One thing in particular: psychoanalytic investigations trace back the symptoms of disease with really surprising regularity to impressions from the sexual life, show us that the pathogenic wishes are of the nature of erotic impulse-components (Triebkomponente), and necessitate the assumption that to disturbances of the erotic sphere must be ascribed the greatest significance among the etiological factors of the disease. This holds of both sexes.
I know that this assertion will not willingly be credited. Even those investigators who gladly follow my psychological labors, are inclined to think that I overestimate the etiological share of the sexual moments. They ask me why other mental excitations should not lead to the phenomena of repression and surrogate-creation which I have described. I can give them this answer; that I do not know why they should not do this, I have no objection to their doing it, but experience shows that they do not possess such a significance, and that they merely support the effect of the sexual moments, without being able to supplant them. This conclusion was not a theoretical postulate; in the Studien über Hysterie, published in 1895 with Dr. Breuer, I did not stand on this ground. I was converted to it when my experience was richer and had led me deeper into the nature of the case. Gentlemen, there are among you some of my closest friends and adherents, who have travelled to Worcester with me. Ask them, and they will tell you that they all were at first completely sceptical of the assertion of the determinative significance of the sexual etiology, until they were compelled by their own analytic labors to come to the same conclusion.
The conduct of the patients does not make it any easier to convince ones self of the correctness of the view which I have expressed. Instead of willingly giving us information concerning their sexual life, they try to conceal it by every means in their power. Men generally are not candid in sexual matters. They do not show their sexuality freely, but they wear a thick overcoata fabric of liesto conceal it, as though it were bad weather in the world of sex. And they are not wrong; sun and wind are not favorable in our civilized society to any demonstration of sex life. In truth no one can freely disclose his erotic life to his neighbor. But when your patients see that in your treatment they may disregard the conventional restraints, they lay aside this veil of lies, and then only are you in a position to formulate a judgment on the question in dispute. Unfortunately physicians are not favored above the rest of the children of men in their personal relationship to the questions of the sex life. Many of them are under the ban of that mixture of prudery and lasciviousness which determines the behaviour of most Kulturmenschen in affairs of sex.
Now to proceed with the communication of our results. It is true that in another series of cases psychoanalysis at first traces the symptoms back not to the sexual, but to banal traumatic experiences. But the distinction loses its significance through other circumstances. The work of analysis which is necessary for the thorough explanation and complete cure of a case of sickness does not stop in any case with the experience of the time of onset of the disease, but in every case it goes back to the adolescence and the early childhood of the patient. Here only do we hit upon the impressions and circumstances which determine the later sickness. Only the childhood experiences can give the explanation for the sensitivity to later traumata and only when these memory traces, which almost always are forgotten, are discovered and made conscious, is the power developed to banish the symptoms. We arrive here at the same conclusion as in the investigation of dreamsthat it is the incompatible, repressed wishes of childhood which lend their power to the creation of symptoms. Without these the reactions upon later traumata discharge normally. But we must consider these mighty wishes of childhood very generally as sexual in nature.
Now I can at any rate be sure of your astonishment. Is there an infantile sexuality? you will ask. Is childhood not rather that period of life which is distinguished by the lack of the sexual impulse? No, gentlemen, it is not at all true that the sexual impulse enters into the child at puberty, as the devils in the gospel entered into the swine. The child has his sexual impulses and activities from the beginning, he brings them with him into the world, and from these the so-called normal sexuality of adults emerges by a significant development through manifold stages. It is not very difficult to observe the expressions of this childish sexual activity; it needs rather a certain art to overlook them or to fail to interpret them.1
As fate would have it, I am in a position to call a witness for my assertions from your own midst. I show you here the work of one Dr. Sanford Bell, published in 1902 in the American Journal of Psychology. The author was a fellow of Clark University, the same institution within whose walls we now stand. In this thesis, entitled A Preliminary Study of the Emotion of Love between the Sexes, which appeared three years before my Drei Abhandlungen zur Sexualtheorie, the author says just what I have been saying to you: The emotion of sex love does not make its appearance for the first time at the period of adolescence as has been thought. He has, as we should say in Europe, worked by the American method, and has gathered not less than 2,500 positive observations in the course of fifteen years, among them 800 of his own. He says of the signs by which this amorous condition manifests itself: The unprejudiced mind, in observing these manifestations in hundreds of couples of children, cannot escape referring them to sex origin. The most exacting mind is satisfied when to these observations are added the confessions of those who have as children experienced the emotion to a marked degree of intensity, and whose memories of childhood are relatively distinct. Those of you who are unwilling to believe in infantile sexuality will be most astonished to hear that among those children who fell in love so early not a few are of the tender ages of three, four, and five years.
