 
that object in the sense of a physical expulsion of faeces. 

I assume that every psycho-analyst will be able to 
confirm this parallel from his own observation. In my 
above-mentioned paper 2 I have discussed it in greater 
detail. I should only like to draw attention in this place 
to the fact that many neurotic persons react in an anal way 
to every loss, whether it is the death of a person or the loss 
of a material object. They will react with constipation or 
diarrhoea according as the loss is viewed by their unconscious 
mind whose attitude, in agreement with the ambivalence 
of their emotional life, is itself naturally a variable one. 
Their unconscious denies or affirms the loss by means of 
the ' organ-speech ' with which we are familiar. News of 
the death of a near relative will often set up in a person a 
violent pressure in his bowels as if the whole of his intestines 
were being expelled, or as if something was being torn 
away inside him and was going to come out through his 
anus. Without forgetting that a reaction like this is over- 
determined, I should like in this place to single out this 
one cause with which we are concerned. We must regard 
the reaction as an archaic form of mourning which has 
been conserved in the unconscious; and we can set it side 
by side with a primitive ritual, described by R6heim, 3 in 

1 Cf. Chapter XXIII. 2 Chapter XXIII. 

8 ' Nach dem Tode des Urvaters * (1923). 



1924 DEVELOPMENT OF THE LIBIDO 427 

which the relatives of the deceased man defaecate on his 
new-made grave. 

It is worth noting that certain forms of speech still 
preserve distinct traces of this parallel between losing 
something and emptying the bowels. For instance, the 
excrement of animals is called 'Losung' 1 in German, and 
the connection between this word and * los ' 2 and the 
English word * lose ' is evident. 

As an illustration I should like to relate the following 
curious ceremonial performed by a neurotic woman. (I 
have already quoted this example in my above-mentioned 
paper.) This woman, who presented anal character-traits 
of an extreme kind, was as a rule unable to throw away 
disused objects. Nevertheless she felt impelled from time 
to time to get 'rid of one or other of them. And so she had 
invented a way of cheating herself, as it were. She used 
to go out into the wood close by, and before she left the 
house she would take the object that was to be thrown 
away an old garment, for instance and tuck a corner of 
it under her petticoat strings behind. Then she would 
4 lose ' the thing on her walk in the wood. She would 
come home by another way so as not to come across it again. 
Thus in order to be able to give up the possession of an 
object she had to let it drop from the back of her body. 

Moreover, nothing is so eloquent in confirmation 
of our view as the utterances of children. A small 
Hungarian boy, whose family lived in Buda-Pesth, once 
threatened his nurse with these words : ' If you make me 
angry Pll ka-ka you across to Ofen ' (a district on the other 
side of the Danube). According to the child's view the 
way to get rid of a person one no longer liked was by means 
of defaecation. 

This primitive idea that removing an object or losing 
it is equivalent to defaecation has become remote to us 
grown-up people; so remote, indeed, that it is only through 
a laborious process of psycho-analytic investigation that 

1 [' What has dropped off'. Cf. the English word c droppings \~-Trans.] 
3 [As a suffix= * without '. ' Einem loswerden '=' to be rid of someone '. 
Trans.} 



428 SELECTED PAPERS OF KARL ABRAHAM XXVI 

we have been able to recover those traces of primitive 
thought and even so the discovery is received by most 
people with an incredulous shake of the head. Neverthe- 
less, certain psychological products, such as myths, folk- 
lore, and usages of speech, enable us to recognize that this 
habit of thought is the common property of the unconscious 
mind. Let me only mention one very general expression 
used by students at the German universities. If a student 
has been excluded by his comrades from all their official 
occasions on account of some misdemeanour, that is, if he 
has been more or less excommunicated, it is commonly said 
of him that * Er gerat in Verschiss V Here the expulsion 
of a person is quite openly compared to the physical 
expulsion of stool. 

The component instinct of sadism, as it exists in the 
infantile libido, also shows us two opposite pleasurable 
tendencies at work. One of these tendencies is to destroy 
the object (or the external world); the other is to control it. 
' I shall later try to show in detail that the tendency to spare 
the object and to preserve it has grown out of the more 
primitive, destructive tendency by a process of repression. 
For the present I shall speak of this process quite in general ; 
but I should like to say at once that psycho-analysis has 
given us a perfectly sound knowledge of these stages and 
the succeeding ones in the development of object-love. 
For the moment we will confine our interest to that sadistic 
instinct which threatens the existence of its object. And we 
see that the removal or loss of an object can be regarded 
by the unconscious either as a sadistic process of destruction 
or as an anal one of expulsion. 

It is worth noticing in this connection that different 
languages express the idea of losing something in two 
different ways, in agreement with the psycho-analytic view 
put forward. The German word * verlieren ', the English 
* to lose ', and the Latin * amtttere ', correspond to the anal 
idea of letting something go; whereas ' a7ro\\vvai, ' in 
Greek, * perdere ' in late Latin, and ' perdre ' in French, 

1 [* He has been sent to Coventry.' * Verse hiss ' (literally ' excrement ') 
instead of ' Verruf* (' bad repute '). Trans.] 



1924 DEVELOPMENT OF THE LIBIDO 429 

signify to ruin or destroy a thing. We may also bear in 
mind Freud's analytic interpretation of losing things as an 
unconsciously motivated tendency to put the object out 
of the way. His interpretation is well confirmed by those 
languages which directly identify losing a thing with 
destroying it. 

Again, certain forms of speech show how closely are 
united in the unconscious mind anal and sadistic tendencies 
to abolish an object. The most widely different languages 
tend to express only by indirect allusion or metaphor 
behaviour which is based on sadistic impulses. But those 
metaphors are derived from activities which psycho- 
analytic experience has taught us to trace back to anal 
erotic and coprophilic instincts. A good example of this 
is to be found in the military reports and despatches which 
appeared on both sides during the late war. In them 
places were * gesaubert ' (' cleaned ') of the enemy, trenches 
were ' aufgeraumt ' (* cleared out ') ; in the French accounts 
the word used was ' nettoyer ' (' to clean '), and in the 
English, ' cleaning up ' or ' mopping up ' was the expression. 

The analysis of neurotic patients has taught us that 
the second, conserving set of tendencies that spring from 
anal and sadistic sources tendencies to retain and to 
control the object combine in many ways and reinforce 
one another. And in the same way there is a close alliance 
between the destructive tendencies coming from those two 
sources tendencies to expel and to destroy the object. 
The way in which these latter tendencies co-operate will 
become especially clear in the psychology of states of 
melancholia. And we shall enter into this point in greater 
detail later on. 

What I should like to do in this place is to discuss 
briefly the convergent action of anal and sadistic instincts 
in the obsessional character. We have hitherto accounted 
for the excessive love of cleanliness shown by such characters 
as being a reaction formation against coprophilic tendencies, 
and for their marked love of order as a repressed or sub- 
limated anal erotic instinct. This view, though correct 
and supported by a great mass of empirical data, is in some 



43O SELECTED PAPERS OF KARL ABRAHAM XXVI 

ways one-sided. It does not take sufficiently into considera- 
tion the over-determination of psychological phenomena. 

For we are able to detect in our patients' compulsive 
love of order and cleanliness the co-operation of sublimated 
sadistic instincts as well. In my above-mentioned essay 
I have adduced examples to show that compulsive orderli- 
ness is at the same time an expression of the patient's 
desire for domination. He exerts power over things. 
He forces them into a rigid and pedantic system. And it 
not seldom happens that he makes people themselves enter 
into a system of this kind. We have only to think of 
the compulsion for cleaning everything from which some 
housewives suffer. They very often behave in such a way 
that nothing and no one is left in peace. They turn the 
whole house upside down and compel other persons to 
submit to their pathological impulses. In extreme cases 
of an obsessional character, as it is met with in housewife's 
neurosis and in neurotic exaggerations of the bureaucratic 
mind, this craving for domination becomes quite un- 
mistakable. Or again, we need only think of the sadistic 
elements that go to make up the well-known anal character- 
trait of obstinacy to realize how anal and sadistic instinctual 
forces act together. 

In order to be able to understand more clearly what 
takes place at the time of the onset of an obsessional 
neurosis or of melancholia, we must once more turn our 
attention to those periods of the patient's life which are 
relatively free from symptoms. The ' remission ' of the 
obsessional patient and the * interval ' of the manic- 
depressive appear as periods in which his anal and sadistic 
instincts have been successfully sublimated. As soon as 
something special occurs to threaten the * loss ' of their 
object in the sense already used, both classes of neurotics 
react with great violence. The patient summons up the 
whole energy of his positive libidinal fixations to combat 
the danger that the current of feeling hostile to 'his object 
will grow too strong. If the conserving tendencies those 
of retaining and controlling his object are the more 
powerful, this conflict around the love-object will call forth 



DEVELOPMENT OF THE LIBIDO 431 

phenomena of psychological compulsion. But if the 
opposing sadistic-anal tendencies are victorious those 
which aim at destroying and expelling the object then 
the patient will fall into a state of melancholic depression. 

We shall not be surprised to find that obsessional 
symptoms make their appearance in a melancholia and 
that states of depression occur in an obsessional neurosis. 
'In cases of this sort the destructive or the conserving 
tendency, as the case may be, has not been able to carry 
.the day completely. As a rule, however, either the one 
or the other the tendency to manic-depressive symptoms 
or the tendency to show signs of obsessional behaviour 
occupies the foreground of the clinical picture. But we 
are not yet in a position to get a deeper insight into the 
causes of this interplay of the two sets of symptoms. 

Psycho-analytic experience and the direct observation 
of children have established the fact that that set of instincts 
which aims at the destruction and expulsion of the object is 
ontogenetically the elder of the two. In the normal develop- 
ment of his psycho-sexual life the individual ends by being 
capable of loving his object. But the road which he 
traverses, beginning from the auto-erotism of his infancy 
and ending with a complete object-love, still needs to be 
studied more exactly. But this much may be said to be 
certain : the child's libido is without an object (auto-erotic) 
to begin with. Later, it takes its ego as its first object; and 
not till after that does it turn towards external objects. But 
even then it retains the quality of ambivalence for some 
time ; and it is only at a relatively late period of his childhood 
that the individual is capable of having a completely friendly 
attitude towards his object. 

When we compare the course taken by the libido in 
obsessional neurosis and in melancholia, we can see at once 
that in the obsessional neurotic, in spite of the insecurity of 
his relations to his object, it has never deviated so far in a 
regressive direction from the normal goal of its development 
as it has in the case of the melancholiac. For at the onset of 
his illness the depressive patient has completely broken off 
all object-relations. 



43^ SELECTED PAPERS OF KARL ABRAHAM XXVI 

Psychoanalytic experience has already obliged us to 
assert the existence of a pre-genital, anal-sadistic stage of 
libidinal development; and we now find ourselves led to 
assume that that stage includes two different levels within it- 
self. On the later level the conserving tendencies of retaining 
and controlling the object predominate, whereas on the 
earlier level those hostile to their object those of destroying 
and losing it come to the fore. The obsessional neurotic 
regresses to the later of these two levels, and so he is able 
to maintain contact with his object. During his quiet 
periods of remission he is able to a great extent to sublimate 
his sadistic and anal impulses so that his relation to the 
external world may even appear normal to the ordinary eye. 
The same thing may happen in melancholia. Even clinical 
psychiatry admits that a melancholic may get ' well ', i.e. 
recover his mental health. For during the period when his 
symptoms are absent the manic-depressive patient can trans- 
form his instincts in the same way as the obsessional neurotic. 
But as soon as his ego enters into an acute conflict with his 
love-object he gives up his relation to that object. And 
now it becomes evident that the whole of his sublimations 
and reaction-formations which are so similar to those of the 
* obsessional character ' are derived from the lower level of 
the anal-sadistic stage of his libidinal development. 

This differentiation of the anal-sadistic stage into a 
primitive and a later phase seems to be of radical importance. 
For at the dividing line between those two phases there 
takes place a decisive change in the attitude of the indi- 
vidual to the external world. Indeed, we may say that this 
dividing line is where ' object-love ' in the narrower sense 
begins, for it is at this point that the tendency to preserve 
the object begins to predominate. 

Nor is such a differentiation of merely theoretical 
interest. It not only serves to give us a clear picture of a 
particular period of the child's psycho-sexual development; 
it also assists us in getting a deeper insight into the regressive 
movement of the libido in the psycho-neuroses. We shall see 
later that the process of regression in melancholia does not 
stop at the earlier level of the anal-sadistic stage, but goes 



*9 2 4 DEVELOPMENT OF THE LIBIDO 433 

steadily back towards still more primitive organizations of 
the libido. It thus appears as though when once the dividing 
line between the two anal-sadistic phases has been crossed 
in a regressive direction the effects are especially unfavour- 
able. Once the libido has relinquished its object-relations 
it seems to glide rapidly downwards from one level to 
the next. 

In regarding this dividing line as extremely important 
we find ourselves in agreement with the ordinary medical 
view. For the division that we psycho-analysts have 
made on the strength of empirical data coincides in fact 
with the classification into neurosis and psychosis made 
by clinical medicine. But analysts, of course, would not 
attempt to make a rigid separation between neurotic and 
psychotic affections. They are, on the contrary, aware that 
the libido of any individual may regress beyond this dividing 
line between the two anal-sadistic phases, given a suitable 
exciting cause of illness, and given certain points of fixation 
in his libidinal development which facilitate a regression of 
this nature. 



ii 

OBJECT-LOSS AND INTROJECTION IN NORMAL MOURNING 
AND IN ABNORMAL STATES OF MIND 

Having taken as the starting-point of our investigations 
the * free interval ' in periodical depressive and manic states, 
we may now proceed to inquire into the event which 
ushers in the actual melancholic, illness that event which 
Freud has called the * loss of object* and into the process, 
so closely allied to it, of the introjection of the lost love- 
object. 

In his paper, * Mourning and Melancholia ', Freud 
described in general outlines the psychosexual processes 
that take place in the melancholic. He was able to obtain 
an intuitive idea of them from the occasional treatment of 
depressive patients; but not very much clinical material has 

2 E 



434 SELECTED PAPERS OF KARL ABRAHAM XXVI 

been published up till now in the literature of psycho- 
analysis in support of this theory. The material which I 
shall bring forward in this connection is, however, intended 
not merely to illustrate that theory but to prepare the way 
for a systematic inquiry into the pathological processes of 
melancholia and into the phenomena of mourning. As we 
shall see, the psychology of melancholia and of mourning 
are not as yet sufficiently understood. 1 

Now and then we come across cases of marked melan- 
cholic depression where the processes of object-loss and 
introjection can be recognized without making any psycho- 
analysis. But we must not forget that this would not have 
been possible if Freud had not drawn our attention to the 
general features of the psychological situation. 

