Part 1

NERVOUS AND MENTAL DISEASE MONOGRAPH SERIES NO. 25

THE HISTORY OF THE PSYCHOANALYTIC MOVEMENT

BY PROF. DR. SIGMUND FREUD, LL.D. OF VIENNA

AUTHORIZED ENGLISH TRANSLATION BY A. A. BRILL, PH.B., M.D. LECTURER IN PSYCHOANALYSIS AND ABNORMAL PSYCHOLOGY, NEW YORK UNIVERSITY FORMER CHIEF OF CLINIC OF PSYCHIATRY, COLUMBIA UNIVERSITY

NEW YORK THE NERVOUS AND MENTAL DISEASE PUBLISHING COMPANY 1917

NERVOUS AND MENTAL DISEASE MONOGRAPH SERIES

Edited by

Drs. SMITH ELY JELLIFFE and WM. A. WHITE

Numbers Issued

1. Outlines of Psychiatry. (5th Edition.) $3.00.

By Dr. William A. White.

2. Studies in Paranoia. (Out of Print.)

By Drs. N. Gierlich and M. Friedman.

3. The Psychology of Dementia Praecox. (Out of Print).

By Dr. C. G. Jung.

4. Selected Papers on Hysteria and other Psychoneuroses.

(2d Edition.) $2.50. By Prof. Sigmund Freud.

5. The Wassermann Serum Diagnosis in Psychiatry. $2.00.

By Dr. Felix Plaut.

6. Epidemic Poliomyelitis. New York, 1907. (Out of Print).

7. Three Contributions to Sexual Theory. (2d Ed.) $2.00.

By Prof. Sigmund Freud.

8. Mental Mechanisms. $2.00. By Dr. Wm. A. White.

(Out of Print.)

9. Studies in Psychiatry. $2.00.

New York Psychiatrical Society.

10. Handbook of Mental Examination Methods. $2.00.

(Out of Print.) By Shepherd Ivory Franz.

11. The Theory of Schizophrenic Negativism. $0.60.

By Professor E. Bleuler.

12. Cerebellar Functions. $3.00. By Dr. André-Thomas.

13. History of Prison Psychoses. $1.25.

By Drs. P. Nitsche and K. Wilmanns.

14. General Paresis. $3.00.

By Prof. E. Kraepelin.

15. Dreams and Myths. $1.00.

By Dr. Karl Abraham.

16. Poliomyelitis. $3.00.

Dr. I. Wickmann.

17. Freud’s Theories of the Neuroses. $2.00.

Dr. E. Hitschmann.

18. The Myth of the Birth of the Hero. $1.00.

Dr. Otto Rank.

19. The Theory of Psychoanalysis. $1.50.

Dr. C. G. Jung.

20. Vagotonia. By Drs. Eppinger and Hess.

$1.00.

21. Wishfulfillment and Symbolism in Fairy Tales.

$1.00.

By Dr. Ricklin.

22. The Dream Problem. By Dr. A. E. Maeder.

$0.60.

23. The Significance of Psychoanalysis for the Mental Sciences. $1.50. By Dr. O. Rank and D. H. Sachs.

24. Organ Inferiority and its Psychical Compensation.

By Dr. Alfred Adler. $1.00.

25. The History of the Psychoanalytic Movement. $0.60.

By Prof. S. Freud.

Copyright, 1917, by NERVOUS AND MENTAL DISEASE PUBLISHING COMPANY

PRESS OF THE NEW ERA PRINTING COMPANY LANCASTER, PA

_Fluctuat nec mergitur_

From the Coat of Arms of the City of Paris

I

If in what follows I bring any contribution to the history of the psychoanalytic movement nobody must be surprised at the subjective nature of this paper, nor at the rôle which falls to me therein. For psychoanalysis is my creation; for ten years I was the only one occupied with it, and all the annoyance which this new subject caused among my contemporaries has been hurled upon my head in the form of criticism. Even today, when I am no longer the only psychoanalyst, I feel myself justified in assuming that none can know better than myself what psychoanalysis is, wherein it differs from other methods of investigating the psychic life, what its name should cover, or what might better be designated as something else.

