Chapter 3

The same holds true in the end with looking which is analogous to touching. The manner in which the libidinous excitement is frequently awakened is by the optical impression, and selection takes account of this circumstance--if this teleological mode of thinking be permitted--by making the sexual object a thing of beauty. The covering of the body, which keeps abreast with civilization, serves to arouse sexual inquisitiveness, which always strives to restore for itself the sexual object by uncovering the hidden parts. This can be turned into the artistic ("sublimation") if the interest is turned from the genitals to the form of the body.[20] The tendency to linger at this intermediary sexual aim of the sexually accentuated looking is found to a certain degree in most normals; indeed it gives them the possibility of directing a certain amount of their libido to a higher artistic aim. On the other hand, the fondness for looking becomes a perversion (_a_) when it limits itself entirely to the genitals; (_b_) when it becomes connected with the overcoming of loathing (voyeurs and onlookers at the functions of excretion); and (_c_) when instead of preparing for the normal sexual aim it suppresses it. The latter, if I may draw conclusions from a single analysis, is in a most pronounced way true of exhibitionists, who expose their genitals so as in turn to bring to view the genitals of others.

In the perversion which consists in striving to look and be looked at we are confronted with a very remarkable character which will occupy us even more intensively in the following aberration. The sexual aim is here present in twofold formation, in an _active_ and a _passive_ form.

The force which is opposed to the peeping mania and through which it is eventually abolished is _shame_ (like the former loathing).

*Sadism and Masochism.*--The desire to cause pain to the sexual object and its opposite, the most frequent and most significant of all perversions, was designated in its two forms by v. Krafft-Ebing as sadism or the active form, and masochism or the passive form. Other authors prefer the narrower term algolagnia which emphasizes the pleasure in pain and cruelty, whereas the terms selected by v. Krafft-Ebing place the pleasure secured in all kinds of humility and submission in the foreground.

The roots of active algolagnia, sadism, can be readily demonstrable in the normal. The sexuality of most men shows a taint of _aggression_, it is a propensity to subdue, the biological significance of which lies in the necessity of overcoming the resistance of the sexual object by actions other than mere _courting_. Sadism would then correspond to an aggressive component of the sexual impulse which has become independent and exaggerated and has been brought to the foreground by displacement.

The conception of sadism fluctuates in the usage of language from a mere active or impetuous attitude towards the sexual object to the exclusive attachment of the gratification to the subjection and maltreatment of the object. Strictly speaking only the last extreme case has a claim to the name of perversion.

Similarly, the designation of masochism comprises all passive attitude to the sexual life and to the sexual object; in its most extreme form the gratification is connected with suffering of physical or mental pain at the hands of the sexual object. Masochism as a perversion seems to be still more remote from the normal sexual life by forming a contrast to it; it may be doubted whether it ever appears as a primary form or whether it does not more regularly originate through transformation from sadism. It can often be recognized that the masochism is nothing but a continuation of the sadism turning against one's own person in which the latter at first takes the place of the sexual object. Analysis of extreme cases of masochistic perversions show that there is a coöperation of a large series of factors which exaggerate and fix the original passive sexual attitude (castration complex, conscience).

The pain which is here overcome ranks with the loathing and shame which were the resistances opposed to the libido.

Sadism and masochism occupy a special place among the perversions, for the contrast of activity and passivity lying at their bases belong to the common traits of the sexual life.

That cruelty and sexual impulse are most intimately connected is beyond doubt taught by the history of civilization, but in the explanation of this connection no one has gone beyond the accentuation of the aggressive factors of the libido. The aggression which is mixed with the sexual impulse is according to some authors a remnant of cannibalistic lust, a participation on the part of the domination apparatus (Bemächtigungsapparatus), which served also for the gratification of the great wants of the other, ontogenetically the older impulse.[21] It has also been claimed that every pain contains in itself the possibility of a pleasurable sensation. Let us be satisfied with the impression that the explanation of this perversion is by no means satisfactory and that it is possible that many psychic efforts unite themselves into one effect.

The most striking peculiarity of this perversion lies in the fact that its active and passive forms are regularly encountered together in the same person. He who experiences pleasure by causing pain to others in sexual relations is also able to experience the pain emanating from sexual relations as pleasure. A sadist is simultaneously a masochist, though either the active or the passive side of the perversion may be more strongly developed and thus represent his preponderate sexual activity.[22]

We thus see that certain perverted propensities regularly appear in _contrasting pairs_, a thing which, in view of the material to be produced later, must claim great theoretical value. It is furthermore clear that the existence of the contrast, sadism and masochism, can not readily be attributed to the mixture of aggression. On the other hand one may be tempted to connect such simultaneously existing contrasts with the united contrast of male and female in bisexuality, the significance of which is reduced in psychoanalysis to the contrast of activity and passivity.

