to be satisfied with obtaining our insight into the childhood neurosis subsequently, when the patient is already well along in life, under conditions in which we are forced to work with certain corrections and under definite precautions.
Secondly, we must admit that the universal regression of the libido to the period of childhood would be inexplicable if there were nothing there which could exert an attraction for it. The fixation which we assume to exist towards specific developmental phases, conveys a meaning only if we think of it as stabilizing a definite amount of libidinous energy. Finally, I am able to remind you that here there exists a complementary relationship between the intensity and the pathogenic significance of the infantile experiences to the later ones which is similar to that studied in previous series. There are cases in which the entire causal emphasis falls upon the sexual experiences of childhood, in which these impressions take on an effect which is unmistakably traumatic and in which no other basis exists for them beyond what the average sexual constitution and its immaturity can offer. Side by side with these there are others in which the whole stress is brought to bear by the later conflicts, and the emphasis the analysis places on childhood impressions appears entirely as the work of regression. There are also extremes of “retarded development” and “regression,” and between them every combination in the interaction of the two factors.
These relations have a certain interest for that pedagogy which assumes as its object the prevention of neuroses by an early interference in the sexual development of the child. So long as we keep our attention fixed essentially on the infantile sexual experiences, we readily come to believe we have done everything for the prophylaxis of nervous afflictions when we have seen to it that this development is retarded, and that the child is spared this type of experience. Yet we already know that the conditions for the causation of neuroses are more complicated and cannot in general be influenced through one single factor. The strict protection in childhood loses its value because it is powerless against the constitutional factor; furthermore, it is more difficult to carry out than the educators imagine, and it brings with it two new dangers that cannot be lightly dismissed. It accomplishes too much, for it favors a degree of sexual suppression which is harmful for later years, and it sends the child into life without the power to resist the violent onset of sexual demands that must be expected during puberty. The profit, therefore, which childhood prophylaxis can yield is most dubious; it seems, indeed, that better success in the prevention of neuroses can be gained by attacking the problem through a changed attitude toward facts.
Let us return to the consideration of the symptoms. They serve as substitutes for the gratification which has been forborne, by a regression of the libido to earlier days, with a return to former development phases in their choice of object and in their organization. We learned some time ago that the neurotic is held fast somewhere in his past; we now know that it is a period of his past in which his libido did not miss the satisfaction which made him happy. He looks for such a time in his life until he has found it, even though he must hark back to his suckling days as he retains them in his memory or as he reconstructs them in the light of later influences. The symptom in some way again yields the old infantile form of satisfaction, distorted by the censoring work of the conflict. As a rule it is converted into a sensation of suffering and fused with other causal elements of the disease. The form of gratification which the symptom yields has much about it that alienates one’s sympathy. In this we omit to take into account, however, the fact that the patients do not recognize the gratification as such and experience the apparent satisfaction rather as suffering, and complain of it. This transformation is part of the psychic conflict under the pressure of which the symptom must be developed. What was at one time a satisfaction for the individual must now awaken his antipathy or disgust. We know a simple but instructive example for such a change of feeling. The same child that sucked the milk with such voracity from its mother’s breast is apt to show a strong antipathy for milk a few years later, which is often difficult to overcome. This antipathy increases to the point of disgust when the milk, or any substituted drink, has a little skin over it. It is rather hard to throw out the suggestion that this skin calls up the memory of the mother’s breast, which was once so intensely coveted. In the meantime, to be sure, the traumatic experience of weaning has intervened.
There is something else that makes the symptoms appear remarkable and inexplicable as a means of libidinous satisfaction. They in no way recall anything from which we normally are in the habit of expecting satisfaction. They usually require no object, and thereby give up all connection with external reality. We understand this to be a result of turning away from fact and of returning to the predominance of pleasurable gratification. But it is also a return to a sort of amplified autoeroticism, such as was yielded the sex impulse in its earliest satisfactions. In the place of a modification in the outside world, we have a physical change, in other words, an internal reaction in place of an external one, an adjustment instead of an activity. Viewed from a phylogenetic standpoint, this expresses a very significant regression. We will grasp this better when we consider it in connection with a new factor which we are still to discover from the analytic investigation of symptom development. Further, we recall that in symptom formation the same processes of the unconscious have been at work as in dream formation — elaboration and displacement. Similarly to the dream, the symptom represents a fulfillment, a satisfaction after the manner of the infantile; by the utmost elaboration this satisfaction can be compressed into a single sensation or innervation, or by extreme displacement it may be restricted to a tiny element of the entire libidinous complex. It is no wonder that we often have difficulties in recognizing in the symptom the libidinous satisfaction which we anticipate and always find verified.
I have indicated that we must still become familiar with a new factor. It is something really surprising and confusing. You know that by analysis of the symptoms we arrive at a knowledge of the infantile experiences upon which the libido is fixated and out of which the symptoms are formed. Well, the surprising thing is this, that these infantile scenes are not always true. Indeed, in the majority of cases they are untrue, and in some instances they are directly contrary to historical truth. You see that this discovery, as no other, serves either to discredit the analysis which has led to such a result, or to discredit the patients upon whose testimony the analysis, as well as the whole understanding of neuroses, is built up. In addition there is something else utterly confusing about it. If the infantile experiences, revealed by analysis, were in every case real, we should have the feeling of walking on sure ground; if they were regularly falsified, disclosed themselves as inventions or phantasies of the patients, we should have to leave this uncertain ground and find a surer footing elsewhere. But it is neither the one nor the other, for when we look into the matter we find that the childhood experiences which are recalled or reconstructed in the course of the analysis may in some in some instances be false, in others undeniably true, and in the majority of cases a mixture of truth and fiction. The symptoms then are either the representation of actual experiences to which we may ascribe an influence in the fixation of the libido, or the representation of phantasies of the patient which, of course, can be of no etiological significance. It is hard to find one’s way here. The first foothold is given perhaps by an analogous discovery, namely, that the same scattered childhood memories that individuals always have had and have been conscious of prior to an analysis may be falsified as well, or at least may contain a generous mixture of true and false. Evidence of error very seldom offers difficulties, and we at least gain the satisfaction of knowing that the blame for this unexpected disappointment is not to be laid at the door of analysis, but in some way upon the patients.
After reflecting a bit we can easily understand what is so confusing in this matter. It is the slight regard for reality, the neglect to keep fact distinct from phantasy. We are apt to feel insulted that the patient has wasted our time with invented tales. There is an enormous gap in our thinking between reality and invention and we accord an entirely different valuation to reality. The patient, too, takes this same viewpoint in his normal thinking. When he offers the material which, by way of the symptom, leads back to the wish situations which are modeled upon the childhood experiences, we are at first, to be sure, in doubt whether we are dealing with reality or with phantasy. Later certain traits determine this decision; we are confronted with the task of acquainting the patient with them. This can never be accomplished without difficulty. If at the outset we tell him that he is going to reveal phantasies with which he has veiled his childhood history, just as every people weaves myths around