During the late 1890s Sigmund Freud developed most of the core concepts for a new psychology. Over the course of a few years he transformed his theorizing about the sources and dynamics of neurotic anxiety from neurophysiological concern with actual predisposing and concurrent causes to interpretive investigation of fantasy and personal psychodynamics. It is the latter formulation which became psychoanalysis, but the former theory deserves re-examination as a basis for understanding the clinical consequences of child abuse and of sexual disorders. Freud's pre-analytic arguments and clinical data form a central part of the evidential base for both The Interpretation of Dreams and his subsequent psychosexual formulations. The psychodynamics of sexual frustration and anxiety were of central clinical and theoretical concern to Freud during this period, and he repeatedly presents examples of ambivalence toward pregnancy, linking this to thoughts of abortion and of infanticide.
In his intimate correspondence with Fliess during the years preceding completion of The Interpretation of Dreams (Freud, 1900) (Masson, 1985), Freud shows himself increasingly preoccupied with impaired sexual functioning as a common source of anxiety and therefore of "actual" (as contrasted with psycho-) neurosis. Themes of desire for fertility and nurturance, of a contradictory ambivalence toward fecundity and progeny, and of the traumatic effects of incomplete sexual satisfaction recur in both the published and the unpublished early Freud writings, and these core issues appear at several points imaginatively linked to abortion and to infanticide.
This manuscript forms part of an extended examination of the personal, clinical, and theoretical sources of Freud's early work with psychoanalytic concepts (Davis, 1990, 1992). I relate Freud's self-analysis following his father's death in late 1896 to his increased concern with dream-interpretation and to increasingly rich counter-transferential involvement with the patient whose "abortion" dream I will discuss. In the period of anxious introspection surrounding the death of his father in 1896, Freud confronted Oedipal and pre-Oedipal issues in his own personality, tested many of these in his nascent clinical practice, and outlined the theoretical and clinical consequences of his new ideas in letters to Wilhelm Fliess (cf. Anzieu, 1975/1986; Masson, 1985). At a theoretical level the major change in Freud's thinking during this period involves a movement away from a causal model for the effects of childhood trauma in the formation of adult personality and neurosis- - the so-called "seduction theory"- - and toward psychoanalysis as a hermeneutic discipline in which the subjective meaning of experience- - whether real or fanciful- - is the basis for understanding.
The Actual Neuroses
Freud's early writings on clinical phenomena make a fundamental distinction between the psychoneuroses or "neuro-psychoses of defence" (Freud, 1894, 1896b), including hysteria and obsession-compulsion, in which personality structures resulting from attempts to deal with traumatic experiences in childhood predispose the individual to later psychopathology, and the "actual neuroses" (Freud, 1898), including anxiety neurosis and neurasthenia, in which contemporary causes suffice to explain the psychopathology. Neurasthenia, or "nervous exhaustion," was a common psychiatric term in Freud's day, describing the presumed physical and emotional consequences of excessive stress on the nervous system. It was a common diagnosis where no organic cause could be found for vague physical complaints. Freud defined "anxiety neurosis" in an 1895 paper and describes the stressors that characteristically produce neurotic anxiety. These are primarily in the realm of sexuality, Freud argued, and include a variety of sources of sexual frustration: coitus interruptus, impotence, and anxiety over pregnancy. Any emotional or physical interference with the full cycle of sexual arousal and orgiastic satisfaction could serve as a cause of anxiety neurosis or as a contributing factor in psychoneurosis. And since, in his view, female sexual gratification in intercourse depended on the male's completion of adequate foreplay and intromission, "it is positively a matter of public interest that men should enter upon sexual relations with full potency" (Freud, 1898, p. 278- - emphasis in original). Both his published clinical examples and the material summarized for Fliess during the 1890s provide abundant evidence that Freud assiduously collected examples of psychopathology resulting from sexual frustration, from attempts at birth control or from unwanted pregnancies. Freud's very first psychological writing, a decade before he began to use psychoanalytic concepts, reveals his concern with sexuality and childbearing as causal factors in neurosis. His earliest letters to Fliess, beginning in November, 1887, report on a Mrs. "A.," whose seemingly organic complaints he had been treating with hydrotherapy and muscle exercises. By February, 1888, Freud had concluded that hers was a case of "cerebral neurasthenia," which he was inclined to attribute to unfulfilled sexual desire. The patient had improved greatly after becoming pregnant, and Freud suggests that
It may be that I am in part responsible for this new citizen. I once spoke very strongly and not unintentionally in the patient's presence about the harmfulness of coitus reservatus (Masson, 1985, p. 18).