Dr. Elekes of Klausenburg has recently communicated 
to me the following peculiarly instructive case from his 
psychiatric practice in an asylum. A female patient was 
brought to the asylum on account of a melancholic depression. 
She repeatedly accused herself of being a thief. In reality 
she had never stolen anything. But her father, with whom 
she lived, and to whom she clung with all an unmarried 
daughter's love, had been arrested a short while before for a 
theft. This event, which not only removed her father from 
her in the literal meaning of the word but also called forth 
a profound psychological reaction in the sense of estranging 
her from him, was the beginning of her attack of melancholia. 
The loss of the loved person was immediately succeeded by 
an act of introjection; and now it was the patient herself 
who had committed the theft. This instance once more 
bears out Freud's view that the self-reproaches of melan- 
cholia are in reality reproaches directed against the loved 
person. 

It is easy enough to see in certain cases that object-loss 
and introjection have taken place. But we must remember 
that our knowledge of these facts is purely superficial, for 
we can give no explanation of them whatever. It is only 

1 Medical discretion forbids me to give in full the analytic material of cases 
at my disposal. I must therefore confine myself to the reproduction of instructive 
extracts from various cases. This method has the advantage of making the material 
less difficult to survey. 



DEVELOPMENT OF THE LIBIDO 435 

by means of a regular psycho-analysis that we are able to 
perceive that there is a relationship between object-loss and 
tendencies, based on the earlier phase of the anal-sadistic 
stage, to lose and destroy things ; and that the process of 
introjection has the character of a physical incorporation by 
way of the mouth. Furthermore, a superficial view of this 
sort misses the whole of the ambivalence conflict that is 
inherent in melancholia. The material which I shall bring 
forward in these pages will, I hope, help to some extent to 
fill in this gap in our knowledge. I should like to point 
out at once, however, that our knowledge of what takes 
place in normal mourning is equally superficial; for psycho- 
analysis has thrown no light on that mental state in healthy 
people and in cases of transference-neurosis. True, Freud 
has made the very significant observation that the serious 
conflict of ambivalent feelings from which the melancholiac 
suffers is absent in the normal person. But how exactly 
the process of mourning is effected in the normal mind we 
do not at present know. Quite recently, however, I have 
had a case of this sort which has at last enabled me to gain 
some knowledge of this- till now obscure subject, and which 
shows that in the normal process of mourning, too, the 
person reacts to a real object-loss by effecting a temporary 
introjection of the loved person. The case was as follows: l 

The wife of one of my analyzands became very seriously 
ill while he was still under treatment. She was expecting 
her first child. At last it became necessary to put an end 
to her pregnancy by a Caesarian section. My analyzand 
was hurriedly called to her bedside and arrived after the 
operation had been performed. But neither his wife nor the 
prematurely born child could be saved. After some time 
the husband came back to me and continued his treatment. 
His analysis, and in especial a dream he had shortly after 
its resumption, made it quite evident that he had reacted 
to his painful loss with an act of introjection of an oral- 
cannibalistic character. 

One of the most striking mental phenomena exhibited 

1 The person concerned has authorized me to make use of this observation in 
view of its scientific value. 



43^ SELECTED PAPERS OF KARL ABRAHAM XXVI 

by him at this time was a dislike of eating, which lasted for 
weeks. This feature was in marked contrast to his usual 
habits, and was reminiscent of the refusal to take nourish- 
ment met with in melancholiacs. One day his disinclination 
for food disappeared, and he ate a good meal in the evening. 
That night he had a dream in which he was present at the 
post-mortem on his late wife. The dream was divided into 
two contrasting scenes. In the one, the separate parts of 
the body grew together again, the dead woman began to 
show signs of life, and he embraced her with feelings of the 
liveliest joy. In the other scene the dissecting-room altered 
its appearance, and the dreamer was reminded of slaughtered 
animals in a butcher's shop. 

The scene of the dissection, twice presented in the dream, 
was associated with his wife's operation (sectio Caesaris). 
In the one part it turned into the re-animation of the dead 
body; in the other it was connected with cannibalistic ideas. 
The dreamer's association to the dream in analysis brought 
out the remarkable fact that the sight of the dissected body 
reminded him of his meal of the evening before, and especially 
of a meat dish he had eaten. 

We see here, therefore, that a single event has had two 
different sequels in the dream, set side by side with one 
another, as is so often the case when a parallel has to be 
expressed. Consuming the flesh of the dead wife is made 
equivalent to restoring her to life. Now Freud has shown 
that by introjecting the lost object the melancholiac does 
indeed recall it to life: he sets it up in his ego. In the 
present case the widowed man had abandoned himself to 
his grief for a certain period of time as though there were no 
possible escape from it. His disinclination for food was in 
part a playing with his own death; it seemed to imply that 
now that the object of his love was dead life had no more 
attraction for him. He then began to work off the traumatic 
effect of his loss by means of an unconscious process of 
introjection of the loved object. While this was going on 
he was once more able to take nourishment, and at the 
same time his dream announced the fact that the work of 
mourning had succeeded. The process of mourning thus 



1924 DEVELOPMENT OF THE LIBIDO 437 

brings with it the consolation: ' My loved object is not 
gone, for now I carry it within myself and can never 
lose it '. 

This psychological process is, we see, identical with 
what occurs in melancholia. I shall try to make it clear 
later on that melancholia is an archaic form of mourning. 
But the instance given above leads us to the conclusion that 
the work of mourning in the healthy individual also assumes 
an archaic form in the lower strata of his mind. 

At the time of writing I find that the fact that intro- 
jection takes place in normal mourning has already come 
near discovery from another quarter. Groddeck l cites the 
case of a patient whose hair went grey at the time of his 
father's death, and he attributes it to an unconscious 
tendency on the part of the patient to become like his father, 
and thus as it were to absorb him in himself and to take his 
place with his mother. 

And here I find myself obliged to contribute an experi- 
ence out of my own life. When Freud published his 
' Mourning and Melancholia ', so often quoted in these 
pages, I noticed that I felt a quite unaccustomed difficulty 
in following his train of thought. I was aware of an inclina- 
tion to reject the idea of an introjection of the loved object. 
I combated this feeling in myself, thinking that the fact that 
the genius of Freud had made a discovery in a field of 
interest so much my own had called forth in me an affective 
' no '. It was not till later that I realized that this obvious 
motive was only of secondary importance compared with 
another. The facts were these : 

Towards the end of the previous year my father had 
died. During the period of mourning which I went through 
certain things occurred which I was not at the time able to 
recognize as the consequence of a process of introjection. 
The most striking event was that my hair rapidly turned 
very grey and then went black again in a few months' time. 
At the time I attributed this to the emotional crisis I had 
been through. But I am now obliged to accept Groddeck's 
view, quoted above, concerning the deeper connection 

1 In his Buck <vom Es (1923)9 p. 24. 



438 SELECTED PAPERS OF KARL ABRAHAM XXVI 

between my hair turning grey and my state of mourning. 
For I had seen my father for the last time a few months 
before his death, when I was home from the war on a short 
leave. I had found him very much aged and not at all 
strong, and I had especially noticed that his hair and his 
beard were almost white and were longer than usual on 
account of his having been confined to his bed. My 
recollection of my last visit to him was closely associated 
with this impression. Certain other features in the situation, 
which I am unfortunately unable to describe here, lead me 
to attribute my temporary symptom of turning grey to a 
process of introjection. It thus appears that my principal 
motive in being averse to Freud's theory of the pathological 
process of melancholia at first was my own tendency to 
employ the same mechanism during mourning. 

Nevertheless, although introjection occurs in mourning 
in the healthy person and in the neurotic no less than in the 
melancholiac, we must not overlook the important differences 
between the process in the one and in the other. In the 
normal person it is set in motion by real loss (death); and 
its main purpose is to preserve the person's relations to the 
dead object, or what comes to the same thing to com- 
pensate for his loss. Furthermore, his conscious knowledge 
of his loss will never leave the normal person, as it does the 
melancholiac. The process of introjection in the melancholiac, 
moreover, is based on a radical disturbance of his libidinal 
relations to his object. It rests on a severe conflict of ambi- 
valent feelings, from which he can only escape by turning 
against himself the hostility he originally felt towards his 
object. 

Recent observations, those of Freud in the first instance, 
have shown that introjection is a far commoner psychological 
process than has hitherto been supposed. I should like to 
refer in particular to a remark of Freud's l concerning the 
psycho-analysis of homosexuality. 

He expresses the view (though he does not support it 
with any clinical material) that we should be able to trace 
certain cases of homosexuality to the fact that the subject 

1 Cf. his Group Psychology, p. 66. 



DEVELOPMENT OF THE LIBIDO 439 

has introjected the parent of the opposite sex. Thus a 
young man will feel an inclination towards male persons 
because he has assimilated his mother by means of a 
psychological process of incorporation and consequently 
reacts to male objects in the way that she would do. Up 
till now we have been chiefly acquainted with another 
aetiology of homosexuality. The analysis of such cases has 
shown that as a rule the person has had a disappointment 
in his love for his mother and has left her and gone over 
to his father, towards whom he henceforward adopts the 
attitude usually taken by the daughter, identifying himself 
like her with his mother. A short time ago I had a case 
in which I was able to establish the presence of both these 
possible lines of mental development. The patient had a 
bisexual libidinal attitude, but was in a homosexual phase 
at the time he came to me for analysis. Twice before 
once in early childhood and once during puberty he had 
passed through a homosexual phase. It was only the second 
of these that set in with what must be described as a complete 
process of introjection. On that occasion the patient's ego 
was really submerged by the introjected object. I shall give 
a short abstract of his analysis, for it seems to me that the 
material is not only important for an understanding of the 
process of introjection, but also throws light on certain 
phenomena of mania and melancholia. 

The patient was the younger of two children and had 
been a spoilt child in every sense of the word in his infancy. 
His mother had continued to suckle him well on into his 
second year, and even in his third year she still occasionally 
gave way to his desire, vehemently urged, to be fed at the 
breast. She did not wean him till he was three years old. 
At the same time as he was being weaned a process which 
was achieved with great difficulty a succession of events 
took place which robbed the spoilt child all at once of the 
paradise he had lived in. Up till then he had been the 
darling of his parents, of his sister, who was three years his 
senior, and of his nurse. Then his sister died. His mother 
withdrew into an abnormally severe and long period of 
mourning and thus became still more estranged from him 



44O SELECTED PAPERS OF KARL ABRAHAM XXVI 

than the weaning had already made her. The nurse left 
them. His parents could not bear to go on living in the 
same house, where they were constantly being reminded of 
their dead child, and they moved into an hotel and then 
into a new house. This series of events deprived the patient 
of all the things he had hitherto enjoyed in the way of 
maternal solicitude. First his mother had withdrawn the 
breast from him. Then she had shut herself off from 
him psychologically in mourning for her other child. His 
elder sister and his nurse were gone. Finally the house, 
that important symbol of the mother, was given up. It 
is not surprising that the small boy should have turned 
towards his father for love at this point. Besides this, he 
fixed his inclinations on a friendly neighbour, a woman 
who lived near their new house, and he made a great 
show of his preference for her over his mother. The 
splitting up of his libido one part going to his father, 
the other to a woman who was a mother-surrogate had 
already become evident. In the years following this 
period he became attached by a strong erotic interest to 
boys older than himself who resembled his father in their 
physical characteristics. 

In his later childhood, as his father began to give way 
to drink more and more, the boy withdrew his libido from 
him and once more directed it towards his mother. He 
maintained this position for several years. Then his father 
died, and he lived alone with his mother, to whom he was 
devoted. But after a short period of widowhood she married 
again and went travelling with her husband for quite a long 
time. In doing this she had once more repulsed her son's 
love. And at the same time the boy's feelings of hatred 
were aroused against his step-father. 

A new wave of homosexual feeling came over the half- 
grown boy. But this time he was attracted by a different 
type of young man, one which closely resembled that of his 
mother in certain physical qualities. The kind of youth he 
had loved on the first occasion, and the kind he loved now, 
exactly represented the contrast between his father and his 
mother in respect of their determining physical character- 



1924 DEVELOPMENT OF THE LIBIDO 44! 

istics. It must be mentioned that the patient was himself 
entirely of his mother's type. His attitude towards this 
second type of young man for whom he now had a pre- 
ference was, in his own words, tender, loving, and full of 
solicitude, like a mother. 

Several years later the patient's mother died. He was 
with her during her last illness and she died in his arms. 
The very great effect which this experience had on him was 
caused by the fact that in a deeper stratum of his mind 
it represented the complete reversal of that unforgotten 
situation in which he, as an infant, had lain at his mother's 
breast and in her arms. 

No sooner was his mother dead than he hurried back 
to the neighbouring town where he lived. His state of 
feeling, however, was by no means that of a sorrowing son ; 
he felt, on the contrary, elated and blissful. He described 
to me how he was filled with the feeling that now he carried 
his mother safely in himself, his own for ever. The only 
thing that caused him uneasiness was the thought of her 
burial. It was as if he was disturbed by the knowledge 
that her body was still visible and lying in the house she 
had died in. It was not till the funeral was over that he 
could give himself up to the feeling that he possessed his 
mother for evermore. 

If it were possible for me to publish more details from 
the analysis of this patient, I could make this process of 
incorporating the mother still more evident. But enough 
has been said to make its occurrence quite clear. 

In this instance the process of introjecting the loved 
object began when the patient lost his mother through her 
second marriage. He was unable to move his libido away 
on to his father, as he had done in his fourth year; and his 
step-father was not qualified to attach his libido to himself. 
The last object of his infantile love that was left his 
mother was also the first. He strove against this heaviest 
loss that could befall him by employing the mechanism of 
introjection. 

It is astonishing to find that this process of introjection 
should have resulted in such a feeling of happiness, in 



442 SELECTED PAPERS OF KARL ABRAHAM XXVI 

direct contradiction to its effect on the melancholiac upon 
whose mind it weighs so heavily. But our surprise is 
lessened when we recollect Freud's explanation of the 
mechanism of melancholia. We have only to reverse his 
statement that * the shadow of the lost love-object falls 
upon the ego ' and say that in this case it was not the 
shadow but the bright radiance of his loved mother which 
was shed upon her son. In the normal person, too, feelings 
of affection easily oust the hostile ones in regard to an 
object he has (in reality) lost. But it is otherwise in the 
case of the melancholiac. For here we find so strong a 
conflict based on libidinal ambivalence that every feeling 
of love is at once threatened by its opposite emotion. A 
* frustration ', a disappointment from the side of the loved 
object, may at any time let loose a mighty wave of hatred 
which will sweep away his all too weakly-rooted feelings 
of love. Such a removal of the positive libidinal cathexes 
will have a most profound effect: it will lead to the giving 
up of the object. In the above-cited case, which was 
not one of melancholia, however, the loss in reality of the 
object was the primary event, and the alteration in the 
libido only a necessary consequence of it. 



in 

THE PROCESS OF INTROJECTION IN MELANCHOLIA: 
Two STAGES OF THE ORAL PHASE OF THE LIBIDO 

The following particularly instructive example may serve 
as a starting-point for further inquiry into the process of 
introjection. 

