Theoretical Basis.—The first task of psychoanalysis was the elucidation of nervous disorders. The analytical theory of the neuroses is based upon three ground-pillars : the recognition of (I) "repression," (2) the importance of the sexual instincts and (3) "transference." Censorship.—There is a force in the mind which exercises the functions of a censorship, and which excludes from consciousness and from any influence upon action all tendencies which displease it. Such tendencies are described as "repressed." They remain unconscious; and if the physician attempts to bring them into the patient's consciousness he provokes a "resistance." These repressed instinctual impulses, however, are not always made powerless by this process. In many cases they succeed in making their influence felt by circuitous paths, and the indirect or substitutive gratifica tion of repressed impulses is what constitutes neurotic symptoms.
For cultural reasons the most intensive repression falls upon the sexual instincts; but it is precisely in connection with them that repression most easily miscarries, so that neurotic symptoms are found to be substitutive gratifica tions of repressed sexuality. The belief that in man sexual life begins only at puberty is incorrect. On the contrary, signs of it can be detected from the beginning of extra-uterine existence ; it reaches a first culminating point at or before the fifth year ("early period"), after which it is inhibited or interrupted ("latency ,,,,to tb. 4 -1:-- _r its development. This double onset of sexual development seems to be distinctive of the genus Homo. All experiences during the first period of childhood are of the greatest importance to the individual, and in combination with his inherited sexual constitu tion, form the dispositions for the subsequent development of character or disease. It is a mistaken belief that sexuality coin cides with "genitality." The sexual instincts pass through a com plicated course of development, and it is only at the end of it that the "priviacy of the genital zone" is attained. Before this there are a number of "pre-genital organisations" of the libido— points at which it may become "fixated" and to which, in the event of subsequent repression, it will return ("regression"). The infantile fixations of the libido are what determine the form of neurosis which sets in later. Thus the neuroses are to be regarded as inhibitions in the development of the libido.
There are no specific causes of nervous disorders ; the question whether a conflict finds a healthy solution or leads to a neurotic inhibition of function depends upon quantitative considerations, that is, upon the relative strength of the forces concerned. The most important conflict with which a small child is faced is his relation to his parents, the "Oedipus complex"; it is in attempting to grapple with this problem that persons destined to suffer from a neurosis habitually fail. The
reactions against the instinctual demands of the Oedipus complex are the source of the most precious and socially important achieve ments of the human mind ; and this probably holds true not only in the life of individuals but also in the history of the human species as a whole. The super-ego, the moral factor which domi nates the ego, also has its origin in the process of overcoming the Oedipus complex.
By "transference" is meant a striking peculiar ity of neurotics. They develop toward their physician emotional relations, both of an affectionate and hostile character, which are not based upon the actual situation but are derived from their relations toward their parents (the Oedipus complex). Trans ference is a proof of the fact that adults have not overcome their former childish dependence ; it coincides with the force which has been named "suggestion"; and it is only by learning to make use of it that the physician is enabled to induce the patient to over come his internal resistances and do away with his repressions. Thus psychoanalytic treatment acts as a second education of the adult, as a correction to his education as a child.
Within this narrow compass it has not been possible to men tion many matters of the greatest interest, such as the "sublima tion" of instincts, the part played by symbolism, the problem of "ambivalence," etc. Nor has there been space to allude to the applications of psychoanalysis, which originated, as we have seen, in the sphere of medicine, to other departments of knowledge (such as anthropology, the study of religion, literary history and education) where its influence is constantly increasing. It is enough to say that psychoanalysis, in its character of the psychol ogy of the deepest, unconscious mental acts, promises to become the link between psychiatry and all of these other fields of study.
The beginnings of psycho analysis may be marked by two dates: 1895, which saw the pub lication of Breuer and Freud's Studien fiber Hysterie, and 1900, which saw that of Freud's Traumdeutung. At first the new dis coveries aroused no interest either in the medical profession or among the general public. In 1907 the Swiss psychiatrists, under the leadership of E. Bleuler and C. G. Jung, began to concern themselves in the subject; and in 1908 there took place at Salz burg a first meeting of adherents from a number of different coun tries. In 1909 Freud and Jung were invited to America by G. Stanley Hall to deliver a series of lectures on psychoanalysis at Clark University, Worcester, Mass. From that time forward in terest in Europe grew rapidly; it showed itself, however, in a forcible rejection of the new teachings, characterised by an emo tional colouring which sometimes bordered upon the unscientific.