Three months later Freud reports that Mrs. A.'s improvement has continued following a miscarriage (Masson, 1985, p. 21).
Many of the draft manuscripts and notes sent by Freud to Fliess in the early 1890s concern the psychopathological effects of incomplete coitus and of other sources of sexual frustraton. "Draft B." mailed to Fliess in February, 1893 and titled "The Etiology of the Neuroses," begins with the assertion that "neurasthenia actually can only be a sexual neurosis" (Masson, 1985, p. 39; emphasis in original), and Freud attributes neurasthenia in males to masturbation and to "onanismus conjugalis -- incomplete intercourse in order to prevent conception" which may function in an additive fashion or in conjuction with other factors (Masson, 1985, pp. 40-41). Whereas male neurasthenia typically begins after puberty and expresses itself clearly in the patient's 20s, Freud suggests, female neurasthenia in married women is often "derived from neurasthenia in a man," and "in that case there is almost always an admixture of hysteria and we have the common mixed neurosis of women" (Masson, 1985, p. 42).
To summarize. Freud's early theorizing about the causes of adult psychopathology assumed that both forgotten childhood trauma and a variety of adult stresses could cause neurosis, and their influence was additive-- a significant childhood disposition or a congenital physiological weakness could lead to the emergence of a psychoneurosis as a response to average levels of adult stress, while exceptional stress could produce an actual neurosis even in the absence of clear disposition. Since the most prevalent and problematic adult stresses where neurasthenia and anxiety neurosis were concerned were in the realm of sexuality, Freud studied the details of sexual satisfaction and frustration among his largely Victorian bourgeois peers. By the middle of the 1890s he had become an advocate of sexual expression and orgiastic satisfaction for both sexes.
Freud's concern with the psychopathological effects of sexual frustration on the male were also personal, on the evidence of the Fliess correspondence and his self-analysis as reflected in The Interpretation of Dreams (Freud, 1900). His own attempts in the 1890s to limit his family-- out of both concern for Martha's health and worry over costs-- led him to experience a variety of psychosomatic symptoms (Anzieu, 1975/1986; Davis, 1990a; Schur, 1972).
By the middle of the 1890s Freud was preoccupied with the psychoneuroses, and in his 1896 articulation of the "Seduction Theory" he attributed these to the results of prepubertal trauma, usually involving sexual abuse of the child, who thereby became disposed to neurosis as a result of even normal levels of adult stress (Davis, 1990b; Freud, 1896a, 1896b, 1896c). The increasingly problematic epidemiological and clinical implications of the seduction theory led to a reorientation of Freud's thinking in 1897, after which a traumatic etiology became merely a special case of the more comprehensive psychoanalytic view that it is the psychodynamics and not the factual content of childhood experience that forms the basis for personality development (see Laplanche, 1987/1989). Freud's primary concern in these early psychiatric or neuropsychological works was with the specific etiology of the common neurotic disorders, i.e., with the developmental preconditions under which common life experiences such as assumption of regular sexual intercourse after puberty would give rise to distinctive psychopathological conditions.
Both in the correspondence with Fliess and in the published interpretive examples I shall mention, Freud betrays a preoccupation with abortion as a factor in male neurosis. Abortion is discussed by Freud as a source of anxiety and guilt for males, and unconscious concern with forestalling or eliminating pregnancy in a female lover is the crux of both interpretations.