In the year 1909, when I was first privileged to speak publicly on psychoanalysis in an American University, fired by this momentous occasion for my endeavors, I declared that it was not myself who brought psychoanalysis into existence. I said that it was Josef Breuer, who had merited this honor at a time when I was a student and busy working for my examinations (1880–1882).[1] Since then, well-intentioned friends have frequently repeated that I then expressed my gratitude out of all due proportion. They considered that, as on previous occasions, I should have dignified Breuer’s “cathartic procedure” as merely preliminary to psychoanalysis, and should have claimed that psychoanalysis itself only began with my rejection of the hypnotic technique and my introduction of free association. Now it is really a matter of indifference whether the history of psychoanalysis be considered to have started with the cathartic method or only with my modification of the same. I only enter into this uninteresting question because some opponents of psychoanalysis are wont to recall, now and then, that the art of psychoanalysis did not originate with me at all, but with Breuer. Naturally, this only happens to be the case when their attitude permits them to find in psychoanalysis something that is noteworthy; on the other hand when their repudiation of psychoanalysis is unlimited, then psychoanalysis is always indisputably my creation. I have never yet heard that Breuer’s great part in psychoanalysis has brought him an equal measure of insult and reproach. As I have recognized long since that it is the inevitable fate of psychoanalysis to arouse opposition and to embitter people, I have come to the conclusion that I must surely be the originator of all that characterizes psychoanalysis. I add, with satisfaction, that none of the attempts to belittle my share in this much disdained psychoanalysis has ever come from Breuer himself, or could boast of his support.

The content of Breuer’s discovery has been so often presented that a detailed discussion of it here may be omitted. Its fundamental fact is that the symptoms of hysterical patients depend upon impressive but forgotten scenes in their lives (traumata). The therapy founded thereon was to cause the patients to recall and reproduce these experiences under hypnosis (catharsis), and the fragmentary theory, deduced from it was that these symptoms corresponded to an abnormal use of undischarged sums of excitement (conversion). In his theoretical contribution to the “Studies of Hysteria” Breuer, wherever obliged to mention _conversion_, has always added my name in parenthesis, as though this first attempt at a theoretical formulation was my mental property. I think this allotment refers only to the nomenclature, whilst the conception itself occurred to us both at the same time.

It is also well known that Breuer, after his first experience with it, allowed the cathartic treatment to rest for a number of years and only resumed it after I caused him to do so, on my return from Charcot. He was then an internist and taken up with a rather busy medical practice. I had become a physician quite reluctantly but had, at that time, received a strong motive for desiring to help nervous patients or, at least, to learn to understand something of their conditions. I had placed reliance on physical therapy and found myself helpless in the face of disappointments that came to me with W. Erb’s “Electrotherapy,” so rich in advice and indications. If I did not, at that time, pilot myself independently to the opinion later announced by Moebius, that the successes of electrotherapy in nervous disorders are the results of suggestion, it was surely only the absence of these successes that was to blame. The treatment by _suggestion_ in deep hypnosis seemed to offer me at that time sufficient compensation for the lost electrical therapy. I learned this treatment through the extremely impressive demonstrations of Liébault and Bernheim. But the investigation under hypnosis with which I became acquainted through Breuer, I found, owing to its automatic manner of working and the simultaneous gratification of one’s eagerness for knowledge, much more attractive than the monotonous and violent suggestive command which was devoid of every possibility of inquiry.

As one of the latest achievements of psychoanalysis, we have lately been admonished to put the actual conflict and the cause of the illness into the foreground of analysis. This is exactly what Breuer and I did in the beginning of our work with the cathartic method. We guided the patient’s attention directly to the traumatic scene during which the symptom had arisen, tried to find therein the psychic conflict and to free the repressed affect. We thus discovered the procedure characteristic of the psychic processes of the neuroses which I later named _regression_. The associations of the patients went back from the scene to be explained, to earlier experiences, and this forced the analysis which was to correct the present to occupy itself with the past. This regression led even further backwards. At first it went quite regularly to the time of puberty. Later, however, such failures as gaps in the understanding tempted the analytic work further back into the years of childhood which had, hitherto, been inaccessible to every sort of investigation. This regressive direction became an important characteristic of the analysis. It was proved that psychoanalysis could not clear up anything actual, except by going back to something in the past. It even proved that every pathological experience presupposes an earlier one which, though not in itself pathological, lent a pathological quality to the later occurrence. But the temptation to stop short at the known actual cause was so great that even in later analyses I yielded to it. In the case of the patient called “Dora,” carried out in 1899, the scene which caused the outbreak of the actual illness was known to me. I tried uncounted times to analyse this experience, but all that I could receive to my direct demands was the same scanty and broken description. Only after a long detour, which led through the earliest childhood of the patient, a dream appeared in the analysis of which the hitherto forgotten details of the scene were remembered, and this made possible the understanding and solution of the actual conflict.

From this one example it may be seen how misleading is the above mentioned admonition and how much of a scientific regression it is to follow the advice of neglecting the regression in the analytic technique.

