Freud complete Works Table of Contents Studies on hysteria



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FREUD


Complete Works

1890 - 1939

FREUD complete Works



Table of Contents


  • Studies on hysteria (1893-1895)

  • The neuro-psychoses of defence, (1895)

  • Obsessions and phobias, their psychical mechanism and their aetiology (1895)

  • Heredity and the aetiology of the neuroses (1896)

  • Further remarks on the neuro-psychoses of defence (1896)

  • The aetiology of hysteria (1896)

  • Sexuality in the aetiology of the neuroses (1898)

  • The psychical mechanism of forgetfulness (1898)

  • Screen memories (1899)

  • The interpretation of dreams (1900)

  • On dreams (1901)

  • The psychopathology of everyday life (1901)

  • Freud’s psycho-analytic procedure (1904)

  • Fragment of an analysis of a case of hysteria DORA (1905)

  • Three essays on the theory of sexuality (1905)

  • On psychotherapy (1905 )

  • My views on the part played by sexuality in the aetiology of the neuroses (1906)

  • Psychical (or mental) treatment (1905)

  • Psychopathic characters on the stage (1905)

  • Jokes and their relation to the unconscious (1905)

  • Delusions and dreams in jensen’s gradiva (1907)

  • Psycho-analysis and the establishment of the facts in legal proceedings (1906)

  • Obsessive actions and religious practices (1907)

  • The sexual enlightenment of children (an open letter to Dr. m. Fürst) (1907)

  • Creative writers and day-dreaming (1908)

  • Hysterical phantasies and their relation to bisexuality (1908)

  • Character and anal erotism (1908)

  • ‘Civilized’ sexual morality and modern nervous illness (1908)

  • On the sexual theories of children (1908)

  • Some general remarks on hysterical attacks (1909)

  • Family romances (1909)

  • Analysis of a phobia in a five-year-old boy HANS (1909)

  • Notes upon a case of obsessional neurosis RAT MAN (1909)

  • Five lectures on psycho-analysis (1910)

  • Leonardo da Vinci and a memory of his childhood (1910)

  • The future prospects of psycho-analytic therapy (1910)

  • The antithetical meaning of primal words (1910)

  • A special type of choice of object made by men (psychology of love I) (1910)

  • On the universal tendency to debasement in the sphere of love (psychology of love. II) (1912)

  • The taboo of virginity (psychology of love III) (1918)

  • Wild psycho-analysis (1910)

  • Psycho-analytic notes on an autobiographical account of a case of paranoia (SCHREBER) (1911)

  • The dynamics of transference (1912)

  • On beginning the treatment (recommendations on the technique of psycho-analysis I) (1913)

  • Remembering, repeating and working-through (recommendations on the technique of psycho-analysis II) (1914)

  • Observations on transference-love (recommendations on the technique of psycho-analysis III) (1915)

  • Dreams in folklore (Freud and Oppenheim) (1957 [1911])

  • On psycho-analysis (1913 [1911])

  • Types of onset of neurosis (1912)

  • Contributions to a discussion on masturbation (1912)

  • A note on the unconscious in psycho-analysis (1912)

  • An evidential dream (1913)

  • The occurrence in dreams of material from fairy tales (1913)

  • The theme of the three caskets (1913)

  • Two lies told by children (1913)

  • The disposition to obsessional neurosis a contribution to the problem of choice of neurosis (1913)

  • ‘Great is Diana of the Ephesians’ (1911)

  • Totem and taboo (1913)

  • The claims of psycho-analysis to scientific interest (1913)

  • Observations and examples from analytic practice (1913)

  • Fausse reconnaissance (‘déjà raconté’) in psycho-analytic treatment (1914)

  • The Moses of Michelangelo (1914)

  • Some reflections on schoolboy psychology (1914)

  • On the history of the psycho-analytic movement (1914)

  • On narcissism: an introduction (1914)

  • “Instincts” and their vicissitudes (1915)

  • Repression (1915)

  • The unconscious (1915)

  • Mourning and melancholia (1915)

  • A case of paranoia running counter to the psycho-analytic theory of the disease (1915)

  • Thoughts for the times on war and death (1915)

  • On transience (1916)

  • Some character-types met with in psycho-analytic work (1916)

  • A mythological parallel to a visual obsession (1916)

  • A connection between a symbol and a symptom (1916)

  • Introductory lectures on psycho-analysis (1916-17)

  • From the history of an infantile neurosis WOLF MAN (1918 [1914])

  • A difficulty in the path of psycho-analysis (1917)

  • A childhood recollection from dichtung und wahrheit (1917)

  • Lines of advance in psycho-analytic therapy (1919)

  • On the teaching of psycho-analysis in universities (1919)

