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an important result, as the discovery of a _caput Nili_ of
neuropathology." Ten years later, enlarging rather than restricting his
conception, Freud remarks: "Sexuality is not a mere _deus ex machina_
which intervenes but once in the hysterical process; it is the motive
force of every separate symptom and every expression of a symptom. The
morbid phenomena constitute, to speak plainly, the patient's sexual
activity."[279] The actual hysterical fit, Freud now states, may be
regarded as "the substitute for a once practiced and then abandoned
_auto-erotic_ satisfaction," and similarly it may be regarded as an
equivalent of coitus.[280]
It is natural to ask how this conception affects that elaborate picture of
hysteria laboriously achieved by Charcot and his school. It cannot be said
that it abolishes any of the positive results reached by Charcot, but it
certainly alters their significance and value; it presents them in a new
light and changes the whole perspective. With his passion for getting at
tangible definite physical facts, Charcot was on very safe ground. But he
was content to neglect the psychic analysis of hysteria, while yet
proclaiming that hysteria is a purely psychic disorder. He had no cause of
hysteria to present save only heredity. Freud certainly admits heredity,
but, as he points out, the part it plays has been overrated. It is too
vague and general to carry us far, and when a specific and definite cause
can be found, the part played by heredity recedes to become merely a
condition, the soil on which the "specific etiology" works. Here probably
Freud's enthusiasm at first carried him too far and the most important
modification he has made in his views occurs at this point: he now
attaches a preponderant influence to heredity. He has realized that sexual
activity in one form or another is far too common in childhood to make it
possible to lay very great emphasis on "traumatic lesions" of this
character, and he has also realized that an outcrop of fantasies may
somewhat later develop on these childish activities, intervening between
them and the subsequent morbid symptoms. He is thus led to emphasize anew
the significance of heredity, not, however, in Charcot's sense, as general
neuropathic disposition but as "sexual constitution." The significance of
"infantile sexual lesions" has also tended to give place to that of
"infantilism of sexuality."[281]
The real merit of Freud's subtle investigations is that--while possibly
furnishing a justification of the imperfectly-understood idea that had
floated in the mind of observers ever since the name "hysteria" was first
invented--he has certainly supplied a definite psychic explanation of a
psychic malady. He has succeeded in presenting clearly, at the expense of
much labor, insight, and sympathy, a dynamic view of the psychic processes
involved in the constitution of the hysterical state, and such a view
seems to show that the physical symptoms laboriously brought to light by
Charcot are largely but epiphenomena and by-products of an emotional
process, often of tragic significance to the subject, which is taking
place in the most sensitive recess of the psychic organism. That the
picture of the mechanism involved, presented to us by Professor Freud,
cannot be regarded as a final and complete account of the matter, may
readily be admitted. It has developed in Freud's own hands, and some of
the developments will require very considerable confirmation before they
can be accepted as generally true.[282] But these investigations have at
least served to open the door, which Charcot had inconsistently held
closed, into the deeper mysteries of hysteria, and have shown that here,
if anywhere, further research will be profitable. They have also served to
show that hysteria may be definitely regarded as, in very many cases at
least, a manifestation of the sexual emotions and their lesions; in other
words, a transformation of auto-erotism.
The conception of hysteria so vigorously enforced by Charcot and his
school is thus now beginning to appear incomplete. But we have to
recognize that that incompleteness was right and necessary. A strong
reaction was needed against a widespread view of hysteria that was in
large measure scientifically false. It was necessary to show clearly that
hysteria is a definite disorder, even when the sexual organs and emotions
are swept wholly out of consideration; and it was also necessary to show
that the lying and dissimulation so widely attributed to the hysterical
were merely the result of an ignorant and unscientific misinterpretation
of psychic elements of the disease. This was finally and triumphantly
achieved by Charcot's school.
There is only one other point in the explanation of hysteria which I will
here refer to, and that because it is usually ignored, and because it has
relationship to the general psychology of the sexual emotions. I refer to
that physiological hysteria which is the normal counterpart of the
pathological hysteria which has been described in its physical details by
Charcot, and to which alone the term should strictly be applied. Even
though hysteria as a disease may be described as one and indivisible,
there are yet to be found, among the ordinary and fairly healthy
population, vague and diffused hysteroid symptoms which are dissipated in
a healthy environment, or pass nearly unnoted, only to develop in a small
proportion of cases, under the influence of a more pronounced heredity, or
a severe physical or psychic lesion, into that definite morbid state which
is properly called hysteria.
This diffused hysteroid condition may be illustrated by the results of a
psychological investigation carried on in America by Miss Gertrude Stein
among the ordinary male and female students of Harvard University and
Radcliffe College. The object of the investigation was to study, with the
aid of a planchette, the varying liability to automatic movements among
normal individuals. Nearly one hundred students were submitted to
experiment. It was found that automatic responses could be obtained in two
sittings from all but a small proportion of the students of both sexes,
but that there were two types of individual who showed a special aptitude.
One type (probably showing the embryonic form of neurasthenia) was a
nervous, high-strung, imaginative type, not easily influenced from
without, and not so much suggestible as autosuggestible. The other type,
which is significant from our present point of view, is thus described by
Miss Stein: "In general the individuals, often blonde and pale, are
distinctly phlegmatic. If emotional, decidedly of the weakest, sentimental
order. They may be either large, healthy, rather heavy, and lacking in
vigor or they may be what we call anæmic and phlegmatic. Their power of
concentrated attention is very small. They describe themselves as never [ Pobierz całość w formacie PDF ]