Morbid Fears and Compulsions

Their Psychology and Psychoanalytic Treatment

H.W. Frink, Frink, H. W.

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780415210928
• eBook ISBN: 9781136340529
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

This is Volume XI in a series of twenty-eight on Psychoanalysis. Originally published in 1918, this study gives illustrations of the varied and significant modes of action of men's unconscious motives whilst looking at their morbid fears and compulsions.

MORBID FEARS AND COMPULSIONS

Chapter I

The Sexual Synthesis

HIPPOCRATES, the Father of Medicine, taught that the malady known as hysteria arose when the unsatisfied womb, longing for the seed of the male, broke loose from its fastenings and restlessly wandered about the interior of the body. In accordance with this theory he applied sweet perfumes to the vulva of the patient and evil-smelling substances to her nostrils, with the idea that by such means the mutinous organ might be induced to return to its proper locus. Remnants from this theory are handed down to present day medicine as the name we apply to the disease (hysteria, from

στέρα, the womb) and the practice of administering to neurotic patients certain ill-smelling drugs such as asafœtida and valerian.

Since the days of Hippocrates the theories advanced to explain hysteria and the other psychoneuroses have been both numerous and varied, some of them being no less fantastic than his. But throughout there has been noticeable a persistent, if ill-defined, tendency to locate the cause of the trouble in the organs of generation. The constant search for malpositions of the uterus, cervical or perineal lacerations or other pelvic disturbances in neurotic women, and the multitude of operations that have been undertaken with the idea of curing the neurosis by removing these conditions are but a few of the manifestations of this tendency.

It remained for Freud to show that this inclination to regard the reproductive organs as the site of the causal factors of the functional neuroses had, in a way, its justification, and really amounted to a dim, imperfect intuition of what actually is the truth. We know now, thanks to his genius, that in these cases the trouble really resides not in the sexual organs of the patient but in the sexual instinct.

The violent and bitter prejudice which arose against this doctrine of Freud’s could in large measure be ascribed to the peculiar feeling prevalent among Caucasian peoples that there is something inherently shameful and indecent about sex, in consequence of which they are quick to resent whatever implies directly or indirectly that the erotic impulses are of much consequence to them.

Another important factor which interfered with Freud’s teachings was that people failed to understand just what he meant by the term sexual, and thus saw in his writings meanings that he never intended, and derived impressions totally different from those he wished to convey. These false notions caused many to reject his teachings who, had they understood him, might have investigated further and readily accepted his views. What in many instances excited prejudice was really something quite different from what Freud had tried to teach.

In view of this, I think it well to begin by an attempt to make clear what is meant by the term sexual when used in the Freudian sense, and what we shall understand the sexual instinct to be.

Each individual leads a double existence; on the one hand he is an entity in himself, on the other an insignificant component of that larger entity, his race or species.

Corresponding to these two rôles he has two great groups of impulses or instinctive tendencies, the one wholly egoistic or self-preservative, the other essentially altruistic and preservative of the race. Of the first group hunger is the chief sensational representative, of the second the desire for sexual congress.

If one studies some simple organism, for instance the amœba, it is easily apparent that all its processes fall readily into one or the other of the two groups, self-preservative and reproductive. If comparative studies are then made with other organisms higher in the phylogenetic scale, it will be found that there is nothing, not excepting even the most complicated mental processes of civilized man, that is not represented in some simple and rudimentary way in the lower organisms, even to the amœba. Thus every item of human behavior whether it be “explicit” (action) or “implicit” (thought or feeling)¹ is revealed, either to direct observation or by tracing it back through phylogenetic history, as belonging either in the self-preservative or in the race-preservative group of reactions.

Now suppose we name these two great groups each according to its chief representative. All processes belonging to the self-preservative group would then be called hunger processes, all those of the other would be termed sexual processes. Thus our desire to have warm clothes in winter and coal ones in summer would be called a hunger phenomenon, while a wish that these clothes might look well would be considered to belong to the sphere of sex. It is exactly in this broad and inclusive sense that Freud uses the term sexual. With him it embraces all those reactions that are race-preservative in purpose or effect according to their phylogenetic or ontogenetic history. His use of the word would be exactly paralleled by including all the self-preservative processes under the term hunger. The word sexual in the Freudian sense is thus most nearly synonymous with the Greek Έρως (Eros) or the English word Love, though having an even broader meaning than either of them. The phenomena popularly termed sexual represent only a comparatively small portion of the group which are sexual in Freud’s sense.²