  • ‘A child is being beaten’ a contribution to the study of the origin of sexual perversions (1919)

  • Introduction to psycho-analysis and the war neuroses (1919)

  • The ‘uncanny’ (1919)

  • Beyond the pleasure principle (1920)

  • Group psychology and the analysis of the ego (1921)

  • The psychogenesis of a case of homosexuality in a woman (1920)

  • Psycho-analysis and telepathy (1941 [1921])

  • Dreams and telepathy (1922)

  • Two encyclopaedia articles (1923)

  • The Ego and the Id (1923)

  • A seventeenth-century demonological neurosis (1923)

  • Remarks on the theory and practice of dream-interpretation (1923)

  • The infantile genital organization (an interpolation into the theory of sexuality) (1923)

  • Neurosis and psychosis (1924)

  • The economic problem of masochism (1924)

  • The dissolution of the œdipus complex (1924)

  • The loss of reality in neurosis and psychosis (1924)

  • A short account of psycho-analysis (1924)

  • The resistances to psycho-analysis (1925)

  • A note upon the ‘mystic writing-pad’ (1925)

  • Negation (1925)

  • Some psychical consequences of the anatomical distinction between the sexes (1925)

  • An autobiographical study (1925)

  • Inhibitions, symptoms and anxiety (1926)

  • The question of lay analysis Conversations with an Impartial Person (1926)

  • Psycho-analysis (1926)

  • The future of an illusion

  • Civilization and its discontents (1930)

  • Fetishism (1927)

  • Humour (1927)

  • A religious experience (1928)

  • Dostoevsky and parricide (1928)

  • Some dreams of Descartes a letter to Maxime Leroy (1929)

  • The Goethe prize (1930)

  • Libidinal types (1931)

  • Female sexuality (1931)

  • New introductory lectures on psycho-analysis (1933)

  • The acquisition and control of fire (1932)

  • Why war ? (Einstein and Freud) (1933)

  • A disturbance of memory on the acropolis (1936)

  • Moses and monotheism three essays (1939)

  • An outline of psycho-analysis (1940)

  • Analysis terminable and interminable (1937)

  • Constructions in analysis (1937)

  • Splitting of the ego in the process of defence (1940)

  • Some elementary lessons in psycho-analysis (1940)

STUDIES ON HYSTERIA (1893-1895)


PREFACE TO THE FIRST EDITION
In 1893 we published a ‘Preliminary Communication’¹ on a new method of examining and treating hysterical phenomena. To this we added as concisely as possible the theoretical conclusions at which we had arrived. We are here reprinting this ‘Preliminary Communication’ to serve as the thesis which it is our purpose to illustrate and prove.

We have appended to it a series of case histories, the selection of which could not unfortunately be determined on purely scientific grounds. Our experience is derived from private practice in an educated and literate social class, and the subject matter with which we deal often touches upon our patients’ most intimate lives and histories. It would be a grave breach of confidence to publish material of this kind, with the risk of the patients being recognized and their acquaintances becoming informed of facts which were confided only to the physician. It has therefore been impossible for us to make use of some of the most instructive and convincing of our observations. This of course applies especially to all those cases in which sexual and marital relations play an important aetiological part. Thus it comes about that we are only able to produce very incomplete evidence in favour of our view that sexuality seems to play a principal part in the pathogenesis of hysteria as a source of psychical traumas and as a motive for ‘defence’ - that is, for repressing ideas from consciousness. It is precisely observations of a markedly sexual nature that we have been obliged to leave unpublished.


The case histories are followed by a number of theoretical reflections, and in a final chapter on therapeutics the technique of the ‘cathartic method’ is propounded, just as it has grown up under the hands of the neurologist.

If at some points divergent and indeed contradictory opinions are expressed, this is not to be regarded as evidence of any fluctuation in our views. It arises from the natural and justifiable differences between the opinions of two observers who are agreed upon the facts and their basic reading of them, but who are not invariably at one in their interpretations and conjectures.


J. BREUER, S. FREUD 

April 1895


¹ 'On the Psychical Mechanism of Hysterical Phenomena’, Neurologisches Centralblatt, 1893, Nos. 1 and 2.
PREFACE TO THE SECOND EDITION
The interest which, to an ever-increasing degree, is being directed to psycho-analysis seems now to be extending to these Studies on Hysteria. The publisher desires to bring out a new edition of the book, which is at present out of print. It appears now in a reprint, without any alterations, though the opinions and methods which were put forward in the first edition have since undergone far-reaching and profound developments. So far as I personally am concerned, I have since that time had no active dealings with the subject; I have had no part in its important development and I could add nothing fresh to what was written in 1895. So I have been able to do no more than express a wish that my two contributions to the volume should be reprinted without alteration.
BREUER 

