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It is true that notions such as that of an ego-libido symptoms 2 weeks pregnant order lukol cheap, an energy of the ego-instincts, and so on, are neither particularly easy to grasp, nor sufficiently rich in content; a speculative theory of the relations in question would begin by seeking to obtain a sharply defined concept as its basis. But I am of opinion that that is just the difference between a speculative theory and a science erected on empirical interpretation. The latter will not envy speculation its privilege of having a smooth, logically unassailable foundation, but will gladly content itself with nebulous, scarcely imaginable basic concepts, which it hopes to apprehend more clearly in the course of its development, or which it is even prepared to replace by others. For these ideas are not the foundation of science, upon which everything rests: that foundation is observation alone. They are not the bottom but the top of the whole structure, and they can be replaced and discarded without damaging it. The same thing is happening in our day in the science of physics, the basic notions of which as regards matter, centres of force, attraction, etc. A differentiation of libido into a kind which is proper to the ego and one which is attached to objects is an unavoidable corollary to an original hypothesis which distinguished between sexual instincts and ego-instincts. At any rate, analysis of the pure transference neuroses (hysteria and obsessional neurosis) compelled me to make this distinction and I only know that all attempts to account for these phenomena by other means have been completely unsuccessful. On Narcissism: An Introduction 2935 In the total absence of any theory of the instincts which would help us to find our bearings, we may be permitted, or rather, it is incumbent upon us, to start off by working out some hypothesis to its logical conclusion, until it either breaks down or is confirmed. There are various points in favour of the hypothesis of there having been from the first a separation between sexual instincts and others, ego-instincts, besides the serviceability of such a hypothesis in the analysis of the transference neuroses. I admit that this latter consideration alone would not be unambiguous, for it might be a question of an indifferent psychical energy which only becomes libido through the act of cathecting an object. But, in the first place, the distinction made in this concept corresponds to the common, popular distinction between hunger and love. The individual does actually carry on a twofold existence: one to serve his own purposes and the other as a link in a chain, which he serves against his will, or at least involuntarily. The individual himself regards sexuality as one of his own ends; whereas from another point of view he is an appendage to his germ plasm, at whose disposal he puts his energies in return for a bonus of pleasure. He is the mortal vehicle of a (possibly) immortal substance like the inheritor of an entailed property, who is only the temporary holder of an estate which survives him. The separation of the sexual instincts from the ego-instincts would simply reflect this twofold function of the individual. Thirdly, we must recollect that all our provisional ideas in psychology will presumably some day be based on an organic substructure. This makes it probable that it is special substances and chemical processes which perform the operations of sexuality and provide for the extension of individual life into that of the species. We are taking this probability into account in replacing the special chemical substances by special psychical forces. On Narcissism: An Introduction 2936 I try in general to keep psychology clear from everything that is different in nature from it, even biological lines of thought. For that very reason I should like at this point expressly to admit that the hypothesis of separate ego-instincts and sexual instincts (that is to say, the libido theory) rests scarcely at all upon a psychological basis, but derives its principal support from biology. But I shall be consistent enough to drop this hypothesis if psycho-analytic work should itself produce some other, more serviceable hypothesis about the instincts. It may turn out that, most basically and on the longest view, sexual energy libido is only the product of a differentiation in the energy at work generally in the mind. It relates to matters which are so remote from the problems of our observation, and of which we have so little cognizance, that it is as idle to dispute it as to affirm it; this primal identity may well have as little to do with our analytic interests as the primal kinship of all the races of mankind has to do with the proof of kinship required in order to establish a legal right of inheritance. Since we cannot wait for another science to present us with the final conclusions on the theory of the instincts, it is far more to the purpose that we should try to see what light may be thrown upon this basic problem of biology by a synthesis of the psychological phenomena. Let us face the possibility of error; but do not let us be deterred from pursuing the logical implications of the hypothesis we first adopted of an antithesis between ego-instincts and sexual instincts (a hypothesis to which we were forcibly led by analysis of the transference neuroses), and from seeing whether it turns out to be without contradictions and fruitful, and whether it can be applied to other disorders as well, such as schizophrenia. On Narcissism: An Introduction 2937 It would, of course, be a different matter if it were proved that the libido theory has already come to grief in the attempt to explain the latter disease. Jung (1912) and it is on that account that I have been obliged to enter upon this last discussion, which I would gladly have been spared. I should have preferred to follow to its end the course embarked upon in the analysis of the Schreber case without any discussion of its premisses. In the first place, he appeals to an admission of my own that I myself have been obliged, owing to the difficulties of the Schreber analysis, to extend the concept of libido (that is, to give up its sexual content) and to identify libido with psychical interest in general. I can only corroborate his criticism and repeat that I have never made any such retractation of the libido theory. It is indeed a tempting possibility to explain the psychology of the loss of reality in this fashion. He may have diverted his sexual interest from human beings entirely, and yet may have sublimated it into a heightened interest in the divine, in nature, or in the animal kingdom, without his libido having undergone an introversion on to his phantasies or a return to his ego. This analogy would seem to rule out in advance the possibility of differentiating between interest emanating from erotic sources and from others. Let us remember, further, that the researches of the Swiss school, however valuable, have elucidated only two features in the picture of dementia praecox the presence in it of complexes known to us both in healthy and neurotic subjects, and the similarity of the phantasies that occur in it to popular myths but that they have not been able to throw any further light on the mechanism of the disease. Our chief means of access to it will probably remain the analysis of the paraphrenias. Just as the transference neuroses have enabled us to trace the libidinal instinctual impulses, so dementia praecox and paranoia will give us an insight into the psychology of the ego. Once more, in order to arrive at an understanding of what seems so simple in normal phenomena, we shall have to turn to the field of pathology with its distortions and exaggerations. At the same time, other means of approach remain open to us, by which we may obtain a better knowledge of narcissism. These I shall now discuss in the following order: the study of organic disease, of hypochondria and of the erotic life of the sexes. In estimating the influence of organic disease upon the distribution of libido, I follow a suggestion made to me orally by Sandor Ferenczi. It is universally known, and we take it as a matter of course, that a person who is tormented by organic pain and discomfort gives up his interest in the things of the external world, in so far as they do not concern his suffering. Closer observation teaches us that he also withdraws libidinal interest from his love-objects: so long as he suffers, he ceases to love. The commonplace nature of this fact is no reason why we should be deterred from translating it into terms of the libido theory. We should then say:(the sick man withdraws his libidinal cathexes back upon his own ego, and sends them out again when he recovers. We find it so natural because we are certain that in the same situation we should behave in just the same way. In both states we have, if nothing else, examples of changes in the distribution of libido that are consequent upon an alteration of the ego. Hypochondria, like organic disease, manifests itself in distressing and painful bodily sensations, and it has the same effect as organic disease on the distribution of libido. The hypochondriac withdraws both interest and libido the latter specially markedly from the objects of the external world and concentrates both of them upon the organ that is engaging his attention. A difference between hypochondria and organic disease now becomes evident: in the latter, the distressing sensations are based upon demonstrable changes; in the former, this is not so. But it would be entirely in keeping with our general conception of the processes of neurosis if we decided to say that hypochondria must be right: organic changes must be supposed to be present in it, too. We will let ourselves be guided at this point by our experience, which shows that bodily sensations of an unpleasurable nature, comparable to those of hypochondria, occur in the other neuroses as well.

