Page:The International Journal of Psycho-Analysis II 1921 1.djvu/17

 PSYCHO- ANALYTICAL OBSERVATIONS ON TIC

broken. To make sure I repeated the movement once, twice, three times without noticing the crack. I varied it in a thousand ways and repeated it more and more violently. At last I felt my

crack again and this gave me real pleasure however the

pleasure was soon disturbed by the fear that I had caused some injury." "Even today. . . . . . I cannot withstand the desire to re- produce the crack and I cannot overcome the feeling of unrest directly I have succeeded".¹ The nature of these sensations, now pleasurable, now anxious, allows us to tabulate them con- iidently as pathological expressions of the patient's sexuality and of hypochondriacal narcissism in particular. We have here the unusual case of the patient remaining aware of the sensory motive for his stereotyped movement. As we shall see, in the majority of cases the motive becomes an unconscious reminiscence of the real sensation. — Charcot, Brissaud, Meige and Feindel are among the few neurologists who did not disdain to listen if the- patient recounted the history of the origin of his trouble. Meige and Feindel say: "only the patient can answer the question of the genesis of his illness (tic) when he harks back to the experiences, often long past, which first gave rise to his motor reactions." With this view in sight, the authors encouraged their patients (although only with the help of the conscious mind) to reproduce those experiences which were to blame for the first appearances of their convulsive actions. We see that the path to the discovery of the unconscious and to its investigation by Psycho-Analysis would have been also possible from this point. They found physical traumata to be often a final explanation: an abscess in the gum was the cause of an inveterate grimace, an operation on the nose a motive for a later wrinkling up of the nose, etc. These authors come near to Charcot's view, according to whom tic is "only a physical illness in appearance and is actually in reality psychical" . . . "the direct product of Psychosis ... a form of hereditary Psychosis".²

Meige and Feindel have. also very much to tell us regarding the character traits of tic patients that we would call "narcissistic". For example, they quote the confession of one patient: "I must admit that I am full of self-love and am particularly sensitive to

¹ Idem., Op. cit.

² Some disadvantages of this conception lie in the fact that Charcot and his followers often class the tics and obsessions under one heading.