NERVOUS AND MENTAL DISEASE MONOGRAPH SERIES NO. 7
THREE CONTRIBUTIONS TO THE THEORY OF SEX
SECOND EDITION SECOND REPRINTING
PROF. SIGMUND FREUD, LL.D. VIENNA
AUTHORIZED TRANSLATION BY
A.A. BRILL, PH.B., M.D. CLINICAL ASSISTANT, DEPARTMENT OF PSYCHIATRY AND NEUROLOGY, COLUMBIA UNIVERSITY; ASSISTANT IN MENTAL DISEASES, BELLEVUE HOSPITAL; ASSISTANT VISITING PHYSICIAN, HOSPITAL FOR NERVOUS DISEASES
WITH INTRODUCTION BY
JAMES J. PUTNAM, M.D.
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TABLE OF CONTENTS
PAGE INTRODUCTION TO TRANSLATION v AUTHOR'S PREFACE TO THE SECOND EDITION ix AUTHOR'S PREFACE TO THE THIRD EDITION x I. THE SEXUAL ABERRATIONS 1 II. THE INFANTILE SEXUALITY 36 III. THE TRANSFORMATION OF PUBERTY 68
INTRODUCTION TO TRANSLATION
The somewhat famous "Three Essays," which Dr. Brill is here bringing to the attention of an English-reading public, occupy—brief as they are—an important position among the achievements of their author, a great investigator and pioneer in an important line. It is not claimed that the facts here gathered are altogether new. The subject of the sexual instinct and its aberrations has long been before the scientific world and the names of many effective toilers in this vast field are known to every student. When one passes beyond the strict domains of science and considers what is reported of the sexual life in folkways and art-lore and the history of primitive culture and in romance, the sources of information are immense. Freud has made considerable additions to this stock of knowledge, but he has done also something of far greater consequence than this. He has worked out, with incredible penetration, the part which this instinct plays in every phase of human life and in the development of human character, and has been able to establish on a firm footing the remarkable thesis that psychoneurotic illnesses never occur with a perfectly normal sexual life. Other sorts of emotions contribute to the result, but some aberration of the sexual life is always present, as the cause of especially insistent emotions and repressions.
The instincts with which every child is born furnish desires or cravings which must be dealt with in some fashion. They may be refined ("sublimated"), so far as is necessary and desirable, into energies of other sorts—as happens readily with the play-instinct—or they may remain as the source of perversions and inversions, and of cravings of new sorts substituted for those of the more primitive kinds under the pressure of a conventional civilization. The symptoms of the functional psychoneuroses represent, after a fashion, some of these distorted attempts to find a substitute for the imperative cravings born of the sexual instincts, and their form often depends, in part at least, on the peculiarities of the sexual life in infancy and early childhood. It is Freud's service to have investigated this inadequately chronicled period of existence with extraordinary acumen. In so doing he made it plain that the "perversions" and "inversions," which reappear later under such striking shapes, belong to the normal sexual life of the young child and are seen, in veiled forms, in almost every case of nervous illness.
It cannot too often be repeated that these discoveries represent no fanciful deductions, but are the outcome of rigidly careful observations which any one who will sufficiently prepare himself can verify. Critics fret over the amount of "sexuality" that Freud finds evidence of in the histories of his patients, and assume that he puts it there. But such criticisms are evidences of misunderstandings and proofs of ignorance.
Freud had learned that the amnesias of hypnosis and of hysteria were not absolute but relative and that in covering the lost memories, much more, of unexpected sort, was often found. Others, too, had gone as far as this, and stopped. But this investigator determined that nothing but the absolute impossibility of going further should make him cease from urging his patients into an inexorable scrutiny of the unconscious regions of their memories and thoughts, such as never had been made before. Every species of forgetfulness, even the forgetfulness of childhood's years, was made to yield its hidden stores of knowledge; dreams, even though apparently absurd, were found to be interpreters of a varied class of thoughts, active, although repressed as out of harmony with the selected life of consciousness; layer after layer, new sets of motives underlying motives were laid bare, and each patient's interest was strongly enlisted in the task of learning to know himself in order more truly and wisely to "sublimate" himself. Gradually other workers joined patiently in this laborious undertaking, which now stands, for those who have taken pains to comprehend it, as by far the most important movement in psychopathology.
It must, however, be recognized that these essays, of which Dr. Brill has given a translation that cannot but be timely, concern a subject which is not only important but unpopular. Few physicians read the works of v. Krafft-Ebing, Magnus Hirschfeld, Moll, and others of like sort. The remarkable volumes of Havelock Ellis were refused publication in his native England. The sentiments which inspired this hostile attitude towards the study of the sexual life are still active, though growing steadily less common. One may easily believe that if the facts which Freud's truth-seeking researches forced him to recognize and to publish had not been of an unpopular sort, his rich and abundant contributions to observational psychology, to the significance of dreams, to the etiology and therapeutics of the psychoneuroses, to the interpretation of mythology, would have won for him, by universal acclaim, the same recognition among all physicians that he has received from a rapidly increasing band of followers and colleagues.
May Dr. Brill's translation help toward this end.
There are two further points on which some comments should be made. The first is this, that those who conscientiously desire to learn all that they can from Freud's remarkable contributions should not be content to read any one of them alone. His various publications, such as "The Selected Papers on Hysteria and Other Psychoneuroses," "The Interpretation of Dreams," "The Psychopathology of Everyday Life," "Wit and its Relation to the Unconscious," the analysis of the case of the little boy called Hans, the study of Leonardo da Vinci,[4a] and the various short essays in the four Sammlungen kleiner Schriften, not only all hang together, but supplement each other to a remarkable extent. Unless a course of study such as this is undertaken many critics may think various statements and inferences in this volume to be far fetched or find them too obscure for comprehension.