Corresponding to the two great groups of processes or reactions into which the phenomena of the individual life may be divided, there are assumed two great groups of impulses or tendencies, the self-preservative or ego-instinct, and the sexual or holophilic instinct as the source from which each group of processes gets its primal push and drive. For our reactions to the stimuli we receive usually if not invariably represent out-puts of energy entirely out of proportion to the amounts of energy impinging on our sense organs as the stimuli themselves. If for instance a photographic plate in a camera is exposed to the light rays coming from a grizzly bear, an impression is made on the plate which is directly proportional to the amount of light and the length of time of exposure. But if these same rays impinge on another sort of sensitized plate, the retina of a human being or of an animal, there results an effect in the shape of fear and flight, the energy output of which bears no definite ratio to the energy-content of the incoming rays, and is of infinitely greater magnitude. The rôle of the stimulus in this and practically all other cases is that of releasing into kinetic expression energy that is latent within the organism. To express this notion of latent energy we require the term instinct which we conceive to be the source of the energy which is released as the responses to various external or internal stimuli. To the energy itself which is thus released we give in the case of the holophilic group of phenomena the name Libido.³

Just as everything in the lives of the higher organisms can be found represented in some simple or rudimentary way in the lives of the lower, so practically everything in the adult has some sort of representation in the child. However trite this statement may appear, its application in the psychosexual sphere was hardly recognized at all until the work of Freud. The sexual instinct was popularly supposed to appear at the time of puberty; the child was tacitly assumed to be practically asexual before that period. Whether the instinct has any prepubertal representation or in what this representation might consist hardly anybody stopped to enquire. One of Freud’s great achievements was the demonstration that the sexual instinct as first manifested at the time of puberty is not new but so to speak a synthetic product, formed by uniting certain of a number of holophilic trends or impulses which were present throughout childhood and thus that the germs of sexuality are present in the individual from his very birth.

That this discovery of Freud’s should have given rise to astonishment and incredulity is from one point of view very surprising. All the receptor surfaces, all the complicated systems of voluntary, sympathetic and autonomic arcs and end-organs involved in the reactions represented by the love life of the adult are present in practically their fully developed form long before the beginning of puberty. Apparently the change which takes place at puberty results not from new arcs being introduced or in old ones suddenly becoming permeable, but rather in the maturing of certain glands which now begin to pour their internal secretions into the blood stream and, in the male, furnish a new substance for external discharge. It would be hard to believe all this complicated machinery waited silent and idle, or was responsive only to non-sexual stimuli and capable only of non-sexual reactions during all the years preceding puberty and this glandular activity. On the contrary it would be logical to expect the occurrence of many and complicated reactions, lacking to be sure something possessed by the sexual processes of the adult, but nevertheless fully deserving to be called sexual. This doctrine that adult sexuality develops by a sort of synthesis out of a preexisting sexuality we should have been prepared for by expecting that the effect of the internal secretions appearing at puberty would be merely that of adding further power and emphasis to certain reactions of the complicated machinery already present and freely reacting before the attainment of sexual maturity. We should have known that the psychosexual phenomena of the adult could not have developed de novo at puberty, but could only represent what had been present much earlier, now brought into high relief through the added effect of the new secretions.

In the sexuality of the human being three phases or periods of development may be distinguished: (1) an infantile or pre-inhibitory period which corresponds to the first three or four years of life; (2) the childhood or latency period which succeeds the first and ends with the onset of puberty, and (3) the adult period, or phase of object-love.

The first period may be called the pre-inhibitory period because it represents a stage in which the so-called reaction-tendencies, (the inhibitory trends such as shame, disgust, modesty, sympathy, etc.) are not yet manifest. The child, during this first period, is incapable of any of these feelings; as soon as he becomes capable of them the period comes to a close and the latency period has its beginning.

The holophilic phenomena of the first period consist chiefly in the pleasurable sensations which the infant derives from the stimulation of certain sensitive areas which are known as the erogenous zones. These zones are represented by the anal, oral, and urethral orifices, the penis in the male and the labia and clitoris in the female. The first pleasurable stimulations from them are incidental to the performing of the functions of alimentation. In the infant the pleasure derived from the taking of nourishment is not represented entirely by taste pleasures and the actual satisfaction of the craving for food; the tactile and kinesthetic sensations created during the act of sucking are distinctly agreeable and pleasurable in themselves. In the same way the voiding of excrement not only represents something more than simply the relief from the discomfort of not voiding, but also gives rise to tactile and muscular sensations that have a definite pleasure value in themselves.

Having experienced these pleasurable sensations as incidents to the performing of the alimentary functions, the infant soon seeks to re-experience them for their own sake. Thus, for instance, he develops the habit of sucking his thumb or some other available object, purely for the sensory pleasure the act of sucking affords and quite apart from any desire for nourishment. In the same way other children refuse to empty the bowel when placed upon the toilet, and hold back the feces until there is an accumulation of sufficient size and consistency to give the act of evacuation the greatest possible amount of pleasure.