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There we still find people who know how to die who treatment zit buy generic lukol 60caps on line, indeed, even manage to kill someone else. There alone too the condition can be fulfilled which makes it possible for us to reconcile ourselves with death: namely, that behind all the vicissitudes of life we should still be able to preserve a life intact. For it is really too sad that in life it should be as it is in chess, where one false move may force us to resign the game, but with the difference that we can start no second game, no return- match. We die with the hero with whom we have identified ourselves; yet we survive him, and are ready to die again just as safely with another hero. It is evident that war is bound to sweep away this conventional treatment of death. People really die; and no longer one by one, but many, often tens of thousands, in a single day. To be sure, it still seems a matter of chance whether a bullet hits this man or that; but a second bullet may well hit the survivor; and the accumulation of deaths puts an end to the impression of chance. Here a distinction should be made between two groups those who themselves risk their lives in battle, and those who have stayed at home and have only to wait for the loss of one of their dear ones by wounds, disease or infection. It would be most interesting, no doubt, to study the changes in the psychology of the combatants, but I know too little about it. I have said already that in my opinion the bewilderment and the paralysis of capacity, from which we suffer, are essentially determined among other things by the circumstance that we are unable to maintain our former attitude towards death, and have not yet found a new one. It may assist us to do this if we direct our psychological enquiry towards two other relations to death the one which we may ascribe to primaeval, prehistoric men, and the one which still exists in every one of us, but which conceals itself, invisible to consciousness, in the deeper strata of our mental life. Thoughts For the Times On War And Death 3084 What the attitude of prehistoric man was towards death is, of course, only known to us by inferences and constructions, but I believe that these methods have furnished us with fairly trustworthy conclusions. On the one hand, he took death seriously, recognized it as the termination of life and made use of it in that sense; on the other hand, he also denied death and reduced it to nothing. This contradiction arose from the fact that he took up radically different attitudes towards the death of other people, of strangers, of enemies, and towards his own. He was no doubt a very passionate creature and more cruel and more malignant than other animals. The instinct which is said to restrain other animals from killing and devouring their own species need not be attributed to him. Even to-day, the history of the world which our children learn at school is essentially a series of murders of peoples. The obscure sense of guilt to which mankind has been subject since prehistoric times, and which in some religions has been condensed into the doctrine of primal guilt, of original sin, is probably the outcome of a blood-guilt incurred by prehistoric man. In my book Totem and Taboo (1912-13) I have, following clues given by Robertson Smith, Atkinson and Charles Darwin, tried to guess the nature of this primal guilt, and I believe, too, that the Christian doctrine of to-day enables us to deduce it. If the Son of God was obliged to sacrifice his life to redeem mankind from original sin, then by the law of talion, the requital of like by like, that sin must have been a killing, a murder. And the original sin was an offence against God the Father, the primal crime of mankind must have been a parricide, the killing of the primal father of the primitive human horde, whose mnemic image was later transfigured into a deity. Thoughts For the Times On War And Death 3085 His own death was certainly just as unimaginable and unreal for primaeval man as it is for any one of us to-day. But there was for him one case in which the two opposite attitudes towards death collided and came into conflict with each other; and this case became highly important and productive of far-reaching consequences. It occurred when primaeval man saw someone who belonged to him die his wife, his child, his friend whom he undoubtedly loved as we love ours, for love cannot be much younger than the lust to kill. Then, in his pain, he was forced to learn that one can die, too, oneself, and his whole being revolted against the admission; for each of these loved ones was, after all, a part of his own beloved ego. But, on the other hand, deaths such as these pleased him as well, since in each of the loved persons there was also something of the stranger. The law of ambivalence of feeling, which to this day governs our emotional relations with those whom we love most, certainly had a very much wider validity in primaeval times. Thus these beloved dead had also been enemies and strangers who had aroused in him some degree of hostile feeling. I believe that here the philosophers are thinking too philosophically, and giving too little consideration to the motives that were primarily operative. In my view, primaeval man must have triumphed beside the body of his slain enemy, without being led to rack his brains about the enigma of life and death. What released the spirit of enquiry in man was not the intellectual enigma, and not every death, but the conflict of feeling at the death of loved yet alien and hated persons. Man could no longer keep death at a distance, for he had tasted it in his pain about the dead; but he was nevertheless unwilling to acknowledge it, for he could not conceive of himself as dead. So he devised a compromise: he conceded the fact of his own death as well, but denied it the significance of annihilation a significance which he had had no motive for denying where the death of his enemy was concerned. It was beside the dead body of someone he loved that he invented spirits, and his sense of guilt at the satisfaction mingled with his sorrow turned these new-born spirits into evil demons that had to be dreaded. The changes brought about by death suggested to him the division of the individual into a body and a soul originally several souls. In this way his train of thought ran parallel with the process of disintegration which sets in with death. His persisting memory of the dead became the basis for assuming other forms of existence and gave him the conception of a life continuing after apparent death. Thoughts For the Times On War And Death 3086 these subsequent existences were at first no more than appendages to the existence which death had brought to a close shadowy, empty of content, and valued at little until later times; they still bore the character of wretched makeshifts. I should choose, so I might live on earth, to serve as the hireling off another, of some portionless man whose livelihood was but small, rather than to be lord over all the dead that have perished. After this, it was no more than consistent to extend life backwards into the past, to form the notion of earlier existences, of the transmigration of souls and of reincarnation, all with the purpose of depriving death of its meaning as the termination of life. This final extension of the commandment is no longer experienced by civilized man. When the furious struggle of the present war has been decided, each one of the victorious fighters will return home joyfully to his wife and children, unchecked and undisturbed by thoughts of the enemies he has killed whether at close quarters or at long range. It is worthy of note that the primitive races which still survive in the world, and are undoubtedly closer than we are to primaeval man, act differently in this respect, or did until they came under the influence of our civilization. Savages Australians, Bushmen, Tierra del Fuegans are far from being remorseless murderers; when they return victorious from the war-path they may not set foot in their villages or touch their wives till they have atoned for the murders they committed in war by penances which are often long and tedious. It is easy, of course, to attribute this to their superstition: the savage still goes in fear of the avenging spirits of the slain. But the spirits of his slain enemy are nothing but the expression of his bad conscience about his blood-guilt; behind this superstition there lies concealed a vein of ethical sensitiveness which has been lost by us civilized men. Thoughts For the Times On War And Death 3088 Pious souls, no doubt, who would like to believe that our nature is remote from any contact with what is evil and base, will not fail to use the early appearance and the urgency of the prohibition against murder as the basis for gratifying conclusions as to the strength of the ethical impulses which must have been implanted in us. So powerful a prohibition can only be directed against an equally powerful impulse. What no human soul desires stands in no need of prohibition;fi it is excluded automatically. Let us now leave primaeval man, and turn to the unconscious in our own mental life.