As regards my share of the book, too, the only possible decision has been that the text of the first edition shall be reprinted without alteration. The developments and changes in my views during the course of thirteen years of work have been too far-reaching for it to be possible to attach them to my earlier exposition without entirely destroying its essential character. Nor have I any reason for wishing to eliminate this evidence of my initial views. Even to-day I regard them not as errors but as valuable first approximations to knowledge which could only be fully acquired after long and continuous efforts. The attentive reader will be able to detect in the present book the germs of all that has since been added to the theory of catharsis: for instance, the part played by psychosexual factors and infantilism, the importance of dreams and of unconscious symbolism. And I can give no better advice to any one interested in the development of catharsis into psycho-analysis than to begin with Studies on Hysteria and thus follow the path which I myself have trodden.


FREUD 

VIENNA, July 1908


PRELIMINARY COMMUNICATION

(1893)
(BREUER AND FREUD)


ON THE PSYCHICAL MECHANISM OF HYSTERICAL PHENOMENA:

PRELIMINARY COMMUNICATION (1893)


(BREUER AND FREUD)
A chance observation has led us, over a number of years, to investigate a great variety of different forms and symptoms of hysteria, with a view to discovering their precipitating cause - the event which provoked the first occurrence, often many years earlier, of the phenomenon in question. In the great majority of cases it is not possible to establish the point of origin by a simple interrogation of the patient, however thoroughly it may be carried out. This is in part because what is in question is often some experience which the patient dislikes discussing; but principally because he is genuinely unable to recollect it and often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon. As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its first appearance; when this has been done, it becomes possible to demonstrate the connection in the clearest and most convincing fashion.
This method of examination has in a large number of cases produced results which seem to be of value alike from a theoretical and a practical point of view.
They are valuable theoretically because they have taught us that external events determine the pathology of hysteria to an extent far greater than is known and recognized. It is of course obvious that in cases of ‘traumatic’ hysteria what provokes the symptoms is the accident. The causal connection is equally evident in hysterical attacks when it is possible to gather from the patient’s utterances that in each attack he is hallucinating the same event which provoked the first one. The situation is more obscure in the case of other phenomena.
Our experiences have shown us, however, that the most various symptoms, which are ostensibly spontaneous and, as one might say, idiopathic products of hysteria, are just as strictly related to the precipitating trauma as the phenomena to which we have just alluded and which exhibit the connection quite clearly. The symptoms which we have been able to trace back to precipitating factors of this sort include neuralgias and anaesthesias of very various kinds, many of which had persisted for years, contractures and paralyses, hysterical attacks and epileptoid convulsions, which every observer regarded as true epilepsy, petit mal and disorders in the nature of tic, chronic vomiting and anorexia, carried to the pitch of rejection of all nourishment, various forms of disturbance of vision, constantly recurrent visual hallucinations, etc. The disproportion between the many years’ duration of the hysterical symptom and the single occurrence which provoked it is what we are accustomed invariably to find in traumatic neuroses. Quite frequently it is some event in childhood that sets up a more or less severe symptom which persists during the years that follow.
The connection is often so clear that it is quite evident how it was that the precipitating event produced this particular phenomenon rather than any other. In that case the symptom has quite obviously been determined by the precipitating cause. We may take as a very commonplace instance a painful emotion arising during a meal but suppressed at the time, and the producing nausea and vomiting which persists for months in the form of hysterical vomiting. A girl, watching beside a sick-bed in a torment of anxiety, fell into a twilight state and had a terrifying hallucination, while her right arm, which was hanging over the back of the chair, went to sleep; from this there developed a paresis of the same arm accompanied by contracture and anaesthesia. She tried to pray but could find no words; a length she succeeded in repeating a children’s prayer in English. When subsequently a severe and highly complicated hysteria developed, she could only speak, write and understand English, while her native language remained unintelligible to her for eighteen months. - The mother of a very sick child, which had at last fallen asleep, concentrated her whole will-power on keeping still so as not to waken it. Precisely on account of her intention she made a ‘clacking’ noise with her tongue. (An instance of ‘hysterical counter-will’.) This noise was repeated on a subsequent occasion on which she wished to keep perfectly still; and from it there developed a tic which, in the form of a clacking with the tongue, occurred over a period of many years whenever she felt excited. - A highly intelligent man was present while his brother had an ankylosed hip-joint extended under an anaesthetic. At the instant at which the joint gave way with a crack, he felt a violent pain in his own hip-joint, which persisted for nearly a year. - Further instances could be quoted.