It would not be surprising if you should believe the observations of a fellow-countryman rather than my own. Fortunately a short time ago from the analysis of a five-year-old boy who was suffering from anxiety, an analysis undertaken with correct technique by his own father,2 I succeeded in getting a fairly complete picture of the bodily expressions of the impulse and the mental productions of an early stage of childish sexual life. And I must remind you that my friend, Dr. C. G. Jung, read you a few hours ago in this room an observation on a still younger girl who from the same cause as my patientthe birth of a little child in the familybetrayed certainly almost the same secret excitement, wish and complex-creation. Accordingly I am not without hope that you may feel friendly toward this idea of infantile sexuality that was so strange at first. I might also quote the remarkable example of the Zürich psychiatrist, E. Bleuler, who said a few years ago openly that he faced my sexual theories incredulous and bewildered, and since that time by his own observations had substantiated them in their whole scope.3 If it is true that most men, medical observers and others, do not want to know anything about the sexual life of the child, the fact is capable of explanation only too easily. They have forgotten their own infantile sexual activity under the pressure of education for civilization and do not care to be reminded now of the repressed material. You will be convinced otherwise if you begin the investigation by a self-analysis, by an interpretation of your own childhood memories.
Lay aside your doubts and let us evaluate the infantile sexuality of the earliest years.4 The sexual impulse of the child manifests itself as a very complex one, it permits of an analysis into many components, which spring from different sources. It is entirely disconnected from the function of reproduction which it is later to serve. It permits the child to gain different sorts of pleasure sensations, which we include, by the analogues and connections which they show, under the term sexual pleasures. The great source of infantile sexual pleasure is the auto-excitation of certain particularly sensitive parts of the body; besides the genitals are included the rectum and the opening of the urinary canal, and also the skin and other sensory surfaces. Since in this first phase of child sexual life the satisfaction is found on the childs own body and has nothing to do with any other object, we call this phase after a word coined by Havelock Ellis, that of auto-erotism. The parts of the body significant in giving sexual pleasure we call erogenous zones. The thumb-sucking (Ludeln) or passionate sucking (Wonnesaugen) of very young children is a good example of such an auto-erotic satisfaction of an erogenous zone. The first scientific observer of this phenomenon, a specialist in childrens diseases in Budapest by the name of Lindner, interpreted these rightly as sexual satisfaction and described exhaustively their transformation into other and higher forms of sexual gratification.5 Another sexual satisfaction of this time of life is the excitation of the genitals by masturbation, which has such a great significance for later life and, in the case of many individuals, is never fully overcome. Besides this and other auto-erotic manifestations we see very early in the child the impulse-components of sexual pleasure, or, as we may say, of the libido, which presupposes a second person as its object. These impulses appear in opposed pairs, as active and passive. The most important representatives of this group are the pleasure in inflicting pain (sadism) with its passive opposite (masochism) and active and passive exhibition pleasure (Schaulust). From the first of these later pairs splits off the curiosity for knowledge, as from the latter the impulse toward artistic and theatrical representation. Other sexual manifestations of the child can already be regarded from the view-point of object-choice, in which the second person plays the prominent part. The significance of this was primarily based upon motives of the impulse of self-preservation. The difference between the sexes plays, however, in the child no very great rôle. One may attribute to every child, without wronging him, a bit of the homosexual disposition.
The sexual life of the child, rich, but dissociated, in which each single impulse goes about the business of arousing pleasure independently of every other, is later correlated and organized in two general directions, so that by the close of puberty the definite sexual character of the individual is practically finally determined. The single impulses subordinate themselves to the overlordship of the genital zone, so that the whole sexual life is taken over into the service of procreation, and their gratification is now significant only so far as they help to prepare and promote the true sexual act. On the other hand, object-choice prevails over auto-erotism, so that now in the sexual life all components of the sexual impulse are satisfied in the loved person. But not all the original impulse components are given a share in the final shaping of the sexual life. Even before the advent of puberty certain impulses have undergone the most energetic repression under the impulse of education, and mental forces like shame, disgust and morality are developed, which, like sentinels, keep the repressed wishes in subjection. When there comes, in puberty, the high tide of sexual desire it finds dams in this creation of reactions and resistances. These guide the outflow into the so-called normal channels, and make it impossible to revivify the impulses which have undergone repression.
The most important of these repressed impulses are koprophilism, that is, the pleasure in children connected with the excrements; and, further, the tendencies attaching themselves to the persons of the primitive object-choice.
Gentlemen, a sentence of general pathology says that every process of development brings with it the germ of pathological dispositions in so far as it may be inhibited, delayed, or incompletely carried out. This holds for the development of the sexual function, with its many complications. It is not smoothly completed in all individuals, and may leave behind either abnormalities or disposition to later diseases by the way of later falling back or regression. It may happen that not all the partial impulses subordinate themselves to the rule of the genital zone. Such an impulse which has remained disconnected brings about what we call a perversion, which may replace the normal sexual goal by one of its own. It may happen, as has been said before, that the auto-erotism is not fully overcome, as many sorts of disturbances testify. The originally equal value of both sexes as sexual objects may be maintained and an inclination to homosexual activities in adult life result from this, which, under suitable conditions, rises to the level of exclusive homosexuality. This series of disturbances corresponds to the direct inhibition of development of the sexual function, it includes the perversions and the general infantilism of the sex life that are not seldom met with.
