The psychical disorders of male potency 23 страница

The view that the sexual representation of ‘higher’ thoughts in dreams and neurosis is nothing but an archaic mode of expression is of course irreconcilable with the fact that in neurosis these sexual complexes prove to be the bearers of the quantities of libido which have been withdrawn from utilization in real life. If it was merely a question of a sexual ‘jargon’, the economy of the libido could not have been altered in any way by it. Jung admits this himself in his Darstellung der psychoanalytischen Theorie and formulates the task of therapy as the detaching of libidinal cathexes from these complexes. This can never be achieved, however, by directing the patient away from them and urging him to sublimate, but only by exhaustive examination of them and by making them fully and completely conscious. The first piece of reality which the patient must deal with is his illness. Efforts to spare him that task point to the physician’s incapacity to help him to overcome his resistances, or else to the physician’s dread of the results of the work.

It may be said lastly that by his ‘modification’ of psycho-analysis Jung has given us a counterpart to the famous Lichtenberg knife. He has changed the hilt, and he has put a new blade into it; yet because the same name is engraved on it we are expected to regard the instrument as the original one.

I think I have made clear, on the contrary, that the new teaching which aims at replacing psycho-analysis signifies an abandonment of analysis and a secession from it. Some people may be inclined to fear that this secession is bound to have more momentous consequences for analysis than would another, owing to its having been started by men who have played so great a part in the movement and have done so much to advance it. I do not share this apprehension.

Men are strong so long as they represent a strong idea; they become powerless when they oppose it. Psycho-analysis will survive this loss and gain new adherents in place of these. In conclusion, I can only express a wish that fortune may grant an agreeable upward journey to all those who have found their stay in the underworld of psycho-analysis too uncomfortable for their taste. The rest of us, I hope, will be permitted without hindrance to carry through to their conclusion our labours in the depths.

February, 1914. 9

ON NARCISSISM AN INTRODUCTION (1914)

The term narcissism is derived from clinical description and was chosen by Paul Näcke in 1899 to denote the attitude of a person who treats his own body in the same way in which the body of a sexual object is ordinarily treated - who looks at it, that is to say, strokes it and fondles it till he obtains complete satisfaction through these activities. Developed to this degree, narcissism has the significance of a perversion that has absorbed the whole of the subject’s sexual life, and it will consequently exhibit the characteristics which we expect to meet with in the study of all perversions.

Psycho-analytic observers were subsequently struck by the fact that individual features of the narcissistic attitude are found in many people who suffer from other disorders - for instance, as Sadger has pointed out, in homosexuals - and finally it seemed probable that an allocation of the libido such as deserved to be described as narcissism might be present far more extensively, and that it might claim a place in the regular course of human sexual development.¹ Difficulties in psycho-analytic work upon neurotics led to the same supposition, for it seemed as though this kind of narcissistic attitude in them constituted one of the limits to their susceptibility to influence. Narcissism in this sense would not be a perversion, but the libidinal complement to the egoism of the instinct of self-preservation, a measure of which may justifiably be attributed to every living creature.

¹ Otto Rank (1911c).2

A pressing motive for occupying ourselves with the conception of a primary and normal narcissism arose when the attempt was made to subsume what we know of dementia praecox (Kraepelin) or schizophrenia (Bleuler) under the hypothesis of the libido theory. Patients of this kind, whom I have proposed to term paraphrenics, display two fundamental characteristics: megalomania and diversion of their interest from the external world - from people and things. In consequence of the latter change, they become inaccessible to the influence of psycho-analysis and cannot be cured by our efforts. But the paraphrenic’s turning away from the external world needs to be more precisely characterized. A patient suffering from hysteria or obsessional neurosis has also, as far as his illness extends, given up his relation to reality. But analysis shows that he has by no means broken off his erotic relations to people and things. He still retains them in phantasy; i.e. he has, on the one hand, substituted for real objects imaginary ones from his memory, or has mixed the latter with the former; and on the other hand, he has renounced the initiation of motor activities for the attainment of his aims in connection with those objects. Only to this condition of the libido may we legitimately apply the term ‘introversion’ of the libido which is used by Jung indiscriminately. It is otherwise with the paraphrenic. He seems really to have withdrawn his libido from people and things in the external world, without replacing them by others in phantasy. When he does so replace them, the process seems to be a secondary one and to be part of an attempt at recovery, designed to lead the libido back to objects.¹