In other cases the connection is not so simple. It consists only in what might be called a ‘symbolic’ relation between the precipitating cause and the pathological phenomenon - a relation such as healthy people form in dreams. For instance, a neuralgia may follow upon mental pain or vomiting upon a feeling of moral disgust. We have studied patients who used to make the most copious use of this sort of symbolization. In still other cases it is not possible to understand at first sight how they can be determined in the manner we have suggested. It is precisely the typical hysterical symptoms which fall into this class, such as hemi-anaesthesia, contraction of the field of vision, epileptiform convulsions, and so on. An explanation of our views on this group must be reserved for a fuller discussion of the subject.
Observations such as these seem to us to establish an analogy between the pathogenesis of common hysteria and that of the traumatic neuroses, and to justify an extension of the concept of traumatic hysteria. In traumatic neuroses the operative cause of the illness is not the trifling physical injury but the affect of fright - the psychical trauma. In an analogous manner, our investigations reveal, for many, if not for most, hysterical symptoms, precipitating causes which can only be described as psychical traumas. Any experience which calls up distressing affects - such as those of fright, anxiety, shame or physical pain - may operate as a trauma of this kind; and whether it in fact does so depends naturally enough on the susceptibility of the person affected (as well as on another condition which will be mentioned later). In the case of common hysteria it not infrequently happens that, instead of a single, major trauma, we find a number of partial traumas forming a group of provoking causes. These have only been able to exercise a traumatic effect by summation and they belong together in so far as they are in part components of a single story of suffering. There are other cases in which an apparently trivial circumstance combines with the actually operative event or occurs at a time of peculiar susceptibility to stimulation and in this way attains the dignity of a trauma which it would not otherwise have possessed but which thenceforward persists.
But the causal relation between the determining psychical trauma and the hysterical phenomenon is not of a kind implying that the trauma merely acts like an agent provocateur in releasing the symptom, which thereafter leads an independent existence. We must presume rather that the psychical trauma - or more precisely the memory of the trauma - acts like a foreign body which long after its entry must continue to be regarded as an agent that is still at work; and we find the evidence for this in a highly remarkable phenomenon which at the same time lends an important practical interest to our findings.
For we found, to our great surprise at first, that each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words. Recollection without affect almost invariably produces no result. The psychical process which originally took place must be repeated as vividly as possible; it must be brought back to its status nascendi and then given verbal utterance. Where what we are dealing with are phenomena involving stimuli (spasms, neuralgias and hallucinations) these re-appear once again with the fullest intensity and then vanish for ever. Failures of function, such as paralyses and anaesthesias, vanish in the same way, though, of course, without the temporary intensification being discernible.¹
¹ The possibility of a therapeutic procedure of this kind has been clearly recognized by Delboeuf and Binet, as is shown by the following quotations : 'On s’expliquerait dès lors comment le magnétiseur aide à la guérison. Il remet le sujet dans l’état où le mal s’est manifesté et combat par la parole le même mal, mais renaissant.’ [‘We can now explain how the hypnotist promotes cure. He puts the subject back into the state in which his trouble first appeared and uses words to combat that trouble, as it now makes a fresh emergence.’] (Delboeuf 1889.) - ‘. . . peut-être verra-t-on qu’en reportant le malade par un artifice mental au moment même où le symptôme a apparu pour la première fois, on rend ce malade plus docile à une suggestion curative.’ [‘. . . we shall perhaps find that by taking the patient back by mean of a mental artifice to the very moment at which the symptom first appeared, we may make him more susceptible to a therapeutic suggestion.’] (Binet, 1892, 243.) - In Janet’s interesting study on mental automatism (1889), there is an account of the cure of a hysterical girl by a method analogous to ours.
It is plausible to suppose that it is a question here of unconscious suggestion: the patient expects to be relieved of his sufferings by this procedure, and it is this expectation, and not the verbal utterance, which is the operative factor. This, however, is not so. The first case of this kind that came under observation dates back to the year 1881, that is to say to the ‘pre-suggestion’ era. A highly complicated case of hysteria was analysed in this way, and the symptoms, which sprang from separate causes, were separately removed. This observation was made possible by spontaneous auto-hypnoses on the part of the patient, and came as a great surprise to the observer.
We may reverse the dictum ‘cessante causa cessat effectuss’ [‘when the cause ceases the effect ceases’] and conclude from these observations that the determining process continues to operate in some way or other for years - not indirectly, through a chain of intermediate causal links, but as a directly releasing cause just as a psychical pain that is remembered in waking consciousness still provokes a lachrymal secretion long after the event. Hysterics suffer mainly from reminiscences.¹
¹ In this preliminary communication it is not possible for us to distinguish what is new in it from what has been said by other authors such as Moebius and Strümpell who have held similar views on hysteria to ours. We have found the nearest approach to what we have to say on the theoretical and therapeutic sides of the question in some remarks, published from time to time, by Benedikt. These we shall deal with elsewhere.
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