Page:The International Journal of Psycho-Analysis II 1921 1.djvu/14

 6 S.FERENCZI

the expression of abnormal localised organic libido. Federn groups all catatonic symptoms collectively as "organic intoxication".¹ All this fits in with the hypothesis of a common constitutional basis of Tic and Catatonia and explains the broad similarity of their symptoms. At any rate one is tempted to draw an the principal symptoms of Catatonia — negativism and rigidity — with the immediate defence against all external stimuli by means of convulsive movement in Tic, and to presume that when in the "maladie de Gilles de la Tourette" tics are converted into Catatonia it is merely a question of perpetuating and generalising a partial defence-innervation appearing in Tic only paroxysmally. Tonic rigidity would prove to be a summation of numberless clonic defensive convulsions, in which case Catatonia would be merely the climax of Cataclonia (Tic).

I must not leave the subject without reference in this to the well-known fact that tics very often appear as the result of physical illness or traumata in loco morbi i. e. twitching of the lids after a cure for Blepharitis or Conjunctivitis, tic of the nose after Catarrh, particular movements of the extremities after painful inflammation. I must bring this circumstance into connection with the theory that a pathoneurotic increase of libido tends to attach itself to the seat of a pathological somatic alteration (or to its psychic equivalent).* The Hyperaesthesia of Tic patients which is frequently only local, could in these cases be traced back to "traumatic" displacement of libido and, as stated above, the motor expression of Tic arises from defence reactions against tlic stimula- tion of such parts of the body. As a further support of the assumption that Tic has something to do with Narcissism I quote the therapeutic successes attained by a certain method of treating Tic. This treatment consists of systematic innervation exercises with enforced quiescence of the twitching part ; the success is still more marked if the patient controls himself by looking in a mirror meanwhile. The authors explain that the control by the sense of sight facilitates the graduation of the inhibition innervation necessary to the treatment ; it appeared to me, however, that beyond this (or perhaps the greater factor) the distortion of face and body observed in

¹ Quoted from Nunberg's paper, "Ober den katatonischcn Anfall", ''Int. Zeitschrift f. Psychoanalyse'', 1920, Bd. V. ³Hysteric und Pathoneuroscn, S. 7.