The first difference of opinion between Breuer and myself came to light on a question of the more intimate psychic mechanism of hysteria. He still favored a physiological theory, so to speak, and wished to explain the psychic splitting of consciousness of hysterical subjects by means of the non-communication of various psychic states (or states of consciousness, as we then called them). He thus created the theory of the “hypnoid states,” the results of which were supposed to bring the unassimilated foreign body into the “waking consciousness.” I had formulated this to myself less scientifically. I suspected everywhere tendencies and strivings analogous to those of everyday life and conceived the psychic splitting itself as a result of a repelling process, which I then called “defense” and later “regression.” I made a short-lived attempt to reconcile both mechanisms, but as experience showed me always the same and only one thing, my defense theory, I soon became opposed to Breuer’s theory of hypnoid states.

I am, however, quite certain that this difference of opinion had nothing to do with the parting of the ways which occurred soon afterward between us. The latter had a deeper reason, but it happened in such a manner that at first I did not understand it, and only later did I learn to interpret it, following many good indexes. It will be recalled that Breuer had stated, concerning his first famous patient, that the sexual element had been astonishingly undeveloped in her and had never contributed anything to her very marked morbid picture.[2] I have always wondered why the critics of my theory of the sexual etiology of the neuroses have not often opposed it with this assertion of Breuer, and up to this day I do not know whether in this reticence I am to see a proof of their discretion, or of their lack of observation. Whoever will reread the history of Breuer’s patient in the light of the experience gained in the last twenty years, will have no difficulty in understanding the symbolism of the snakes and of the arm. By taking into account also the situation at the sick-bed of the father, he will easily guess the actual meaning of that symptom-formation. His opinion as to the part sexuality played in the psychic life of that girl will then differ greatly from that of her physician. To cure the patient Breuer utilized the most intensive suggestive _rapport_ which may serve us as prototype of that which we call “transference.” Now I have strong grounds to suppose that Breuer, after the disposal of the symptoms, must have discovered the sexual motivity of this transference by new signs, but that the general nature of this unexpected phenomenon escaped him, so that here, as though hit by “an untoward event,” he broke off the investigation. I did not obtain from him any direct information of this, but at different times he has given me sufficient connecting links to justify me in making this combination. And then, as I stood more and more decidedly for the significance of sexuality in the causation of the neuroses, Breuer was the first to show me those reactions of unwilling rejection, with which it was my lot to become so familiar later on, but which I had then not yet recognized as my unavoidable destiny.

The fact that a grossly sexual, tender or inimical, transference occurs in every treatment of a neurosis, although this was neither desired nor induced by either party, has, for me, always seemed to be the most unshakable proof that the forces of the neuroses originate in the sexual life. This argument has surely not been seriously enough considered, for if it were, there would be no question as to where the investigation would tend. For my own conviction, it has remained decisive over and above the special results of the work of the analysis.

Some comfort for the bad reception which my theory of the sexual etiology of the neuroses met with, even in the closer circle of my friends—a negative space was soon formed about my person—I found in the thought that I had taken up the fight for a new and original idea. One day, however, my memories grouped themselves in such a way that this satisfaction was disturbed, but in return I obtained an excellent insight into the origin of our activities and into the nature of our knowledge. The idea for which I was held responsible had not at all originated with me. It had come to me from three persons, whose opinions could count upon my deepest respect; from Breuer himself, from Charcot, and from Chrobak, the gynecologist of our university, probably the most prominent of our Vienna physicians. All three men had imparted to me an insight which, strictly speaking, they had not themselves possessed. Two of them denied their communication to me when later I reminded them of this: the third (Master Charcot) might also have done so, had it been granted me to see him again. But these identical communications, received without my grasping them, had lain dormant within me, until one day they awoke as an apparently original discovery.

One day, while I was a young hospital doctor, I was accompanying Breuer on a walk through the town when a man came up to him urgently desiring to speak with him. I fell back and, when Breuer was free again, he told me, in his kindly, teacher-like manner, that this was the husband of a patient, who had brought him some news about her. The wife, he added, behaved in so conspicuous a manner when in company, that she had been turned over to him for treatment as a nervous case. He ended with the remark—“those are always secrets of the alcove.” Astonished, I asked his meaning and he explained the expression to me (“secrets of the conjugal bed”), without realizing how preposterous the matter appeared to me.