The disposition to neuroses is to be derived in another way from an injury to the development of the sex life. The neuroses are related to the perversions as the negative to the positive; in them we find the same impulse-components as in perversions, as bearers of the complexes and as creators of the symptoms; but here they work from out the unconscious. They have undergone a repression, but in spite of this they maintain themselves in the unconscious. Psychoanalysis teaches us that overstrong expression of the impulse in very early life leads to a sort of fixation (Fixirung), which then offers a weak point in the articulation of the sexual function. If the exercise of the normal sexual function meets with hindrances in later life, this repression, dating from the time of development, is broken through at just that point at which the infantile fixation took place.
You will now perhaps make the objection: But all that is not sexuality. I have used the word in a very much wider sense than you are accustomed to understand it. This I willingly concede. But it is a question whether you do not rather use the word in much too narrow a sense when you restrict it to the realm of procreation. You sacrifice by that the understanding of perversions; of the connection between perversion, neurosis and normal sexual life; and have no means of recognizing, in its true significance, the easily observable beginning of the somatic and mental sexual life of the child. But however you decide about the use of the word, remember that the psychoanalyst understands sexuality in that full sense to which he is led by the evaluation of infantile sexuality.
Now we turn again to the sexual development of the child. We still have much to say here, since we have given more attention to the somatic than to the mental expressions of the sexual life. The primitive object-choice of the child, which is derived from his need of help, demands our further interest. It first attaches to all persons to whom he is accustomed, but soon these give way in favor of his parents. The relation of the child to his parents is, as both direct observation of the child and later analytic investigation of adults agree, not at all free from elements of sexual accessory-excitation (Miterregung). The child takes both parents, and especially one, as an object of his erotic wishes. Usually he follows in this the stimulus given by his parents, whose tenderness has very clearly the character of a sex manifestation, though inhibited so far as its goal is concerned. As a rule, the father prefers the daughter, the mother the son; the child reacts to this situation, since, as son, he wishes himself in the place of his father, as daughter, in the place of the mother. The feelings awakened in these relations between parents and children, and, as a resultant of them, those among the children in relation to each other, are not only positively of a tender, but negatively of an inimical sort. The complex built up in this way is destined to quick repression, but it still exerts a great and lasting effect from the unconscious. We must express the opinion that this with its ramifications presents the nuclear complex of every neurosis, and so we are prepared to meet with it in a not less effectual way in the other fields of mental life. The myth of King dipus, who kills his father and wins his mother as a wife is only the slightly altered presentation of the infantile wish, rejected later by the opposing barriers of incest. Shakespeares tale of Hamlet rests on the same basis of an incest complex, though better concealed. At the time when the child is still ruled by the still unrepressed nuclear complex, there begins a very significant part of his mental activity which serves sexual interest. He begins to investigate the question of where children come from and guesses more than adults imagine of the true relations by deduction from the signs which be sees. Usually his interest in this investigation is awakened by the threat to his welfare through the birth of another child in the family, in whom at first he sees only a rival. Under the influence of the partial impulses which are active in him be arrives at a number of infantile sexual theories, as that the same male genitals belong to both sexes, that children are conceived by eating and born through the opening of the intestine, and that sexual intercourse is to be regarded as an inimical act, a sort of overpowering.
But just the unfinished nature of his sexual constitution and the gaps in his knowledge brought about by the hidden condition of the feminine sexual canal, cause the infant investigator to discontinue his work as a failure. The facts of this childish investigation itself as well as the infant sex theories created by it are of determinative significance in the building of the childs character, and in the content of his later neuroses.
It is unavoidable and quite normal that the child should make his parents the objects of his first object-choice. But his libido must not remain fixed on these first chosen objects, but must take them merely as a prototype and transfer from these to other persons in the time of definite object-choice. The breaking loose (Ablösung) of the child from his parents is thus a problem impossible to escape if the social virtue of the young individual is not to be impaired. During the time that the repressive activity is making its choice among the partial sexual impulses and later, when the influence of the parents, which in the most essential way has furnished the material for these repressions, is lessened, great problems fall to the work of education, which at present certainly does not always solve them in the most intelligent and economic way.
Gentlemen, do not think that with these explanations of the sexual life and the sexual development of the child we have too far departed from psychoanalysis and the cure of neurotic disturbances. If you like, you may regard the psychoanalytic treatment only as a continued education for the overcoming of childhood-remnants (Kindheitsresten).