The themes of fertility and anxiety over pregnancy are combined in the "specimen dream" of psychoanalysis, Freud's 1895 dream of Irma's injection, which occupies Chapter 2 of The Interpretation of Dreams (Freud, 1900) and serves as the primal example of wish-fulfillment. I will not summarize this famous interpretive tour de force here, but will simply note that Freud's interpretation conjoins his therapeutic anxiety that he may have missed a physical cause for a female patient's illness -- a concern at least as old as Mrs. A.'s treatment 7 years before-- with worry about the health of his wife Martha, then pregnant with Anna Freud. These issues in turn form a microcosm of the arguments Freud was having with colleagues (and with himself) over causal factors in neurosis. As Erikson (1950) has shown, the Irma dream is also an exemplary treatment of male Generativity issues, placing procreation and professional ambition in apposition: Martha struggles to produce another child, and Sigmund his great book. "Irma"'s reproachful stance toward Freud in the dream comes to represent variously his patient Emma Eckstein's mishandling by Fliess (Masson, 1984, 1985); the counter-transferential sexual tensions of his clinical practice; ambivalence about Martha the wife/mother; his rampant competitiveness toward his male colleagues; and his grandiose, doubt-ridden plans for a new discipline.
Another evidence of Freud's concern during this period with unwanted pregnancy and abortion as unconscious issues is his explanation of the forgetting of the word aliquis in a quote from Virgil (Freud, 1901). I am especially indebted to Carol Gilligan for having helped me understand Dido's voice in this affair. In one of the most discussed of Freud's interpretive triumphs a male's failure to correctly recall the passage in which Dido curses the departing Aeneas-- "May someone arise from my bones as an avenger"-- is linked to anxiety over the possible pregnancy of the male's lover and to unconscious wishes to abort the fetus. This anecdote has been the subject of great interest since Peter Swales's argument that it is in fact autobiographical, implicating Freud himself in an abortion and hence an in affair with his sister-in-law, Minna Bernays (cf. Gay, 1988, pp. 752-753; Rudnytsky, 1987, p. 69; Swales, 1982).
The example I wish to examine in some detail is from Freud's 5 year treatment of a male patient known simply as "E," whose dream of being arrested for infanticide Freud reported to Fliess shortly after hearing it in a therapy session. Freud presented the dream as part of a draft paper (Draft L.) enclosed with the letter of May 2, 1897 (Freud, 1897). The same dream is quoted and discussed in an expanded form two years later in The Interpretation of Dreams (Freud, 1900, 155), where it forms part of a set of manifestly non-wish-fulfulling dreams whose latent content Freud interprets as expressing a concealed wish. I will present both versions of the dream, as I believe together they reveal a good deal about Freud's concern with male responses to fertility and abortion. Here is the 1897 version, as reported to Fliess:
"I suppose that this is a wish-dream," said E. " I dreamed that, just as I arrived at my house with a lady, I was arrested by a policeman, who requested me to get into a carriage. I demanded more time to put my affairs in order, and so on. It was in the morning, after I had spent the night with this lady."-- "Were you horrified?"- - "No."-- "Do you know what you were charged with?"-- "Yes. With having killed a child."-- "Has that any connection with reality?"-- "I was once responsible for the abortion of a child resulting from an affair. I dislike thinking about it."-- "Well, had nothing happened on the morning before the dream?"-- "Yes, I woke up and had intercourse."-- "But you took precautions?"-- "Yes. By withdrawing."-- "Then you were afraid that you might have made a child, and the dream shows you the fulfillment of your wish that nothing should happen, that you nipped the child in the bud. You made use of the feeling of anxiety that arises after a coitus of that kind as material for your dream." (Masson, 1985, p. 242)
Freud's recounting of the dream precedes by four months his announcement to Fliess that he has abandoned his neurotica, his "seduction theory," and offers the material in the context of discussing male sexual relations with women of lower social class as a consequence of infantile lust for a nursemaid. Freud had concluded by this time that servant girls and nursemaids were often the most significant infantile lust-objects, and his description in the Fliess letters of "E."'s early fixation on his nurse is strikingly similar to what he revealed to Fliess in October, 1897, about the role played in his own case by his nurse (Masson, 1985, pp. 270-273; see Rudnytsky, 1987, chap. 3). The initial tone is ironic: the patient is presented as petulantly protesting Freud's readiness to fit all dreams into his theory, and Freud indeed suggests that the dream is using "E."'s frustrated sexual energy to drive a phantasy of punishment for his affair.