The other point is the following: One frequently hears the psychoanalytic method referred to as if it was customary for those practicing it to exploit the sexual experiences of their patients and nothing more, and the insistence on the details of the sexual life, presented in this book, is likely to emphasize that notion. But the fact is, as every thoughtful inquirer is aware, that the whole progress of civilization, whether in the individual or the race, consists largely in a "sublimation" of infantile instincts, and especially certain portions of the sexual instinct, to other ends than those which they seemed designed to serve. Art and poetry are fed on this fuel and the evolution of character and mental force is largely of the same origin. All the forms which this sublimation, or the abortive attempts at sublimation, may take in any given case, should come out in the course of a thorough psychoanalysis. It is not the sexual life alone, but every interest and every motive, that must be inquired into by the physician who is seeking to obtain all the data about the patient, necessary for his reeducation and his cure. But all the thoughts and emotions and desires and motives which appear in the man or woman of adult years were once crudely represented in the obscure instincts of the infant, and among these instincts those which were concerned directly or indirectly with the sexual emotions, in a wide sense, are certain to be found in every case to have been the most important for the end-result.
JAMES J. PUTNAM.
BOSTON, August 23, 1910.
 Translated by A.A. Brill, NERVOUS AND MENTAL DISEASE MONOGRAPH SERIES, NO. 4.
 Translated by A.A. Brill, The Macmillan Co., New York, and Allen & Unwin, London.
 Translated by A.A. Brill, The Macmillan Co., New York.
 Translated by A.A. Brill, Moffatt, Yard & Co., New York.
[4a] Translated by A.A. Brill, Moffatt, Yard & Co., New York.
AUTHOR'S PREFACE TO THE SECOND EDITION
Although the author is fully aware of the gaps and obscurities contained in this small volume, he has, nevertheless, resisted a temptation to add to it the results obtained from the investigations of the last five years, fearing that thus its unified and documentary character would be destroyed. He accordingly reproduces the original text with but slight modifications, contenting himself with the addition of a few footnotes. For the rest, it is his ardent wish that this book may speedily become antiquated—to the end that the new material brought forward in it may be universally accepted, while the shortcomings it displays may give place to juster views.
VIENNA, December, 1909.
AUTHOR'S PREFACE TO THE THIRD EDITION
After watching for ten years the reception accorded to this book and the effect it has produced, I wish to provide the third edition of it with some prefatory remarks dealing with the misunderstandings of the book and the demands, insusceptible of fulfillment, made against it. Let me emphasize in the first place that whatever is here presented is derived entirely from every-day medical experience which is to be made more profound and scientifically important through the results of psychoanalytic investigation. The "Three Contributions to the Theory of Sex" can contain nothing except what psychoanalysis obliges them to accept or what it succeeds in corroborating. It is therefore excluded that they should ever be developed into a "theory of sex," and it is also quite intelligible that they will assume no attitude at all towards some important problems of the sexual life. This should not however give the impression that these omitted chapters of the great theme were unfamiliar to the author, or that they were neglected by him as something of secondary importance.
The dependence of this work on the psychoanalytic experiences which have determined the writing of it, shows itself not only in the selection but also in the arrangement of the material. A certain succession of stages was observed, the occasional factors are rendered prominent, the constitutional ones are left in the background, and the ontogenetic development receives greater consideration than the phylogenetic. For the occasional factors play the principal role in analysis, and are almost completely worked up in it, while the constitutional factors only become evident from behind as elements which have been made functional through experience, and a discussion of these would lead far beyond the working sphere of psychoanalysis.
A similar connection determines the relation between ontogenesis and phylogenesis. Ontogenesis may be considered as a repetition of phylogenesis insofar as the latter has not been varied by a more recent experience. The phylogenetic disposition makes itself visible behind the ontogenetic process. But fundamentally the constitution is really the precipitate of a former experience of the species to which the newer experience of the individual being is added as the sum of the occasional factors.
Beside its thoroughgoing dependence on psychoanalytic investigation I must emphasize as a character of this work of mine its intentional independence of biological investigation. I have carefully avoided the inclusion of the results of scientific investigation in general sex biology or of particular species of animals in this study of human sexual functions which is made possible by the technique of psychoanalysis. My aim was indeed to find out how much of the biology of the sexual life of man can be discovered by means of psychological investigation; I was able to point to additions and agreements which resulted from this examination, but I did not have to become confused if the psychoanalytic methods led in some points to views and results which deviated considerably from those merely based on biology.
I have added many passages in this edition, but I have abstained from calling attention to them, as in former editions, by special marks. The scientific work in our sphere has at present been retarded in its progress, nevertheless some supplements to this work were indispensable if it was to remain in touch with our newer psychoanalytic literature.
VIENNA, October, 1914.
THE SEXUAL ABERRATIONS
The fact of sexual need in man and animal is expressed in biology by the assumption of a "sexual impulse." This impulse is made analogous to the impulse of taking nourishment, and to hunger. The sexual expression corresponding to hunger not being found colloquilly, science uses the expression "libido."
Popular conception makes definite assumptions concerning the nature and qualities of this sexual impulse. It is supposed to be absent during childhood and to commence about the time of and in connection with the maturing process of puberty; it is supposed that it manifests itself in irresistible attractions exerted by one sex upon the other, and that its aim is sexual union or at least such actions as would lead to union.
But we have every reason to see in these assumptions a very untrustworthy picture of reality. On closer examination they are found to abound in errors, inaccuracies and hasty conclusions.
If we introduce two terms and call the person from whom the sexual attraction emanates the sexual object, and the action towards which the impulse strives the sexual aim, then the scientifically examined experience shows us many deviations in reference to both sexual object and sexual aim, the relations of which to the accepted standard require thorough investigation.