3. GENERAL STATEMENTS APPLICABLE TO ALL PERVERSIONS

*Variation and Disease.*--The physicians who at first studied the _perversions_ in pronounced cases and under peculiar conditions were naturally inclined to attribute to them the character of a morbid or degenerative sign similar to the _inversions_. This view, however, is easier to refute in this than in the former case. Everyday experience has shown that most of these transgressions, at least the milder ones, are seldom wanting as components in the sexual life of normals who look upon them as upon other intimacies. Wherever the conditions are favorable such a perversion may for a long time be substituted by a normal person for the normal sexual aim or it may be placed near it. In no normal person does the normal sexual aim lack some designable perverse element, and this universality suffices in itself to prove the inexpediency of an opprobrious application of the name perversion. In the realm of the sexual life one is sure to meet with exceptional difficulties which are at present really unsolvable, if one wishes to draw a sharp line between the mere variations within physiological limits and morbid symptoms.

Nevertheless, the quality of the new sexual aim in some of these perversions is such as to require special notice. Some of the perversions are in content so distant from the normal that we cannot help calling them "morbid," especially those in which the sexual impulse, in overcoming the resistances (shame, loathing, fear, and pain) has brought about surprising results (licking of feces and violation of cadavers). Yet even in these cases one ought not to feel certain of regularly finding among the perpetrators persons of pronounced abnormalities or insane minds. We can not lose sight of the fact that persons who otherwise behave normally are recorded as sick in the realm of the sexual life where they are dominated by the most unbridled of all impulses. On the other hand, a manifest abnormality in any other relation in life generally shows an undercurrent of abnormal sexual behavior.

In the majority of cases we are able to find the morbid character of the perversion not in the content of the new sexual aim but in its relation to the normal. It is morbid if the perversion does not appear beside the normal (sexual aim and sexual object), where favorable circumstances promote it and unfavorable impede the normal, or if it has under all circumstances repressed and supplanted the normal; _the exclusiveness_ and _fixation_ of the perversion justifies us in considering it a morbid symptom.

*The Psychic Participation in the Perversions.*--Perhaps it is precisely in the most abominable perversions that we must recognize the most prolific psychic participation for the transformation of the sexual impulse. In these cases a piece of psychic work has been accomplished in which, in spite of its gruesome success, the value of an idealization of the impulse can not be disputed. The omnipotence of love nowhere perhaps shows itself stronger than in this one of her aberrations. The highest and the lowest everywhere in sexuality hang most intimately together. ("From heaven through the world to hell.")

*Two Results.*--In the study of perversions we have gained an insight into the fact that the sexual impulse has to struggle against certain psychic forces, resistances, among which shame and loathing are most prominent. We may presume that these forces are employed to confine the impulse within the accepted normal limits, and if they have become developed in the individual before the sexual impulse has attained its full strength, it is really they which have directed it in the course of development.[23]

We have furthermore remarked that some of the examined perversions can be comprehended only by assuming the union of many motives. If they are amenable to analysis--disintegration--they must be of a composite nature. This may give us a hint that the sexual impulse itself may not be something simple, that it may on the contrary be composed of many components which detach themselves to form perversions. Our clinical observation thus calls our attention to _fusions_ which have lost their expression in the uniform normal behavior.

4. THE SEXUAL IMPULSE IN NEUROTICS

*Psychoanalysis.*--A proper contribution to the knowledge of the sexual impulse in persons who are at least related to the normal can be gained only from one source, and is accessible only by one definite path. There is only one way to obtain a thorough and unerring solution of problems in the sexual life of so-called psychoneurotics (hysteria, obsessions, the wrongly-named neurasthenia, and surely also dementia præcox, and paranoia), and that is by subjecting them to the psychoanalytic investigations propounded by J. Breuer and myself in 1893, which we called the "cathartic" treatment.

I must repeat what I have said in my published work, that these psychoneuroses, as far as my experience goes, are based on sexual motive powers. I do not mean that the energy of the sexual impulse merely contributes to the forces supporting the morbid manifestations (symptoms), but I wish distinctly to maintain that this supplies the only constant and the most important source of energy in the neurosis, so that the sexual life of such persons manifests itself either exclusively, preponderately, or partially in these symptoms. As I have already stated in different places, the symptoms are the sexual activities of the patient. The proof for this assertion I have obtained from the psychoanalysis of hysterics and other neurotics during a period of twenty years, the results of which I hope to give later in a detailed account.