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If excitation from two sensory cells flows into a nerve-fibre that connects them whether per continuitatem or per contiguitatem then a state of tension must exist in it symptoms neuropathy buy lukol 60 caps lowest price. This state of tension has the same relation to the excitation flowing away in, for instance, a peripheral motor fibre as hydrostatic pressure has to the living force of flowing water or as electric tension has to an electric current. Apart then from a potential energy which lies quiescent in the chemical substance of the cell and an unknown form of kinetic energy which is discharged when the fibres are in a state of excitation, we must assume the existence of yet another quiescent state of nervous excitation: tonic excitation or nervous tension. Studies On Hysteria 173 Let us imagine a man in a state of intense expectation, which is not, however, directed to any particular sensory field. We may rightly suppose that in such a brain all the paths of conduction are at the maximum of their conductive capability that they are in a state of tonic excitation. It is a significant fact that in ordinary language we speak of such a state as one of tension. Experience teaches us what a strain this state is and how fatiguing, though no actual motor or psychical work is performed in it. This is an exceptional state, which, precisely on account of the great consumption of energy involved, cannot be tolerated for long. But even the normal state of being wide awake calls for an amount of intracerebral excitation varying between limits that are not very widely separated. Every diminishing degree of wakefulness down to drowsiness and true sleep is accompanied by correspondingly lower degrees of excitation. When the brain is performing actual work, a greater consumption of energy is no doubt required than when it is merely prepared to perform work. The brain, however, behaves like one of those electrical systems of restricted capability which are unable to produce both a large amount of light and of mechanical work at the same time. If it is transmitting power, only a little energy is available for lighting, and vice versa. Thus we find that if we are making great muscular efforts we are unable to engage in continuous thought, or that if we concentrate our attention in one sensory field the efficiency of the other cerebral origins is reduced that is to say, we find that the brain works with a varying but limited amount of energy. Whether alterations in the blood- circulation in the brain are essential links here in the causal chain, and whether the blood-vessels are directly dilated by the stimulus, or whether the dilatation is a consequence of the excitation of the cerebral elements all this is undecided. What is certain is that the state of excitation, entering through a gateway of the senses, spreads over the brain from that point, becomes diffused and brings all the paths of conduction into a state of higher facilitation. It is still not in the least clear, of course, how spontaneous awakening occurs whether it is always one and the same portion of the brain that is the first to enter a state of waking excitation and the excitation then spreads from there, or whether sometimes one and sometimes another group of elements acts as the awakener. Nevertheless spontaneous awakening, which, as we know, can take place in complete quiet and darkness without any external stimulus, proves that the development of energy is based on the vital process of the cerebral elements themselves. A muscle remains unstimulated, quiescent, however long it has been in a state of rest and even though it has accumulated a maximum of tensile force. We are no doubt right in supposing that during sleep the latter regain their previous condition and gather tensile force. When this has happened to a certain degree, when, as we may say, a certain level has been reached, the surplus flows away into the paths of conduction, facilitates them and sets up the intracerebral excitation of the waking state. When the waking brain has been quiescent for a considerable time without transforming tensile force into live energy by functioning, there arises a need and an urge for activity. Long motor quiescence creates a need for movement (compare the aimless running round of a caged animal) and if this need cannot be satisfied a distressing feeling sets in. Lack of sensory stimuli, darkness and complete silence become a torture; mental repose, lack of perceptions, ideas and associative activity produce the torment of boredom. Studies On Hysteria 175 Thus the cerebral elements, after being completely restored liberate a certain amount of energy even when they are at rest and if this energy is not employed functionally it increases the normal intracerebral excitation. Since these feelings disappear when the surplus quantity of energy which has been liberated is employed functionally, we may conclude that the removal of such surplus excitation is a need of the organism. Such a surplus of intracerebral excitation is a burden and a nuisance, and an urge to use it up arises in consequence. If it cannot be used in sensory or ideational activity, the surplus flows away in purposeless motor action, in walking up and down, and so on, and this we shall meet with later as the commonest method of discharging excessive tensions. Studies On Hysteria 176 We have spoken of a tendency on the part of the organism to keep tonic cerebral excitation constant. A tendency of this kind is, however, only intelligible if we can see what need it fulfils. We can understand the tendency in warm-blooded animals that to keep a constant mean temperature, because our experience has taught us that that temperature is an optimum for the functioning of their organs. And we make a similar assumption in regard to the constancy of the water-content of the blood; and so on. I think that we may also assume that there is an optimum for the height of the intracerebral tonic excitation. At that level of tonic excitation the brain is accessible to all external stimuli, the reflexes are facilitated, though only to the extent of normal reflex activity, and the store of ideas is capable of being aroused and open to association in the mutual relation between individual ideas which corresponds to a clear and reasonable state of mind. This makes the organism hyperaesthetic towards sensory stimuli, which quickly become distressing, and also increases its reflex excitability above what is useful (proneness to fright). No doubt this state is useful for some situations and purposes; but if it appears spontaneously and not for any such reasons, it does not improve our efficiency but impairs it. In the great majority of forms of increase in excitation, however, the over-excitation is not uniform, and this is always detrimental to efficiency. That the organism should tend to maintain the optimum of excitation and to return to that optimum after it has been exceeded is not surprising, but quite in keeping with other regulating factors in the organism. I shall venture once more to recur to my comparison with an electrical lighting system. The tension in the network of lines of conduction in such a system has an optimum too. If this is exceeded its functioning may easily be impaired; for instance, the electric light filaments may be quickly burned through. Studies On Hysteria 177 (B) Our speech, the outcome of the experience of many generations, distinguishes with admirable delicacy between those forms and degrees of heightening of excitation which are still useful for mental activity because they raise the free energy of all cerebral functions uniformly, and those forms and degrees which restrict that activity because they partly increase and partly inhibit these psychical functions in a manner that is not uniform. While incitement only arouses the urge to employ the increased excitation functionally, excitement seeks to discharge itself in more or less violent ways which are almost or even actually pathological. Excitement constitutes the psycho-physical basis of the effects, and these will be discussed below. But I must first touch briefly on some physiological and endogenous causes of increases of excitation. Since the excitement which they set going is linked to certain sensations and purposive ideas, it is not such a pure example of increase of excitation as the one discussed above, which arose solely from the quiescence of the cerebral elements. But it is unmistakable in the anxious agitation which accompanies dyspnoea and in the restlessness of a starving man. The increase of excitation that comes from these sources is determined by the chemical change in the cerebral elements themselves, which are short of oxygen, of tensile force or of water. It flows away along preformed motor paths, which lead to the satisfaction of the need that set it going: dyspnoea leads to breathing with effort, and hunger and thirst to a search for and attainment of food and water. The principle of the constancy of excitation scarcely comes into operation as far as this kind of excitation is concerned; for the interests which are served by the increase in excitation in these cases are of far greater importance to the organism than the re-establishment of normal conditions of functioning in the brain. It is true that we see animals in a zoo running backwards and forwards excitedly before feeding-time; but this may no doubt be regarded as a residue of the preformed motor activity of looking for food, which has now become useless owing to their being in captivity, and not as a means of freeing the nervous system of excitement.