1. DEVIATION IN REFERENCE TO THE SEXUAL OBJECT
The popular theory of the sexual impulse corresponds closely to the poetic fable of dividing the person into two halves—man and woman—who strive to become reunited through love. It is therefore very surprising to hear that there are men for whom the sexual object is not woman but man, and that there are women for whom it is not man but woman. Such persons are called contrary sexuals, or better, inverts; the condition, that of inversion. The number of such individuals is considerable though difficult of accurate determination.
*The Behavior of Inverts.*—The above-mentioned persons behave in many ways quite differently.
(a) They are absolutely inverted; i.e., their sexual object must be always of the same sex, while the opposite sex can never be to them an object of sexual longing, but leaves them indifferent or may even evoke sexual repugnance. As men they are unable, on account of this repugnance, to perform the normal sexual act or miss all pleasure in its performance.
(b) They are amphigenously inverted (psychosexually hermaphroditic); i.e., their sexual object may belong indifferently to either the same or to the other sex. The inversion lacks the character of exclusiveness.
(c) They are occasionally inverted; i.e., under certain external conditions, chief among which are the inaccessibility of the normal sexual object and initiation, they are able to take as the sexual object a person of the same sex and thus find sexual gratification.
The inverted also manifest a manifold behavior in their judgment about the peculiarities of their sexual impulse. Some take the inversion as a matter of course, just as the normal person does regarding his libido, firmly demanding the same rights as the normal. Others, however, strive against the fact of their inversion and perceive in it a morbid compulsion.
Other variations concern the relations of time. The characteristics of the inversion in any individual may date back as far as his memory goes, or they may become manifest to him at a definite period before or after puberty. The character is either retained throughout life, or it occasionally recedes or represents an episode on the road to normal development. A periodical fluctuation between the normal and the inverted sexual object has also been observed. Of special interest are those cases in which the libido changes, taking on the character of inversion after a painful experience with the normal sexual object.
These different categories of variation generally exist independently of one another. In the most extreme cases it can regularly be assumed that the inversion has existed at all times and that the person feels contented with his peculiar state.
Many authors will hesitate to gather into a unit all the cases enumerated here and will prefer to emphasize the differences rather than the common characters of these groups, a view which corresponds with their preferred judgment of inversions. But no matter what divisions may be set up, it cannot be overlooked that all transitions are abundantly met with, so that the formation of a series would seem to impose itself.
*Conception of Inversion.*—The first attention bestowed upon inversion gave rise to the conception that it was a congenital sign of nervous degeneration. This harmonized with the fact that doctors first met it among the nervous, or among persons giving such an impression. There are two elements which should be considered independently in this conception: the congenitality, and the degeneration.
*Degeneration.*—This term degeneration is open to the objections which may be urged against the promiscuous use of this word in general. It has in fact become customary to designate all morbid manifestations not of traumatic or infectious origin as degenerative. Indeed, Magnan's classification of degenerates makes it possible that the highest general configuration of nervous accomplishment need not exclude the application of the concept of degeneration. Under the circumstances, it is a question what use and what new content the judgment of "degeneration" still possesses. It would seem more appropriate not to speak of degeneration: (1) Where there are not many marked deviations from the normal; (2) where the capacity for working and living do not in general appear markedly impaired.
That the inverted are not degenerates in this qualified sense can be seen from the following facts:
1. The inversion is found among persons who otherwise show no marked deviation from the normal.
2. It is found also among persons whose capabilities are not disturbed, who on the contrary are distinguished by especially high intellectual development and ethical culture.
3. If one disregards the patients of one's own practice and strives to comprehend a wider field of experience, he will in two directions encounter facts which will prevent him from assuming inversions as a degenerative sign.
(a) It must be considered that inversion was a frequent manifestation among the ancient nations at the height of their culture. It was an institution endowed with important functions. (b) It is found to be unusually prevalent among savages and primitive races, whereas the term degeneration is generally limited to higher civilization (I. Bloch). Even among the most civilized nations of Europe, climate and race have a most powerful influence on the distribution of, and attitude toward, inversion.
*Innateness.*—Only for the first and most extreme class of inverts, as can be imagined, has innateness been claimed, and this from their own assurance that at no time in their life has their sexual impulse followed a different course. The fact of the existence of two other classes, especially of the third, is difficult to reconcile with the assumption of its being congenital. Hence, the propensity of those holding this view to separate the group of absolute inverts from the others results in the abandonment of the general conception of inversion. Accordingly in a number of cases the inversion would be of a congenital character, while in others it might originate from other causes.
In contradistinction to this conception is that which assumes inversion to be an acquired character of the sexual impulse. It is based on the following facts. (1) In many inverts (even absolute ones) an early affective sexual impression can be demonstrated, as a result of which the homosexual inclination developed. (2) In many others outer influences of a promoting and inhibiting nature can be demonstrated, which in earlier or later life led to a fixation of the inversion—among which are exclusive relations with the same sex, companionship in war, detention in prison, dangers of hetero-sexual intercourse, celibacy, sexual weakness, etc. (3) Hypnotic suggestion may remove the inversion, which would be surprising in that of a congenital character.
In view of all this, the existence of congenital inversion can certainly be questioned. The objection may be made to it that a more accurate examination of those claimed to be congenitally inverted will probably show that the direction of the libido was determined by a definite experience of early childhood, which has not been retained in the conscious memory of the person, but which can be brought back to memory by proper influences (Havelock Ellis). According to that author inversion can be designated only as a frequent variation of the sexual impulse which may be determined by a number of external circumstances of life.
The apparent certainty thus reached is, however, overthrown by the retort that manifestly there are many persons who have experienced even in their early youth those very sexual influences, such as seduction, mutual onanism, without becoming inverts, or without constantly remaining so. Hence, one is forced to assume that the alternatives congenital and acquired are either incomplete or do not cover the circumstances present in inversions.