The question arises: What happens to the libido which has been withdrawn from external objects in schizophrenia? The megalomania characteristic of these states points the way. This megalomania has no doubt come into being at the expense of object-libido. The libido that has been withdrawn from the external world has been directed to the ego and thus gives rise to an attitude which may be called narcissism. But the megalomania itself is no new creation; on the contrary, it is, as we know, a magnification and plainer manifestation of a condition which had already existed previously. This leads us to look upon the narcissism which arises through the drawing in of object-cathexes as a secondary one, superimposed upon a primary narcissism that is obscured by a number of different influences.

¹ In connection with this see my discussion of the ‘end of the world’ in the analysis of Senatspräsident Schreber; also Abraham, 1908.3

Let me insist that I am not proposing here to explain or penetrate further into the problem of schizophrenia, but that I am merely putting together what has already been said elsewhere, in order to justify the introduction of the concept of narcissism.

This extension of the libido theory - in my opinion, a legitimate one - receives reinforcement from a third quarter, namely, from our observations and views on the mental life of children and primitive peoples. In the latter we find characteristics which, if they occurred singly, might be put down to megalomania: an over-estimation of the power of their wishes and mental acts, the ‘omnipotence of thoughts’, a belief in the thaumaturgic force of words, and a technique for dealing with the external world - ‘magic’ - which appears to be a logical application of these grandiose premisses.¹ In the children of to-day, whose development is much more obscure to us, we expect to find an exactly analogous attitude towards the external world.² Thus we form the idea of there being an original libidinal cathexis of the ego, from which some is later given off to objects, but which fundamentally persists and is related to the object-cathexes much as the body of an amoeba is related to the pseudopodia which it puts out. In our researches, taking, as they did, neurotic symptoms for their starting-point, this part of the allocation of libido necessarily remained hidden from us at the outset. All that we noticed were the emanations of this libido - the object-cathexes, which can be sent out and drawn back again. We see also, broadly speaking, an antithesis between ego-libido and object-libido. The more of the one is employed, the more the other becomes depleted. The highest phase of development of which object-libido is capable is seen in the state of being in love, when the subject seems to give up his own personality in favour of an object-cathexis; while we have the opposite condition in the paranoic’s phantasy (or self-perception) of the ‘end of the world’.³ Finally, as regards the differentiation of psychical energies, we are led to the conclusion that to begin with, during the state of narcissism, they exist together and that our analysis is too coarse to distinguish between them; not until there is object-cathexis is it possible to discriminate a sexual energy - the libido - from an energy of the ego-instincts.

¹ Cf. the passages in my Totem and Taboo (1912-13) which deal with this subject.

² Cf. Ferenczi (1913a).

³ There are two mechanisms of this ‘end of the world’ idea: in the one case, the whole libidinal cathexis flows off to the loved object; in the other, it all flows back into the ego.4 Before going any further I must touch on two questions which lead us to the heart of the difficulties of our subject. In the first place, what is the relation of the narcissism of which we are now speaking to auto-erotism, which we have described as an early state of the libido? Secondly, if we grant the ego a primary cathexis of libido, why is there any necessity for further distinguishing a sexual libido from a non-sexual energy of the ego-instincts? Would not the postulation of a single kind of psychical energy save us all the difficulties of differentiating an energy of the ego-instincts from ego-libido, and ego-libido from object-libido?

As regards the first question, I may point out that we are bound to suppose that a unity comparable to the ego cannot exist in the individual from the start; the ego has to be developed. The auto-erotic instincts, however, are there from the very first; so there must be something added to auto-erotism - a new psychical action - in order to bring about narcissism.