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In regard to the passive impulses of the phallic phase treatment of tuberculosis buy lukol 60 caps cheap, it is noteworthy that girls regularly accuse their mother of seducing them. This is because they necessarily received their first, or at any rate their strongest, genital sensations when they were being cleaned and having their toilet attended to by their mother (or by someone such as a nurse who took her place). Mothers have often told me, as a matter of observation, that their little daughters of two and three years old enjoy these sensations and try to get their mothers to make them more intense by repeated touching and rubbing. The fact that the mother thus unavoidably initiates the child into the phallic phase is, I think, the reason why, in phantasies of later years, the father so regularly appears as the sexual seducer. When the girl turns away from her mother, she also makes over to her father her introduction into sexual life. Female Sexuality 4603 Lastly, intense active wishful impulses directed towards the mother also arise during the phallic phase. This is probably accompanied by ideas of the mother, but whether the child attaches a sexual aim to the idea, and what that aim is, I have not been able to discover from my observations. It is only when all her interests have received a fresh impetus through the arrival of a baby brother or sister that we can clearly recognize such an aim. The little girl wants to believe that she has given her mother the new baby, just as the boy wants to; and her reaction to this event and her behaviour to the baby is exactly the same as his. No doubt this sounds quite absurd, but perhaps that is only because it sounds so unfamiliar. We have already described what takes place in it and the many motives put forward for it; we may now add that hand in hand with it there is to be observed a marked lowering of the active sexual impulses and a rise of the passive ones. It is true that the active trends have been affected by frustration more strongly; they have proved totally unrealizable and are therefore abandoned by the libido more readily. With the turning-away from the mother clitoridal masturbation frequently ceases as well; and often enough when the small girl represses her previous masculinity a considerable portion of her sexual trends in general is permanently injured too. The transition to the father-object is accomplished with the help of the passive trends in so far as they have escaped the catastrophe. The path to the development of femininity now lies open to the girl, to the extent to which it is not restricted by the remains of the pre-Oedipus attachment to her mother which she has surmounted. Female Sexuality 4604 If we now survey the stage of sexual development in the female which I have been describing, we cannot resist coming to a definite conclusion about female sexuality as a whole. We have found the same libidinal forces at work in it as in the male child and we have been able to convince ourselves that for a period of time these forces follow the same course and have the same outcome in each. Biological factors subsequently deflect those libidinal forces from their original aims and conduct even active and in every sense masculine trends into feminine channels. Since we cannot dismiss the notion that sexual excitation is derived from the operation of certain chemical substances, it seems plausible at first to expect that biochemistry will one day disclose a substance to us whose presence produces a male sexual excitation and another substance which produces a female one. But this hope seems no less naive than the other one happily obsolete to-day that it may be possible under the microscope to isolate the different exciting factors of hysteria, obsessional neurosis, melancholia, and so on. For psychology, however, it is a matter of indifference whether there is a single sexually exciting substance in the body or two or countless numbers of them. Psycho-analysis teaches us to manage with a single libido, which, it is true, has both active and passive aims (that is, modes of satisfaction). This antithesis and, above all, the existence of libidinal trends with passive aims, contains within itself the remainder of our problem. It would have been superfluous to publish this paper if it were not that in a field of research which is so difficult of access every account of first-hand experiences or personal views may be of value. Moreover, there are a number of points which I have defined more sharply and isolated more carefully. In some of the other papers on the subject the description is obscured because they deal at the same time with the problems of the super-ego and the sense of guilt. Also, in describing the various outcomes of this phase of development, I have refrained from discussing the complications which arise when a child, as a result of disappointment from her father, returns to the attachment to her mother which she had abandoned, or when, in the course of her life, she repeatedly changes over from one position to the other. But precisely because my paper is only one contribution among others, I may be spared an exhaustive survey of the literature, and I can confine myself to bringing out the more important points on which I agree or disagree with these other writings. Female Sexuality 4606 Fenichel (1930) rightly emphasizes the difficulty of recognizing in the material produced in analysis what parts of it represent the unchanged content of the pre-Oedipus phase and what parts have been distorted by regression (or in other ways). A means of softening this contradiction is afforded by the reflection that we are not as yet able to distinguish in this field between what is rigidly fixed by biological laws and what is open to movement and change under the influence of accidental experience. Certain as is the occurrence of later reinforcements through regression and reaction- formation, and difficult as it is to estimate the relative strength of the confluent libidinal components, I nevertheless think that we should not overlook the fact that the first libidinal impulses have an intensity of their own which is superior to any that come later and which may indeed be termed incommensurable. It is undoubtedly true that there is an antithesis between the attachment to the father and the masculinity complex; it is the general antithesis that exists between activity and passivity, masculinity and femininity. But this gives us no right to assume that only one of them is primary and that the other owes its strength merely to the force of defence. This does not correspond either to the dynamic or the chronological position of things. Reik, who has gained a wide reputation from his philosophical and psychological writings, possesses a far greater gift for psycho- analysis than the physicians attached to the Freudian school; and he has entrusted the most difficult cases only to him and to his daughter Anna, who has proved quite specially adept in the difficult technique of psycho-analysis. Reik himself would, I think, be the first to reject any such account of the basis of our relations. It is true, however, that I have availed myself of his skill in particularly difficult cases, but this has only been where the symptoms lay in a sphere far removed from the physical one. And I have never failed to inform a patient that he is not a physician but a psychologist. My daughter Anna has devoted herself to the pedagogic analysis of children and adolescents.