When the same dream is presented in more elaborate form two years later in The Interpretation of Dreams, Freud specifies that he owes it, "not to a patient, but to an intelligent jurist of my acquaintance," who has recounted it "in order to restrain me from rash generalizing in the theory of wishful dreams" (Freud, 1900, p. 155).
'I dreamt,' said my informant, 'that I came up to my house with a lady on my arm. A closed carriage was standing in front of it and a man came up to me, showed me his credentials as a police officer and requested me to follow him. I asked him to allow me a little time to put my affairs in order. Can you suppose that I have a wish to be arrested?'- - Of course not, I could only agree. Do you happen to know the charge on which you were arrested?- - 'Yes, for infanticide, I believe.'- - Infanticide? But surely you're aware that that's a crime that can only be committed by a mother on a new-born child?- - 'Quite true.'- - And what were the circumstances in which you had the dream? What happened on the previous evening? 'I would prefer not to tell you. It's a delicate matter.'- - Nevertheless, I shall have to hear it; otherwise we shall have to give up the idea of interpreting the dream.- - 'Very well, then, listen. I didn't spend last night at home but with a lady who means a great deal to me. When we woke up in the morning there was a further passage between us, after which I fell asleep again and had the dream I described to you.'- - Is she a married woman?- - 'Yes.'- - And you don't want to have a child by her?- - 'Oh, no; that might give us away.'- - So you don't practice normal intercourse?- - 'I take the precaution of withdrawing before ejaculation.'- - I think I may assume that you had used this device several times during the night, and that after using it in the morning you felt a little uncertain whether you had carried it out successfully.- - 'That's possible, no doubt.'- - In that case your dream was the fulfilment of a wish. It gave you a reassurance that you had not procreated a child, or, what amounts to the same thing, that you had killed a child. (Freud, 1900, 155)
The associated phantasies- - of destroying a child through abortion and of consequent punishment or injury- - are themes which concerned Freud throughout this early period of his theorizing, as evidenced by the 1895 papers on anxiety neurosis. The tone of Freud's interlocutor in this second telling of the dream is similar to that in the aliquis episode, which also concerns guilt over aborting a fetus and in which Freud displays a similar didactic style. The apparent addition of the interpretive comment concerning infanticide shows Freud's readiness to assume a psychodynamic link between termination of pregnancy and killing a child, and perhaps suggests that this was an issue for Freud himself. Male guilt over arranging an abortion is associated by Freud with infanticide, which he brings to his patient's attention, insists is a mother's crime, and footnotes as the "key to the dream's interpretation," whose significance is suggested by its having been forgotten at first.
You remember that a few days ago we were talking about marriage difficulties and how inconsistent it is that there should be no objection to carrying out intercourse in such a way that no fertilization takes place, whereas any interference when once the ovum and sperm have come together and a foetus has been formed is punished as a crime. We went on to recall the mediaeval controversy over the exact point of time at which the soul enters the foetus, since it is not until after that that the concept of murder becomes applicable (Freud, 1900, pb. 189).