The patient in question had already had several typical 
attacks of melancholia when he first came to me, and I 
began his analysis just as he was recovering from an attack 
of this kind. It had been a severe one, and had set in 
under rather curious circumstances. The patient had 
been fond of a young girl for some time back and had 
become engaged to her. Certain events, which I will not 
go into here, had caused his inclinations to give place to a 



I9 2 4 DEVELOPMENT OF THE LIBIDO 443 

violent resistance. It had ended in his turning away 
completely from his love-object whose identification with 
his mother became quite evident in his analysis and 
succumbing to a depressive condition accompanied by 
marked delusions. During his convalescence a rapproche- 
ment took place between him and his fiancee, who had 
remained constant to him in spite of his having left her. 
But after some time he had a brief relapse, the onset and 
termination of which I was able to observe in detail in 
his analysis. 

His resistance to his fiancee re-appeared quite clearly 
during his relapse, and one of the forms it took was the 
following transitory symptom: During the time when his 
state of depression was worse than usual, he had a com- 
pulsion to contract his sphincter ani. This symptom proved 
to be over-determined. What is of most interest here is 
its significance as a convulsive holding fast to the contents 
of the bowels. As we know, such a retention symbolizes 
possession, and is its prototype in the unconscious. Thus 
the patient's transitory symptom stood for a retention, in 
the physical sense, of the object which he was once more 
in danger of losing. It had another determinant which 
I shall briefly notice. This was his passive homo- 
sexual attitude towards his father. Whenever he turned 
away from his mother or from a mother-substitute he was 
in danger of adopting this attitude; and his symptom 
was a defence not only against an object-loss but against a 
move towards homosexuality. 

We have followed Freud in assuming that after he has 
lost his object the melancholiac attempts some kind of 
restitution of it. In paranoia this restitution is achieved 
by the specific mechanism of projection. In melancholia 
the mechanism of introjection is adopted, and the results 
are different. In the case of my patient the transitory 
symptom mentioned above, which was formed at the 
beginning of a brief remission of his illness, was not the 
end of the matter. A few days later he told me, once more 
of his own accord, that he had a fresh symptom which had, 
as it were, stepped into the shoes of the first one. As he 



444 SELECTED PAPERS OF KARL ABRAHAM XXVI 

was walking along the street he had had a compulsive 
phantasy of eating the excrements that were lying about. 
This phantasy turned out to be the expression of a desire 
to take back into his body the love-object which he had 
expelled from it in the form of excrement. We have here, 
therefore, a literal confirmation of our theory that the 
unconscious regards the loss of an object as an anal process, 
and its introjection as an oral one. 

The tendency to coprophagia seems to me to contain 
a symbolism which is typical for melancholia. My own 
observations on a number of cases have always shown that 
the patient makes his love-object the target of rertain 
impulses which correspond to the lower level of hipanal- 
sadistic libidinal development. These are the impulses of 
.expelling (in an anal sense) and of destroying (murdering). 
*The product of such a murder the dead body becomes 
identified with the product of expulsion with excrement. 
We can now understand that the patient's desire to eat 
excrement is a cannibalistic impulse to devour the love- 
object which he has killed. In one of my patients the idea 
of eating excrement was connected with the idea of being 
punished for a great sin. Psychologically speaking, he 
was right. For it was in this way that he had to make up 
for a certain crime whose identity with the deed of Oedipus 
we shall presently learn to understand. 1 I should like in 
this place to mention R6heim's interesting remarks 2 on 
the subject of necrophagia. What he has said makes it 
very probable that in their archaic form mourning rites 
consisted in the eating of the dead person. 

The example given above is unusual in the easy and 
simple way in which it discloses the meaning of melancholic 
symptoms as an expulsion and a re-incorporation of the 
love-object. To show to what a degree these impulses can 
be rendered unrecognizable, I will give a second instance, 
taken from the psycho-analysis of another patient. 

This patient told me one day that he had noticed a 

1 Dr. J. HArnik has pointed out that in Egypt a prayer is often put on grave- 
stones in which the dead man asks that he may be spared the punishment of having 
to eat excrement. Cf. Erman, Religion der Agypter. 

* Communicated to the Psycho-Analytical Congress in 1922. 



DEVELOPMENT OF THE LIBIDO 445 

curious tendency that he had during his states of depression. 
At the beginning of those states he used to go about with 
his head lowered, so that his eyes were fixed on the ground 
rather than on the people about him. He would then 
begin to look with compulsive interest to see whether any 
mother-of-pearl buttons were lying in the street. If he 
found one he would pick it up and put it in his pocket. 
He rationalized this habit by saying that at the beginning 
of his depression he had such a feeling of inferiority that 
he had to feel glad if he even so much as found a button 
in the street; for he did not know whether he would ever 
again be capable of earning enough money to buy the least 
thing for himself. In the wretched condition he was in, 
he said, even those objects which other people left about 
must have a considerable value for him. 

This explanation was contradicted by the fact that he 
passed by other objects, especially buttons made of other 
material, with a certain feeling of contempt. His free 
associations gradually led us to the deeper motives of his 
strange inclination. They showed that he connected the 
mother-of-pearl of which the buttons were made with the 
idea of brightness and cleanness, and then of special worth. 
We had thus arrived at his repressed coprophilic interests. 
I may remind my readers of Ferenczi's excellent paper on 
this subject. 1 In it he shows how the child first takes 
pleasure in substance that is soft and yielding, then in hard 
and granular material, and finally in small, solid objects 
with a clean and shining surface. In the unconscious these 
objects all remain equivalent to excrement. 

The mother-of-pearl buttons stood, then, for excrement. 
Having to pick them up from the road reminds us of the 
obsessional impulse in the case described before, in which 
there was a direct compulsion to pick up excrement from 
the street and eat it. A further point of similarity between 
the two may be noted, namely, that people lose buttons off 
clothes just as they let faeces drop. 2 In both instances, 

1 * On the Ontogenesis of an Interest in Money ' (1914). 

2 Regarding this assimilation of ideas, cf. the case described in Section I. 
of this chapter. 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

therefore, the action is concerned with taking up and 
keeping a lost object. 

In one of his next analytic hours the patient resumed 
this theme and said that what he had told me was 
not the only strange impulse he had had in his states of 
depression. During his first attack of this kind he had 
gone to Professor Y.'s nursing home at X. One day two 
relatives of his had come to take him out for a walk. They 
had shown him the public gardens and buildings and 
other things, but he had been utterly uninterested in them. 
But on his way back he had stopped in front of a shop- 
window in which he saw some pieces of Johannis bread. 1 
He felt a strong desire to buy some of it, and had 
done so. 

The patient at once had an association to this story, 
which was as follows: In the little town in which he 
lived as a child there was a small shop opposite his house. 
The shop was owned by a widow, whose son was a play- 
mate of his. He recollected that this woman used to give 
him Johannis bread. At that time he had already had 
the fateful experience which was the origin of his later 
illness a profound disappointment in his love-relations 
from the side of his mother. In his childhood memories 
this woman across the road was set up as a model and 
contrasted with his ' wicked ' mother. His automatic 
impulse to buy Johannis bread in a shop and to eat it had 
as its immediate significance his desire for maternal love 
and care. That he should have selected precisely Johannis 
bread as a symbol for this was because its long shape and 
brown colour reminded him of faeces. Thus we once more 
meet with the impulse to eat excrement as an expression 
of the desire for a lost love-object. 

The patient had another association that went back to 
his childhood days, A road was being constructed in his 
native town and the workmen had dug up some shells. One 
side of them was covered with earth and looked dirty, but the 
other side glistened like mother-of-pearl. Here again the 
patient's associations took him back to his native place, which 

1 [A fancy bread. Trans.] 



1924 DEVELOPMENT OF THE LIBIDO 447 

he undoubtedly identified with his mother. These shells 
were the precursors of the mother-of-pearl buttons about 
which he had his obsession. The idea of mother-of-pearl 
shells, moreover, proved in analysis to be a means of repre- 
senting his ambivalent attitude towards his mother. The 
word * mother-of-pearl ' expressed his high esteem for his 
mother as a * pearl '. But the smooth, shining surface was 
deceptive the other side was not so beautiful. In likening 
this other side, which was covered with dirt (excrement) to 
his ' wicked ' mother, from whom he had had to withdraw 
his libido, he was abusing her and holding her up to scorn. 1 

The instances given above may suffice for the present. 
They help us to understand psycho-analytically the course 
run by melancholia in its two phases the loss and the 
re-incorporation of the love-object. Each of these phases, 
however, calls for further examination. 

We have already said that the tendency to give up the 
love-object has its source in the fixation of the libido on the 
earlier phase of the anal-sadistic level. But if we find that 
the melancholiac is inclined to give up that position in favour 
of a yet more primitive one, namely, the oral level, then we 
must suppose that there are also certain fixation points in 
his libidinal development which date back to the time when 
his instinctual life was still mainly centred in the oral zone. 
And psycho-analytic observations bear out this supposition 
fully. A few examples may serve as an illustration. 

In dealing with melancholic cases I have repeatedly 
come across strong perverse cravings which consisted in 
using the mouth in place of the genitals. The patients 
satisfied these cravings in part by practising cunnilinctus. 

1 Before leaving this subject I should like to add that the shell is a universal 
female symbol. 

We learn from R6heim that in many places shells are employed as money. 
This use of them is once more connected with them as a symbol of the female 
genitals. It is worth noting that they are never used in this way in the place in 
which they are found. Only shells coming from a distance can be used as money. 
This fact seems to be the expression of a widely extended fear of incest, and parallel 
to the law of exogamy. A woman belonging to the same tribe or a shell found on 
the shore near by both represent the forbidden genitals of the mother. 

Moreover, shells are also likened to excrement, since they are cast up by the sea 
as are sea-amber and other substances. (These notes are taken in part from a 
discussion that took place at a meeting of the Berlin Psycho-Analytical Society.) 



448 SELECTED PAPERS OF KARL ABRAHAM XXVI 

But they chiefly used to indulge in very vivid phantasies 
based on cannibalistic impulses. They used to phantasy 
about biting into every possible part of the body of their 
love-object breast, penis, arm, buttocks, and so on. In 
their free associations they would very frequently have the 
idea of devouring the loved person or of biting pieces off his 
body; or they would occupy themselves with necrophagic 
images. They sometimes produced these various phantasies 
in an uninhibited and infantile way, sometimes concealed 
them behind feelings of disgust and terror. They also often 
exhibited a violent resistance against using their teeth. 
One of them used to speak of a * chewing laziness ' as one 
of the phenomena of his melancholic depression. It even 
appears that the consequent disuse of the teeth can actually 
cause them to become diseased. I showed some years 
ago (in 1917), in cases of melancholia where the patient 
absolutely declines to take nourishment, that his refusal 
represents a self-punishment for his cannibalistic impulses. 
At a recent meeting of the British Psycho-Analytical Society, 
Dr. James Glover spoke about a case of periodic melan- 
cholia which exhibited cannibalistic impulses of this kind; 
and he gave in especial an analytic account of the way in 
which those impulses became transformed into suicidal 
tendencies. 1 

In their pathological symptoms, their phantasies and 
their dreams, melancholic patients supply us with a great 
number and variety of oral-sadistic tendencies both conscious 
and repressed. These tendencies are one of the main 
sources of the mental suffering of depressive patients, 
especially in the case where they are turned against the 
subject's ego in the shape of a tendency to self-punishment. 
It is to be noticed that this situation is in contrast to some 
neurotic conditions of mind in which particular symptoms 
can be seen to be substitutive forms of gratification of the 
oral zone. I have described cases of this type in my paper 

1 One of my patients had made a deep cut in his throat and nearly succeeded 
in killing himself. His attempted suicide was really an attack on his introjected 
love-object, combined with an impulse to punish himself. In his analysis he 
produced phantasies connected with the sacrifice of Isaac, the theme of which is, 
of course, the father at the altar about to slay his own son with his knife. 



1924 DEVELOPMENT OF THE LIBIDO 449 

on the earliest pre-genital level of the libido. 1 And there 
are besides certain perversions in which oral erotism pro- 
vides a considerable amount of pleasure. Even taking 
into account the masochistic pleasure-value of its symptoms, 
we must nevertheless lay stress upon the fact that melan- 
cholia brings with it a very high degree of displeasure com- 
pared to other mental illnesses. If we observe attentively 
the depressive patient's chain of associations we shall dis- 
cover that the excessive amount of displeasure he feels is 
allied to that stage of libidinal development to which he has 
regressed after he has lost his object. For we shall notice 
that he has a peculiar longing to use his mouth in a manner 
quite at variance with the biting and eating phantasies 
mentioned above. I will give an instance. 

At a time when he was recovering from his depression 
a patient told me about his day-dreams. In these he was 
at times impelled to imagine that he had a female body. 
He would employ all sorts of devices to create in himself 
the illusion that he had a woman's breasts, and would take 
special pleasure in the phantasy that he was suckling an 
infant. Although he played the part of the mother in this 
phantasy, he would sometimes exchange his role for that 
of the child at her breast. His fixation on the mother's 
breast found expression in two ways in a great number 
of symptoms connected with the oral zone, and in a very 
marked desire to lean his head against something soft like 
a woman's breast. Thus, for instance, he used to behave 
in a very curious way with the cushion on the sofa during 
analysis. Instead of leaving it where it was and laying his 
head on it, he used to take it up and put it over his face. 
His associations showed that the cushion represented the 
breast being brought close to his head from above. The 
scene with the cushion repeated a pleasurable situation in his 
infancy. He had, moreover, seen his younger brother in 
this position later on and had connected feelings of intense 
jealousy with that spectacle. 

Another melancholic patient I had said that during his 
deepest fits of depression he had the feeling that a woman 

1 Cf. Chapter XII. 

2 F 



45 SELECTED PAPERS OF KARL ABRAHAM XXVI 

might free him from his suffering if she expended on him 
a special maternal love and solicitude. The same type of 
conative idea was present here* I have repeatedly been 
able to analyse the meaning of an idea like this, and I can 
remember a case in point which I described in an earlier 
paper. A young man suffering from depression though 
not a melancholic one used to feel himself almost 
miraculously soothed by drinking a glass of milk which his 
mother handed to him. The milk gave him a sensation 
of something warm, soft, and sweet, and reminded him of 
something he had known long ago. In this instance the 
patient's longing for the breast was unmistakable. 

