I. The Sexual Aberrations

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

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

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

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

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

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

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

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

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

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