*Explanation of Inversion.*—The nature of inversion is explained neither by the assumption that it is congenital nor that it is acquired. In the first case, we need to be told what there is in it of the congenital, unless we are satisfied with the roughest explanation, namely, that a person brings along a congenital sexual impulse connected with a definite sexual object. In the second case it is a question whether the manifold accidental influences suffice to explain the acquisition unless there is something in the individual to meet them half way. The negation of this last factor is inadmissible according to our former conclusions.
*The Relation of Bisexuality.*—Since the time of Frank Lydston, Kiernan, and Chevalier, a new series of ideas has been introduced for the explanation of the possibility of sexual inversion. This contains a new contradiction to the popular belief which assumes that a human being is either a man or a woman. Science shows cases in which the sexual characteristics appear blurred and thus the sexual distinction is made difficult, especially on an anatomical basis. The genitals of such persons unite the male and female characteristics (hermaphroditism). In rare cases both parts of the sexual apparatus are well developed (true hermaphroditism), but usually both are stunted.
The importance of these abnormalities lies in the fact that they unexpectedly facilitate the understanding of the normal formation. A certain degree of anatomical hermaphroditism really belongs to the normal. In no normally formed male or female are traces of the apparatus of the other sex lacking; these either continue functionless as rudimentary organs, or they are transformed for the purpose of assuming other functions.
The conception which we gather from this long known anatomical fact is the original predisposition to bisexuality, which in the course of development has changed to monosexuality, leaving slight remnants of the stunted sex.
It was natural to transfer this conception to the psychic sphere and to conceive the inversion in its aberrations as an expression of psychic hermaphroditism. In order to bring the question to a decision, it was only necessary to have one other circumstance, viz., a regular concurrence of the inversion with the psychic and somatic signs of hermaphroditism.
But this second expectation was not realized. The relations between the assumed psychical and the demonstrable anatomical androgyny should never be conceived as being so close. There is frequently found in the inverted a diminution of the sexual impulse (H. Ellis) and a slight anatomical stunting of the organs. This, however, is found frequently but by no means regularly or preponderately. Thus we must recognize that inversion and somatic hermaphroditism are totally independent of each other.
Great importance has also been attached to the so-called secondary and tertiary sex characters and their aggregate occurrence in the inverted has been emphasized (H. Ellis). There is much truth in this but it should not be forgotten that the secondary and tertiary sex characteristics very frequently manifest themselves in the other sex, thus indicating androgyny without, however, involving changes in the sexual object in the sense of an inversion.
Psychic hermaphroditism would gain in substantiality if parallel with the inversion of the sexual object there should be at least a change in the other psychic qualities, such as in the impulses and distinguishing traits characteristic of the other sex. But such inversion of character can be expected with some regularity only in inverted women; in men the most perfect psychic manliness may be united with the inversion. If one firmly adheres to the hypothesis of a psychic hermaphroditism, one must add that in certain spheres its manifestations allow the recognition of only a very slight contrary determination. The same also holds true in the somatic androgyny. According to Halban, the appearance of individual stunted organs and secondary sex characters are quite independent of each other.
A spokesman of the masculine inverts stated the bisexual theory in its crudest form in the following words: "It is a female brain in a male body." But we do not know the characteristics of a "female brain." The substitution of the anatomical for the psychological is as frivolous as it is unjustified. The tentative explanation by v. Krafft-Ebing seems to be more precisely formulated than that of Ulrich but does not essentially differ from it. v. Krafft-Ebing thinks that the bisexual predisposition gives to the individual male and female brain centers as well as somatic sexual organs. These centers develop first towards puberty mostly under the influence of the independent sex glands. We can, however, say the same of the male and female "centers" as of the male and female brains; and, moreover, we do not even know whether we can assume for the sexual functions separate brain locations ("centers") such as we may assume for language.
After this discussion, two notions, at all events, persist; first, that a bisexual predisposition is to be presumed for the inversion also, only we do not know of what it consists beyond the anatomical formations; and, second, that we are dealing with disturbances which are experienced by the sexual impulse during its development.
*The Sexual Object of Inverts.*—The theory of psychic hermaphroditism presupposed that the sexual object of the inverted is the reverse of the normal. The inverted man, like the woman, succumbs to the charms emanating from manly qualities of body and mind; he feels himself like a woman and seeks a man.
But however true this may be for a great number of inverts, it by no means indicates the general character of inversion. There is no doubt that a great part of the male inverted have retained the psychic character of virility, that proportionately they show but little of the secondary characters of the other sex, and that they really look for real feminine psychic features in their sexual object. If that were not so it would be incomprehensible why masculine prostitution, in offering itself to inverts, copies in all its exterior, to-day as in antiquity, the dress and attitudes of woman. This imitation would otherwise be an insult to the ideal of the inverts. Among the Greeks, where the most manly men were found among inverts, it is quite obvious that it was not the masculine character of the boy which kindled the love of man, but it was his physical resemblance to woman as well as his feminine psychic qualities, such as shyness, demureness, and the need of instruction and help. As soon as the boy himself became a man he ceased to be a sexual object for men and in turn became a lover of boys. The sexual object in this case as in many others is therefore not of the like sex, but it unites both sex characters, a compromise between the impulses striving for the man and for the woman, but firmly conditioned by the masculinity of body (the genitals).
The conditions in the woman are more definite; here the active inverts, with special frequency, show the somatic and psychic characters of man and desire femininity in their sexual object; though even here greater variation will be found on more intimate investigation.
*The Sexual Aim of Inverts.*—The important fact to bear in mind is that no uniformity of the sexual aim can be attributed to inversion. Intercourse per anum in men by no means goes with inversion; masturbation is just as frequently the exclusive aim; and the limitation of the sexual aim to mere effusion of feelings is here even more frequent than in hetero-sexual love. In women, too, the sexual aims of the inverted are manifold, among which contact with the mucous membrane of the mouth seems to be preferred.