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Listeners identified sounds from the /bI/-/dI/ continuum where the sounds that were acting as adaptors were the third syllable of words beginning either with /b/ or /d/ symptoms 5 weeks into pregnancy buy generic lukol 60caps. Crucially, this adaptation occurred even if the critical phoneme in the adaptor word was replaced with a loud burst of noise. This study suggests that restored phonemes can act like real ones by causing adaptation. The adaptation only occurred when the critical phonemes were replaced with a burst of noise, but not when they were replaced with silence. This suggests that the restored phonological code is created by top-down lexical context rather than just provided by the lexical code. In particular, there is little evidence that sentential context affects speech processing. We can identify three stages of identification: initial contact, lexical selection, and word recognition (Frauenfelder & Tyler, 1987). These stages might overlap; whether they do or not is an empirical question, and is an aspect of our concern with modularity. Recognizing a spoken word begins when some representation of the sensory input makes initial contact with the lexicon. In the selection phase, activation continues to accumulate until one lexical entry is selected. This is the point in a word where a proportion of listeners identify the word correctly, even though they may not be confident about this decision (Grosjean, 1980; Tyler & Wessels, 1983). By the isolation point, the listener has isolated a word candidate; they then continue to monitor the sensory input until some level of confidence is reached; this is the recognition point. The process of integration that then follows is the start of the comprehension process proper, where the semantic and syntactic properties of the word are integrated into the higher-level sentence representation. It includes information available from the previous sensory input (the prior context) and from higher knowledge sources. For example, we might have word-level context operating on phoneme identification, and sentencelevel context operating on word identification. To show that context affects recognition, we need to demonstrate top-down influences on the bottomup processing of the acoustic signal. We have already examined whether context affects low-level perceptual processing; here we are concerned with the possible effects of context on word identification. Even if there are some contextual effects, we would still need to determine which types of context have an effect, at what stage or stages they have an effect, and how they have this effect. We have already noted that there are two opposing positions on the role of context in recognition, which can be called the autonomous and interactionist positions. The autonomous position says that context cannot have an effect prior to word recognition. It can only contribute to the evaluation and integration of the output of lexical processing, not its generation. For example, information flow is allowed between words within the lexicon, but not from the lexicon to lower-level processes such as phoneme identification. In particular, there may be feedback from later levels of processing to earlier ones. For example, information about the meaning of the sentence or the pragmatic context might affect perception. This description is the simplest way of putting the autonomous-interactive distinction. However, perhaps the autonomous and interactive models should be looked at as the extreme ends of a continuum of possible models rather than the two poles of a dichotomy. For example, context can propose candidates for what word the stimulus might be before sensory processing has begun (Morton, 1969), or it might be restricted to disposing of candidates and not proposing them (Marslen-Wilson, 1987). Because there are such huge differences between models it can be difficult to test between them. Strong evidence for the interactionist view is if context has an effect before or during the access and selection phases. In an autonomous model, context can only have an influence after a word has emerged as the best fit to the sensory input. Frauenfelder and Tyler (1987) distinguished between two types of context: non-structural and structural. Non-structural context can be thought of as information from the same level of processing as that which is currently being processed. It can be explained in terms of relations within a single level of processing and hence need not violate the principle of autonomy, in terms of the spread of activation within the lexicon. Alternatively, associative facilitation can be thought of as occurring because of hard-wired connections between similar things at the same level. According to autonomy theorists such as Fodor (1983) and Forster (1981b), this is the only type of context that affects processes prior to recognition. Structural context affects the combination of words into higher-level units, and it involves higher-level information. Word knowledge (lexical context) might be used to help identify phonemes, and sentence-level knowledge (sentence and syntactic context) might be used to help identify individual words. Frauenfelder and Tyler (1987) distinguished two sub- types, semantic and interpretative. Words that are appropriate for the context are responded to faster than those that are not, across a range of tasks which we will discuss in more detail later, such as phoneme monitoring, shadowing, naming, and gating. But it is not clear whether non-structural and semantic structural context effects can be distinguished, or at which stages they operate. Furthermore, these effects must be studied using tasks that minimize the chance of postperceptual factors operating. This might happen, for example, if there is too long a delay between the stimulus and the response. Participants have a chance to reflect upon and maybe alter their decisions, which would obviously reflect late-stage, post-access mechanisms. Interpretative structural context involves more high-level information, such as pragmatic information, discourse information, and knowledge about the world. There is some evidence that non-linguistic context can have affects on word recognition. Indeed, when no confusion object was present participants identified the object before hearing the end of the word. This result suggests that interpretative structural context can affect word recognition. It is obviously an important topic for the machine recognition of speech, as there are many obvious advantages to computers and other machines being able to understand speech. A template is an exact description of the sound or word that is being searched for. However, there is far too much variation in speech for this to be a plausible account except in the most restricted domains. Speakers differ in their dialect, basic pitch, basic speed of talking, and in many other ways.