To be asked to give a definite answer to the second question must occasion perceptible uneasiness in every psycho-analyst. One dislikes the thought of abandoning observation for barren theoretical controversy, but nevertheless one must not shirk an attempt at clarification. It is true that notions such as that of an ego-libido, an energy of the ego-instincts, and so on, are neither particularly easy to grasp, nor sufficiently rich in content; a speculative theory of the relations in question would begin by seeking to obtain a sharply defined concept as its basis. But I am of opinion that that is just the difference between a speculative theory and a science erected on empirical interpretation. The latter will not envy speculation its privilege of having a smooth, logically unassailable foundation, but will gladly content itself with nebulous, scarcely imaginable basic concepts, which it hopes to apprehend more clearly in the course of its development, or which it is even prepared to replace by others. For these ideas are not the foundation of science, upon which everything rests: that foundation is observation alone. They are not the bottom but the top of the whole structure, and they can be replaced and discarded without damaging it. The same thing is happening in our day in the science of physics, the basic notions of which as regards matter, centres of force, attraction, etc., are scarcely less debatable than the corresponding notions in psycho-analysis.

The value of the concepts ‘ego-libido’ and ‘object-libido’ lies in the fact that they are derived from the study of the intimate characteristics of neurotic and psychotic processes. A differentiation of libido into a kind which is proper to the ego and one which is attached to objects is an unavoidable corollary to an original hypothesis which distinguished between sexual instincts and ego-instincts. At any rate, analysis of the pure transference neuroses (hysteria and obsessional neurosis) compelled me to make this distinction and I only know that all attempts to account for these phenomena by other means have been completely unsuccessful.

In the total absence of any theory of the instincts which would help us to find our bearings, we may be permitted, or rather, it is incumbent upon us, to start off by working out some hypothesis to its logical conclusion, until it either breaks down or is confirmed. There are various points in favour of the hypothesis of there having been from the first a separation between sexual instincts and others, ego-instincts, besides the serviceability of such a hypothesis in the analysis of the transference neuroses. I admit that this latter consideration alone would not be unambiguous, for it might be a question of an indifferent psychical energy which only becomes libido through the act of cathecting an object. But, in the first place, the distinction made in this concept corresponds to the common, popular distinction between hunger and love. In the second place, there are biological considerations in its favour. The individual does actually carry on a twofold existence: one to serve his own purposes and the other as a link in a chain, which he serves against his will, or at least involuntarily. The individual himself regards sexuality as one of his own ends; whereas from another point of view he is an appendage to his germ plasm, at whose disposal he puts his energies in return for a bonus of pleasure. He is the mortal vehicle of a (possibly) immortal substance - like the inheritor of an entailed property, who is only the temporary holder of an estate which survives him. The separation of the sexual instincts from the ego-instincts would simply reflect this twofold function of the individual. Thirdly, we must recollect that all our provisional ideas in psychology will presumably some day be based on an organic substructure. This makes it probable that it is special substances and chemical processes which perform the operations of sexuality and provide for the extension of individual life into that of the species. We are taking this probability into account in replacing the special chemical substances by special psychical forces.

I try in general to keep psychology clear from everything that is different in nature from it, even biological lines of thought. For that very reason I should like at this point expressly to admit that the hypothesis of separate ego-instincts and sexual instincts (that is to say, the libido theory) rests scarcely at all upon a psychological basis, but derives its principal support from biology. But I shall be consistent enough to drop this hypothesis if psycho-analytic work should itself produce some other, more serviceable hypothesis about the instincts. So far, this has not happened. It may turn out that, most basically and on the longest view, sexual energy - libido - is only the product of a differentiation in the energy at work generally in the mind. But such an assertion has no relevance. It relates to matters which are so remote from the problems of our observation, and of which we have so little cognizance, that it is as idle to dispute it as to affirm it; this primal identity may well have as little to do with our analytic interests as the primal kinship of all the races of mankind has to do with the proof of kinship required in order to establish a legal right of inheritance. All these speculations take us nowhere. Since we cannot wait for another science to present us with the final conclusions on the theory of the instincts, it is far more to the purpose that we should try to see what light may be thrown upon this basic problem of biology by a synthesis of the psychological phenomena. Let us face the possibility of error; but do not let us be deterred from pursuing the logical implications of the hypothesis we first adopted of an antithesis between ego-instincts and sexual instincts (a hypothesis to which we were forcibly led by analysis of the transference neuroses), and from seeing whether it turns out to be without contradictions and fruitful, and whether it can be applied to other disorders as well, such as schizophrenia.