A few years later, at one of Charcot’s evening receptions, I found myself near the venerated teacher who was just relating to Brouardel a very interesting history from the day’s practice. I did not hear the beginning clearly but gradually the story obtained my attention. It was the case of a young married couple from the far East. The wife was a great sufferer and the husband was impotent, or exceedingly awkward. I heard Charcot repeat: “Tâchez donc, je vous assure vous y arriverez.” Brouardel, who spoke less distinctly, must have expressed his astonishment that symptoms as those of the young wife should have appeared as a result of such circumstances, for Charcot said suddenly and with great vivacity: “Mais, dans des cas pareils c’est toujours la chose génital, toujours—toujours—toujours.” And while saying that he crossed his hands in his lap and jumped up and down several times, with the vivacity peculiar to him. I know that for a moment I was almost paralyzed with astonishment, and I said to myself: “Yes, but if he knows this why does he never say so?” But the impression was soon forgotten; brain-anatomy and the experimental production of hysterical paralysis absorbed all my interests.

A year later when I had begun my medical activities in Vienna as a private _dozent_ in nervous diseases I was as innocent and ignorant in all that concerned the etiology of the neuroses as any promising academician could be expected to be. One day I received a friendly call from Chrobak, who asked me to take a patient to whom he could not give sufficient time in his new capacity as lecturer at the university. I reached the patient before he did and learned that she suffered from senseless attacks of anxiety, which could only be alleviated by the most exact information as to the whereabouts of her physician at any time in the day. When Chrobak appeared, he took me aside and disclosed to me that the patient’s anxiety was due to the fact that though she had been married eighteen years, she was still a _virgo intacta_, that her husband was utterly impotent. In such cases the physician can only cover the domestic mishap with his reputation and must bear it if people shrug their shoulders and say of him: “He is not a good doctor if in all these years, he has not been able to cure her.” He added: “The only prescription for such troubles is the one well known to us, but which we cannot prescribe. It is:

Penis normalis dosim Repetatur!”

I had never heard of such a prescription and would like to have shaken my head at my informant’s cynicism.

I certainly have not uncovered the illustrious origins of this vicious idea because I would like to shove the responsibility for it on others. I know well that it is one thing to express an idea once or several times in the form of a rapid _aperçu_, and quite another to take it seriously and literally to lead it through all opposing details and conquer for it a place among accepted truths. It is the difference between a light flirtation and a righteous marriage with all its duties and difficulties. Epouser les idées de—(to marry so and so’s ideas,) is, at least in French, a quite usual form of speech.

Other doctrines which were contributed to the cathartic method through my efforts thus transforming it into psychoanalysis, are the following: The theories of repression and resistance, the addition of the infantile sexuality, and the usage and interpretation of dreams for the understanding of the unconscious.

Concerning the theory of repression, I was certain that I worked independently. I knew of no influence that directed me in any way to it, and I long considered this idea to be original, till O. Rank showed us the place in Schopenhauer’s “The World as Will and Idea,” where the philosopher is struggling for an explanation for insanity.[3] What is there said concerning the striving against the acceptance of a painful piece of reality agrees so completely with the content of my theory of repression that, once again, I must be indebted to my not being well-read for the possibility of making a discovery. To be sure, others have read this passage and overlooked it, without making this discovery and perhaps the same would have happened to me, if, in former years, I had taken more pleasure in reading philosophical authors. In later years I denied myself the great pleasure of Nietzsche’s works, with the conscious motive of not wishing to be hindered in the working out of my psychoanalytic impressions by any preconceived ideas. Therefore, I had to be prepared—and am so gladly—to renounce all claim to priority in those many cases in which the laborious psychoanalytic investigation can only confirm the insights intuitively won by the philosophers.

The theory of repression is the main pillar upon which rests the edifice of psychoanalysis. It is really the most essential part of it, and is itself nothing other than the theoretical expression of an experience which can be repeated at pleasure whenever one analyzes a neurotic patient without the aid of hypnosis. One is then confronted with a resistance which opposes the analytic work by causing a failure of memory in order to block it. This resistance had to be covered by the use of hypnosis; hence the history of psychoanalysis proper only starts technically with the rejection of hypnosis. The theoretical value of the fact that this resistance is connected with an amnesia leads unavoidably to that conception of the unconscious psychic activities which is peculiar to psychoanalysis, and distinguishes it markedly from the philosophical speculations about the unconscious. It may, therefore, be said that the psychoanalytic theory endeavors to explain two experiences, which result in a striking and unexpected manner during the attempt to trace back the morbid symptoms of a neurotic to their source in his life-history; viz., the facts of transference and of resistance. Every investigation which recognizes these two facts and makes them the starting points of its work may call itself psychoanalysis, even if it lead to other results than my own. But whoever takes up other sides of the problem and deviates from these two assumptions will hardly escape the charge of interfering with the rights of ownership through attempted imitation, if he insist upon calling himself a psychoanalyst.