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Overwhelming evidence left me at last in no doubt that in males the motive force of these dreams was derived from nothing other than the masturbatory desires of the pubertal period medications 126 cost of lukol. Suddenly he flew through the air right across the stalls, put his hand in his mouth and pulled out two of his teeth. Two other lines were more to the point: W em dergrosse Wurf gelungen, Eines Freundes Freund zu sein. It concealed, too, his fear that this misfortune might be repeated in relation to the young man by whose side he was enjoying the performance of Fidelio. And now followed what the fastidious dreamer regarded as a shameful confession: that once, after being rejected by one of his friends, he had masturbated twice in succession in the state of sensual excitement provoked by his desire. Here is the second dream: He was being treated by two University professors of his acquaintance instead of by me. The other was pushing against his mouth with an iron rod, so that he lost one or two of his teeth. The dreamer had never carried out coitus and had never aimed at having sexual intercourse with men in real life; and he pictured sexual intercourse on the model of the pubertal masturbation with which he had once been familiar. But I should like to draw attention to the frequency with which sexual repression makes use of transpositions from a lower to an upper part of the body. Thanks to them it becomes possible in hysteria for all kinds of sensations and intentions to be put into effect, if not where they properly belong in relation to the genitals, at least in relation to other, unobjectionable parts of the body. One instance of a transposition of this kind is the replacement of the genitals by the face in the symbolism of unconscious thinking. Comparisons between nose and penis are common, and the similarity is made more complete by the presence of hair in both places. The one structure which affords no possibility of an analogy is the teeth; and it is precisely this combination of similarity and dissimilarity which makes the teeth so appropriate for representational purposes when pressure is being exercised by sexual repression. I cannot pretend that the interpretation of dreams with a dental stimulus as dreams of masturbation an interpretation whose correctness seems to me beyond doubt has been entirely cleared up. A distinction must in general be made between dreams with a dental stimulus and dentist dreams, such as those recorded by Coriat (1913). Jung informs us that dreams with a dental stimulus occurring in women have the meaning of birth dreams. The element in common between this interpretation and the one put forward above lies in the fact that in both cases (castration and birth) what is in question is the separation of a part of the body from the whole. The Interpretation Of Dreams 845 According to popular belief dreams of teeth being pulled out are to be interpreted as meaning the death of a relative, but psycho-analysis can at most confirm this interpretation only in the joking sense I have alluded to above. In this connection, however, I will quote a dream with a dental stimulus that has been put at my disposal by Otto Rank. He then seized it with a forceps and pulled it out with an effortless ease that excited my astonishment. He told me not to bother about it, for it was not the tooth that he was really treating, and put it on the table, where the tooth (as it now seemed to me, an upper incisor) fell apart into several layers. The dentist explained to me, while he separated out the various portions of the strikingly white tooth and crushed them up (pulverized them) with an instrument, that it was connected with puberty and that it was only before puberty that teeth came out so easily, and that in the case of women the decisive factor was the birth of a child. I succeeded at the last moment in jumping on to the hindmost carriage where someone was already standing. I was not able, though, to make my way into the inside of the carriage, but was obliged to travel in an uncomfortable situation, from which I tried, successfully in the end, to escape. We entered a big tunnel and two trains, going in the opposite direction to us, passed through our train as if it were the tunnel. On the morning of the dream-day I had once more been to the dentist on account of the pain; and he had suggested to me that I should have another tooth pulled out in the same jaw as the one he had been treating, saying that the pain probably came from this other one. This acquaintance had also told her that he had once had the wrong tooth pulled out under an anaesthetic, and this had increased her dread of the necessary operation. I pointed out to her on the one hand the superstitious element in all these opinions, though at the same time I emphasized the nucleus of truth in certain popular views. She was then able to repeat to me what she believed was a very old and wide-spread popular belief that if a pregnant woman had toothache she would have a boy. On the evening of the same day, therefore, I read through the relevant passage in the Interpretation of Dreams and found there amongst other things the following statements whose influence upon my dream may be observed just as clearly as that of the other two experiences I have mentioned. It may, however, puzzle us to discover how "dental stimuli" should have come to have this meaning. I was already familiar with this expression in my early youth as a description of masturbation, and no experienced dream-interpreter will have any difficulty in finding his way from here to the infantile material underlying the dream. I will only add that the ease with which the tooth in the dream, which after its extraction turned into an upper incisor, came out, reminded me of an occasion in my childhood on which I myself pulled out a loose upper front tooth easily and without pain. This event, which I can still remember clearly to-day in all its details, occurred at the same early period to which my first conscious attempts at masturbation go back. In this connection I recall an earlier dream of mine which I had soon after a visit to the dentist and in which I dreamt that the gold crowns which had just been fixed fell out; this annoyed me very much in the dream on account of the considerable expense in which I had been involved and which I had not yet quite got over at the time. This other dream now became intelligible to me (in view of a certain experience of mine) as a recognition of the material advantages of masturbation over object-love: the latter, from an economic point of view, was in every respect less desirable (cf. I have nothing to add to it, except, perhaps, a hint at the probable meaning of the second part of the dream. The dreamer made use for this purpose of the verbal bridges "Zahn-ziehen (Zug)" and "Zahn-reissen (Reisen)". In whatever form the emission may appear, we are obliged to regard it as a masturbatory satisfaction brought about without the assistance of any mechanical stimulation. Moreover, in this case, the satisfaction accompanying the emission was not, as it usually is, directed to an object, even if only to an imaginary one, but had no object, if one may say so; it was completely auto-erotic, or at the most showed a slight trace of homosexuality (in reference to the dentist).

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These differentiations have symptoms ebola buy lukol 60caps low cost, of course, only come to light clearly during the last few days. Hans was delighted, and planned that, instead of stopping in front of the street-door as usual, he should go across the street into the yard, where he had often enough seen street-boys playing. I told him I should be pleased if he were to go across, and took the opportunity of asking him why he is so much afraid when the loaded carts at the loading dock start moving (b). Because I should like to load and unload the boxes, and I should like to climb about on the boxes there. For when Hans ventured once more in front of the street-door, the few steps across the street and into the courtyard awoke too great resistances in him, because carts were constantly driving into the yard. But, if it did not seem too daring, this wish might already, even at this stage, be constructed. He only told me besides this that he had first been afraid of bus-horses, then of all others, and only in the end of furniture-van horses. The train of thought, as we shall see, was that the horse (his father) would bite him because of his wish that it (his father) should fall down. It extends on to horses and on to carts, on to the fact that horses fall down and that they bite, on to horses of a particular character, on to carts that are heavily loaded. I will reveal at once that all these characteristics were derived from the circumstance that the anxiety originally had no reference at all to horses but was transposed on to them secondarily and had now become fixed upon those elements of the horse-complex which showed themselves well adapted for certain transferences. We have learned the immediate precipitating cause after which the phobia broke out. This was when the boy saw a big heavy horse fall down; and one at least of the interpretations of this impression seems to be that emphasized by his father, namely, that Hans at that moment perceived a wish that his father might fall down in the same way and be dead. His serious expression as he was telling the story no doubt referred to this unconscious meaning. Thus he was the horse, and bit his father, and in this way was identifying himself with his father. At every horse that passed I asked him if he saw the "black on its mouth"; he said "no" every time. My first idea, that he meant the thick leather straps that are part of the harness of dray-horses, is therefore unconfirmed. I asked him if the "black" reminded him of a moustache, and he said: "Only by its colour. When a cart drew up at our door and came to a stop, he became frightened and ran into the house, because the horse began pawing with its foot. I asked him why he was afraid, and whether perhaps he was nervous because the horse had done like this (and I stamped with my foot). I myself have seen no such horse on any of my walks, although Hans asseverates that such horses do exist. The radius of his circle of activity with the street-door as its centre grows ever wider. He has even accomplished the feat, which has hitherto been impossible for him, of running across to the pavement opposite. All the fear that remains is connected with the bus scene, the meaning of which is not yet clear to me. I had suggested that that may have been his own reaction when he retained his urine. Hans now confirmed this by means of the re-emergence during the conversation of a desire to micturate; and he added some other meanings of the making a row with the feet. The analysis was making little progress; and I am afraid the reader will soon begin to find this description of it tedious. My wife said he had done this two or three times already when he had seen the drawers. He was of opinion that Hans was overfed, which was in fact the case, and recommended a more moderate diet and the condition was at once brought to an end. It was a question of things which had once afforded him a great deal of pleasure, but of which, now that repression had set in, he was very much ashamed, and at which he professed to be disgusted. He told some downright lies so as to disguise the circumstances in which he had seen his mother change her drawers. His father was perfectly aware of what it was all about and of what Hans was trying to conceal. When a horse has a cart, it can go without a cart just as well, and the cart can stay at home. Fritzlfi was the horse once, too, and Franzl the coachman; and Fritzl ran ever so fast and all at once he hit his foot on a stone and bled. Indeed, it must have been so, for theoretical considerations require that what is to-day the object of a phobia must at one time in the past have been the source of a high degree of pleasure. It must never be forgotten how much more concretely children treat words than grown-up people do, and consequently how much more significant for them are similarities of sound in words. I was given a paper ball once by Grete up there at Gmunden, and Olga tore it all to pieces. The servants told us about it once, and I recollect that we forbade Hans to do it. In the little garden where the radishes were there was a little sand-heap; I used to play there with my spade. He may perhaps have meant that the drawers only recalled his feelings of disgust when he saw them on their own account; as soon as his mother had them on, he ceased to connect them with lumf or widdle, and they then interested him in a different way. Hans went his own way and would produce nothing if attempts were made to draw him off it.

