clamorous; they show an unquestionable similarity to those of hysteria, or less often to those of compulsion neurosis, and yet they are different in every respect. It appears that in dementia praecox the libido in its endeavor to return to the objects, i.e., to the images of the objects, really captures something, but only their shadows — I mean, the verbal images belonging to them. This is not the place to discuss this matter, but I believe that these reversed impulses of the libido have permitted us an insight into what really determines the difference between a conscious and an unconscious representation.
I have now brought you into the field where we may expect the further progress of analytic work. Since we can now employ the conception of ego-libido, the narcistic neuroses have become accessible to us. We are confronted with the problem of finding a dynamic explanation of these conditions and at the same time of enlarging our knowledge of psychic life by an understanding of the ego. The ego psychology, which we strive to understand, must not be founded upon introspective data, but rather, as in the libido, upon analysis of the disturbances and decompositions of the ego. When this greater task is accomplished we shall probably disparage our previous knowledge of the fate of the libido which we gained from our study of the transference neuroses. But there is still much to be said in this matter. Narcistic neuroses can scarcely be approached by the same technique which served us in the transference neuroses. Soon you will hear why. After forging ahead a little in the study of narcistic neuroses we always seem to come to a wall which impedes progress. You know that in the transference neuroses we also encountered such barriers of resistance, but we were able to break them down piece by piece. In narcistic neuroses the resistance is insuperable; at best we are permitted to cast a curious glance over the wall to spy out what is taking place on the other side. Our technical methods must be replaced by others; we do not yet know whether or not we shall be able to find such a substitute. To be sure, even these patients furnish us with ample material. They do say many things, though not in answer to our questions, and for the time being we are forced to interpret these utterances through the understanding we have gained from the symptoms of transference neuroses. The coincidence is sufficiently great to assure us a good beginning. How far this technique will go, remains to be seen.
There are additional difficulties that impede our progress. The narcistic conditions and the psychoses related to them can only be solved by observers who have schooled themselves in analytic study of transference neuroses. But our psychiatrists do not study psychoanalysis and we psychoanalysts see too few psychiatric cases. A race of psychiatrists that has gone through the school of psychoanalysis as a preparatory science most first grow up. The beginnings of this are now being made in America, where many leading psychiatrists explain the teachings of psychoanalysis to their students, and where many owners of sanatoriums and directors of institutes for the insane take pains to observe their patients in the light of these teachings. But even here we have occasionally been successful in casting a glance over the narcistic wall and I shall tell you a few things that we think we have discovered.
The disease of paranoia, chronic systematic insanity, is given a very uncertain position by the attempts at classification of present-day psychiatry. There is no doubt of its close relationship to dementia praecox. I once was so bold as to propose that paranoia and dementia praecox could be classed together under the common name of paraphrenia. The types of paranoia are described according to their content as: megalomania, the mania of persecution, eroto mania, mania of jealousy, etc. From psychiatry we do not expect attempts at explanation. As an example of such an attempt, to be sure an antiquated and not entirely valid example, I might mention the attempt to develop one symptom directly out of another by means of an intellectual rationalization, as: the patient who primarily believes he is being persecuted draws the conclusion from this persecution that he must be an extraordinarily important personality and thus develops megalomania. In our analytical conception megalomania is the immediate outcome of exaggeration of the ego, which results from the drawing-in of libidinous occupation with objects, a secondary narcism as a recurrence of the originally early infantile form. In cases of the mania of persecution we have noticed a few things that lead us to follow a definite track. In the first place, we observed that in the great majority of cases the persecutor was of the same sex as the persecuted. This could still be explained in a harmless way, but in a few carefully studied cases it was clearly shown that the person of the same sex, who was most loved in normal times, became the persecutor after the malady set in. A further development is made possible by the fact that one loved person is replaced by another, according to familiar affinities, e.g., the father by the teacher or the superior. We concluded from such ever-increasing experiences, that paranoia persecutoria is the form in which the individual guards himself against a homosexual tendency that has become too powerful. The change from affection to hate, which notoriously may take the form of serious threats against the life of the loved and hated person, expresses the transformation of libidinous impulse into fear, which is a regularly recurring result of the process of suppression. As an illustration I shall cite the last case in which I made observations on this subject. A young physician had to be sent away from his home town because he had threatened the life of the son of a university professor, who up to that time had been his best friend. He ascribed truly devilish intentions to his erstwhile friend and credited him with power of a demon. He was to blame for all the misfortunes that had in recent years befallen the family of the patient, for all his personal and social ill-luck. But this was not enough. The wicked friend, and his father the professor, had been the cause of the war and had called the Russians into the land. He had forfeited his life a thousand times and our patient was convinced that with the death of the culprit all misfortune would come to an end. And yet his old affection for his friend was so great that it had paralyzed his hand when he had had the opportunity of shooting down the enemy at close quarters. In my short consultations with the patient, I discovered that the friendship between the two dated back to early school-life. Once at least the bonds of friendship had been over-stepped; a night spent together had been the occasion for complete sexual intercourse. Our patient never felt attracted to women, as would have been natural to his age or his charming personality. At one time he was engaged to a beautiful and distinguished young girl, but she broke off the engagement because she found so little affection in her fiancé. Years later his malady broke out just at that moment when for the first time he had succeeded in giving complete gratification to a woman. When this woman embraced him, full of gratitude and devotion, he suddenly felt a strange pain which cut around his skull like a sharp incision. His later interpretation of this sensation was that an incision such as is used to expose a part of the brain had been performed upon him, and since his friend had become a pathological anatomist, he gradually came to the conclusion that he alone could have sent him this last woman as a temptation. From that time on his eyes were also opened to the other persecutions in which he was to be the victim of the intrigues of his former friend.
But how about those cases where the persecutor is not of the same sex as the persecuted, where our explanation of a guard against homosexual libido is apparently contradicted? A short time ago I had occasion to investigate such a case and was able to glean corroboration from this apparent contradiction. A young girl thought she was followed by a man, with whom she had twice had intimate relations. She had, as a matter of fact, first laid these maniacal imputations at the door of a woman, whom we may consider as having played the part of a mother-substitute in her psychic life. Only after the second meeting did she progress to the point of diverting this maniacal idea from the woman and of transferring it to the man. The condition that the persecutor must be of the same sex was also originally maintained in this instance. In her claim before the lawyer and the physician, this patient did not mention this first stage of her mania, and this caused the appearance of a contradiction to our theory of paranoia.
Homosexual choice of object is originally more natural to narcism than the heterosexual. If it is a matter of thwarting a strong and undesirable homosexual impulse, the way back to narcism is made especially easy. Until now I have had very little opportunity of speaking to you about the fundamental conditions of love-life, so far as we know them, and now I cannot make up for lost time. I only want to point out that the choice of an object, that progress in the development of the libido which comes after the narcistic stage, can proceed according to two different types — either according to the narcistic type, which puts a very similar personality in the place of the personal ego, or according to the dependent type, which chooses those persons who have become valuable