It may be asked why such tricks of the infant as thumb-sucking and the holding back of the feces are classed in the sexual or holophilic group, and not as hunger phenomena. We may answer that the principal reason for so regarding them is because of their later history. By the study of the oral perversions or perversities (fellatio, cunnilingus, etc.,) the perverse action can be demonstrated as a direct descendant of the infantile pleasure-sucking which in most cases of such perversion had been indulged in with great fervor and continued for a long time. Then too the analysis of certain neurotic disturbances such as hysterical vomiting and some food idiosyncrasies reveals them as a reaction against similar oralerotic longings and phantasies, now offensive to the controlling trends of the personality, but likewise easily traceable through the developmental history of the individual back to the pleasure-sucking of infancy. The oral erotism of the infant is represented in the normal adult as the pleasure in kissing. Of course the rudimentary sexual activities cannot be expected to be in every particular like those of the adult. Kissing in the adult excites the genital system while the sensations excited in pleasure-sucking remain local. But we must remember that the intercommunication of the various holophilic impulses (the sexual synthesis) has not yet been established, for the reason that the glands whose internal secretions are largely instrumental in its accomplishment have yet to mature. Nevertheless the infantile erotism as exemplified in pleasure-sucking is not set off so sharply from adult sexuality as one might perhaps expect. In certain cases at least, it proceeds to an orgastic climax succeeded by a period of complete passivity and relaxation, the whole phenomenon bearing such a striking similarity to the sexual acme and immediately subsequent relaxation in the adult that it could hardly escape the observer.

The first stimulations of the penile and clitoris zones appear to result either from irritations produced by discharged secretions or excretions in contact with them, or from the manipulations involved in keeping the child clean. These pleasurably experienced stimulations the infant then seeks to repeat either by thigh rubbing or the use of the hand. The former appears to be more common in female infants, the latter in males.

All the erogenous zones in infancy have, at least to start with, about the same degree of pleasuresensibility. As time goes on the significance of one zone may be accentuated over that of the others through repeated stimulation, but there is nothing corresponding to the primacy that in the normal adult the genitals have over all other regions of the body. Furthermore, the zones ordinarily remain perfectly independent of one another; excitement of one does not of itself produce an excitement or heightened sensibility in any of the others, as happens in the adult when for instance the oral zone is stimulated and the phenomena of sexual excitement occur in the genitals without their being stimulated directly.

In addition to the zonal components of the holophilic instinct there appear a little later a set of impulses which have at first no connection with the erogenous areas. These so-called partial impulses (Partial-triebe) go in pairs of which the one is active and the, other passive. One of these pairs consists of the sadistic and masochistic impulse. The former is an aggressive tendency, and is manifested as a desire to dominate, to use force, roughness or violence, and if it goes far enough, to inflict pain.⁴ The masochistic tendency has just the opposite nature, and is shown as a pleasure in obedience, submission, and the enduring of humiliation or pain.

A second pair consists of the impulse to showing and looking, the former passive and the latter active. They refer not only to the genitals themselves, but to the entire body. Out of a union of the looking impulse with a contribution from the acquisitive trend of the self-preservative group there develops the curiosity impulse, of which we shall have a good deal to say in some of the later portions of this book. The impulses to touch and to be touched, etc., belong in the same group of partial desires.

These partial desires of infancy are readily identified as fore-runners of tendencies apparent in the sex-life of the normal adult. The sadistic impulse, for instance, corresponds to the normal aggressiveness in courtship shown by the male in comparison with the female, and his inclination to master, and occasionally to be rough with the loved object. This inclination corresponds to an evolutionary period when the male had need of other means of overcoming the resistance of the female than those implied by the term courtship, (marriage by capture, etc.)

The disposition of the looking and showing impulses in adult life is well illustrated by the differences in the evening dress of the male and the female. As shown by this the female has a greater desire to be looked at than has the male, while in the male the pleasure in looking and the curiosity impulse (sexual curiosity) is stronger than in the female.

It must be pointed out that the partial impulses represent rudiments corresponding not only t...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Introduction
• Author’s Note
• Table of Contents
• Chapter I: The Sexual Synthesis
• Chapter II: The Unconscious
• Chapter III: Two Kinds of Thinking, and the Psychology of the Dream
• Chapter IV: The Mechanisms of Psychopathological Manifestations
• Chapter V: The Neurosis as a Whole
• Chapter VI: Psychology of the Compulsion Neurosis
• Chapter VII: A Case of Compulsion Neurosis
• Chapter VIII: The Psychology of Anxiety Hysteria
• Chapter IX: A Case of Anxiety Hysteria
• Synopsis of Chapter X: The Theory and Mechanism of the Psychoanalytic Cure
• Bibliography
• Index