Page:The International Journal of Psycho-Analysis II 1921 1.djvu/21

 PSYCHO-ANALYTICAL OBSERVATIONS ON TIC 13

traumatic moment: there are also, however, not unessential dififerences between the two. In hysteria the physical symptom is only the symbol of a mental shock with the emotion suppressed and the memory of it repressed. In actual Tic the organic injury is the only trauma, which is, it appears, no less qualified to leave behind pathogenic memories than the mental conflict of hysteria. (At any rate the relative independence of tic from actual patho- logical alteration and its dependence on memories would go to show that the "lasting change" that remains behind after trauma, lies not in the periphery, in the organ itself, but in the psychical representative of the organ.) Hysteria is a transference neurosis in which the libidinous relation to the object (person) is repressed and appears as a conversion-symptom, as it were an auto-erotic, symbolisation in the body of the patient himself.¹ In Tic on the contrary, it would seem that no relation to the object is hidden behind the symptom; in this case the memory of the organic trauma itself acts pathogenically.

This differentiation obliges us to introduce a complication into the scheme put forward by Freud on the building up of the "psychical systems". The psychical systems consist of simple reflex arcs in the form of unconscious, preconscious and conscious memory-systems (M-systems) interpolated between the afferent (sensory) and the efferent (motor) apparatus. Now Freud himself already accepts a plurality of such M-systems that are orientated accor- ding to the different principles of temporal, formal, or affective asso- ciation, or association of content. What I should like to introduce here is the acceptance of a particular M-system, that one would have to call the "ego-memory-system", to which fell the task of con- tinually registering the subject's own physical or mental processes. It is self-evident that this system would have a stronger develop- ment in a constitutional narcissist than in persons of completely developed object-love, but an unexpectedly powerful trauma can have the result in Tic, as in traumatic neurosis, of an over-strong memory fixation on the attitude of the body at the moment of experiencing the trauma, and that to such a degree as to provoke a perpetual or paroxysmatic reproduction of the attitude. The increased tendency of tic patients to self-observation, to attention to their endosomatic and endopsychical sensations is also remarked

¹ Compare "Hysterische Materialisationsphcinomene", in Hysterie and Pathoneurosen, by the author.