by our insight into the conflict out of which the transference neuroses emerge. We can no longer reckon without it. The assumption that object-libido can change into the ego-libido, in other words, that we must reckon with an ego-libido, appeared to us the only possible one wherewith to solve the riddle of the so-called narcistic neuroses — for instance, dementia praecox — or to justify the similarities and differences in a comparison of hysteria and compulsion. We now apply to sickness, sleep and love that which we found undeniably affirmed elsewhere. We may proceed with such applications as far as they will go. The only assertion that is not a direct refutation of our analytic experience is that libido remains libido whether it is directed towards objects or toward the ego itself, and is never transferred into egoistic interest, and vice-versa. But this assertion is of equal weight with the distinction of sex and ego instincts which we have already critically appraised, and which we will maintain from methodological motives until it may possibly be disproved.
Your second objection, too, raises a justified question, but it points in a wrong direction. To be sure the retreat of object-libido into the ego is not purely pathogenic; we see that it occurs each time before going to sleep, only to be released again upon awaking. The little protoplasmic animal draws in its protrusions, only to send them out again on a later occasion. But it is quite another matter when a specific, very energetic process compels the withdrawal of libido from the object. The libido has become narcistic and cannot find its way back to the object, and this hindrance to the mobility of the libido certainly becomes pathogenic. It appears that an accumulation of narcistic libido cannot be borne beyond a certain point. We can imagine that the reason for occupation with the object is that the ego found it necessary to send out its libido in order not to become diseased because it was pent up. If it were our plan to go further into the subject of dementia praecox, I would show you that this process which frees the libido from the objects and bars the way back to them, is closely related to the process of suppression, and must be considered as its counterpart. But above all you would recognize familiar ground, for the conditions of these processes are practically identical, as far as we can now see, with those of suppression. The conflict appears to be the same, and to take place between the same forces. The reason for a result as different as, for instance, the result in hysteria, can be found only in a difference of dispositions. The vulnerable point in the libido development of these patients lies in another phase; the controlling fixation, which, as you will remember, permits the breach resulting in the formation of symptoms, is in another place probably in the stage of primitive narcism, to which dementia praecox returns in its final stage. It is noteworthy that for all the narcistic neuroses, we must assume fixation points of the libido which reach back into far earlier phases of development than in cases of hysteria or compulsion neuroses. But you have heard that the conceptions obtained in our study of transference neuroses are sufficient to orient us in the narcistic neuroses, which present far greater practical difficulties. The similarities are considerable; it is fundamentally the same field of observation. But you can easily imagine how hopeless the explanations of these conditions, which belong to psychiatry, appear to him who is not equipped for this task with an analytic knowledge of transference neuroses.
The picture given by the symptoms of dementia praecox, which, moreover, is highly variable, is not exclusively determined by the symptoms. These result from forcing the libido away from the objects and accumulating it in the ego in the form of narcistic libido. A large space is occupied by other phenomena, which result from the impulses of the libido to regain the objects, and so show an attempt toward restitution and healing. These symptoms are in fact the more conspicuous, the more clamorous; they show an unquestionable similarity to those of hysteria, or less often to those of compulsion neurosis, and yet they are different in every respect. It appears that in dementia praecox the libido in its endeavor to return to the objects, i.e., to the images of the objects, really captures something, but only their shadows — I mean, the verbal images belonging to them. This is not the place to discuss this matter, but I believe that these reversed impulses of the libido have permitted us an insight into what really determines the difference between a conscious and an unconscious representation.
I have now brought you into the field where we may expect the further progress of analytic work. Since we can now employ the conception of ego-libido, the narcistic neuroses have become accessible to us. We are confronted with the problem of finding a dynamic explanation of these conditions and at the same time of enlarging our knowledge of psychic life by an understanding of the ego. The ego psychology, which we strive to understand, must not be founded upon introspective data, but rather, as in the libido, upon analysis of the disturbances and decompositions of the ego. When this greater task is accomplished we shall probably disparage our previous knowledge of the fate of the libido which we gained from our study of the transference neuroses. But there is still much to be said in this matter. Narcistic neuroses can scarcely be approached by the same technique which served us in the transference neuroses. Soon you will hear why. After forging ahead a little in the study of narcistic neuroses we always seem to come to a wall which impedes progress. You know that in the transference neuroses we also encountered such barriers of resistance, but we were able to break them down piece by piece. In narcistic neuroses the resistance is insuperable; at best we are permitted to cast a curious glance over the wall to spy out what is taking place on the other side. Our technical methods must be replaced by others; we do not yet know whether or not we shall be able to find such a substitute. To be sure, even these patients furnish us with ample material. They do say many things, though not in answer to our questions, and for the time being we are forced to interpret these utterances through the understanding we have gained from the symptoms of transference neuroses. The coincidence is sufficiently great to assure us a good beginning. How far this technique will go, remains to be seen.
There are additional difficulties that impede our progress. The narcistic conditions and the psychoses related to them can only be solved by observers who have schooled themselves in analytic study of transference neuroses. But our psychiatrists do not study psychoanalysis and we psychoanalysts see too few psychiatric cases. A race of psychiatrists that has gone through the school of psychoanalysis as a preparatory science most first grow up. The beginnings of this are now being made in America, where many leading psychiatrists explain the teachings of psychoanalysis to their students, and where many owners of sanatoriums and directors of institutes for the insane take pains to observe their patients in the light of these teachings. But even here we have occasionally been successful in casting a glance over the narcistic wall and I shall tell you a few things that we think we have discovered.
The disease of paranoia, chronic systematic insanity, is given a very uncertain position by the attempts at classification of present-day psychiatry. There is no doubt of its close relationship to dementia praecox. I once was so bold as to propose that paranoia and dementia praecox could be classed together under the common name of paraphrenia. The types of paranoia are described according to their content as: megalomania, the mania of persecution, eroto mania, mania of jealousy, etc. From psychiatry we do not expect attempts at explanation. As an example of such an attempt, to be sure an antiquated and not entirely valid example, I might mention the attempt to develop one symptom directly out of another by means of an intellectual rationalization, as: the patient who primarily believes he is being persecuted draws the conclusion from this persecution that he must be an extraordinarily important personality and thus develops megalomania. In our analytical conception megalomania is the immediate outcome of exaggeration of the ego, which results from the drawing-in of libidinous occupation with objects, a secondary narcism as a recurrence of the originally early infantile form. In cases of the mania of persecution we have noticed a few things that lead us to follow a definite track. In the first place, we observed that in the great majority of cases the persecutor was of the same sex as the persecuted. This could still be explained in a harmless way, but in a few carefully studied cases it was clearly shown that the person of the same sex, who was most loved in normal times, became the persecutor after the malady set in. A further development is made possible by the fact that one loved person is replaced by another, according to familiar affinities, e.g., the father by the teacher or the superior. We concluded from such ever-increasing experiences, that paranoia persecutoria is the form in which the individual guards himself against a homosexual tendency that has become too powerful. The change from affection to hate, which notoriously