It would, of course, be a different matter if it were proved that the libido theory has already come to grief in the attempt to explain the latter disease. This has been asserted by C. G. Jung (1912) and it is on that account that I have been obliged to enter upon this last discussion, which I would gladly have been spared. I should have preferred to follow to its end the course embarked upon in the analysis of the Schreber case without any discussion of its premisses. But Jung’s assertion is, to say the least of it, premature. The grounds he gives for it are scanty. In the first place, he appeals to an admission of my own that I myself have been obliged, owing to the difficulties of the Schreber analysis, to extend the concept of libido (that is, to give up its sexual content) and to identify libido with psychical interest in general. Ferenczi (1913b), in an exhaustive criticism of Jung’s work, has already said all that is necessary in correction of this erroneous interpretation. I can only corroborate his criticism and repeat that I have never made any such retractation of the libido theory. Another argument of Jung’s, namely, that we cannot suppose that the withdrawal of the libido is in itself enough to bring about the loss of the normal function of reality, is no argument but a dictum. It ‘begs the question’,¹ and saves discussion; for whether and how this is possible was precisely the point that should have been under investigation. In his next major work, Jung (1913) just misses the solution I had long since indicated: ‘At the same time’, he writes, ‘there is this to be further taken into consideration (a point to which, incidentally, Freud refers in his work on the Schreber case) - that the introversion of the libido sexualis leads to a cathexis of the "ego", and that it may possibly be this that produces the result of a loss of reality. It is indeed a tempting possibility to explain the psychology of the loss of reality in this fashion.’ But Jung does not enter much further into a discussion of this possibility. A few lines later he dismisses it with the remark that this determinant ‘would result in the psychology of an ascetic anchorite, not in a dementia praecox’. How little this inapt analogy can help us to decide the question may be learnt from the consideration that an anchorite of this kind, who ‘tries to eradicate every trace of sexual interest’ (but only in the popular sense of the word ‘sexual’), does not even necessarily display any pathogenic allocation of the libido. He may have diverted his sexual interest from human beings entirely, and yet may have sublimated it into a heightened interest in the divine, in nature, or in the animal kingdom, without his libido having undergone an introversion on to his phantasies or a return to his ego. This analogy would seem to rule out in advance the possibility of differentiating between interest emanating from erotic sources and from others. Let us remember, further, that the researches of the Swiss school, however valuable, have elucidated only two features in the picture of dementia praecox - the presence in it of complexes known to us both in healthy and neurotic subjects, and the similarity of the phantasies that occur in it to popular myths - but that they have not been able to throw any further light on the mechanism of the disease. We may repudiate Jung’s assertion, then, that the libido theory has come to grief in the attempt to explain dementia praecox, and that it is therefore disposed of for the other neuroses as well.

¹ [In English in the original.]8

II

Certain special difficulties seem to me to lie in the way of a direct study of narcissism. Our chief means of access to it will probably remain the analysis of the paraphrenias. Just as the transference neuroses have enabled us to trace the libidinal instinctual impulses, so dementia praecox and paranoia will give us an insight into the psychology of the ego. Once more, in order to arrive at an understanding of what seems so simple in normal phenomena, we shall have to turn to the field of pathology with its distortions and exaggerations. At the same time, other means of approach remain open to us, by which we may obtain a better knowledge of narcissism. These I shall now discuss in the following order: the study of organic disease, of hypochondria and of the erotic life of the sexes.