Freud goes on to call the patient's attention to a "gruesome" poem by Lenau "in which child murder and child prevention are equated," and the patient responds, "'Oddly enough, I happened to think of Lenau this morning'" (Freud, 1900, 147). Continuing in a pedagogical vein, Freud suggests as a further explanation of the dream:
Perhaps you have learned from my paper on the aetiology of anxiety neurosis that I regard coitus interruptus as one of the aetiological factors in the development of neurotic anxiety? It would tally with this if, after carrying out sexual intercourse in this way several times, you were left in an uneasy mood which afterwards became an element in the construction of your dream. Moreover, you made use of the moodiness to help disguise the wish-fulfilment. Incidentally, your reference to infanticide has not been explained. How did you come to light on this specifically feminine crime?- - 'I must admit that some years ago I became involved in an occurrence of that kind. I was responsible for a girl's trying to avoid the consequences of an affair with me by means of an abortion. I had nothing to do with her carrying out her intention, but for a long time I naturally felt very nervous in case the business came out.' (pb. 190)
Freud had had over two years to reflect on "E."'s dream by the time he finished this account of its interpretation. Indeed, he had apparently already used the dream pedagogically, since he notes that:
a young physician who heard me describe this dream during a course of lectures must have been greatly struck by it, for he promptly re-dreamt it, applying the same pattern of thought to another theme. (pb. 190)
This second account of the dream omits explicit reference to abortion, referring instead to "infanticide," but gives the attendant verbal exchange between Freud and the dreamer in considerably more detail; and in the discussion of the dream the patient associates pregnancy prevention with both abortion and infanticide. What are we to make of this extended dialogue? It is certainly possible that Freud kept detailed notes of the dream from the time of its occurrence during a therapy session in 1897. Yet it is puzzling that he would have troubled to tell the story of the dream in other words in the letter to Fliess shortly after its occurrence. Another possibility is that the second, more detailed account has in fact been constructed by Freud from memory, and that both errors of commission and omission have crept in. The apparent addition of the interpretive comment concerning infanticide suggests that this was an issue for Freud himself, whether because of guilt in relationship to an actual abortion, infantile feelings over the death in infancy of his younger brother Julius (see Krüll, 1979/1986), or identification with themes of infanticide in the Oedipus myth. Male guilt over arranging an abortion is associated with child murder. Freud's discussion links this dream image to the theme of maternal crime (see Balmary, 1979/1982, for an extended discussion of the themes of maternal and paternal guilt in Freud's early writing).
How shall we account for the fact that the later telling of this dream is more detailed in several regards than the former? It is possible that Freud kept detailed notes on this dream and its discussion with "E.," from which he was able to add- - two years after the event- - such details as the police officer's display of credentials. It seems likely that infanticide is a topic Freud and his patient had discussed repeatedly. The roles of patient and therapist have by this time blurred. This blurring- - in which the shared phantasy of analyst and analysand takes precedence over the recovery of factual material in the patient's history- - is illustrative of the new Freudian hermeneutic position which makes possible psychoanalysis. Finally, the analyst's personality and emotional investment in the therapy has become an essential aspect of the treatment.
Freud and Fliess finally split over bisexuality. The ostensible argument is over priority in the idea. Freud is forced to admit that he had talked in detail and for years with Fliess about psychic bisexuality, and later that he had passed on biopsychological ideas of Fliess's to his junior colleague Weininger. Fliess for his part seems to have cast Freud back with the dream-readers of yore (from whom Freud is at such pains to distinguish himself in Chapter One), then twisted the knife by suggesting the dream-meanigs are read into the data, are projected by the interpreter, the scientist.
Freud's readiness a century ago to assume that birth control leads to sexual anxiety, which in turn gives rise to thoughts of abortion, which is subjectively equated with infanticide, has a sadly modern tone. We are still trying to understand why pregnancy-prevention is conflated with pregnancy-termination; and the distinction between abortion of a fetus and murder is still a legal issue. It is important to recognize that Freud was not attempting to justify either of these comparisons at a factual level, but simply to observe their psychodynamic equation for both females and males. Lack of psychologically non-intrusive birth control methods seemed a major social problem to him, and his advocation of full sexual satisfaction for both males and females put him well ahead of his contemporaries. He could not escape the unconscious issues evoked by pregnancy and birth, however, and in his male ambivalence and readiness to project his own anxieties onto this quintessentially feminine domain he anticipates some of the problems of later Freudian gender psychology (cf. Gilligan, 1982).