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Where questions of religion are concerned medicines discount 60caps lukol with amex, people are guilty of every possible sort of dishonesty and intellectual misdemeanour. Philosophers stretch the meaning of words until they retain scarcely anything of their original sense. The man who goes no further, but humbly acquiesces in the small part which human beings play in the great world such a man is, on the contrary, irreligious in the truest sense of the word. To assess the truth-value of religious doctrines does not lie within the scope of the present enquiry. It is enough for us that we have recognized them as being, in their psychological nature, illusions. But we do not have to conceal the fact that this discovery also strongly influences our attitude to the question which must appear to many to be the most important of all. We know approximately at what periods and by what kind of men religious doctrines were created. If in addition we discover the motives which led to this, our attitude to the problem of religion will undergo a marked displacement. We shall tell ourselves that it would be very nice if there were a God who created the world and was a benevolent Providence, and if there were a moral order in the universe and an after-life; but it is a very striking fact that all this is exactly as we are bound to wish it to be. And it would be more remarkable still if our wretched, ignorant and downtrodden ancestors had succeeded in solving all these difficult riddles of the universe. Must not the assumptions that determine our political regulations be called illusions as wellfi And once our suspicion has been aroused, we shall not shrink from asking too whether our conviction that we can learn something about external reality through the use of observation and reasoning in scientific work whether this conviction has any better foundation. Nothing ought to keep us from directing our observation to our own selves or from applying our thought to criticism of itself. We surmise, moreover, that such an effort would not be wasted and that it would at least in part justify our suspicion. But the author does not dispose of the means for undertaking so comprehensive a task; he needs must confine his work to following out one only of these illusions that, namely, of religion. If men are taught that there is no almighty and all-just God, no divine world- order and no future life, they will feel exempt from all obligation to obey the precepts of civilization. Everyone will, without inhibition or fear, follow his asocial, egoistic instincts and seek to exercise his power; Chaos, which we have banished through many thousands of years of the work of civilization, will come again. Even if we knew, and could prove, that religion was not in possession of the truth, we ought to conceal the fact and behave in the way prescribed by the philosophy of "As if" and this in the interest of the preservation of us all. Countless people find their one consolation in religious doctrines, and can only bear life with their help. You would rob them of their support, without having anything better to give them in exchange. It is admitted that so far science has not achieved much, but even if it had advanced much further it would not suffice for man. Man has imperative needs of another sort, which can never be satisfied by cold science; and it is very strange indeed, it is the height of inconsistency that a psychologist who has always insisted on what a minor part is played in human affairs by the intelligence as compared with the life of the instincts that such a psychologist should now try to rob mankind of a precious wish-fulfilment and should propose to compensate them for it with intellectual nourishment. Nevertheless I am ready with rebuttals for them all; and, what is more, I shall assert the view that civilization runs a greater risk if we maintain our present attitude to religion than if we give it up. Perhaps with the assurance that I myself regard my undertaking as completely harmless and free of risk. Besides, I have said nothing which other and better men have not said before me in a much more complete, forcible and impressive manner. Their names are well known, and I shall not cite them, for I should not like to give an impression that I am seeking to rank myself as one of them. All I have done and this is the only thing that is new in my exposition is to add some psychological foundation to the criticisms of my great predecessors. It is hardly to be expected that precisely this addition will produce the effect which was denied to those earlier efforts. No doubt I might be asked here what is the point of writing these things if I am certain that they will be ineffective. The Future Of An Illusion 4445 the one person this publication may injure is myself. I shall have to listen to the most disagreeable reproaches for my shallowness, narrow-mindedness and lack of idealism or of understanding for the highest interests of mankind. But on the one hand, such remonstrances are not new to me; and on the other, if a man has already learnt in his youth to rise superior to the disapproval of his contemporaries, what can it matter to him in his old age when he is certain soon to be beyond the reach of all favour or disfavourfi But, I repeat, those times are past and to-day writings such as this bring no more danger to their author than to their readers. The most that can happen is that the translation and distribution of his book will be forbidden in one country or another and precisely, of course, in a country that is convinced of the high standard of its culture. But if one puts in any plea at all for the renunciation of wishes and for acquiescence in Fate, one must be able to tolerate this kind of injury too. The further question occurred to me whether the publication of this work might not after all do harm. For it cannot be denied that psycho- analysis is my creation, and it has met with plenty of mistrust and ill-will. If I now come forward with such displeasing pronouncements, people will be only too ready to make a displacement from my person to psycho-analysis. The mask has fallen; it leads to a denial of God and of a moral ideal, as we always suspected. To keep us from this discovery we have been deluded into thinking that psycho-analysis has no Weltanschauung and never can construct one. But psycho-analysis has already weathered many storms and now it must brave this fresh one. In point of fact psycho-analysis is a method of research, an impartial instrument, like the infinitesimal calculus, as it were. Nothing that I have said here against the truth-value of religions needed the support of psycho-analysis; it had been said by others long before analysis came into existence. If the application of the psycho-analytic method makes it possible to find a new argument against the truths of religion, tant pis for religion; but defenders of religion will by the same right make use of psycho-analysis in order to give full value to the affective significance of religious doctrines. It has ruled human society for many thousands of years and has had time to show what it can achieve. If it had succeeded in making the majority of mankind happy, in comforting them, in reconciling them to life and in making them into vehicles of civilization, no one would dream of attempting to alter the existing conditions. We see that an appallingly large number of people are dissatisfied with civilization and unhappy in it, and feel it as a yoke which must be shaken of; and that these people either do everything in their power to change that civilization, or else go so far in their hostility to it that they will have nothing to do with civilization or with a restriction of instinct. At this point it will be objected against us that this state of affairs is due to the very fact that religion has lost a part of its influence over human masses precisely because of the deplorable effect of the advances of science. We will note this admission and the reason given for it, and we shall make use of it later for our own purposes; but the objection itself has no force. It is doubtful whether men were in general happier at a time when religious doctrines held unrestricted sway; more moral they certainly were not. They have always known how to externalize the precepts of religion and thus to nullify their intentions. The priests, whose duty it was to ensure obedience to religion, met them half-way in this. One sinned, and then one made a sacrifice or did penance and then one was free to sin once more. Russian introspectiveness has reached the pitch of concluding that sin is indispensable for the enjoyment of all the blessings of divine grace, so that, at bottom, sin is pleasing to God.