All my psycho-analytic observations up till now lead me 

to the conclusion that the melancholiac is trying to escape 

j from his oral-sadistic impulses. Beneath these impulses, 

whose manifestations colour the clinical picture, there lurks 

the desire for a pleasurable, sucking activity. 

We are thus obliged to assume that there is a differentia- 
tion within the oral phase of the libido, just as there is within 
the anal-sadistic phase. On the primary level of that phase 
the libido of the infant is attached to the act of sucking. 
This act is one of incorporation, but one which does not put 
an end to the existence of the object. The child is not yet 
able to distinguish between its own self and the external 
object. Ego and object are concepts which are incom- 
patible with that level of development. There is as yet no 
differentiation made between the sucking child and the 
suckling breast. Moreover, the child has as yet neither feel- 
ings of hatred nor of love. Its mental state is consequently 
free from all manifestations of ambivalence in this stage. 

The secondary level of this phase differs from the first 
in that the child exchanges its sucking activity for a biting 
one. In this place I should like to mention a private com- 
munication made to me by van Ophuijsen, which supplies 
an important addition to our knowledge of the mechanism 
of melancholia. 1 Psycho-analytic observation has led him 

1 In the same way, in his paper, ' On the Origin of the Feeling of Persecution * 
(1920), van Ophuijsen has thrown light on the relations of paranoia to the anal- 
sadistic phase. 



IQ24 DEVELOPMENT OF THE LIBIDO 451 

to believe that certain neurotic phenomena are due to a 
regression to the age when the teeth were being formed, 
and furthermore that biting represents the original form 
taken by the sadistic impulses. Undoubtedly the teeth are 
the first instruments with which the child can do damage 
to the outer world. For they are already effective at a 
time when the hands can at most only assist their activity 
by seizing and keeping hold of the object. Federn l has 
derived sadism from genital sensations, and no doubt the 
observations on which he bases his view are correct. Never- 
theless phenomena connected with the genital zone cannot 
be as primary as those connected with the oral zone. The 
fact is, that what we call the sadistic impulses spring from a 
number of different sources, among which we may mention 
in especial the excremental ones. We must also bear in 
mind the close association of sadism with the muscular 
system. But there is no doubt that in small children far 
and away the most powerful muscles of the body are the 
jaw muscles. And, besides, the teeth are the only organs 
they possess that are sufficiently hard to be able to injure 
objects around them, 

In the biting stage of the oral phase the individual in- 
corporates the object in himself and in so doing destroys it. 
One has only to look at children to see how intense the 
impulse to bite is an impulse in which the eating instinct 
and the libido still co-operate. This is the stage in which 
cannibalistic impulses predominate. As soon as the child 
is attracted by an object, it is liable, indeed bound, to 
attempt its destruction. It is in this stage that the ambiva- 
lent attitude of the ego to its object begins to grow up. We 
may say, therefore, that in the child's libidinal development 
the second stage of the oral-sadistic phase marks the begin- 
ning of its ambivalence conflict; whereas the first (sucking) 
stage should still be regarded as pre-ambivalent. 

The libidinal level, therefore, to which the melancholiac 
regresses after the loss of his object contains in itself a 
conflict of ambivalent feelings in its most primitive and 
therefore most unmodified form. On that level the indi- 

1 ' Beitrage zur Analyse des Sadismus und Masochismus ' (1913). 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

vidual threatens to destroy his libidinal object by devour- 
ing it. It is only gradually that the ambivalence conflict 
assumes a milder aspect and that the libido consequently 
adopts a less violent attitude towards its object. Neverthe- 
less this ambivalent attitude remains inherent in the ten- 
dencies of the libido during the subsequent phases of its 
development. We have already discussed its importance 
in the anal-sadistic phase. But even in the structure of 
neuroses based on the genital phase we meet this ambivalence 
everywhere in the patient's emotional life. It is only the 
normal person the person who is relatively far removed 
from the infantile forms of sexuality who is in the main 
without ambivalence. His libido has, as it were, reached a 
post-ambivalent stage and has thus achieved a full capacity 
for adapting itself to the external world. 

It now becomes evident that we ought also to distinguish 
two stages within the genital phase of the libido, just as we 
did within its two pre-genital phases. And this leads us 
to a result which seems to coincide perfectly with Freud's 
recently published view 1 that there exists an early stage of 
the genital phase what he calls a ' phallic ' stage. Thus 
it would seem that the libido passes through six stages 
of development in all. But I should like to state explicitly 
that I do not consider the above classification either as final 
or exhaustive. It only presents a general picture of the 
continuous evolution of the libido in so far as our present- 
day psycho-analytic knowledge has been able to throw light 
on that slow and laborious process. Nevertheless in my 
opinion the transition from the earlier stage to the later 
one within each of the three main developmental phases of 
the libido is by no means a process of minor importance. 
We have long since become acquainted with the significance 
that the change from one preponderating erotogenic zone 
to another has for the normal psychosexual development of 
the individual and for the formation of his character. We 
now see that within each of those three main periods a 
process takes place which is of great importance for the 
gradual attainment by the individual of complete object- 

1 ' The Infantile Genital Organization of the Libido ' (1923). 



DEVELOPMENT OF THE LIBIDO 453 

love. Within the first the oral period, the child ex- 
changes its pre-ambivalent libidinal attitude, which is free 
from conflict, for one which is ambivalent and preponderantly 
hostile towards its object. Within the second the anal- 
sadistic period, the transition from the earlier to the later 
stage means that the individual has begun to spare his 
object from destruction. Finally, within the third the 
genital period, he overcomes his ambivalent attitude and 
his libido attains to its full capacity both from a sexual and 
a social point of view. 

The above account does not by any means cover the 
whole of the changes that take place in the relations between 
the individual and the external world. Those changes will 
have to form the subject of a thorough investigation in a 
later part of my study. 



IV 
NOTES ON THE PSYCHOGENESIS OF MELANCHOLIA 

We are now in a position to understand why it is that 
the ambivalence of his instinctual life involves the melan- 
choliac in quite especially grave conflicts which strike at the 
roots of his relation to his love-objects. The act of turning 
away from that original object round whom his whole 
emotional life revolved does not end there. It extends 
to other people; first to those in his immediate vicinity, 
then to a wider circle, and finally to every human being. 
And the withdrawal of his libido goes even further. It 
affects everything which had formerly interested him. His 
profession, his hobbies, his pursuits, scientific and other- 
wise, the whole field of nature everything has lost its 
attraction for him. We find an equally extensive detach- 
ment of the libido from the external world in another illness, 
namely, dementia praecox or schizophrenia; but in this 
case the individual accepts his complete loss of interest 
with a dull indifference, whereas the melancholiac complains 
of that loss, and indeed tends to connect his feelings of 
inferiority with it. 



454 SELECTED PAPERS OF KARL ABRAHAM XXVI 

When we penetrate more deeply into the mental life of 
the melancholiac, however, we find that that very person 
who, in his state of depression, lamented the loss of all his 
interests, was all along predisposed to such a loss by the 
unusually high degree of ambivalence of his emotional life. 
Long before the first onset of his illness he had been 
carrying on his profession, his mental interests, and so on, 
in a forced and spasmodic manner, and this involved a 
danger that he might suddenly give them up. But these 
are not the only effects of ambivalence in melancholia. 
When the libidinal cathexis has been withdrawn from the 
object, it is directed, as we know, to the ego, while at the 
same time the object is introjected into the ego. The 
ego must now bear all the consequences of this process; 
henceforward it is mercilessly exposed to the ambivalence 
of the libidinal impulses. It is only a superficial observation 
that leads us to believe that the melancholiac is exclusively 
filled with a tormenting self-contempt and a craving to 
belittle himself. An attentive examination will show that 
we may equally truly say the opposite of him. As we shall 
see presently, the interchangeability of depressive and manic 
states in the melancholic patient hinges on this ambivalent 
attitude of his libido towards his ego. At present, however, 
our task is to establish the existence of such an ambivalence 
towards the ego and to show how it manifests itself during 
the depressive phase. It is only in this way that we can 
hope to gain an understanding of the symptoms of 
melancholia. 

As far as I know, orthodox clinical psychiatry has failed 
to notice this important characteristic of melancholia. 
Freud, however, recognized it. 1 Speaking of these patients 
he says : * Moreover, they are far from evincing towards 
those around them the attitude of humility and submission 
that alone would befit such worthless persons; on the 
contrary, they give a great deal of trouble, perpetually 
taking offence and behaving as if they had been treated 
with great injustice ', But, as we shall see, the facts warrant 
us in going even further than this. 

1 ' Mourning and Melancholia ' (1917). 



DEVELOPMENT OF THE LIBIDO 455 

Naturally the characteristics under discussion are much 
more noticeable in some cases than in others. But speaking 
generally we may say that the melancholiac has a feeling of 
superiority which is observable even during his free interval. 
He has this feeling towards his family, his friends, his 
fellow-workers, and the world at large. And the analyst who 
treats him gets a good share of it. One of my patients used 
always to walk into my room with an air of lofty condescension 
in his look and carriage. Patients like these are especially 
fond of displaying a superior scepticism about the dis- 
coveries of psycho-analysis. In another patient this attitude 
used to alternate with an exaggerated attitude of humility. 
In this second state of mind he would, for instance, have the 
phantasy of falling down in front of me, embracing my knees, 
and imploring me to help him. 

We all know how inaccessible melancholic patients are 
to any criticism on the part of the analyst of their ways of 
thought ; and of course their delusional ideas are especially 
resistant to any such interference. A patient once said to 
me that whenever his physician had tried to make him see 
how unfounded his self-reproaches were, he ' had not even 
heard him '. What makes of a phantasy a delusional idea, 
and what prevents that delusion from being open to correc- 
tion, is the purely narcissistic character of the train of thought. 
Besides this, there is another factor which determines the 
behaviour of the melancholiac, and that is his contempt for 
other people who apply the standards of reality to his ideas. 

One of the most marked defects of clinical psychiatry 
is its predilection for characterizing the pathological ideas 
of melancholiacs as ' delusions of inferiority ', when in fact 
those ideas include a great deal of self-appreciation on the 
part of the sufferer, especially in regard to the importance 
and effect of his own thoughts, feelings, and behaviour. 
A good example of this is the idea not uncommonly met 
with in melancholiacs that they are the greatest sinners of all, 
that they are guilty of every sin committed since the begin- 
ning of the world. Every delusion of this kind contains, 
besides the introjected reproach aimed at the love-object, 
a tendency on the part of the melancholiac to represent his 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

feelings of hatred as enormously powerful and himself as a 
monster of wickedness. 

Thus melancholia presents a picture in which there 
stand in immediate juxtaposition yet absolutely opposed to 
one another self-love and self-hatred, an overestimation of 
the ego and an underestimation of it the manifestations, 
that is, of a -positive and a negative narcissism. We have 
already learned to understand in a quite general way this 
striking relation of the libido to the ego. But we must 
now go a step further and look for the factors in the life of 
the melancholiac that have caused so grave a deviation from 
the psychological norm. We must endeavour to ascertain 
how that psychological process which Freud was able to 
discover is actually carried out in the patient's unconscious 
and what were the events which directed his libido into those 
channels. In other words, we must deal with the problem 
of the choice of neurosis, and we have to ask ourselves 
why it is that these persons have not become hysterics or 
obsessional neurotics but manic-depressive patients. To 
expect to find a complete solution of the problem would be 
to under-estimate its difficulty. But we may perhaps hope 
to approach that distant goal a little nearer. 

There can be no doubt that an attack of melancholic 
depression is ushered in by a disappointment in love. In 
analysing patients who have been through several periods of 
depression we find that each fresh attack was immediately 
preceded by an experience of this sort. I need hardly say 
that I do not use the expression * disappointment in love ' 
in the ordinary sense of an unhappy love affair only. The 
events which culminate in the person's loss of object are 
often a great deal more obscure. Only a thorough analysis 
can discover the causal connections between the event and the 
illness. Such an analysis invariably shows that that event had 
a pathogenic effect because the patient was able to regard it 
in his unconscious as a repetition of an original infantile 
traumatic experience and to treat it as such. In no other 
form of neurosis, it seems to me, does the compulsive 
tendency to repeat an experience operate so strongly as in 
manic-depressive illnesses. How powerful this repetition- 



DEVELOPMENT OF THE LIBIDO 457 

compulsion in melancholiacs becomes is evident when we 
consider to what frequent recurrences of their manic- 
depressive states they are exposed. 

It is no part of my intention in this essay, based as it 
is on a very limited number of psycho-analyses, to make a 
general and final pronouncement about the psychogenesis 
of the circular insanities. Nevertheless I believe that the 
material at our disposal does warrant us in making certain 
statements of whose provisional and incomplete character 
I am fully aware. I think it is permissible to point out a 
number of aetiological factors in this disease. But I should 
like to make it quite clear that it is only when those factors 
are all present together that a melancholic depression with 
its specific symptoms will result. Each one taken by itself 
could enter into the aetiology of some other psycho-neurosis. 

The factors are these : 

1. A constitutional factor. In accordance with my 
experience in clinical psychiatry, and more especially in 
psycho-analysis, I should say that there is no direct inheritance 
of a tendency to develop manic-depressive states as such. 
This only happens in a small proportion of melancholic 
cases. Among those of my patients who suffered from 
manic-depressive states according to the strict clinical 
diagnosis I did not have a single one in whose family there 
was another member who was subject to any grave disorder 
of the same kind. On the other hand, neuroses of other 
kinds abounded. I am therefore much more inclined to 
think that what really is constitutional and inherited is an 
over-accentuation of oral erotism, in the same way that in 
certain families anal erotism seems to be a preponderant 
factor from the very beginning. An inherited pre-dis- 
position of this kind would help to bring the next factor into 
operation, namely: 

2. A special fixation of the libido on the oral level. 
People with a constitutional intensification of this sort of 
their oral erotism are very exacting in their demands to 
have their special erotogenic zone gratified, and react with 
great displeasure to every frustration in this connection. 
The excessive pleasure they derive from sucking persists 



458 SELECTED PAPERS OF KARL ABRAHAM XXVI 

in many forms throughout life. They get abnormal pleasure 
from eating, and especially from the use of the jaws. One 
of my patients described to me quite spontaneously what a 
great pleasure he got from opening his mouth wide. Others 
speak of the contraction of the muscles of the jaw as being 
especially pleasurable. People like these are insatiable in 
their demands for exchanges of affection of an oral nature. 
As a child one of my patients had been so vehement 
in this method of demonstrating his love that at last his 
mother had been able to bear it no longer and had checked 
him on the rather ill-chosen pretext that she did not like 
that kind of thing. Shortly after, the child's observant eye 
had caught her exchanging the same tokens of love with his 
father. This observation, together with others, had had 
the effect of arousing and fostering in him an abnormally 
large amount of hostile feeling. Another patient said that 
whenever he thought of his childhood he had a stale kind 
of taste in his mouth that reminded him of a gruel soup 
which he used to be given and which he disliked very much. 
His analysis showed that this sensation was an expression 
of his jealousy of his younger brother, whom he used to see 
being suckled by his mother at a time when he had to drink 
soup and slops. In the depths of his heart he envied his 
brother that intimate relation with his mother which he 
himself no longer enjoyed. In his depressive states he would 
be overcome by longing for his mother's breast, a longing 
that was indescribably powerful and different from anything 
else. If the libido still remains fixated on this point when 
the individual is grown up, then one of the most important 
conditions for the appearance of a melancholic depression 
is fulfilled. 