Psychoanalysis removes the symptoms of hysteria on the supposition that they are the substitutes--the transcriptions as it were--for a series of emotionally accentuated psychic processes, wishes, and desires, to which a passage for their discharge through the conscious psychic activities has been cut off by a special process (repression). These thought formations which are restrained in the state of the unconscious strive for expression, that is, for _discharge_, in conformity to their affective value, and find such in hysteria through a process of _conversion_ into somatic phenomena--the hysterical symptoms. If, _lege artis_, and with the aid of a special technique, retrogressive transformations of the symptoms into the affectful and conscious thoughts can be effected, it then becomes possible to get the most accurate information about the nature and origin of these previously unconscious psychic formations.

*Results of Psychoanalysis.*--In this manner it has been discovered that the symptoms represent the equivalent for the strivings which received their strength from the source of the sexual impulse. This fully concurs with what we know of the character of hysterics, which we have taken as models for all psycho-neurotics, before they have become diseased, and with what we know concerning the causes of the disease. The hysterical character evinces a part of sexual repression which reaches beyond the normal limits, an exaggeration of the resistances against the sexual impulse which we know as shame and loathing. It is an instinctive flight from intellectual occupation with the sexual problem, the consequence of which in pronounced cases is a complete sexual ignorance, which is preserved till the age of sexual maturity is attained.[24]

This feature, so characteristic of hysteria, is not seldom concealed in crude observation by the existence of the second constitutional factor of hysteria, namely, the enormous development of the sexual craving. But the psychological analysis will always reveal it and solves the very contradictory enigma of hysteria by proving the existence of the contrasting pair, an immense sexual desire and a very exaggerated sexual rejection.

The provocation of the disease in hysterically predisposed persons is brought about if in consequence of their progressive maturity or external conditions of life they are earnestly confronted with the real sexual demand. Between the pressure of the craving and the opposition of the sexual rejection an outlet for the disease results, which does not remove the conflict but seeks to elude it by transforming the libidinous strivings into symptoms. It is an exception only in appearance if a hysterical person, say a man, becomes subject to some banal emotional disturbance, to a conflict in the center of which there is no sexual interest. Psychoanalysis will regularly show that it is the sexual components of the conflict which make the disease possible by withdrawing the psychic processes from normal adjustment.

*Neurosis and Perversion.*--A great part of the opposition to my assertion is explained by the fact that the sexuality from which I deduce the psychoneurotic symptoms is thought of as coincident with the normal sexual impulse. But psychoanalysis teaches us better than this. It shows that the symptoms do not by any means result at the expense only of the so called normal sexual impulse (at least not exclusively or preponderately), but they represent the converted expression of impulses which in a broader sense might be designated as _perverse_ if they could manifest themselves directly in phantasies and acts without deviating from consciousness. The symptoms are therefore partially formed at the cost of abnormal sexuality. _The neurosis is, so to say, the negative of the perversion._[25]

The sexual impulse of the psychoneurotic shows all the aberrations which we have studied as variations of the normal and as manifestations of morbid sexual life.

(_a_) In all the neurotics without exception we find feelings of inversion in the unconscious psychic life, fixation of libido on persons of the same sex. It is impossible, without a deep and searching discussion, adequately to appreciate the significance of this factor for the formation of the picture of the disease; I can only assert that the unconscious propensity to inversion is never wanting and is particularly of immense service in explaining male hysteria.[26]

(_b_) All the inclinations to anatomical transgression can be demonstrated in psychoneurotics in the unconscious and as symptom-creators. Of special frequency and intensity are those which impart to the mouth and the mucous membrane of the anus the rôle of genitals.

(_c_) The partial desires which usually appear in contrasting pairs play a very prominent rôle among the symptom-creators in the psychoneuroses. We have learned to know them as carriers of new sexual aims, such as peeping mania, exhibitionism, and the actively and passively formed impulses of cruelty. The contribution of the last is indispensable for the understanding of the morbid nature of the symptoms; it almost regularly controls some portion of the social behavior of the patient. The transformation of love into hatred, of tenderness into hostility, which is characteristic of a large number of neurotic cases and apparently of all cases of paranoia, takes place by means of the union of cruelty with the libido.

The interest in these deductions will be more heightened by certain peculiarities of the diagnosis of facts.

Alpha. There is nothing in the unconscious streams of thought of the neuroses which would correspond to an inclination towards fetichism; a circumstance which throws light on the psychological peculiarity of this well understood perversion.