In estimating the influence of organic disease upon the distribution of libido, I follow a suggestion made to me orally by Sándor Ferenczi. It is universally known, and we take it as a matter of course, that a person who is tormented by organic pain and discomfort gives up his interest in the things of the external world, in so far as they do not concern his suffering. Closer observation teaches us that he also withdraws libidinal interest from his love-objects: so long as he suffers, he ceases to love. The commonplace nature of this fact is no reason why we should be deterred from translating it into terms of the libido theory. We should then say:(the sick man withdraws his libidinal cathexes back upon his own ego, and sends them out again when he recovers. ‘Concentrated is his soul’, says Wilhelm Busch of the poet suffering from toothache, ‘in his molar’s narrow hole.’ Here libido and ego-interest share the same fate and are once more indistinguishable from each other. The familiar egoism of the sick person covers both. We find it so natural because we are certain that in the same situation we should behave in just the same way. The way in which a lover’s feelings, however strong, are banished by bodily ailments, and suddenly replaced by complete indifference, is a theme which has been exploited by comic writers to an appropriate extent.

The condition of sleep, too, resembles illness in implying a narcissistic withdrawal of the positions of the libido on to the subject’s own self, or, more precisely, on to the single wish to sleep. The egoism of dreams fits very well into this context. In both states we have, if nothing else, examples of changes in the distribution of libido that are consequent upon an alteration of the ego.

Hypochondria, like organic disease, manifests itself in distressing and painful bodily sensations, and it has the same effect as organic disease on the distribution of libido. The hypochondriac withdraws both interest and libido - the latter specially markedly - from the objects of the external world and concentrates both of them upon the organ that is engaging his attention. A difference between hypochondria and organic disease now becomes evident: in the latter, the distressing sensations are based upon demonstrable changes; in the former, this is not so. But it would be entirely in keeping with our general conception of the processes of neurosis if we decided to say that hypochondria must be right: organic changes must be supposed to be present in it, too.

But what could these changes be? We will let ourselves be guided at this point by our experience, which shows that bodily sensations of an unpleasurable nature, comparable to those of hypochondria, occur in the other neuroses as well. I have said before that I am inclined to class hypochondria with neurasthenia and anxiety-neurosis as a third ‘actual’ neurosis. It would probably not be going too far to suppose that in the case of the other neuroses a small amount of hypochondria was regularly formed at the same time as well. We have the best example of this, I think, in anxiety neurosis with its superstructure of hysteria. Now the familiar prototype of an organ that is painfully tender, that is in some way changed and that is yet not diseased in the ordinary sense, is the genital organ in its states of excitation. In that condition it becomes congested with blood, swollen and humected, and is the seat of a multiplicity of sensations. Let us now, taking any part of the body, describe its activity of sending sexually exciting stimuli to the mind as its ‘erotogenicity’, and let us further reflect that the considerations on which our theory of sexuality was based have long accustomed us to the notion that certain other parts of the body - the ‘erotogenic’ zones - may act as substitutes for the genitals and behave analogously to them. We have then only one more step to take. We can decide to regard erotogenicity as a general characteristic of all organs and may then speak of an increase or decrease of it in a particular part of the body. For every such change in the erotogenicity of the organs there might then be a parallel change of libidinal cathexis in the ego. Such factors would constitute what we believe to underlie hypochondria and what may have the same effect upon the distribution of libido as is produced by a material illness of the organs.

We see that, if we follow up this line of thought, we come up against the problem not only of hypochondria, but of the other ‘actual’ neuroses - neurasthenia and anxiety neurosis. Let us therefore stop at this point. It is not within the scope of a purely psychological inquiry to penetrate so far behind the frontiers of physiological research. I will merely mention that from this point of view we may suspect that the relation of hypochondria to paraphrenia is similar to that of the other ‘actual’ neuroses to hysteria and obsessional neurosis: we may suspect, that is, that it is dependent on ego-libido just as the others are on object-libido, and that hypochondriacal anxiety is the counterpart, as coming from ego-libido, to neurotic anxiety. Further, since we are already familiar with the idea that the mechanism of falling ill and of the formation of symptoms in the transference neuroses - the path from introversion to regression - is to be linked to a damming-up of object-libido,¹ we may come to closer quarters with the idea of a damming-up of ego-libido as well and may bring this idea into relation with the phenomena of hypochondria and paraphrenia.

