Page:The International Journal of Psycho-Analysis II 1921 1.djvu/10

2 of the genital libido; they were at times accompanied by regular orgasm.

When I incidentally discussed the meaning and significance of Tic with Prof. Freud he mentioned that apparently there was an organic factor in the question. In the course of this paper I may be able to show in what sense this view proved to be right.

This is about all the information I was able to gather from psycho-analytical sources about the Tics, nor can I say that since then I have been able to learn anything fresh either from direct observation or from the analysis of "passing" Tics, in spite of the frequency of their appearance in neurotic cases. In the majority of cases one can carry the analysis to a close, and even heal a psycho-neurosis, without being obliged to pay much heed to this symptom. On occasions one was led to enquire which psychical situation favoured the appearance of such a tic (e.g. a grimace, a twitch of the shoulders or of the head, etc.). Here and there one can also touch upon the meaning, the sense, of the symptom. One patient of mine continually shook her head vigorously as though saying "No" when carrying out a purely conventional gesture such as taking leave of or greeting anyone. I noticed the movement occurred more frequently and more violently whenever the patient desired to show more feeling, as for instance friendliness, than she really felt and I was obliged to tell her that the shaking of her head was intended to give the lie to the friendly manner or gesture.

I have never so far had a patient who came for analysis for the express purpose of curing a Tic; the minor tics I have had under observation during my analytical practice were so little trouble to the patients that they never complained of them; in each case I had to draw attention to the symptom myself. Naturally under these circumstances all motive was lacking for deeper research and, as stated above, the patients left the treatment with it unaltered.

Now we know this never occurs in the usual analysis of hysteria or obsessional neurosis. The most insignificant symptom can be proved before the end of the analysis to be part of the complicated structure of the neurosis and even to be supported by more than one determining factor. This peculiarity of Tic in itself points to the suggestion that the disturbance in question is in some way differently orientated from other features of a transference neurosis, so that the usual reciprocal action of symptoms