*Conclusion.*—Though from the material on hand we are by no means in a position satisfactorily to explain the origin of inversion, we can say that through this investigation we have obtained an insight which can become of greater significance to us than the solution of the above problem. Our attention is called to the fact that we have assumed a too close connection between the sexual impulse and the sexual object. The experience gained from the so called abnormal cases teaches us that a connection exists between the sexual impulse and the sexual object which we are in danger of overlooking in the uniformity of normal states where the impulse seems to bring with it the object. We are thus instructed to separate this connection between the impulse and the object. The sexual impulse is probably entirely independent of its object and is not originated by the stimuli proceeding from the object.
B. The Sexually Immature and Animals as Sexual Objects
Whereas those sexual inverts whose sexual object does not belong to the normally adapted sex, appear to the observer as a collective number of perhaps otherwise normal individuals, the persons who choose for their sexual object the sexually immature (children) are apparently from the first sporadic aberrations. Only exceptionally are children the exclusive sexual objects. They are mostly drawn into this role by a faint-hearted and impotent individual who makes use of such substitutes, or when an impulsive urgent desire cannot at the time secure the proper object. Still it throws some light on the nature of the sexual impulse, that it should suffer such great variation and depreciation of its object, a thing which hunger, adhering more energetically to its object, would allow only in the most extreme cases. The same may be said of sexual relations with animals—a thing not at all rare among farmers—where the sexual attraction goes beyond the limits of the species.
For esthetic reasons one would fain attribute this and other excessive aberrations of the sexual impulse to the insane, but this cannot be done. Experience teaches that among the latter no disturbances of the sexual impulse can be found other than those observed among the sane, or among whole races and classes. Thus we find with gruesome frequency sexual abuse of children by teachers and servants merely because they have the best opportunities for it. The insane present the aforesaid aberration only in a somewhat intensified form; or what is of special significance is the fact that the aberration becomes exclusive and takes the place of the normal sexual gratification.
This very remarkable relation of sexual variations ranging from the normal to the insane gives material for reflection. It seems to me that the fact to be explained would show that the impulses of the sexual life belong to those which even normally are most poorly controlled by the higher psychic activities. He who is in any way psychically abnormal, be it in social or ethical conditions, is, according to my experience, regularly so in his sexual life. But many are abnormal in their sexual life who in every other respect correspond to the average; they have followed the human cultural development, but sexuality remained as their weak point.
As a general result of these discussions we come to see that, under numerous conditions and among a surprising number of individuals, the nature and value of the sexual object steps into the background. There is something else in the sexual impulse which is the essential and constant.
2. DEVIATION IN REFERENCE TO THE SEXUAL AIM
The union of the genitals in the characteristic act of copulation is taken as the normal sexual aim. It serves to loosen the sexual tension and temporarily to quench the sexual desire (gratification analogous to satisfaction of hunger). Yet even in the most normal sexual process those additions are distinguishable, the development of which leads to the aberrations described as perversions. Thus certain intermediary relations to the sexual object connected with copulation, such as touching and looking, are recognized as preliminary to the sexual aim. These activities are on the one hand themselves connected with pleasure and on the other hand they enhance the excitement which persists until the definite sexual aim is reached. One definite kind of contiguity, consisting of mutual approximation of the mucous membranes of the lips in the form of a kiss, has received among the most civilized nations a sexual value, though the parts of the body concerned do not belong to the sexual apparatus but form the entrance to the digestive tract. This therefore supplies the factors which allow us to bring the perversions into relation with the normal sexual life, and which are available also for their classification. The perversions are either (a) anatomical transgressions of the bodily regions destined for sexual union, or (b) a lingering at the intermediary relations to the sexual object which should normally be rapidly passed on the way to the definite sexual aim.
(a) Anatomical Transgression
*Overestimation of the Sexual Object.*—The psychic estimation in which the sexual object as a goal of the sexual impulse shares is only in the rarest cases limited to the genitals; generally it embraces the whole body and tends to include all sensations emanating from the sexual object. The same overestimation spreads over the psychic sphere and manifests itself as a logical blinding (diminished judgment) in the face of the psychic attainments and perfections of the sexual object, as well as a blind obedience to the judgments issuing from the latter. The full faith of love thus becomes an important, if not the primordial source of authority.
It is this sexual overvaluation, which so ill agrees with the restriction of the sexual aim to the union of the genitals only, that assists other parts of the body to participate as sexual aims. In the development of this most manifold anatomical overestimation there is an unmistakable desire towards variation, a thing denominated by Hoche as "excitement-hunger" (Reiz-hunger).
*Sexual Utilization of the Mucous Membrane of the Lips and Mouth.*—The significance of the factor of sexual overestimation can be best studied in the man, in whom alone the sexual life is accessible to investigation, whereas in the woman it is veiled in impenetrable darkness, partly in consequence of cultural stunting and partly on account of the conventional reticence and dishonesty of women.
The employment of the mouth as a sexual organ is considered as a perversion if the lips (tongue) of the one are brought into contact with the genitals of the other, but not when the mucous membrane of the lips of both touch each other. In the latter exception we find the connection with the normal. He who abhors the former as perversions, though these since antiquity have been common practices among mankind, yields to a distinct feeling of loathing which protects him from adopting such sexual aims. The limit of such loathing is frequently purely conventional; he who kisses fervently the lips of a pretty girl will perhaps be able to use her tooth brush only with a sense of loathing, though there is no reason to assume that his own oral cavity for which he entertains no loathing is cleaner than that of the girl. Our attention is here called to the factor of loathing which stands in the way of the libidinous overestimation of the sexual aim, but which may in turn be vanquished by the libido. In the loathing we may observe one of the forces which have brought about the restrictions of the sexual aim. As a rule these forces halt at the genitals; there is, however, no doubt that even the genitals of the other sex themselves may be an object of loathing. Such behavior is characteristic of all hysterics, especially women. The force of the sexual impulse prefers to occupy itself with the overcoming of this loathing (see below).