3. A severe injury to infantile narcissism brought about 
by successive disappointments in love. We are accustomed 
to hear of events in the childhood of the neurotic which 
caused him to be disappointed in his desire for love, although 
of course experiences of this sort are not in themselves 
sufficient to provide the basis for a melancholia. As regards 
this factor several of my melancholic cases disclosed a 
remarkable similarity in the scheme of significant events. 



DEVELOPMENT OF THE LIBIDO 459 

The child had felt that he was his mother's favourite and 
had been secure of her love. He had then suffered a dis- 
appointment at her hands and had with difficulty recovered 
from its shattering effect. Later on, he had had fresh 
experiences of the same sort which had made him feel that 
his loss was an irreparable one, especially as there had been 
no suitable female person on to whom he could carry over his 
libido. Furthermore, his attempt to direct it towards his 
father had failed, either straight away or after some time. 
Thus as a child he had got the impression of being com- 
pletely deserted. And it was this feeling that had given 
rise to his first attacks of depression. A dream-analysis 
which I shall give later on will leave no doubt possible as to 
this. The constantly repeated attempts of the melancholiac 
to gain love from a person of the opposite sex are intimately 
bound up with this early disappointment from both sides. 

4. The occurrence of the first important disappointment 
in love before the Oedipus-wishes have been overcome. It 
has invariably been my experience that the boy is most deeply 
and permanently affected by the great disappointment in 
love which he receives from his mother if it comes at a time 
when his libido has not adequately overcome the narcissistic 
stage. In this stage his incestuous desires have awakened 
and his revolt against his father is in full activity. But the 
repressive forces have as yet gained no control over his 
Oedipus impulses. If the child is suddenly subjected to a 
mental trauma such as we have described just as he is making 
his first important step towards object-love, the consequences 
are especially serious. And since at that date his oral- 
sadistic instincts are still in force, a permanent association 
will be established between his Oedipus complex and the 
cannibalistic stage of his libido. This will facilitate a sub- 
sequent introjection of both his love-objects that is, his 
mother in the first place and in the second place his father. 

5. The repetition of the primary disappointment in 
later life. This is the exciting cause of the onset of a 
melancholic depression. 

We have been led to assume that the psychogenesis of 
melancholia is closely bound up with disappointments in the 



460 SELECTED PAPERS OF KARL ABRAHAM XXVI 

patient's early life or after; and we ought consequently to 
expect to find in him extremely strong hostile feelings 
towards all those persons who have so fatally thwarted his 
narcissistic desire for love. But since all his subsequent 
disappointments derive their importance from being repe- 
titions of his original one, the whole sum of his anger is 
ultimately directed against one single person against the 
person, that is, whom he had been most fond of as a child 
and who had then ceased to occupy this position in his life. 
Freud has already shown that the self-reproaches of the 
melancholiac are in reality aimed at the love-object he 
has relinquished. And we shall therefore be prepared 
to discover that his self-criticisms, and more especially 
his delusions, are complaints directed against that former 
object. 

In this connection we may consider a characteristic of 
melancholia which would seem to put it in a place apart from 
the other neuroses. My analyses showed that the ambivalent 
attitude of the male patients, with its hostile, cannibalistic 
impulses, was mainly directed against the mother, whereas 
we know that in other neurotic conditions the father is 
pre-eminently the object of the patient's hostile tendencies. 
The disappointment which the melancholiac has suffered as 
a child at the hands of his mother while he was still in a 
markedly ambivalent state of feeling has affected him in such 
a permanent way and made him so hostile to her that even 
his hatred and jealousy of his father has become of minor 
importance. In every male melancholiac I have hitherto 
analysed I have been able to satisfy myself that the patient's 
castration complex was quite predominantly connected with 
his mother, whereas in other kinds of patients it is usually 
much more in evidence in relation to the father. Neverthe- 
less I was able to discover that its connection with the 
mother was a secondary one and the result of a tendency to 
invert the Oedipus situation. When thoroughly analysed 
the hostility of the melancholiac towards his mother is seen 
to have roots in the Oedipus complex. In fact, his ambi- 
valence really applies to both parents alike. And his father 
is also the object of a process of introjection. Many 



DEVELOPMENT OF THE LIBIDO 461 

melancholic symptoms, as, for instance, certain self-re- 
proaches, show their original relation to both parents quite 
clearly. What I have just said does not invalidate my 
previous statement that in melancholia the whole psycho- 
logical process centres in the main round the mother; it only 
seeks to emphasize the fact that the process has more than 
one determinant. 

A careful analysis of the self-criticisms and self-re- 
proaches especially those of a delusional nature uttered 
by melancholic patients will show that the process of 
introjection takes two forms: 

1. The patient has introjected his original love-object 
upon which he had built his ego ideal; so that that object 
has taken over the role of conscience for him, although, it is 
true, a pathologically formed one. Our material goes to 
show that the pathological self-criticism of the melancholiac 
emanates from this introjected object. 1 One of my patients 
used to be continually taking himself to task and repeating 
the same reproaches against himself; and in doing this he 
copied exactly the tone of voice and actual expressions that 
he had often heard his mother use when she had scolded him 
as a little boy. 

2. The content of those self-reproaches is ultimately a 
merciless criticism of the introjected object, A patient of 
mine used to pass judgement on himself in the following 
words: ' My whole existence is based on deceit*. This 
reproach turned out to be determined by certain elements 
in the relationship of his mother and father. 

I will give an example to illustrate the way in which 
these two forms of introjection work in with one another. 
The patient I have just spoken about used to say that he was 
utterly incapable and could never lead a useful life. Analysis 
showed that this complaint was an exaggerated criticism 
of his father's quiet and inactive character, in contrast 
to whom his mother was for him the ideal of practical 
efficiency. He felt that he himself took after his father. 

1 Freud's The Ego and the Id appeared shortly after I had written this part of 
my book. In it he gives such a lucid account of the process that I need only refer 
the reader to its pages. To give a r&ume* of it would only be to render it less clear. 



462 SELECTED PAPERS OF KARL ABRAHAM XXVI 

His criticism of himself therefore stood for an unfavourable 
judgement passed by his introjected mother on his intro- 
jected father. We have here a very instructive instance of a 
twofold process of introjection. 

If we take this view we are able to understand another 
symptom this patient had a delusional self-reproach. 
During his last period of depression he had been put in an 
asylum. One day he declared that he had introduced lice 
into the place. He grew more and more agitated and 
bewailed the enormity of his act, saying that he had infected 
the whole house with lice. He tried to demonstrate the 
presence of the lice to the house-physician. He saw them 
in every particle of dust and in every shred of material. 
The analysis of this delusion brought to light the special 
symbolic importance of lice to him. In dream-symbolism 
and all other forms of phantasy small animals represent 
children. A house which is full of lice thus means a house 
(his father's and mother's house) which is full of children. 
As a child the patient had been deprived of his mother's 
love because a great many younger brothers and sisters had 
been born. One of the determinants of his introjected 
complaint had been the thought, ' My wicked mother, who 
once pretended to love me so much, has filled the whole 
house with children '. Furthermore, if we consider that 
the house is a symbol of the mother, we can see that he is 
also blaming his father for having procreated the children. 
Thus in this example also the patient's accusations against 
both his parents have been condensed into a single accusation 
directed against himself. 

I should like to remark in this place that the complaints 
of the melancholiac against his love-object are not all of them 
uttered in this introjected form. Apart from that form, 
which is specific for his illness, he has other means of 
expression at his disposal ; and he makes use of these in his 
free intervals as well. I will give an instance. 

Just before the onset of his first severe depression one 
of my patients was seized with an obsessive interest in 
prostitutes. He used to spend many hours of the night 
watching the women in the streets, but he never entered 



IQ24 DEVELOPMENT OF THE LIBIDO 463 

into closer relations with them. Analysis showed that he 
was repeating in a compulsive way certain observations he 
had made as a child. Prostitutes represented his mother 
in a derogatory sense his mother who had let his father 
understand her sexual desires by means of certain looks and 
gestures. In comparing her to a prostitute he was revenging 
himself for having been disappointed by her. His reproach 
was meant to say, ' You are only a sensual woman, not a 
loving mother'. On the other hand, his nocturnal peram- 
bulation of the streets represented an identification with 
the prostitutes (his mother). Here we have once more the 
mechanism of introjection. 

Another patient depicted his mother as unloving and 
cruel in his phantasies. In this case the patient's association 
of his castration complex with the female that is, with his 
mother was especially noticeable. For instance, in his 
phantasies he likened the vagina to the jaws of a crocodile. 
This was an unambiguous symbol of castration by biting. 

If we want to realize the full strength of the melancholiac's 
hostility towards his mother, and to understand the parti- 
cular character of his castration complex, we must keep in 
mind Starcke's theory that the withdrawal of the mother's 
breast is a * primal castration V As the analysis of many of 
his symptoms shows, the melancholiac wants to revenge 
himself on his mother for this by castrating her in his turn, 
either taking away her breasts or her imaginary penis. In 
his imagination he always chooses biting as the means of 
doing it, as I have already shown in some of the phantasies 
produced by such patients. I should like once more to 
lay stress on the ambivalent character of those phantasies. 
They involve on the one hand a total or partial incorporation 
of the mother, that is, an act of positive desire ; and on the 
other, her castration or death, that is, a negative desire tend- 
ing to her destruction. 

Up till now we have been examining the process of 
introjection and some of its effects, and we may shortly 
sum up our conclusions as follows: When melancholic 
persons suffer an unbearable disappointment from their 

1 'The Castration Complex* (1921). 



464 SELECTED PAPERS OF KARL ABRAHAM XXVI 

love-object they tend to expel that object as though it 
were faeces and to destroy it. They thereupon accomplish 
the act of introjecting and devouring it an act which is a 
specifically melancholic form of narcissistic identification. 
Their sadistic thirst for vengeance now finds its satisfaction 
in tormenting the ego an activity which is in part pleasur- 
^ible. We have reason to suppose that that period of self- 
torment lasts until lapse of time and the gradual appeasement 
of sadistic desires have removed the love-object from the 
danger of being destroyed. When this has happened the 
object can, as it were, come out of its hiding-place in the 
ego. The melancholiac can restore it to its place in the 
outer world. 

It seems to me to be of no little psychological interest 
to be able to establish the fact that in his unconscious the 
melancholiac regards this liberation from his object as once 
more an act of evacuation. During the time when his 
depression was clearly beginning to diminish, one of my 
cases had a dream in which he expelled with the greatest 
sensation of relief a stopper that was sticking in his anus, 1 
This act of expulsion concludes the process of that archaic 
form of mourning which we must consider melancholia to 
be. We may truly say that during the course of an attack 
of melancholia the love-object goes through a process of 
psychological metabolism within the patient. 



THE INFANTILE PROTOTYPE OF MELANCHOLIC 
DEPRESSION 

An examination of the material before us has led us to the 
view that in the last resort melancholic depression is derived 
from disagreeable experiences in the childhood of the patient. 
It is therefore natural that we should be particularly inter- 
ested in the original emotional reactions of the child to such 
traumatic experiences. We may justifiably assume that 
those experiences caused feelings of an unhappy character, 

1 The over-determination of this symbol its passive homosexual significance 
need not occupy us here. 



1924 DEVELOPMENT OF THE LIBIDO 465 

but we have not up till now got any direct idea, any living 
picture, of the child's actual state of mind at the time. 
Owing to special circumstances, as will be seen, I was able 
in one case to get some very instructive information on 
this subject. After going through a depressive attack my 
patient had had a free interval which had lasted some time. 
He had become attached to a young girl, when certain 
events awoke in him the causeless fear that he was once 
more in danger of losing what he loved. At this time he 
dreamt several times about losing a tooth a very obvious 
symbolic occurrence which typified both his fear of castra- 
tion and of an object-loss (evacuation). One night this 
dream was succeeded by another, which I give here: 

' I was in some place with Herr Z.'s wife. In the 
course of the dream I somehow got mixed up in some theft 
of books. The dream was a long one. I remember the 
painful feeling in it better than its content/ 

Herr Z. was an acquaintance of the dreamer and a 
periodic drinker. He caused his wife a great deal of un- 
happiness, and on the day before his dream my patient had 
got to hear of another instance of this. His dream was 
connected with his waking life at this point. Stealing books 
symbolized stealing his mother, whom he thus took away 
from his father who tormented her. But it also represented 
castrating his father. We have here a straightforward 
Oedipus dream, only interesting to us because the theme 
of theft is the active complement to that of the loss of a 
tooth in the first dream of the same night. The importance 
of the dream in the patient's analysis lay not so much in the 
things that happened in it as in the aforesaid feeling which 
accompanied it. For my patient told me that when he had 
woken up it had struck him that that feeling was familiar 
to him. He knew it in connection with a particular dream 
which he had repeatedly dreamt when he was about five 
years old. He said that up till now he had never thought 
of that dream in the whole course of his long analysis. But 
now he remembered it quite plainly, and what he especially 
noticed about it was this dreadful, tormenting feeling which 
his recent dream had also had. He told me it as follows : 

2 G 



466 SELECTED PAPERS OF KARL ABRAHAM XXVI 

* I was standing in front of my parents' house, where I 
was horn. A line of carts came up the street. The street 
was otherwise quite still and deserted. Each waggon had 
two horses in front of it, A driver walked beside the horses 
and beat them with his whip. The cart had tall sides so 
that I could not see what was inside. There was something 
mysterious about it. Underneath it there hung a man, 
tied up and dragged along by a rope. There was a rope 
round his neck, and he could only manage to draw a little 
breath with great difficulty and at long intervals. The 
sight of this man who could neither go on living nor die 
affected me very much. Then I saw to my horror that two 
more carts followed the first one and each presented the 
same terrible spectacle/ 

The analysis of this dream proceeded in the face of 
unusually strong resistances and took up the whole of our 
time for several weeks. During this part of the analytic 
work the patient was dominated by what he described as 
the ' tormenting ' feeling-tone of the dream, which he once 
very significantly called a 'scene in Hell'. 