At this point, our curiosity will of course raise the question why this damming-up of libido in the ego should have to be experienced as unpleasurable. I shall content myself with the answer that unpleasure is always the expression of a higher degree of tension, and that therefore what is happening is that a quantity in the field of material events is being transformed here as elsewhere into the psychical quality of unpleasure. Nevertheless it may be that what is decisive for the generation of unpleasure is not the absolute magnitude of the material event, but rather some particular function of that absolute magnitude. Here we may even venture to touch on the question of what makes it necessary at all for our mental life to pass beyond the limits of narcissism and to attach the libido to objects. The answer which would follow from our line of thought would once more be that this necessity arises when the cathexis of the ego with libido exceeds a certain amount. A strong egoism is a protection against falling ill, but in the last resort we must begin to love in order not to fall ill, and we are bound to fall ill if, in consequence of frustration, we are unable to love. This follows somewhat on the lines of Heine’s picture of the psychogenesis of the Creation:

Krankheit ist wohl der letzte Grund

Des ganzen Schöpferdrangs gewesen;

Erschaffend konnte ich genesen,

Erschaffend wurde ich gesund.²

We have recognized our mental apparatus as being first and foremost a device designed for mastering excitations which would otherwise be felt as distressing or would have pathogenic effects. Working them over in the mind helps remarkably towards an internal draining away of excitations which are incapable of direct discharge outwards, or for which such a discharge is for the moment undesirable. In the first instance, however, it is a matter of indifference whether this internal process of working-over is carried out upon real or imaginary objects. The difference does not appear till later - if the turning of the libido on to unreal objects (introversion) has led to its being dammed up. In paraphrenics, megalomania allows of a similar internal working-over of libido which has returned to the ego; perhaps it is only when the megalomania fails that the damming-up of libido in the ego becomes pathogenic and starts the process of recovery which gives us the impression of being a disease.

¹ Cf. ‘Types of Onset of Neurosis’ (1912c).

² [‘Illness was no doubt the final cause of the whole urge to create. By creating, I could recover; by creating, I became healthy.’]1

I shall try here to penetrate a little further into the mechanism of paraphrenia and shall bring together those views which already seem to me to deserve consideration. The difference between paraphrenic affections and the transference neuroses appears to me to lie in the circumstance that, in the former, the libido that is liberated by frustration does not remain attached to objects in phantasy, but withdraws on to the ego. Megalomania would accordingly correspond to the psychical mastering of this latter amount of libido, and would thus be the counterpart of the introversion on to phantasies that is found in the transference neuroses; a failure of this psychical function gives rise to the hypochondria of paraphrenia and this is homologous to the anxiety of the transference neuroses. We know that this anxiety can be resolved by further psychical working over, i.e. by conversion, reaction-formation or the construction of protections (phobias). The corresponding process in paraphrenics is an attempt at restoration, to which the striking manifestations of the disease are due. Since paraphrenia frequently, if not usually, brings about only a partial detachment of the libido from objects, we can distinguish three groups of phenomena in the clinical picture: (1) those representing what remains of a normal state or of neurosis (residual phenomena); (2) those representing the morbid process (detachment of libido from its objects and, further, megalomania, hypochondria, affective disturbance and every kind of regression); (3) those representing restoration, in which the libido is once more attached to objects, after the manner of a hysteria (in dementia praecox or paraphrenia proper), or of an obsessional neurosis (in paranoia). This fresh libidinal cathexis differs from the primary one in that it starts from another level and under other conditions. The difference between the transference neuroses brought about in the case of this fresh kind of libidinal cathexis and the corresponding formations where the ego is normal should be able to afford us the deepest insight into the structure of our mental apparatus.

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