*Sexual Utilization of the Anal Opening.*—It is even more obvious than in the former case that it is the loathing which stamps as a perversion the use of the anus as a sexual aim. But it should not be interpreted as espousing a cause when I observe that the basis of this loathing—namely, that this part of the body serves for the excretion and comes in contact with the loathsome excrement—is not more plausible than the basis which hysterical girls have for the disgust which they entertain for the male genital because it serves for urination.
The sexual role of the mucous membrane of the anus is by no means limited to intercourse between men; its preference has nothing characteristic of the inverted feeling. On the contrary, it seems that the pedicatio of the man owes its role to the analogy with the act in the woman, whereas among inverts it is mutual masturbation which is the most common sexual aim.
*The Significance of Other Parts of the Body.*—Sexual infringement on the other parts of the body, in all its variations, offers nothing new; it adds nothing to our knowledge of the sexual impulse which herein only announces its intention to dominate the sexual object in every way. Besides the sexual overvaluation, a second and generally unknown factor may be mentioned among the anatomical transgressions. Certain parts of the body, like the mucous membrane of the mouth and anus, which repeatedly appear in such practices, lay claim as it were to be considered and treated as genitals. We shall hear how this claim is justified by the development of the sexual impulse, and how it is fulfilled in the symptomatology of certain morbid conditions.
*Unfit Substitutes for the Sexual Object. Fetichism.*—We are especially impressed by those cases in which for the normal sexual object another is substituted which is related to it but which is totally unfit for the normal sexual aim. According to the scheme of the introduction we should have done better to mention this most interesting group of aberrations of the sexual impulse among the deviations in reference to the sexual object, but we have deferred mention of these until we became acquainted with the factor of sexual overestimation, upon which these manifestations, connected with the relinquishing of the sexual aim, depend.
The substitute for the sexual object is generally a part of the body but little adapted for sexual purposes, such as the foot, or hair, or an inanimate object which is in demonstrable relation with the sexual person, and preferably with the sexuality of the same (fragments of clothing, white underwear). This substitution is not unjustly compared with the fetich in which the savage sees the embodiment of his god.
The transition to the cases of fetichism, with a renunciation of a normal or of a perverted sexual aim, is formed by cases in which a fetichistic determination is demanded in the sexual object if the sexual aim is to be attained (definite color of hair, clothing, even physical blemishes). No other variation of the sexual impulse verging on the pathological claims our interest as much as this one, owing to the peculiarity occasioned by its manifestations. A certain diminution in the striving for the normal sexual aim may be presupposed in all these cases (executive weakness of the sexual apparatus). The connection with the normal is occasioned by the psychologically necessary overestimation of the sexual object, which inevitably encroaches upon everything associatively related to it (sexual object). A certain degree of such fetichism therefore regularly belong to the normal, especially during those stages of wooing when the normal sexual aim seems inaccessible or its realization deferred.
"Get me a handkerchief from her bosom—a garter of my love." —FAUST.
The case becomes pathological only when the striving for the fetich fixes itself beyond such determinations and takes the place of the normal sexual aim; or again, when the fetich disengages itself from the person concerned and itself becomes a sexual object. These are the general determinations for the transition of mere variations of the sexual impulse into pathological aberrations.
The persistent influence of a sexual impress mostly received in early childhood often shows itself in the selection of a fetich, as Binet first asserted, and as was later proven by many illustrations,—a thing which may be placed parallel to the proverbial attachment to a first love in the normal ("On revient toujours a ses premiers amours"). Such a connection is especially seen in cases with only fetichistic determinations of the sexual object. The significance of early sexual impressions will be met again in other places.
In other cases it was mostly a symbolic thought association, unconscious to the person concerned, which led to the replacing of the object by means of a fetich. The paths of these connections can not always be definitely demonstrated. The foot is a very primitive sexual symbol already found in myths. Fur is used as a fetich probably on account of its association with the hairiness of the mons veneris. Such symbolism seems often to depend on sexual experiences in childhood.
(b) Fixation of Precursory Sexual Aims
*The Appearance of New Intentions.*—All the outer and inner determinations which impede or hold at a distance the attainment of the normal sexual aim, such as impotence, costliness of the sexual object, and dangers of the sexual act, will conceivably strengthen the inclination to linger at the preparatory acts and to form them into new sexual aims which may take the place of the normal. On closer investigation it is always seen that the ostensibly most peculiar of these new intentions have already been indicated in the normal sexual act.
*Touching and Looking.*—At least a certain amount of touching is indispensable for a person in order to attain the normal sexual aim. It is also generally known that the touching of the skin of the sexual object causes much pleasure and produces a supply of new excitement. Hence, the lingering at the touching can hardly be considered a perversion if the sexual act is proceeded with.
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. 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 cooeperation 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 (Bemaechtigungsapparatus), which served also for the gratification of the great wants of the other, ontogenetically the older impulse. 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.
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.
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 praecox, 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.
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.
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.
(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 role of genitals.
(c) The partial desires which usually appear in contrasting pairs play a very prominent role 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 role 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.
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.
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.
In individual cases of neurosis the behavior may be different; now the congenital force of the tendency to perversion may be more decisive and at other times more influence may be exerted by the collateral increase of the same through the deviation of the libido from the normal sexual aim and object. It would be unjust to construe a contrast where a cooperation exists. The greatest results will always be brought about by a neurosis if constitution and experience cooperate in the same direction. A pronounced constitution may perhaps be able to dispense with the assistance of daily impressions, while a profound disturbance in life may perhaps bring on a neurosis even in an average constitution. These views similarly hold true in the etiological significance of the congenital and the accidental experiences in other spheres.