Beta. Wherever any such impulse is found in the unconscious which can be paired with a contrasting one, it can regularly be demonstrated that the latter, too, is effective. Every active perversion is here accompanied by its passive counterpart. He who in the unconscious is an exhibitionist is at the same time a voyeur, he who suffers from sadistic feelings as a result of repression will also show another reinforcement of the symptoms from the source of masochistic tendencies. The perfect concurrence with the behavior of the corresponding positive perversions is certainly very noteworthy. In the picture of the disease, however, the preponderant rôle is played by either one or the other of the opposing tendencies.

Gamma. In a pronounced case of psychoneurosis we seldom find the development of one single perverted impulse; usually there are many and regularly there are traces of all perversions. The individual impulse, however, on account of its intensity, is independent of the development of the others, but the study of the positive perversions gives us the accurate counterpart to it.

PARTIAL IMPULSES AND EROGENOUS ZONES

Keeping in mind what we have learned from the examination of the positive and negative perversions, it becomes quite obvious that they can be referred to a number of "partial impulses," which are not, however, primary but are subject to further analysis. By an "impulse" we can understand in the first place nothing but the psychic representative of a continually flowing internal somatic source of excitement, in contradistinction to the "stimulus" which is produced by isolated excitements coming from without. The impulse is thus one of the concepts marking the limits between the psychic and the physical. The simplest and most obvious assumption concerning the nature of the impulses would be that in themselves they possess no quality but are only taken into account as a measure of the demand for effort in the psychic life. What distinguishes the impulses from one another and furnishes them with specific attributes is their relation to their somatic _sources_ and to their _aims_. The source of the impulse is an exciting process in an organ, and the immediate aim of the impulse lies in the elimination of this organic stimulus.

Another preliminary assumption in the theory of the impulse which we cannot relinquish, states that the bodily organs furnish two kinds of excitements which are determined by differences of a chemical nature. One of these forms of excitement we designate as the specifically sexual and the concerned organ as the _erogenous zone_, while the sexual element emanating from it is the partial impulse.[27]

In the perversions which claim sexual significance for the oral cavity and the anal opening the part played by the erogenous zone is quite obvious. It behaves in every way like a part of the sexual apparatus. In hysteria these parts of the body, as well as the tracts of mucous membrane proceeding from them, become the seat of new sensations and innervating changes in a manner similar to the real genitals when under the excitement of normal sexual processes.

The significance of the erogenous zones in the psychoneuroses, as additional apparatus and substitutes for the genitals, appears to be most prominent in hysteria though that does not signify that it is of lesser validity in the other morbid forms. It is not so recognizable in compulsion neurosis and paranoia because here the symptom formation takes place in regions of the psychic apparatus which lie at a great distance from the central locations for bodily control. The more remarkable thing in the compulsion neurosis is the significance of the impulses which create new sexual aims and appear independently of the erogenous zones. Nevertheless, the eye corresponds to an erogenous zone in the looking and exhibition mania, while the skin takes on the same part in the pain and cruelty components of the sexual impulse. The skin, which in special parts of the body becomes differentiated as sensory organs and modified by the mucous membrane, is the erogenous zone, [Greek: kat] ex ogen.[28]

EXPLANATION OF THE MANIFEST PREPONDERANCE OF SEXUAL PERVERSIONS IN THE PSYCHONEUROSES

The sexuality of psychoneurotics has perhaps been placed in a false light by the above discussions. It appears that the sexual behavior of the psychoneurotic approaches in predisposition to the pervert and deviates by just so much from the normal. Nevertheless, it is very possible that the constitutional disposition of these patients besides containing an immense amount of sexual repression and a predominant force of sexual impulse also possesses an unusual tendency to perversions in the broadest sense. However, an examination of milder cases shows that the last assumption is not an absolute requisite, or at least that in pronouncing judgment on the morbid effects one ought to discount the effect of one of the factors. In most psychoneurotics the disease first appears after puberty following the demands of the normal sexual life. Against these the repression above all directs itself. Or the disease comes on later, owing to the fact that the libido is unable to attain normal sexual gratification. In both cases the libido behaves like a stream the principal bed of which is dammed; it fills the collateral roads which until now perhaps have been empty. Thus the manifestly great (though to be sure negative) tendency to perversion in psychoneurotics may be collaterally conditioned; at any rate, it is certainly collaterally increased. The fact of the matter is that the sexual repression has to be added as an inner factor to such external ones as restriction of freedom, inaccessibility to the normal sexual object, dangers of the normal sexual act, etc., which cause the origin of perversions in individuals who might have otherwise remained normal.