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I really have an impression that the points on which we are agreed in connection with masturbation are now firmer and more deep-going than the disagreements though these undeniably exist medicine 968 discount lukol 60 caps on-line. Some of the apparent contradictions are only the result of the many different directions from which you have approached the subject, whereas in fact the opinions in question may quite well find a place alongside one another. With your permission I will set before you a summary of the points on which we seem to be agreed or divided. We are all agreed, I feel, (a) on the importance of the phantasies which accompany or represent the act of masturbation, (b) on the importance of the sense of guilt, whatever its source may be, which is attached to masturbation, and (c) on the impossibility of assigning a qualitative determinant for the injurious effects of masturbation. As regards the majority of the points of controversy among us, we have to thank the challenging criticisms of our colleague Wilhelm Stekel, based on his great and independent experience. There is no doubt that we have left very many points over to be established and clarified by some future band of observers and enquirers. But we may console ourselves with the knowledge that we have worked honestly and in no narrow spirit, and that in so doing we have opened up paths along which later research will be able to travel. Contributions To A Discussion On Masturbation 2569 You must not expect much from my own contributions to the questions we are concerned with. You are aware of my preference for the fragmentary treatment of a subject, with emphasis on the points which seem to me best established. I have nothing new to offer no solutions, only a few repetitions of things I have already maintained, a few words in defence of these old assertions against attacks made upon them by some of you, and in addition, a few comments which must inevitably force themselves on anyone listening to your papers. In some of the accounts which I have heard you give, full justice has not quite been done to this temporal division. The ostensible unity of masturbation, which is fostered by the customary medical terminology, has given rise to some generalizations where a differentiation according to the three periods of life would have been better justified. I come now to the objections raised by Reitler to my teleological argument in favour of the ubiquity of masturbation in infancy. If one more edition of my Three Essays on the Theory of Sexuality is called for, it will not contain the sentence under attack. I will renounce my attempt at guessing the purposes of Nature and will content myself with describing the facts. This was to the effect that certain arrangements in the genital apparatus which are peculiar to human beings seem to tend towards preventing sexual intercourse in childhood. The occlusion of the female sexual orifice and the absence of an os penis which would assure erection are, after all, directed only against actual coition, not against sexual excitations in general. Reitler seems to me to take too anthropomorphic a view of the way in which Nature pursues her aims as though it were a question of her carrying through a single purpose, as is the case with human activity. But so far as we can see, in natural processes a whole number of aims are pursued alongside one another, without interfering with one another. If we are to speak of Nature in human terms, we shall have to say that she appears to us to be what, in the case of men, we should call inconsistent. For my part, I think Reitler should not attach so much weight to his own teleological arguments. It is the same as when one drives a nail into the wall of a room: one cannot be certain whether one is going to come up against lath and plaster or brick-work. This is clearer, it is true, of anxiety neurosis and its relation to hysteria than it is of neurasthenia, into which no careful psycho-analytic investigations have yet been made. In anxiety neurosis, as you have often been able to convince yourselves, it is at bottom a small fragment of undischarged excitation connected with coition which emerges as an anxiety symptom or provides the nucleus for the formation of a hysterical symptom. Stekel shares with many non-psycho-analytic writers an inclination to reject the morphological differentiations which we have made within the jumble of the neuroses and to lump them all together under one heading under psychasthenia, perhaps. We have often contradicted him on this, and have held fast to our expectation that the morphologico-clinical differences will prove valuable as indications that have not yet been understood of essentially distinct processes. When he justly points out to us that he has regularly found the same complexes present in what are termed neurasthenics as in other neurotics, his argument fails to meet the point at issue. We have long known that the same complexes and conflicts are to be looked for, too, in all normal and healthy people. In fact, we have grown accustomed to attributing to every civilized human being a certain amount of repression of perverse impulses, a certain amount of anal erotism, of homosexuality and so on, as well as a piece of father-complex and mother-complex and of other complexes besides just as in the chemical analysis of an organic substance we have every hope of finding certain elements: carbon, oxygen, hydrogen, nitrogen and a trace of sulphur. What distinguishes organic substances from one another is the relative amounts of these elements and the way in which the links between them are constituted. In the same way, in the case of normal and neurotic people what is in question is not whether these complexes and conflicts exist but whether they have become pathogenic and, if so, by means of what mechanisms they have become so. That is to say, the constipation, headaches and fatigue of the so-called neurasthenic do not admit of being traced back historically or symbolically to operative experiences and cannot be understood as substitutes for sexual satisfaction or as compromises between opposing instinctual impulses, as is the case with psycho-neurotic symptoms (even though the latter may perhaps have the same appearance). I do not believe it will be possible to upset this assertion by the help of psycho-analysis. It can do so either by enabling the current noxae to be better tolerated, or by enabling the sick person to escape from the current noxae by making a change in his sexual regime. These would be desirable prospects from the point of view of our therapeutic interest. You may then ask why, since I have such a laudable appreciation of the limitations of my own infallibility, I do not at once give in to these new suggestions but prefer to re-enact the familiar comedy of an old man obstinately clinging to his opinions. In early days I made a number of alterations in my views and did not conceal them from the public. I was reproached on account of these changes, just as to-day I am reproached for my conservativeness. I shall await it, and in the meantime I shall behave towards our science as earlier experience has taught me. I am loth to take up a position on the question that has been dealt with by you so extensively of the injuriousness of masturbation, for it offers no proper approach to the problems which concern us. But we must all do so, no doubt: the world seems to feel no other interest in masturbation. You will recall that at our former series of discussions on the subject we had among us as a visitor a distinguished Viennese paediatrician. Simply, how far masturbation is injurious and why it injures some people but not others. So we must force our researches to make a pronouncement to meet this practical demand. As he sees it, the injuriousness of masturbation amounts to no more than a senseless prejudice which, purely as a result of personal limitations, we are unwilling to cast off with sufficient thoroughness. I believe, however, that if we fix our eyes on the problem sine ira et studiofi so far, of course, as we are able to , we shall be obliged to declare, rather, that to take up such a position contradicts our fundamental views on the aetiology of the neuroses. Masturbation corresponds essentially to infantile sexual activity and to its subsequent retention at a more mature age.