If, however, preference is given to the assumption that an especially formed tendency to perversions is characteristic of the psychoneurotic constitution, there is a prospect of being able to distinguish a multiformity of such constitutions in accordance with the congenital preponderance of this or that erogenous zone, or of this or that partial impulse. Whether there is a special relationship between the predisposition to perversions and the selection of the morbid picture has not, like many other things in this realm, been investigated.
REFERENCE TO THE INFANTILISM OF SEXUALITY
By demonstrating the perverted feelings as symptomatic formations in psychoneurotics, we have enormously increased the number of persons who can be added to the perverts. This is not only because neurotics represent a very large proportion of humanity, but we must consider also that the neuroses in all their gradations run in an uninterrupted series to the normal state. Moebius was quite justified in saying that we are all somewhat hysterical. Hence, the very wide dissemination of perversions urged us to assume that the predisposition to perversions is no rare peculiarity but must form a part of the normally accepted constitution.
We have heard that it is a question whether perversions should be referred to congenital determinations or whether they originate from accidental experiences, just as Binet showed in fetichisms. Now we are forced to the conclusion that there is indeed something congenital at the basis of perversions, but it is something which is congenital in all persons, which as a predisposition may fluctuate in intensity and is brought into prominence by influences of life. We deal here with congenital roots in the constitution of the sexual impulse which in one series of cases develop into real carriers of sexual activity (perverts); while in other cases they undergo an insufficient suppression (repression), so that as morbid symptoms they are enabled to attract to themselves in a round-about way a considerable part of the sexual energy; while again in favorable cases between the two extremes they originate the normal sexual life through effective restrictions and other elaborations.
But we must also remember that the assumed constitution which shows the roots of all perversions will be demonstrable only in the child, though all impulses can be manifested in it only in moderate intensity. If we are led to suppose that neurotics conserve the infantile state of their sexuality or return to it, our interest must then turn to the sexual life of the child, and we will then follow the play of influences which control the processes of development of the infantile sexuality up to its termination in a perversion, a neurosis or a normal sexual life.
 The facts contained in the first "Contribution" have been gathered from the familiar publications of Krafft-Ebing, Moll, Moebius, Havelock Ellis, Schrenk-Notzing, Loewenfeld, Eulenberg, J. Bloch, and M. Hirschfeld, and from the later works published in the "Jahrbuch fuer sexuelle Zwischenstufen." As these publications also mention the other literature bearing on this subject I may forbear giving detailed references.
The conclusions reached through the investigation of sexual inverts are all based on the reports of J. Sadger and on my own experience.
 For general use the word "libido" is best translated by "craving." (Prof. James J. Putnam, Journal of Abnormal Psychology, Vol. IV, 6.)
 For the difficulties entailed in the attempt to ascertain the proportional number of inverts compare the work of M. Hirschfeld in the Jahrbuch fuer sexuelle Zwischenstufen, 1904. Cf. also Brill, The Conception of Homosexuality, Journal of the A.M.A., August 2, 1913.
 Such a striving against the compulsion to inversion favors cures by suggestion of psychoanalysis.
 Many have justly emphasized the fact that the autobiographic statements of inverts, as to the time of the appearance of their tendency to inversion, are untrustworthy as they may have repressed from memory any evidences of heterosexual feelings.
Psychoanalysis has confirmed this suspicion in all cases of inversion accessible, and has decidedly changed their anamnesis by filling up the infantile amnesias.
 With what reserve the diagnosis of degeneration should be made and what slight practical significance can be attributed to it can be gathered from the discussions of Moebius (Ueber Entartung; Grenzfragen des Nerven- und Seelenlebens, No. III, 1900). He says: "If we review the wide sphere of degeneration upon which we have here turned some light we can conclude without further ado that it is really of little value to diagnose degeneration."
 We must agree with the spokesman of "Uranism" that some of the most prominent men known have been inverts and perhaps absolute inverts.
 In the conception of inversion the pathological features have been Separated from the anthropological. For this credit is due to I. Bloch (Beitraege zur Aetiologie der Psychopathia Sexualis, 2 Teile, 1902-3), who has also brought into prominence the existence of inversion in the old civilized nations.
 Compare the last detailed discussion of somatic hermaphroditism (Taruffi, Hermaphroditismus und Zeugungsunfaehigkeit, German edit. by R. Teuscher, 1903), and the works of Neugebauer in many volumes of the Jahrbuch fuer sexuelle Zwischenstufen.
 J. Halban, "Die Entstehung der Geschlechtscharaktere," Arch. fuer Gynaekologie, Bd. 70, 1903. See also there the literature on the subject.
