Consequently, the psychical mechanism revealed by the ‘Pre-
liminary Communication 5 could not be pathognomonic for
hysteria. Nor could I resolve, merely for the sake of preserving
that mechanism as a criterion of it, to lump all these other
neuroses in with hysteria. I eventually found a way out of all
these emerging doubts by the plan of treating all the other
neuroses in question in the same way as hysteria. I determined
to investigate their aetiology and the nature of their psychical
mechanism in every case and to let the decision as to whether
the diagnosis of hysteria was justified depend upon the outcome
of that investigation.


Thus, starting out from Breuer’s method, I found myself
engaged in a consideration of the aetiology and mechanism of
the neuroses in general. I was fortunate enough to arrive at
some serviceable findings in a relatively short time. 1 In the first
place I was obliged to recognize that, in so far as one can speak
of determining causes which lead to the acquisition of neuroses,
their aetiology is to be looked for in sexual factors. There fol-
lowed the discovery that different sexual factors, in the most
general sense, produce different pictures of neurotic disorders.


And it then became possible, in the degree to which this
relation was confirmed, to venture on using aetiology for the
purpose of characterizing the neuroses and of making a sharp
distinction between the clinical pictures of the various neuroses.
Where the aetiological characteristics coincided regularly with
the clinical ones, this was of course justified.


In this manner I found that neurasthenia presented a mon-
otonous clinical picture in which, as my analyses showed, a
‘psychical mechanism’ played no part. There was a sharp
distinction between neurasthenia and ‘obsessional neurosis’, the
neurosis of obsessional ideas proper. In this latter one I was
able to recognize a complicated psychical mechanism, an
aetiology similar to that of hysteria and an extensive possibility
of reducing it by psychotherapy. On the other hand, it seemed
to me absolutely necessary to detach from neurasthenia a com-
plex of neurotic symptoms which depend on a quite different
and indeed at bottom a contrary aetiology.


The component
symptoms of this complex are united by a characteristic which
has already been recognized by Hecker (1893). For they are
either symptoms or equivalents and rudiments of manifestations
of anxiety and for this reason I have given to this complex
which is to be detached from neurasthenia the name of ‘anxiety


I have maintained [Freud 1895] that it arises from
an accumulation of physical tension, which is itself once more
of sexual origin. This neurosis, too, has no psychical mech-
anism, but it invariably influences mental life, so that ‘anxious
expectation 5 , phobias, hyperaesthesia to pains, etc., are among
its regular manifestations. This anxiety neurosis, in my sense
of the term, no doubt coincides in part with the neurosis which,
under the name of ‘hypochondria’, finds a place in not a few
descriptions alongside hysteria and neurasthenia. But I cannot
regard the delimitation of hypochondria in any of the works in
question as being the correct one, and the applicability of its
name seems to me to be prejudiced by the fixed connection of
that term with the symptom of ‘fear of illness’. 1

我曾经主张(弗洛伊德 1895),这个情结是由于生理的紧张的累积而产生。这个生理上的紧张再次是出于性的起源。这个神经症也没有心理的机制,但是它一成不变地影响到精神的生活。所以,“焦虑的期待,恐惧症,对于痛苦的过度敏感症,等等,都是它的规律的展示的症状。从我对术语的理解,这个焦虑神经症无可置疑地,部分跟”忧郁症“这个名称之下找到一席之地的神经症不谋而合。在癔症与神经衰弱症之外的许多描述里。但是,我无法将任何受到置疑的研究里的忧郁症的除掉限制,认为就是正确的除掉限制。我觉得,忧郁症的名称的应用似乎是一种偏见,那个术语跟”对于疾病的恐惧“的症状固定地联接一块,产生的偏见。


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