The dream-analysis first led us to recognize the driver 
as his father, whom he had always spoken of as a hard and 
repellent man. On this superficial level the beating of 
the horses referred to the frequent corporal punishment his 
father had administered to him. According to him, the 
patient wanted to protest in the dream against the horses 
being beaten, and against the horrible way in which the 
bound man was being treated, but he felt too much intimi- 
dated. His feelings of pity betrayed the fact that he 
identified himself with the unfortunate man. It was evident 
that the dreamer was represented in at least three different 
figures : as the onlooker, as the horse, and as the bound man. 

At this point the work of interpretation ceased for the 
time being, since a fresh dream engaged our attention in the 
following hour. This new dream was concerned with the 
young girl we have already mentioned, and whom we will 
call E. It was this : 

' I saw a part of E.'s naked body, only the middle part. 
Her breasts and her genitals were covered. This part of 



1924 DEVELOPMENT OF THE LIBIDO 467 

the body formed a flat surface and had no navel. Where 
the navel ought to have been something suddenly grew out 
like a male organ. I touched it and asked E. whether it was 
sensitive. It now began to swell a little, and I got frightened 
and woke up/ 

In this dream, the analysis of which proceeded with 
some interruptions, the female body was endowed with 
male attributes, and the dreamer was frightened at seeing 
the female penis swelling up. Another determinant was the 
dreamer's interest in the breasts (the body with its swelling 
protuberance). The whole female body was represented 
as a breast. The meaning of the dream becomes still more 
evident when we know that E. was for the patient the ideal 
of motherhood. So that we have once more the intense 
longing of the melancholiac for the happy state when he 
was still at his mother's breast. I pass over certain other 
determinants of the dream in this place. 

Going back to his childhood dream, the patient compared 
the impression the scene made on him with the petrifying 
sight of the Gorgon's head. 1 He had the same feeling of 
terror in his old dream as in the recent one we have just 
interpreted in outline. 

The patient's associations led us through a succession 
of impressions of childhood among them the sight of a 
hanged man to certain infantile observations of his parents' 
married life that had already come into his analysis. It 
became evident that the driver who was using the whip 
stood for his father having coitus with his mother (' beating ' 
in its typical symbolic sense). Then, however, it turned out 
that the hanging man was a man who was in the position of 
succubus and being crushed during copulation (his difficulty 
in breathing). It was clear that this was an inversion of the 
man's position as actually observed by the child. 

During the following days of analysis the patient was 
often in a depressed state of mind, rather as he had been 
in his early dream. Without having referred to that dream, 
he one day said that he felt like a ' five-year-old boy who 

1 Cf. Freud's analysis of this myth in ' The Infantile Genital Organization 
of the Libido ' (1923). 



468 SELECTED PAPERS OF KARL ABRAHAM XXVI 

had somehow lost his way ' and as if he was in need of 
protection but could not find any. Immediately afterwards 
he called his depression * infernal ', just as he had said that 
his early dream was a ' scene in Hell '. The words he used, 
however, did not merely serve to express the excess of his 
sufferings ; it also had reference to a particular circumstance 
associated with the onset of his last severe attack of depres- 
sion. It had begun immediately after he had been reading 
a book, the Enfer (' Hell ') of Barbusse, about which all 
that need be said here is that it contains a description of 
certain intimate scenes whose action is observed from an 
adjoining room. This gave a clue to the situation which 
had excited such stormy feelings in him in his early child- 
hood. A trifling incident that took place at that time showed 
how greatly subject he had been to the recurrence of that 
impression of childhood terror. On one occasion he had 
heard his parents say something softly to one another, and 
he had become frightened and had ' automatically * made an 
effort to force out of his mind a rising recollection of 
* something terrible '. He noticed that he had a similar 
strong feeling of repugnance whenever he thought of the 
bound man in the dream. During the next few days his 
analysis brought to light a number of such repressed 
observations; and his affect became less violent, in especial 
his horror at the sight of the bound man. At the same time 
he began to get a clear general view of that decisive period 
of his childhood. He said : ' Even as a child I was always 
mourning for something. I was always grave and reserved. 
In the photographs of myself as a small child I already look 
thoughtful and sad/ 

I shall omit many details of the dream-analysis and only 
add the following remarks : Going back to the * hanging 
man ', the patient said one day, ' his head was tied some- 
where near the navel ', meaning near the middle of the cart. 
A number of associations now made it evident that in his 
unconscious he had an infantile sexual theory that the 
imaginary penis of the female was concealed in her navel. 
And now we were able to return to the analysis of his dream 
about a female body without a navel out of which a penis 



IQ24 DEVELOPMENT OF THE LIBIDO 469 

grew. The principal motive of the early dream was the 
following wish: ' My mother is to pay my father back for 
what he has done to her (in copulating with her) and to 
me (in beating me). She is to throw herself on top of him, 
as he did on her, and she is to use her concealed penis to 
strangle him as he lies underneath her/ 

During the next few days the patient happened to see a 
relative of his who for certain reasons had the significance 
of a father for him. He suddenly found himself having 
the phantasy that he might push this man into some dark 
doorway and strangle him with his hands. This act clearly 
represented the Oedipus act and was at the same time an 
allusion to the theme of suffocation in the dream. It may 
be worth adding that in his most recent depressive attack 
the patient had made serious preparations for hanging 
himself with a rope. 

The above extract from the analysis of a dream has thus 
enabled us to reconstruct a vivid picture of the patient's 
state of feeling at the early age of five. I should be inclined 
to speak of a ' primal parathymia ' ensuing from the boy's 
Oedipus complex. We see with impressive clearness how 
much the child longed to gain his mother as an ally in 
his struggle against his father, and his disappointment at 
having his own advances repulsed combined with the 
violent emotions aroused in him by what he had observed 
going on in his parents' bedroom. He nursed terrible plans 
of revenge in his breast, and yet the ambivalence of his 
feelings prevented his ever putting them into practice. 
Unable either to achieve a complete love or an unyielding 
hatred, he succumbed to a feeling of hopelessness. In the 
years that followed he made repeated attempts to attain a 
successful object-love; and every failure to do so brought 
with it a state of mind that was an exact replica of his 
primal parathymia. It is this state of mind that we call 
melancholia. 

An instance may show how ready the melancholiac is 
even during his free intervals to be disappointed, betrayed, 
or abandoned by his love-object. A patient who had 
married a considerable time after a depressive attack was 



47O SELECTED PAPERS OF KARL ABRAHAM XXVI 

constantly looking forward, without the slightest cause, to 
his wife's infidelity as to a self-evident occurrence. Once, 
as he was talking about a man, somewhat younger than 
himself, who was living in the same building, his first 
association was ' My wife will have an affair with him and 
betray me \ His analysis showed that his mother had been 
* unfaithful * to him and had transferred her ' favours ' to 
his younger brother i.e. she had nursed him at the breast. 
This brother occupied for him the position of father in his 
Oedipus complex. In each symptom of his various depres- 
sive periods he faithfully repeated all those feelings of 
hatred, rage, and resignation, of being abandoned and 
without hope, which had gone to colour the primal para- 
thymia of his early childhood. 



VI 

MANIA 

In our discussion so far I have dealt with the melan- 
cholic phase of the circular insanities and have neglected 
the manic phase. This is partly due to the nature of the 
material that has presented itself to me for observation; 
and partly to the fact that psycho-analysis has enabled us 
to understand the psychological processes of melancholia 
irrespective of any closer knowledge of those involved in 
mania, whilst this latter phase would remain a mystery to 
us did we not already possess the key to it in virtue of our 
analytic knowledge of depression. It is for these reasons, 
no doubt, that Freud, in investigating this illness, has 
penetrated so much more deeply into the nature of the 
depressive states than into that of the manic ones. I should 
like to say at once that I am able to add to the knowledge 
gained by Freud on this subject only in a very slight degree 
and in but few respects. 

In clinical psychiatry the manic state has always been 
likened to a state of intoxication in which all existing 
inhibitions are swept away, Freud, in one of his most 



DEVELOPMENT OF THE LIBIDO 471 

recent publications, 1 has put forward a view of it which at 
at any rate renders its relation to melancholic depression 
more comprehensible. We know that one of the principal 
respects in which the two conditions differ from one another 
is in the relation of the individual to his super-ego. Accord- 
ing to Freud's view, the child forms its super-ego by intro- 
jecting the objects of its libido into its ego, of which they 
henceforward form an organic part. The super-ego takes 
on those functions of criticizing the behaviour of the ego 
which form the individual into a social being. Of those 
functions, the one we call conscience interests us most at 
present. The super-ego instructs the ego by means of that 
function as to what it may or may not do, in the same way 
as the persons in authority over it used formerly to do. 

In melancholia we see the super-ego exercising this 
function of criticism with an excessive severity. In mania, 
on the other hand, we see it use no such harsh criticism 
of the ego. On the contrary, the individual has a sense of 
self-importance and power instead of those feelings and 
delusions of inferiority that characterized his depressive 
state. One of my patients believed during his states of 
depression that he was utterly devoid of every intellectual 
capacity and could not perform even the simplest practical 
action ; but when a phase of reactive hypo-mania set in he 
became all of a sudden a great inventor in his own opinion. 
We see that the manic patient has thrown off the yoke 
of his super-ego, which now no longer takes up a critical 
attitude towards the ego, but has become merged in it. 
The difference between ego and super-ego has now dis- 
appeared. For this reason Freud takes the view that in 
the manic condition the patient is celebrating a triumph 
over the object he once loved and then gave up and intro- 
jected. The ' shadow of the object ' which had fallen on 
his ego has passed away. He is able to breathe freely once 
more, and he gives himself up to his sense of regained 
freedom with a kind of frenzy. We are reminded of our 
earlier observation that the circular type of patient has a very 
highly ambivalent attitude towards his ego. And we may 

1 Group Psychology (1921). 



47^ SELECTED PAPERS OF KARL ABRAHAM XXVI 

add to Freud's statement and say that the withdrawal of his 
super-ego allows his narcissism to enter upon a positive, 
pleasurable phase. 

Now that his ego is no longer being consumed by the 
introjected object, the individual turns his libido to the 
outer world with an excess of eagerness. This change of 
attitude gives rise to many symptoms, all of them based on 
an increase in the person's oral desires. A patient of mine 
once called it a * gobbling mania '. This appetite is not 
confined to the taking of nourishment alone. The patient 
* devours ' everything that comes his way. We are all 
familiar with the strength of the erotic cravings of the manic 
patient. But he shows the same greed in seizing on new 
impressions from which, in his melancholic state, he had 
cut himself off. Whereas in his depressive phase he had 
felt that he was dispossessed and cast out from the world 
of external objects, in his manic phase he as it were proclaims 
his power of assimilating all his objects into himself. But 
it is characteristic that this pleasurable act of taking in new 
impressions is correlated to an equally pleasurable act of 
ejecting them almost as soon as they have been received. 
Anyone who has listened to the associations of a manic 
patient will recognize that his flight of ideas, expressed in 
a stream of words, represents a swift and agitated process 
of receiving and expelling fresh impressions. In melan- 
cholia we saw that there was some particular introjected 
object which was treated as a piece of food that had been 
incorporated and which was eventually got rid of. In 
mania, all objects are regarded as material to be passed 
through the patient's ' psychosexual metabolism * at a rapid 
rate. And it is not difficult to see from the associations of 
the manic patient that he identifies his uttered thoughts 
with excrement. 

Freud has pointed out and discussed the psychological 
relationship of melancholia and normal mourning; but he 
does not find anything in the normal mind which is analogous 
to the reversal from melancholia to mania. I believe we 
are now in a position to point to such an analogy. It is an 
occurrence which is observable in normal mourning, and 



DEVELOPMENT OF THE LIBIDO 473 

has, I suspect, a general application, although I cannot at 
present be sure of this. We find, namely, that when the 
mourning person has gradually detached his libido from 
his dead object by means of the ' work of mourning ' he is 
aware of an increase in his sexual desires. He manifests 
this in sublimated forms as well, such as showing greater 
enterprise, enlarging his circle of intellectual interests, and 
so on. Such an increase of libidinal desire after a loss of 
object will set in at an interval of time which varies with the 
course that the ' work of mourning ' runs in each case. 

At the Psycho- Analytical Congress of 1922, at which I 
put forward this view, R6heim also read his paper l on 
primitive mourning ceremonies, in which he showed con- 
clusively that in primitive man the period of mourning is 
followed by an outbreak of the libido, which is brought to 
an end by yet another symbolic killing and eating of the 
dead person, this time performed with evident and undis- 
guised pleasure is ended, in other words, by a repetition 
of the Oedipus act. Now the manic phase which follows 
upon pathological mourning (melancholia) contains the 
same impulse once more to incorporate and expel the love- 
object, in the same way as R6heim has shown to be the 
case in primitive mourning rites. So that the increase in 
libidinal activities which set in at the end of normal mourn- 
ing, as described above, shows like a faint replica of archaic 
mourning customs. 

I had a patient in whom certain events brought on a 
parathymic condition when he was already well forward in 
his analysis. It passed off much more lightly than his 
earlier attacks of depression had done, and resembled in 
some of its main features an obsessional condition. 2 This 
state was followed by a very slight deviation in the direction 
of mania. It passed over after a few days, and then the 
patient told me that during that short period he had felt the 
desire to indulge in some form of excess. He said: ' I had 
the feeling that I must eat a great deal of meat that I must 

1 ' Nach dem Tode des Urvaters' (1923). 

2 The next section contains one or two further remarks concerning this kind 
of modification of the symptoms. 



474 SELECTED PAPERS OF KARL ABRAHAM XXVI 

go on eating till I was absolutely glutted '. He had thought 
of it as a yielding to a kind of intoxication or orgy. 

In this instance it was quite evident that the patient's 
manic state was ultimately nothing else than an orgy of a 
cannibalistic character. His words, quoted above, are con- 
vincing evidence of the correctness of Freud's view that in 
mania the ego is celebrating the festival of its liberation. 
That celebration takes the form in phantasy of a wild excess 
in eating flesh, as to whose cannibalistic significance enough 
has already been said, I trust, to leave no room for doubt. 

Like melancholia, the reactive manic parathymia takes 
a certain length of time in which to work itself off. Gradu- 
ally the narcissistic requirements of the ego diminish and 
larger quantities of libido are set free and can be transferred 
to external objects. Thus, after both phases of the illness 
have passed off, the libido is able to attain a relatively real 
relation to its objects. That this relation remains incom- 
plete has already been fully shown in the chapter dealing 
with the fixation of the libido in the anal-sadistic phase. 