 According to a report in Vol. 6 of the Jahrbuch f. sexuelle Zwischenstufen, E. Gley is supposed to have been the first to mention bisexuality as an explanation of inversion. He published a paper (Les Aberrations de l'instinct Sexuel) in the Revue Philosophique as early as January, 1884. It is moreover noteworthy that the majority of authors who trace the inversion to bisexuality assume this factor not only for the inverts but also for those who have developed normally, and justly interpret the inversion as a result of a disturbance in development. Among these authors are Chevalier (Inversion Sexuelle, 1893), and v. Krafft-Ebing ("Zur Erklaerung der kontraeren Sexualempfindung," Jahrbuecher f. Psychiatrie u. Nervenheilkunde, XIII), who states that there are a number of observations "from which at least the virtual and continued existence of this second center (of the underlying sex) results." A Dr. Arduin (Die Frauenfrage und die sexuellen Zwischenstufen, 2d vol. of the Jahrbuch f. sexuelle Zwischenstufen, 1900) states that "in every man there exist male and female elements." See also the same Jahrbuch, Bd. I, 1899 ("Die objektive Diagnose der Homosexualitat," by M. Hirschfeld, pp. 8-9). In the determination of sex, as far as heterosexual persons are concerned, some are disproportionately more strongly developed than others. G. Herman is firm in his belief "that in every woman there are male, and in every man there are female germs and qualities" (Genesis, das Gesetz der Zeugung, 9 Bd., Libido und Manie, 1903). As recently as 1906 W. Fliess (Der Ablauf des Lebens) has claimed ownership of the idea of bisexuality (in the sense of double sex). Psychoanalytic investigation very strongly opposes the attempt to separate homosexuals from other persons as a group of a special nature. By also studying sexual excitations other than the manifestly open ones it discovers that all men are capable of homosexual object selection and actually accomplish this in the unconscious. Indeed the attachments of libidinous feelings to persons of the same sex play no small role as factors in normal psychic life, and as causative factors of disease they play a greater role than those belonging to the opposite sex. According to psychoanalysis, it rather seems that it is the independence of the object, selection of the sex of the object, the same free disposal over male and female objects, as observed in childhood, in primitive states and in prehistoric times, which forms the origin from which the normal as well as the inversion types developed, following restrictions in this or that direction. In the psychoanalytic sense the exclusive sexual interest of the man for the woman is also a problem requiring an explanation, and is not something that is self-evident and explainable on the basis of chemical attraction. The determination as to the definite sexual behavior does not occur until after puberty and is the result of a series of as yet not observable factors, some of which are of a constitutional, while some are of an accidental nature. Certainly some of these factors can turn out to be so enormous that by their character they influence the result. In general, however, the multiplicity of the determining factors is reflected by the manifoldness of the outcomes in the manifest sexual behavior of the person. In the inversion types it can be ascertained that they are altogether controlled by an archaic constitution and by primitive psychic mechanisms. The importance of the narcissistic object selection and the clinging to the erotic significance of the anal zone seem to be their most essential characteristics. But one gains nothing by separating the most extreme inversion types from the others on the basis of such constitutional peculiarities. What is found in the latter as seemingly an adequate determinant can also be demonstrated only in lesser force in the constitution of transitional types and in manifestly normal persons. The differences in the results may be of a qualitative nature, but analysis shows that the differences in the determinants are only quantitative. As a remarkable factor among the accidental influences of the object selection, we found the sexual rejection or the early sexual intimidation, and our attention was also called to the fact that the existence of both parents plays an important role in the child's life. The disappearance of a strong father in childhood not infrequently favors the inversion. Finally, one might demand that the inversion of the sexual object should notionally be strictly separated from the mixing of the sex characteristics in the subject. A certain amount of independence is unmistakable also in this relation.
 Although psychoanalysis has not yet given us a full explanation for the origin of inversion, it has revealed the psychic mechanism of its genesis and has essentially enriched the problems in question. In all the cases examined we have ascertained that the later inverts go through in their childhood a phase of very intense but short-lived fixation on the woman (usually on the mother) and after overcoming it they identify themselves with the woman and take themselves as the sexual object; that is, proceeding on a narcissistic basis, they look for young men resembling themselves in persons whom they wish to love as their mother has loved them. We have, moreover, frequently found that alleged inverts are by no means indifferent to the charms of women, but the excitation evoked by the woman is always transferred to a male object. They thus repeat through life the mechanism which gave origin to their inversion. Their obsessive striving for the man proves to be determined by their restless flight from the woman.
 The most pronounced difference between the sexual life (Liebesleben) of antiquity and ours lies in the fact that the ancients placed the emphasis on the impulse itself, while we put it on its object. The ancients extolled the impulse and were ready to ennoble through it even an inferior object, while we disparage the activity of the impulse as such and only countenance it on account of the merits of the object.
 I must mention here that the blind obedience evinced by the hypnotized subject to the hypnotist causes me to think that the nature of hypnosis is to be found in the unconscious fixation of the libido on the person of the hypnotizer (by means of the masochistic component of the sexual impulse).
Ferenczi connects this character of suggestibility with the "parent complex" (Jahrbuch fuer Psychoanalytische und psychopathologische Forschungen, I, 1909).
 Moreover, it is to be noted that sexual overvaluation does not become pronounced in all mechanisms of object selection, and that we shall later learn to know another and more direct explanation for the sexual role of the other parts of the body.
 Further investigations lead to the conclusion that I. Bloch has overestimated the factor of excitement-hunger (Reizhunger). The various roads upon which the libido moves behave to each other from the very beginning like communicating pipes; the factor of collateral streaming must also be considered.
 This weakness corresponds to the constitutional predisposition. The early sexual intimidation which pushes the person away from the normal sexual aim and urges him to seek a substitute, has been demonstrated by psychoanalysis, as an accidental determinant.
 The shoe or slipper is accordingly a symbol for the female genitals.
 Psychoanalysis has filled up the gap in the understanding of fetichisms by showing that the selection of the fetich depends on a coprophilic smell-desire which has been lost by repression. Feet and hair are strong smelling objects which are raised to fetiches after the renouncing of the now unpleasant sensation of smell. Accordingly, only the filthy and ill-smelling foot is the sexual object in the perversion which corresponds to the foot fetichism. Another contribution to the explanation of the fetichistic preference of the foot is found in the Infantile Sexual Theories (see later). The foot replaces the penis which is so much missed in the woman. In some cases of foot fetichism it could be shown that the desire for looking originally directed to the genitals, which wished to reach its object from below, was stopped on the way by prohibition and repression, and therefore adhered to the foot or shoe as a fetich. In conformity with infantile expectation, the female genital was hereby imagined as a male genital.