would like to turn to the psychiatrist with such questions, but here he leaves us in the lurch. There is only one of our queries which he heeds. He will examine the family history of this woman and perhaps will give us the answer: “The people who develop obsessions are those in whose families similar and other psychic disturbances have repeatedly occurred.” In other words, if this lady develops an obsession she does so because she was predisposed to it by reason of her heredity. That is certainly something, but is it all that we want to know? Is it all that was effective in causing this breakdown? Shall we be content to assume that it is immaterial, accidental and inexplicable why the obsession of jealousy develops rather than any other? And may we also accept this sentence about the dominance of the influence of heredity in its negative meaning, that is, that no matter what experiences came to this human being she was predestined to develop some kind of obsession? You will want to know why scientific psychiatry will give no further explanation. And I reply, “He is a rascal who gives more than he owns.” The psychiatrist does not know of any path that leads him further in the explanation of such a case. He must content himself with the diagnosis and a prognosis which, despite a wealth of experience, is uncertain.
Yet, can psychoanalysis do more at this point? Indeed yes! I hope to show you that even in so inaccessible a case as this it can discover something which makes the further understanding possible. May I ask you first to note the apparently insignificant fact that the patient actually provoked the anonymous letter which now supports her delusion. The day before, she announces to the intriguing chambermaid that if her husband were to have an affair with a young girl it would be the worst misfortune that could befall her. By so doing she really gave the maid the idea of sending her the anonymous letter. The obsession thus attains a certain independence from the letter; it existed in the patient beforehand — perhaps as a dread; or was it a wish? Consider, moreover, these additional details yielded by an analysis of only two hours. The patient was indeed most helpful when, after telling her story, she was urged to communicate her further thoughts, ideas and recollections. She declared that nothing came to her mind, that she had already told everything. After two hours the undertaking had really to be given up because she announced that she already felt cured and was sure that the morbid idea would not return. Of course, she said this because of this resistance and her fear of continuing the analysis. In these two hours, however, she had let fall certain remarks which made possible definite interpretation, indeed made it incontestable; and this interpretation throws a clear light on the origin of her obsession of jealousy. Namely, she herself was very much infatuated with a certain young man, the very same son-in-law upon whose urging she had come to consult me professionally. She knew nothing of this infatuation, or at least only a very little. Because of the existing relationship, it was very easy for this infatuation to masquerade under the guise of harmless tenderness. With all our further experience it is not difficult to feel our way toward an understanding of the psychic life of this honest woman and good mother. Such an infatuation, a monstrous, impossible thing, could not be allowed to become conscious. But it continued to exist and unconsciously exerted a heavy pressure. Something had to happen, some sort of relief had to be found and the mechanism of displacement which so constantly takes part in the origin of obsessional jealousy offered the most immediate mitigation. If not only she, old woman that she was, was in love with a young man but if also her old husband had an affair with a young girl, then she would be freed from the voice of her conscience which accused her of infidelity. The phantasy of her husband’s infidelity was thus like a cooling salve on her burning wound. Of her own love she never became conscious, but the reflection of it, which would bring her such advantages, now became compulsive, obsessional and conscious. Naturally all arguments directed against the obsession were of no avail since they were directed only to the reflection, and not to the original force to which it owed its strength and which, unimpeachable, lay buried in the unconscious.
Let us now piece together these fragments to see what a short and impeded psychoanalysis can nevertheless contribute to the understanding of this case. It is assumed of course that our inquiries were carefully conducted, a point which I cannot at this place submit to your judgment. In the first place, the obsession becomes no longer nonsensical nor incomprehensible, it is full of meaning, well motivated and an integral part of the patient’s emotional experience. Secondly, it is a necessary reaction toward an unconscious psychological process, revealed in other ways, and it is to this very circumstance that it owes its obsessional nature, that is, its resistance to arguments based on logic or fact. In itself the obsession is something wished for, a kind of consolation. Finally, the experiences underlying the condition are such as unmistakably determine an obsession of jealousy and no other. You will also recognize the part played by the two important analogies in the analysis of the symptomatic act with reference to its meaning and intent and also to its relation to an unconscious factor in the situation.
Naturally, we have not yet answered all the questions which may be put on the basis of this case. Rather the case bristles with further problems of a kind which we have not yet been able to solve in any way, and of others which could not be solved because of the disadvantage of the circumstances under which we were working. For example: why is this happily married woman open to an infatuation for her son-in-law, and why does the relief which could have been obtained in other ways come to her by way of this mirror-image, this projection of her own condition upon her husband? I trust you will not think that it is idle and wanton to open such problems. Already we have much material at our disposal for their possible solution. This woman is in that critical age when her sexual needs undergo a sudden and unwelcome exaggeration. This might in itself be sufficient. In addition, her good and faithful mate may for many years have been lacking in that sufficient sexual capacity which the well-preserved woman needs for her satisfaction. We have learned by experience to know that those very men whose faithfulness is thus placed beyond a doubt are most gentle in their treatment of their wives and unusually forbearing toward their nervous complaints. Furthermore, the fact that it was just the young husband of a daughter who became the object of her abnormal infatuation is by no means insignificant. A strong erotic attachment to the daughter, which in the last analysis leads back to the mother’s sexual constitution, will often find a way to live on under such a disguise. May I perhaps remind you in this connection that the relationship between mother and son-in-law has seemed particularly delicate since all time and is one which among primitive peoples gave rise to very powerful taboos and avoidances.37 It often transgresses our cultural standards positively as well as negatively. I cannot tell you of course which of these three factors were at work in our case; whether two of them only, or whether all of them coöperated, for as you know I did not have the opportunity to continue the analysis beyond two hours.
I realize at this point, ladies and gentlemen, that I have been speaking entirely of things for which your understanding was not prepared. I did this in order to carry through the comparison of psychiatry and psychoanalysis. May I now ask one thing of you? Have you noticed any contradiction between them? Psychiatry does not apply the technical methods of psychoanalysis, and neglects to look for any significance in the content of the obsession. Instead of first seeking out more specific and immediate causes, psychiatry refers us to the very general and remote source — heredity. But does this imply a contradiction, a conflict between them? Do they not rather supplement one another? For does the hereditary factor deny the significance of the experience, is it not rather true that both operate together in the most effective way? You must admit that there is nothing in the nature of psychiatric work which must repudiate psychoanalytic research. Therefore, it is the psychiatrists who oppose psychoanalysis, not psychiatry itself. Psychoanalysis stands in about the same relation to psychiatry as does histology to anatomy. The one studies the outer forms of organs, the other the closer structure of tissues and cells. A contradiction between two types of study, where one simplifies the other, is not easily conceivable. You know that anatomy today forms the basis of scientific medicine, but there was a time when the dissection of human corpses to learn the inner structure of the body was as much frowned upon as the practice of psychoanalysis, which seeks to ascertain the inner workings of the human soul, seems proscribed today. And presumably a not too distant time will bring us to the realization that a psychiatry which aspires to scientific depth is not possible without a real knowledge of the deeper unconscious processes in the psychic life.