In this phase we must consider a point which has already 
been discussed in connection with melancholia. Freud has 
drawn a very instructive parallel between mania and the 
celebration of a festival by the ego ; and he has associated 
that festival with the totem-feast of primitive people, that 
is, with man's * primal crime ', which consisted in killing 
and eating the primal father. What I must here point out 
is that the criminal phantasies of the manic patient are 
for the most part directed against his mother. A striking 
illustration of this was given by one of my patients who had 
a delusion during his manic excitement that he was the 
emperor Nero. He afterwards accounted for this by the 
fact that Nero had killed his own mother, and had also had 
the idea of burning the city of Rome (as a mother-symbol). 
Let me once more add that those emotions directed towards 
the mother are of a secondary kind; they were in the first 
instance aimed at the father, as became quite evident in the 
course of the analysis referred to above. 

We are now, therefore, able to some extent to under- 
stand the reactive state of exaltation following upon melan- 



DEVELOPMENT OF THE LIBIDO 475 

cholia as a pleasurable emancipation on the part of the 
individual from the painful relation in which he has hitherto 
been to his introjected object of love. But we know that 
an attack of mania can come on without having been pre- 
ceded by a melancholia. However, if we remember what 
has been said in the previous chapter, we shall not be quite 
at a loss to account for this fact. In that chapter we showed 
that certain definite psychological traumas in the early child- 
hood of the patient caused a state of mind in him which we 
called the ' primal parathymia '. In c pure ' mania, which 
is frequently of periodic occurrence, the patient seems to 
me to be shaking off that primal parathymia without having 
had any attack of melancholia in the clinical sense. But 
lack of suitable data forbids me to make any definite state- 
ments in this connection. 

This paper took as its starting-point a comparison of 
melancholia with obsessional neuroses. Returning to this 
comparison, we are now able to explain the difference in 
the course run by the two illnesses and to say that manic- 
depressive states, which set in in an acute form and are inter- 
mittent and liable to relapses, represent an expulsion of the 
love-object repeated at certain intervals of time; whereas 
obsessional states, which have a more chronic character and 
allow of remissions, correspond to a dominant tendency to 
keep possession of the object. 

If we follow the lines of thought of Freud and R6heim, 
we may say that each of the two illnesses presents a different 
attitude of the individual towards that primal crime which 
he has not enacted in reality. In melancholia and mania 
he carries out that crime from time to time on a psycho- 
logical plane, just as primitive people perform it in a 
ceremonial way at their totem-feasts. In the obsessional 
neurosis he carries on a constant struggle against its com- 
mission. His morbid anxiety bears witness on the one 
hand to his impulse to do that deed, and on the other, to 
the yet more powerful inhibition of his criminal impulses. 

What has been said has not, I know, presented a 
complete answer to the problems of mania and melancholia. 
The empirical material of psycho-analysis is not as yet 



47^ SELECTED PAPERS OF KARL ABRAHAM XXVI 

sufficient to enable us to find any such answer. But I 
should like to remind the reader that this paper does not 
profess to deal in the first instance with the psychological 
aspect of those two mental disorders. Its principal aim 
is to show that certain things which we discover in manic- 
depressive patients find their place in the sexual theory of 
psycho-analysis. But I should not like to close this section 
without once more acknowledging that the problem of the 
choice of neurosis in the circular insanities still awaits its 
final solution. 



VII 

THE PSYCHO-ANALYTIC THERAPY OF MANIC- 
DEPRESSIVE STATES 

After what has been said in the foregoing section it 
is not difficult to understand what the aim of a treatment 
of melancholia should ideally be. It should be to do away 
with the regressive libidinal impulses of the individual and 
to effect a progression of his libido until it reaches the 
stage of genital organization and complete object-love. The 
question is. Can that aim be in any way brought nearer by 
psycho-analysis? In this section I should like to try to 
answer that question, basing my views exclusively on the 
facts so far collected. For it would be as inadvisable to 
incline to a premature optimism as regards psycho-analysis 
as to adopt the traditional attitude of nihilism maintained 
by clinical psychiatry. As far back as 1911 I pointed out 
that in certain stages of his illness, and especially during 
his free interval, the melancholiac is capable of establishing 
a sufficient amount of the transference necessary for thera- 
peutic results to justify us in attempting to treat him. And 
on Freud's advice I have recently started psycho-analysing 
melancholiacs at a time when they were just coming out of 
a depressive state and entering upon a free interval. I 
need hardly add that I would not in these circumstances 
attribute any continued improvement on the patient's part 
to the treatment he has begun to receive. An improvement 



IQ24 DEVELOPMENT OF THE LIBIDO 477 

of this sort will take place of itself in every case, but it 
never enables the patient to attain to that complete object- 
love which is the touchstone of real mental health. More- 
over, this is not, in my opinion, what a psycho-analytic 
treatment is aiming at fundamentally. What its aim 
really is I have already briefly outlined above. It ought, 
in the first place, to do more for the patient than merely 
remove his symptoms, and it ought furthermore to safe- 
guard him from a return of his illness. If this first 
requisite is satisfied we shall see many changes take place 
in his whole mental life such as did not use to occur 
spontaneously during his free interval. Here, therefore, 
we shall have an objective criterion of the success of the 
treatment. But so far as the second requisite is concerned 
a long period of time and continuous and careful observation 
will be necessary before we can say whether or no the danger 
of a fresh onset of the illness has been successfully averted. 
The psycho-analyses of melancholic cases which I have 
recently been carrying on are none of them completely 
finished, so that there is no question of making any prophecy 
about the lasting nature of analytic treatment. All I can 
do is to place on record those changes which it undeniably 
did bring about. They are these: 

1. The patient's capacity for transference is sometimes 
quite visibly increased immediately after some piece of 
analytic work has been accomplished. In the case of the 
patient whose childhood dream we have discussed 1 his 
whole attitude to the analyst changed under the influence 
of this part of the analysis. And, as we know, important 
changes cannot be effected in the patient until he succeeds 
in establishing a transference on to his analyst. 

2. The patient's narcissistic and negative attitude 
towards certain persons or towards his whole environment 
and his high degree of irritability in regard to them are 
diminished in a way which never happened before during 
his free interval. 

3. In one instance the patient's attitude towards the 
female sex was greatly modified. His obsessive interest in 

1 Cf. Section V. 



SELECTED PAPERS OF KARL ABRAHAM XXVI 

prostitutes disappeared, and he gradually became able to 
direct his libido on to one particular person in a quite 
normal way. This was the patient's first successful attempt 
to do this after a great number of failures. 

4. The same patient used to harp upon his own in- 
feriority in a self-tormenting manner even during his 
interval. But after we had succeeded in analysing the 
process of introjection in him a good way, he suddenly 
told me that he felt very much relieved. As he said, he 
no longer regarded himself as a * monstrosity '. And this 
new outlook, which began nine months ago, has been 
maintained up till the present time. 

5. The most important criterion seems to me to be 
the formation of transitory symptoms. As has already 
been said, patients often exhibit mild parathymias in their 
free interval, which, slight as they are, bear all the essential 
marks of true melancholia or mania. It happened that 
two of my patients, both of whom I had been treating for 
over a year and a half, were exposed to a series of severe 
emotional shocks due to external events. Before their 
analysis and in the beginning part of it they had invariably 
reacted to disturbances of this sort with marked melancholic 
symptoms. But later on I observed that the new symptoms 
which the patients produced on such occasions bore a 
different stamp. And the regularity with which this 
happened precluded the possibility of chance. On such 
occasions something in the patient seemed to urge him 
towards a renewed attack of depression. If, for instance, 
he was obliged to make an important decision concerning 
his practical life, he would show an inclination to take refuge 
once again in his illness. But he did not actually make 
the first and essential step towards melancholia; he did 
not give up his object. He did form a fresh symptom, 
it is true, but it was an obsessional one or a phobia or a 
hysterical conversion. I could not avoid having the 
impression that the patient no longer produced a genuine 
melancholic depression. That a psychoneurosis should 
have ascended from a melancholic to a hysterical level 
seems to me a significant and noteworthy achievement. 



DEVELOPMENT OF THE LIBIDO 479 

And the fact that the patient's object-love has shown itself 
more resistant than before to external influences is un- 
doubtedly of the greatest practical consequence. 1 

I pass over many of the minor improvements that were 
observable in my patients because they seem to me to 
have no very great theoretical importance. Nevertheless I 
should like to point out once more that I had to deal with 
especially severe cases that had had repeated relapses. I 
got the decided impression that younger patients who have 
not had a great many attacks of illness, and have not, in 
consequence, withdrawn so much from the real world, 
would very probably respond more rapidly and effectively 
to treatment. Later on I shall have a few more things to 
say about the cases I have had for treatment. 

Since I myself do not possess sufficient experience to 
make any judgement about the lasting effects of analytic 
therapy in melancholic cases, I am all the more happy to 
be able to quote an opinion from an authoritative quarter. 
In a private communication Professor Freud has told me 
that he has had two cases of this kind in which the cure 
has been permanent. One of these has had no relapse now 
for over ten years. 

I feel I cannot leave this question of therapeutic results 
without bringing up for consideration the subjective value 
which psycho-analytic treatment has for depressive patients 
in especial. The mental relief which it brings them is 
often quite astonishing, and the patients themselves lay 
much stress on it. Nor should we forget that it is precisely 
this class of person who is as a rule the most inaccessible 
to any outside influence. It therefore seems to me that, 
while maintaining a due reserve in the evaluation of its 
therapeutic results in this field, we cannot deny that psycho- 
analysis does exercise an effect on patients suffering from 
the circular insanities. Nor do I believe that we are in 
danger of overestimating the extent of our results. For 
the method of psycho-analysis itself, which discloses to us 

1 In the second part of this paper, which deals with the development of 
object-love, I discuss this question in greater detail, and adduce examples from 
actual cases. 



480 SELECTED PAPERS OF KARL ABRAHAM XXVI 

in all their strength the resistances of the patients, and 
which in each individual case obliges us to conduct a 
wearisome and difficult technical procedure of many 
months' duration, offers the best guarantee against enter- 
taining too great hopes in regard to the success of our 
therapeutic endeavours. 



PART II 
ORIGINS AND GROWTH OF OBJECT-LOVE 

In the first part of this study I have attempted to throw 
light on the psychology of certain pathological states of 
mind and to add something to our knowledge of the sexual 
life of the individual. But in doing this I have confined 
myself to the theory of the pregenital levels of the libido. 
That part of sexual theory deals with the transformations 
which the individual undergoes in regard to his sexual aim 
during the course of his psychosexual development. Since 
Freud's classical work on this subject x we are accustomed 
to distinguish the sexual aims of the individual from those 
processes which concern his relations to his sexual object. 
What we have so far said about the ontogenesis of object- 
love does not sufficiently cover the field of facts. This is 
especially so in those pathological states which, in accordance 
with Freud, we group together under the name of the 
4 narcissistic neuroses '. In analysing them we meet with 
a number of psychosexual phenomena which our theory 
must take account of. And I propose in the following 
section to attempt to do this. 

In thus tracing separately the development of the 
relation of the individual to his love-object we shall not 
overlook the close and manifold psychological connections 
which exist between it and the subject of our earlier in- 
vestigations. Those connections will, on the contrary, 
become much more evident in this way than before. And 

1 Drei Abhandlungen xur Sexualtheorie (1905). 



1924 DEVELOPMENT OF THE LIBIDO 481 

just as in the previous section we were led to discuss at 
some length certain important aspects of object-relations, 
such, for instance, as ambivalence in man's instinctual life, 
so now there can be no question of treating particular 
subjects as isolated problems. And indeed we shall most 
easily be able to see in what respects the history of the 
development of object-love requires amplification if we begin 
by giving a short summary of the theory of the stages of 
libidinal organization. 

We have recognized the presence of two different 
pleasurable tendencies in the anal-sadistic phase: a more 
primitive one of expelling the object (evacuation) and 
destroying it, and a later one of retaining and controlling 
it. Thus we have been led on empirical grounds to believe 
that there is a differentiation within the anal-sadistic phase 
which before had been supposed to be homogeneous. We 
have come to the conclusion that the melancholic patient 
regresses to the lower level of that phase but does not make 
a halt there. His libido tends towards a still earlier phase 
the cannibalistic phase in which his instinctual aim is to 
incorporate the object in himself. In his unconscious he 
identifies the love-object he has lost and abandoned with 
the most important product of bodily evacuation with his 
faeces and re-incorporates it in his ego by means of the 
process we have called introjection. But he cannot, even 
by regressing so far, escape from the conflict of his ambivalent 
feelings. That conflict, on the contrary, increases in strength, 
until there begins to arise in him a tendency to regress to a 
still more primitive stage of libidinal development whose 
sexual aim is that of sucking. This stage we have considered 
as pre-ambivalent. Thus we have been led to distinguish 
two levels in the oral phase as well as in the anal one. 
Finally we have been able to observe a similar differentiation 
within the later, genital phase. And it is only the most 
recent of those two levels that we have been able to regard as 
free from ambivalence, or post-ambivalent. 

By assuming that each of the three main phases of the 
libido is differentiated into two stages we have bee'n 'able, 
so far at least, to account satisfactorily for the observed facts 

2 H 



482 SELECTED PAPERS OF KARL ABRAHAM XXVI 

concerning the changes undergone by the individual in 
regard to his sexual aim. And we have also been able 
to find a more definite genetic connection between certain 
kinds of illness and certain levels of the libido than has 
hitherto been possible. But we will not try to conceal the 
very considerable gaps that still exist in our knowledge in 
this respect. For instance, we have up till now not succeeded 
in finding a connection of this sort for paranoic conditions. 
This is a point to which we shall return later. 

Up till now much less has been known about the 
development of object-love. Just as we have hitherto been 
accustomed to distinguish three phases in the development 
of the libido, so we have recognized three phases in the 
relationship of the individual to his object. And here 
once more it is to Freud that we owe the first discoveries 
of importance. He grouped the development of that rela- 
tionship into an auto -erotic phase belonging to earliest 
infancy in which the individual has no object, a narcissistic 
phase in which the individual is his own love-object, and a 
phase in which there is object-love in the true sense of the 
word. In the following discussion I shall try to show how 
far we are able to add new knowledge to this part of our 
sexual theory. 

The new contributions which I hope to be able to make 
are derived from a particular field of psycho-analytic 
empiricism, namely, from the study of the * narcissistic 
neuroses ' and of certain neuroses belonging to those levels 
of object-love which are closely related to the narcissistic 
neuroses in a certain respect. 

The manic-depressive cases whose analysis formed the 
groundwork of the first part of this study are of considerable 
assistance in helping us to solve our present problem also. 
At the time that I was analysing those cases it happened that 
I was also having two female patients under long treatment 
of whose neurotic condition I should like to give a brief 
account in these pages. The clinical picture they pre- 
sented tfras quite different from melancholia, but it will 
soon become evident why I have placed them side by side 
with the latter. 