I believe these observations from the dawn of psychoanalysis almost a century ago have several claims on our current interest. Since they partly concern Freud himself, they may help us understand the interplay of personal predilection and professional preoccupation in this most written-about individual. I am also convinced that Freud's pre-psychoanalytic concerns with real adult stresses and with the complex interplay of childhood trauma and adult psychopathology have relevance beyond psychoanalysis. Fertility and procreation remain psychological mysteries, ground for the fears and projections of both sexes; and the father of psychoanalysis has left us a legacy of clinical and theoretical puzzles linked to the dilemma of abortion.
Anzieu, D. (1986). Freud's self-analysis (P. Graham, Trans.). New York: International Universities Press. (Original work published 1975)
Balmary, Marie (1982). Psychoanalyzing psychoanalysis: Freud and the hidden fault of the father. Baltimore: The Johns Hopkins University Press. (Original work published 1979).
Breuer, J., & Freud, S. (1895). Studies on hysteria. S.E., 2.
Davis, D.A. (1990). Freud's unwritten case. Psychoanalytic Psychology, 7, 185-209.
Davis, D.A. (1992). A Theory for the 90s: Freud's theory of traumatic seduction in historical context. In press, Psychoanalytic Review.
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Freud, S. (1895b). A reply to criticisms of my paper on anxiety neurosis. S.E., 3, 123-139.
Freud, S. (1896a). Heredity and the etiology of the neuroses. S.E., 3, 141-161.
Freud, S. (1896b). Further remarks on the neuropsychoses of defense. S.E., 3, 162-188.
Freud, S. (1896c). The etiology of hysteria. S.E., 3, 189-224.
Freud, S. (1897). Letter 61/Draft L. S.E., 1, 247-250.
Freud, S. (1898). Sexuality in the etiology of the neuroses. S.E., 3, 261-286.
Freud, S. (1900). The Interpretation of Dreams. S.E. 4-5. (cf. On-line A.A. Brill translation; Doug Davis's teaching notes)
Freud, S. (1901). The psychopathology of everyday life. S.E. 6.
Gay, P. (1988). Freud: A life for our time. New York: Norton.
Gilligan, C. (1982). In a different voice. Cambridge: Harvard University Press.
Gilligan, C. (1993). paper delivered at Haverford College symposiou, "Complex Femininity," February, 1993.
Krüll, Marianne (1979). Freud and his father. New York: Norton, 1986.
Laplanche (1989). New foundations for psychoanalysis. Oxford: Blackwell. (Original work published in 1987)
Masson, J.M. (1984). The assault on truth: Freud's suppression of the seduction theory. New York: Farrar, Strauss, and Giroux.
Masson, J.M. (Ed.) (1985) The complete letters of Sigmund Freud to Wilhelm Fliess. Cambridge: Harvard University Press.
Rudnytsky, P. L. (1987). Freud and Oedipus. New York: Columbia University Press.
Schur, M. (1972). Freud: Living and dying. New York: International Universities Press.
Swales, P.J. (1982). Freud, Minna Bernays, and the conquest of Rome: New light on the origins of psychoanalysis. New American Review, 1, 1-23.
Department of Psychology, Haverford College, Haverford, PA, 19041. Copyright © Douglas A. Davis, 1995-1999. All rights reserved. Do not quote without permission.
 sehr entsetz
 umgebracht zu haben
 im Keim erstickt haben
as we may attempt to reconstruct this from Freud's side of the conversation, since Fliess's letters have apparently been lost.