1924 DEVELOPMENT OF THE LIBIDO 483 

The first of these patients, whom I shall call X, pre- 
sented a very complicated clinical picture, and I shall only 
reproduce the most outstanding features of it. Foremost 
of these was a marked pseudologia phantastica dating back to 
her sixth year. Besides this, she had severe impulses of 
kleptomania going back to the same time. And lastly, she 
suffered from attacks of despair which could be occasioned 
by the slightest thing and which found utterance in uncon- 
trollable fits of weeping of many hours' duration. This 
compulsive weeping had two main determinants. It was, 
in the first place, derived from her castration complex, and 
represented the loss of her masculinity with all that this 
involved, such as envy of her more favoured younger brother, 
and so on. During menstruation, which used to excite her 
castration complex in a typical way, she scarcely ever stopped 
crying. 1 The second determinant of her crying fits was 
connected with her relation to her father whose loss she was 
mourning, not in a real sense because he was dead, but in a 
psychological one. It was in connection with this psycho- 
logical loss of him that the earliest symptoms of her neurosis 
had appeared. As a child she had early developed an 
especially strong transference-love towards her father, but, 
as her analysis showed, it had suffered a sudden check in the 
first half of her sixth year. At that time she had been 
convalescing from an illness and had shared her parents' 
bedroom. There she had had an opportunity of seeing her 
mother and father having sexual intercourse, and of observ- 
ing her father's body. This increased her scoptophilic 
tendencies greatly, until they were overtaken by an intense 
repression. I should like to mention one especial conse- 
quence which those experiences had in her case in addition 
to those familiar to all analysts. This was that she com- 
plained of having lost all emotional contact with her father, 
and indeed of being unable to form any kind of mental 
image of him. She was conscious neither of affectionate 
feelings nor of sensual ones towards him. But we were 
able to infer from a quantity of neurotic material that she 

1 It may be mentioned in passing that this copious flow of tears represented her 
unconscious wish to urinate like a man. 



484 SELECTED PAPERS OF KARL ABRAHAM XXVI 

had a quite specialized compulsive interest in one particular 
part of his body, namely, his penis. He had ceased to 
exist for her as a whole person ; only one part of him had 
remained, and this formed the object of her compulsive 
looking. 1 Besides this, she unconsciously identified herself 
now with him, now with his genitals, which had become for 
her his representative. Her kleptomanic impulses were in 
a great measure derived from her active castration tendency 
directed against her father. The unconscious aim of her 
thefts was to rob him of his envied possession so as to have 
it herself or to identify herself with it. That those thefts 
were connected with the person of her father was made 
evident in many ways. For instance, she had on one occa- 
sion taken an enema tube out of his room and had used it 
as a substitute for his male member for anal-erotic 
purposes. She used to 'castrate' him in other ways, by 
taking money \Vermogen\ 2 out of his purse, and by stealing 
his pens, pencils, and other male symbols, as is so common 
in cases of kleptomania. 

The patient's castration complex also proved to be an 
important motive of her pseudologia. Just as her klepto- 
manic impulses expressed the idea, ' I seize by force or 
fraud what has been withheld from me or taken away from 
me ', we might formulate one of the main determinants of 
her lying in this way : * I do possess that desired part of the 
body, and so I am equal to my father '. It is particularly 
interesting to learn from the patient that telling these 
imaginary facts gave her strong sexual excitement and a 
sensation as if something was growing and swelling out of 
her abdomen. This sensation was connected with a feeling 
of physical strength and activity; and in the same way the 
act of lying made her feel mentally powerful and superior 
to others. 

Her relation to her father, as I have roughly sketched 
it, was in keeping with her attitude to the rest of her en- 
vironment. She had no real mental contact whatever with 

1 This took the form of looking for the outline of his genitals underneath 
his clothes. 

8 [= ' means ', is also used in the sense of ' capacity ', and thus comes to stand 
for * sexual potency ' in German. Trans.} 



DEVELOPMENT OF THE LIBIDO 485 

anyone. Telling lies had for many years represented for 
her her sole mental relation with the external world. 

As we have said, she had arrived at this position, so far 
removed from a regular and complete object-love, through 
a regression from such an object-love. She did nevertheless 
maintain some kind of relation to her objects, and she clung 
to them with the utmost tenacity. Further analysis of her 
kleptomania, together with analysis of one or two other 
cases, threw light on the nature of her peculiar and incom- 
plete form of object-love. Her dreams and day-dreams 
contained ever-recurring images of castration by means of 
biting. The aim of her phantasies was not to incorporate 
her love-object as a whole but to bite off and swallow a part 
of it and then to identify herself with the part. Such a 
partial incorporation of the object seems to occur in other 
cases of kleptomania as well. I will give another example. 

A female patient whom I shall call Y was suffering 
from a grave neurosis whose most marked symptom was 
severe hysterical vomiting. In addition she exhibited very 
strong kleptomanic tendencies which in her case too 
were found to be determined by her castration complex. 
Her habit of stealing had grown up around an incorrigible 
inclination she had had in childhood to pull everything out 
with her hands, especially flowers and hair. But this 
impulse was itself a modification of a desire to bite off 
everything that ' stuck out '. Even when she was grown 
up she had phantasies of this kind. As soon as she got to 
know a man she had a compulsive idea of biting off his 
penis. Her neurotic vomiting was closely related to these 
oral-sadistic impulses. In her case, too, her father had lost 
all value for her as a person. Her libidinal interest was 
focussed on his penis alone. And when he had died she 
too had been unable to feel any sorrow. But she had had 
a vivid phantasy of stealing his penis by biting it off, and 
of keeping it. In her day-dreams she used to have a great 
many phantasies of copulating with a penis ' without any 
man belonging to it '. 

Another similarity between these two patients was that in 
each case the mother also was represented by only one part 



486 SELECTED PAPERS OF KARL ABRAHAM XXVI 

of her body, namely, her breasts. They had obviously 
been identified in the child's mind with the supposed penis 
of the female. She was alternatively represented by her 
buttocks, which in their turn stood for her breasts. The 
relation of this image to oral erotism (pleasure in biting) 
was more than evident, and could be supported by many 
examples, one of which I shall give. X once dreamed as 
follows : * I was eating away at a piece of meat, tearing it 
with my teeth. At last I swallowed it. Suddenly I noticed 
that the piece of meat was the back part of a fur coat 
belonging to Frau N.'. 

It is not difficult to understand the ' back part ' as a 
displacement from before backwards. In the same way 
we can understand the frequent symbolic use made of fur 
as an allusion to the female genital. Frau N.'s surname 
was in fact the name of an animal, and of an animal which 
frequently symbolized her mother in this patient's dreams. 

* Displacement backwards ' was a process that con- 
stantly occurred in the mental images of both patients. 
Both had a feeling of disgust at their mother, and in their 
phantasies and certain symptoms both likened her to the 
essence of all that is most disgusting, namely, excrement. 
Thus the mother was represented in imagination by a piece 
of the body that had left it, i.e. a penis, and faeces. 

In both cases the libido had undergone a considerable 
degree of narcissistic regression, though by no means a 
complete one. What had happened was that untU 
analysis set this right its capacity for object-love had been 
imperfectly developed in a certain respect or had regressed 
to a stage of imperfect development. The stage in question 
must have lain somewhere between narcissism and object- 
love. Another fact which was to be noticed about both 
cases, and which I later on observed in other persons, 
pointed in the same direction. This was that the libido 
was in an unmistakable state of ambivalence towards its 
object and showed a strong tendency to inflict injuries on 
it. Nevertheless, that destructive tendency had already 
been subjected to limitations. At this stage the sexual 
aim of the individual must have been to deprive his object 



IQ24 DEVELOPMENT OF THE LIBIDO 487 

of a part of its body, i.e. to attack its integrity without 
destroying its existence. We are put in mind of a child 
which catches a fly and, having pulled off a leg, lets it go 
again. We must once more emphasize the fact that the 
pleasure in biting is very markedly associated with this 
form of object-relation which had hitherto escaped our 
notice. 

I have been able to ascertain the presence of similar 
psychological processes ir. the two manic-depressive patients 
about whom I have spoken in greater detail in the first part 
of this study. But the really valuable evidence for this 
only appeared when their gravest symptoms were beginning 
to pass off. So long as these were present the cannibalistic, 
destructive tendencies of the libido manifested themselves 
in many ways. During the period of recovery one of the 
patients used very often to have a phantasy of biting off 
the nose, or the lobe of the ear or the breast, of a young girl 
whom he was very fond of. At other times he used to play 
with the idea of biting off his father's finger. And once, 
when he believed that I was not going to continue his 
analysis, he all of a sudden had the same thought about me. 
This idea of biting off a finger was found to have a great 
number of determinants besides its obvious significance of 
castration. What chiefly interests us here is the ambivalence 
expressed in the phantasy. For although in it the patient's 
physician as the substitute of his father was to be 
maimed by having a piece of his body bitten off, we must not 
see the hostile side of the phantasy only and overlook its 
friendly tendency which was expressed in the patient's 
desire to spare the existence of the object except for one 
part, and again in his desire to keep that part as his own 
property for ever. We may thus speak of an impulse of 
partial incorporation of the object. The patient just referred 
to once said that he would like to ' eat up ' the young girl 
in question (whom he identified with his mother) ' mouthful 
by mouthful'. And the following incident will show how 
greatly occupied his mind was in this stage of his analysis 
with the idea of biting off things. On one occasion he was 
speaking about a man under whom he was working who 



488 SELECTED PAPERS OF KARL ABRAHAM XXVI 

represented both his father and his mother in his unconscious 
and towards whom he had an extremely ambivalent attitude. 
As often happened with him his free associations flowed over 
into phantasies of a markedly concrete kind, which would 
at times be interrupted by an affective ' blocking '. A 
4 blocking ' of this nature occurred as he was speaking about 
his superior. In accounting for that stoppage in his associa- 
tions he said, ' Now [i.e. in the phantasied situation] I must 
first tear out his beard with my teeth; I can't get any 
further till I've done that ', The patient was thus himself 
saying that there was no possible way of avoiding the 
intrusion of those phantasies which belonged unmistakably 
to the class of partial cannibalism. 

Complete and unrestricted cannibalism is only possible 
on the basis of unrestricted narcissism. On such a level all 
that the individual considers is his own desire for pleasure. 
He pays no attention whatever to the interests of his object, 
and destroys that object without the least hesitation. 1 On 
the level of partial cannibalism we can still detect the signs 
of its descent from total cannibalism, yet nevertheless the 
distinction between the two is sharply marked. On that 
later level the individual shows the first signs of having 
some care for his object. We may also regard such a care, 
incomplete as it is, as the first beginnings of object-love in 
a stricter sense, since it implies that the individual has 
begun to conquer his narcissism. But we must add that 
on this level of development the individual is far from 
recognizing the existence of another individual as such and 
from * loving ' him in his entirety, whether in a physical or a 
mental way. His desire is still directed towards removing 
a part of the body of his object and incorporating it. This, 
on the other hand, implies that he has resigned the purely 
narcissistic aim of practising complete cannibalism. 

Now that we have become alive to certain occurrences 
relating to infantile development, there will not be wanting 
confirmatory evidence obtained from the direct observation 

1 The cannibalism of primitive people after which we have named this phase 
of the infantile libido cannot be said to be unrestricted in this way. It is not at all 
the case that any one person can kill and eat any other. The selection of the victim 
has a strict affective determination. 



DEVELOPMENT OF THE LIBIDO 489 

of the child. Our inquiries have, moreover, led us a certain 
distance forward into unknown country, and we are glad to 
come upon some traces of earlier exploration. Several years 
ago two psycho-analysts, whose reliability as observers is not 
open to question, have each independently added to our 
knowledge of the psychology of paranoic delusions of 
persecution. Both van Ophuijsen l and Starcke 2 discovered 
during the course of their psycho-analytic practice that in 
paranoia the * persecutor ' can be traced back to the patient's 
unconscious image of the faeces in his intestines which he 
identifies with the penis of the ' persecutor ', i.e. the person 
of his own sex whom he originally loved. Thus in paranoia 
the patient represents his persecutor by a part of his body, 
and believes that he is carrying it within himself. He would 
like to get rid of that foreign body but cannot. 

I must admit that I did not at the time recognize the 
full importance of van Ophuijsen's and Starcke's discovery. 
It was an isolated one, and did not fit easily into the general 
body of known facts, although the relations between paranoia 
and anal-erotism had already been recognized by Ferenczi. 
Now, however, it finds its place in a wider scheme and is 
thus seen to possess a very great significance. 

When the paranoiac has lost his libidinal relations to his 
object and to all objects in general, he tries as far as he can 
to compensate for the loss which to him amounts to a 
destruction of the world. As we know since Freud's analysis 
of the case of Schreber, he proceeds to reconstruct his lost 
object. We may now add that in this process of recon- 
struction the paranoiac incorporates a part of his object. 
In doing this he undergoes much the same fate as the 
melancholiac who has introjected the whole of his object 
by a process of incorporation. Nor can he, either, escape 
his ambivalence in this way. Like the melancholiac, there- 
fore, he tries to get rid of that part of his object which he 
has taken into himself. And on the psychosexual develop- 
mental level on which he is this can only be an anal process 
for him. To a paranoiac, therefore, the love-object is 

1 " On the Origin of the Feeling of Persecution ' (1920). 
* * The Reversal of the Libido-Sign in Delusions of Persecution ' (1919). 



49O SELECTED PAPERS OF KARL ABRAHAM XXVI 

equivalent to faeces which he cannot get rid of. The intro- 
jected part of his love-object will not leave him, just as in 
the case of the melancholiac the object, which has been 
introjected in /0/0, continues to exercise its despotic power 
from within. 

We have thus come to the conclusion that the melan- 
choliac incorporates his abandoned love-object as a whole, 
whereas the paranoiac only introjects a part of his. In the 
latter case there is another alternative to be considered, 
namely, that this partial introjection need not be effected in 
an oral way but can be thought of as an anal process. 
Pending a more complete understanding of the situation 
we may put forward the view though with all due hesi- 
tation that in respect of its sexual aim the libido of the 
paranoiac regresses to the earlier of the two sadistic-anal 
stages, while in respect of its attitude towards its object it 
goes back to the stage of partial introjection. Whether that 
introjection takes place in an oral or an anal way must be 
left an open question. We meet with a similar state of 
affairs in melancholiacs during their period of convalescence. 
Nor can we as yet say why it is that in the latter case regular 
paranoic delusions are not formed. This difference may 
be due to the different effects of introjection according as it is 
total or partial in its extent, and oral or anal in its means. 
We shall have no certainty on this subject until we know 
more about the part played by the ego in those two forms of 
illness.